Teladoc Health Inc (TDOC) 2022 Q3 法說會逐字稿

Hello and welcome to the Teladoc Health Third Quarter 2022 Earnings Conference Call. My name is Alex, and I'll be coordinating the call today. (Operator Instructions)

您好，歡迎參加 Teladoc Health 2022 年第三季度收益電話會議。我的名字是亞歷克斯，我將在今天協調電話會議。 （操作員說明）

I'll hand over to your host, Patrick Feeley, Head of Investor Relations. Patrick, please go ahead.

我將移交給您的主持人，投資者關係主管 Patrick Feeley。帕特里克，請繼續。

Thank you and good afternoon. Today, after the market closed, we issued a press release announcing our third quarter 2022 financial results. This press release and the accompanying slide presentation are available on the Investor Relations section of the teladochealth.com website. On this call to discuss the results are Jason Gorevic, Chief Executive Officer; and Mala Murthy, Chief Financial Officer. During this call, we will also provide our fourth quarter and full year 2022 outlook, and our prepared remarks will be followed by a question-and-answer session.

謝謝你，下午好。今天，在市場收盤後，我們發布了一份新聞稿，宣布了我們 2022 年第三季度的財務業績。本新聞稿和隨附的幻燈片可在 teladochealth.com 網站的投資者關係部分獲取。在這次電話會議上討論結果的是首席執行官 Jason Gorevic；和首席財務官 Mala Murthy。在這次電話會議中，我們還將提供我們的第四季度和 2022 年全年展望，我們準備好的講話之後將進行問答環節。

Please note that we'll be discussing certain non-GAAP financial measures that we believe are important in evaluating Teladoc Health's performance. Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release that is posted on our website.

請注意，我們將討論我們認為對評估 Teladoc Health 的業績很重要的某些非 GAAP 財務指標。有關這些非公認會計原則措施與最具可比性的公認會計原則措施之間的關係及其對賬的詳細信息，請參閱我們網站上發布的新聞稿。

Also, please note that certain statements made during this call will be forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. Such forward-looking statements are subject to risks, uncertainties and other factors that could cause the actual results for Teladoc Health to differ materially from those expressed or implied on this call. For additional information, please refer to our cautionary statement in our press release and our filings with the SEC, all of which are available on our website.

此外，請注意，本次電話會議期間做出的某些陳述將是 1995 年《私人證券訴訟改革法案》所定義的前瞻性陳述。此類前瞻性陳述受風險、不確定性和其他可能導致實際結果的因素影響Teladoc Health 與本次電話會議中明示或暗示的內容存在重大差異。有關更多信息，請參閱我們在新聞稿中的警告聲明以及我們向 SEC 提交的文件，所有這些都可以在我們的網站上找到。

I would now like to turn the call over to Jason.

我現在想把電話轉給傑森。

Thank you, Patrick. Good afternoon and thanks for joining us. After the close today, Teladoc Health reported strong third quarter results driven by solid execution across the business. Revenue grew 17% over the prior year to $611 million, above the midpoint of our guidance range. And adjusted EBITDA of $51 million exceeded the high end of our expectations.

謝謝你，帕特里克。下午好，感謝您加入我們。今天收盤後，Teladoc Health 報告了強勁的第三季度業績，這得益於整個業務的穩健執行。收入比上一年增長 17% 至 6.11 億美元，高於我們指導範圍的中點。調整後的 EBITDA 為 5100 萬美元，超出了我們預期的高端。

While the broader operating environment remains challenging across the economy, during the quarter, we made meaningful progress against our strategy, including 4 areas I want to briefly highlight: first, driving better outcomes and lower costs for our chronic care populations; second, continued momentum in our Primary360 product with clients and members; third, closing meaningful new deals; and fourth, delivering strong performance at BetterHelp.

儘管整個經濟體更廣泛的運營環境仍然充滿挑戰，但在本季度，我們的戰略取得了有意義的進展，包括我想簡要強調的 4 個領域：首先，為我們的慢性病護理人群帶來更好的結果和更低的成本；第二，我們的 Primary360 產品與客戶和會員的持續發展勢頭；第三，完成有意義的新交易；第四，在 BetterHelp 表現出色。

Starting with chronic care. We're encouraged to see a growing trend of clients looking for partners who can deliver proven cost savings and outcomes. Earlier this month, we held our client advisory panel with leaders from 30 health plans, large employers and health systems in attendance. It was universally clear that value-based care is high on the priority list for these organizations with strong interest in programs that manage chronic conditions and drive engagement with populations via virtual primary care relationships.

從慢性護理開始。我們很高興看到越來越多的客戶正在尋找能夠提供經證實的成本節約和成果的合作夥伴。本月早些時候，我們召開了客戶諮詢小組，來自 30 個健康計劃、大型雇主和衛生系統的領導人出席了會議。普遍清楚的是，對於這些對管理慢性病和通過虛擬初級保健關係推動與人群互動的項目有濃厚興趣的組織而言，基於價值的護理在優先事項列表中排名靠前。

Value-based arrangements are becoming even more important in the current macroeconomic environment. And as I look at the chronic care pipeline, we're seeing a notable increase in deals with such features. We view this trend as very favorable for us since our proven outcomes present a tremendous value proposition for our clients, and we're well positioned in the market to capitalize on that dynamic.

在當前的宏觀經濟環境中，基於價值的安排變得更加重要。當我查看慢性護理管道時，我們看到此類功能的交易顯著增加。我們認為這一趨勢對我們非常有利，因為我們經過驗證的結果為我們的客戶提供了巨大的價值主張，我們在市場上處於有利地位，可以利用這種動態。

An example of our ability to drive outcomes and savings is evidenced by the results of one of our recent pilots. In early 2021, we launched a chronic care shared savings pilot with fully insured members at a large Blue Cross Blue Shield plan. Our team just concluded a study with this partner's actuarial team, who determined that we have exceeded our medical cost savings target by 60%. Not only do we drive better outcomes for our members and drive more savings for our client, but we were able to realize a small shared savings bonus.

我們最近一項試點的結果證明了我們推動成果和節約的能力的一個例子。 2021 年初，我們在一項大型 Blue Cross Blue Shield 計劃中啟動了一項慢性護理共享儲蓄試點，其中有完全投保的成員。我們的團隊剛剛與該合作夥伴的精算團隊完成了一項研究，他們確定我們已經超出了我們的醫療成本節約目標 60%。我們不僅為我們的會員帶來了更好的結果並為我們的客戶節省了更多的錢，而且我們還能夠實現少量的共享儲蓄紅利。

We believe the outcome of this pilot and others like it validate our ability to move further toward value-based contracting over time. Ultimately, we believe the ability to leverage broad integrated virtual and digital care models to drive measurable savings uniquely positions us to capitalize on market demand for these arrangements.

我們相信這個試點和其他類似項目的結果驗證了我們隨著時間的推移進一步朝著基於價值的合同方向發展的能力。最終，我們相信，利用廣泛的集成虛擬和數字護理模型來推動可衡量的節省的能力使我們能夠獨特地利用這些安排的市場需求。

Turning to Primary360. At the start of the year, we told you we would provide additional insight later in the year. And so today, we'll provide you with a first look at some of the encouraging results we've seen thus far.

轉向Primary360。今年年初，我們告訴過您，我們將在今年晚些時候提供更多見解。因此，今天，我們將讓您初步了解迄今為止我們所看到的一些令人鼓舞的結果。

Primary360 members are reporting high satisfaction with NPS scores currently in the 70s, a strong vote of confidence. Members who have engaged with Primary360 this year are connecting with care teams at a rate greater than once every 3 months, a result of the significant value we are delivering.

Primary360 的成員對目前 70 年代的 NPS 分數表示高度滿意，這是一次強烈的信任投票。今年參與 Primary360 的會員每 3 個月與護理團隊聯繫一次以上，這是我們提供的重要價值的結果。

We're also finding that members with chronic conditions are significantly more likely to engage with Primary360. This year, we're seeing those members as 4 times as likely to meet with their Primary360 care team. Meanwhile, 1 in every 3 of our Primary360 members is using 2 or more of our services, demonstrating Primary360's role not just as virtual primary care, but also as a front door to multi-specialty care. So while we're at the beginning stages of bringing integrated virtual primary care to the market, the strong member and client response to the service gives us a lot of confidence in the long-term opportunity.

