Teladoc Health Inc (TDOC) 2024 Q2 法說會逐字稿

Hello all, and welcome to Teladoc Health second-quarter 2024 earnings call.

大家好，歡迎參加 Teladoc Health 2024 年第二季財報電話會議。

My name is Lydia, and I will be your operator today.

我叫莉迪亞，今天我將成為你們的接線生。

(Operator Instructions)

（操作員說明）

I'll now hand you over to Michael Minchak, Head of Investor Relations at Teladoc Health, to begin.

現在我將把您交給 Teladoc Health 投資者關係主管 Michael Minchak 開始。

Please go ahead.

請繼續。

Thank you, and good afternoon.

謝謝你，下午好。

Today, after the market closed, we issued a press release announcing our second-quarter 2024 financial results.

今天收盤後，我們發布新聞稿，宣布 2024 年第二季財務業績。

This press release and the accompanying slide presentation are available in the Investor Relations section of the teladochealth.com website.

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。

On this call to discuss the results are Chuck Divita, Chief Executive Officer; and Mala Murthy, Chief Financial Officer.

執行長 Chuck Divita 出席了此次電話會議，討論結果。和財務長 Mala Murthy。

During this call, we will also discuss our outlook, and our prepared remarks will be followed by a question-and-answer session.

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。

Please note that we will be discussing certain non-GAAP financial measures that we believe are important in evaluating Teladoc Health's performance.

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.

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.

另請注意，本次電話會議中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。

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.

此類前瞻性聲明受到風險、不確定性和其他因素的影響，這些因素可能導致 Teladoc Health 的實際結果與本次電話會議中明示或暗示的結果有重大差異。

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.

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 Chuck.

我現在想把電話轉給查克。

Thanks, Mike, and good afternoon, everyone.

謝謝麥克，大家下午好。

Let me start by saying how excited I am to have joined Teladoc Health and to lead the organization going forward.

首先我要說的是，我對加入 Teladoc Health 並領導組織向前發展感到非常興奮。

The company has many strengths to build upon and to drive higher levels of execution and performance.

該公司擁有許多優勢，可以推動並推動更高水準的執行和績效。

I'll comment on the quarter's results, but I also want to share some early perspectives since joining the company in June.

我將對本季度的業績發表評論，但我也想分享自 6 月加入公司以來的一些早期觀點。

I've had the opportunity to engage with employees across the organization and visit with many customers and stakeholders, including recently attending our annual forum event, which brought together health care leaders, virtual care advocates and innovators.

我有機會與整個組織的員工進行交流，並拜訪了許多客戶和利益相關者，包括最近參加了我們的年度論壇活動，該活動匯集了醫療保健領導者、虛擬護理倡導者和創新者。

These discussions have further reinforced my optimism about the future.

這些討論進一步增強了我對未來的樂觀態度。

I've been impressed by the depth of talent and resiliency of our employees and a level of commitment to serving our customers, members and patients.

我們員工的才華和韌性以及對服務客戶、會員和患者的承諾給我留下了深刻的印象。

I'm also gratified to see such a strong focus on patient safety, clinical quality and health equity as well as an organizational understanding of the importance of more holistically supporting the physical and mental health needs of people.

我還很高興看到對病人安全、臨床品質和健康公平的強烈關注，以及組織對更全面支持人們身心健康需求重要性的理解。

Not only are these important aspects from a care perspective, but also represent key points of differentiation in the marketplace to build upon.

這些不僅從護理角度來看很重要，也代表了市場中差異化的關鍵點。

From a technology perspective, we have important capabilities that will be essential to driving the business going forward, including our member to provider matching engines, our ability to effectively manage millions of patients and provider interactions and the investments we've made in the areas of data science and artificial intelligence.

從技術角度來看，我們擁有推動業務發展所必需的重要能力，包括我們的會員與提供者匹配引擎、我們有效管理數百萬患者和提供者互動的能力以及我們在以下領域所做的投資：數據科學和人工智慧。

Together with other capabilities that we're working towards, this will position us well to meet the evolving needs of our customers and the health care system, and it further underscores the need to ensure we're achieving the expected impact of these investments, which is an area I expect us to further strengthen in short order.

加上我們正在努力實現的其他能力，這將使我們能夠很好地滿足客戶和醫療保健系統不斷變化的需求，並進一步強調需要確保我們實現這些投資的預期影響，這我希望我們在短期內進一步加強這一領域。

We also have scaled business and leading brands that are well recognized in the marketplace.

我們還擁有規模化的業務和在市場上廣泛認可的領先品牌。

Over 92 million people in the US have access to one or more of our products today, and we intend to increase our ability to serve additional needs over time.

如今，美國有超過 9,200 萬人可以使用我們的一種或多種產品，隨著時間的推移，我們打算提高滿足更多需求的能力。

I'm also excited about our success and market potential internationally, including the strong results and momentum that our international teams are delivering.

我也對我們在國際上的成功和市場潛力感到興奮，包括我們的國際團隊正在提供的強勁成果和動力。

All of that said, this is a company that is not yet delivering on its fullest potential.

綜上所述，這家公司尚未充分發揮其潛力。

Since joining the company seven weeks ago, I've been evaluating together with the team, all aspects of our business, our strategic direction and priorities, our product offerings in terms of current performance and market potential, the outlook for our business units and where we can drive improved performance and long-term shareholder value.

自從七週前加入公司以來，我一直與團隊一起評估我們業務的各個方面、我們的策略方向和優先事項、我們提供的產品的當前績效和市場潛力、我們業務部門的前景以及未來的發展方向。我們可以提高業績和長期股東價值。

And we will be acting on opportunities accordingly.

我們將根據機會採取相應行動。

From an operating perspective, I see an ability to strengthen execution, streamline the organization and further raise the bar on performance.

從營運的角度來看，我看到有能力加強執行力，精簡組織，進一步提高績效標準。

For example, the challenges noted earlier in the year had a real impact on our business at that time, but can also continue to influence results after resolution.

例如，今年稍早提到的挑戰對我們當時的業務產生了真正的影響，但在解決後也可能繼續影響結果。

This is what I mean by raising the bar on performance, and we are working with focus and urgency to ensure that we execute with a higher level of precision going forward.

這就是我所說的提高績效標準的意思，我們正在專注和緊迫地工作，以確保我們今後以更高的精度執行。

In terms of streamlining the organization, actions are already underway including making changes to ensure we are organized to best serve our markets, clarifying and reinforcing accountabilities and deliverables and scrutinizing our cost structure with an eye towards greater cost efficiency as we deliver for both customers and shareholders now and into the future.

在精簡組織方面，我們已經採取行動，包括進行變革以確保我們的組織能夠最好地服務於我們的市場，澄清和加強責任和可交付成果，以及審查我們的成本結構，著眼於在為客戶和客戶提供服務時提高成本效率。

With respect to cost savings initiatives that we've already shared previously, the company is on target for achieving both 2024 and 2025 commitments, which Mala will comment on further.

關於我們先前分享過的成本節約舉措，該公司的目標是實現 2024 年和 2025 年的承諾，Mala 將進一步對此發表評論。

Through these and other actions, we intend to strengthen decision-making, accelerate the pace of innovation and speed to market and unlock greater value over time.

透過這些和其他行動，我們打算加強決策，加快創新步伐和上市速度，並隨著時間的推移釋放更大的價值。

This has been and continues to be a key area of focus since joining the company, and I look forward to providing further updates going forward.

自加入公司以來，這一直是並將繼續成為重點關注領域，我期待著提供進一步的更新。

I'll turn to our second-quarter results and provide some brief comments before handing over to Mala for more detail.

我將轉向我們的第二季度業績並提供一些簡短的評論，然後交給馬拉了解更多細節。

In total, we reported consolidated revenues in the second quarter within the company's previous guidance range, along with overall adjusted EBITDA above the range.

總的來說，我們報告的第二季合併收入在公司先前的指導範圍內，整體調整後的 EBITDA 高於該範圍。

Our integrated care business achieved solid business and financial results including on both the top line and adjusted EBITDA basis.

我們的綜合護理業務取得了穩健的業務和財務業績，包括營收和調整後的 EBITDA 基礎。

In the US, integrated care members have grown by nearly 3 million people since the beginning of the year, including $600,000 on a sequential quarter basis.

在美國，自今年年初以來，綜合護理成員已增加近 300 萬人，其中季增 60 萬美元。

International business continued to grow and create further expansion opportunities.

國際業務持續成長並創造了進一步擴張的機會。

I'm also pleased to see additional ways that our teams are working together across our various businesses to create new areas of differentiation for Teladoc Health.

我還很高興看到我們的團隊在各個業務領域開展合作，為 Teladoc Health 創造新的差異化領域。

From a commercial perspective, three-quarters of our bookings in the second quarter came from cross-selling into our existing book of business, continuing the momentum we've seen over the past several quarters with the remainder coming from new clients.

從商業角度來看，第二季四分之三的訂單來自現有業務的交叉銷售，延續了過去幾季的勢頭，其餘訂單來自新客戶。

Our chronic care bundled solutions are generating solid interest from new and existing clients, and we remain focused on increasing our product penetration to serve more people.

