Teladoc Health Inc (TDOC) 2023 Q1 法說會逐字稿

Hello, and welcome to the Teladoc Health Q1 '23 Earnings Conference Call. My name is Alex, and I'll be coordinating the call today. (Operator Instructions) I'll now hand over to your host, Patrick Feeley, Head of Investor Relations, to begin. Please go ahead.

您好，歡迎來到 Teladoc Health Q1 '23 收益電話會議。我叫亞歷克斯，今天我將負責協調電話會議。 （操作員說明）我現在將交給您的主持人，投資者關係主管 Patrick Feeley 開始。請繼續。

Thank you, and good afternoon. Today, after the market closed, we issued a press release announcing our first quarter 2023 financial results. This press release and the accompanying slide presentation are available on the Investor Relations section of the teladochealth.com website.

謝謝，下午好。今天，收市後，我們發布了一份新聞稿，宣布了我們 2023 年第一季度的財務業績。本新聞稿和隨附的幻燈片演示可在 teladochealth.com 網站的投資者關係部分獲取。

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 discuss our second quarter and full year 2023 outlook, and our prepared remarks will be followed by a question-and-answer session.

首席執行官 Jason Gorevic 在此次電話會議上討論了結果；和首席財務官 Mala Murthy。在這次電話會議中，我們還將討論我們的第二季度和 2023 年全年展望，我們準備好的評論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，我們將討論某些我們認為對評估 Teladoc Health 的業績很重要的非 GAAP 財務指標。有關這些非 GAAP 措施與最具可比性的 GAAP 措施及其調節之間關係的詳細信息，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，本次電話會議期間作出的某些陳述將是 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、不確定性和其他因素的影響，這些因素可能導致實際結果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和我們向美國證券交易委員會提交的文件，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. I'm pleased to report a strong start to the year across the business, meeting or exceeding all of our key financial and operating guidance in the first quarter. Today, we're raising the low end of our revenue and adjusted EBITDA guidance, a reflection of the quarter's strong results, and we'll speak to some of the key progress we've made in the first few months of the year.

謝謝你，帕特里克。下午好，感謝您加入我們。我很高興地報告今年整個業務的良好開端，在第一季度達到或超過了我們所有的關鍵財務和運營指導。今天，我們提高了收入的下限並調整了 EBITDA 指引，反映了本季度的強勁業績，我們將談談我們在今年頭幾個月取得的一些關鍵進展。

First, let's start with a brief recap of the quarter. Consolidated revenue in Q1 grew by 11% year-over-year to $629 million, which was above the high end of our guidance range. Our consolidated adjusted EBITDA was $52.8 million, also exceeding the high end of our guidance.

首先，讓我們先簡要回顧一下本季度。第一季度的綜合收入同比增長 11% 至 6.29 億美元，高於我們指導範圍的上限。我們的綜合調整後 EBITDA 為 5280 萬美元，也超過了我們指導的上限。

Our BetterHelp segment continued to see strong demand in the first quarter as the quality, convenience and affordability offered by our direct-to-consumer mental health service resonates in the marketplace. Segment revenue grew 21% year-over-year in Q1, driven by new member growth and outperforming our expectations.

我們的 BetterHelp 部門在第一季度繼續看到強勁的需求，因為我們直接面向消費者的心理健康服務所提供的質量、便利性和可負擔性在市場上引起了共鳴。在新會員增長和超出我們預期的推動下，第一季度分部收入同比增長 21%。

Customer acquisition trends have remained stable year-to-date, resulting in solid margin pull-through in what is typically our seasonally weakest quarter. Mala will discuss guidance in more detail shortly, but we feel confident in our expectation for a strong and consistent sequential margin improvement in our BetterHelp business throughout the course of 2023.

年初至今，客戶獲取趨勢保持穩定，導致我們在通常是季節性最弱的季度實現了可觀的利潤率提升。 Mala 將在短期內更詳細地討論指導意見，但我們對我們對 BetterHelp 業務在整個 2023 年期間強勁且持續的連續利潤率改善的預期充滿信心。

In the Integrated Care segment, revenue grew 5% to $350 million, again, at the high end of our expectations. Integrated Care growth was relatively balanced across our B2B portfolio, and we're pleased to see continued strong interest in our whole-person care suite of products. In particular, chronic care enrollment is off to a solid start to the year with new member recruitment ramping up ahead of schedule. This also helped drive strong segment margin expansion in the quarter.

在綜合護理部門，收入增長 5% 至 3.5 億美元，再次達到我們預期的上限。 Integrated Care 的增長在我們的 B2B 產品組合中相對平衡，我們很高興看到人們對我們的全人護理產品套件的持續濃厚興趣。特別是，隨著新成員招募提前增加，慢性病護理註冊在今年開局良好。這也有助於推動本季度強勁的部門利潤率擴張。

Year-to-date trends have increased our level of confidence in the outlook for the rest of the year in both the BetterHelp and Integrated Care segments. During the quarter, we've remained focused on expanding our leadership position in whole-person virtual care, including advancing Primary360, our virtual primary care offering, and I'm pleased with the significant progress we've made.

年初至今的趨勢提高了我們對今年剩餘時間 BetterHelp 和 Integrated Care 細分市場前景的信心。在本季度，我們一直專注於擴大我們在全人虛擬護理方面的領導地位，包括推進我們的虛擬初級保健產品 Primary360，我對我們取得的重大進展感到高興。

Allow me to highlight 3 key examples. First, we began rolling out our new integrated app during the quarter. This has been a considerable effort, and I'm pleased that we're already seeing significant positive results for migrated populations, including higher engagement and multiproduct utilization. While it's still very early, we're optimistic about the potential impact of this fully integrated experience in helping our members better manage their health across our whole-person suite of programs from primary care to chronic care.

請允許我強調 3 個關鍵示例。首先，我們在本季度開始推出新的集成應用程序。這是一項相當大的努力，我很高興我們已經看到遷移人口的顯著積極成果，包括更高的參與度和多產品利用率。雖然現在還很早，但我們對這種完全整合的體驗在幫助我們的會員更好地管理從初級保健到慢性病保健的全人計劃套件中的健康的潛在影響持樂觀態度。

As the health care landscape continues to evolve, we remain committed to investing in innovation and leveraging technology to better drive outcomes for our members. The early results demonstrating engagement with our new app are a testament to our ongoing efforts to improve the quality and accessibility of care for our members.

隨著醫療保健領域的不斷發展，我們仍然致力於投資創新和利用技術來更好地為我們的會員帶來成果。表明與我們的新應用程序互動的早期結果證明了我們為提高會員的護理質量和可及性所做的持續努力。

Next, we announced the results of a new clinical study proving the benefits of whole-person chronic care. The study shows that individuals who are initially enrolled in one of our stand-alone diabetes, hypertension or weight management programs experienced a significant improvement in those underlying conditions when they added one or more of our other chronic care programs.

接下來，我們公佈了一項新的臨床研究結果，證明了全人長期護理的好處。該研究表明，最初參加我們的一項獨立糖尿病、高血壓或體重管理計劃的個人在加入我們的一項或多項其他慢性病護理計劃後，這些潛在狀況有了顯著改善。

These data points represent another reminder of why we're investing in our whole-person offering. And they come at a time when the marketplace is increasingly focused on demonstrated outcomes. For employers and health plans, these results validate the benefit of expanded access from stand-alone chronic condition programs to whole-person programs.

