Teladoc Health Inc (TDOC) 2024 Q1 法說會逐字稿

Good afternoon. Thank you for attending the Teladoc Health Q1 2024 Earnings Call. My name is Matt, and I'll be your moderator for today's call. (Operator Instructions)

午安.感謝您參加 Teladoc Health 2024 年第一季財報電話會議。我叫馬特，我將擔任今天電話會議的主持人。 （操作員說明）

I would now like to pass the conference over to our host, Adam Vandervoort, Chief Legal Officer, Teladoc. Adam, please go ahead.

現在我想將會議轉交給我們的東道主 Teladoc 首席法務官 Adam Vandervoort。亞當，請繼續。

Thank you, and good afternoon. Today, after the market closed, we issued a press release announcing our first quarter 2024 financial results. This press release and the accompanying slide presentation are available in the Investor Relations section of the teladochealth.com website. On this call to discuss the results are Mala Murthy, our acting Chief Executive Officer and Chief Financial Officer; and Laizer Kornwasser, our President of Enterprise Growth and Global Markets.

謝謝你，下午好。今天收盤後，我們發布新聞稿，宣布 2024 年第一季財務業績。本新聞稿和隨附的幻燈片簡報可在 teladochealth.com 網站的投資者關係部分取得。我們的代理執行長兼財務長 Mala Murthy 出席了這次電話會議，討論結果。以及我們的企業成長和全球市場總裁 Laizer Kornwasser。

During this call, we will also discuss our outlook, and our prepared remarks will be followed by a question-and-answer session. Please note that we will be discussing certain non-GAAP financial measures that we believe are important in evaluating Teladoc Health's performance.

在這次電話會議中，我們還將討論我們的前景，我們準備好的演講之後將進行問答環節。請注意，我們將討論某些我們認為對評估 Teladoc Health 績效非常重要的非 GAAP 財務指標。

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. 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.

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。另請注意，本次電話會議期間所做的某些陳述將屬於1995 年《私人證券訴訟改革法案》所定義的前瞻性陳述。的因素的影響。

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

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。我現在想把電話轉給馬拉。

Thank you, Adam, and thanks, everyone, for joining us today. Before we begin, I'd like to take a moment to reflect on the recent leadership changes at Teladoc Health. First off, on behalf of Teladoc's more than 5,000 employees, Board of Directors and executive leadership team, I would like to extend our deepest gratitude to Jason Gorevic for his accomplishments over the past 15 years. Jason leaves a tremendous legacy having firmly established Teladoc as the industry leader in whole person virtual care.

謝謝亞當，也謝謝大家今天加入我們。在開始之前，我想花點時間回顧一下 Teladoc Health 最近的領導層變動。首先，我謹代表 Teladoc 的 5,000 多名員工、董事會和執行領導團隊，對 Jason Gorevic 在過去 15 年取得的成就表示最深切的感謝。 Jason 留下了巨大的遺產，牢固地確立了 Teladoc 作為全人虛擬護理行業領導者的地位。

As we mentioned in our February earnings call, Teladoc is in a time of transition. And as part of this evolution, the Board of Directors decided that it was time to look for a new leader for our company, someone to help us write the next chapter in our growth story. The Board's search for a successor is well underway, and our permanent CEO is expected to be named later this year.

正如我們在 2 月的財報電話會議中提到的，Teladoc 正處於轉型時期。作為這一演變的一部分，董事會決定是時候為我們的公司尋找一位新的領導者，幫助我們譜寫成長故事的下一個篇章。董事會尋找繼任者的工作正在順利進行，我們的永久執行長預計將於今年稍後任命。

The Board has appointed me to serve as CEO while they conduct a search, and I'm honored to play this role for a company whose work I believe in so deeply. In the meantime, however, we are wasting no time in identifying and seizing opportunities to leverage our significant assets and capabilities. As an organization, our focus is on accelerating growth on both the top and bottom lines over the medium and longer term. And my focus as acting CEO is to ensure that our strategy continues to be supported by the appropriate level of investment, that our leadership team is executing on our priorities and that we are accelerating the pace of change and innovation across our business.

董事會任命我在他們進行搜尋期間擔任首席執行官，我很榮幸能夠為一家我深信其工作的公司擔任這一角色。但同時，我們正在抓緊時間尋找和抓住機會來利用我們的重要資產和能力。作為一個組織，我們的重點是在中長期加速收入和利潤的成長。作為代理首席執行官，我的重點是確保我們的策略繼續得到適當水平的投資的支持，確保我們的領導團隊執行我們的優先事項，並確保我們加快整個業務的變革和創新的步伐。

With that, turning now to a review of our first quarter performance. I'm pleased to report a solid start to the year across the business, exceeding our financial and operating guidance for both consolidated revenue and adjusted EBITDA in the first quarter. Our team remains laser-focused on our key initiatives, which include building upon our market leadership position, driving increased product penetration through our large installed base of over 90 million virtual care members and accelerating our bottom line performance.

現在，我們來回顧一下我們第一季的業績。我很高興地向大家報告，今年整個業務取得了良好的開局，第一季的合併收入和調整後 EBITDA 都超出了我們的財務和營運指導。我們的團隊仍然專注於我們的關鍵舉措，其中包括鞏固我們的市場領導地位，透過我們超過 9000 萬虛擬護理會員的龐大安裝基礎推動產品滲透率的提高，以及提高我們的底線績效。

This focus is evident in our first quarter results. In the Integrated Care segment, we are pleased to see continued strong interest in our whole-person care suite of products. First quarter Integrated Care revenue grew 7.8% year-over-year to $377 million, benefiting from high single-digit growth in our Chronic Care book of business, as well as strong visit revenues driven by increased infectious disease activity as well as an 8% increase in membership year-over-year.

這種關注在我們第一季的業績中顯而易見。在綜合護理領域，我們很高興看到人們對我們的全人護理產品套件持續產生濃厚興趣。第一季綜合護理收入年增 7.8% 至 3.77 億美元，受益於慢性病護理業務的高個位數增長，以及傳染病活動增加推動的強勁就診收入以及 8% 的增長會員數量逐年增加。

Chronic Care enrollment remained strong, up 9% year-over-year in the first quarter. BetterHelp revenue of $269 million declined 3.7% versus a difficult comparison in the first quarter of last year. BetterHelp also generated modestly lower revenue on a sequential basis, driven in part by a decline in paying users following our typical pullback in ad spend in the fourth quarter, which is the most expensive time of the year in our marketing channels.

慢性病護理入學人數依然強勁，第一季較去年同期成長 9%。 BetterHelp 營收為 2.69 億美元，與去年第一季相比下降了 3.7%。 BetterHelp 的營收也較上季略有下降，部分原因是第四季廣告支出典型縮減後付費用戶的下降，第四季是我們行銷管道一年中最昂貴的時期。

Additionally, as expected, the lower returns on our social media advertising spend we experienced in the second half of 2023, persisted in the first quarter and are impacting our year-over-year growth rate in the first half of this year. We are making progress to improve our yield on advertising spend which contemplates not only cost per acquisition, but also retention and other factors as well. I will speak to our efforts to reinvigorate growth in our BetterHelp business later in the call.

此外，正如預期的那樣，我們在 2023 年下半年經歷的社群媒體廣告支出回報率較低，在第一季持續存在，並影響了我們今年上半年的同比成長率。我們正在努力提高廣告支出的收益，這不僅考慮了每次獲取的成本，還考慮了保留率和其他因素。我將在稍後的電話會議中談到我們為重振 BetterHelp 業務成長所做的努力。

We continue to make progress on our bottom line performance with first quarter consolidated adjusted EBITDA margin of 9.8%, improving 140 basis points year-over-year and adjusted EBITDA of $63 million, growing nearly 20% year-over-year. We are executing against our cost savings and productivity initiatives, and we remain on track to deliver $43 million in cost savings on a GAAP basis for our business in 2024 and a total of $85 million in 2025.

我們的利潤持續取得進展，第一季綜合調整後 EBITDA 利潤率為 9.8%，年增 140 個基點，調整後 EBITDA 為 6,300 萬美元，較去年同期成長近 20%。我們正在執行我們的成本節約和生產力計劃，我們仍有望在 2024 年為我們的業務實現按 GAAP 計算的 4,300 萬美元的成本節約，並在 2025 年實現總計 8,500 萬美元的成本節約。

The breadth of our product portfolio continues to drive productive conversations with both prospective and existing clients. 2/3 of our bookings in the quarter came from cross-selling into our existing book of business, with the remaining 1/3 coming from new clients reflecting a continuation of our cross-selling momentum over the past several quarters, along with an acceleration in bookings from new business.