我們的慢性護理捆綁解決方案引起了新舊客戶的濃厚興趣，我們仍然致力於提高產品滲透率，為更多人服務。

Shifting to BetterHelp, we're proud of the work the team is doing to support the mental health and well-being of people.

轉向 BetterHelp，我們對該團隊為支持人們的心理健康和福祉所做的工作感到自豪。

The business is serving well over 1 million unique individuals on an annual basis and has a Net Promoter Score of over 70.

該公司每年為超過 100 萬人提供服務，淨推薦價值超過 70。

While it is resonating with consumers who are paying out of pocket for the services today, the operating environment remains challenging and elevated customer acquisition costs continue to impact both top and bottom line results.

雖然它引起了當今自付費用的消費者的共鳴，但營運環境仍然充滿挑戰，客戶獲取成本的上升繼續影響著營收和利潤。

We see BetterHelp as a business in transition, one with a market-leading position, but needing to find additional ways to reach more people who can benefit from the service while also balancing scale, growth and financial performance.

我們認為 BetterHelp 是一家轉型中的企業，擁有市場領先地位，但需要找到其他方法來吸引更多可以從服務中受益的人，同時平衡規模、成長和財務表現。

Several initiatives are being pursued to positively impact results going forward, ranging from furthering international expansion, pursuing insurance coverage access in the US and continued product enhancements.

我們正在採取多項舉措，以對未來的業績產生積極影響，包括進一步國際擴張、在美國尋求保險覆蓋以及持續改進產品。

We'll provide a further update on the actions we're taking for the business in the third-quarter call, but also believe it's appropriate at this point to modify our guidance approach as we navigate through these changes and challenges.

我們將在第三季的電話會議中提供有關我們為業務採取的行動的進一步更新，但我們也認為，在我們應對這些變化和挑戰時，目前修改我們的指導方法是適當的。

Mala will comment more on BetterHelp in a moment.

Mala 稍後將在 BetterHelp 上發表更多評論。

In closing, let me say that we are operating with a strong sense of urgency and have intensified our efforts on both the opportunities ahead of us and in strengthening execution and performance.

最後，我想說的是，我們正在以強烈的緊迫感開展工作，加大力度抓住眼前的機遇，加強執行力和績效。

Through our leadership position in the marketplace, our talented and committed employees and our value proposition, we expect to deliver for our customers and drive long-term potential and success of the organization.

透過我們在市場中的領導地位、我們才華橫溢、忠誠的員工以及我們的價值主張，我們期望為客戶提供服務，並推動組織的長期潛力和成功。

With that, I'll turn the call over to Mala to review our second-quarter results and our outlook.

接下來，我將把電話轉給 Mala，以審查我們的第二季業績和前景。

Thank you, Chuck, and good afternoon, everyone.

謝謝你，查克，大家下午好。

Second-quarter consolidated revenue of $642 million decreased 2% year over year.

第二季綜合營收為 6.42 億美元，年減 2%。

Second-quarter adjusted EBITDA was $89.5 million, which was above the high end of our guidance range and up 24% year over year, representing a margin of 13.9%.

第二季調整後 EBITDA 為 8,950 萬美元，高於我們指引範圍的上限，年增 24%，利潤率為 13.9%。

Consolidated net loss per share in the second quarter was $4.92 compared to a net loss per share of $0.40 in the second quarter of 2023.

第二季合併每股淨虧損為 4.92 美元，而 2023 年第二季每股淨虧損為 0.40 美元。

Net loss per share in the second quarter included a non-cash goodwill impairment charge of $4.64 per share, amortization of acquired intangibles of $0.38 per share and stock-based compensation expense of $0.25 per share.

第二季每股淨虧損包括每股 4.64 美元的非現金商譽減損費用、每股收購無形資產攤銷 0.38 美元以及每股 0.25 美元的股票補償費用。

The goodwill impairment testing was triggered by the decline in Teladoc Health share price with the impairment amount impacted by a higher discount rate and lower forecasted cash flows, and particularly the impact of challenges at BetterHelp.

商譽減損測試是由 Teladoc Health 股價下跌引發的，減損金額受到較高折現率和較低預測現金流的影響，特別是 BetterHelp 挑戰的影響。

Second-quarter free cash flow was $60.9 million compared to $64.6 million in the second quarter of 2023.

第二季自由現金流為 6,090 萬美元，而 2023 年第二季為 6,460 萬美元。

Excluding our non-recurring -- non-income tax refund in the prior year quarter, free cash flow was up approximately 25%.

不包括去年同期的非經常性非所得稅退稅，自由現金流成長了約 25%。

We ended the quarter with $1.2 billion in cash and equivalents on the balance sheet.

本季結束時，我們的資產負債表上有 12 億美元的現金和等價物。

Turning to our segment results, integrated care segment revenue increased 5% year over year to $377 million in the second quarter.

轉向我們的部門業績，第二季綜合護理部門營收年增 5% 至 3.77 億美元。

Chronic care was a key contributor to this year-over-year revenue growth.

慢性病照護是收入年增率的主要貢獻者。

We ended the quarter with chronic care program enrollment of $1.17 million, up 9% year over year and up 5% sequentially.

本季末，我們的慢性照護計畫註冊人數為 117 萬美元，年增 9%，較上季成長 5%。

The largest drivers of chronic care enrollment growth versus the prior year period were our diabetes prevention and weight management programs, followed by hypertension.

與去年同期相比，慢性病護理註冊人數成長的最大驅動因素是我們的糖尿病預防和體重管理計劃，其次是高血壓。

As an example of the continued success we are seeing with our land and expand strategy, we recently upgraded the fully insured population at a large regional Blues plan from our diabetes management solution to Diabetes Plus and expanded it to all fully insured members while also securing a hunting license for our newly launched advanced weight management solution for their self-insured population.

作為我們在土地和擴張策略方面不斷取得成功的一個例子，我們最近將一個大型區域Blues 計劃的完全參保人群從我們的糖尿病管理解決方案升級為Diabetes Plus，並將其擴展到所有完全參保成員，同時也確保了我們為其自保人群新推出的先進體重管理解決方案的狩獵許可證。

In addition to enrollment growth, we also saw a benefit in the quarter from performance-based revenue in our chronic care programs where we are earning fees for successfully delivering on outcomes.

除了入學人數成長之外，本季我們還看到了慢性病護理課程中基於績效的收入帶來的好處，我們透過成功實現成果來賺取費用。

While these types of arrangements currently represent a smaller portion of our business, we believe that our ability to deliver positive results in value-based arrangements will remain an important lever going forward.

雖然這些類型的安排目前只占我們業務的一小部分，但我們相信，我們在基於價值的安排中取得積極成果的能力仍將是未來的重要槓桿。

International was also an important contributor with strong revenue growth in the quarter, driven by our B2B business, while we are also seeing success in leveraging our hospital and health systems offering to unlock new public health system opportunities.

在我們的 B2B 業務的推動下，國際業務也是本季收入強勁增長的重要貢獻者，同時我們也成功利用我們的醫院和衛生系統產品來釋放新的公共衛生系統機會。

US integrated care segment membership at the end of the quarter was 92.4 million members, increasing by 8% year over year and up by approximately 600,000 members sequentially, in line with our guidance range.

截至本季末，美國綜合護理細分市場會員人數為 9,240 萬名，年增 8%，季增約 60 萬名會員，符合我們的指導範圍。

Average integrated care revenue per US member of $1.36, decreased by $0.05 versus the prior year second quarter.

美國會員平均綜合護理收入為 1.36 美元，比去年第二季減少 0.05 美元。

This is driven by mix as we have onboarded a significant number of new members within our general medical product and typically, they contribute less materially to our average revenue per member.

這是由混合驅動的，因為我們在普通醫療產品中吸收了大量新會員，通常，他們對我們每個會員的平均收入的貢獻較小。

As we have said, based on our land and expand strategy, we see significant runway to cross-sell additional higher revenue products over time, including our chronic care services.

正如我們所說，根據我們的土地和擴張策略，我們看到隨著時間的推移，交叉銷售更多高收入產品的重要途徑，包括我們的慢性護理服務。

Second-quarter integrated care adjusted EBITDA was $64 million, a 69% increase over the second quarter of 2023.

第二季綜合護理調整後 EBITDA 為 6,400 萬美元，比 2023 年第二季成長 69%。

Adjusted EBITDA margin of 17% was well above our guidance range of 12% to 14% and represented growth of approximately 640 basis points versus the second quarter of 2023.

調整後 EBITDA 利潤率為 17%，遠高於我們 12% 至 14% 的指導範圍，與 2023 年第二季度相比增長約 640 個基點。

Three factors helped to contribute to the upside versus the guidance range in the quarter.

三個因素促成了本季相對指導範圍的上行。

The first was the performance-based revenue in our chronic care programs.

第一個是我們的慢性病照護計畫中以績效為基礎的收入。

The second factor was adjustments to compensation accruals in line with current year performance, including lower-than-expected performance in our BetterHelp business.

第二個因素是根據本年度業績調整應計薪酬，包括我們 BetterHelp 業務低於預期的業績。

And the third part is related to timing as certain marketing and other operating expenses were pushed into the second half of the year.

第三部分與時機有關，因為某些行銷和其他營運費用被推到了下半年。

In aggregate, these three factors accounted for over 300 basis points of benefit to year-over-year margin expansion.