這些數據點再次提醒我們為什麼要投資我們的全人服務。它們出現在市場越來越關注已證明的結果的時候。對於雇主和健康計劃，這些結果證實了從獨立的慢性病計劃擴展到全人計劃的好處。

Finally, last week, we took another step forward in our efforts to provide integrated whole-person care solutions to our clients and members with the introduction of our new provider-based care programs for weight management and prediabetes. Distinct from our existing digital programs, enrollees will have access to personalized care plans developed in collaboration with a Teladoc physician, who will leverage our broad-based tools and capabilities such as nutrition counseling, mental health care, behavioral science, health coaching, and prescription drug management.

最後，上週，我們又向前邁進了一步，我們推出了新的基於提供者的體重管理和糖尿病前期護理計劃，為我們的客戶和會員提供綜合的全人護理解決方案。與我們現有的數字計劃不同，參與者將能夠獲得與 Teladoc 醫生合作開發的個性化護理計劃，該醫生將利用我們基礎廣泛的工具和功能，例如營養諮詢、心理健康護理、行為科學、健康指導和處方藥物管理。

These programs will help members with complications related to uncontrolled chronic conditions get back on track, improving outcomes and reducing downstream costs. This includes the ability for physicians to prescribe medications such as GLP-1s when clinically appropriate. We believe that access to key new developments is important for members. However, providing access to medication alone is not enough when it comes to patient outcomes and safety. It's also critical that these therapies are provided as part of a broader care model that includes a longitudinal provider relationship and a customized care plan built in conjunction with a care team to help manage the patient through their health journey.

這些計劃將幫助患有與不受控制的慢性病相關的並發症的會員重回正軌，改善結果並降低下游成本。這包括醫生在臨床適當時開出 GLP-1 等藥物處方的能力。我們認為，獲得重要的新發展對成員來說很重要。然而，就患者結果和安全而言，僅僅提供藥物治療是不夠的。同樣重要的是，這些療法是作為更廣泛的護理模型的一部分提供的，該模型包括縱向提供者關係和與護理團隊一起制定的定制護理計劃，以幫助管理患者的健康之旅。

Teladoc Health's provider-based programs build on the success of our existing digital weight management and prediabetes programs and will be offered to clients in our employer and health plan channels starting later this year. These programs follow the launch of integrated provider-based digital programs in mental health, diabetes and hypertension.

Teladoc Health 基於提供商的計劃建立在我們現有數字體重管理和前驅糖尿病計劃的成功基礎之上，並將於今年晚些時候開始在我們的雇主和健康計劃渠道中向客戶提供。這些計劃是在心理健康、糖尿病和高血壓方面推出基於提供商的綜合數字計劃之後推出的。

With the addition of these programs for weight management and prediabetes, we're now offering integrated virtual and digital programs across all our key chronic condition programs, ensuring that our members receive the comprehensive support that addresses the full scope of their needs.

通過增加這些體重管理和前驅糖尿病項目，我們現在在所有主要慢性病項目中提供集成的虛擬和數字項目，確保我們的會員獲得全面支持，滿足他們的全部需求。

We understand the importance of delivering high-quality care while reducing costs for our clients. And we're proud to be at the forefront of innovation in this space. Our provider-based care programs are a testament to our commitment to improving the health of our members and exploring new ways to leverage technology and innovation to achieve better outcomes.

我們了解在為客戶降低成本的同時提供高質量護理的重要性。我們很自豪能夠站在這個領域的創新前沿。我們基於提供者的護理計劃證明了我們致力於改善會員的健康並探索利用技術和創新實現更好結果的新方法。

Let me end by saying that the importance of a strong financial position has never been more evident than over the past few months. The disruption in the banking system, combined with a strained funding environment, has created a lot of uncertainty in the venture-backed digital health care space, resulting in many companies facing significant financial constraints.

最後讓我說，穩健財務狀況的重要性從未像過去幾個月那樣明顯。銀行系統的中斷，加上緊張的資金環境，給風險投資支持的數字醫療保健領域帶來了很多不確定性，導致許多公司面臨嚴重的財務限制。

In contrast, at Teladoc Health, we're continuing to invest in innovation while providing high-quality health care solutions, all while generating positive free cash flow. Over the last 12 months, we've generated over $230 million in operating cash flow and nearly $50 million in free cash flow. We have nearly $900 million of cash on the balance sheet and expect to deliver over $100 million of free cash flow in 2023. Financial strength is emerging as another important advantage as clients are seeking quality in times of uncertainty.

相比之下，在 Teladoc Health，我們在提供高質量醫療保健解決方案的同時繼續投資於創新，同時產生正的自由現金流。在過去的 12 個月裡，我們產生了超過 2.3 億美元的運營現金流和近 5000 萬美元的自由現金流。我們的資產負債表上有近 9 億美元的現金，預計到 2023 年將提供超過 1 億美元的自由現金流。隨著客戶在不確定時期尋求質量，財務實力正在成為另一個重要優勢。

In conclusion, we remain focused on expanding our competitive advantage while creating efficiencies in the business to drive margins and generate value. We're confident that our strategy and execution will enable us to advance our leadership position while delivering strong results.

總之，我們仍然專注於擴大我們的競爭優勢，同時提高業務效率以推動利潤和創造價值。我們相信，我們的戰略和執行將使我們能夠在取得強勁業績的同時提升我們的領導地位。

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

有了這個，我將把電話轉給 Mala 來審查第一季度和我們的前瞻性指導。

Thank you, Jason, and good afternoon, everyone. First quarter consolidated revenue increased 11% year-over-year to $629 million while first quarter adjusted EBITDA was $52.8 million, representing a margin of 8.4%. The first quarter financial outperformance was driven primarily by stronger chronic care product revenue, BetterHelp membership growth and improved expense control.

謝謝你，傑森，大家下午好。第一季度綜合收入同比增長 11% 至 6.29 億美元，而第一季度調整後的 EBITDA 為 5280 萬美元，利潤率為 8.4%。第一季度的財務表現出色主要是由於長期護理產品收入的增長、BetterHelp 會員的增長和費用控制的改善。

Turning to segment results. Integrated Care segment revenue increased 5% year-over-year to $350 million in the quarter, with growth relatively balanced across the portfolio. First quarter Integrated Care adjusted EBITDA was $35.1 million, representing an over 300 basis point expansion in margins to 10%.

轉向細分結果。本季度綜合護理部門的收入同比增長 5% 至 3.5 億美元，整個投資組合的增長相對均衡。第一季度 Integrated Care 調整後的 EBITDA 為 3510 萬美元，利潤率增長超過 300 個基點至 10%。

The margin outperformance relative to guidance was largely driven by strong chronic care program enrollment during the first quarter, which helped drive stronger gross margins and bottom line results, combined with better expense control. Total chronic care program enrollment was $1.03 million at the end of the first quarter, representing growth of 13% year-over-year.

相對於指導的利潤率表現主要是由於第一季度強勁的慢性病護理計劃註冊人數推動的，這有助於推動更高的毛利率和底線結果，以及更好的費用控制。第一季度末，慢性病護理項目註冊總人數為 103 萬美元，同比增長 13%。

Total Integrated Care members grew $5.7 million over the prior year, representing 7% year-over-year growth and $1.6 million sequentially to 84.9 million U.S. members. Average Integrated Care revenue per U.S. member of $1.39 was down $0.02 over the prior year's first quarter due to the mix impact of large new telemedicine population added over the last 12 months.