我們還發現患有慢性病的會員更有可能參與 Primary360。今年，我們看到這些成員與他們的 Primary360 護理團隊會面的可能性增加了 4 倍。與此同時，每 3 名 Primary360 成員中就有 1 名使用我們的 2 項或更多服務，這表明 Primary360 的作用不僅是虛擬初級保健，而且是多專科保健的前門。因此，雖然我們正處於將綜合虛擬初級保健推向市場的初期階段，但會員和客戶對該服務的強烈反應讓我們對長期機會充滿信心。

As I turn to commercial momentum, we've discussed throughout the first half of the year our pipeline has developed more slowly than we expected coming into the year. Year-to-date bookings, which represents the estimated incremental annual revenue contribution from deals signed during the year, is roughly equivalent to the same period in the prior year. We are, however, encouraged by a number of new significant deals that we expect to contribute to our growth for the next few years.

當我轉向商業動力時，我們在整個上半年都在討論，我們的管道發展速度比我們預期的要慢。年初至今的預訂，代表年內簽署的交易的估計增量年度收入貢獻，大致相當於上一年同期。然而，我們對一些新的重大交易感到鼓舞，我們預計這些交易將為我們未來幾年的增長做出貢獻。

First, you may have seen HCSC's press release last month announcing our partnership to make Primary360 along with our general medical, mental health and nutrition services available to self-insured employer groups. This follows on the heels of our agreement last year to bring our full suite of chronic care products to HCSC employer clients. The launch of this partnership is validation of our integrated whole-person care strategy and another example of our ability to land and expand across products.

首先，您可能已經看到 HCSC 上個月發布的新聞稿，宣布我們合作將 Primary360 以及我們的一般醫療、心理健康和營養服務提供給自我保險的雇主團體。這是繼我們去年達成協議之後將我們全套慢性護理產品帶給 HCSC 雇主客戶的協議。這一合作夥伴關係的啟動是對我們綜合全人護理戰略的驗證，也是我們跨產品落地和擴展能力的又一例證。

And that deal represents just one example of the momentum we're seeing with large health plans looking to partner with us to offer our products and services to bear employer clients. In addition to Primary360, we're also seeing this momentum in chronic care with multiple large health plans looking to partner. We expect these agreements will contribute to our pipeline over a multiyear period.

這筆交易只是我們看到的勢頭的一個例子，大型健康計劃希望與我們合作，為雇主客戶提供我們的產品和服務。除了 Primary360，我們還看到了慢性護理領域的這種勢頭，多個大型健康計劃都在尋求合作。我們預計這些協議將在多年期間為我們的管道做出貢獻。

Finally, while we typically close many new employer deals in any given quarter, I wanted to highlight one in particular as I think it underscores the value proposition of our broad integrated service offering. We're replacing 3 different competitors all at once across chronic care, telemedicine and our myStrength mental health solutions at one of the largest providers of care to correctional facilities and other government-run institutions. We believe the market is shifting away from disparate point solutions and toward integrated offerings, a trend that we believe strongly favors Teladoc Health.

最後，雖然我們通常會在任何特定季度完成許多新的雇主交易，但我想特別強調一個，因為我認為它強調了我們廣泛的綜合服務產品的價值主張。我們正在為懲教設施和其他政府機構提供最大的護理服務提供商之一，同時在慢性護理、遠程醫療和我們的 myStrength 心理健康解決方案方面取代 3 個不同的競爭對手。我們認為市場正在從分散的單點解決方案轉向集成產品，我們認為這一趨勢非常有利於 Teladoc Health。

Turning to BetterHelp. The team continued to drive impressive top line growth, particularly in this time of increased macroeconomic uncertainty while addressing the tremendous unmet need for global medical services. While yield on advertising spend remains below where we expected it to be at the beginning of the year, we've seen it stabilize as anticipated. BetterHelp remains on track to deliver strong revenue and margin contribution. We expect to continue building upon BetterHelp's significant leadership position in the direct-to-consumer mental health market while driving both growth and margin.

轉向 BetterHelp。該團隊繼續推動令人印象深刻的收入增長，特別是在宏觀經濟不確定性增加的時期，同時解決全球醫療服務的巨大未滿足需求。雖然廣告支出的收益仍低於我們在年初的預期，但我們已經看到它如預期的那樣穩定。 BetterHelp 仍有望實現強勁的收入和利潤貢獻。我們希望繼續鞏固 BetterHelp 在直接面向消費者的心理健康市場的重要領導地位，同時推動增長和利潤率。

With that, I'll turn the call over to Mala for a review of the third quarter and our forward guidance.

有了這個，我將把電話轉給馬拉，以審查第三季度和我們的前瞻性指導。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

During the third quarter, total revenue increased 17% year-over-year to $611 million. The biggest driver of that growth was BetterHelp, our direct-to-consumer mental health brand, which grew over 35% as compared to the prior year's quarter or approximately 7% sequentially over the second quarter and in line with our expectations.

第三季度，總收入同比增長 17% 至 6.11 億美元。這一增長的最大驅動力是我們直接面向消費者的心理健康品牌 BetterHelp，與去年同期相比增長了 35% 以上，或比第二季度環比增長了約 7%，符合我們的預期。

We continue to expect the typical seasonal slowdown in advertising spending during the holiday season in the direct-to-consumer market, and therefore, expect to see material acceleration in consolidated adjusted EBITDA margin in the fourth quarter.

我們繼續預計假日季節直接面向消費者市場的廣告支出將出現典型的季節性放緩，因此預計第四季度合併調整後 EBITDA 利潤率將大幅加速。

Turning to chronic care. The total number of our members enrolled in one or more of our chronic care programs was 791,000 at the end of the third quarter, an increase of 66,000 or 9% over the prior year's quarter and a sequential decline of 7,000 enrollees as compared to the second quarter. The decline in enrollment was driven by the loss of 1 government sector client, which due to changes in leadership, has chosen to cease offering primary care management programs to its populations.

轉向慢性護理。截至第三季度末，我們的一個或多個慢性護理計劃的會員總數為 791,000 人，比去年同期增加 66,000 人或 9%，與第二季度相比，連續減少 7,000 人。四分之一。入學率下降的原因是失去了 1 個政府部門客戶，由於領導層的變化，該客戶選擇停止向其人口提供初級保健管理計劃。

If not for the loss of this client, chronic care member enrollment would have increased by 15,000 lives over the second quarter. I would also add that while the client's decision resulted in a higher-than-expected attrition rate in the third quarter, even including this loss, our full year member churn is still trending in line to slightly better than the past 2 years, a testament to our efforts to drive better member engagement.

如果不是因為失去了這位客戶，慢性護理成員的註冊人數將在第二季度增加 15,000 人。我還要補充一點，儘管客戶的決定導致第三季度的離職率高於預期，即使包括這一損失，我們全年的會員流失率仍趨於比過去 2 年略好，證明了這一點我們努力推動更好的會員參與。

We ended the quarter with total U.S. paid membership of 57.8 million members, an increase of 1.2 million members over the second quarter, driven by a combination of new virtual care client onboardings and population expansions within existing clients. Individuals with visit fee only access was 24.3 million at the end of the third quarter.

在本季度末，我們的美國付費會員總數為 5780 萬，比第二季度增加了 120 萬，這得益於新的虛擬護理客戶入職和現有客戶的人口擴張。截至第三季度末，僅訪問費的個人為 2430 萬。

Average U.S. revenue per member per month was $2.61 in the third quarter, up 9% from $2.40 in the prior year's quarter. As compared to the second quarter, PMPM growth was driven by growth in BetterHelp revenue although largely offset by membership mix as we added 1.2 million net new telemedicine members in the quarter.

第三季度美國每位會員每月平均收入為 2.61 美元，比去年同期的 2.40 美元增長 9%。與第二季度相比，PMPM 的增長是由 BetterHelp 收入的增長推動的，但在很大程度上被會員組合所抵消，因為我們在本季度增加了 120 萬淨新遠程醫療會員。

Adjusted EBITDA was $51.2 million in the third quarter compared to $67.4 million in the prior year's quarter and above the high end of our guidance range. The third quarter adjusted EBITDA outperformance relative to our expectations was driven primarily by stronger cost control as we look to drive efficiency. Both technology and development expense and gross margin contributed to the upside.