總的來說，這三個因素為利潤率同比擴張帶來了超過 300 個基點的好處。

Turning to the BetterHelp segment, revenue was $265 million in the second quarter, down 9% versus the prior year period and slightly below our guidance range of down 4% to 8%.

至於 BetterHelp 部門，第二季營收為 2.65 億美元，比去年同期下降 9%，略低於我們下降 4% 至 8% 的指引範圍。

Revenue was down 1.5% versus the first quarter of 2024 as average paid users declined by 1.9% sequentially.

營收較 2024 年第一季下降 1.5%，平均付費用戶季減 1.9%。

With average revenue per user generally stable and churn in the first half of 2024 improving versus the second half of 2023, the decline in revenue and users versus the first quarter was a result of fewer user additions to the platform.

與 2023 年下半年相比，2024 年上半年每用戶平均收入整體穩定且流失有所改善，收入和用戶數較第一季下降的原因是平台新增用戶減少。

We've talked about how a variety of factors influence the revenue yield on advertising spend, including cost of media, the overall health of the consumer and dynamics within the advertising channels themselves.

我們討論了各種因素如何影響廣告支出的收益，包括媒體成本、消費者的整體健康狀況以及廣告管道本身的動態。

In the first quarter, we saw challenging customer acquisition costs through early Q1, which caused us to pull back on our advertising dollars in the quarter in keeping with our goals to balance growth and margin.

在第一季度，我們看到第一季初期的客戶獲取成本充滿挑戰，這導致我們在本季度縮減廣告費用，以實現平衡成長和利潤的目標。

Although we entered the second quarter with lower paid users, creating headwinds to our top line performance, we did see signs of advertising costs stabilizing at Q1 levels in the first few weeks.

儘管我們進入第二季時付費用戶較低，這給我們的營收業績帶來了阻力，但我們確實看到廣告成本在前幾週穩定在第一季水準的跡象。

However, we saw a further deterioration from those levels in May with that trend continuing into June.

然而，我們看到 5 月的水平進一步惡化，這種趨勢持續到 6 月。

To help put this in context, we saw a double-digit percentage increase in customer acquisition costs in May versus what we had seen exiting the first quarter.

為了幫助說明這一點，我們發現 5 月的客戶獲取成本與第一季相比出現了兩位數的百分比成長。

In line with our strategy to constantly optimize for return on advertising spend, we made the decision to pull back during the second quarter to ensure the appropriate level of return for marginal dollar spend.

根據我們持續優化廣告支出回報的策略，我們決定在第二季縮減規模，以確保邊際美元支出獲得適當的回報水準。

This led to fewer growth additions and a lower paid user count, which drove the revenue decline in the quarter.

這導致成長減少和付費用戶數量減少，從而導致本季收入下降。

We believe higher customer acquisition costs in the US are being driven by several factors.

我們認為，美國較高的客戶獲取成本是由多種因素所推動的。

First, we are seeing customer acquisition cost pressure broadly across many of our advertising channels, which suggests some broader macro weakening of the consumer.

首先，我們在許多廣告管道中普遍看到客戶獲取成本壓力，這顯示消費者的宏觀經濟疲軟。

Next, BetterHelp growth is dependent on our ability to efficiently deploy marketing dollars to acquire new customers.

接下來，BetterHelp 的成長取決於我們有效部署行銷資金來獲取新客戶的能力。

Our scale makes us the largest advertiser of virtual mental health.

我們的規模使我們成為最大的虛擬心理健康廣告商。

And while our spending is diversified across various channels, there is only so much incremental ad spend we can drive in a short period of time without further inflating our customer acquisition costs.

雖然我們的支出在各個管道上是多樣化的，但在短時間內我們只能增加這麼多的增量廣告支出，而不會進一步增加我們的客戶獲取成本。

At our scale and at these elevated levels of customer acquisition costs, we are making a conscious decision not to chase inefficient customer acquisition to points below an appropriate return.

以我們的規模和客戶獲取成本的升高水平，我們正在做出有意識的決定，不追逐低效的客戶獲取，使其低於適當的回報。

So this balanced approach and focus on driving ROI and margin is going to come at a lower overall rate of top line growth as long as customer acquisition costs in our key advertising channels remain elevated.

因此，只要我們主要廣告管道的客戶獲取成本仍然很高，這種平衡的方法和專注於提高投資回報率和利潤率的整體成長率就會較低。

As we have noted, BetterHelp is a business in transition.

正如我們所指出的，BetterHelp 是一家正在轉型的企業。

We are undertaking several strategic pivots to address these challenges and expand our addressable market.

我們正在採取多項策略重點來應對這些挑戰並擴大我們的目標市場。

As Chuck had discussed, we are actively working on bringing the BetterHelp value proposition to the insurance market.

正如 Chuck 所討論的，我們正在積極致力於將 BetterHelp 價值主張引入保險市場。

In addition, we are also moving forward with further international expansion beyond our current footprint with a focus on certain non-English-speaking markets.

此外，我們也在目前的業務範圍之外進一步進行國際擴張，並專注於某些非英語市場。

Consistent with our prior commentary, we have seen much healthier customer acquisition costs in non-US markets, which is translating to strong international revenue growth at BetterHelp.

與我們先前的評論一致，我們在非美國市場看到了更健康的客戶獲取成本，這轉化為 BetterHelp 強勁的國際收入成長。

BetterHelp adjusted EBITDA was $25 million in the second quarter, representing a 26% year-over-year decline.

BetterHelp 第二季調整後 EBITDA 為 2,500 萬美元，年減 26%。

Adjusted EBITDA margin of 9.6%, was just above the midpoint of our guidance range of 9% to 10% and decreased 210 basis points versus the prior year quarter.

調整後 EBITDA 利潤率為 9.6%，略高於我們指導範圍 9% 至 10% 的中點，比去年同期下降 210 個基點。

As we faced higher-than-expected customer acquisition costs, we made the deliberate decision to moderate advertising spend in certain channels during the quarter, which allowed us to meet our adjusted EBITDA margin target and was consistent with our focus on managing the business to an appropriate return on ad spend.

由於我們面臨高於預期的客戶獲取成本，我們在本季度深思熟慮地決定減少某些管道的廣告支出，這使我們能夠實現調整後的EBITDA 利潤率目標，並且與我們管理業務以實現盈利目標的重點一致。

Now, let me turn to guidance.

現在，讓我談談指引。

For integrated care, we continue to expect 2024 revenue growth in the low to mid-single digits.

對於綜合護理，我們繼續預期 2024 年收入成長將保持在中低個位數。

We are narrowing our range for adjusted EBITDA margin expansion, which we now expect to be up 150 to 200 basis points.

我們正在縮小調整後 EBITDA 利潤率擴張的範圍，目前預計將成長 150 至 200 個基點。

Our guidance reflects the first half performance, offset by a slower ramp in chronic care enrollment primarily related to client-driven delays in the launch of certain member populations, which will likely lead to chronic care enrollment being relatively flat on a sequential basis in the third quarter.

Our guidance reflects the first half performance, offset by a slower ramp in chronic care enrollment primarily related to client-driven delays in the launch of certain member populations, which will likely lead to chronic care enrollment being relatively flat on a sequential basis in the third四分之一.

We are raising the lower end of our US integrated care member guidance range and now expect 92.5 million to 94 million members at year-end.

我們正在提高美國綜合護理會員指導範圍的下限，目前預計到年底會員人數將達到 9,250 萬至 9,400 萬。

For the third quarter, we expect integrated care revenue to be down 1% to up 2% and adjusted EBITDA margin between 14.5% and 16%.

對於第三季度，我們預計綜合護理收入將下降 1% 至成長 2%，調整後 EBITDA 利潤率將在 14.5% 至 16% 之間。

US integrated care members are expected to be in the range of 92.5 million to 93.5 million members.

美國綜合護理會員預計將在 9,250 萬至 9,350 萬之間。

We note that the deceleration in year-over-year revenue growth in the third quarter is due in part to a tougher comp due to the realization of performance guarantees in the third quarter of 2023, which added approximately 100 basis points of growth and adjusted EBITDA margin in the prior year period as well as impact from lower chronic care enrollment.

我們注意到，第三季營收年增率放緩的部分原因是由於2023年第三季業績保證的實現而導致的競爭更加嚴格，這增加了約100個基點的成長並調整了EBITDA上一年期間的利潤率以及慢性病護理入學人數減少的影響。

For BetterHelp, customer acquisition costs have continued to trend higher over the past few quarters, and there is limited visibility on the near-term path which, as we have discussed, could be further affected by the unknown impact of the upcoming presidential election on ad pricing.

對於 BetterHelp 來說，過去幾季的客戶獲取成本持續走高，而且近期路徑的可見性有限，正如我們所討論的，即將到來的總統選舉對廣告的未知影響可能會進一步影響該路徑價錢。

Based on actions we are taking as we actively manage the business for an appropriate return on ad spend, while at the same time, positioning the business and brand for long-term success, this is leading to an atypically wide range of potential outcomes.

