Teladoc Health Inc (TDOC) 2023 Q2 法說會逐字稿

Hello, and welcome to the Teladoc Second Quarter '23 Earnings Conference Call. My name is Alex, and I'll be coordinating the call today. (Operator Instructions)

您好，歡迎參加 Teladoc '23 年第二季度收益電話會議。我叫亞歷克斯，今天我將協調通話。 （操作員說明）

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

現在我將把它交給東道主投資者關係主管帕特里克·菲利 (Patrick Feeley)。請繼續。

Thank you and good afternoon. Today, after the market closed, we issued a press release announcing our second quarter 2023 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 discuss our third quarter and full year 2023 outlook, and our prepared remarks will be followed by a question-and-answer session.

謝謝你，下午好。今天收盤後，我們發布新聞稿，宣布 2023 年第二季度財務業績。本新聞稿和隨附的幻燈片演示文稿可在 teladochealth.com 網站的投資者關係部分獲取。首席執行官賈森·戈雷維奇 (Jason Gorevic) 出席了此次電話會議，討論結果。和首席財務官 Mala Murthy。在本次電話會議中，我們還將討論我們的第三季度和 2023 年全年展望，我們準備好的發言之後將進行問答環節。

Please note that we will 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 業績非常重要的非 GAAP 財務指標。有關這些非公認會計準則衡量標準與最具可比性的公認會計準則衡量標準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.

另請注意，本次電話會議期間做出的某些陳述將屬於 1995 年《私人證券訴訟改革法案》所定義的前瞻性陳述。此類前瞻性陳述受到風險、不確定性和其他可能導致實際結果的因素的影響。 Teladoc Health 與本次電話會議中明示或暗示的內容存在重大差異。如需了解更多信息，請參閱我們新聞稿中的警告聲明以及我們向 SEC 提交的文件，所有這些均可在我們的網站上獲取。

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, and thanks, everyone, for joining us. This afternoon, we are pleased to report a strong second quarter with results that met or exceeded all of our financial and operating guidance. It's a reflection of the strength and stability we've seen across the business and why we're raising the low end of our revenue and adjusted EBITDA guidance for the rest of the year.

謝謝你，帕特里克，謝謝大家加入我們。今天下午，我們很高興地報告第二季度的強勁業績，其業績達到或超過了我們所有的財務和運營指導。這反映了我們在整個業務中所看到的實力和穩定性，以及為什麼我們提高了今年剩餘時間的收入低端和調整後的 EBITDA 指導。

In my remarks today, I'll start with a brief recap of the quarter. But then I'll also want to touch on some of the themes and market trends we've seen through the first half of the year from continuing economic uncertainty and the growing demand for whole-person care to the changing discussion around weight loss drugs and, of course, the explosion of interest in AI. But let's begin with Q2 results.

在今天的講話中，我將首先簡要回顧本季度的情況。但接下來我還想談談我們在今年上半年看到的一些主題和市場趨勢，從持續的經濟不確定性和對全人護理不斷增長的需求，到圍繞減肥藥物和藥物的不斷變化的討論。當然，還有人們對人工智能興趣的爆發。但讓我們從第二季度的結果開始。

Consolidated revenue grew 10% on a year-over-year basis last quarter and 4% sequentially to $652 million. Our consolidated adjusted EBITDA of $72 million exceeded the high end of our expectations. And both the Integrated Care and BetterHelp segments had a strong quarter. Revenue from our Integrated Care segment grew 5% year-over-year to $360 million. Compared to the first quarter, revenue grew 3% sequentially driven in large part by higher enrollment in our chronic care program. At the halfway point, we remain on track for our full year enrollment targets, which is one of the factors giving us the confidence to raise the bottom end of our guidance range.

上季度合併收入同比增長 10%，環比增長 4%，達到 6.52 億美元。我們的綜合調整後 EBITDA 為 7200 萬美元，超出了我們預期的上限。綜合護理和 BetterHelp 部門都有強勁的季度表現。綜合護理部門的收入同比增長 5%，達到 3.6 億美元。與第一季度相比，收入環比增長了 3%，這在很大程度上是由於我們的慢性病護理項目的註冊人數增加所致。到了一半，我們仍有望實現全年入學目標，這是讓我們有信心提高指導範圍下限的因素之一。

Within the Integrated Care segment, we're seeing growth across all our chronic care programs year-to-date. In particular, more clients are taking advantage of our digital diabetes prevention program as they expand their portfolio of solutions within our whole-person suite. Today, more than 1 in every 3 of our chronic care members is now enrolled in multiple programs. It's an example of the ongoing shift in the market towards whole-person strategies as more and more clients recognize the value and effectiveness of a holistic approach to care.

在綜合護理領域，我們看到今年迄今為止所有慢性病護理項目都在增長。特別是，越來越多的客戶正在利用我們的數字糖尿病預防計劃，因為他們在我們的全人套件中擴展了解決方案組合。如今，超過三分之一的慢性病護理人員加入了多個項目。這是市場正在向全人策略轉變的一個例子，因為越來越多的客戶認識到整體護理方法的價值和有效性。

As a company, Teladoc Health remains our industry's clear leader in this shift to a whole-person approach, and we're going to keep driving more growth, expanding our offerings and delivering exceptional value to our clients and members.

作為一家公司，Teladoc Health 仍然是我們行業向全人方法轉變的明顯領導者，我們將繼續推動更多增長，擴大我們的產品範圍，並為我們的客戶和會員提供卓越的價值。

BetterHelp also continues to set itself apart as the leading player in this category. We're happy to report strong performance in the second quarter with segment revenue growing 18% year-over-year, which was in line with our expectations. This reflects both our ability to successfully execute against our strategies and the continued demand for our mental health services.

BetterHelp 也繼續成為該類別中的領先者。我們很高興地報告第二季度的強勁業績，部門收入同比增長 18%，這符合我們的預期。這既反映了我們成功執行戰略的能力，也反映了對我們心理健康服務的持續需求。

We've also seen stable customer acquisition costs through the first half of the year. This stability, combined with consistently strong gross margin performance, meant that our margins improved significantly over Q2 last year, a result which was also consistent with our forecast.

我們還看到今年上半年的客戶獲取成本保持穩定。這種穩定性，加上持續強勁的毛利率表現，意味著我們的利潤率比去年第二季度顯著提高，這一結果也與我們的預測一致。

Consumer demand has proven resilient through the first half of the year even with the financial pressures that many households are facing. But given the uncertainty in the broader economy, we're continuing to incorporate a more cautious outlook at the low end of our guidance range. Regardless, we'll continue to provide exceptional value to our BetterHelp members.

儘管許多家庭面臨財務壓力，但今年上半年消費者需求仍表現出彈性。但考慮到更廣泛的經濟的不確定性，我們將繼續在指導範圍的低端納入更加謹慎的前景。無論如何，我們將繼續為 BetterHelp 會員提供卓越的價值。

Those are the main headlines from the quarter. Now I'll take a few minutes to talk about some of the themes we're seeing in the marketplace and what we're hearing from our clients. First, the role of virtual care continues to grow. A recent market survey commissioned by Teladoc Health tells us 3 out of every 4 employers expect to spend more on virtual care over the next 3 years. This represents significant opportunities for our business.

這些是本季度的主要頭條新聞。現在我將花幾分鐘時間談談我們在市場上看到的一些主題以及我們從客戶那裡聽到的內容。首先，虛擬護理的作用持續增長。 Teladoc Health 最近委託進行的一項市場調查告訴我們，四分之三的雇主預計在未來 3 年內在虛擬護理上花費更多。這對我們的業務來說是重大機遇。

It also validates our approach. Over half of the employers we surveyed said they plan to implement a whole-person virtual care strategy over the next 3 years as they move toward consolidating vendors. And half of the employers said they're interested in health plans that incentivize virtual care. These trends, combined with the fact that consumers are looking for more convenient and affordable options, mean that comprehensive virtual care will be the first stop for more people on their care journeys, and we'll keep leading the way.