第三季度調整後的 EBITDA 為 5120 萬美元，而去年同期為 6740 萬美元，高於我們指導範圍的高端。相對於我們的預期，第三季度調整後的 EBITDA 表現優於我們的預期，主要是由於我們希望提高效率時更強的成本控制。技術和開發費用以及毛利率都促成了上漲。

Net loss per share in the third quarter was $0.45 compared to a net loss per share of $0.53 in the third quarter of 2021. Net loss per share includes stock-based compensation expense of $0.34 per share, amortization of acquired intangibles of $0.30 per share, and $0.02 per share of lease abandonment costs associated with office space rationalization. During the third quarter, we generated free cash flow of $20 million and ended the quarter with $900 million in cash and short-term investments on the balance sheet.

第三季度的每股淨虧損為 0.45 美元，而 2021 年第三季度的每股淨虧損為 0.53 美元。每股淨虧損包括每股 0.34 美元的股票補償費用、每股 0.30 美元的收購無形資產攤銷、與辦公空間合理化相關的租賃放棄成本每股 0.02 美元。在第三季度，我們產生了 2000 萬美元的自由現金流，並在本季度結束時在資產負債表上擁有 9 億美元的現金和短期投資。

Now turning to forward guidance. Last quarter, we noted that full year results were likely to be near the low end of our prior guidance range. Our updated guidance today is consistent with that expectation. For the full year 2022, we expect revenue to be in the range of $2.395 billion to $2.41 billion. We expect adjusted EBITDA for the full year to be in the range of $240 million to $250 million. We expect total U.S. paid membership of 57 million to 58 million members, an increase of 1.5 million members over our prior guidance.

現在轉向前向指導。上個季度，我們注意到全年業績可能接近我們先前指導範圍的低端。我們今天更新的指南與這一預期一致。對於 2022 年全年，我們預計收入將在 23.95 億美元至 24.1 億美元之間。我們預計全年調整後的 EBITDA 將在 2.4 億美元至 2.5 億美元之間。我們預計美國付費會員總數將達到 5700 萬至 5800 萬，比我們之前的預期增加 150 萬。

We expect total visits for the year to be between 18.4 million and 18.6 million visits, representing growth of 19% to 21% over the prior year. For the fourth quarter of 2022, we expect revenue of $625 million to $640 million, representing growth of 13% to 15% year-over-year. We expect fourth quarter adjusted EBITDA to be in the range of $88 million to $98 million. Total fourth quarter visits are expected to be between 4.7 million and 4.9 million visits.

我們預計今年的總訪問量將在 1840 萬至 1860 萬之間，比上年增長 19% 至 21%。對於 2022 年第四季度，我們預計收入為 6.25 億美元至 6.4 億美元，同比增長 13% 至 15%。我們預計第四季度調整後的 EBITDA 將在 8800 萬美元至 9800 萬美元之間。第四季度的總訪問量預計在 470 萬至 490 萬之間。

With that, I will turn the call back to Jason for closing remarks.

有了這個，我將把電話轉回傑森的閉幕詞。

Thanks, Mala. This week, we are pleased to welcome Laizer Kornwasser to the team as our new President of Enterprise Growth and Global Markets. Some of you may know Laizer from his role as Chief Operating Officer of CareCentrix, where he was responsible for driving operational excellence and business strategy, growing EBITDA through product and client diversification and leading the integration of the company's diabetes franchise to build a new suite of services.

謝謝，馬拉。本週，我們很高興地歡迎 Laizer Kornwasser 加入我們的團隊，擔任我們的新任企業增長和全球市場總裁。你們中的一些人可能從擔任 CareCentrix 首席運營官的角色中認識 Laizer，他負責推動卓越運營和業務戰略，通過產品和客戶多樣化來增加 EBITDA，並領導整合公司的糖尿病特許經營以建立一套新的服務。

At Teladoc Health, Laizer will help optimize company performance across all client channels and product lines to further unlock the revenue and profit growth potential of our whole-person care strategy. I look forward to working closely with him and know he will make an immediate impact on our commitment to empowering all people everywhere to live their healthiest lives.

在 Teladoc Health，Laizer 將幫助優化公司所有客戶渠道和產品線的績效，以進一步釋放我們全人護理戰略的收入和利潤增長潛力。我期待與他密切合作，並知道他將立即影響我們致力於讓世界各地的所有人過上最健康的生活的承諾。

With that, we'll open the call for questions. Operator?

有了這個，我們將打開問題的電話。操作員？

(Operator Instructions) Our first question for today comes from Lisa Gill of JPMorgan.

（操作員說明）我們今天的第一個問題來自摩根大通的 Lisa Gill。

Jason, it's the third quarter, so you know I'm going to ask about the selling season. You talked a little bit about signing some incremental deals. You talked about where the pipeline is. But can you give us an idea of how to think about how the selling season is going to play into 2023? And as we think about some of the newer deals, are any of them with some of the new payment models you talked about? And are there anything from an implementation cost perspective or anything else to think about as we think about headwinds and tailwinds going into '23.

傑森，現在是第三季度，所以你知道我要問關於銷售季節的問題。你談了一些關於簽署一些增量交易的事情。你談到了管道在哪裡。但是你能告訴我們如何考慮銷售季節將如何發揮到 2023 年嗎？當我們考慮一些較新的交易時，它們中是否有你談到的一些新的支付模式？當我們考慮進入 23 年的逆風和順風時，是否有任何從實施成本的角度或其他任何事情需要考慮。

Yes. Thanks, Lisa. I'd be disappointed if you didn't ask that now. So appreciate the question. Let me start with sort of an overview of how to think about our revenue outlook going forward, and then I'll dig a little deeper into the bookings and what the pipeline looks like.

是的。謝謝，麗莎。如果你現在不問，我會很失望。所以感謝這個問題。讓我從如何看待我們未來收入前景的概述開始，然後我將更深入地研究預訂和管道的樣子。

So if I think about the overall outlook, obviously, we won't give specific guidance until February, but I'll try to give you some of the dynamics going on. So if I think about the swing factors for next year, first, BetterHelp. As I think about the direct-to-consumer business, it's reasonable to expect BetterHelp to be more closely tied to the financial health of the consumer, and therefore, a little bit more sensitive to the macroeconomic outlook. We see a little bit of impact to BetterHelp growth from that macroeconomic dynamic this year, as we discussed in the July call. That, of course, can cut both ways though.

因此，如果我考慮整體前景，很明顯，我們要到 2 月才會給出具體指導，但我會盡量給你一些正在發生的動態。因此，如果我考慮明年的波動因素，首先是 BetterHelp。當我考慮直接面向消費者的業務時，可以合理地預期 BetterHelp 與消費者的財務健康狀況更密切相關，因此對宏觀經濟前景更加敏感。正如我們在 7 月份的電話會議中所討論的，我們看到今年宏觀經濟動態對 BetterHelp 增長產生了一些影響。當然，這可以雙向切割。

So if we see economic recovery next year and inflation coming down and the consumer feeling more confident, that could be helpful for us. If the consumer sees significantly more inflation and pressure, that could pressure the consumer since BetterHelp is one of the more expensive things that the consumer buys online that doesn't come in a box.

因此，如果我們看到明年經濟復甦和通脹下降並且消費者感到更有信心，那可能對我們有所幫助。如果消費者看到明顯更多的通貨膨脹和壓力，這可能會給消費者帶來壓力，因為 BetterHelp 是消費者在網上購買的更昂貴的東西之一，它不是裝在盒子裡的。

I think you should also just expect us to continue to take a more balanced approach to growth and margin in BetterHelp. That business has grown and scaled incredibly fast. It's at a run rate of $1 billion. And I think it's fair to expect us to focus on driving both growth and efficiency. And you started to see some of the benefits of that in the second half of this year, and some of our gross margin improvement comes from specifically BetterHelp.

我認為您還應該期望我們繼續對 BetterHelp 的增長和利潤採取更平衡的方法。該業務以驚人的速度增長和擴展。它的運行速度為 10 億美元。我認為期望我們專注於推動增長和效率是公平的。你在今年下半年開始看到它的一些好處，我們的一些毛利率改善來自於 BetterHelp。

The second thing I'd look at is what you asked about specifically, the pipeline development. I would call the third quarter kind of a catch-up quarter when it comes to bookings. So you heard us talk about the first couple of quarters as the pipeline developing more slowly than it had in prior years or slower than our expectations.