我們產品組合的廣度繼續推動與潛在客戶和現有客戶的富有成效的對話。本季 2/3 的訂單來自現有業務的交叉銷售，其餘 1/3 來自新客戶，反映出過去幾個季度我們交叉銷售勢頭的延續以及加速來自新業務的預訂。

Both existing and prospective clients are demonstrating increased interest in our Chronic Care Plus bundled solutions, and we remain optimistic about our ability to drive increased product penetration through our installed base of nearly 92 million members over the next several years.

現有客戶和潛在客戶都對我們的 Chronic Care Plus 捆綁解決方案表現出越來越大的興趣，我們對未來幾年透過近 9,200 萬會員的安裝基礎推動產品滲透率的能力保持樂觀。

In Q1, we saw another example of our land and expand strategy playing out as we added our diabetes program into a large health benefits provider, a client who had previously only purchased our telehealth solutions. We are also seeing growing interest in our weight management solution from employers who are grappling with rising costs for GLP-1s and employee demand for these products. The addition of approximately 2.2 million members on a sequential basis since Q4 represents additional greenfield opportunity for future cross-sell and product penetration.

在第一季度，我們看到了我們的土地和擴張策略的另一個例子，我們將糖尿病計劃添加到一家大型健康福利提供者中，該客戶之前只購買了我們的遠距醫療解決方案。我們也看到雇主對我們的體重管理解決方案越來越感興趣，他們正在努力應對 GLP-1 成本不斷上升的問題以及員工對這些產品的需求。自第四季度以來連續增加了約 220 萬會員，這為未來交叉銷售和產品滲透提供了額外的綠地機會。

And with more than $1 billion in cash and cash equivalents on our balance sheet, our financial strength continues to be another differentiator for our company and provides us with significant capacity and flexibility to invest and innovate in our business. We also continue to see growing benefits from our early and ongoing commitment to data and artificial intelligence with AI models now integrated across nearly all aspects of our business. From provider matching to enrollment optimization to member engagement, this automation is helping us not only reach our revenue and profitability goals, but also achieve our mission of improving health by reaching more consumers.

我們的資產負債表上有超過 10 億美元的現金和現金等價物，我們的財務實力仍然是我們公司的另一個優勢，並為我們的業務投資和創新提供了強大的能力和靈活性。我們也繼續看到，我們早期和持續致力於數據和人工智慧，人工智慧模型現在已整合到我們業務的幾乎所有方面，帶來了越來越多的好處。從提供者配對到註冊優化再到會員參與，這種自動化不僅幫助我們實現收入和獲利目標，而且還幫助我們實現透過接觸更多消費者來改善健康的使命。

One exciting example is our use of generative AI in member engagement to create hyper-personalized content for individuals to get them signed up for Teladoc services they need and then keep them on track. Our pilot with this AI use case while still being carefully studied, are already delivering significant improvement in member engagement over prior approaches. I would now like to spend a few minutes reviewing our first quarter financial results in detail. First quarter consolidated revenue increased 3% year-over-year to $646 million, while first quarter adjusted EBITDA was $63 million, representing a margin of 9.8%. First quarter financial performance benefited from higher revenues in our Integrated Care segment and improved expense control.

一個令人興奮的例子是，我們在會員參與中使用生成式人工智慧，為個人創建超個人化內容，讓他們註冊所需的 Teladoc 服務，然後讓他們走上正軌。我們對此人工智慧用例的試點雖然仍在仔細研究中，但與先前的方法相比，已經在會員參與度方面取得了顯著的進步。我現在想花幾分鐘詳細回顧我們第一季的財務表現。第一季合併營收年增 3%，達到 6.46 億美元，第一季調整後 EBITDA 為 6,300 萬美元，利潤率為 9.8%。第一季的財務表現得益於我們綜合護理部門收入的增加和費用控制的改善。

Turning to segment results. Integrated Care revenue increased 8% year-over-year to $377 million in the quarter, with growth relatively balanced across the portfolio. First quarter Integrated Care adjusted EBITDA was $47.7 million, representing a 260 basis point expansion in margins to 12.6%. The margin outperformance relative to guidance was largely driven by strong Chronic Care program enrollment during the first quarter, which combined with better expense control helped deliver improved gross margin and bottom line performance.

轉向細分結果。本季綜合護理收入年增 8%，達到 3.77 億美元，整個投資組合的成長相對均衡。第一季 Integrated Care 調整後 EBITDA 為 4,770 萬美元，利潤率成長 260 個基點，達到 12.6%。利潤率相對於指導價值的表現優於預期主要是由於第一季慢性病護理計畫的註冊人數強勁，再加上更好的費用控制，有助於提高毛利率和底線績效。

Total Chronic Care program enrollment was 1.12 million at the end of the first quarter, representing growth of 9% year-over-year. Total U.S. Integrated Care members grew 6.9 million over the prior year, representing 8% growth and grew by 2.2 million sequentially to 91.8 million. Average Integrated Care revenue per U.S. member of $1.38 was down $0.01 over the prior year's first quarter, reflecting the timing of new client onboarding and enrollment ramp. The onboarding of large populations and our expanding membership base represents a long runway for continued cross-selling of our chronic care and other B2B products as we execute against our land and expand strategy.

截至第一季末，慢性病護理計畫總註冊人數為 112 萬人，年增 9%。美國綜合護理會員總數比前一年增加 690 萬人，成長 8%，較上季增加 220 萬人，達 9,180 萬人。每位美國會員的平均綜合護理收入為 1.38 美元，比去年第一季下降了 0.01 美元，反映了新客戶加入和註冊人數增加的時間。隨著我們執行我們的土地和擴張策略，大量人群的加入和我們不斷擴大的會員基礎為我們的慢性護理和其他 B2B 產品的持續交叉銷售提供了一條漫長的道路。

First quarter BetterHelp segment revenue decreased 4% year-over-year to $269 million, driven by an 11% decrease in paying users. First quarter BetterHelp adjusted EBITDA was $15.5 million, representing a margin of 5.7%. As we have discussed previously, the first quarter is typically the seasonally weakest quarter from a margin perspective for our BetterHelp business 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 we expect consistent quarter-over-quarter margin improvement through the course of 2024.

第一季 BetterHelp 部門營收年減 4% 至 2.69 億美元，原因是付費用戶減少 11%。第一季 BetterHelp 調整後 EBITDA 為 1,550 萬美元，利潤率為 5.7%。正如我們之前討論的，從利潤率的角度來看，第一季通常是我們 BetterHelp 業務季節性最弱的季度，因為行銷費用在第四季度假期後增加。因此，我們仍然預計第一季將是 BetterHelp 部門利潤率的年度最低點，並且我們預計到 2024 年季度利潤率將持續改善。

Consolidated net loss per share in the first quarter was $0.49 compared to a net loss per share of $0.42 in the first quarter of 2023. Net loss per share in the first quarter includes stock-based compensation of $42.3 million or $0.25 per share, restructuring charges, primarily related to severance of $9.7 million or $0.06 per share and amortization of acquired intangibles of $64.2 million or $0.38 per share.

第一季合併每股淨虧損為 0.49 美元，而 2023 年第一季每股淨虧損為 0.42 美元。與970 萬美元或每股0.06 美元的遣散費以及6,420 萬美元或每股0.38 美元的收購無形資產攤銷有關。

During the first quarter, free cash flow was a net outflow of $27 million compared to a net outflow of $32 million in the first quarter of 2023. As a reminder, the first quarter is our seasonally lowest cash flow quarter given the payment of annual incentive compensation. We ended the quarter with $1.1 billion in cash and cash equivalents on the balance sheet.

第一季自由現金流淨流出 2,700 萬美元，而 2023 年第一季淨流出 3,200 萬美元。本季結束時，我們的資產負債表上有 11 億美元的現金和現金等價物。

Turning now to forward guidance, beginning with our Integrated Care segment. We expect Integrated Care revenue in the second quarter to be between 2% and 5% versus the prior year period. As a reminder, in our first quarter call, we called out a delay in launching our B2B consumer engagement efforts due to a technical issue in mapping new client populations.

現在轉向前瞻性指導，從我們的綜合護理部門開始。我們預計第二季綜合護理收入將比去年同期成長 2% 至 5%。提醒一下，在第一季的電話會議中，我們指出，由於繪製新客戶群時出現技術問題，我們推遲了 B2B 消費者參與工作的啟動。

With an expected cumulative negative impact of $20 million for the full year, particularly in the second and third quarters. The impact of this delay, coupled with strong year-over-year first quarter Chronic Care results and the seasonal falloff of infectious disease driven visit revenues versus the first quarter is expected to result in a lower year-over-year second quarter growth rate compared to our first quarter results.