這也驗證了我們的方法。我們調查的超過一半的雇主表示，他們計劃在未來 3 年內實施全人虛擬護理策略，以整合供應商。一半的雇主表示他們對激勵虛擬護理的健康計劃感興趣。這些趨勢，再加上消費者正在尋找更方便、更實惠的選擇，意味著全面的虛擬護理將成為更多人護理之旅的第一站，我們將繼續引領潮流。

Clients are also talking to us about the challenges of managing the cost of GLP-1 drugs. These drugs were originally designed to treat diabetes but have since been found to help patients lose weight. Employers and health plans want to meet rising consumer demand but in a way that doesn't break the bank.

客戶還與我們談論管理 GLP-1 藥物成本的挑戰。這些藥物最初設計用於治療糖尿病，但後來發現可以幫助患者減肥。雇主和健康計劃希望滿足不斷增長的消費者需求，但又不至於傾家蕩產。

Right now, roughly 4 out of every 5 of our clients believe that virtual care programs can help them manage access to these high-cost medications. As a result, we're seeing growing interest in our provider-based care programs, especially our recently announced weight management program scheduled to launch later this year. This program gives patients access to personalized care plans developed in collaboration with a Teladoc Health physician.

目前，大約五分之四的客戶認為虛擬護理計劃可以幫助他們管理這些高成本藥物的獲取。因此，我們看到人們對我們基於提供者的護理計劃越來越感興趣，特別是我們最近宣布的體重管理計劃，計劃於今年晚些時候推出。該計劃使患者能夠獲得與 Teladoc Health 醫生合作開發的個性化護理計劃。

And because we know drugs aren't enough on their own, the program is based on a broader strategy with tailored support to help patients lose weight. It's more effective and it helps our clients manage the runaway costs of GLP-1 medication.

因為我們知道藥物本身是不夠的，所以該計劃基於更廣泛的策略，並提供量身定制的支持來幫助患者減肥。它更有效，可以幫助我們的客戶管理 GLP-1 藥物的失控成本。

We also continue to hear concerns about overall economic uncertainty. As access to capital has become tighter, some start-ups are struggling and companies of all sizes are being forced to do more with less. This is yet another factor causing more clients to explore vendor consolidation because they want a strong, stable partner who can drive innovation and deliver real value over the long term. This means working with a partner that has a solid financial foundation.

我們還繼續聽到對整體經濟不確定性的擔憂。隨著獲得資金的渠道變得更加緊張，一些初創企業陷入困境，各種規模的公司都被迫以更少的資源做更多的事情。這是促使更多客戶探索供應商整合的另一個因素，因為他們需要一個強大、穩定的合作夥伴，能夠推動創新並長期提供真正的價值。這意味著與擁有堅實財務基礎的合作夥伴合作。

At Teladoc Health, we're providing high-quality care and continuing to innovate, all while generating strong free cash flow. As the health care landscape continues to evolve, we will keep making investments and leveraging technology to drive better outcomes for our members, clinicians and clients, which brings me to another key theme this year, AI.

在 Teladoc Health，我們提供高質量的護理並持續創新，同時產生強勁的自由現金流。隨著醫療保健領域的不斷發展，我們將繼續進行投資並利用技術為我們的會員、臨床醫生和客戶帶來更好的結果，這讓我想到了今年的另一個關鍵主題：人工智能。

At Teladoc Health, we use AI across our business, leveraging more than 60 proprietary AI models to strengthen our products and create a better experience for our members. For example, our proprietary virtual care queuing system allows us to facilitate tens of thousands of visits every day, connecting patients with the right providers in real time. It's a complex problem to solve at scale and one that requires taking into account provider licensing, availability, geography, specialty and patient preferences. AI is helping us to grow and become more efficient at the same time.

在 Teladoc Health，我們在整個業務中使用人工智能，利用 60 多個專有人工智能模型來增強我們的產品並為我們的會員創造更好的體驗。例如，我們專有的虛擬護理排隊系統使我們每天能夠促進數以萬計的就診，實時將患者與合適的提供者聯繫起來。這是一個需要大規模解決的複雜問題，需要考慮提供商許可、可用性、地理位置、專業和患者偏好。人工智能正在幫助我們成長，同時提高效率。

The same is true for BetterHelp. When it comes to mental health, finding the right provider can make all the difference. So we use AI to optimize member-therapist matching based on over 100 different criteria. On average, we're matching a patient with a provider every 30 seconds, something no one else in the industry can say. Besides making life better for patients and providers, it's also helping to drive our strong gross margin performance and competitive advantage.

BetterHelp 也是如此。在心理健康方面，找到合適的提供者可以發揮重要作用。因此，我們使用人工智能根據 100 多種不同的標準來優化會員與治療師的匹配。平均而言，我們每 30 秒就會為一名患者與一名醫療服務提供者進行匹配，這是業內其他人無法比擬的。除了讓患者和醫療服務提供者的生活變得更好之外，它還有助於推動我們強勁的毛利率表現和競爭優勢。

Finally, AI allows us to deliver personalized content and insights to our members, helping them change their behavior in a sustainable way. We provide customized next best actions on a massive scale, driving better outcomes at lower costs. Because if you want to have a real impact, a one-size-fits-all approach isn't good enough.

最後，人工智能使我們能夠向會員提供個性化的內容和見解，幫助他們以可持續的方式改變自己的行為。我們大規模提供定制的下一個最佳行動，以更低的成本實現更好的結果。因為如果你想產生真正的影響，一刀切的方法還不夠好。

So we're already taking advantage of AI across our business. And now we're going even further. Last week, we announced that we're expanding our partnership with Microsoft to bring Microsoft's OpenAI services and Nuance DAX capabilities on to the Teladoc platform. Our goal is to automate more of the clinical documentation during virtual exams, making visits more efficient, improving the quality of medical data and letting providers focus on what they do best, caring for patients.

因此，我們已經在整個業務中利用人工智能。現在我們更進一步。上週，我們宣布擴大與 Microsoft 的合作夥伴關係，將 Microsoft 的 OpenAI 服務和 Nuance DAX 功能引入 Teladoc 平台。我們的目標是在虛擬檢查期間實現更多臨床記錄的自動化，提高就診效率，提高醫療數據的質量，並讓提供者專注於他們最擅長的事情，照顧患者。

We're also exploring ways to use generative AI to improve the experience of our members.

我們還在探索使用生成式人工智能來改善會員體驗的方法。

So that's what we're focused on right now: expanding our competitive advantage, making our business more efficient to drive higher margins, and generating more value for our clients and our members. It puts us in a very strong position today and will allow us to keep setting the pace and delivering strong results for years to come.

這就是我們現在關注的重點：擴大我們的競爭優勢，提高我們的業務效率以提高利潤，並為我們的客戶和會員創造更多價值。它使我們今天處於非常有利的地位，並使我們能夠在未來幾年繼續引領步伐並取得強勁成果。

With that, I'll turn the call over to Mala to review the second quarter and share our forward guidance.

接下來，我將把電話轉給 Mala，回顧第二季度並分享我們的前瞻性指引。

Thank you, Jason, and good afternoon, everyone. Second quarter consolidated revenue of $652 million increased 10% year-over-year or 4% sequentially as compared to the first quarter. Second quarter adjusted EBITDA was $72 million, representing a margin of 11.1%.

謝謝杰森，大家下午好。第二季度合併收入為 6.52 億美元，同比增長 10%，環比增長 4%。第二季度調整後 EBITDA 為 7200 萬美元，利潤率為 11.1%。

Turning to segment results. Integrated Care segment revenue increased 5% year-over-year to $360 million in the quarter and grew 3% sequentially. On a year-over-year basis, Integrated Care segment revenue growth was relatively balanced across the portfolio.

轉向細分結果。本季度綜合護理部門收入同比增長 5%，達到 3.6 億美元，環比增長 3%。與去年同期相比，綜合護理部門的收入增長在整個投資組合中相對平衡。

On a sequential basis, new chronic care program enrollment growth of 45,000 was the largest driver of segment revenue growth over the first quarter. Total chronic care program enrollment was 1.07 million at the end of the second quarter, an increase of 7% year-over-year and 4% over the first quarter.