我要看的第二件事是您具體詢問的內容，即管道開發。在預訂方面，我將第三季度稱為追趕季度。因此，您聽到我們談論前幾個季度，因為管道的發展速度比前幾年慢或慢於我們的預期。

The third quarter saw a turnaround of that, and it was not only our biggest quarter of the year in terms of bookings, but it was significantly larger than our third quarter bookings last year. So it puts us at a place now where year-to-date through the third quarter, we're almost identical to the total sort of gross bookings that we saw through the third quarter last year.

第三季度出現了轉機，這不僅是我們今年預訂量最大的季度，而且比我們去年第三季度的預訂量要大得多。因此，它使我們現在處於一個從年初至今到第三季度的地方，我們幾乎與去年第三季度的總預訂量相同。

So just a reminder about how to think about that on the B2B side of our business. The B2B side of our business, if you look at revenue next year, it's essentially baseline revenue this year plus bookings minus churn. Our churn is in line to even slightly better than it was over the previous several years and in line with last year. So we don't see any significant changes there.

所以只是提醒一下如何在我們業務的 B2B 方面考慮這一點。我們業務的 B2B 方面，如果你看明年的收入，它基本上是今年的基線收入加上預訂量減去流失率。我們的流失率甚至比前幾年和去年的水平略好。因此，我們看不到那裡有任何重大變化。

And we still have 2 months left in the selling season. The fourth quarter is always really important for us. As I look at our pipeline, our pipeline is similar to what it was at this time last year. There are some good characteristics to the deals that we've closed. Our deals that we've closed are significantly larger than they have been in prior years. So our average deal size is 2x what it was -- in the third quarter, it was 2x what it was in the first 2 quarters and 50% larger than a year ago period.

我們還有 2 個月的銷售旺季。第四季度對我們來說總是非常重要。當我查看我們的管道時，我們的管道與去年這個時候的相似。我們完成的交易有一些很好的特點。我們完成的交易比往年要大得多。因此，我們的平均交易規模是原來的 2 倍——在第三季度，是前兩個季度的 2 倍，比一年前增加了 50%。

We're continuing to see good cross-sells. That contributes, obviously, to the significantly larger deal size. And over 3/4 of our deals are multiple -- multiproduct sales. So I think that hopefully gives you some color.

我們繼續看到良好的交叉銷售。顯然，這有助於顯著擴大交易規模。我們超過 3/4 的交易是多產品銷售。所以我認為這希望能給你一些顏色。

You asked a little bit about value-based deals. We do have some deals that we've signed this year that are more value-based deals and give us upside to share in the savings that we generate. And I'm excited by the results of the pilot that we talked about in our prepared remarks at that large Blue plan. And I think that portends well for us leaning further into more value-based arrangements.

你問了一些關於基於價值的交易。我們今年確實簽署了一些更基於價值的交易，讓我們有機會分享我們產生的節省。我對我們在準備好的藍色計劃的評論中談到的試點結果感到興奮。我認為這預示著我們將進一步傾向於更多基於價值的安排。

Our next question comes from Richard Close of Canaccord.

我們的下一個問題來自 Canaccord 的 Richard Close。

I had 2, if I could flip those in. But Jason, you talked a little bit about balancing the growth in margins on BetterHelp. Just curious if you could go in maybe a little bit more detail on that.

我有 2 個，如果我能把它們翻過來的話。但是傑森，你談到了平衡 BetterHelp 上的利潤率增長。只是好奇您是否可以對此進行詳細說明。

And then can you talk about market share? Obviously, with the tough economy, I suspect some of your competitors and the noise you talked about earlier in the year maybe have pulled back some. So just talk about the competitive environment in that as well.

然後你能談談市場份額嗎？顯然，在經濟不景氣的情況下，我懷疑你的一些競爭對手以及你在今年早些時候談到的噪音可能已經退縮了一些。因此，也請談談其中的競爭環境。

Yes. I think, Richard, there's not a whole lot more to say with BetterHelp about focusing on the combination of growth and margin. We always try to optimize that business.

是的。我認為，Richard，BetterHelp 沒有更多關於關注增長和利潤的組合的內容。我們總是試圖優化該業務。

I will say, for example -- I'll point out a couple of things that have yielded improvements in the margin, especially the gross margin on that business. We're leaning more into digital interactions with consumers as well as group -- virtual group therapy sessions, which is a more efficient way of interacting with the consumer, improves the gross margins. It actually has the -- sort of the other effect of actually depressing our visit volume. So that's -- we actually see fewer visits. Fewer visits in the BetterHelp business is actually good because it improves our gross margin and enables us to serve more people with fewer professional resources. So that's an example of some things that are good for lifetime value of a consumer, good for member retention and also good for margin.

例如，我會說 - 我會指出一些提高利潤率的因素，尤其是該業務的毛利率。我們更傾向於與消費者和團體進行數字互動——虛擬團體治療課程是一種更有效的與消費者互動的方式，可以提高毛利率。它實際上具有實際上降低我們訪問量的其他效果。這就是——我們實際上看到的訪問量減少了。 BetterHelp 業務的訪問次數減少實際上是件好事，因為它提高了我們的毛利率，並使我們能夠用更少的專業資源為更多的人服務。因此，這是一些有利於消費者終身價值、有利於會員保留以及有利於利潤的事情的一個例子。

When I think about margin or market share, Richard, I'll just give a couple of comments relative to what we're seeing in the overall landscape. I've spent a fair amount of time recently with a number of our clients, both some of our largest clients as well as, as I mentioned, at our client advisory group and then also with other CEOs in the health care industry. And we're definitely seeing an impact from a tightening economic environment and a higher cost of capital impacting some of the smaller companies.

理查德，當我考慮利潤率或市場份額時，我將就我們在整體環境中看到的情況發表一些評論。最近，我與我們的一些客戶一起度過了相當長的時間，包括我們的一些最大客戶以及正如我所提到的，在我們的客戶諮詢小組中，然後還有醫療保健行業的其他首席執行官。我們肯定會看到經濟環境趨緊和資本成本上升對一些小公司的影響。

In fact, I was with a very large client yesterday, and the challenge of them, quite frankly, questioning whether some of those smaller companies are going to be able to survive is definitely top of mind for them. So I'm not sure that I would say that we've seen a massive shakeout yet, but I'm hearing quite a bit among both clients as well as other health care companies that is very much attuned to that.

事實上，我昨天和一個非常大的客戶在一起，坦率地說，他們面臨的挑戰是質疑其中一些小公司是否能夠生存下來，這絕對是他們的首要任務。因此，我不確定我是否會說我們已經看到了大規模的重組，但我在客戶和其他非常適應這一點的醫療保健公司中聽到了很多。

Our next question comes from Jailendra Singh from Truist Securities.

我們的下一個問題來自 Truist Securities 的 Jailendra Singh。

Jason, I was wondering if you could spend a little bit more time on the BCBS pilot program you called out just in general. Trying to understand the role Teladoc is expected to play in the shift to value-based care. Clearly, the outcomes are pretty encouraging, but I'd like to understand if Teladoc's role is going to evolve in the shift. Should we think about the company more as a BBC enabler? Or should we think about them as like company taking more risk at some point in future? And if you can quantify how much of the benefit in the quarter from these shared savings.

傑森，我想知道你是否可以多花一點時間在你通常所說的 BCBS 試點項目上。試圖了解 Teladoc 在向基於價值的護理轉變中所扮演的角色。顯然，結果非常令人鼓舞，但我想了解 Teladoc 的角色是否會在轉變中發生變化。我們是否應該將公司更多地視為 BBC 的推動者？還是我們應該將它們視為未來某個時候承擔更多風險的公司？如果您可以量化這些共享儲蓄在本季度的收益有多少。

Yes. So Jailendra, welcome back. It's nice to hear from you. I'll talk about that specific shared savings pilot and maybe a little bit of the downstream impact that we are seeing from that. I'll probably defer on -- it's a small shared savings bonus, so I'm not going to quantify what that is. It's immaterial to the quarter.

是的。 Jailendra，歡迎回來。很高興收到您的來信。我將討論具體的共享儲蓄試點，以及我們從中看到的一些下游影響。我可能會推遲 - 這是一個小的共享儲蓄獎金，所以我不打算量化它是什麼。這對本季度無關緊要。

But what I will say is we signed up for a program specifically focused on chronic conditions. In this case, it was diabetes management. And we had a base PMPM and the opportunity to share in the savings that we generated. We significantly outpaced the savings that was expected. As I said in my prepared remarks, we beat it by 60% relative to the target.