預計全年累計負面影響為 2,000 萬美元，特別是第二季和第三季。這一延遲的影響，加上第一季度慢性病護理業績同比強勁，以及傳染病驅動的就診收入較第一季度季節性下降，預計將導致第二季度同比增長率下降。

For the full year, as previously guided, we expect Integrated Care revenues to be in the low to mid-single digits, reflecting higher revenues in the second half versus the first half of the year due primarily to the enrollment ramp in Chronic Care and a growing contribution from the nearly 6 million new Integrated Care members we have added since the second quarter of last year.

正如先前的指導，我們預計全年綜合護理收入將處於中低個位數，這反映出下半年收入高於上半年，這主要是由於慢性病護理的入學人數增加和自去年第二季度以來，我們新增的近600 萬綜合護理會員做出了不斷增長的貢獻。

From an adjusted EBITDA perspective, we expect a 12% to 14% margin in the second quarter, and we continue to expect 150 to 250 basis points of margin expansion for the full year, reflecting revenue-driven operating leverage and the impact of our cost-saving initiatives. As it relates to U.S. Integrated Care membership, we expect 92 million to 93 million members for the second quarter and 92 million to 94 million members for the full year, an increase from previous guidance after adding 2 million members in the first quarter.

從調整後的 EBITDA 角度來看，我們預計第二季度利潤率為 12% 至 14%，我們繼續預計全年利潤率擴張 150 至 250 個基點，反映了收入驅動的營運槓桿和成本的影響- 節約舉措。就美國綜合護理會員而言，我們預計第二季會員數量為 9,200 萬至 9,300 萬，全年會員數量為 9,200 萬至 9,400 萬，比第一季增加 200 萬會員後的先前指導有所增加。

Turning now to our BetterHelp segment. For the second quarter, we expect BetterHelp revenues to be in the range of a negative 8% to negative 4% over the prior year period. Our second quarter guidance reflects challenging cost per acquisition through early Q1, which caused us to pull back on our advertising dollars in the quarter in keeping with our goal of balancing growth and margin.

現在轉向我們的 BetterHelp 部分。對於第二季度，我們預計 BetterHelp 營收將比去年同期下降 8% 至 4%。我們第二季的指導反映了第一季初的每次收購成本具有挑戰性，這導致我們在本季削減廣告費用，以實現平衡成長和利潤的目標。

These factors led to a decline in users in Q1, which is impacting our Q2 revenue growth rate on top of a difficult comparison relative to the second quarter of 2023. However, we are seeing signs of stabilization in our cost per acquisition in more recent weeks, which gives us increased confidence in the back half of the year for a BetterHelp business, something I will speak to momentarily.

這些因素導致第一季用戶數量下降，除了與2023 年第二季的比較困難之外，這也影響了我們第二季的營收成長率。穩定的跡象，這讓我們對今年下半年的 BetterHelp 業務更有信心，我稍後會談到這一點。

For the full year, we continue to expect flat to low single-digit revenue growth in BetterHelp. We do expect BetterHelp growth to accelerate in the second half of the year.

就全年而言，我們繼續預期 BetterHelp 的營收成長將持平至低個位數。我們確實預計 BetterHelp 的成長將在今年下半年加速。

I'd like to take a moment to discuss what's giving us increased confidence in the future of our BetterHelp business, which has been challenged in recent quarters. Late last year, we brought in new leadership for BetterHelp, who have helped inject a broader and more global perspective on growth levers for this business. We are seeing improvements in retention and in our international business, which are helping offset some of the impact from higher CPAs in the U.S. by improving our overall yield on advertising spend. The success we are starting to see with these levers along with the efforts in select international geographies that we expect to ramp in the second half of the year, give us confidence in our second half BetterHelp outlook.

我想花點時間討論一下是什麼讓我們對 BetterHelp 業務的未來更有信心，該業務在最近幾季受到了挑戰。去年年底，我們為 BetterHelp 引入了新的領導層，他們為該業務的成長槓桿注入了更廣泛、更全球化的視角。我們看到留任率和國際業務都在改善，這有助於透過提高廣告支出的整體收益來抵消美國每次轉換費用較高的影響。我們開始看到這些槓桿所取得的成功，以及我們預計在今年下半年將在選定的國際地區做出的努力，這讓我們對下半年 BetterHelp 的前景充滿信心。

We expect these initiatives to lead to meaningfully higher membership growth and improve customer retention versus the first half. We are excited about the international opportunity, particularly in select English-speaking geographies that are relatively underpenetrated compared to the U.S. market, which will allow us to reallocate some advertising and marketing dollars at a higher marginal return as we continue to build out our infrastructure in those markets.

與上半年相比，我們預計這些措施將顯著提高會員數量並提高客戶保留率。我們對國際機會感到興奮，特別是在與美國市場相比滲透率相對較低的特定英語地區，這將使我們能夠在繼續建立我們的基礎設施的同時，以更高的邊際回報重新分配一些廣告和行銷資金。

Given these dynamics throughout the year, we expect BetterHelp revenue growth for the full year to be in the flat to low single-digit range as previously guided despite our lower first half growth. I would also note that we have thoroughly pressure tested the assumptions that underpin our BetterHelp guidance for the rest of the year. We take several factors into account when developing both the low end and the high end of the range, including recent trends in advertising yields, channel dynamics, consumer sentiment and other macro factors, and we have taken a close look at each one of these.

鑑於全年的這些動態，儘管上半年成長較低，但我們預計 BetterHelp 全年營收成長將保持在持平至低個位數的範圍內，正如先前所指導的那樣。我還要指出的是，我們已經對今年剩餘時間支撐 BetterHelp 指導的假設進行了徹底的壓力測試。在開發低端和高端產品系列時，我們會考慮多個因素，包括廣告收益、通路動態、消費者情緒和其他宏觀因素的最新趨勢，並且我們仔細研究了其中的每一個因素。

That said, the impact of difficult to predict macro events create unknowns as it pertains to our yield on advertising in the second half of the year. And we will continue to provide updates on the trends that we are seeing in upcoming earnings calls.

也就是說，難以預測的宏觀事件的影響會帶來未知因素，因為這關係到我們下半年的廣告收益。我們將繼續在即將舉行的財報電話會議中提供我們所看到的趨勢的最新資訊。

From a margin perspective, we expect BetterHelp adjusted EBITDA margins to be in the 9% to 10% range in the second quarter and continue to expect margins to be flat, plus or minus 50 basis points for the full year. The sequential margin improvements that we expect to see over the course of the year primarily reflect the cumulative effect of new members added over the course of the year, the cadence of advertising spending, including the typical seasonal pullback in the fourth quarter and innovation-driven improvements in our yield on advertising spend.

從利潤率角度來看，我們預計第二季 BetterHelp 調整後 EBITDA 利潤率將在 9% 至 10% 範圍內，並繼續預計全年利潤率將持平，上下浮動 50 個基點。我們預期全年利潤率的環比改善主要反映了年內新增會員的累積效應、廣告支出的節奏，包括第四季度典型的季節性回檔和創新驅動提高我們的廣告支出收益。

On a consolidated basis, we expect second quarter revenue of $635 million to $660 million and adjusted EBITDA of $70 million to $80 million. Our full year guidance remains unchanged with the exception of the increase to our U.S. Integrated Care membership that I had mentioned previously.

在合併基礎上，我們預計第二季營收為 6.35 億美元至 6.6 億美元，調整後 EBITDA 為 7,000 萬美元至 8,000 萬美元。除了我之前提到的美國綜合護理會員數量的增加之外，我們的全年指導保持不變。

We continue to expect consolidated revenue to be in the range of $2.635 billion to $2.735 billion for the full year, representing revenue growth of 1% to 5%, along with consolidated adjusted EBITDA of $350 million to $390 million, representing growth of 7% to 19% on a year-over-year basis. We expect full year free cash flow of $210 million to $240 million, driven by both the growth in adjusted EBITDA and an expected decline in capitalized software development costs. We are also maintaining our prior EPS guidance for the full year.

我們仍預期全年綜合營收將在 26.35 億美元至 27.35 億美元之間，即營收成長 1% 至 5%，綜合調整後 EBITDA 為 3.5 億美元至 3.9 億美元，即成長 7% 至 5%。增長19%。我們預計全年自由現金流將達到 2.1 億至 2.4 億美元，這主要得益於調整後 EBITDA 的成長和資本化軟體開發成本的預期下降。我們也維持先前的全年每股收益指引。

Lastly, we are reiterating the 3-year outlook that we provided you on our earnings call in February. In closing, I want to recognize my executive team and our broader leadership team for leaning in during this time of change. I've been incredibly pleased with their continued focus on living our values and delivering for our members and clients this year, especially over the past several weeks.