根據我們在積極管理業務以獲得適當的廣告支出回報的同時，為業務和品牌定位以獲得長期成功而採取的行動，這將帶來異常廣泛的潛在結果。

Therefore, we are choosing to not provide segment revenue or adjusted EBITDA guidance for the third quarter, and we are withdrawing our full-year guidance for both metrics in our BetterHelp segment at this time.

因此，我們選擇不提供第三季的部門收入或調整後的 EBITDA 指導，而我們目前正在撤回對 BetterHelp 部門中這兩個指標的全年指導。

We recognize the challenge this presents from a modeling standpoint.

我們從建模的角度認識到這帶來的挑戰。

Therefore, to provide a baseline, we note that if customer acquisition costs continue at current level, we would expect second half 2024 revenue to decline in the low double digits.

因此，為了提供基準，我們注意到，如果客戶獲取成本繼續保持在當前水平，我們預計 2024 年下半年收入將出現低兩位數下降。

Consistent with our decision to not provide guidance for the BetterHelp segment, we are, therefore, not providing guidance for the consolidated company revenue, adjusted EBITDA, net loss per share or free cash flow for the third quarter or full year 2024.

因此，與我們不為 BetterHelp 部門提供指導的決定一致，我們不會為 2024 年第三季或全年的合併公司收入、調整後 EBITDA、每股淨虧損或自由現金流提供指引。

We continue to make progress executing against our cost-saving 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.

我們繼續在執行成本節約生產力計劃方面取得進展，並且按照 GAAP 原則，我們仍有望在 2024 年為我們的業務節省 4,300 萬美元的成本，並在 2025 年節省總計 8,500 萬美元的成本。

As we look to 2025 and beyond, there are a number of initiatives that will inform our longer-term outlook, including the areas mentioned by Chuck.

展望 2025 年及以後，有許多舉措將為我們的長期前景提供信息，包括查克提到的領域。

While our focus remains on driving sustainable financial performance and value creation, we are not in a position to provide a longer-term forecast for our segments or an outlook for the full company, including for 2025 at the current time.

雖然我們的重點仍然是推動可持續的財務表現和價值創造，但我們無法為我們的部門提供長期預測或整個公司的前景，包括目前的 2025 年。

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

說完，我會把電話轉回給查克。

Thanks, Mala.

謝謝，馬拉。

The decision to withdraw our long-term guidance comes as I continue to evaluate all aspects of the business, including our strategic priorities, our cost structure, investments in the business, our product offerings and capital allocation.

在決定撤銷我們的長期指導之際，我繼續評估業務的各個方面，包括我們的策略重點、成本結構、業務投資、產品供應和資本配置。

I look forward to sharing further details on our third-quarter earnings call in October.

我期待在 10 月的第三季財報電話會議上分享更多細節。

With that, we will open it up for questions.

至此，我們將開放提問。

Operator?

操作員？

(Operator Instructions) Lisa Gill, JPMorgan.

（操作員指示）Lisa Gill，摩根大通。

Chuck, I want to start with a comment that was in the press release, and that was unlocking greater value across the entire company.

查克，我想從新聞稿中的一條評論開始，這為整個公司釋放了更大的價值。

As I listened to your comments and Mala's comments around BetterHelp, should I think that BetterHelp is maybe not strategically a component of the company going forward and potentially this would be in better hands of somebody else owning this?

當我聽到你的評論和 Mala 對 BetterHelp 的評論時，我是否應該認為 BetterHelp 在戰略上可能不是公司未來發展的一個組成部分，並且可能會由擁有它的其他人更好地掌握？

And if that's not the way we should think about it, what are some of the other things we should be thinking about in that comment of this greater opportunity across the company?

如果這不是我們應該考慮的方式，那麼在對整個公司的這一更大機會的評論中我們還應該考慮哪些其他事情？

Yes.

是的。

Thank you for the question.

感謝你的提問。

I think with respect to BetterHelp, it's important to note that the company has really built a great capability.

我認為就 BetterHelp 而言，值得注意的是該公司確實建立了強大的功能。

It's the largest of its kind, serving well over 1 million people, great results with consumers who are paying out of pocket.

它是同類產品中規模最大的，為超過 100 萬人提供服務，對於自付費用的消費者來說效果很好。

So all of that is terrific.

所以這一切都很棒。

I think the operating challenges Mala has touched on and you're well aware of, I think at this point, BetterHelp is an important part of the company.

我認為 Mala 所面臨的營運挑戰你們都很清楚，我認為在這一點上，BetterHelp 是公司的重要組成部分。

We're primarily focused right now on managing through this transition period, advancing the deliverables that Mala touched on in terms of international expansion, insurance market, other enhancements and balancing the scale and financial strength of the company and financial performance.

我們現在主要關注的是管理這個過渡期，推進馬拉在國際擴張、保險市場和其他增強方面所涉及的可交付成果，並平衡公司的規模和財務實力以及財務表現。

With that said, like any business, we're going to continue to evaluate what we're doing, where we're operating in a way that creates long-term shareholder value.

話雖如此，與任何企業一樣，我們將繼續評估我們正在做的事情，以及我們以創造長期股東價值的方式運作的方式。

When I'm talking about unlocking value, when you look across our businesses, there's opportunities -- there already are some synergies being realized today, but there are opportunities to do more.

當我談論釋放價值時，當你縱觀我們的業務時，你會發現機會——今天已經實現了一些協同效應，但還有機會做更多事情。

You've got a consumer business that has resonated well, and we have need for engagement in our B2B business.

你們的消費者業務引起了良好的反響，而我們需要參與我們的 B2B 業務。

We have a scale B2B business that can benefit from other parts of the organization as well.

我們擁有規模化的 B2B 業務，也可以從組織的其他部門中受益。

So what I'm looking for is each individual business to meet the market needs and realize its own potential, but as part of the broader company, where those opportunities to unlock new value and differentiate.

因此，我正在尋找的是每個單獨的企業都能滿足市場需求並實現自身潛力，但作為更廣泛公司的一部分，這些機會可以釋放新價值並實現差異化。

And I think there's a number of areas that we're going to explore.

我認為我們將探索許多領域。

Stephanie Davis, Barclays.

史蒂芬妮戴維斯，巴克萊銀行。

Chuck, Mala, you both talked to pursuing insurance coverage for BetterHelp in your prepared remarks.

Chuck、Mala，你們在準備好的發言中都談到了為 BetterHelp 尋求保險。

So I'd like for you to talk a little bit more about that.

所以我想讓你多談談這個問題。

What are the steps that you'll need to take to make an insurance reimburse products versus your current out-of-pocket construct?

與目前的自付費用產品相比，您需要採取哪些步驟來製作保險報銷產品？

How is that going to compare to my strength?

和我的實力比起來如何？

And what are the approximate timelines for taking these steps?

採取這些步驟的大致時間表是多少？

Yes, I'll start and then Mala can add to this.

是的，我先開始，然後馬拉可以補充。

From my perspective, this is what I see is the next logical step for BetterHelp.

從我的角度來看，這就是 BetterHelp 的下一個合乎邏輯的步驟。

We've got a lot of eyes on the product.

我們有很多人關注該產品。

But as people work through the process, a significant number, a significant percentage of those consumers that don't choose to move forward, site high out-of-pocket costs as well as having insurance coverage.

但當人們完成這個過程時，很大一部分消費者不選擇繼續前進，他們會支付高昂的自付費用併購買保險。

So we want to be able to those consumers to offer the ability to access their coverage where we can.

因此，我們希望能夠為這些消費者提供盡可能獲得保險的能力。

In terms of timeline, we're working on deliverables right now to have at least, what we call, the technical capabilities by year-end to be able to offer that.

就時間表而言，我們現在正在研究可交付成果，以便至少在年底前具備我們所說的技術能力來提供這項服務。

Obviously, with insurance contracting and so forth, it will be rolling out over the course of 2025.

顯然，隨著保險合約等的推出，它將在 2025 年推出。

As you note, there are some additional requirements, additional credentialing.

正如您所注意到的，還有一些額外的要求和額外的認證。

There's other requirements, operational contracting, et cetera.

還有其他要求、營運合約等等。

The way we're approaching that, I think, is a very thoughtful way where areas where we want to control the experience, which are key to the experience, we are handling those.

我認為，我們實現這一目標的方式是一種非常深思熟慮的方式，我們正在處理那些我們想要控制體驗的領域，這些領域是體驗的關鍵。

But we're also leveraging third-party partners for areas that we don't see as core to that experience.

但我們也在不認為是該體驗核心的領域利用第三方合作夥伴。

That increases the speed to market, reduces the investments we need to make to bring it live.

這提高了上市速度，減少了我們投入使用所需的投資。

So we see that as a manageable upfront investment in terms of building out the capability.

因此，我們認為，就能力建構而言，這是一項可管理的前期投資。

But we do see this as a logical progression.

但我們確實認為這是一個合乎邏輯的進展。

But again, I would underscore, it's primarily focused on meeting that consumer need that we're -- we have their eyes on the product now, but they want to be able to access their insurance coverage.

但我要再次強調，它的主要重點是滿足消費者的需求，我們現在關注的是該產品，但他們希望能夠獲得保險。

Yes.

是的。

And Stephanie, what I'd add to what Chuck said is, if you take a step back and think about our efforts for offering insurance, look, BetterHelp mission has always been to make mental health care more accessible to everyone.