按環比計算，新的慢性病護理項目註冊人數增長了 45,000 人，是第一季度部門收入增長的最大推動力。截至第二季度末，慢性病護理項目總註冊人數為 107 萬人，同比增長 7%，環比增長 4%。

Second quarter Integrated Care adjusted EBITDA was $38 million, representing nearly 30% growth and a 200 basis point margin expansion over the prior year second quarter. The Integrated Care segment added 1 million members sequentially, ending at 85.9 million U.S. members. Average Integrated Care revenue per U.S. member of $1.41 was down $0.02 over the prior year second quarter driven by the impact of 6 million new telemedicine member additions over the last 12 months. As compared to the first quarter, average revenue per U.S. member increased $0.02.

第二季度 Integrated Care 調整後 EBITDA 為 3800 萬美元，較去年第二季度增長近 30%，利潤率擴大 200 個基點。綜合護理部門連續增加了 100 萬會員，美國會員總數達到 8590 萬。由於過去 12 個月新增 600 萬遠程醫療會員的影響，每位美國會員的平均綜合護理收入為 1.41 美元，比去年第二季度下降了 0.02 美元。與第一季度相比，每位美國會員的平均收入增加了 0.02 美元。

Turning to BetterHelp. Revenue increased 18% year-over-year to $292 million in the second quarter driven primarily by membership growth. Second quarter BetterHelp adjusted EBITDA was $34 million, resulting in a margin of 11.7%, in line with our expectations. This represents a 360 basis point increase over last year's second quarter and a 540 basis point improvement over the first quarter, a result of both a more stable customer acquisition environment and improved gross margins.

轉向 BetterHelp。第二季度收入同比增長 18% 至 2.92 億美元，這主要得益於會員數量的增長。第二季度 BetterHelp 調整後 EBITDA 為 3400 萬美元，利潤率為 11.7%，符合我們的預期。這比去年第二季度增長了 360 個基點，比第一季度提高了 540 個基點，這得益於更穩定的客戶獲取環境和毛利率的提高。

Consolidated net loss per share in the second quarter was $0.40 compared to a net loss per share of $19.22 in the second quarter of 2022. Net loss per share in the second quarter includes stock-based compensation expense of $0.34 per share, amortization of acquired intangibles of $0.32 per share and restructuring charges of $0.05 per share, primarily related to office-based rationalization. Second quarter free cash flow was $65 million compared to $48 million in the second quarter of 2022. We ended the quarter with $959 million in cash and short-term investments on the balance sheet.

第二季度合併每股淨虧損為 0.40 美元，而 2022 年第二季度每股淨虧損為 19.22 美元。第二季度每股淨虧損包括每股 0.34 美元的股票補償費用、收購無形資產攤銷每股 0.32 美元，重組費用為每股 0.05 美元，主要與辦公室合理化相關。第二季度自由現金流為 6500 萬美元，而 2022 年第二季度為 4800 萬美元。本季度末，我們資產負債表上的現金和短期投資為 9.59 億美元。

Now turning to forward guidance. For the full year, we now expect revenue to be in the range of $2.6 billion to $2.675 billion, an increase of $25 million at the low end. This outlook contemplates high single-digit percentage growth in our Integrated Care segment versus our prior expectation for mid- to high single-digit growth and low double digits to mid-teen percentage growth in our BetterHelp segment.

現在轉向前瞻性指導。我們現在預計全年收入將在 26 億美元至 26.75 億美元之間，低端增加 2500 萬美元。這一展望考慮到我們的綜合護理部門將實現高個位數百分比增長，而我們之前的預期是我們的 BetterHelp 部門將實現中高個位數增長以及低兩位數到中雙位數百分比增長。

We now expect consolidated adjusted EBITDA for the full year to be in the range of $300 million to $325 million, an increase of $15 million on the low end. We now expect full year 2023 adjusted EBITDA margins to increase approximately 75 to 125 basis points for the Integrated Care segment versus our prior expectations for flat to 50 basis points margin improvement.

我們現在預計全年綜合調整後 EBITDA 將在 3 億美元至 3.25 億美元之間，低端增加 1500 萬美元。我們現在預計綜合護理業務 2023 年全年調整後 EBITDA 利潤率將增加約 75 至 125 個基點，而我們之前的預期為持平至 50 個基點的利潤率改善。

We continue to anticipate an increase of 100 to 300 basis points for the BetterHelp segment. We now expect full year free cash flow of approximately $150 million. For the third quarter, we expect revenue of $650 million to $675 million, representing growth of 6% to 10% year-over-year. We expect adjusted EBITDA in the range of $72 million to $82 million.

我們繼續預計 BetterHelp 細分市場將增長 100 至 300 個基點。我們現在預計全年自由現金流約為 1.5 億美元。我們預計第三季度收入為 6.5 億至 6.75 億美元，同比增長 6% 至 10%。我們預計調整後 EBITDA 在 7200 萬美元至 8200 萬美元之間。

For the third quarter, we expect year-over-year revenue growth for each of the segments roughly in line with overall consolidated revenue growth. We expect Integrated Care segment margins to exceed BetterHelp segment margins in the third quarter. Finally, we expect total Integrated Care segment U.S. membership of approximately 86 million members.

對於第三季度，我們預計每個細分市場的同比收入增長與整體合併收入增長大致一致。我們預計第三季度 Integrated Care 部門的利潤率將超過 BetterHelp 部門的利潤率。最後，我們預計美國綜合護理細分市場的會員總數約為 8600 萬。

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

這樣，我會將電話轉回給傑森。

Thanks, Mala. Before we take your questions, I want to share that last week, Mala and I had the pleasure of addressing more than 200 of our key clients at our annual forum event in Boston. It was great to spend time with so many employers, health plans, hospital systems and governments from around the world. We discussed many of the themes that I just talked about, including GLP-1s, AI and how Teladoc Health is becoming the way more people get more of their care. And I was happy to see many of our clients see us not just as a vendor but as a true partner in innovation.

謝謝，馬拉。在回答您的問題之前，我想告訴大家，上週，我和 Mala 有幸在波士頓舉行的年度論壇活動中向 200 多名重要客戶發表了演講。與來自世界各地的這麼多雇主、健康計劃、醫院系統和政府共度時光真是太好了。我們討論了我剛才談到的許多主題，包括 GLP-1、人工智能以及 Teladoc Health 如何成為更多人獲得更多護理的方式。我很高興看到我們的許多客戶不僅將我們視為供應商，而且將我們視為真正的創新合作夥伴。

So I'm pleased with our first half performance and look forward to providing updates on our progress throughout the year. With that, we'll open the call for questions. Operator?

因此，我對我們上半年的表現感到滿意，並期待提供有關我們全年進展的最新信息。至此，我們將開始提問。操作員？

(Operator Instructions) Our first question for today comes from Sandy Draper of Guggenheim.

（操作員說明）我們今天的第一個問題來自古根海姆的桑迪·德雷珀（Sandy Draper）。

Congrats on a second consecutive pretty solid quarter. I guess my question, Mala, the really big change or notable change to me was your latter comment about the improvement in free cash flow now looking at $150 million versus $100 million previously. Just trying to understand what's improving because EBITDA is up a little bit but not that much. Where are the cash benefits, lower cash uses? Just trying to understand the dynamics of what's improving that because that's a 50% jump at a -- at the mid -- at simple math. So that's a pretty big improvement.

祝賀連續第二個相當穩定的季度。我想我的問題是，馬拉，對我來說真正重大的變化或顯著的變化是你後面關於自由現金流改善的評論，現在自由現金流為 1.5 億美元，而之前為 1 億美元。只是想了解哪些方面有所改善，因為 EBITDA 略有上升，但幅度不大。現金好處在哪裡，現金使用量減少？只是想了解改進的動力，因為簡單的數學計算，中間值就增加了 50%。所以這是一個相當大的改進。

Yes. Thank you, Sandy, for the question. Look, we are really pleased with our free cash flow performance of the business through the first half of the year. You're seeing that in our results. Our prior outlook, as you said, cover over $100 million of free cash flow. We have now upped it and we expect to generate over $150 million.