最後，我們重申我們在 2 月的財報電話會議上向您提供的 3 年展望。最後，我想感謝我的執行團隊和更廣泛的領導團隊在這個變革時期的努力。我對他們今年繼續致力於實踐我們的價值觀並為我們的會員和客戶提供服務感到非常高興，尤其是在過去的幾周里。

We've had a solid start to the year and are poised to deliver significant growth in the second half of 2024. I remain focused on our strategy, our execution and on our people.

我們今年開局良好，並準備在 2024 年下半年實現顯著成長。

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

至此，我們將開放提問。操作員？

(Operator Instructions) First question is from the line of Stephanie Davis with Barclays.

（操作員說明）第一個問題來自巴克萊銀行的史蒂芬妮戴維斯。

Mala, thank you for wearing all of the hats right now. I was hoping you could talk a little bit about some early color on the international strategy and timing for BetterHelp. Can you talk to us about the rollout, how we should be thinking about the cadence of that? And maybe if -- have you seen some of that come through already, which is giving you that confidence in that second half growth rate?

馬拉，謝謝你現在戴上所有的帽子。我希望您能談談 BetterHelp 國際戰略和時機的一些早期色彩。能和我們談談推出的情況嗎？也許，您是否已經看到其中一些已經發生，這讓您對下半年的成長率充滿信心？

Thank you, Stephanie. Yes, I'm wearing many hats, Happy to be here.

謝謝你，斯蒂芬妮。是的，我身兼數職，很高興來到這裡。

So in terms of the growth in International, as we had said on our last call, last year, international as a percentage of our total BetterHelp business was in the mid-teens. It is certainly contributing to the second half ramp of revenue this year.

因此，就國際業務的成長而言，正如我們在上次電話會議中所說，去年，國際業務在我們 BetterHelp 總業務中所佔的百分比處於十幾歲左右。這無疑對今年下半年的收入成長做出了貢獻。

Remember, this is -- it's not as if we are going into international de novo. We are already in a few markets. Several of them are English-speaking markets such as the U.K., Canada, Australia. And the plan we have is for us to continue penetrating into those markets first. And that is what is driving our confidence in the second half ramp because we have been in these markets, we know the dynamics of the BetterHelp business in this -- in these markets.

請記住，這並不是說我們要從頭開始國際化。我們已經進入了一些市場。其中一些是英語市場，例如英國、加拿大、澳大利亞。我們的計劃是首先繼續滲透到這些市場。這就是推動我們對下半年成長信心的原因，因為我們一直在這些市場中，我們知道 BetterHelp 業務在這些市場中的動態。

Based on our experience, we have knowledge of the economics of being in these markets. Obviously, as we penetrate these markets and invest more in these markets, we hope to continue to see the return on ad spend as well as the revenue growth. So the balance of both top line growth and bottom line growth that I expect to see.

根據我們的經驗，我們了解這些市場的經濟狀況。顯然，隨著我們滲透這些市場並對這些市場進行更多投資，我們希望繼續看到廣告支出的回報和收入的成長。因此，我期望看到收入成長和利潤成長的平衡。

And for like any follow-up, is there any way to compare the kind of rollout you're seeing on those international markets where you're already in them versus what we're seeing in the U.S.?

與任何後續行動一樣，是否有任何方法可以將您在已經進入的國際市場上看到的推出類型與我們在美國看到的推出類型進行比較？

Here's what I would say. I expect international to grow faster than the U.S. Certainly, that is something that we saw last year, and I do expect that to continue. From a rollout perspective, Stephanie, I would say we are going to start in the second half and roll out as we do our ad spending in these markets, as we go through the second half.

這就是我要說的。我預計國際市場的成長速度將超過美國。從推出的角度來看，史蒂芬妮，我想說我們將從下半年開始，並在下半年開始在這些市場上進行廣告支出。

The one thing I will remind you is Q4 typically in the U.S. is always the seasonally weakest quarter from an ad spending perspective, it's the quarter where we will typically pull back our ad spend. And I would say that dynamic is in the U.S. We will evaluate and assess how much of that dynamic also plays out in the international markets.

我要提醒您的一件事是，從廣告支出的角度來看，美國的第四季通常總是季節性最弱的季度，我們通常會在這個季度縮減廣告支出。我想說的是，這種動態發生在美國。

Next question is from the line of Lisa Gill with JPMorgan.

下一個問題來自摩根大通的麗莎吉爾。

Trying to understand two things. One, clearly, I understand the change in leadership and what the Board is going through. But just also curious if you're looking at any strategic changes to the business. And once again under pressure on the BetterHelp side. I just heard you talk about international. But are there things that the Board is reviewing would be my first question?

試著理解兩件事。第一，顯然，我了解領導層的變化以及董事會正在經歷的事情。但也很好奇您是否正在考慮對業務進行任何策略變革。並再次面臨 BetterHelp 方面的壓力。我剛剛聽到你談論國際。但我的第一個問題是董事會正在審查的事項是否有？

And then secondly, I just really want to understand the opportunity around that 8% membership growth, which was really strong in the quarter. We didn't see an increase in either revenue or adjusted EBITDA. Is that just timing? Is there an opportunity for cross-sell? So just really understanding how that's going to play into the numbers.

其次，我真的很想了解 8% 的會員成長帶來的機會，該成長在本季非常強勁。我們沒有看到收入或調整後 EBITDA 的成長。這只是時間安排嗎？是否有交叉銷售的機會？因此，只需真正了解這將如何影響數字。

Thanks, Lisa. Great question. So from an overall Board perspective and what might that imply for changes, obviously, as I said in our prepared remarks, right now, the focus of the leadership team, my focus and I would say the focus of the Board as well is for us to be laser heads down focused on implementing our plans, our investments, our priorities. And frankly, leading our employee base, the 5,000-plus employees we have through this period of transition and change.

謝謝，麗莎。很好的問題。因此，從董事會的整體角度來看，這可能意味著什麼變化，顯然，正如我在準備好的演講中所說，現在，領導團隊的重點，我的重點，我想說董事會的重點也是我們專注於執行我們的計劃、我們的投資和我們的優先事項。坦白說，帶領我們的 5,000 多名員工經歷了這段過渡和變革時期。

I would say also that I'm pleased with the solid start we have to the year. Hopefully, we have given you enough transparency and color as -- in our prepared remarks on what is really driving our confidence in our growth both from a top line perspective and our bottom line perspective as we roll through the year.

我還想說，我對今年的好開局感到滿意。希望我們在我們準備好的評論中為您提供了足夠的透明度和色彩，從頂線角度和底線角度，從我們全年的營收和利潤角度，真正推動我們對成長的信心。

We've kept our overall 2024 guidance as is from a revenue adjusted EBITDA and a cash flow perspective. We continue to make progress on our cost initiatives that we have talked about in February. So all of those are things that require execution, and I would say we are laser focused on that.

從收入調整後的 EBITDA 和現金流角度來看，我們維持了 2024 年的整體指引。我們在二月份討論過的成本計劃方面繼續取得進展。所以所有這些都是需要執行的事情，我想說我們非常關注這一點。

Beyond that, look, we are always looking at different parts of our business. We are looking at what top line growth they bring in and what bottom line growth they bring in. Certainly, as we said in our prepared remarks, the BetterHelp business has been challenged in recent quarters. And I would say I am focused on the execution of the various initiatives that we talked about that will give us that second half ramp, whether it be improved retention, whether it be the fact that we are driving growth in international markets and the growth in the much smaller part of BetterHelp, the BetterSleep part of that business, which is also growing nicely. All of these require execution.

除此之外，我們一直在關注業務的不同部分。我們正在研究它們帶來的營收成長和利潤成長。我想說的是，我專注於執行我們談到的各種舉措，這些舉措將為我們帶來下半年的成長，無論是提高保留率，還是我們正在推動國際市場的成長和BetterHelp 的一小部分，BetterSleep 業務的一部分，也成長良好。這些都需要執行力。

On the Integrated Care side, I would say, I'm pleased with the strong enrollment that we have started out with. Obviously, you know this, the enrollment ramps through the year. And we are certainly working through that and that is going to drive our revenue growth and our profit -- our margin expansion on the Integrated Care side as we go through the year.

在綜合護理方面，我想說，我對我們一開始的大量入學感到高興。顯然，你知道這一點，入學人數全年都在增加。我們當然正在努力解決這個問題，這將推動我們的收入成長和利潤——我們全年綜合護理的利潤率擴張。

So the answer to your question in terms of what we are evaluating and assessing is we are executing, we are focused on driving our plans for this year, and we continue to assess how the various parts of our business are doing and whether they are driving both the top line and the bottom line we seek. Beyond that, I would say there isn't really more to comment on it at this time.