史蒂芬妮，我要補充的是，如果你退一步想想我們在提供保險方面所做的努力，你會發現，BetterHelp 的使命一直是讓每個人都更容易獲得心理健康護理。

And affordability is the main reason users as they go through sort of the path to enroll with BetterHelp don't convert.

負擔能力是用戶在透過某種途徑註冊 BetterHelp 時未能轉換的主要原因。

And it's honestly the number one cause for customer churn.

老實說，這是客戶流失的首要原因。

If you think about the macros that we are dealing with, if you think about softening consumer spend, inflation, et cetera, we have an opportunity to actually expand our TAM quite significantly if we were to sort of expand beyond cash pay.

如果你考慮我們正在處理的宏觀問題，如果你考慮一下消費者支出的疲軟、通貨膨脹等，如果我們要擴展到現金支付之外，我們實際上有機會顯著地擴大我們的 TAM。

So that's sort of the -- we are being very thoughtful on how we approach this.

所以這就是——我們正在非常認真地考慮如何處理這個問題。

We are looking thoughtfully into the modalities, each step of what we do to implement and execute this with precision, with trigger and to make sure that from an investment standpoint, we are getting the appropriate return on investments that we will make in this space.

我們正在深思熟慮地研究我們所做的每一步，以精確、有觸發地實施和執行這一目標，並確保從投資的角度來看，我們在這個領域的投資獲得適當的回報。

Jess Tassan, Piper Sandler.

傑西·塔桑，派珀·桑德勒。

Congrats, Chuck, on starting in the role.

恭喜查克開始擔任這個角色。

I wanted to get maybe your perspective just having come from a health plan, how would you kind of rank the Teladoc chronic care platform today among competitors in the market?

我想了解您對健康計劃的看法，您認為今天的 Teladoc 慢性護理平台在市場競爭對手中的排名如何？

And what are kind of the biggest issues or like low-hanging fruit that you think you can address?

您認為可以解決的最大問題或容易實現的目標是什麼？

And then a quick follow-up would be of the people who have access to a Teladoc chronic care solution, how many are actually eligible for enrollment, so have the condition that can be resolved or ameliorated by the chronic care platform?

然後快速跟進那些能夠使用 Teladoc 慢性護理解決方案的人，有多少人實際上有資格註冊，那麼慢性護理平台可以解決或改善他們的病情嗎？

It was easy when Livongo was just diabetes 12%, but I'm curious what that number is today?

當 Livongo 的糖尿病患者只有 12% 時，這很容易，但我很好奇今天這個數字是多少？

Thanks.

謝謝。

Yes.

是的。

I'll take a stab at it, and then Mala can comment further.

我會嘗試一下，然後馬拉可以進一步發表評論。

From a market perspective, from a former customer perspective, I think the company's chronic care products are effective, and we were a purchaser of that in my prior role.

從市場的角度，從以前的客戶的角度來看，我認為該公司的慢性護理產品是有效的，而我們在我之前的角色中是該產品的購買者。

I like the way that the company approaches a more comprehensive model as opposed to targeting just a specific situation that they're really being thoughtful in terms of what else that member needs.

我喜歡該公司採用更全面的模型的方式，而不是只針對特定情況，他們真正考慮了會員的其他需求。

As you know, with chronic conditions, a lot of cases, it's more than one condition in play.

如您所知，對於慢性疾病，在許多情況下，不僅僅是一種疾病在起作用。

And like most things with people, it's bigger than just one matter that they're wrestling with.

就像人們遇到的大多數事情一樣，這不僅僅是他們正在努力解決的事情。

So I like the comprehensive approach that the company takes and that resonated with me.

所以我喜歡公司採取的全面方法，這引起了我的共鳴。

In terms of where I see our position relative to others, I would highlight that.

就我相對於其他人的立場而言，我想強調這一點。

I would say that we have more opportunities to create services that can benefit those patients.

我想說的是，我們有更多機會創造可以造福這些患者的服務。

And I think the journey the company has been on in terms of where it's headed with its weight and obesity management is a good example of that.

我認為該公司在體重和肥胖管理方面所經歷的歷程就是一個很好的例子。

I think, ultimately, you've got a sophisticated buyer, if you will, out there and they're looking for demonstrated value.

我認為，如果你願意的話，最終你會遇到一個成熟的買家，他們正在尋找可證明的價值。

They're looking for measurements against that.

他們正在尋找針對這一點的衡量標準。

I think we've done a nice job with both our chronic care models in terms of ROI and our new cardiometabolic health value model that was validated by Milliman.

我認為我們的長期照護模型在投資回報率方面以及經過 Milliman 驗證的新心臟代謝健康價值模型都做得很好。

So I guess I would say that I think we've got a nice approach.

所以我想我會說我認為我們有一個很好的方法。

It's resonating in the market.

正在市場引起共鳴。

It's comprehensive, and it is demonstrating value.

它很全面，並且正在展示價值。

And the last thing I would say, for Mala if you want to add anything, if you look at the impact we're having on the patients that do engage, it's pretty impressive.

我要說的最後一件事是，對於 Mala，如果你想添加任何內容，如果你看看我們對參與的患者所產生的影響，這是相當令人印象深刻的。

So I think we're in a good position there, but obviously more to build upon.

所以我認為我們在這方面處於有利位置，但顯然還有更多需要繼續努力的地方。

Yes.

是的。

And to answer your second question, Jess, look, here's the good news, right?

回答你的第二個問題，傑西，聽著，這是個好消息，對吧？

We are continuing to see strength in the number of recruitables that we have, right?

我們繼續看到我們擁有的可招募人數的優勢，對吧？

The recruitables momentum continues.

可招募人員的勢頭仍在繼續。

And I would say, that is a testament to our product offerings, the fact that we are seeing strength in selling chronic care bundles increasingly.

我想說，這證明了我們的產品供應，事實上我們看到了慢性護理捆綁銷售日益增長的優勢。

If you think about our overall chronic care bookings, more than half of it was chronic care bundles.

如果您考慮我們整體的慢性護理預訂，您會發現其中一半以上是慢性護理套餐。

The reason I mentioned this is if you think about your question around how are we doing in converting those recruitable into chronic care enrollees, we don't give the actual number in terms of enrollment, but it continues to be strong and increase relative to what you quoted as the enrollment numbers in the Livongo days.

我提到這一點的原因是，如果您考慮我們如何將那些可招募的人轉化為慢性護理參與者的問題，我們不會給出註冊人數的實際數字，但它仍然強勁，並且相對於您引用的是Livongo 時期的入學人數。

And the reason for that is, if you think about our ability increasingly to sell chronic care bundles to clients, what happens when you do that is you will see enrollees essentially enroll into multiple conditions, use multiple of our programs rather than, say, one diabetes program, et cetera.

原因是，如果您考慮到我們越來越多地向客戶銷售慢性護理套餐的能力，當您這樣做時會發生什麼，您會看到參與者基本上註冊了多種條件，使用我們的多個計劃，而不是一個，比如說糖尿病計劃等。

And all of that helps from an enrollment perspective.

從招生的角度來看，所有這些都有幫助。

Jailendra Singh, Truist Securities.

Jailendra Singh，Truist 證券公司。

Given we are in the heart of the selling season, I was wondering if you could speak to what you're seeing in terms of RFP activity in your integrated care segment, employer interest?

鑑於我們正處於銷售季節的中心，我想知道您是否可以談談您在綜合護理領域的 RFP 活動以​​及雇主興趣方面所看到的情況？

I mean, last year, I believe employees were likely caught off guard primarily because of GLP-1 costs, which likely resulted in sales cycle generally getting elongated.

我的意思是，去年，我相信員工可能會措手不及，主要是因為 GLP-1 成本，這可能導致銷售週期普遍延長。

Curious what you guys are seeing this year and maybe spend some time on your provider-led weight management program and traction that is getting, given GLP-1 still remains on top of mind for most employers?

鑑於 GLP-1 仍然是大多數雇主的首要考慮因素，想知道你們今年會看到什麼，也許會花一些時間在提供者主導的體重管理計劃和正在獲得的關注上？

Yes.

是的。

Thank you for the questions.

謝謝你的提問。

A couple of things.

有幾件事。

In terms of the selling season, if you will, I think we're feeling really good about that at this point overall.

就銷售季節而言，如果你願意的話，我認為我們目前總體感覺非常好。

The sales teams are progressing on both bookings as well as actively managing pipeline opportunities.

銷售團隊在預訂和積極管理通路機會方面都取得了進展。

And as I mentioned before, I mean, I think what we're seeing in the market generally is good activity, but a sophisticated buyer base that's looking for, again, raising the bar in terms of demonstrated value, they are definitely looking for ways to reduce fragmentation.

正如我之前提到的，我的意思是，我認為我們在市場上看到的情況總體上是良好的活動，但成熟的買家群體正在尋求再次提高展示價值的標準，他們肯定正在尋找方法以減少碎片。

So I think at least having a more effective experience versus all these point solutions.

因此，我認為與所有這些單點解決方案相比，至少擁有更有效的體驗。

So that's definitely a trend and theme out there.

所以這絕對是一個趨勢和主題。

I think that -- so we're seeing good activity across the board, and we'll continue to go after that.