但我要說的是，我們報名參加了一個專門針對慢性病的項目。在這種情況下，它是糖尿病管理。我們有一個基本的 PMPM 並有機會分享我們產生的節省。我們大大超過了預期的節省。正如我在準備好的評論中所說，我們相對於目標超過了 60%。

The way that, that deal was structured, we had a risk corridor where we had shared savings, where we share in the savings with the health plan in that risk corridor. And that worked out great for us. I think one of the downstream impacts that maybe isn't quite as obvious is that, that client as a result of our significant success has accelerated the expansion both in terms of the population that we serve and also the number of products and services that we bring to their populations.

該交易的結構方式是，我們有一個風險走廊，我們共享儲蓄，我們與該風險走廊中的健康計劃分享儲蓄。這對我們來說效果很好。我認為可能不太明顯的下游影響之一是，由於我們的重大成功，該客戶加速了我們所服務的人口以及我們所服務的產品和服務數量的擴張帶給他們的人口。

So we got the benefit of a little economic boost from the shared savings bonus that inured to us. The bigger impact, quite frankly, is acceleration of the expansion of both our products and the population that we serve within that client. It also sets us up for great learning as we lean into more of those value-based arrangements. We're very happy to put our fees on the line to guarantee both clinical and economic impact, and we can do that because of the underlying data science and our significant track record and scale of making that impact.

因此，我們從習慣於我們的共享儲蓄紅利中獲得了一點經濟增長的好處。坦率地說，更大的影響是加速我們的產品和我們在該客戶中服務的人口的擴張。當我們傾向於更多基於價值的安排時，它也為我們的學習做好了準備。我們很高興將我們的費用放在線上，以保證臨床和經濟影響，我們可以做到這一點，因為基礎數據科學和我們顯著的記錄和產生這種影響的規模。

And I would add that it sort of generates the return on the investments that we have been saying we are making in all of our data infrastructure over the past 18 months to 2 years. So this is an example of the return on investments such as that.

我還要補充一點，在過去 18 個月到 2 年的時間裡，我們一直在說我們在所有數據基礎設施中所做的投資產生了某種回報。所以這是一個這樣的投資回報的例子。

Our next question comes from Ryan Daniels of William Blair.

我們的下一個問題來自 William Blair 的 Ryan Daniels。

Jason, I wanted to go back to Primary360. It's interesting that you're seeing higher utilization, high NPS. So I'm curious if there's an opportunity to move into value-based contracting with that as well so that you might be able to garner shared savings as the better utilization with your. clinicians drives better outcomes over time.

Jason，我想回到 Primary360。有趣的是，您會看到更高的利用率和更高的 NPS。因此，我很好奇是否有機會進入基於價值的合同，以便您能夠獲得共享儲蓄作為更好的利用。隨著時間的推移，臨床醫生會帶來更好的結果。

Yes. Ryan, I appreciate that. I'll go through just a couple of other stats that I didn't include in my prepared remarks. We're very, very pleased with the progress in Primary360. As I sat down with some of our largest employer clients, some of the things that they were most moved by was not just the things that I talked about, the data points that I talked about relative to treating members with chronic illnesses, but especially the fact that what we're seeing is 60% of our Primary360 members who engage with a virtual primary care relationship haven't seen a physician in the last -- in at least 2 years.

是的。瑞安，我很感激。我將僅介紹一些其他統計數據，這些統計數據未包含在我準備好的評論中。我們對 Primary360 的進展非常非常滿意。當我與我們的一些最大的雇主客戶坐下來時，他們最感動的一些事情不僅僅是我談到的事情，我談到的與治療慢性病成員相關的數據點，尤其是事實上，我們所看到的是，在參與虛擬初級保健關係的 Primary360 成員中，有 60% 的人在過去至少 2 年內沒有看過醫生。

And almost 30% of them say that they wouldn't have seen a provider if they didn't have access to Primary360. And so those are some of the things that when I talk to the largest employers who are interested in the long-term health of their employees, are really focused on. Because we know if we can't engage consumers and their distant franchise from the health care system, they're never going to do early identification of chronic conditions or take the necessary steps relative to appropriate screenings.

幾乎 30% 的人表示，如果他們無法訪問 Primary360，他們就不會看到提供者。因此，當我與那些對員工的長期健康感興趣的最大雇主交談時，這些都是真正關注的事情。因為我們知道，如果我們不能讓消費者及其遠離醫療保健系統的專營權參與進來，他們就永遠不會對慢性病進行早期識別或採取與適當篩查相關的必要步驟。

When we talk to large health plans, they're very focused, as you might imagine right now, on Star Ratings and closing and HEDIS measures and closing gaps in care. And because of all those reasons, Ryan, you're exactly right, we are starting to lean into value-based arrangements with some of our health plan partners, and to a lesser degree, with our employer partners for Primary360. And I think you'll see that continue to evolve over time.

當我們談論大型健康計劃時，正如您現在可能想像的那樣，它們非常專注於星級評級和關閉以及 HEDIS 措施和縮小護理差距。由於所有這些原因，瑞恩，你是對的，我們開始傾向於與我們的一些健康計劃合作夥伴進行基於價值的安排，並在較小程度上與我們的 Primary360 雇主合作夥伴進行合作。我想你會看到隨著時間的推移繼續發展。

Our next question comes from Sean Dodge of RBC.

我們的下一個問題來自 RBC 的 Sean Dodge。

Maybe going back to the gross margins for a moment. So on a consolidated basis, those stepped up pretty considerably the last couple of quarters now. Jason, you mentioned the BetterHelp example. I guess beyond that, is there any more detail you can give us on drivers there? Are there any onetime items in that? And so with you closing in on gross margin of 70%, 69.6% adjusted for the last quarter, how sustainable should we think about that being -- going forward?

也許暫時回到毛利率。因此，在綜合基礎上，這些數字在過去幾個季度中大幅增加。 Jason，您提到了 BetterHelp 示例。我想除此之外，您能提供更多關於那裡的驅動程序的詳細信息嗎？裡面有一次性物品嗎？因此，隨著您接近 70% 的毛利率，上一季度調整後的毛利率為 69.6%，我們應該如何看待這種情況——未來的可持續性？

Yes. Sean, if you think about the performance we've had in our gross margin, and you're exactly right, we have been seeing the uptick in the -- in our gross margins as we have gone through the year. The biggest increase is coming from improved efficiencies in BetterHelp, as we talked about in our prepared remarks. Specifically, the driver of that, that is helping in our gross margin is really around the utilization dynamics of the membership base.

是的。肖恩，如果您考慮一下我們在毛利率方面的表現，並且您是對的，那麼隨著這一年的發展，我們的毛利率一直在上升。正如我們在準備好的評論中談到的那樣，最大的增長來自 BetterHelp 效率的提高。具體來說，這有助於提高我們的毛利率的驅動因素實際上是圍繞會員基礎的利用動態。

As we talked about, we are seeing members engaging a little bit more digitally. And we are also seeing members utilizing things like group therapy more. And it's those kinds of things that lead to greater efficiency, and therefore, are improving our gross margin as we go through the year.

正如我們所談到的，我們看到成員參與的數字化程度更高。而且我們還看到成員更多地利用團體治療等東西。正是這些事情可以提高效率，因此，隨著我們這一年的發展，我們的毛利率正在提高。

The other thing to also note, and we have talked about this, we -- if you think about our provider model, we are certainly advancing from what a few years ago was a purely 1099 model, to a bit more of a hybrid model. And that is also going really well in terms of gaining more productivity and efficiency. We are really pleased with the productivity metrics that we are seeing on the part of the providers who are now our full-time employees. And we'll continue, obviously, to monitor that and optimize that. But it is in initiatives like that, that are driving the more sustained impact on our gross margins.

還要注意的另一件事是，我們已經討論過這一點，我們 - 如果您考慮我們的提供商模型，我們肯定會從幾年前的純 1099 模型推進到更多的混合模型。這在提高生產力和效率方面也進展順利。我們對現在是我們全職員工的供應商所看到的生產力指標感到非常滿意。顯然，我們將繼續監控並優化它。但正是在這樣的舉措中，才對我們的毛利率產生了更持久的影響。

Our next question comes from Jessica Tassan from Piper Sandler.