因此，就我們正在評估和評估的內容而言，您的問題的答案是我們正在執行，我們專注於推動今年的計劃，並且我們將繼續評估我們業務的各個部分的表現以及它們是否正在推動我們尋求的頂線和底線。除此之外，我想說目前沒有更多可評論的。

On the second question you had around membership, here's what I would say. We certainly are pleased with the 2 million-plus member adds that we had in the quarter. Remember, the benefit we have of the membership adds is always the fact that it is the underpinning of our land and expand strategy.

關於你提出的關於會員資格的第二個問題，我要說的是。我們當然對本季新增的超過 200 萬會員感到滿意。請記住，我們從會員資格中獲得的好處始終是這樣一個事實：它是我們土地和擴張策略的基礎。

So it gives us fertile ground to continue to penetrate, cross-sell, upsell once we get these members into our fold. And as we sell in additional products, we expect to see the revenue accretion from that in the quarters ahead.

因此，一旦我們將這些成員納入我們的業務範圍，它就為我們繼續滲透、交叉銷售、追加銷售提供了肥沃的土壤。隨著我們銷售更多產品，我們預計未來幾季的收入將會增加。

The next question is from the line of Jailendra Singh with Truist.

下一個問題來自 Jailendra Singh 和 Truist 的對話。

I wanted to ask about Chronic Care program enrollment metric. I understand it was up year-over-year, but it actually declined a little over 3% sequentially. Typically, we see a pickup from Q4 to Q1 due to new contract starts and enrollment increase in the new calendar year. So can you provide some color there, Mala?

我想詢問慢性病護理計劃的入學指標。據我了解，該數字同比有所上升，但實際上環比下降了 3% 多一點。通常情況下，由於新日曆年新合約的開始和入學人數的增加，我們會看到從第四季到第一季的回升。那麼你能提供一些顏色嗎，馬拉？

And then what are your expectations around that metric as the year progresses? And more broadly, anything you can share how you're focused on improving the positioning of your business in Chronic Care longer term in market which seems to be getting very competitive?

那麼隨著時間的推移，您對該指標的期望是什麼？更廣泛地說，您可以分享一下您如何專注於提高慢性病護理業務在競爭日益激烈的市場中的長期定位嗎？

Yes. So look, I would say I expect the enrollment to ramp through the year. That is typically always the case in a traditional year and this year would be no different.

是的。所以看，我想說我預計今年的入學人數會不斷增加。傳統年份通常都是這樣，今年也不例外。

Now the one thing I would also say is, remember, we had talked about the marketing pause. In the last earnings call, we had talked about $20 million of revenue impact for this year. I would expect most of the impact of that marketing pause to be in the second and third quarters. But despite that, I would expect for our Chronic Care program enrollment to ramp up through the year, just like in prior years.

現在我還要說的一件事是，請記住，我們已經討論過行銷暫停的問題。在上次財報電話會議上，我們談到了今年 2000 萬美元的收入影響。我預計行銷暫停的大部分影響將出現在第二和第三季。但儘管如此，我預計我們的慢性病護理計劃的註冊人數將在今年有所增加，就像前幾年一樣。

Laizer, do you want to handle Jailendra's question on competitive?

Laizer，你想回答 Jailendra 關於競技的問題嗎？

Sure. When you look at what our customers and our clients are looking for, we're happy with where we are in the selling season. We're having productive conversations with both new and existing accounts, as Mala mentioned in her earlier remarks, for the quarter, 2/3 of our existing clients -- 2/3 of our growth in bookings came from existing clients and 1/3 came from new clients.

當然。當您了解我們的客戶和我們的客戶正在尋找什麼時，我們對銷售季節的情況感到滿意。我們正在與新客戶和現有客戶進行富有成效的對話，正如Mala 在先前的演講中提到的那樣，本季度我們現有客戶的2/3 - 我們預訂增長的2/3 來自現有客戶， 1/3 來自現有客戶。

I want to make sure that we highlight that we're happy with the growth in bookings not just in our domestic business, but also in our international business. And what are our clients looking for? Our clients are looking for value. They're looking for a scalable, reputable vendor that they can partner with that has a strong balance sheet that they can continue to partner with to drive value for them and for their consumers. And that hasn't changed. And I think that is feeding into our conversations with respect to our bookings.

我想確保我們強調，我們對國內業務和國際業務預訂的成長感到滿意。我們的客戶在尋找什麼？我們的客戶正在尋找價值。他們正在尋找一個可擴展、信譽良好的供應商，他們可以與之合作，擁有強大的資產負債表，他們可以繼續合作，為他們和他們的消費者創造價值。這一點沒有改變。我認為這正在融入我們有關預訂的對話中。

And then, Jailendra, just finishing up on your question around the Chronic Care enrollment. Look, this is a function of the fact that typically when we start off the year, we onboard a number of lives. And we also, at the same time, in Q1 is typically the time we would also see enrollees come on and enrollees roll off and the net impact of that is what you're seeing. I would expect as we ramp up the year, despite the marketing pause, I would expect that to continue to go on into the rest of the year.

然後，Jailendra，剛剛完成您關於慢性病護理登記的問題。看，這是因為通常當我們開始新的一年時，我們會經歷許多生活。同時，我們通常也會在第一季看到註冊者加入和註冊者退出的時間，其淨影響就是您所看到的。我預計，儘管行銷暫停，但隨著今年的成長，我預計這種情況將持續到今年剩餘時間。

Next question is from the line of Jessica Tassan with Piper Sandler.

下一個問題來自傑西卡·塔桑和派珀·桑德勒。

Mala, congrats on the good quarter and guide. I kind of -- I wanted to ask about the 3-year outlook that you all issued on the fourth quarter call and then reiterated today. So the low to mid-single-digit annual consolidated revenue growth, mid-single Integrated Care, low-single BetterHelp, is that target achievable on an organic basis?

馬拉，恭喜你的好季度和指南。我想問一下你們在第四季電話會議上發布並在今天重申的 3 年前景。那麼，低至中個位數的年度綜合收入成長、中個位數的綜合護理、低個位數的 BetterHelp，這個目標可以在有機的基礎上實現嗎？

And just maybe from an Integrated Care perspective, should we think about that growth continuing to be led by Chronic Care? And does it anticipate any new product launches? Just hoping for color around that 3-year guide.

也許從綜合護理的角度來看，我們是否應該考慮慢性病護理繼續引領這種成長？它預計會推出任何新產品嗎？只是希望三年指南能有色彩。

Yes. Thanks, Jess, for the question. Look, when we put that guide outlook out there in February, we had thought about the building blocks to those numbers, that trajectory, both on the Integrated Care side and the BetterHelp side.

是的。謝謝傑西提出的問題。聽著，當我們在二月發布該指南展望時，我們已經考慮了這些數字的組成部分，以及綜合護理方面和 BetterHelp 方面的軌跡。

So let me sort of comment on it one by one. On the Integrated Care side, I would say, as we had stated previously, think of it as a combination of low single-digit growth on the much more well-penetrated telehealth side, and I would say mid- to high single-digit growth in Chronic Care. So yes, we do expect Chronic Care momentum to help us achieve the overall mid-single-digit revenue growth for Integrated Care.

那麼就讓我來一一評論一下。在綜合護理方面，我想說，正如我們之前所說，將其視為滲透率更高的遠距醫療方面的低個位數增長的組合，我想說中高個位數增長在慢性病護理中。所以，是的，我們確實預期慢性病照護的勢頭將幫助我們實現綜合護理整體中個位數的收入成長。

On the BetterHelp side, from a revenue growth perspective, we had said low single-digit. Look, here's what I would say on the BetterHelp side. The second half ramp that we have talked about, the initiatives that we have going to help us achieve that second half ramp, again, whether it be retention, international, continued momentum on BetterSleep, these are the inputs into the low single-digit revenue growth for BetterHelp.

在 BetterHelp 方面，從收入成長的角度來看，我們說過低個位數。看，這就是我在 BetterHelp 方面要說的話。我們已經討論過下半年的成長，我們將幫助我們實現下半年成長的舉措，無論是保留率、國際化還是 BetterSleep 的持續勢頭，這些都是對低個位數收入的投入BetterHelp 的成長。

And I would say we will continue to execute against it, and we will continue to monitor it, again, assuming that we don't have something very, very unfavorable happen from a cost per acquisition perspective, which will impact our advertising yields. So assuming that we see CPAs in a reasonable range, I would say the building blocks that will help us grow in the second half will continue to be contributors into the low single-digit revenue growth for BetterHelp.