我認為，我們看到了全面的良好活動，我們將繼續努力。

I think with respect to the weight and obesity management, obviously, as you know, that's a significant area of focus, particularly with employers, not just with GLP-1, but just how to manage this issue more holistically.

我認為，就體重和肥胖管理而言，正如您所知，顯然這是一個重要的關注領域，特別是對於雇主來說，不僅僅是 GLP-1，而是如何更全面地管理這個問題。

I think there's a range of approaches out there.

我認為有多種方法。

And I think it's a little early to see kind of how those all play out.

我認為現在觀察這些結果如何還為時過早。

I think what we're trying to play is a place where we can create customized options for employers depending on what they're trying to solve.

我認為我們正在嘗試做的是一個可以根據雇主想要解決的問題為他們創建自訂選項的地方。

And as you know, all the way up to our most advanced program which includes physician access, a Teladoc physician that's trained in obesity management.

如您所知，一直到我們最先進的計劃，其中包括醫生訪問，即接受過肥胖管理培訓的 Teladoc 醫生。

So I think we're seeing a lot of interest there, maybe even perhaps more than we probably thought coming into the year, but it's early in this whole process.

所以我認為我們看到了很多人的興趣，甚至可能比我們今年想像的還要多，但現在還處於整個過程的早期。

And I think what we're trying to do is make sure we're there for the long haul so that the approach we're taking and the impact we're making is something that's sustainable versus something that's maybe perhaps a quick fix.

我認為我們正在努力做的是確保我們長期存在，以便我們正在採取的方法和我們正在產生的影響是可持續的，而不是可能是快速解決的方法。

Richard Close, Canaccord Genuity.

理查德·克洛斯，Canaccord Genuity。

Mala, I was curious on the charge.

馬拉，我對這個指控很好奇。

If you could just go into a little bit of the details on the BetterHelp component of that, just that process?

您是否可以詳細了解 BetterHelp 組件的一些細節，只是這個過程？

And then, my follow-up is on BetterHelp and if you get insurance coverage, are you thinking about leveraging that into the existing employer book of business, which I would assume would be really low acquisition costs for BetterHelp?

然後，我的後續行動是關於 BetterHelp，如果您獲得保險承保，您是否正在考慮將其利用到現有的雇主業務中，我認為這對 BetterHelp 來說確實是很低的獲取成本？

Yes.

是的。

So let me do it in reverse order, Richard.

所以讓我以相反的順序來做，理查德。

Thank you for your questions.

謝謝您的提問。

When Chuck talked earlier to Lisa's questions around where is -- what do we mean in terms of synergies across the business and Chuck spoke about leveraging the B2B side of the business.

當 Chuck 早些時候回答 Lisa 提出的關於整個業務協同效應的含義時，Chuck 談到如何利用 B2B 業務。

What you just said is one of the examples that I would cite in terms of go-to-market for how we are thinking about BetterHelp with insurance and what do I mean by that?

你剛才所說的就是我在進入市場時引用的例子之一，以說明我們如何考慮保險方面的 BetterHelp，我的意思是什麼？

The fact is, look, if you think about the strength of the client relationships we have, we have talked about our client retention rate being over 90%.

事實是，如果你考慮我們擁有的客戶關係的強度，我們就說過我們的客戶保留率超過 90%。

We have long-standing good relationships with our clients.

我們與客戶有著長期良好的關係。

And this is an opportunity for us to actually use that to your point in a smart, efficient way with the BetterHelp product.

這是我們透過 BetterHelp 產品以智慧、高效的方式實際運用這一點的機會。

Obviously, there are things we need to do to make sure that the BetterHelp platform and product is suitable for the B2B space, and we just talked about that a few minutes ago.

顯然，我們需要做一些事情來確保 BetterHelp 平台和產品適合 B2B 領域，我們幾分鐘前剛剛談到這一點。

So that's on your second question.

這是你的第二個問題。

On your first question around the charge, look, as I said in the prepared remarks, the impairment charge essentially was the -- for us to take a look at impairment, it's really triggered by the decline in share price.

關於你關於費用的第一個問題，正如我在準備好的發言中所說，減損費用本質上是——對我們來說，減損費用實際上是由股價下跌引發的。

And then it's sort of, as I said, the drivers for the impairment charge really are the discount rate as well as cash flows.

正如我所說，減損費用的驅動因素實際上是貼現率和現金流。

And if you think about the BetterHelp business and the fact that our revenues are lower and our adjusted EBITDA is lower than what we had expected, it's not really a surprise that we do have to take the impairment.

如果你考慮一下 BetterHelp 業務，以及我們的收入較低、調整後的 EBITDA 低於我們預期的事實，那麼我們必須承擔減損就不足為奇了。

So those are the factors that really went into us coming to the impairment charge that we did.

因此，這些才是真正影響我們做出減損準備的因素。

The last thing I would say is maybe one of the things that is implied in your question is how is it sort of on the BetterHelp side.

我要說的最後一件事可能是您的問題中暗示的一件事是 BetterHelp 方面的情況如何。

If you think about it from an accounting perspective, when we broke out into segments a couple of years ago, we essentially allocated the goodwill across both the segments based on value.

如果您從會計角度考慮，幾年前當我們劃分部門時，我們基本上根據價值在兩個部門之間分配商譽。

And that is the reason why you're seeing the goodwill charge on the BetterHelp side.

這就是為什麼您會在 BetterHelp 方面看到商譽費用的原因。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

I was wondering if you could comment on current BetterHelp tax as we are in the third quarter?

我想知道您是否可以對第三季目前的 BetterHelp 稅發表評論？

And if not, I was also wondering if you could talk about the lower member growth that you talked about due to delays in enrollment in integrated care in the second half of the year?

如果沒有，我還想知道您是否可以談談您提到的由於下半年綜合護理註冊延遲而導致的會員增長較低的問題？

Can you just give us a little bit more color on sort of what's causing those delays and what are your updated expectations for when those members come on board?

您能否為我們提供更多關於造成這些延誤的原因以及您對這些成員加入後的最新期望是什麼？

Yes.

是的。

So I'll take them in order, Elizabeth.

所以我會按順序排列它們，伊麗莎白。

In terms of the customer acquisition cost for BetterHelp, the reason we sort of moved away from giving guidance is, as we have talked about, as we went through the quarter in Q2, relative to the expectations that we had about customer acquisition costs upon entering the quarter, the CAC was certainly a lot higher.

就 BetterHelp 的客戶獲取成本而言，正如我們所討論的，我們放棄提供指導的原因是，隨著我們進入第二季度，相對於我們進入時對客戶獲取成本的預期本季度，CAC 肯定要高得多。

We've talked about double-digit relative growth relative to the first quarter.

我們已經討論過相對於第一季的兩位數相對成長。

So the customer acquisition costs were a lot higher.

所以獲客成本高很多。

And we are not seeing, at this moment, a lot of improvement or change relative to that trajectory.

目前，我們還沒有看到相對於這一軌跡有很大的改進或變化。

For all of the reasons that we cited in the prepared remarks, right, we are diversified in terms of channels within the BetterHelp business, but we are the largest advertiser in this space.

出於我們在準備好的評論中引用的所有原因，我們在 BetterHelp 業務的管道方面實現了多元化，但我們是該領域最大的廣告商。

We are the most scaled business.

我們是規模最大的企業。

And for us to drive revenue growth, we would have to deploy incremental ad spend, but it is harder and harder to do that efficiently and more importantly, profitably.

為了推動收入成長，我們必須增加廣告支出，但要有效率、更重要的是要獲利，這一點越來越難。

And as we balance top line growth with return on ad spend and efficiency, that certainly increasingly becomes a challenge.

當我們平衡營收成長與廣告支出回報和效率時，這無疑日益成為一個挑戰。

So we continue to see elevated levels of customer acquisition costs.

因此，我們繼續看到客戶獲取成本不斷上升。

We have limited visibility into how those will play out as we go through the rest of the year.

在今年剩下的時間裡，我們對這些措施將如何發揮作用的了解有限。

You combine that with softening macros and so we felt the range of outcomes is just too large for us to provide guidance.

將其與軟化的宏觀政策結合起來，因此我們認為結果的範圍太大，我們無法提供指導。

So that's sort of on the customer acquisition cost.

所以這在某種程度上是關於客戶獲取成本的。

On the chronic care enrollees, couple of points to make.

對於慢性護理參與者，有幾點需要指出。

One is the client -- the launch -- the delays in client launches really are into 2025.

一是客戶端——發布——客戶端發布確實延遲到了 2025 年。

And so we would expect to enroll those members really in next year, not in the back half of this year.

因此，我們預計在明年真正招募這些成員，而不是今年下半年。

The other thing I would just comment and maybe, Chuck, you want to add more to this in terms of your mindset and philosophy from an execution standpoint, I do think there is an opportunity for us to continue to get better in conversion, in enrollment to execute better and better as we sort of get more data, do this for an increasing amount of time.

我只想評論的另一件事，也許查克，你想從執行的角度補充更多你的心態和理念，我確實認為我們有機會繼續在轉化和入學方面取得更好的成績當我們獲得更多數據時，為了更好地執行，請增加執行此操作的時間。

And that is also something that we certainly are taking a very hard look at from an execution perspective.