我們的下一個問題來自 Piper Sandler 的 Jessica Tassan。

Congrats on a good quarter. We were hoping you could maybe give us some color just on how pricing within chronic care is trending, especially as you continue to see multi-solution kind of adoption 0and bookings? And then just how should we think about the growth rate of the chronic care business exiting '22 and into 2023?

祝賀一個好季度。我們希望您能給我們一些關於慢性護理定價趨勢的信息，尤其是當您繼續看到多解決方案的採用 0 和預訂時？然後我們應該如何看待從 22 年到 2023 年的慢性護理業務的增長率？

Yes. Jess, I'll take the pricing question and Mala can comment on growth rates. We're seeing pricing hold in the CCM market, I think for probably 2, maybe 3 reasons. One, as you mentioned, most of our sales now are multiproduct sales. And so -- the truth is there aren't many out there who can match even a portion of the full portfolio that we have, much less the entirety of it. And so there is less apples-to-apples in buying the entire bundle of services. So it gives us the opportunity to be a little bit more clear about defining the price rather than having to react to a head-to-head single-point solution competitive bid.

是的。 Jess，我會回答定價問題，Mala 可以評論增長率。我們看到 CCM 市場的定價保持不變，我認為可能有 2 個，也許有 3 個原因。一，正如你所提到的，我們現在的大部分銷售都是多產品銷售。所以 - 事實上，沒有多少人可以匹配我們擁有的全部投資組合的一部分，更不用說整個投資組合了。因此，購買整套服務的成本更低。因此，它讓我們有機會更清楚地定義價格，而不必對面對面的單點解決方案競爭性投標做出反應。

The second reason I would say is because of what we talked about before. We are willing to put our fees at risk for the clinical outcomes that we drive. And because of that, it kind of derisks the offering for the clients who are buying it. When we are willing to put ourselves at risk and our fees at risk for those clinical measures, and in some cases for guaranteed ROIs, that enables us to keep pricing solid and even in many cases, as you heard with that pilot with the Blue Cross Blue Shield plan, have upside opportunity relative to shared savings.

我要說的第二個原因是因為我們之前談過的。我們願意為我們推動的臨床結果承擔費用。正因為如此，它有點為購買它的客戶提供服務。當我們願意為這些臨床措施以及在某些情況下為保証投資回報率而冒險時，我們願意將自己的費用置於風險之中，這使我們能夠保持穩定的定價，甚至在許多情況下，正如您在 Blue Cross 的試點中所聽到的那樣藍盾計劃，相對於共享儲蓄有上行機會。

And then the third reason, I think, is just because of our track record and our stability, what I mentioned earlier about fear among buyers, about whether some of those smaller players are going to be able to continue to exist in a more difficult cost of capital environment. That does play in our favor relative to our scale, stability and longevity. So I think generally, what we're seeing is that it's staying stable.

然後第三個原因，我認為，僅僅是因為我們的業績記錄和我們的穩定性，我之前提到的關於買家的恐懼，關於那些較小的參與者是否能夠以更困難的成本繼續存在的資本環境。相對於我們的規模、穩定性和壽命，這確實對我們有利。所以我認為總的來說，我們看到的是它保持穩定。

And then, Jess, in terms of your question around chronic care growth, revenue growth, we expect high single-digit chronic care revenue growth this year. And that's what I would expect to us have exiting through the end of this year into next year.

然後，傑西，就您關於慢性護理增長、收入增長的問題而言，我們預計今年慢性護理收入將實現高個位數增長。這就是我希望我們從今年年底到明年退出的情況。

Our next question comes from Stephanie Davis of SVB Securities.

我們的下一個問題來自 SVB 證券的 Stephanie Davis。

Congrats on a solid quarter. Could you walk us through some of the granularity on the EBITDA beat and the upside surprises, such as greater scale efficiency or any benefit from the Blue Cross Blue Shield savings relationship? And given that upside, are you still considering a similar magnitude of DTC ad cuts to fuel the 4Q ramp? Or could you moderate this a bit more to focus on growth, especially when we think about January and February, its impact on that?

祝賀一個堅實的季度。您能否向我們介紹 EBITDA 節拍的一些細節和上行驚喜，例如更大的規模效率或從 Blue Cross Blue Shield 儲蓄關係中獲得的任何好處？考慮到這一優勢，您是否還在考慮以類似幅度的 DTC 廣告削減來推動第 4 季度的增長？或者你能不能稍微緩和一點，把重點放在增長上，尤其是當我們考慮到 1 月和 2 月時，它對增長的影響？

Yes. Yes. Thanks, Stephanie. So in terms of the drivers of the beat, the majority of the upside came on the cost side of the equation. So given the revenue performance this year and obviously in light of the macroeconomic environment, we are looking more closely at efficiency like many other companies. And all those efforts, I mentioned some of those efforts, resulted in just better margin pull-through in the quarter.

是的。是的。謝謝，斯蒂芬妮。因此，就節拍的驅動因素而言，大部分上漲都來自等式的成本方面。因此，鑑於今年的收入表現，並且顯然考慮到宏觀經濟環境，我們正在像許多其他公司一樣更密切地關注效率。所有這些努力，我提到了其中的一些努力，都在本季度帶來了更好的利潤率。

Relative to our internal expectations, the biggest driver of our margin beat was on the technology and development line, okay? The second driver was the gross margin performance, and I just walked through the drivers of the gross margin performance, especially and largely at BetterHelp as we are seeing improved utilization dynamics.

相對於我們的內部預期，我們利潤增長的最大驅動力是在技術和開發線上，好嗎？第二個驅動因素是毛利率表現，我剛剛介紹了毛利率表現的驅動因素，尤其是在 BetterHelp，因為我們看到利用動態有所改善。

In terms of your question around what does this mean for the full year adjusted EBITDA and the ramp for Q4, the way we -- I'm thinking about it is the following: we have -- when we talked about our full year adjusted EBITDA expectations last quarter, we expect it to be near the low end of our prior guidance range. Our updated guidance assumes that we can deliver our adjusted EBITDA solidly at the -- in the range that we have just talked about, the 250 -- $240 million to $250 million range.

關於您關於這對全年調整後 EBITDA 和第四季度增長意味著什麼的問題，我們 - 我正在考慮的方式如下：我們有 - 當我們談到我們的全年調整後 EBITDA 時上個季度的預期，我們預計它將接近我們先前指導範圍的低端。我們更新後的指導假設我們可以在我們剛剛談到的 250 美元至 2.4 億美元至 2.5 億美元的範圍內穩定地交付調整後的 EBITDA。

But if I just take a step back and think about the Q4 adjusted EBITDA performance and therefore the full year, it still calls for the sequential ramp that will be largely driven by the seasonally -- the seasonal lower advertising expense in the fourth quarter. And again, I would remind you what we have said before, this is not new, right? If you think about the ad spend dynamics that we have had pre-COVID, the pullback in Q4 of our ad spend is something that we were doing in the BetterHelp business every single year just because we optimize for pricing, we optimize that business for returns. And therefore, as ad spending becomes much more expensive in the holiday season, so we sort of manage our ad spend around that.

但是，如果我退後一步，考慮一下第四季度調整後的 EBITDA 表現以及全年，它仍然需要在很大程度上由季節性因素驅動的連續增長——第四季度的季節性較低的廣告費用。再一次，我想提醒你我們之前說過的，這不是新的，對吧？如果您考慮一下我們在 COVID 之前的廣告支出動態，我們的廣告支出在第四季度的回落是我們每年在 BetterHelp 業務中所做的事情，僅僅因為我們優化了定價，我們優化了該業務以獲得回報.因此，隨著假日季節的廣告支出變得更加昂貴，因此我們在某種程度上管理我們的廣告支出。

It happened through COVID that those dynamics changed, became far more muted, and we are just now going back to what was pre-COVID dynamics. Of course, BetterHelp, as you know, is just a more scaled business now than it was pre-COVID, so it is a bit more visible in terms of those dynamics.

通過 COVID，這些動態發生了變化，變得更加平靜，我們現在才回到 COVID 之前的動態。當然，如您所知，BetterHelp 現在只是比 COVID 之前規模更大的業務，因此在這些動態方面它更加明顯。

And then the other thing I would say is just in terms of Q4 adjusted EBITDA, we do anticipate a sequential step-up in technology and development spend in the fourth quarter as we continue to invest in the business. That is included in the guidance that we have given out for 4Q for adjusted EBITDA.