是的。謝謝桑迪的提問。看，我們對今年上半年的業務自由現金流表現非常滿意。您在我們的結果中看到了這一點。正如您所說，我們之前的展望覆蓋了超過 1 億美元的自由現金流。我們現在已經提高了這一目標，預計將產生超過 1.5 億美元的收入。

If I step back and talk about the drivers of it, part of that is improved visibility into the operating performance of our business. Our adjusted EBITDA guidance reflects that as well with the low end of the range up $25 million versus our initial expectations.

如果我退後一步談談其驅動因素，其中一部分是提高了我們業務運營績效的可見性。我們調整後的 EBITDA 指導也反映了這一點，與我們最初的預期相比，該範圍的低端增加了 2500 萬美元。

Part of it is also a reflection of better CapEx expectations. You'll see this quarter, for example, that our capitalized soft costs have come down by nearly $9 million quarter-over-quarter sequentially. So that improvement is in part due to completion of projects, including the launch of the unified consumer app earlier this year, and we are pleased to see that trend.

部分原因也反映了更好的資本支出預期。例如，您會看到本季度我們的資本化軟成本環比下降了近 900 萬美元。因此，這種改善部分歸功於項目的完成，包括今年早些時候推出的統一消費者應用程序，我們很高興看到這一趨勢。

And frankly, finally, free cash flow is also a little harder to predict because there is a significant timing component to it. So naturally, as we are halfway through the year, we have a little more visibility on the timing of when things may land than we did at the start of the year.

坦率地說，最後，自由現金流也有點難以預測，因為它有一個重要的時間因素。因此，很自然地，由於今年已過半，我們對事情可能發生的時間比年初有了更多的了解。

So if I were to summarize what the key drivers are of the cash flow expectations, the revised cash flow expectations, it is we are seeing better adjusted EBITDA. We are taking the lower end of the range off the table, as we've said in our guidance. We continue to see good cost control and efficiencies when it comes to capital spending. And as we move through the year, we generally have more visibility on the timing of the cash flows, especially since, as I just said, the timing component when it comes to cash flow is large.

因此，如果我要總結現金流量預期的關鍵驅動因素，即修訂後的現金流量預期，那就是我們看到了更好的調整後 EBITDA。正如我們在指導中所說，我們正在取消該範圍的下限。在資本支出方面，我們繼續看到良好的成本控制和效率。隨著這一年的推移，我們通常對現金流的時間安排有了更多的了解，特別是正如我剛才所說，現金流的時間安排很大。

And then, Sandy, I would just add, I think Mala did an excellent job of going through the drivers of our cash flow. If I step back and talk about the importance of our free cash flow, more and more, we are speaking with the CFOs of our clients who have concerns about the financial strength of their vendors and partners. And they want greater visibility into the financial stability, the free cash flow or cash drain of their partners. And it becomes a very positive discussion.

然後，桑迪，我想補充一點，我認為馬拉在分析我們現金流的驅動因素方面做得非常出色。如果我退後一步，越來越多地談論我們自由現金流的重要性，我們正在與客戶的首席財務官交談，他們擔心其供應商和合作夥伴的財務實力。他們希望更清楚地了解合作夥伴的財務穩定性、自由現金流或現金流。這成為一個非常積極的討論。

We welcome when our commercial team comes to us and says, hey, can you get on the phone with the CFO of our clients. Because when we can walk them through what our balance sheet looks like and the very strong free cash flow performance that we have, it really becomes a positive for us.

我們歡迎我們的商業團隊來找我們，說，嘿，你能和我們客戶的首席財務官通電話嗎？因為當我們可以向他們介紹我們的資產負債表以及我們擁有的非常強勁的自由現金流表現時，這對我們來說確實是一個積極的因素。

Our next question comes from Jailendra Singh of Truist Securities.

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

I actually want to go back to your comments around gross margin trends at BetterHelp. It seems like, I mean, those came in much better than expectations. Can you provide a little bit more color, the key drivers there? What specific trends outperformed compared to expectations? How do you -- how are you thinking about gross margin trends at BetterHelp for rest of the year?

我實際上想回到您在 BetterHelp 上關於毛利率趨勢的評論。我的意思是，這些結果似乎比預期要好得多。您能否提供更多一點的顏色，即那裡的關鍵驅動因素？與預期相比，哪些具體趨勢表現優於預期？您如何看待今年剩餘時間內 BetterHelp 的毛利率趨勢？

Yes, Jailendra, thank you for the question. Yes, as you said, we are seeing strong gross margin performance overall. We're seeing that across the business both on the Integrated Care side and the BetterHelp side.

是的，Jailendra，謝謝你的提問。是的，正如您所說，我們總體上看到了強勁的毛利率表現。我們在整個企業的 Integrated Care 和 BetterHelp 方面都看到了這一點。

Specific to BetterHelp, look, over the course of 2022, we talked about improvements in BetterHelp gross margins. We have done a number of things. We've actually taken a number of initiatives to improve therapist productivity, ranging from group sessions, group therapy sessions, to more digital interactions. And all of that is resulting certainly in the trends that we are seeing in our gross margin improvement for BetterHelp. I would say that's really the key driver of the gross margin expansion that we are seeing: overall therapist productivity improvements.

具體到 BetterHelp，看，在 2022 年期間，我們談到了 BetterHelp 毛利率的改善。我們已經做了很多事情。實際上，我們採取了許多舉措來提高治療師的工作效率，從小組會議、小組治療會議到更多的數字互動。所有這些肯定會導致我們看到 BetterHelp 毛利率改善的趨勢。我想說，這確實是我們所看到的毛利率擴張的關鍵驅動因素：治療師整體生產力的提高。

Our next question comes from Lisa Gill of JPMorgan.

我們的下一個問題來自摩根大通的麗莎·吉爾。

Jason, I want to go back to your comments talking about weight loss programs, and I know you spent time with your clients last week. As I think about those programs, is there an opportunity for both direct-to-consumer as well as direct to the employer? And how do you view that? So are we thinking about that as in addition to who you're adding in these chronic programs? Are we thinking of this as incremental? I know it's going to start in the third quarter, but I just want to try to frame how big a potential opportunity this could be and again just understand if there's also a direct-to-consumer opportunity here.

傑森，我想回到你關於減肥計劃的評論，我知道你上週與你的客戶共度了時光。當我思考這些計劃時，是否有直接面向消費者和直接面向雇主的機會？您對此有何看法？那麼，除了您在這些長期計劃中添加的人員之外，我們是否還考慮了這一點？我們是否認為這是增量的？我知道它將在第三季度開始，但我只是想嘗試確定這可能有多大的潛在機會，並再次了解這裡是否還有直接面向消費者的機會。

Yes. Thanks, Lisa. I appreciate the question. And certainly, the GLP-1s and weight management solutions are a hot topic right now, especially among our employer and health plan clients. Right now, we're focusing our sort of newly updated weight management program that features provider-based care on the B2B market. We're seeing significant demand from employers who are very concerned about the cost of GLP-1s.

是的。謝謝，麗莎。我很欣賞這個問題。當然，GLP-1 和體重管理解決方案是目前的熱門話題，尤其是在我們的雇主和健康計劃客戶中。目前，我們的重點是我們新近更新的體重管理計劃，該計劃的特點是在 B2B 市場上提供基於提供商的護理。我們看到非常關心 GLP-1 成本的雇主的巨大需求。

We talked to one large employer or, I guess, midsized employer of 5,000 employees who saw $100,000 increase in cost of GLP-1s in a single month. We talked to others who were seeing fourfold increase in the cost of these medications over the course of a year. And so that is very, very front and center for them in terms of their concerns relative to overall cost of care.

我們採訪了一位大型雇主，或者我猜是一家擁有 5,000 名員工的中型雇主，他們發現 GLP-1 的成本在一個月內增加了 100,000 美元。我們與其他人進行了交談，他們發現這些藥物的成本在一年內增加了四倍。因此，就他們對總體護理成本的擔憂而言，這是非常非常重要的。

Of course, they want to balance this with the benefits that can be derived from these medications in terms of weight management and certainly as they affect people living with diabetes. So today, we're very focused with those programs on our B2B market.