Integrated Care 會員總數比上年增長 570 萬美元，同比增長 7%，美國會員總數達到 8490 萬美元，環比增長 160 萬美元。由於過去 12 個月新增大量遠程醫療人口的綜合影響，每位美國會員的平均綜合護理收入為 1.39 美元，比去年第一季度下降 0.02 美元。

Excluding the impact of new population onboardings over the course of the last 12 months, revenue per member would have increased on a year-over-year basis by low- to mid-single-digit percentage. First quarter BetterHelp segment revenue increased 21% year-over-year to $279 million, driven by growth in membership and stable customer acquisition costs.

不計入過去 12 個月新人口入職的影響，每位會員的收入將同比增長低至中個位數百分比。第一季度 BetterHelp 部門收入同比增長 21% 至 2.79 億美元，這得益於會員數量的增長和穩定的客戶獲取成本。

First quarter BetterHelp adjusted EBITDA was $17.7 million, representing a margin of 6.3%. As discussed over the last several quarters, the first quarter is typically the seasonally weakest quarter as marketing expense ramps up following the fourth quarter holiday season. As such, we continue to expect the first quarter to be the low point of the year for BetterHelp segment margins. And as Jason mentioned, we expect consistent quarter-over-quarter margin improvement progression throughout the course of 2023.

第一季度 BetterHelp 調整後的 EBITDA 為 1770 萬美元，利潤率為 6.3%。正如過去幾個季度所討論的那樣，第一季度通常是季節性最疲軟的季度，因為營銷費用在第四季度假期之後增加。因此，我們繼續預計第一季度將是 BetterHelp 部門利潤率的年度最低點。正如 Jason 所提到的，我們預計在整個 2023 年期間利潤率將出現持續的季度環比改善。

Consolidated net loss per share in the first quarter was $0.42 compared to a net loss per share of $41.58 in the first quarter of 2022. Net loss per share in the first quarter includes restructuring charges of $8.1 million or $0.05 per share primarily related to severance, stock-based compensation expense of $0.28 per share and amortization of acquired intangibles of $0.31 per share.

第一季度的合併每股淨虧損為 0.42 美元，而 2022 年第一季度的每股淨虧損為 41.58 美元。第一季度的每股淨虧損包括 810 萬美元的重組費用或主要與遣散費相關的每股 0.05 美元，每股 0.28 美元的股票補償費用和每股 0.31 美元的收購無形資產攤銷。

During the first quarter, free cash flow was a net outflow of $32 million compared to a net outflow of $63 million in the first quarter of 2022. As a reminder, the first quarter is our seasonally weakest cash flow quarter. We ended the quarter with $889 million in cash and short-term investments on the balance sheet.

第一季度，自由現金流淨流出 3200 萬美元，而 2022 年第一季度為 6300 萬美元。提醒一下，第一季度是我們季節性現金流最弱的季度。我們在本季度結束時資產負債表上有 8.89 億美元的現金和短期投資。

Now turning to forward guidance. For the full year 2023, we now expect revenue to be in the range of $2.575 billion to $2.675 billion, an increase of $25 million at the low end, representing revenue growth of 7% to 11%. This outlook includes mid- to high-single-digit percentage growth in our Integrated Care segment and low double digit to mid-teen percentage growth in our BetterHelp segment. There is no change to our full year Integrated Care segment U.S. membership guidance of 84 million to 86 million members.

現在轉向前瞻性指導。對於 2023 年全年，我們現在預計收入將在 25.75 億美元至 26.75 億美元之間，低端增加 2500 萬美元，收入增長 7% 至 11%。這一前景包括我們的 Integrated Care 部門的中高個位數百分比增長和 BetterHelp 部門的低兩位數到中等百分比的增長。我們的全年綜合護理部分美國會員人數為 8400 萬至 8600 萬，沒有變化。

We expect consolidated adjusted EBITDA for the full year to be in the range of $285 million to $325 million or growth of 16% to 32%. Consolidated guidance continues to assume year-over-year adjusted EBITDA margin, a flat to up 50 basis points for the Integrated Care segment and an increase of 100 to 300 basis points for the BetterHelp segment.

我們預計全年合併調整後的 EBITDA 將在 2.85 億美元至 3.25 億美元之間，或增長 16% 至 32%。綜合指導繼續假設調整後的 EBITDA 利潤率同比增長，綜合護理部門持平至上升 50 個基點，BetterHelp 部門增長 100 至 300 個基點。

We expect full year free cash flow of at least $100 million, driven by both the growth in adjusted EBITDA and an expected decline in capitalized software development costs. For the second quarter, we expect revenue of $635 million to $660 million, representing growth of 7% to 11% year-over-year. We expect adjusted EBITDA of $60 million to $68 million for the second quarter.

在調整後的 EBITDA 增長和資本化軟件開發成本預期下降的推動下，我們預計全年自由現金流至少為 1 億美元。對於第二季度，我們預計收入為 6.35 億美元至 6.6 億美元，同比增長 7% 至 11%。我們預計第二季度調整後的 EBITDA 為 6000 萬至 6800 萬美元。

Second quarter consolidated guidance contemplates low to mid-single-digit revenue growth for the Integrated Care segment and mid- to high-teens revenue growth for the BetterHelp segment. We expect total Integrated Care segment U.S. membership of 84.5 million to 85.5 million members. We expect BetterHelp segment margins to be slightly higher than Integrated Care segment margin in the second quarter.

第二季度的綜合指導預計綜合護理部門的收入將實現中低個位數增長，而 BetterHelp 部門的收入將實現中高收入增長。我們預計 Integrated Care 部分的美國會員總數為 8450 萬至 8550 萬。我們預計第二季度 BetterHelp 部門的利潤率將略高於 Integrated Care 部門的利潤率。

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

有了這個，我會把電話轉回傑森。

Thanks, Mala. In closing, I'm very pleased with the strong start to 2023, and we look forward to providing continued updates on our progress throughout the year.

謝謝，馬拉。最後，我對 2023 年的強勁開局感到非常高興，我們期待著持續更新我們全年的進展情況。

With that, we'll open it up for questions. Operator?

有了這個，我們將打開它來提問。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麗莎吉爾。

Jason, is it too early to start asking about the selling season? So just really 2 things I just want to understand. One, how you're thinking about the selling season; and two, the recent announcement that you made around the weight loss programs and GLP-1s starting in the back half of the year.

傑森，現在開始詢問銷售旺季是否為時過早？所以我只想了解兩件事。第一，您如何看待銷售季節；第二，你最近宣布了從今年下半年開始的減肥計劃和 GLP-1。

Can you maybe just talk about what you're seeing for early sign-ups? And you talked about the integration with other chronic programs. Maybe just what the initial expectation is as we start to think about things for the back half of '23 and going into '24.

你能不能談談你對提前註冊的看法？你談到了與其他慢性項目的整合。當我們開始考慮 23 年後半期和進入 24 年的事情時，也許正是最初的期望。

Lisa, it's never too soon to start asking about the selling season. I appreciate the question. I'll give you at least the early indications. First quarter was strong, and we're running in line to slightly ahead of our expectations so far for the year. I think a highlight is that multiproduct sales represent over 80% of the bookings in the first quarter, and I think that's really a testament to the value of the breadth of our product portfolio as well as a continued trend in the market to vendor consolidation and looking for integrated whole-person solutions and our position really at the lead of that market.

麗莎，現在開始詢問銷售旺季永遠不會太早。我很欣賞這個問題。我至少會給你早期的跡象。第一季度表現強勁，今年迄今為止我們的表現略高於我們的預期。我認為一個亮點是多產品銷售額佔第一季度預訂量的 80% 以上，我認為這確實證明了我們產品組合廣度的價值以及市場上供應商整合的持續趨勢和尋找綜合的全人解決方案和我們真正處於該市場領先地位的地位。

If I think about the pipeline, we're in a good position relative to late-stage pipeline. We frequently talk about how much -- how big is the late-stage pipeline because, obviously, those are the most developed deals, and that's up materially versus the same stage last year or the same time of year last year. So overall, we feel good about the selling season, although, of course, I'll make the caveat that it is early in the season.