然後我要說的另一件事是就第四季度調整後的 EBITDA 而言，我們確實預計隨著我們繼續投資該業務，第四季度技術和開發支出將連續增加。這包含在我們為第四季度調整後的 EBITDA 提供的指導中。

Our next question comes from Charles Rhyee of Cowen.

我們的下一個問題來自 Cowen 的 Charles Rhyee。

Jason, you gave us some metrics around Primary360, and I think you characterized it as for members who have engaged with it. Can you give us a sense for those members who it's available for, what the actual uptake has been in terms of members selecting a virtual primary care team? And then secondly, what are your expectations then as we think about for HCSC next year? If it's available to their self-insured clients, is the selling efforts really driven by you? Or is that something that's driven by HCSC in terms of pushing the product?

Jason，你給了我們一些關於 Primary360 的指標，我認為你將其描述為參與其中的成員。您能否讓我們了解一下那些可以使用它的成員，在成員選擇虛擬初級保健團隊方面的實際吸收情況？其次，當我們考慮明年的 HCSC 時，您的期望是什麼？如果他們的自我保險客戶可以使用它，那麼銷售努力真的是由你推動的嗎？還是說這是 HCSC 在推動產品方面的推動力？

Yes. It's always a team approach. We work with our partners to engage their self-insured clients. Their self-insured clients have to make the decision that they want to go with Primary360 or any of our chronic care management programs. And so that's a team sell. Our team is deeply engaged with theirs. And as we've said, that's a multiyear approach. So we expect to see the benefit of that over the course of multiple years as we penetrate that book of business and the other health plan partners that we work with.

是的。這始終是一種團隊方法。我們與合作夥伴合作，吸引他們的自保客戶。他們的自保客戶必須做出決定，選擇 Primary360 或我們的任何慢性護理管理計劃。所以這是一個團隊銷售。我們的團隊與他們的團隊深入互動。正如我們所說，這是一個多年的方法。因此，隨著我們深入研究業務手冊和與我們合作的其他健康計劃合作夥伴，我們希望在多年的過程中看到這一點的好處。

With respect to the overall population, we now have several hundred thousand members who are eligible for Primary360 through their insurance coverage. We have tens of thousands of members who have enrolled in plans that have Primary360 as an integral part of them. We've done thousands of primary care visits this year, and it's growing rapidly.

就總人口而言，我們現在有數十萬成員通過他們的保險範圍有資格獲得 Primary360。我們有成千上萬的會員參加了將 Primary360 作為其組成部分的計劃。今年我們進行了數千次初級保健就診，而且還在迅速增長。

So remember, this is really the first year that we are in the market with that product. And we saw a significant step-up in volume in the third quarter versus the first half of the year. But we haven't quantified it at this point. We haven't given a direct number on either the penetration of the population that's eligible or the total number. I think you'll see us continue to expand the clarity on that as we get through the end of this year and into next year, and quite frankly, through this open enrollment season.

所以請記住，這確實是我們在市場上推出該產品的第一年。與今年上半年相比，我們看到第三季度的交易量顯著增加。但我們目前還沒有量化它。我們沒有給出符合條件的人口滲透率或總數的直接數字。我想你會看到我們在今年年底和明年，坦率地說，通過這個開放的招生季節，繼續擴大這一點。

Our next question comes from Daniel Grosslight of Citi.

我們的下一個問題來自花旗的 Daniel Grosslight。

Just a quick clarification before I get into my actual question. Did you say the Blue Cross Blue Shield bonus contributed to this quarter? And are you able to quantify that? And then my question is on 2023 revenue -- sorry, go ahead. Go ahead.

在我進入實際問題之前，請快速澄清一下。您是否說本季度的藍十字藍盾獎金有貢獻？你能量化嗎？然後我的問題是關於 2023 年的收入——抱歉，繼續。前進。

So Daniel, it was immaterial to this quarter.

所以丹尼爾，這對本季度無關緊要。

Okay. Is it going to hit next quarter? Or it's immaterial to your revenue guidance?

好的。下個季度會打嗎？或者這對您的收入指導無關緊要？

It's immaterial. It's immaterial.

這是無關緊要的。這是無關緊要的。

Okay. Got it. Okay. And then as I think about revenue growth for 2023, Jason, you mentioned your pipeline is similar to where you were last year. Attrition is a bit better. If you're likely to see a step-down in BetterHelp growth next year, assuming a softening economy, should we think about growth rates for 2023 at slightly below where you are based on your '22 guidance, which is around 18% year-over-year?

好的。知道了。好的。然後當我想到 2023 年的收入增長時，傑森，你提到你的管道與去年相似。減員好一點。如果您可能會看到 BetterHelp 明年的增長放緩，假設經濟疲軟，我們是否應該考慮到 2023 年的增長率略低於您基於 22 年指導的水平，即每年 18% 左右-超過一年？

So we're not going to give guidance today. We'll do that in February. What we tried to do is give you sort of the components of how to think about that and how to start modeling that. And so I'm going to stop short of going further than that. I think I've given quite a bit relative to the bookings thus far, the pipeline thus far, and how we're thinking about BetterHelp. And obviously, at $1 billion, that's a big business, and it takes a lot to continue to drive those very impressive growth rates.

所以我們今天不打算給出指導。我們將在二月份這樣做。我們試圖做的是給你一些關於如何思考以及如何開始建模的組件。因此，我將不再走得更遠。我想我已經給出了相當多的關於到目前為止的預訂、迄今為止的管道以及我們如何考慮 BetterHelp。顯然，10 億美元，這是一項大生意，要繼續推動這些令人印象深刻的增長率需要付出很多努力。

Our next question comes from Elizabeth Anderson from Evercore.

我們的下一個問題來自 Evercore 的 Elizabeth Anderson。

This is Sameer Patel speaking on behalf of Elizabeth Anderson. I was just wondering, what are you guys seeing in the market in terms of the pricing on Virtual First plans? Is it coming up cheaper or not so much? Any light would be great.

我是薩米爾·帕特爾（Sameer Patel）代表伊麗莎白·安德森（Elizabeth Anderson）發言。我只是想知道，你們在市場上對 Virtual First 計劃的定價有何看法？它會更便宜還是沒有那麼多？任何光線都會很棒。

You mean in terms, I assume, of the pricing, the premiums to the end consumer or the end buyer. We actually have seen -- what I can tell you is what we've seen last year. I don't think everything is fully baked yet and in the market relative to the exchanges and things like that. What I can tell you is that the exchange -- the Virtual First exchange products that we were part of in -- for this year were not the least expensive priced on the exchange.

我假設您的意思是定價，最終消費者或最終買家的溢價。我們實際上已經看到了——我可以告訴你的是我們去年看到的。我不認為一切都已經完全成熟，相對於交易所和類似的東西在市場上。我可以告訴你的是，今年的交易所——我們參與的 Virtual First 交易所產品——並不是交易所中價格最低的。

And I think that actually is really positive. I think it's a demonstration of the value that consumers are seeing in those Virtual First plan designs. Because all in, the premium may be a little bit more, but ultimately, the benefits are richer because the cost sharing is less and it's a plan that meets them on their terms. And so we're actually very pleased with what that looks like for this past year for pricing for '22 plans. And we'll see what happens as we head into '23. But so far, the experience has been very good.

我認為這實際上是非常積極的。我認為這是消費者在那些 Virtual First 計劃設計中看到的價值的體現。因為總而言之，保費可能會多一點，但最終，收益會更豐富，因為成本分攤更少，而且這是一個符合他們條件的計劃。因此，我們實際上對過去一年 '22 計劃的定價情況感到非常滿意。我們將看到進入 23 年會發生什麼。但到目前為止，體驗非常好。

Our next question comes from Steve Valiquette from Barclays.

我們的下一個問題來自巴克萊的 Steve Valiquette。

This is [Tiffany] on for Steve. I think you talked about the macro impact on the DTC side. I was wondering if you could give a bit more color on maybe what you're seeing on the B2B side in terms of macro environment and employer sentiment.

這是史蒂夫的[蒂芙尼]。我認為您談到了對 DTC 方面的宏觀影響。我想知道您是否可以就宏觀環境和雇主情緒方面的 B2B 方面提供更多顏色。

Yes. I think the only thing we're seeing directly is a little bit of distraction among HR executives who are responsible for both managing the benefits and health of their employee base and, in many cases, are facing a difficult inflationary environment where they have to think about managing their workforce in a different way. And of course, we're all dealing with workforces that are now remote more than in physical locations and office buildings.