當然，他們希望平衡這一點與這些藥物在體重管理方面帶來的好處，當然也因為它們對糖尿病患者的影響。因此，今天，我們非常關注 B2B 市場上的這些計劃。

I would never close the door to saying that we wouldn't take something like that into a direct-to-consumer market, but we're more focused today on the B2B market. And I think you'll see the benefits of that in '24.

我永遠不會拒絕說我們不會將類似的東西帶入直接面向消費者的市場，但我們今天更關注 B2B 市場。我想你會在 24 年看到它的好處。

Our next question comes from Daniel Grosslight of Citi.

我們的下一個問題來自花旗銀行的丹尼爾·格羅斯萊特。

Congrats on the quarter. I'd like to dig in a bit more into BetterHelp guide. So at the high end of the '23 guidance, it implies a step-down in year-over-year growth from around 20% in the first half of this year to kind of 11-ish percent in the second half. Given the stability in tax, I'm curious what's causing the step-down? Is it just general conservatism given the macro backdrop? Or is there some structural change in that business that would cause that to slow to kind of the low double digits?

恭喜本季度。我想深入了解 BetterHelp 指南。因此，在 23 年指導的高端，這意味著同比增長率將從今年上半年的 20% 左右下降到下半年的 11% 左右。鑑於稅收的穩定，我很好奇是什麼導致了降稅？這是否只是宏觀背景下的普遍保守主義？或者該業務是否存在某種結構性變化，導致其增速放緩至兩位數？

Yes. Thank you, Daniel, for the question. No structural change. Let me just give you some color on the dynamics of that business. So the lower sequential growth is sort of fueled, if you will -- think of it as in part by the planned cadence of ad spend over the course of the year, which is different from last year. We have talked about that in the past few quarters, but just to put a finer point on it.

是的。謝謝丹尼爾提出的問題。沒有結構性變化。讓我簡單介紹一下該業務的動態。因此，如果你願意的話，較低的環比增長在某種程度上是受到推動的——可以將其部分歸因於全年計劃的廣告支出節奏，這與去年不同。我們在過去幾個季度已經討論過這一點，但只是為了更詳細地闡述這一點。

Last year, over half of the ads then in BetterHelp business took place in the second half of the year. This year's plan calls for the opposite with over half of the ad spend taking place in the first half. So last year's cadence looked different due to the dynamics we've talked about the experience in some of our ad channels partway through the year. So last year, we actually spent more in 3Q than we did in 2Q. And we saw that reflected in the BetterHelp margins last year, which declined over the course of 1Q to 2Q, 2Q to 3Q and then accelerated back up in 4Q.

去年，BetterHelp 業務中超過一半的廣告發生在下半年。今年的計劃則相反，一半以上的廣告支出發生在上半年。因此，去年的節奏看起來有所不同，因為我們在今年中期討論了一些廣告渠道的經驗。所以去年，我們實際上在第三季度的支出比第二季度還要多。我們看到這一點反映在去年 BetterHelp 的利潤率上，該利潤率在第一季度到第二季度、第二季度到第三季度期間有所下降，然後在第四季度加速回升。

So this year, the cadence of ad spending is more balanced across the first 3 quarters of the year in contrast to the steep ramp over the same period last year. And so if you think about what the implication of that is, what it means is the sequential revenue contribution is also going to be more balanced across the quarters than last year. So that's sort of the difference in the pacing of the ad spend in this year versus the prior year means that the revenue comps line up differently, and that is what is essentially resulting in the deceleration in the second half versus the first half.

因此，與去年同期的急劇增長相比，今年前三個季度的廣告支出節奏更加平衡。因此，如果你考慮一下這意味著什麼，這意味著各季度的連續收入貢獻也將比去年更加平衡。因此，今年廣告支出節奏與前一年的差異意味著收入構成不同，這就是導致下半年與上半年相比減速的根本原因。

Again, this is something that as we -- it's not new. We've talked about this right from the beginning of the year when we have set guidance. It's now -- it's just that we are -- you're seeing that now in the numbers as you see the first half now actualized and we are guiding to the second half.

再說一次，這對我們來說並不是什麼新鮮事。我們從今年年初制定指導方針時就已經討論過這個問題。現在——只是我們——你現在可以在數字中看到這一點，因為你看到上半年已經實現，我們正在引導下半年。

Our next question comes from Sean Dodge of RBC.

我們的下一個問題來自加拿大皇家銀行的肖恩·道奇。

Maybe just with all the recent payer commentary around growth in behavioral health utilization, Jason, are there any updates you can give us on what you're seeing with your enterprise or B2B mental health offerings? You mentioned lots of interest in whole-person care. I guess, how integral is mental health in those conversations? And then maybe anything you can share to help us size within Integrated Care, how meaningful a contributor this is, how fast it's been growing?

也許只是最近關於行為健康利用率增長的所有付款人評論，Jason，您是否可以向我們提供有關您的企業或 B2B 心理健康產品的最新情況？您提到了對全人護理的濃厚興趣。我想，心理健康在這些談話中有多重要？然後也許您可以分享任何可以幫助我們在 Integrated Care 中規模化的內容，這個貢獻者有多大意義，它的增長速度有多快？

Yes, we continue to see very strong demand for our mental health programs. I would say, in general, they are -- the demand is in concert with our other products and services. So we're now seeing and continue to see that over 3/4 of our sales are multiproduct sales, and mental health is the most frequently included sort of second product, if you will.

是的，我們繼續看到對我們的心理健康項目的非常強勁的需求。我想說，總的來說，需求與我們的其他產品和服務是一致的。因此，我們現在看到並將繼續看到，超過 3/4 的銷售額是多產品銷售，如果您願意的話，心理健康是最常包含的第二種產品。

We're seeing it as an integral part of our sales for chronic care programs, which we're very pleased with the continued growth and really strong results in our chronic care programs. We believe very strongly that that's bolstered by our strength in mental health, where we can provide a whole-person solution rather than an individual or isolated point solution.

我們將其視為慢性護理項目銷售的一個組成部分，我們對慢性護理項目的持續增長和真正強勁的業績感到非常滿意。我們堅信，這得益於我們在心理健康方面的實力，我們可以提供全人的解決方案，而不是個人或孤立的點解決方案。

We also continue to see mental health as a very important part of Primary360, which we're very pleased with the results. Obviously, it's off of a small base, but it continues to grow tremendously. So I would say very, very strong demand for mental health. It continues to be top of mind among health plans, employers and obviously as well among consumers as we see the strength in our BetterHelp business.

我們還繼續將心理健康視為 Primary360 的一個非常重要的組成部分，我們對結果非常滿意。顯然，它的基數很小，但仍在大幅增長。所以我想說，對心理健康的需求非常非常強烈。當我們看到 BetterHelp 業務的優勢時，它仍然是健康計劃、雇主以及消費者的首要考慮因素。

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。

Congratulations on the great quarter. So on the integrated weight management and diabetes solution, is there incremental price versus prior iterations of those products? And then just curious to know if you all are going to market with any kind of case studies or clinical evidence just supporting the validity of the Teladoc solution versus maybe any possible alternative.

祝賀這個偉大的季度。那麼，在體重管理和糖尿病綜合解決方案上，與這些產品的先前迭代相比，是否存在價格增量？然後只是想知道你們是否都會向市場提供任何類型的案例研究或臨床證據來支持 Teladoc 解決方案與任何可能的替代方案的有效性。

Yes. So obviously, our weight management solution that includes provider-based care is just being introduced in the third quarter. It does sell at a modest premium with the provider-based care as a component of it. Obviously, provider-based care isn't unique to our weight management solution. We had previously rolled that out as part of our diabetes and hypertension programs. And we believe very strongly that we are uniquely positioned to bring this to market in a virtual chronic care management program.