這也是我們從執行角度認真檢視的。

Chuck, I don't know

查克，我不知道

--

--

Yes.

是的。

I think you said it well.

我覺得你說得很好。

I think this is an example of what we mean by raising the bar on performance and execution in this space as an example, is taking an end-to-end look at how we are performing, how do we get the information we need, how do we leverage it, how do we reach out and engage, how do we measure each step of that process so that we are maximizing our potential in terms of the eligibles that are in front of us.

我認為這就是我們所說的提高這個領域的性能和執行標準的一個例子，我們正在端到端地審視我們的表現，我們如何獲得我們需要的信息，如何我們是否利用它，我們如何接觸和參與，我們如何衡量該過程的每一步，以便我們在我們面前的合格者方面最大限度地發揮我們的潛力。

So I think that's something you're going to see from us is just continuing to make sure that the processes we have and the operating model is delivering and performing as we expect.

因此，我認為您將從我們這裡看到的只是繼續確保我們擁有的流程和營運模式按照我們的預期交付和執行。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，康托費茲傑拉。

Can you clarify if the increase in advertising pricing is increasing evenly across all of the channels or if there are outliers where maybe a mix shift could be beneficial?

您能否澄清一下，廣告定價的成長是否在所有管道中均勻成長，或者是否存在可能有益的異常值？

And then when you talk about your strategy of not chasing customer acquisitions, does that mean that you're prioritizing holding the ratio of advertising and marketing to revenue flat from the level here?

然後，當您談論不追逐客戶獲取的策略時，這是否意味著您優先考慮將廣告和行銷與收入的比率保持在此處的水平？

Or should we think about it as more of a direction on your total dollar spend on advertising being more flattish?

或者我們應該將其視為廣告總支出更加平穩的方向？

Yes.

是的。

So let me address them in turns.

那麼讓我依次談談它們。

The thing that I would say on the channels -- the various channels, what we saw as we went through the second quarter is the following.

我要在通路上說的——各種管道，我們在第二季看到的情況如下。

We did see heightened cost in our non-auction channel.

我們確實看到非拍賣通路的成本增加。

So if you think about podcast, channels like that, we did see elevation in pricing in those channels to some extent relative to the first quarter, where we did see quite significant increase in our customer acquisition cost was in the auction channel.

因此，如果您考慮播客等管​​道，我們確實看到這些管道的定價相對於第一季上升，我們確實看到拍賣管道的客戶獲取成本顯著增加。

If you think about the dynamics of how ad spend works across these different channels, Sarah, the non-auction channels typically are somewhat gated in terms of capacity.

如果你考慮一下廣告支出在這些不同管道中如何運作的動態，莎拉，非拍賣管道通常在容量方面受到一定程度的限制。

And so where we really have a lot more flexibility in deploying ad spend is in the auction channel, paid search, et cetera.

因此，我們在部署廣告支出方面真正擁有更大彈性的是拍賣管道、付費搜尋等。

So that is really where we saw quite significant increase in our customer acquisition costs.

因此，這確實是我們的客戶獲取成本顯著增加的地方。

But we did see some elevation even in the non-auction channels.

但即使在非拍賣通路中，我們也確實看到了一些提升。

And that's one of the things I cited in my prepared remarks that the elevation in pricing across all of these channels leads us to believe that certainly, there is consumer pressure, there are macro softening because we are seeing that pressure across all of the channels.

這是我在準備好的發言中引用的一件事，即所有這些管道的定價上漲使我們相信，當然存在消費者壓力，並且存在宏觀經濟疲軟，因為我們看到所有管道都存在這種壓力。

In terms of how we are essentially managing this business for BetterHelp, I'm not going to speak to adjusted EBITDA for the back half or for the full year, just given the fact that we have withdrawn our guidance, and we've chosen to withdraw our guidance.

就我們如何本質上管理 BetterHelp 的這項業務而言，我不會談論下半年或全年的調整後 EBITDA，只是考慮到我們已經撤回了指導，並且我們選擇撤回我們的指導。

What I would say is the following.

我要說的是以下。

We are -- it's not like we are leaving profitable revenue dollars on the table.

我們並不是要放棄獲利收入。

What we are attempting to do and doing is essentially optimize return on ad spend so that if you think about the returns on the marginal dollar of revenue, it is not unprofitable.

我們正在嘗試做的事情本質上是優化廣告支出的回報，因此如果你考慮邊際收入的回報，它並不是無利可圖的。

So that is what we mean when we say we are not chasing revenue for revenue sake.

這就是我們說我們不會為了收入而追逐收入的意思。

We are balancing top line and revenue with bottom line.

我們正在平衡頂線和收入與底線。

Sean Dodge, RBC Capital Markets.

肖恩·道奇，加拿大皇家銀行資本市場部。

Mala, you mentioned three factors benefiting margins in the quarter.

Mala，您提到了本季有利於利潤率的三個因素。

The first one you called out, I think, was a performance fee you received related to the chronic care business.

我認為，您提出的第一個問題是您收到的與慢性病護理業務相關的績效費。

Can you quantify for us how much that contributed?

您能為我們量化一下這貢獻了多少嗎？

And then I think you also mentioned the timing of a shift in ad marketing spend related to what you were just talking about, that was pushed from Q2 into the back half of the year.

然後我認為您還提到了與您剛才談論的相關的廣告行銷支出轉變的時機，該轉變從第二季度推遲到今年下半年。

I was wondering if you could quantify that for us as well?

我想知道您是否也可以為我們量化這一點？

Yes.

是的。

So look, what we have said in the prepared remarks is we were -- we saw an adjusted EBITDA margin expansion of 640 basis points year over year.

所以看，我們在準備好的發言中所說的是——我們看到調整後的 EBITDA 利潤率同比增長了 640 個基點。

The three factors that we cited contributed to roughly about 340 basis points in total.

我們引用的三個因素總共促成了大約 340 個基點。

So excluding that, we would have expanded our margins by 300 basis points, still very healthy relative to what we generally expect on average.

因此，排除這一點，我們的利潤率將擴大 300 個基點，相對於我們普遍的平均預期仍然非常健康。

The only thing I would say, Sean, is offset 340 basis points, the factor of performance-based revenues was roughly, call it, about half of that or slightly less than half of that.

肖恩，我唯一想說的是抵銷了 340 個基點，基於績效的收入因素大約是其中的一半或略低於一半。

So about 150 basis points was around performance-based revenue.

因此，基於績效的收入大約有 150 個基點。

Charles Rhyee, TD Cowen.

查爾斯‧萊伊 (Charles Rhyee)，TD 考恩 (TD Cowen)。

Mala, I know you've mentioned you're not providing guidance here on BetterHelp.

Mala，我知道您提到您不會在 BetterHelp 上提供指導。

But just historically, if you think about the cadence that we've seen over the last couple of years, you've talked about sort of using ad spend for the second and third quarters, kind of ramping that down in the fourth quarter, then to sort of harvest the margin.

但從歷史上看，如果你考慮我們在過去幾年中看到的節奏，你會談到在第二季和第三季使用廣告支出，在第四季減少廣告支出，然後來收穫利潤。

And so historically, at least over the last couple of years, fourth quarter has been sort of the biggest EBITDA quarter in terms of dollars for BetterHelp.

從歷史上看，至少在過去幾年中，第四季是 BetterHelp EBITDA（以美元計算）最大的季度。

But given sort of what you're seeing now in terms of CAC, customer acquisition costs, in -- it looks like in 3Q as well, should we still expect sort of that seasonal pattern for EBITDA?

但考慮到您現在在 CAC、客戶獲取成本方面所看到的情況，第三季的情況也是如此，我們是否仍應該預期 EBITDA 會出現這種季節性模式？

Or should we think about EBITDA maybe being a little bit more sequentially flattish in the fourth quarter?

或者我們應該考慮第四季度的 EBITDA 可能會比上一季持平一些？

Would you expect sort of that historical pattern still to sort of be evident?

您是否認為這種歷史模式仍然很明顯？

Yes.

是的。

Thank you, Charles.

謝謝你，查爾斯。

Here's what I would say to you.

這就是我要對你說的話。

I think that given the fact that we typically historically have pulled back on ad spend in the fourth quarter for an important reason, the holiday pricing season for ad spend tends to be relatively inefficient.

我認為，鑑於歷史上我們通常會出於一個重要原因而減少第四季度的廣告支出，因此假日定價季節的廣告支出往往效率相對較低。

And I would say, if you combine that with what may happen leading up to the elections, again, this is -- we have limited visibility into how customer acquisition costs are going to go.

我想說，如果你將其與選舉前可能發生的情況結合起來，我們對客戶獲取成本將如何變化的了解有限。

But if you look at what has happened in terms of holiday pricing, I would expect that obviously to continue this year.

但如果你看看假期定價方面發生的情況，我預計今年這種情況顯然會持續下去。

And that certainly will have -- will weigh in on our decision on how much to spend in the fourth quarter.

這肯定會影響我們第四季支出的決定。

I would also say, as always, we would balance that with setting ourselves up for 2025 in a reasonable manner from a top line growth perspective and a user perspective.

我還想說，一如既往，我們會從營收成長的角度和用戶的角度，以合理的方式為 2025 年做好平衡。

So again, what I'm saying is no different from the different considerations we put into the mix every single year.