是的。我認為我們直接看到的唯一一件事是人力資源主管有點分心，他們負責管理員工群體的福利和健康，在許多情況下，他們面臨著艱難的通貨膨脹環境，他們必須思考關於以不同的方式管理他們的勞動力。當然，我們都在與現在比物理位置和辦公樓更偏遠的勞動力打交道。

So I think there's just a little bit more distraction in the current environment. But what we haven't seen is -- and again, I think in the first 2 quarters, I would have said that caused a little bit of slowdown in decision-making among employer benefits leaders. We saw that -- like I said, I described the third quarter as a bit of a catch-up quarter with respect to bookings. And so I think that the employer greater focus in the third quarter led in part to that and enabled us to break through some of that. So I don't yet see a significant impact on employer buying patterns.

所以我認為在當前的環境中只是有點分心。但我們沒有看到的是——而且，我認為在前兩個季度，我會說這導致雇主福利領導者的決策有所放緩。我們看到了——就像我說的那樣，我將第三季度描述為在預訂方面的一個追趕季度。因此，我認為雇主在第三季度更加關注這部分導致了這一點，並使我們能夠突破其中的一些。所以我還沒有看到對雇主購買模式的重大影響。

The thing that's also hard to sort of pinpoint is if -- to the extent that there is a potential recession, what is the impact to our business? Virtual care was not really around in the last recession. So we don't exactly have a lot of history to lean on.

也很難確定的事情是，如果——在潛在的經濟衰退的程度上，對我們的業務有什麼影響？在上一次經濟衰退中，虛擬護理並沒有真正出現。所以我們沒有太多的歷史可以依靠。

Our next question comes from George Hill of Deutsche Bank.

我們的下一個問題來自德意志銀行的喬治希爾。

I guess I've got one for Jason and one for Mala. Jason, you talked a lot about kind of the margin opportunity and looking into '23 focused on cost opportunities as opposed to kind of outsized revenue growth. I guess my big-picture question would be is, do you feel like the company is rightsized from a cost perspective? And kind of how aggressive do you feel like you could be there to attack costs?

我想我有一份給傑森，一份給馬拉。傑森，你談了很多關於利潤機會的話題，並在 23 年關注成本機會，而不是那種超大的收入增長。我想我的大局問題是，你覺得公司從成本的角度來看是合適的嗎？你覺得你可以在那裡攻擊成本有多積極？

And then, Mala, just kind of a housekeeping question on gross margins. You talked about the gross margin expansion being attributed to the growth in BetterHelp. If we see some of that consumer weakness that a lot of people are talking about for '23, would we expect to see gross margins revert a little bit?

然後，馬拉，只是一個關於毛利率的家務問題。您談到毛利率的增長歸因於 BetterHelp 的增長。如果我們看到很多人在 23 年談論的一些消費者弱點，我們是否會期望看到毛利率略有回升？

Yes. So I'll take both, George. So in terms of sort of the cost control, here's what I would say. We are always conscious of managing our costs. That is not a new thing. And if you look at the current macroeconomic environment, as I said a few minutes ago, it does require all companies to be more focused on managing costs, and we are no exception to that.

是的。所以我兩個都要，喬治。因此，就成本控製而言，這就是我要說的。我們總是有意識地管理我們的成本。這不是什麼新鮮事。如果你看看當前的宏觀經濟環境，正如我幾分鐘前所說，它確實要求所有公司更加專注於管理成本，我們也不例外。

We've certainly increased our efforts to control expenses. We've talked about that as we talked about the adjusted EBITDA beat for the quarter. And so we are pleased we've seen the results of those efforts.

我們當然加大了控制開支的力度。當我們談到本季度調整後的 EBITDA 時，我們已經談到了這一點。因此，我們很高興看到了這些努力的成果。

We are being intentional in terms of multiple initiatives to date that are focused on driving the cost side of the equation. So I'll give you an example. We have had a project underway for several months now, where we are seeking to make several of our financial systems more efficient and streamlined. As we talked about, we are consolidating our real estate footprint in a world where a large number of our colleagues are working remotely. We have assessed, evaluated, and we have begun to reduce the amount of office space that we need to maintain. That's just 2 small examples of many of the initiatives that we have underway.

迄今為止，我們正在有意採取多項舉措，這些舉措專注於推動等式的成本方面。所以我給你舉個例子。我們已經有一個項目進行了幾個月，我們正在尋求使我們的幾個金融系統更加高效和精簡。正如我們所談到的，我們正在一個我們的大量同事都在遠程工作的世界中鞏固我們的房地產足跡。我們已經評估、評估並開始減少我們需要維護的辦公空間數量。這只是我們正在進行的許多舉措中的兩個小例子。

So I would say we did not, to be clear, say anything really about revenue growth rate for 2023. We will, as always, provide more specific outlook, more specific guidance when we do our Q4 call in February. But we are looking for ways, as always, to optimize our cost structure, and we will take an even closer look at that as we head into 2023.

因此，我想說的是，我們並沒有真正說明 2023 年的收入增長率。我們將一如既往地在 2 月份進行第四季度電話會議時提供更具體的前景和更具體的指導。但我們一如既往地在尋找優化成本結構的方法，我們將在進入 2023 年時更仔細地研究這一點。

I will say, though, in conclusion, we will look at it and we will be thoughtful about how we balance efficiency with the need to make the right investments to continue to drive our top line revenue growth. As we have said before, there is still an enormous runway for top line growth in this space, and it would be a shame for us to not make those right investments to continue to capture that growth. And we are really well positioned based on all of the things we have said on the call until now to go do that. So as always, we will look for both -- looking at our cost structure, optimizing it and making the right investments towards longer-term revenue growth.

不過，我會說，總而言之，我們將研究它，我們將考慮如何平衡效率與進行正確投資以繼續推動我們的收入增長的需要。正如我們之前所說，這一領域的營收增長仍有巨大的空間，如果我們不進行正確的投資以繼續抓住這一增長，那將是一種恥辱。根據我們迄今為止在電話會議上所說的所有事情，我們確實處於有利地位。因此，與往常一樣，我們將同時兼顧兩者——著眼於我們的成本結構，優化它，並為長期收入增長做出正確的投資。

Our next question comes from Cindy Motz of Goldman Sachs.

我們的下一個問題來自高盛的 Cindy Motz。

I just wanted to go back to chronic care a little bit. So in the quarter, you lost a client and you're down a little bit. But judging by the enthusiasm and the bookings, it feels like that we can assume maybe that's going to go up next quarter with the guidance. And then with PMPM as well, you said it's sort of stable. So I would think the overall PMPM, we could assume that is going to rise. Is that correct?

我只是想回到慢性護理領域。所以在這個季度，你失去了一個客戶，你有點失望。但從熱情和預訂量來看，感覺我們可以假設下個季度可能會在指導下上升。然後還有 PMPM，你說它有點穩定。所以我認為整體 PMPM，我們可以假設它會上升。那是對的嗎？

I mean we're not giving specific outlook on CCM, on chronic care revenue or membership in Q4. But you're exactly right. We feel good about where the overall CCM product portfolio is and the receptivity in the market. Mala called out what the growth would have been absent this one client loss. We would have added 16,000 enrollment -- members in enrollment and 26,000 in total program enrollment.

我的意思是，我們沒有對第四季度的 CCM、慢性護理收入或會員資格給出具體展望。但你完全正確。我們對整個 CCM 產品組合的位置以及市場的接受度感到滿意。馬拉指出，如果沒有這一客戶損失，增長會是怎樣的。我們將增加 16,000 名註冊——註冊會員和 26,000 名計劃註冊總人數。

So we feel good about that, especially in the fourth quarter of -- sorry, in the third quarter of the year. So we'll continue to feel good, especially as we look at the bookings for the year and heading into next year. And then Mala, I think, gave the sort of general outlook as far as CCM growth as we look forward.

所以我們對此感覺很好，尤其是在第四季度——對不起，在今年第三季度。因此，我們將繼續感覺良好，尤其是當我們查看今年的預訂情況並進入明年時。然後，我認為 Mala 給出了我們所期待的 CCM 增長的總體展望。

That was the final question for today. So that concludes today's conference call. Thank you for joining. You may now disconnect.

這是今天的最後一個問題。今天的電話會議到此結束。感謝您的加入。您現在可以斷開連接。