是的。顯然，我們的體重管理解決方案（包括基於提供者的護理）剛剛在第三季度推出。它確實以適度的溢價出售，其中包含基於提供者的護理。顯然，基於提供者的護理並不是我們體重管理解決方案所獨有的。我們之前已將其作為糖尿病和高血壓計劃的一部分推出。我們堅信，我們擁有獨特的優勢，可以通過虛擬慢性護理管理計劃將其推向市場。

I feel strongly that those are supporting our overall success in our selling season relative to chronic care solutions as well as the enrollment gains that we saw in the second quarter. It's early, Jess, to be able to bring clinical studies to market. Obviously, we're just launching the provider-based care and weight management in the third quarter, so we don't have results from clinical studies yet. But certainly, we always rely on measuring and demonstrating improved outcomes. And as soon as we have adequate data to be able to demonstrate that in the weight management program, we'll bring that to market as well.

我強烈認為，這些因素支持了我們在銷售季相對於慢性護理解決方案的整體成功以及我們在第二季度看到的入學人數增長。傑西，現在將臨床研究推向市場還為時過早。顯然，我們剛剛在第三季度推出基於提供者的護理和體重管理，因此我們還沒有臨床研究的結果。但當然，我們始終依賴於衡量和展示改進的結果。一旦我們有足夠的數據能夠證明體重管理計劃中的這一點，我們也會將其推向市場。

Our next question comes from Richard Close of Canaccord Genuity.

我們的下一個問題來自 Canaccord Genuity 的 Richard Close。

Congratulations on a strong quarter. I know international is a relatively small part of the business, but Jason, maybe if you can give us an update there. It looked like growth is accelerating somewhat first quarter to second quarter. Any update would be helpful.

祝賀季度表現強勁。我知道國際業務只佔業務的一小部分，但傑森，也許你能給我們介紹一下最新情況。從第一季度到第二季度，增長似乎有所加速。任何更新都會有幫助。

Yes. Richard, we're pleased with the results and the growth of our international, I would say, in -- among a number of dimensions. We're seeing strength actually selling our technology into hospitals and health systems. Overseas, we're seeing strength selling into governments, and I would specifically call out success in the U.K. as well as in Canada with respect to wins, recent wins, among nationalized health care systems. Those are relatively new for us over the last couple of years.

是的。理查德，我們對我們國際的成果和發展感到滿意，我想說的是，在許多方面。我們看到了實際將我們的技術出售給醫院和衛生系統的實力。在海外，我們看到了政府的實力，我要特別指出英國和加拿大在國有化醫療保健系統方面取得的勝利，最近的勝利。在過去的幾年裡，這些對我們來說是相對較新的。

Of course, we see a significant opportunity in the nationalized health care systems. And we've been working hard to adapt our solutions and to be able to create the right selling capabilities into those larger nationalized health care systems.

當然，我們在國有化醫療保健系統中看到了重大機遇。我們一直在努力調整我們的解決方案，並能夠在更大的國有化醫療保健系統中建立適當的銷售能力。

So across the board, I would say we feel very positive about the growth in the international arena and continue to focus our efforts and resources on taking advantage of the global opportunity, not just the domestic opportunity.

因此，總的來說，我想說，我們對國際舞台的增長感到非常積極，並將繼續集中我們的努力和資源來利用全球機遇，而不僅僅是國內機遇。

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'll say thanks to Lisa Gill for leaving me the selling season question for '24. I guess, as you guys think about the kind of the sales outlook for '24, Jason, can you talk about whether you guys are focused more on the cross-sell of products like the diabetes product and the weight management product? Or do you still kind of see an opportunity to add a lot of new lives to the Integrated Care business? I'm just kind of trying to think about how you have sales force focus thinking about '24.

我要感謝麗莎·吉爾（Lisa Gill）給我留下了 24 年銷售季節的問題。我想，當你們考慮 24 世紀的銷售前景時，Jason，您能否談談你們是否更關注糖尿病產品和體重管理產品等產品的交叉銷售？或者您仍然認為有機會為綜合護理業務增添許多新生命？我只是想思考如何讓銷售人員集中精力思考“24”。

Yes. Appreciate the question, George. I would say, generally speaking, we're pleased with the selling season through the first half. I would say we're -- it's in line to slightly ahead of our expectations for the first half of the year. I would say it's been especially strong in the health plan part of the market. And of course, the employer market tends to make decisions in the back half of the year.

是的。感謝這個問題，喬治。我想說，總的來說，我們對上半年的銷售季節感到滿意。我想說，這略高於我們對今年上半年的預期。我想說，它在市場的健康計劃部分尤其強勁。當然，雇主市場往往會在下半年做出決定。

Multiproduct sales continues to be a key with over 3/4 of our deals being multiproduct sales. We are seeing more clients go, what I would call all-in with Teladoc, where they buy our entire suite of services. And we've signed deals in the first half to bring the full suite of chronic care solutions, telemedicine, Primary360 and mental health to health plan clients.

多產品銷售仍然是關鍵，我們超過 3/4 的交易是多產品銷售。我們看到越來越多的客戶轉向 Teladoc，我稱之為“全力以赴”，他們在那裡購買我們的整套服務。我們在上半年簽署了協議，為健康計劃客戶提供全套慢性護理解決方案、遠程醫療、Primary360 和心理健康。

If I think about cross-sell versus new logos, we are certainly continuing to see our land-and-expand strategy pay dividends for us with about 75% of our bookings in the first half be cross-sell and upsell. Now upsell, of course, may be additional populations within an existing client. So that could result in additional lives. So I don't want to preclude those.

如果我考慮交叉銷售與新徽標，我們肯定會繼續看到我們的土地和擴張策略為我們帶來紅利，上半年我們約 75% 的預訂是交叉銷售和追加銷售。當然，現在追加銷售可能是現有客戶中的額外人群。這樣可能會帶來額外的生命。所以我不想排除這些。

But as I think about our overall opportunity with 85 million, 86 million members, I would say that our biggest opportunity is to continue to penetrate those populations with more products. Now having said that, over the last 12 months, we've added 6 million new members to the Integrated Care segment, which is, I would say, very strong growth.

但當我想到我們擁有 8500 萬、8600 萬會員的整體機會時，我想說我們最大的機會是繼續向這些人群提供更多產品。話雖如此，在過去 12 個月裡，我們的綜合護理細分市場增加了 600 萬新會員，我想說，這是非常強勁的增長。

Our next question comes from Charles Rhyee of TD Cowen.

我們的下一個問題來自 TD Cowen 的 Charles Rhyee。

Jason, I want to go back to the GLP-1 comment because you've mentioned your clients are struggling with sort of the cost aspect. And from what we've heard, a lot of employers are trying to put in more restrictive prior authorization requirements sort of to validate diabetes diagnosis, et cetera. Is there something that you guys in the -- where you guys deliver it that can sort of ensure that compliance so that these drugs get to appropriate patients? And is there something that you're able to deliver that's kind of unique from what having just a usual broad network of physicians in a regular health plan setting would allow for?

Jason，我想回到 GLP-1 評論，因為您提到您的客戶正在努力應對成本方面的問題。據我們所知，許多雇主正在嘗試制定更嚴格的事先授權要求，以驗證糖尿病診斷等。你們提供的藥物是否可以確保合規性，以便這些藥物到達適當的患者手中？您是否能夠提供一些與常規健康計劃環境中通常擁有廣泛的醫生網絡所允許的東西不同的東西？

Yes, Charles, I appreciate the question. And the answer is absolutely yes. Our new provider-based care programs are an evolution of our existing weight management and prediabetes solutions. Of course, those are native digital programs. And so we're adding on the provider-based care, meaning the ability to both prescribe as well as titrate those medications through a physician-based delivery mechanism and working with our existing coaches.

是的，查爾斯，我很欣賞這個問題。答案是肯定的。我們新的基於醫療服務提供者的護理計劃是我們現有體重管理和糖尿病前期解決方案的演變。當然，這些都是原生數字節目。因此，我們增加了基於提供者的護理，這意味著能夠通過基於醫生的交付機制並與我們現有的教練合作來開處方和滴定這些藥物。

So if you think about the difference between our solution and someone going to their local physician in their market, the local physician is limited to simply a prescription. We're working with our health plans and our employer clients to make sure that we are bringing the full scope of our services, the digital solutions, the coaches as well as the physicians with the goal of ensuring that the people who are appropriate and in need of these medications get them and that we're engaging them with all of those other behavior and lifestyle changes, including registered dieticians and nutritionists, including coaching relative to activity and exercise.