我想說，我們將繼續執行它，我們將再次繼續監控它，假設從每次獲取成本的角度來看，我們沒有發生非常非常不利的事情，這將影響我們的廣告收益。因此，假設我們看到每次轉換費用處於合理範圍內，我想說，有助於我們下半年成長的基石將繼續為 BetterHelp 的低個位數收入成長做出貢獻。

When it comes to margins, I would say the cost initiative programs that we have that will help us with OpEx leverage, along with the revenue growth that we will see on the top line, particularly on the Chronic Care side, will certainly be contributors into our margin expansion that we have put out there.

談到利潤率，我想說的是，我們擁有的成本計劃計劃將幫助我們提高營運支出槓桿率，以及我們將在營收中看到的收入增長，特別是在慢性病護理方面，肯定會為我們的利潤做出貢獻。

So what I would say in summary is we have thought of the building blocks that go into the long-term outlook. And we will continue to assess how they perform. And as I said, this year and especially in the second half, BetterHelp will give us a lot more information on that.

因此，我想說的總結是，我們已經想到了長期前景的建構模組。我們將繼續評估他們的表現。正如我所說，今年，尤其是下半年，BetterHelp 將為我們提供更多相關資訊。

Next question is from the line of Sean Dodge with RBC.

下一個問題來自 RBC 的 Sean Dodge。

Mala, you mentioned in BetterHelp with the new leadership team, having seen some improvement in subscriber retention, can you give us a sense of how long you're retaining BetterHelp users now on average? How much has that changed over the last couple of years? And then how much room and what kind of levers do you have to continue to drive improvements in that? What can you do to lengthen that?

Mala，您在 BetterHelp 中提到新領導團隊在訂閱者保留率方面取得了一些進步，您能否告訴我們您現在平均保留 BetterHelp 用戶的時間有多長？過去幾年發生了多大變化？那麼你有多少空間和什麼樣的槓桿來繼續推動這方面的改進？你能做些什麼來延長這個時間？

Yes. So we haven't given out KPIs, metrics, et cetera, specifically on retention, Sean. So I don't want to go into specific retention metrics.

是的。所以我們還沒有給出關鍵績效指標、指標等，特別是關於留任率的指標，肖恩。所以我不想討論具體的保留指標。

What I will say is the following. We are looking -- we are seeing improved member retention primarily because of the innovation that we are driving in the platform, in our user experience, frankly, with the help of AI models that are continually improving our matching of consumers with their various needs with providers.

我要說的是以下。我們正在尋找——我們看到會員保留率有所提高，主要是因為我們在平台、用戶體驗方面所推動的創新，坦白說，在人工智慧模型的幫助下，人工智慧模型不斷改善我們對消費者的各種需求的匹配。

So it's never one thing that is driving this improvement in retention, it is many things that are driving this improvement in retention. And I would say that when I talk about the new leadership at BetterHelp, one of the important things to highlight is we are looking now at pressing on more than one lever in the BetterHelp business. We are looking to beyond the traditional focus on CAC. As we've talked about, we're looking at additional geographies, how can we continue to innovate in the user experience.

因此，推動留存率提高的從來不是一件事，而是很多因素推動留存率的提高。我想說，當我談論 BetterHelp 的新領導層時，需要強調的重要事情之一是，我們現在正在考慮在 BetterHelp 業務中施加多個槓桿。我們希望超越傳統的 CAC 關注點。正如我們所討論的，我們正在尋找更多的地區，我們如何繼續在用戶體驗方面進行創新。

In some instances, and we have talked about this in the past, we're looking at small surgical targeted pricing changes, all of which, in my view, are things that will improve on our revenue growth. And it's the innovation that is helping on our improved member retention, the user retention.

在某些情況下，我們過去已經討論過這一點，我們正在考慮進行小規模的手術目標定價變化，在我看來，所有這些都將改善我們的收入成長。正是創新幫助我們提高了會員保留率和用戶保留率。

Laizer, is there anything you would like to add to that?

Laizer，您還有什麼要補充的嗎？

Yes. I guess the only thing I would add is historically, in BetterHelp, we've been very focused on the innovation on patient acquisition. And what I would tell you is, we are balancing spending time on increasing the value of that member, and I would say there's not one specific thing other than being very innovative and testing out little things that are driving value so that our return on our advertising dollars increase.

是的。我想我唯一要補充的是，從歷史上看，在 BetterHelp 中，我們一直非常關注患者獲取方面的創新。我要告訴你的是，我們正在平衡花費時間來增加該會員的價值，我想說，除了非常創新和測試推動價值的小事情之外，沒有什麼具體的事情，以便我們的回報廣告費增加。

The next question is from the line of Allen Lutz with Bank of America.

下一個問題來自美國銀行的 Allen Lutz。

Another one on BetterHelp, Mala, have you considered at all moving from just cash paid to participating in health plan networks as a way to drive growth? Is that something that you've considered? And can you kind of talk about the pros and cons of making a move like that?

BetterHelp 上的另一位女士 Mala，您是否考慮過從只支付現金轉向參與健康計劃網絡作為推動增長的一種方式？這是你考慮過的嗎？您能談談這樣做的利弊嗎？

So I would say, look, we assess various initiatives to continually innovate to drive growth both on the top line and the bottom line. At this point in time, with the scale that BetterHelp has over $1 billion in revenue, it is by far one of the largest DTC players. And look, there are other competitors in the market who have done, tried DTC, moved away to B2B, we have built scale in DTC. And I would say we will continue to focus on DTC.

所以我想說，我們評估了各種不斷創新的舉措，以推動營收和利潤的成長。目前，BetterHelp 的收入規模已超過 10 億美元，是迄今為止最大的 DTC 參與者之一。看，市場上還有其他競爭對手已經嘗試過 DTC，轉向 B2B，我們已經在 DTC 中建立了規模。我想說我們將繼續關注 DTC。

Having said that, I would also say, we are looking for ways to improve and accelerate our growth in different ways. I don't want to comment much more on specifics at this point. To the extent that there is anything relevant to update, we will absolutely do so. But we are looking at various ways to drive top line -- to accelerate our top line growth in BetterHelp.

話雖如此，我還要說，我們正在尋找以不同方式改進和加速我們成長的方法。目前我不想對具體細節發表更多評論。如果有任何相關的更新，我們絕對會這樣做。但我們正在尋找各種方法來推動收入——加速我們在 BetterHelp 中的營收成長。

The next question is from the line of Sarah James with Cantor Fitzgerald.

下一個問題來自莎拉·詹姆斯和康托·菲茨杰拉德。

Mala, I was hoping you could help us a little bit with the pacing of this year, specifically thinking of the items that you have control over, like some of the savings initiatives to get to that run rate of 43 at the end of the year and then the advertising spend. Can you help us pace through how the savings initiatives are going to play out? And then on the ad spend, is there any pull forward of that into 2Q versus your normal cadence? And are you thinking about because of the increased efficiency, just lower overall need for ad spend for the year?

Mala，我希望你能幫助我們調整今年的節奏，特別是考慮你可以控制的項目，例如一些節省舉措，以在年底達到 43 的運行率然後是廣告支出。您能幫助我們了解節約計畫將如何實施嗎？然後，在廣告支出方面，與正常節奏相比，第二季是否有任何拉動？您是否在考慮，由於效率的提高，今年廣告支出的整體需求會降低？

Yes. Thanks, Sarah, for the question. So from a pacing perspective, we would be looking for the cost initiatives. And if you think about what those -- what are underpinning those cost initiatives, things like offshoring, things like automation, savings from our third-party supplier spend. Several of those are initiatives that are evenly paced through the year.

是的。謝謝莎拉提出的問題。因此，從節奏的角度來看，我們將尋找成本舉措。如果你想想這些成本計畫的基礎是什麼，例如離岸外包、自動化、我們第三方供應商支出的節省。其中一些舉措是全年均勻推進的舉措。

Now obviously, if you think about something like offshoring and as we offshore, you will get the incremental impact, the full impact of the offshoring as we go later into the year. But I would say to you several of the others, like third-party supplier spend, et cetera, you will see sort of evenly pace through the year.

顯然，如果你考慮離岸外包之類的事情，當我們離岸時，你會得到漸進的影響，當我們進入今年晚些時候時，離岸外包的全面影響。但我想對你說的是其他幾個，例如第三方供應商支出等等，你會看到全年的成長速度是均勻的。

On your question on ad spend, the way I would think about it is as follows: in Q1 and especially early in Q1, we did see pressure on our advertising yield. We did see pressure on our cost per acquisition. And we did pull back on our ad spend as we sort of rolled through Q1.

關於你關於廣告支出的問題，我的思考方式如下：在第一季度，尤其是第一季度初期，我們確實看到了廣告收益的壓力。我們確實看到了每次收購成本的壓力。當我們進入第一季時，我們確實減少了廣告支出。

And I would say as we went later into Q1 and into Q2, we are seeing more stable ad spend -- yield on our ad spend. When I say stable, it's -- the CPA still remain elevated relative to the back half of the -- similar to the back half of last year. But I would say to you that they are -- they have stabilized relative to the early part of Q1.