如果我考慮管道，相對於後期管道，我們處於有利位置。我們經常談論有多少 - 後期管道有多大，因為顯然，這些是最發達的交易，並且與去年同期或去年同期相比大幅增加。所以總的來說，我們對銷售季節感覺良好，當然，我會警告說現在是銷售季節的早期。

With respect to the weight management program, we're excited about the continued development of provider-based care. And of course, this is an example of us really continuing on the path that we've been on, which is -- which started with mental health where we brought provider-based care together with our digital assets and then to our diabetes and hypertension programs. And now with our weight management and prediabetes programs featuring provider-based care, that sort of rounds out the portfolio of cardiometabolic solutions all integrated with our provider-based care and a full care team.

關於體重管理計劃，我們對基於提供者的護理的持續發展感到興奮。當然，這是我們真正繼續沿著我們一直走的道路前進的一個例子，那就是 - 從心理健康開始，我們將基於提供者的護理與我們的數字資產結合在一起，然後是我們的糖尿病和高血壓程式。現在，我們的體重管理和糖尿病前期計劃以提供者為基礎的護理為特色，這完善了心臟代謝解決方案的組合，所有這些都與我們基於提供者的護理和完整的護理團隊相結合。

So we're actively now in the market selling that for the 1/1/'23. Certainly, we will include it in the back half of this year as we're taking care of our members, but we haven't really gotten into the market or really it's only been a week or 2 that we've been in the market talking about it. So it's too soon to tell what kind of an impact that will have on the selling season in the back half of the year. What I will say is we don't expect it to have a material impact on revenue for this year in 2023.

所以我們現在正積極地在市場上為 1/1/'23 銷售它。當然，我們會在今年下半年將其包括在內，因為我們正在照顧我們的會員，但我們還沒有真正進入市場，或者實際上我們進入市場只有一兩週談論它。因此，現在判斷這會對下半年的銷售旺季產生什麼樣的影響還為時過早。我要說的是，我們預計它不會對 2023 年今年的收入產生重大影響。

Our next question comes from Sandy Draper of Guggenheim.

我們的下一個問題來自古根海姆的桑迪德雷珀。

Mala, probably just a financial question here. Appreciate the reiteration of the free cash flow guidance this year. But looking at the capitalized software that was greater in the first quarter, when I think about that, because you're obviously for free cash flow, it doesn't matter if it's on the income statement or the cash flow statement, does that mean you're going to end up spending less on R&D? And I'm thinking maybe that's coming from you've gotten the integrated platform. I'm just trying to think about the mechanics of what's going on operationally that's going to allow the R&D dollars to come back to start generating that leverage.

Mala，這裡可能只是一個財務問題。感謝今年重申自由現金流指導。但是看看第一季度更大的資本化軟件，當我想到這一點時，因為你顯然是為了自由現金流，所以無論是在損益表還是現金流量表上，這是否意味著您最終會減少研發支出嗎？我想這可能是因為您已經獲得了集成平台。我只是想想想運營上正在發生的事情的機制，這將使研發資金重新開始產生這種影響力。

Sandy, thank you for the question. What we have been talking about for the past few quarters is that we have been at an elevated level of spend on R&D. We have highlighted some of the important investments in R&D. Jason talked last time about the launch of one app, which is the integrated app that brings together all of our programs so that the consumer can actually see all of the services that they have access to.

桑迪，謝謝你的提問。過去幾個季度我們一直在談論的是，我們在研發方面的支出一直處於較高水平。我們強調了一些重要的研發投資。 Jason 上次談到了一個應用程序的發布，這是一個集成的應用程序，它將我們所有的程序結合在一起，這樣消費者就可以真正看到他們有權訪問的所有服務。

And I would say we are very pleased with the early read on one app. But it's -- what I would say to you is, as I look at our overall R&D spend and, therefore, CapEx spend for the year, we have said last time, Sandy, that we would expect to see absolute levels going down year-over-year this year. And the other thing I would point to is as we think about our efficiency programs, we are being judicious about our hiring, both onshore and offshore. That is also something that is contributing to the efficiency of not just our R&D spend, our overall people spend, including R&D. So those are the drivers of the dynamics of CapEx within our free cash flow.

我想說我們對一個應用程序的早期閱讀感到非常滿意。但它 - 我想對你說的是，當我查看我們的總體研發支出以及今年的資本支出支出時，我們上次說過，桑迪，我們預計今年的絕對水平會下降 -今年超過一年。我要指出的另一件事是，當我們考慮我們的效率計劃時，我們對在岸和離岸的招聘持審慎態度。這不僅有助於提高我們研發支出的效率，還有助於提高我們整體人員支出的效率，包括研發。因此，這些是我們自由現金流中資本支出動態的驅動因素。

Our next question comes from Ryan Daniels of William Blair.

我們的下一個問題來自威廉布萊爾的瑞安丹尼爾斯。

This is Jack Senft on for Ryan Daniels. Can you just remind us what you're seeing when it comes to the DTC marketing yield for BetterHelp and then kind of how that has trended as of late? And then just as a quick follow-up, do you have any update on the BetterHelp competitive environment, just given the vast amount of new entrants in the space over the past year, both within the DTC side and the B2B side? I'm just curious if you're seeing any updates on the competitive environment front and if you've noticed any consolidation or kind of what dynamics you have experienced.

這是瑞恩丹尼爾斯的傑克森夫特。您能否提醒我們您在 BetterHelp 的 DTC 營銷收益方面所看到的情況，以及最近的趨勢如何？然後，作為快速跟進，您是否對 BetterHelp 競爭環境有任何更新，考慮到過去一年該領域的大量新進入者，包括 DTC 方面和 B2B 方面？我只是想知道您是否看到競爭環境方面的任何更新，以及您是否注意到任何合併或您所經歷的某種動態。

Sure. I'll start, and then Mala can add color if there's anything I miss. With respect to the advertising market and the customer acquisition environment, we're seeing stable trends that are in line with our expectations through the first quarter. And that enabled us to continue to lean in a little bit more in the first quarter with advertising spend. Of course, we will see the benefit of that over the course of the year.

當然。我先開始，如果有什麼我想念的，Mala 可以添加顏色。關於廣告市場和客戶獲取環境，我們在第一季度看到了符合我們預期的穩定趨勢。這使我們能夠在第一季度繼續在廣告支出方面投入更多。當然，我們將在這一年中看到這樣做的好處。

In terms of the competitive environment, we don't see a significant change in the competitive environment overall. We see some competitors sort of pulling back and other new entrants coming in. But I wouldn't say that it's a more competitive environment than it has been in the past. And I think you would -- if it were, then you might see an impact on the yield to our advertising spend and specifically in the cost of advertising and customer acquisition. So the fact that those trends and the data there is stable and in line with our expectations, I think, supports our view of the competitive landscape.

在競爭環境方面，我們沒有看到整體競爭環境發生重大變化。我們看到一些競爭對手有點退縮，而其他新進入者則進來了。但我不會說現在的環境比過去更具競爭性。而且我認為你會 - 如果是的話，那麼你可能會看到對我們廣告支出收益的影響，特別是對廣告和客戶獲取成本的影響。因此，我認為，這些趨勢和數據穩定且符合我們的預期這一事實支持了我們對競爭格局的看法。

And the only other thing I would add, just to add a little bit of color. If you look at our 1Q dynamics and our revenue being ahead of expectations, Jack, the stability, the cost of customer acquisitions remaining stable so far this year, that's actually allowed us to effectively deploy a little bit more capital over the course of the quarter of driving higher member acquisitions, as we've pointed out, and driving better revenue. And we feel good about where we are ending the first quarter with a strong revenue base with that in BetterHelp.