因此，如果您考慮一下我們的解決方案與去市場上當地醫生那裡就診的人之間的區別，就會發現當地醫生僅限於開處方。我們正在與我們的健康計劃和雇主客戶合作，以確保我們提供全方位的服務、數字解決方案、教練和醫生，目標是確保合適的人我們正在讓他們參與所有其他行為和生活方式的改變，包括註冊營養師和營養師，包括與活動和鍛煉相關的指導。

And the goal of making sure that the people who don't really need to be on them for a long term are ultimately getting the right support so that eventually they can move off of those medications and live a healthier life while at the same time maintaining a healthier weight. So from our perspective, our clients are coming to us looking for exactly that: a broader, more comprehensive solution than what they are finding in the general marketplace.

我們的目標是確保那些並不真正需要長期服用藥物的人最終得到正確的支持，以便最終他們能夠擺脫這些藥物並過上更健康的生活，同時保持更健康的體重。因此，從我們的角度來看，我們的客戶向我們尋求的正是這一點：比他們在一般市場上找到的解決方案更廣泛、更全面的解決方案。

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。

Jason, one for you. You talked a few times about some of the noise in the end market with your smaller competitors maybe not having the balance sheet and capital to give their clients comfort that they're going to be sustainable entities. I'm curious, number one, if you'll just leverage that to gain organic market share? Or number two, are there opportunities for M&A either to expand the client base or perhaps get some unique products in the market at a more favorable valuation?

傑森，給你一個。您多次談到了終端市場中的一些噪音，您的較小競爭對手可能沒有資產負債表和資本來讓他們的客戶放心，他們將成為可持續發展的實體。我很好奇，第一，你是否會利用它來獲得有機市場份額？或者第二，併購是否有機會擴大客戶群，或者以更優惠的估值在市場上獲得一些獨特的產品？

Yes. Thanks, Ryan. Certainly, we're going to leverage our financial strength for organic growth. And as I mentioned, when our clients or prospects go deep into our financials relative to those smaller competitors, there's a stark difference. And we see that resulting in decisions in our favor -- buying decisions in our favor.

是的。謝謝，瑞安。當然，我們將利用我們的財務實力實現有機增長。正如我所提到的，當我們的客戶或潛在客戶深入了解我們相對於那些規模較小的競爭對手的財務狀況時，就會發現明顯的差異。我們看到這導致了對我們有利的決定——對我們有利的購買決定。

We are certainly starting to see -- I would say finally starting to see some rationalization among private companies in terms of their valuations. And we're definitely starting to see some companies who are struggling to raise subsequent rounds of capital given the higher cost of capital and higher hurdle rates for both growth and profitability.

我們當然開始看到——我想說的是，最終開始看到私營公司的估值出現了一些合理化。由於資本成本較高，增長和盈利能力的門檻較高，我們肯定開始看到一些公司在籌集後續幾輪資金方面遇到困難。

For us, we have to make sure that those line up with strategic priorities and that there is both a strategic imperative as well as a strong financial proposition for us to move forward. We're always looking to be opportunistic in that regard and to be able to continue to expand the scope of our clinical solutions to be able to deliver on the promise of whole-person virtual care. So I would say that the current environment will likely yield benefits on both sides of that equation.

對於我們來說，我們必須確保這些與戰略優先事項保持一致，並且既具有戰略必要性，又具有強有力的財務主張來推動我們前進。我們一直在這方面尋求機會，並能夠繼續擴大我們的臨床解決方案的範圍，以便能夠兌現全人虛擬護理的承諾。所以我想說，當前的環境可能會給等式兩邊帶來好處。

Our next question comes from Scott Schoenhaus from KeyBanc.

我們的下一個問題來自 KeyBanc 的 Scott Schoenhaus。

So following up on the breakout in margins between Integrated Care and BetterHelp for 3Q, you noted that you expect Integrated Care margins to be actually above BetterHelp. Could you give us more color here? It's a pretty nice acceleration for 2Q levels. What's driving this? Is this higher PMPM associated with the accelerating chronic care and that mix shift? Or is there something else that we should be aware of?

因此，繼第三季度 Integrated Care 和 BetterHelp 之間的利潤率突破之後，您指出，您預計 Integrated Care 的利潤率實際上會高於 BetterHelp。你能給我們更多的顏色嗎？對於第二季度的水平來說，這是一個相當不錯的加速。是什麼推動了這一點？ PMPM 的升高是否與加速慢性病護理和混合轉變有關？或者還有什麼我們應該注意的嗎？

Yes. Thank you, Scott, for the question. So if I think about the margin expansion, really, it comes down to a few different drivers. One is you are certainly seeing the benefit and the flow-through of our Integrated Care revenue and particularly the chronic care revenue flow-through to our margins. So that is the first.

是的。謝謝斯科特的提問。因此，如果我考慮利潤率的擴張，實際上，這取決於幾個不同的驅動因素。一是您肯定會看到我們的綜合護理收入的好處和流動，特別是慢性護理收入流入我們的利潤。這是第一個。

The second thing is we are certainly getting some modest tailwind on the Integrated Care side from the fact that we are seeing some nice productivity gains from our employed physicians in our gross margins. So you're seeing the benefit of that.

第二件事是，我們確實在綜合護理方面獲得了一些適度的推動力，因為我們看到我們僱用的醫生在毛利率方面取得了一些不錯的生產力提高。所以你已經看到了這樣做的好處。

And then I would say we are demonstrating good cost control across the business on line items such as G&A, even technology and development spend, I would say. As we have said for the last couple of quarters, we do expect to get leverage from our T&D spend over the next several quarters. So you put all of that together, and that is what is driving our gross -- our overall margin performance.

然後我想說，我們在整個業務中展示了良好的成本控制，例如管理費用，甚至是技術和開發支出。正如我們在過去幾個季度所說的那樣，我們確實希望在未來幾個季度從輸配電支出中獲得槓桿作用。所以你把所有這些放在一起，這就是推動我們毛利率的因素——我們的整體利潤率表現。

Our next question comes from Stan Berenshteyn of Wells Fargo.

我們的下一個問題來自富國銀行的斯坦·貝倫施泰因。

Maybe swinging back to BetterHelp. Revenue grew 5% sequentially. Membership grew 2% sequentially. So just curious what drove the incremental revenue performance in excess of membership growth.

也許會回到 BetterHelp。收入環比增長 5%。會員數量環比增長 2%。所以只是好奇是什麼推動了增量收入表現超過了會員增長。

It's essentially -- it's a combination of both the user performance, as you talked about. And then it's also the -- think of it as we -- our ad spend was quite significant in the first quarter. You saw that in our first quarter results. If you think about what that yields in terms of revenue, a lot of those users coming on at the end of the quarter, the revenue realized from that really happens through the second quarter. So that is really the pickup that you are seeing in our second quarter revenue for BetterHelp.

正如您所說，它本質上是用戶性能的組合。然後，我們第一季度的廣告支出也相當可觀。您在我們第一季度的業績中看到了這一點。如果你考慮一下這會產生什麼收入，很多用戶會在季度末出現，由此實現的收入實際上會在第二季度發生。因此，這確實是您在 BetterHelp 第二季度收入中看到的回升。

Our next question comes from Kevin Caliendo from UBS.

我們的下一個問題來自瑞銀集團的 Kevin Caliendo。

I was wondering if you guys -- what you're contemplating, if anything, for the impact of student loan repayments coming back on board in October, I guess, specifically as it accounts with BetterHelp and BetterHelp volumes. Have you guys done any analysis on the overlap of people that might have to pay again and those who are your users?

我想知道你們是否正在考慮，如果有的話，對於 10 月份學生貸款償還的影響，我想，特別是因為它考慮了 BetterHelp 和 BetterHelp 數量。你們是否對可能需要再次付費的人和您的用戶的重疊進行過分析？

Yes, Kevin, I won't go into the components of our guide. I think what you heard us say relative to the overall expectations of the economic environment, we've included a range that contemplates a variety of scenarios where, I would say, a greater impact of economic factors at the lower end of our range and less of an impact at the upper end of our range. And I would put student loans into that category of overall economic factors. I don't think it's big enough to, quite frankly, be isolated as its own factor. And I wouldn't break it out as such.