我想說，當我們進入第一季和第二季時，我們看到廣告支出更加穩定——廣告支出的收益率。當我說穩定時，每次轉換費用相對於下半年仍然保持在較高水平，與去年下半年相似。但我想說的是，相對於第一季初期，它們已經穩定下來。

Having said that, I am not satisfied with our BetterHelp segment margins in the first quarter. And so one of the things we are assessing is how do we manage the ad spend in Q2 so that we are getting the balance of top line and bottom line that we are seeking.

話雖如此，我對第一季 BetterHelp 部門的利潤率並不滿意。因此，我們正在評估的事情之一是我們如何管理第二季的廣告支出，以便我們可以實現我們所尋求的頂線和底線的平衡。

And we have said this before. That is something that is very dynamic, right? Because we manage the BetterHelp business based on ROIs. We want to make sure that the marginal return on every dollar of spend is getting to the efficiencies we speak and sort of we toggle that to get to the balance of top line and bottom line.

我們之前已經說過這​​一點。這是非常有活力的事情，對嗎？因為我們根據投資回報率來管理 BetterHelp 業務。我們希望確保每一美元支出的邊際回報達到我們所說的效率，並且我們會進行切換以達到頂線和底線的平衡。

If I think about the second half, I would say we are looking to pull back in Q4 as we typically do. And we would be looking to spend a little bit more on ad spend relative to the second quarter, provided again that we see the -- we get to the efficiencies, we see -- we seek.

如果我考慮下半年，我會說我們希望像往常一樣在第四季度有所回落。相對於第二季度，我們希望在廣告支出上多花一點錢，前提是我們再次看到我們所尋求的效率。

And then the last point I would make is, remember, international typically is slightly more efficient from an ad yield perspective. So as we roll out international in the second half, I would expect to see that spend on international market being more efficient.

我要說的最後一點是，請記住，從廣告收益的角度來看，國際通常會稍微更有效率。因此，當我們在下半年推出國際業務時，我希望看到國際市場的支出更有效率。

Next question is from the line of Kevin Caliendo with UBS.

下一個問題來自瑞銀集團的 Kevin Caliendo。

Mala, this is Dylan on for Kevin Caliendo. Earlier this week, one of your competitors announced that they are winding down their telehealth business. Could you maybe speak to whether or not the guidance today contemplates any tailwinds from a competitive perspective?

馬拉，這是凱文·卡里恩多的迪倫。本週早些時候，您的一位競爭對手宣布他們將結束遠距醫療業務。您能否談談今天的指導是否從競爭的角度考慮了任何有利因素？

Laizer, would you like to address that?

Laizer，你想解決這個問題嗎？

Sure, Mala. So clearly, there's been some noise in the marketplace. And we're really not going to comment on the specifics, and we would refer you to that partner of ours that made that comment. But what I do want to highlight is we have a very strong relationship partnership, and we value the relationship that we have with UnitedHealthcare, and we foresee that strong relationship continuing.

當然，馬拉。很明顯，市場上出現了一些噪音。我們確實不會對具體細節發表評論，我們會將您推薦給我們發表評論的合作夥伴。但我確實想強調的是，我們擁有非常牢固的合作關係，我們重視與聯合醫療保健的關係，並且我們預計這種牢固的關係將繼續下去。

The next question is from the line of George Hill with Deutsche Bank.

下一個問題來自德意志銀行的喬治·希爾。

Mala, I do like to kind of come back to Lisa's topic, which is, I guess, can you talk about the degree to which the current management team kind of feels empowered to make change at the company as it either relates to margins or growth or strategic direction? And then, because I know we're trying to keep people to one question, if I can sneak in a second one. Just if there's any way you can kind of quantify the success you're seeing in BetterHelp? And what metrics you guys are looking at internally? I think we'd find that helpful.

馬拉，我確實想回到麗莎的話題，我想你能談談目前的管理團隊在多大程度上感到有權在公司進行變革，因為這與利潤或成長有關或策略方向？然後，因為我知道我們正試圖讓人們只回答一個問題，所以我是否可以偷偷地提出第二個問題。是否有任何方法可以量化您在 BetterHelp 中看到的成功？你們在內部關注哪些指標？我想我們會發現這很有幫助。

Yes. Your question on whether the leadership team is empowered to act I would say, absolutely unhesitatingly a big yes. As I said in our prepared remarks, we are not waiting. We have a plan to deliver, we have investments to execute and that is absolutely our focus.

是的。你問的關於領導團隊是否有權採取行動的問題我想說，絕對是毫不猶豫的肯定。正如我在準備好的發言中所說，我們不會等待。我們有計劃要交付，我們有投資要執行，這絕對是我們的重點。

We are also reiterating our longer-term outlook. That is certainly going to require us to, as a leadership team as we do every single year, look at our strategy, look at various aspects of that strategy and think about how do we want to stack our investments against those, what's working, what's not working.

我們也重申了我們的長期前景。這肯定會要求我們，作為一個領導團隊，就像我們每年所做的那樣，審視我們的戰略，審視該戰略的各個方面，並思考我們如何根據這些方面進行投資，哪些是有效的，哪些是有效的不工作。

Again, that is part of what we do every single year. And we will absolutely continue to drive that. So the answer to your question is we are -- I'm empowered to drive this business forward. And we, as a leadership team, as I said in our prepared remarks, are all in, we are leaning in, and we are focusing on driving this business forward.

同樣，這是我們每年所做工作的一部分。我們絕對會繼續推動這項進程。所以你問題的答案是──我有能力推動這項業務向前發展。正如我在準備好的演講中所說，作為一個領導團隊，我們全力以赴，全力以赴，專注於推動這項業務向前發展。

In terms of BetterHelp metrics, the things that we typically will look at from an internal operating perspective is we will look at, obviously, the CAC and where it is. We will look at the ROIs of our ad spend. We will look at retention, churn, the lifetime value of the CAC that we are placing. And we will also look at the users that we are attracting to the platform.

就 BetterHelp 指標而言，我們通常會從內部營運角度考慮的事情顯然是 CAC 及其位置。我們將關注廣告支出的投資報酬率。我們將關注我們所放置的 CAC 的保留率、流失率和生命週期價值。我們還將關注我們吸引到該平台的用戶。

So we also -- so that is -- those are things that we look at. And besides that, we look at a number of other things that inform the user experience as well as the provider experience, the provider NPS, the user -- the NPS, all of which, by the way, continue to remain very strong because of the strong experience that people have on the platform. So those are the typical metrics that we would be looking at.

所以我們也——也就是說——這些都是我們所關注的事情。除此之外，我們還關注了許多其他因素，這些因素影響著用戶體驗以及提供者體驗、提供者 NPS、用戶——NPS，順便說一句，所有這些因素都繼續保持強勁，因為人們在平台上擁有的豐富經驗。這些都是我們要考慮的典型指標。

Next question is from the line of Ryan Daniels with William Blair.

下一個問題來自瑞安·丹尼爾斯和威廉·布萊爾。

This is Jack Senft on for Ryan Daniels. I think in your prepared remarks, you mentioned reallocating some of the dollars in the second half as the international penetration ramps up. So first, did I get that right? And then two, can you just talk a bit more about where you plan to reallocate these dollars? Was it just reallocating dollars to ramp up the international portion? Or is there something else? Just curious if you can dive deeper into this.

我是瑞恩·丹尼爾斯的傑克·森夫特。我認為在您準備好的演講中，您提到隨著國際滲透率的提高，下半年將重新分配一些美元。首先，我做對了嗎？第二，您能多談談您打算將這些美元重新分配到哪裡嗎？難道只是重新分配美元以增加國際部分嗎？或是還有別的什麼嗎？只是好奇您是否可以更深入地研究這一點。

Yes. So we've been talking over the last 2 calls about the fact that we do expect international in BetterHelp to ramp. The -- where we are placing our ad spend dollars internationally and BetterHelp is in the markets that we already have a presence in, those are largely English-speaking markets like U.K., Canada, Australia. So these are the markets where we would be putting our ad spend dollars in.

是的。因此，我們在過去的兩次電話會議中一直在討論這樣一個事實，即我們確實期望 BetterHelp 的國際化程度不斷提高。我們在國際上投放廣告支出，而 BetterHelp 在我們已經涉足的市場中，這些市場主要是英國、加拿大、澳洲等英語市場。因此，這些就是我們將投入廣告支出的市場。

Next question is from the line of Elizabeth Anderson with Evercore.