我唯一要添加的另一件事是添加一點顏色。如果你看看我們第一季度的動態和我們的收入超出預期，傑克，穩定性，今年到目前為止客戶獲取的成本保持穩定，這實際上使我們能夠在本季度有效地部署更多的資本正如我們所指出的那樣，推動更高的會員收購，並推動更好的收入。我們對第一季度結束時在 BetterHelp 中擁有強大的收入基礎感到滿意。

Now of course, as we have pointed out before, if you think about the dynamics of the direct-to-consumer business, it is about the dynamics in the ad space, ad spend space. It is also about how consumers are feeling as we go through the year. And that will play out over the course of the year.

當然，正如我們之前指出的那樣，如果你考慮直接面向消費者業務的動態，那就是廣告空間、廣告支出空間的動態。這也關係到消費者在這一年中的感受。這將在一年中發揮作用。

Our next question comes from Stephanie Davis of SVB.

我們的下一個問題來自 SVB 的斯蒂芬妮戴維斯。

Congrats on the quarter. So this one is mainly for Mala, but Jason, I'd love if you weigh in as well. The 2Q guidance reflects effectively stable to slower growth despite a meaningfully easier comp, especially now 2 years back. Can you help us understand what's baked in the 2Q guidance and where you may be held off on baking things in following this 1Q upside? And then from a full year guidance perspective, are we thinking about any potential impact from the prediabetes weight loss product? Or is that still all upside to the range?

祝賀這個季度。所以這個主要是為 Mala 準備的，但 Jason，如果你也能參與進來，我會很高興。第二季度的指導反映了儘管比較容易的有意義的更容易的增長實際上穩定到放緩的增長，尤其是現在 2 年前。您能否幫助我們了解 2Q 指南中包含的內容以及在遵循 1Q 上行過程中您可能會在哪些方面被推遲？然後從全年指導的角度來看，我們是否在考慮糖尿病前期減肥產品的任何潛在影響？或者這仍然完全超出範圍？

Yes. As Jason pointed out a few minutes ago, Stephanie, there is nothing -- it's too -- for 2023, we won't really expect any impact on the weight loss. It is -- we just came out with the announcement last week. It's very early in the selling season. It will play out over the course of the year. And we will update you guys at the right moment accordingly when it starts accruing to a material impact, but I would not expect any impact to that for 2023 revenue, to be clear.

是的。正如傑森幾分鐘前指出的那樣，斯蒂芬妮，到 2023 年，我們真的不會期望對減肥產生任何影響。它是——我們上周剛剛發布了公告。現在是銷售旺季的早期。它將在一年中發揮作用。當它開始產生實質性影響時，我們會在適當的時候相應地更新你們，但我預計不會對 2023 年的收入產生任何影響，這是明確的。

In terms of the 2Q guidance and how we are thinking about it, what I would say is, if you think about the beat that we had in 1Q, and I decompose it into the dynamics in the Integrated Care segment as well as in BetterHelp segment, the beat we had on the Integrated Care segment, think of it as a early start on chronic care enrollment.

就第二季度的指導以及我們的思考方式而言，我想說的是，如果你考慮一下我們在第一季度的節拍，我將其分解為綜合護理部分和 BetterHelp 部分的動態，我們在綜合護理領域的表現，將其視為慢性護理註冊的早期開始。

We have seen some nice outperformance in chronic care enrollment. We've done a nice job of getting to the enrollment curves a little bit faster. We've talked about in the past how that ramps up over time, and we have gotten to a slightly faster start than expected in 1Q.

我們在長期護理註冊方面看到了一些不錯的表現。我們在更快地達到註冊曲線方面做得很好。我們過去曾討論過這種情況是如何隨著時間的推移而增加的，而且我們在第一季度的開始速度比預期的要快一些。

And so as I think about 2Q and the rest of the year, our guidance assumes that, that early start is essentially a little bit of a pull forward of enrollment than something that will result in higher ultimate enrollment rates in the rest of the quarters, right? So think of that as an early start.

因此，當我考慮第二季度和今年餘下時間時，我們的指導意見假設，提前開始本質上是對入學的一點點推動，而不是在其餘季度導致更高的最終入學率，正確的？因此，將其視為一個早期的開始。

On BetterHelp, candidly, as I just pointed out, we are pleased with the Q1 performance. We are incrementally more comfortable with the achievability of our 2023 guidance. Remember, when we gave our '23 guidance, we had talked about the impact -- the things that drive the bottom end of the guidance and the top end of the guidance. The bottom end of the guidance assumes unfavorability or a deterioration in yield. The top end assumes that there will be modest favorability in yield of ad spend.

關於 BetterHelp，坦率地說，正如我剛才指出的那樣，我們對第一季度的表現感到滿意。我們對 2023 年指南的可實現性越來越滿意。請記住，當我們給出 23 年指南時，我們已經談到了影響——推動指南底部和頂部的因素。指導的底端假設不利或收益率下降。最高端假設廣告支出的收益率會有適度的好感。

And so those dynamics continue. It just wouldn't be prudent for us to assume that we can continue to perform at this level throughout the rest of the year. So that sort of gives you a feel for what drove the 1Q beat and then how we are thinking about it in the context of 2Q and the rest of the year.

因此，這些動態仍在繼續。假設我們可以在今年餘下的時間裡繼續保持這個水平，這對我們來說是不明智的。因此，這讓您了解是什麼推動了 1Q 節拍，然後我們如何在 2Q 和今年剩餘時間的背景下考慮它。

Our next question comes from Jailendra Singh from Truist.

我們的下一個問題來自 Truist 的 Jailendra Singh。

I actually want to follow up on your comment, Mala, about chronic care business enrollment -- business coming in better than expectations. I know you're not disclosing unique chronic care enrollment anymore, but can you provide any qualitative color around trends in terms of new member enrollment versus further penetration into your existing membership base?

Mala，我實際上想跟進你關於長期護理業務註冊的評論——業務好於預期。我知道您不再披露獨特的慢性病護理註冊人數，但是您能否提供有關新會員註冊趨勢與進一步滲透現有會員基礎的任何定性顏色？

And maybe I think you have talked about this figure in the past. Like what percentage of chronic care members are utilizing multiple programs? And any particular programs or offerings did you see favorable trends in the quarter?

也許我認為你過去曾談論過這個數字。比如有多少百分比的長期護理成員正在使用多個程序？您是否在本季度看到了任何特定的計劃或產品的有利趨勢？

So if I think about the trends that we are seeing in chronic care, the percentage that are utilizing multiple chronic care programs is in the zip code, think of it as about 33% plus. And that is a significant improvement both year-over-year, Jailendra, as well as sequential improvement.

因此，如果我考慮一下我們在慢性病護理方面看到的趨勢，使用多個慢性病護理計劃的百分比在郵政編碼中，可以想像成大約 33% 以上。 Jailendra 與去年同期相比以及連續改進都是顯著的改進。

And again, as we have said before, right, that is one of the proof points for the success we've been having for the many past quarters in multiproduct bookings. We have consistently, over the last many quarters, trended over 70% in multiproduct bookings. And as Jason just talked about in 1Q, it's over 80%. So it's a proof positive of the benefit of having multiproduct bookings.