是的，凱文，我不會詳細介紹我們指南的組成部分。我想你聽到我們所說的相對於經濟環境的總體預期，我們已經納入了一個考慮了各種情景的範圍，我想說的是，經濟因素對我們範圍下限的影響更大，而且影響更小。影響範圍的上限。我會將學生貸款歸入整體經濟因素的類別中。坦率地說，我認為它還不夠大，不足以作為其自身因素被孤立。我不會這樣分解它。

Our next question comes from David Larsen of BTIG.

我們的下一個問題來自 BTIG 的 David Larsen。

Congratulations on the good quarter. Just do you have any thoughts on the proposed physician fee schedule for 2024? There were a couple of things in there on telehealth. Does that matter or not, especially for your plan clients that have a large MA presence? I mean it looks fairly favorable to me. Like they're talking about potentially increasing the kinds of providers that can participate in telehealth or talking about expanding revenue or reimbursement for primary care physicians. Just any thoughts or color there would be helpful. Or does it not matter?

祝賀季度業績良好。您對 2024 年擬議的醫生費用表有何想法？其中有一些關於遠程醫療的內容。這是否重要，特別是對於擁有大量 MA 的計劃客戶？我的意思是它看起來對我相當有利。就像他們正在談論可能增加可以參與遠程醫療的提供者的種類，或者談論擴大初級保健醫生的收入或報銷一樣。只要有任何想法或顏色都會有幫助。還是沒關係？

Yes. Thanks, David. I would say, at a macro level, the trends coming out of CMS and the administration are favorable relative to virtual care. With respect to the fee schedule itself, we don't get direct reimbursement from the government on a fee-for-service basis for Medicare. So it really doesn't affect us directly.

是的。謝謝，大衛。我想說，從宏觀層面來看，CMS 和管理部門的趨勢相對於虛擬護理是有利的。就費用表本身而言，我們沒有從政府以按服務收費的方式獲得醫療保險的直接報銷。所以它確實不會直接影響我們。

We work with the health plans on MA and on managed Medicaid. And so I would say, while the overall environment is favorable for us and I would call it tailwind, those specific changes don't really have a bearing directly on our revenue.

我們與 MA 和託管醫療補助的健康計劃合作。所以我想說，雖然整體環境對我們有利，我稱之為順風，但這些具體變化並沒有真正對我們的收入產生直接影響。

Our next question comes from Elizabeth Anderson of Evercore.

我們的下一個問題來自 Evercore 的伊麗莎白·安德森。

Congrats on a nice quarter. I was wondering if you could talk a little bit about some of the productivity improvement, I think, Mala, that you mentioned. Is that sort of a result of like new initiatives that you're doing? I assume it's sort of too early for something with like the Microsoft deal that you announced. And have you thought through sort of like what would be sort of the financial benefits of that either over the next year or sort of more broadly, over the next couple of years?

恭喜您度過了一個美好的季度。我想知道您是否可以談談您提到的一些生產力提高問題，我想，馬拉。這是您正在採取的新舉措的結果嗎？我認為對於您宣布的微軟交易之類的事情來說還為時過早。您是否想過，在未來一年或更廣泛的範圍內，在未來幾年內，這樣做會帶來什麼樣的經濟效益？

Yes. Thanks for the question, Elizabeth. Look, we are continuously looking at efficiency and productivity across all of our lines, including our provider costs. When you look at things such as geography, we look at things such as how we can leverage technology. Jason talked about some of the uses of AI in his prepared remarks on how we are leveraging that for greater efficiency. As he said, we look -- we use over 16 models in AI alone already to just get more productivity. And the way it manifests is how we can do better matching of providers with our members who are seeking care, and that ultimately does result in better productivity.

是的。謝謝你的提問，伊麗莎白。看，我們一直在關注我們所有生產線的效率和生產力，包括我們的供應商成本。當你關注地理等問題時，我們也會關注諸如如何利用技術等問題。 Jason 在他準備好的關於我們如何利用人工智能來提高效率的演講中談到了人工智能的一些用途。正如他所說，我們認為，僅在人工智能領域我們就已經使用了超過 16 個模型來提高生產力。它體現的方式是我們如何更好地將提供者與正在尋求護理的會員進行匹配，這最終確實會帶來更高的生產力。

We are certainly also seeing some modest tailwind in productivity when it comes to our employee physicians. As you know, we have talked about the shift that we are making in our provider force in terms of the hybrid model between the 1099s and W-2s, and we are seeing some modest tailwind from that in terms of productivity. So it's not one initiative. It is a series of initiatives. We are continuously looking at ways to improve our margin profile.

當涉及到我們的員工醫生時，我們當然也看到了生產力的一些適度的推動力。如您所知，我們已經討論了我們在 1099 和 W-2 之間的混合模型方面正在對我們的供應商力量進行的轉變，並且我們看到了生產力方面的一些適度的推動力。所以這不是一項倡議。這是一系列舉措。我們不斷尋找改善利潤狀況的方法。

Our next question comes from Vikram Kesavabhotla from Baird.

我們的下一個問題來自貝爾德 (Baird) 的 Vikram Kesavabhotla。

I just wanted to follow up on some of the comments around the user behavior at BetterHelp. So specifically, when someone joins the platform, how long are they typically staying with the service? And when they leave, how often are they coming back? And are you seeing any changes in that behavior as the business continues to scale? And related to that, I was also curious if you could give us some color on how much BetterHelp is contributing to the total visit performance of 4.7 million.

我只是想跟進 BetterHelp 上有關用戶行為的一些評論。具體來說，當有人加入該平台時，他們通常會使用該服務多長時間？當他們離開時，他們多久回來一次？隨著業務的不斷擴大，您是否發現這種行為有任何變化？與此相關的是，我也很好奇您能否告訴我們 BetterHelp 對 470 萬總訪問量的貢獻有多大。

Yes. So Vikram, thanks for the set of questions. We haven't given specific average duration of a member or frequency of returning to the platform. What I would say is that we continue to see consistent improvements in lifetime value of a member, which incorporates customer acquisition cost, duration. And then, of course, return to platform is part of it. And then pricing is the last component. So if you wrap all of that together, we continue to see strong performance in terms of lifetime value of a member.

是的。 Vikram，謝謝你提出的一系列問題。我們沒有給出會員的具體平均時長或返回平台的頻率。我想說的是，我們繼續看到會員的終身價值不斷提高，其中包括客戶獲取成本和持續時間。當然，回歸平台也是其中的一部分。定價是最後一個組成部分。因此，如果將所有這些綜合起來，我們將繼續看到會員在終身價值方面的強勁表現。

With the -- sorry, there was a last part of the question...

抱歉，問題的最後一部分......

Volume.

體積。

Oh, the volume. We don't break out visit volume for BetterHelp. What I can tell you is that we're actually seeing, as Mala said, more digital interaction and more group therapy. So that actually serves to depress the -- what we call visits because we only count a visit if it's a live interaction with a therapist or a clinician.

哦，音量。我們沒有公佈 BetterHelp 的訪問量。我可以告訴你的是，正如馬拉所說，我們實際上看到了更多的數字互動和更多的團體治療。因此，這實際上會抑制我們所說的就診次數，因為我們只在與治療師或臨床醫生進行現場互動時才算作一次就診。

And so we've actually seen the fact that our digital interactions and group interactions are growing faster actually serves to depress the volume on the -- what we count as visits on the BetterHelp side. Now of course, that drives better gross margins for us. So we see that as a favorable trend.

因此，我們實際上看到了這樣一個事實，即我們的數字交互和群組交互增長得更快，實際上會降低我們所統計的 BetterHelp 方面的訪問量。當然，現在這為我們帶來了更好的毛利率。所以我們認為這是一個有利的趨勢。

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，今天我們不再回答任何問題。今天的電話會議到此結束。感謝大家的加入。您現在可以斷開線路。