再說一次，我所說的話與我們每年都會考慮的不同因素沒有什麼不同。

I would say our thinking would be along the same line as we go through the year.

我想說，我們的想法將與今年的情況保持一致。

Michael Cherny, Leerink Partners.

邁克爾·切爾尼，Leerink Partners。

Maybe if we can go back relative to the removal of the multiyear targets, I understand given all the commentary you've had so far regarding BetterHelp why you would do that.

也許如果我們可以回顧一下取消多年目標的問題，鑑於您迄今為止收到的有關 BetterHelp 的所有評論，我理解您為什麼要這樣做。

That being said, is the intention still to run the business as if those were the targets you were pushing for?

話雖如此，您是否仍打算按照您所推動的目標來經營業務？

Are you using this as a potential pivot point to make any drastic changes?

您是否將此作為潛在的支點來進行任何重大改變？

I know someone earlier had asked about the launch of future of BetterHelp.

我知道早些時候有人詢問過 BetterHelp 未來的推出。

I'm just thinking about operationally, how you're thinking about running the organization, managing the organization, given this elevated level of uncertainty with what I'm hearing, still a little bit lack of visibility in terms of when it can turn around?

我只是在考慮營運方面，你如何考慮營運組織、管理組織，考慮到我所聽到的不確定性很高，對於何時能夠扭轉局面仍然缺乏可見性？

Yes.

是的。

So -- we'll address that in two ways specific to BetterHelp and then what it means, obviously, BetterHelp is an important contributor to our overall financial revenue, profit as well as free cash flow.

因此，我們將透過兩種特定於 BetterHelp 的方式來解決這個問題，然後它的含義顯然是，BetterHelp 是我們整體財務收入、利潤以及自由現金流的重要貢獻者。

So as it relates to BetterHelp, look, it's a business in transition.

因此，就 BetterHelp 而言，它是一項正在轉型的業務。

And because we have limited near-term visibility, I think what's important for us to do is to really manage the business in a very disciplined way to balance top line and bottom line, not chase revenue growth for revenue growth sake.

由於我們的近期能見度有限，我認為對我們來說重要的是以非常嚴格的方式真正管理業務，以平衡營收和利潤，而不是為了收入成長而追逐收入成長。

Really look at optimizing our return on ad spend, while preparing the business to make the strategic pivots that we need to make.

真正著眼於優化我們的廣告支出回報，同時讓業務做好準備，實現我們需要的策略轉型。

Those include the international expansion, which is going well relative to our expectations that we had as we went into the year.

其中包括國際擴張，相對於我們今年的預期，國際擴張進展順利。

We are making progress and going deeper into the English-speaking markets.

我們正在取得進展並深入英語市場。

We are looking judiciously expanding into some non-English speaking markets.

我們正在明智地尋求擴展到一些非英語市場。

So far, the revenue per user and customer acquisition costs that we are seeing are in line with expectations in line with what we had gone into this expansion with.

到目前為止，我們看到的每用戶收入和客戶獲取成本符合我們此次擴張的預期。

So that's on international.

所以這是在國際上。

We have talked about BetterHelp with insurance.

我們已經討論了保險方面的 BetterHelp。

We are looking at other strategic pivots in this business.

我們正在尋找該業務的其他策略支點。

And I think it is important for us to balance the shorter term of how we stabilize the -- what I call, the US consumer business, the core business with managing all of pivot from a leadership perspective, from a bandwidth perspective of the management team at BetterHelp as well as from an investment perspective.

我認為，對我們來說，平衡短期內如何穩定我所說的美國消費者業務、核心業務與從領導力角度、從管理團隊的頻寬角度管理所有關鍵業務之間的平衡非常重要在BetterHelp 以及從投資角度來看。

So that is, I would say, on the BetterHelp side.

我想說的是，在 BetterHelp 方面。

I would say, more broadly, from an integrated care standpoint, we've reformed our 2024 guidance on revenue.

我想說，更廣泛地說，從綜合護理的角度來看，我們已經改革了 2024 年的收入指導。

You've talked about bringing down the low end of the adjusted EBITDA margin expansion, still a healthy margin expansion year over year, 150 to 200 basis points.

您談到了降低調整後 EBITDA 利潤率擴張的下限，但同比仍保持健康的利潤率擴張，即 150 至 200 個基點。

And under Chuck's leadership, we are taking a serious look at many different things from a structure and a management perspective of the business.

在查克的領導下，我們正在從業務的結構和管理角度認真審視許多不同的事情。

We are clarifying accountability, and that's really going to help us prioritize our investments for growth.

我們正在澄清責任，這確實有助於我們優先考慮成長投資。

So Chuck has spoken in his remarks on how he's taking a comprehensive look across all aspects of the business.

因此，查克在演講中談到了他如何全面審視業務的各個方面。

And that's a process that's going to take a little bit of time.

這個過程需要一些時間。

So we wanted to just give him the ability to go through that, to complete that in a thoughtful way.

所以我們想讓他有能力經歷這一切，以深思熟慮的方式完成這一切。

And we will come back to you all in terms of what that means in terms of an updated outlook over the coming months.

我們將在接下來的幾個月向大家介紹這對更新的前景意味著什麼。

Daniel Grosslight, Citi.

丹尼爾‧格羅斯萊特，花旗銀行。

Just wanted to clarify that the chronic care enrollment delay, that's separate from the technical issue you mentioned last quarter.

只是想澄清一下，慢性護理登記延遲，這與您上季度提到的技術問題是分開的。

And then my real question is on how you're thinking about performance guarantees and really value-based care and population health going forward?

然後我真正的問題是，您如何考慮績效保證以及真正基於價值的護理和人口健康？

I understand it's a small part of the business right now.

我知道這只是目前業務的一小部分。

But Chuck, given your experience building out value-based care assets at Guidewell, I'm curious how you're thinking about leveraging that experience to take a more clinical risk, not necessarily this year, but maybe '25, '26 and beyond?

但是 Chuck，考慮到您在 Guidewell 建立基於價值的護理資產的經驗，我很好奇您如何考慮利用這些經驗來承擔更多的臨床風險，不一定是今年，但可能是 25 年、26 年及以後？

Yes.

是的。

Well, I'll hit the second part and then Mala can comment.

好吧，我會講第二部分，然後馬拉可以發表評論。

Yes, I do think back to the customer base and the sophisticated buyers and expecting more and more in terms of performance measurements and outcomes, that aligns well with what we've been doing as a company and what we are and will be building out in terms of a more complete picture to manage patients.

是的，我確實回想起客戶群和成熟的買家，他們對績效衡量和結果的期望越來越高，這與我們作為一家公司一直在做的事情以及我們正在和將要建立的目標非常吻合。更全面地了解患者管理情況。

So I think those things are going to converge where you're going to see, one, our capabilities expand, which are already strong today, but there's additional elements as we move forward and a convergence with the customer base in the marketplace that is expecting and demanding more value-based measurements and willing to put more of the economics in play, if you will, and allow a company like ours to participate in the value that we are able to create.

因此，我認為這些事情將會融合在一起，您將看到，第一，我們的能力擴展，這些能力今天已經很強大，但是隨著我們的前進，還有其他因素以及與市場中預期的客戶群的融合要求更多基於價值的衡量標準，如果願意的話，願意更多地考慮經濟因素，並允許像我們這樣的公司參與我們所能創造的價值。

So I think both of those are going to be an important part of the future for us and for other organizations like us.

因此，我認為對於我們以及像我們這樣的其他組織來說，這兩者都將成為未來的重要組成部分。

Mala, would you add anything?

馬拉，你要補充點什麼嗎？

No, I'll just hit the first part of your question, Daniel.

不，我只想回答你問題的第一部分，丹尼爾。

Look, the issues and the challenges that we had at the beginning of the year were really related more to client mapping, data mapping on our client hierarchies.

看，我們在年初遇到的問題和挑戰實際上與客戶映射、客戶層次結構上的資料映射有關。

That is -- really, we've solved for that.

事實上，我們已經解決了這個問題。

That's behind us.

那是在我們身後。

What I will say is -- and Chuck sort of mentioned this in his prepared remarks, I do think that, as we move forward, it is important that we don't have execution misses like that because it does certainly mean that we have to get over the challenges it creates from a results perspective relative to the plans that we have.

我要說的是——查克在他準備好的演講中提到了這一點，我確實認為，隨著我們前進，重要的是我們不要出現這樣的執行失誤，因為這確實意味著我們必須從與我們現有計劃相關的結果角度來看，克服它帶來的挑戰。

And so as we are beginning to work with Chuck, we are certainly spending time as a leadership team, looking at our internal structures, our governance, et cetera, that is really going to prevent us from having those kinds of

因此，當我們開始與查克合作時，我們肯定會花時間作為一個領導團隊，研究我們的內部結構、我們的治理等等，這確實會阻止我們出現這種情況。

--

--

We're now out of time for any further questions.

我們現在沒有時間回答任何進一步的問題了。

So this concludes the Q&A session as well as the conference call.

問答環節和電話會議到此結束。

Thank you, everyone, for joining.

謝謝大家的加入。

You may now disconnect your lines.

現在您可以斷開線路。