再一次，正如我們之前所說，對，這是我們在過去多個季度在多產品預訂方面取得成功的證據之一。在過去的多個季度中，我們的多產品預訂率一直保持在 70% 以上。正如傑森剛剛在第一季度談到的那樣，它超過了 80%。因此，這證明了多產品預訂的好處。

In terms of the unique enrollees, obviously, as we said last time, we won't get that out as a specific reported metric. What I will say is we are seeing growth in unique billables. That is something that we track internally. And that is definitely something that we are seeing growth in on a year-over-year basis. I won't comment more than that. We've obviously given out the program enrollment increase of 13%, but I will say that we have been seeing some nice increase in unique billables as well.

就唯一登記者而言，顯然，正如我們上次所說，我們不會將其作為特定報告指標公佈。我要說的是，我們看到了獨特賬單的增長。這是我們內部跟踪的事情。這絕對是我們看到的同比增長。我不會評論更多。我們顯然已經給出了 13% 的計劃註冊增長，但我要說的是，我們也看到了獨特的計費方面的一些不錯的增長。

Our next question comes from Daniel Grosslight of Citi.

我們的下一個問題來自花旗銀行的 Daniel Grosslight。

I want to stick with the outperformance in Integrated Care margin. I'm just curious why you're keeping the full year guidance for that segment relatively constant given the earlier-than-expected chronic care enrollment. I would assume that those members have relatively high contribution margin to the overall business, so an earlier-than-expected enrollment should flow through for the full year. Is it just conservatism? Or is there something else that I'm missing here?

我想堅持 Integrated Care 利潤率的優異表現。我只是很好奇為什麼你要保持該部分的全年指導相對穩定，因為慢性病護理入學時間早於預期。我假設這些成員對整體業務的邊際貢獻率相對較高，因此全年的註冊人數應該比預期的要早。僅僅是保守主義嗎？還是我在這裡還缺少其他東西？

So if you look at the Integrated Care segment margins, I just -- let me give you a little bit of color. First, as I said a few minutes ago, think of it, the gains we are seeing in the enrollment in 1Q and the fact that we are -- it is an early start, so we are ramping up faster. Therefore, what it means is if you think about the expectations that we have for the rest of the year, we expect those expectations continue. So I would say our expectations for the remaining quarters in terms of the enrollment curves are relatively unchanged.

因此，如果你看看綜合護理部門的利潤率，我只是 - 讓我給你一點顏色。首先，正如我幾分鐘前所說，想一想，我們在第一季度的入學人數中看到的收益以及我們的事實 - 這是一個早期的開始，所以我們正在加快速度。因此，這意味著如果你考慮我們對今年剩餘時間的期望，我們預計這些期望會繼續下去。所以我想說我們對剩餘季度的入學曲線預期相對不變。

And again, I would say at this moment, given the fact that it is still early in the year, I do believe it is prudent for us to have those assumptions baked in for the rest of the year. So how does that translate into margins? If I think about Integrated Care margins in 1Q relative to the rest of the year, 2 comments. One, it is -- Integrated Care margins in 1Q, it has a relatively easy comp compared to 1Q 2022.

再說一遍，我現在要說的是，鑑於現在還處於今年年初，我確實認為我們在今年餘下的時間裡考慮這些假設是明智的。那麼這如何轉化為利潤率呢？如果我考慮第一季度相對於今年剩餘時間的 Integrated Care 利潤率，有 2 條評論。一是——第一季度的 Integrated Care 利潤率，與 2022 年第一季度相比，它的利潤率相對較低。

And the reason for that is, one, last year, we did have some significant amount of step-up in R&D spend last year. And the second is we also did have some amount of elevated provider spend in terms of incentives because we did have a spike in respiratory volume in Q1 of last year. So we look at the 1Q margins this year. It's a relatively easy comp compared to last year's 1Q. So I'd be really careful about how we think about that as we go through the rest of the year.

原因是，第一，去年，我們去年的研發支出確實有一些顯著增加。其次，我們在激勵方面也確實增加了供應商支出，因為去年第一季度我們的呼吸量確實出現了激增。所以我們看看今年第一季度的利潤率。與去年第一季度相比，這是一個相對容易的比較。因此，在今年餘下的時間裡，我會非常小心地考慮我們如何考慮這一點。

Having said that, what I would remind you of is that if I think about how the margin for Integrated Care ramps through the year, what you should expect to see a second half is typically seasonally stronger in the year for Integrated Care margins. And that, as we've talked about before, is driven by spending ahead of new client onboarding enrollment and utilization.

話雖如此，我要提醒你的是，如果我考慮綜合護理的利潤率如何在一年中上升，你應該期望看到下半年綜合護理利潤率通常在今年季節性更強。而且，正如我們之前談到的那樣，這是由新客戶入職註冊和使用之前的支出驅動的。

So think of it as having higher costs and engagement spend, marketing spend in the beginning of the year and the first half of the year, but the revenue ramps up over the course of the year, and therefore, you should be looking at margin progression as we go through the quarters of the year.

因此，將其視為在年初和上半年有更高的成本和參與支出、營銷支出，但收入在一年中增加，因此，你應該關注利潤率的增長當我們經歷一年中的各個季度時。

Our next question comes from Richard Close of Canaccord.

我們的下一個問題來自 Canaccord 的 Richard Close。

On the provider-based programs, I was wondering if you could talk a little bit how you think about is there a notable revenue uplift in those programs compared to only digital? And how do we think about the margins of those programs?

關於基於提供商的計劃，我想知道您是否可以談談您如何看待這些計劃與僅數字計劃相比是否有顯著的收入增長？我們如何看待這些項目的利潤？

Yes, I think -- Richard, thanks for the question. I think the answer is yes to the revenue increase for 2 reasons. One, the richer the program clinically, the more engagement it's going to drive with consumers. And as a result, the greater the clinical outcomes that we can drive for our clients and, therefore, savings. So all of that comes together to translate to greater revenue opportunity for us.

是的，我想——理查德，謝謝你提出這個問題。我認為收入增長的答案是肯定的，原因有二。第一，臨床項目越豐富，它與消費者的互動就越多。因此，我們可以為客戶帶來更大的臨床結果，從而節省更多。因此，所有這些匯集在一起，為我們帶來了更大的收入機會。

The -- what I just want to be clear is that unlike some other companies in the market, we're not looking at economics out of the pharmaceuticals. So for example, if we prescribe or if one of our physicians prescribes GLP-1 for a member in our prediabetes program, we're not taking revenue from the actual prescription or the medication itself. Rather, we're driving our revenue from greater engagement among the consumers and greater clinical outcomes and, therefore, greater savings for the member.

我只是想澄清的是，與市場上的其他一些公司不同，我們不是在研究製藥業的經濟學。因此，例如，如果我們開處方或我們的一位醫生為我們糖尿病前期計劃的成員開 GLP-1，我們就不會從實際處方或藥物本身中獲取收入。相反，我們正在通過消費者之間更多的參與和更好的臨床結果來推動我們的收入，從而為會員節省更多的錢。

And margins of those offerings compared to only digital?

與僅數字產品相比，這些產品的利潤率如何？

I would say, Richard, it's a little too soon for us to talk about margins. We -- as we sell into the market and we go through the pricing across the different conversations we have, listen, I -- as I've said before, we are very disciplined as we think about the pricing. As you can tell from the way our gross margins have held up over the past year and even into 1Q, you can see the discipline that we are demonstrating in the way we manage -- we hold our gross margins. So I would say it's a little early for us to talk about gross margins. As we sell in market and as we launch, we will definitely provide updates as meaningfully relevant.