下一個問題來自伊麗莎白·安德森 (Elizabeth Anderson) 和 Evercore。

Mala, when you think about the longer-term growth, I appreciate your commentary, but was there other changes in the international focus, et cetera, how do we think about the component that pricing plays in both the Integrated Care outlook as well as BetterHelp?

Mala，當您考慮長期成長時，我很欣賞您的評論，但是國際焦點是否有其他變化等等，我們如何考慮定價在綜合護理前景和 BetterHelp 中所扮演的角色？

Yes. Great question, Elizabeth. So I think about the pricing lever we have on both sides in a couple of different ways. First, if you think about our Integrated Care side and think about Chronic Care and the momentum that we are seeing in Chronic Care, we've spoken about this dynamic in the past couple of calls. Firstly, we are seeing nice momentum in Chronic Care bookings. And if you think about the momentum you're seeing in Chronic Care bookings, part of what's driving that is the fact that we are selling more Chronic Care bundles.

是的。好問題，伊麗莎白。因此，我以幾種不同的方式思考雙方的定價槓桿。首先，如果您考慮我們的綜合護理方面，並考慮慢性護理以及我們在慢性護理中看到的勢頭，我們在過去的幾次電話會議中已經談到了這種動態。首先，我們看到慢性病護理預訂的良好勢頭。如果您考慮您在慢性護理預訂中看到的勢頭，那麼推動這一趨勢的部分原因是我們正在銷售更多的慢性護理捆綁包。

And if you think about the pricing that -- with these bundles, it is accretive from a -- on a per client basis from a revenue perspective. And that is certainly something that as we increasingly gaining traction on our land and expand, the fact that we've added over 2 million members in the first quarter, again, that gives us fertile ground for us to cross-sell more of our Chronic Care products into that population.

如果你考慮一下定價——透過這些捆綁包，從收入的角度來看，它是基於每個客戶的增值的。隨著我們在我們的土地上越來越受到關注並不斷擴張，我們在第一季度增加了超過 200 萬會員，這無疑為我們交叉銷售更多慢性病提供了肥沃的土壤。

The fact that Chronic Care at the end of the day is still relatively underpenetrated, right? If you think of our overall 90-plus million base, it is still 16% of our overall Chronic Care -- of our overall telehealth base. And so it's things like that, that will allow us to get more revenue accretion. And that certainly is something that we are focused on.

事實上，慢性病照護最終的滲透率仍然相對較低，對嗎？如果您考慮我們 90 多萬的總體基數，它仍然占我們整體慢性病護理（即我們總體遠距醫療基數）的 16%。因此，類似的事情將使我們獲得更多的收入成長。這當然是我們關注的重點。

On the BetterHelp side, when I think about pricing, I would say it really is us thinking more broadly about how we can do more of targeted surgical pricing as we think about the different, whether it be BetterHelp and BetterSleep, and when I say targeted and surgical, it could be by geography. It could be in other ways. And by the way, that is something that we are doing constantly continuously, right? This is a business that is dynamic in multiple ways, including in pricing.

在BetterHelp 方面，當我考慮定價時，我想說，這確實是我們更廣泛地思考如何進行更多有針對性的手術定價，因為我們考慮的是不同的，無論是BetterHelp 還是BetterSleep，當我說有針對性時和外科手術，這可能是由地理因素決定的。也可以透過其他方式。順便說一句，這是我們一直在做的事情，對嗎？這是一個在多種方面都充滿活力的業務，包括定價。

The next question is from the line of Daniel Grosslight with Citi.

下一個問題來自花旗銀行的 Daniel Grosslight。

There's been some noise out in the market questioning the cost and efficacy of some digital diabetes management programs. I know it's still pretty early in the selling season for you guys. But I was curious if that report is having any impact on what you're seeing out there in the market. And maybe if you can comment a little bit on where you're currently seeing the greatest uptick from a new sales perspective in terms of indications, that would be great.

市場上出現了一些質疑一些數位糖尿病管理專案的成本和功效的聲音。我知道現在對你們來說還處於銷售季節的早期。但我很好奇這份報告是否會對您在市場上看到的情況產生任何影響。也許如果您能從新的銷售角度來看目前在哪些方面看到了最大的成長，那就太好了。

Yes. Thanks, Daniel, for the question. Let me start, and then I will turn it over to Laizer for more comments. Look, if I think about the momentum that we are seeing in the market, the things that we are seeing traction on is a few. The first is, obviously, I've talked about our land and expand. The second is when we talk to our clients about both the breadth of our products and solutions and second, the fact that we are able to show value and ROI, that is certainly resonating in the marketplace.

是的。謝謝丹尼爾提出的問題。讓我開始吧，然後我會將其交給 Laizer 以徵求更多意見。聽著，如果我考慮一下我們在市場上看到的勢頭，我們看到的吸引力就很少了。首先，顯然，我已經談到了我們的土地和擴張。第二個是當我們與客戶談論我們產品和解決方案的廣度時，第二個事實是我們能夠展示價值和投資回報率，這肯定會在市場上引起共鳴。

And the last is, as I've said before, the strength of our balance sheet relative to many of the other competitors in our markets. And the strength of the balance sheet certainly is compelling if you think about our ability to bring innovation into our products -- into all our products, including chronic care. So those are broadly the trends that we are seeing in the market as we sell. Let me turn it over to Laizer to address your specific questions.

最後一點是，正如我之前所說，我們的資產負債表相對於市場上許多其他競爭對手的實力。如果您考慮到我們將創新帶入我們的產品（包括慢性護理）的所有產品的能力，那麼資產負債表的實力無疑是引人注目的。這些大致上就是我們在銷售時在市場上看到的趨勢。讓我將其轉交給萊澤來解決您的特定問題。

Yes. So with respect to that specific study, I would say we haven't seen any impact from that study on our business. What I would tell you is just some caveats to keep in mind.

是的。因此，就該具體研究而言，我想說我們還沒有看到該研究對我們的業務產生任何影響。我要告訴您的只是一些需要記住的注意事項。

The first is that report was a review of limited, selected secondary research and the party did not conduct any original testing or any primary analysis of patient data. And I just want to highlight that based on our studies and those of third parties, we believe that our Chronic Care programs provide a clear ROI for our customers.

首先，該報告是對有限的、選定的二級研究的審查，該方沒有對患者數據進行任何原始測試或任何初步分析。我只想強調，根據我們和第三方的研究，我們相信我們的慢性病照護計畫為我們的客戶提供了明確的投資報酬率。

Our programs have demonstrated meaningful reductions in A1c over a sustained period of time, but it's more than just A1cs. We also have shown improvements in blood pressure, and in weight and the whole concept of value is one that we are having good conversations with our clients about.

我們的計劃已證明在持續一段時間內顯著降低 A1c，但不僅僅是 A1c。我們還顯示出血壓和體重的改善，以及我們正在與客戶進行良好對話的整個價值概念。

Our members in our diabetes programs also demonstrate higher adherence to their diabetes-related drugs. And so it's really important that you understand what's based in the research, what's included. But what I would tell you is we aren't seeing an impact, but we are having good conversations with our clients related to the ROI and the value of our products.

我們糖尿病計畫的成員也表現出對糖尿病相關藥物的更高依從性。因此，了解研究的基礎和內容非常重要。但我要告訴你的是，我們沒有看到影響，但我們正在與客戶就投資回報率和產品價值進行良好的對話。

Yes. And just to wrap up on that, Daniel. What I would say is, look, we continue to see strength and momentum in Chronic Care. I would say, as I think about our guidance this year, Integrated Care is off to a solid start. I expect Integrated Care, both from a revenue growth perspective as well as a margin expansion perspective, as indicated in our guidance to continue its momentum.

是的。最後，丹尼爾。我想說的是，我們繼續看到慢性病護理領域的力量和動力。我想說，當我想到我們今年的指導時，綜合護理已經有了一個很好的開始。我預計綜合護理，無論是從收入成長的角度還是從利潤擴張的角度來看，正如我們的指導中所表明的那樣，將繼續保持其勢頭。

I would say, certainly, if you think about the BetterHelp business, we have had a couple of challenging quarters. And we have the set of drivers that are driving the back half of the year ramp. So I would say, certainly on the Integrated Care side, we are continuing to drive -- get traction, especially on our Chronic Care book.

我想說，當然，如果你考慮 BetterHelp 業務，我們經歷了幾個充滿挑戰的季度。我們擁有一批推動今年下半年成長的驅動因素。所以我想說，當然在綜合護理方面，我們正在繼續推動 - 獲得牽引力，特別是在我們的慢性護理書籍上。

There are no additional questions waiting at this time. That will conclude the conference call. Thank you for your participation. You may now disconnect your lines.

目前沒有其他問題等待。電話會議到此結束。感謝您的參與。現在您可以斷開線路。