我會說，理查德，我們現在談論利潤率還為時過早。我們 - 當我們進入市場並通過我們進行的不同對話進行定價時，聽著，我 - 正如我之前所說的那樣，我們在考慮定價時非常自律。從我們過去一年甚至第一季度毛利率的保持方式可以看出，您可以看到我們在管理方式中展示的紀律——我們保持毛利率。所以我想說我們現在談論毛利率還為時過早。當我們在市場上銷售和發佈時，我們一定會提供有意義的相關更新。

I think the best sort of proof point behind our confidence in the longer-term margins is we launched provider-based care in mental health last year, middle of last year. We haven't seen any degradation there, for example. So we continue to believe that we'll be able to drive continued strong margins along with the rollout of additional provider-based care.

我認為，我們對長期利潤率充滿信心的最好證據是，我們去年年中推出了基於提供者的心理健康護理。例如，我們在那裡沒有看到任何退化。因此，我們仍然相信，隨著額外的基於提供者的護理的推出，我們將能夠推動持續強勁的利潤率。

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 the good results. So I just wanted to clarify, Mala, I think you said consistent quarter-over-quarter margin improvement throughout the course of 2023. So does that mean that we're not expecting to see that fourth quarter marketing pullback and the kind of large margin ramp in the fourth quarter?

恭喜取得好成績。所以我只是想澄清一下，Mala，我想你說的是整個 2023 年期間利潤率的季度環比持續改善。這是否意味著我們預計不會看到第四季度的營銷回調和那種大幅利潤率第四季度的增長？

And then I was just hoping you might talk a little bit about retention rates in the BetterHelp business. Did they improve markedly relative to the second half of '22? And if so, what did you guys do to improve those retention levels?

然後我只是希望你能談談 BetterHelp 業務中的保留率。相對於 22 年下半年，他們有明顯改善嗎？如果是這樣，你們做了什麼來提高這些保留水平？

So we are seeing retention levels stable. So I would say, if you think about the overall operating metrics for the BetterHelp business, Jess, I would say the word that comes to mind is stable, whether it be the dynamics we are seeing in terms of ad pricing, and that is allowing us to essentially deploy our capital more effectively and efficiently towards member acquisitions.

所以我們看到保留水平穩定。所以我想說，如果你考慮 BetterHelp 業務的整體運營指標，Jess，我會說想到的詞是穩定的，無論是我們在廣告定價方面看到的動態，這允許我們從本質上更有效地部署我們的資本用於會員收購。

The fact that member churn is stable. So there is nothing notable that we are seeing in terms of the dynamics of the business that would suggest a departure from prior quarters. Just to be very clear, what we said in our prepared remarks is we do expect to see improving margins for BetterHelp as we go through the year, sequentially as we go through the year every quarter. And the reason that we have confidence in that is, as we have talked about before, the issues that developed in the first quarter of last year are clearly behind us.

會員流失穩定的事實。因此，就業務動態而言，我們沒有看到任何值得注意的跡象表明與前幾個季度有所不同。需要明確的是，我們在準備好的評論中所說的是，我們確實希望看到 BetterHelp 的利潤率在我們度過這一年時有所提高，隨著我們每個季度經歷這一年的順序。我們對此充滿信心的原因是，正如我們之前所說，去年第一季度出現的問題顯然已經過去了。

We've been seeing more stable trends in ad pricing since, I would say, the back half of last year. And so we are also making a -- so there's that. We are also making a choice this year in terms of balancing revenue growth with profitability. And frankly, at the scale that we operate in, the BetterHelp business is over $1 billion in revenue last year. And with the channel diversity we have, we do have the ability to pull on more than a few levers in response to what we are seeing in the market.

自去年下半年以來，我們一直看到廣告定價的趨勢更加穩定。所以我們也在做一個——就是這樣。我們今年也在平衡收入增長與盈利能力方面做出選擇。坦率地說，按照我們的經營規模，BetterHelp 業務去年的收入超過 10 億美元。憑藉我們擁有的渠道多樣性，我們確實有能力利用多個槓桿來應對我們在市場上看到的情況。

So to be very clear, what we did say in our remarks is we do expect to see improvement in our margins through the year. And that includes, by the way, how we deploy our A&M, the dollars we deploy in the A&M -- the dollars we deploy quarter-by-quarter and what we are seeing in the dynamics of the market.

所以要非常清楚，我們在評論中所說的是我們確實希望看到全年的利潤率有所提高。順便說一下，這包括我們如何部署我們的 A&M，我們在 A&M 中部署的美元——我們每季度部署的美元以及我們在市場動態中看到的情況。

Which -- and to answer the last part of your question, we would expect to see a lower ad spend in the fourth quarter, reflecting the more expensive advertising market at that time of year. So we -- I think as we said last year, the seasonality last year was more typical relative to the fourth quarter spend.

哪個 - 並回答你問題的最後一部分，我們預計第四季度的廣告支出會減少，反映出一年中那個時候廣告市場更加昂貴。所以我們 - 我認為正如我們去年所說的那樣，去年的季節性相對於第四季度的支出更為典型。

Our next question comes from Sean Dodge of RBC Capital Markets.

我們的下一個問題來自 RBC Capital Markets 的 Sean Dodge。

Maybe just staying on BetterHelp. You said you spent a little bit more on marketing in Q1 than planned. As we think about the growth gains for BetterHelp over the remainder of the year, typically, how long is the lead time there between when you spend and when you begin to see some pull-through in revenue? I guess did you already begin to capture some of the benefits from this extra spending in Q1?

也許只是停留在 BetterHelp 上。你說你在第一季度的營銷支出比計劃多一點。當我們考慮 BetterHelp 在今年剩餘時間裡的增長收益時，通常情況下，從你花錢到你開始看到收入有所增加之間的準備時間有多長？我想您是否已經開始從第一季度的額外支出中獲得一些好處？

And then if we look at the quarter BetterHelp again sequentially, users there grew faster than revenue. And I was just curious, are there some like seasonal factors at play there? Or are you starting to see some kind of gravitating around some of the kind of the more lower monthly cost options there?

然後，如果我們按順序再次查看 BetterHelp 季度，那裡的用戶增長速度快於收入增長速度。我很好奇，是否有一些季節性因素在起作用？或者你是否開始看到一些更便宜的月度費用選擇？

With respect to, sorry, the first part of your question relative to BetterHelp and the lag between ad spend and revenue, it's 30 to 60 days. And so we did see some of the benefit of that in the tail end of Q1, so that's certainly true. Do you want to take the second half of that question?

抱歉，關於 BetterHelp 問題的第一部分以及廣告支出和收入之間的滯後時間，是 30 到 60 天。所以我們確實在第一季度末看到了一些好處，所以這當然是真的。你想回答這個問題的後半部分嗎？

So the dynamic you're seeing is essentially a result of the way we have talked about the spending of our marketing. We -- you saw in 4Q, we pulled back on ad spend quite significantly because that is typically the less efficient time for us to essentially spend. Consumers are distracted by other things and ad pricing is typically more expensive.

所以你看到的動態本質上是我們談論營銷支出方式的結果。我們 - 你在第四季度看到，我們大幅縮減了廣告支出，因為這通常是我們基本上花費的效率較低的時間。消費者會被其他事情分散注意力，而廣告定價通常更貴。

What we had also said when we gave guidance, if you recall, is that we are ramping our ad spend in 1Q, and we also, therefore, expected 1Q to be seasonally the lowest point from a margin perspective in the year for BetterHelp because of that. So as we have ramped up ad spend through the quarter, what you are seeing is essentially consumers, members coming on to the platform through the quarter, including right until the end of the quarter.

如果您還記得的話，我們在提供指導時還說過，我們正在增加第一季度的廣告支出，因此我們還預計，從 BetterHelp 的利潤率角度來看，第一季度將是季節性最低點，因為那。因此，隨著我們在整個季度增加廣告支出，您看到的基本上是消費者，會員在整個季度都在使用該平台，包括一直到本季度末。

And so if you think about the revenue capture from them, that will continue as we go through Q2 and the rest of the year, which is why I made the comment a few minutes ago that the exit point for 1Q and the member acquisitions that we have had in the quarter that has performed above our expectations gives us incremental confidence about revenue as we go through Q2, et cetera.

因此，如果你考慮從他們那裡獲得的收入，那將在我們經歷第二季度和今年剩餘時間時繼續下去，這就是為什麼我在幾分鐘前發表評論說第一季度的退出點和我們的會員收購本季度的表現超出了我們的預期，這讓我們在經歷第二季度時對收入更有信心，等等。

Our next question comes from Allen Lutz of Bank of America.

我們的下一個問題來自美國銀行的 Allen Lutz。

I guess one for Mala on BetterHelp. Does the guidance assume that acquisition costs remain unchanged for the rest of the year? And then I guess one for Jason, just more broadly. The consumer has been through a lot over the past year or so, inflation. There's been job cuts sort of around the board. Just curious, are you seeing any changes with the consumer today versus 3 months ago, 6 months ago? Because you've been able to grow nicely through it, I'm just curious if anything has changed over that time period.

我猜是 BetterHelp 上的 Mala。該指南是否假設購置成本在今年剩餘時間保持不變？然後我猜是給傑森的，範圍更廣。在過去一年左右的時間裡，消費者經歷了很多通貨膨脹。董事會周圍都有裁員的情況。只是好奇，您是否看到今天的消費者與 3 個月前、6 個月前相比有任何變化？因為你已經能夠通過它很好地成長，所以我很好奇那段時間是否有任何變化。

Yes. Thanks, Allen. We'll take it in order. In terms of what we are assuming for ad spend, the range that we have for growth -- for revenue growth for the full year, as we have talked about, is low to mid-teens, essentially assumes at the low end that we will see some deterioration in yields, and at the high end, that we will see some modest improvement in yields. That's the reason we have given you the range we have. Jason, do you want to take the second part?

是的。謝謝，艾倫。我們會按順序處理的。就我們對廣告支出的假設而言，正如我們所討論的那樣，我們對全年收入增長的增長范圍是低到十幾歲，基本上假設我們將在低端看到收益率有所下降，在高端，我們將看到收益率略有改善。這就是我們為您提供範圍的原因。傑森，你想參加第二部分嗎？

Yes. We haven't seen a significant change in consumer behavior. We've talked down previously about the fact that I think there are maybe competing forces with respect to the consumer. On the one hand, certainly, if the consumer is feeling pinched due to job cuts or inflation, then a $300 roughly monthly subscription can be a significant expense.

是的。我們還沒有看到消費者行為發生重大變化。我們之前已經討論過這樣一個事實，即我認為可能存在與消費者相關的競爭力量。一方面，當然，如果消費者因裁員或通貨膨脹而感到手頭拮据，那麼大約每月 300 美元的訂閱費可能是一筆不小的開支。

On the other hand, those kinds of situations increase the need for therapy and mental health care. And BetterHelp is, in many cases, a less expensive alternative. Historically, 50% of mental health care has been paid out of pocket by the consumer for all kinds of reasons in the mental health market.

另一方面，這些情況增加了對治療和心理保健的需求。在許多情況下，BetterHelp 是一種更便宜的選擇。從歷史上看，在心理健康市場上，由於各種原因，50% 的心理健康護理都是由消費者自掏腰包支付的。

And so the fact that BetterHelp at $300 a month is significantly less expensive than paying out of pocket for traditional therapy actually makes that offering more attractive. So I think those are netting out as essentially neutral. And as a result, we haven't seen significant change in the consumer behavior.

因此，每月 300 美元的 BetterHelp 比傳統療法的自付費用要便宜得多，這一事實實際上使該服務更具吸引力。所以我認為這些基本上是中立的。因此，我們沒有看到消費者行為發生重大變化。

Our next question comes from Charles Rhyee from TD Cowen.

我們的下一個問題來自 TD Cowen 的 Charles Rhyee。

This is Lucas on for Charles. On your provider-based care program, can you give us a sense of what the PMPM increase would be versus the chronic care enrollment product? And then also, can you give us any way to think about Primary360 contribution currently?

這是查爾斯的盧卡斯。在您的基於提供者的護理計劃中，您能否讓我們了解 PMPM 的增加與慢性護理登記產品的對比？然後，你能給我們任何方式來思考 Primary360 目前的貢獻嗎？

Yes. So we're not looking at significant increases in PMPMs for the provider-based care program with respect to weight management and prediabetes. We're early in the market, and so we're certainly testing that. But we feel very strongly that increased engagement and better results across our entire cardiometabolic suite drives more value for the buyer and better clinical outcomes for the consumer. And then ultimately, we'll be able to share in the improvement of that. Sorry, what was the second part of the question?

是的。因此，我們並未考慮體重管理和前驅糖尿病方面基於提供者的護理計劃的 PMPM 顯著增加。我們在市場上處於早期階段，因此我們肯定會對此進行測試。但我們非常強烈地感覺到，在我們整個心臟代謝套件中增加參與度和更好的結果會為買家帶來更多價值，並為消費者帶來更好的臨床結果。然後最終，我們將能夠分享改進的成果。抱歉，問題的第二部分是什麼？

Just on Primary360 contribution today and how that is expected to go. You talked about it tripling last quarter. Just kind of want to get an update on that.

就今天的 Primary360 貢獻以及預計的進展情況。你在上個季度談到了三倍。只是有點想了解最新情況。

Yes. We're very pleased with the progress we're making with Primary360. In fact, we're seeing our clients who have Primary360 at the core of their products outperforming the market in the open enrollment periods. And that's a great sign and a great demonstration of our partnership with those clients.

是的。我們對 Primary360 取得的進展感到非常高興。事實上，我們看到以 Primary360 為核心產品的客戶在開放註冊期間表現優於市場。這是一個很好的標誌，也是我們與這些客戶建立夥伴關係的一個很好的證明。

We're also pleased to see the revenue increase this year from P360. Obviously, it's off of a small base, but it's a meaningful step-up relative to what we saw in '22. And we're also seeing great satisfaction from consumers as well as we continue to see that about 60% of the visits from P360 members are from members who haven't seen a provider in the past 2 years.

我們也很高興看到今年 P360 帶來的收入增長。顯然，它的基礎很小，但相對於我們在 22 年看到的情況，這是一個有意義的進步。我們也看到消費者非常滿意，我們繼續看到 P360 會員中約 60% 的訪問來自過去 2 年未見過提供商的會員。

So again, we feel very good about the contribution. And as we look out into '24 and beyond, we expect that to continue to be a more and more meaningful part of our revenue.

因此，我們再次對貢獻感到非常滿意。當我們展望 24 世紀及以後，我們預計這將繼續成為我們收入中越來越有意義的一部分。

Due to time, we will take no further questions for today. So that concludes today's conference call. Thank you all for joining. You may now disconnect your lines.

由於時間關係，我們今天不再回答任何問題。今天的電話會議到此結束。謝謝大家的加入。您現在可以斷開線路。