Teladoc Health Inc (TDOC) 2024 Q3 法說會逐字稿

Hello, and welcome to the Teladoc Health's third quarter 2024 earnings call. My name is Alex, I'll be coordinating the call today. (Operator Instructions) I'll now hand over to your host, Michael Minchak, Head of Investor Relations. Please go ahead.

您好，歡迎參加 Teladoc Health 的 2024 年第三季財報電話會議。我叫亞歷克斯，今天我將協調通話。 （操作員指示）我現在將會議交給東道主投資者關係主管 Michael Minchak。請繼續。

Thank you and good afternoon. Today after the market closed, we issued a press release announcing our third quarter 2024 financial results. This press release and the accompanying slide presentation are available in the Investor Relations section of the teladochealth.com website.

謝謝你，下午好。今天收盤後，我們發布了新聞稿，宣布 2024 年第三季財務業績。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。

On this call to discuss the results are Chuck Divita, Chief Executive Officer, and Mala Murthy, Chief Financial Officer. During this call, we will also discuss our outlook, and our prepared remarks will be followed by a question-and-answer session.

執行長 Chuck Divita 和財務長 Mala Murthy 出席了此次電話會議，討論結果。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. Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release that is posted on our website.

請注意，我們將討論某些我們認為對評估 Teladoc Health 績效非常重要的非 GAAP 財務指標。有關這些非公認會計準則衡量標準與最具可比性的公認會計準則衡量標準及其調節之間關係的詳細信息，請參閱我們網站上發布的新聞稿。

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

另請注意，本次電話會議期間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。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. We're pleased with our results for the quarter, including delivering integrated care revenue, adjusted EBITDA, and membership of our guidance as well as better help revenue in line with prior commentary. Mala will provide more detail on our results in a moment. And before turning to Mala, I would like to share some additional thoughts on the business having ramped up my first full quarter as CEO.

謝謝麥克，大家下午好。我們對本季的業績感到滿意，包括提供綜合護理收入、調整後的 EBITDA 和我們的指導會員資格，以及根據先前的評論更好地幫助收入。 Mala 稍後將提供有關我們結果的更多詳細資訊。在談到 Mala 之前，我想分享一些關於我擔任執行長的第一個完整季度業務成長的其他想法。

I believe in our potential I see many strengths to build upon, including the company's market position and scale assets and talented employees. We are making a lot of changes, and I want to thank our employees for their dedication to serving our customers and how they're leaning in to move the business forward.

我相信我們的潛力，我看到了許多可以依靠的優勢，包括公司的市場地位、規模資產和有才華的員工。我們正在做出很多改變，我要感謝我們的員工為客戶服務的奉獻精神以及他們如何努力推動業務向前發展。

As I mentioned in the second quarter call, I also see opportunities to strengthen performance and position the company for long-term success. We've been addressing this with urgency, including streamlining our leadership structure, rationalizing priorities, and improving execution. The operational challenges experienced earlier in the year, which can have a lingering impact on the business underscores the importance of making progress in this regard.

正如我在第二季電話會議中提到的，我還看到了增強業績並為公司取得長期成功定位的機會。我們一直在緊急解決這個問題，包括精簡領導結構、合理化優先事項和提高執行力。今年稍早經歷的營運挑戰可能對業務產生持久影響，凸顯了在這方面取得進展的重要性。

Changes have also been made to how we manage the business to sharper market focused, accelerate product innovation, and pursue new ways to serve our customers' needs. For example, in US in a good care, we brought together areas previously managed separately and combined them directly under a single business leadership structure.

我們的業務管理方式也發生了變化，更加以市場為中心，加速產品創新，並尋求新的方式來滿足客戶的需求。例如，在美國的良好護理中，我們將以前單獨管理的領域合併在一起，並將它們直接合併到一個業務領導結構中。

We've also broadened our clinical delivery capabilities, refined shared services, and more closely aligned investments and deliverables. There is more work ahead of us, but we're already seeing positive impacts in terms of efficiency and effectiveness, and I'm confident that we're creating a stronger foundation for the future.

我們也擴大了我們的臨床交付能力，完善了共享服務，並更緊密地結合了投資和交付成果。我們還有更多的工作要做，但我們已經看到了效率和效益的正面影響，我相信我們正在為未來奠定更堅實的基礎。

These actions are also important as we look at the dynamics within the markets we're serving. In the US market, it's clear that continued high medical cost trends and other pressures are impacting our current and prospective customers. And in turn, they are evaluating their strategies and expecting more value from the broader health care ecosystem, including from virtual care.

當我們審視我們所服務的市場的動態時，這些行動也很重要。在美國市場，很明顯，持續的高醫療成本趨勢和其他壓力正在影響我們現有和潛在的客戶。反過來，他們正在評估自己的策略，並期望從更廣泛的醫療保健生態系統（包括虛擬醫療）中獲得更多價值。

Through our leadership position in the US, we see an ability to further enhance our value proposition to support these evolving needs. This includes generating greater value from our virtual visits and touch points and deepening the impact of our chronic condition management services. We see these areas as essential to unlocking our growth potential. As such, this will be a core priority in terms of strategic direction and investments we're making.

透過我們在美國的領導地位，我們看到有能力進一步增強我們的價值主張，以支持這些不斷變化的需求。這包括從我們的虛擬訪問和接觸點中產生更大的價值，並加深我們的慢性病管理服務的影響。我們認為這些領域對於釋放我們的成長潛力至關重要。因此，這將是我們正在進行的策略方向和投資的核心優先事項。

Our international integrated care business is well-positioned and continues to gain strong momentum through geographic expansion in market penetration and added services to existing customers. We've had some important wins in several markets, including in Canada. We expect to further invest in our International Integrated Care business as a core priority as well to support our growth agenda.

我們的國際綜合護理業務處於有利地位，並透過市場滲透的地理擴張和為現有客戶提供的附加服務繼續獲得強勁動力。我們在包括加拿大在內的多個市場取得了一些重要的勝利。我們希望將進一步投資國際綜合護理業務作為核心優先事項，並支持我們的成長議程。

With respect to better help, our current focus is on running it effectively by balancing top line growth with profitability and evaluating initiatives aimed at generating greater value from the business, better help us become the largest direct to consumer virtual therapy business of its kind by addressing an unmet need and serves over 1 million people per year and with the consumer net promoter score of over 70.

關於更好的幫助，我們目前的重點是透過平衡營收成長和獲利能力來有效地運作它，並評估旨在從業務中產生更大價值的舉措，透過解決以下問題，更好地幫助我們成為同類中最大的直接面向消費者的虛擬治療業務未滿足的需求，每年為超過 100 萬人提供服務，消費者淨推薦值超過 70。

With that said, challenges remain including declining revenues when compared to prior periods. Solid progress is being made towards stabilizing results in the US and growing internationally. Mala will comment more on that in a moment.

儘管如此，挑戰仍然存在，包括與前期相比收入下降。在美國穩定業績和國際成長方面正在取得紮實進展。馬拉稍後將對此發表更多評論。

BetterHelp is also making progress on an initiative to provide consumers with the ability to access their coverage benefits. Capability milestones are on track and exploratory discussions have begun with selected health plans and other potential partners. As I mentioned in the second quarter call, a measured approach being taken with this initiative and the primary focus remains on improving direct to consumer results.

BetterHelp 在一項為消費者提供獲得保險福利的能力的計劃方面也取得了進展。能力里程碑已步入正軌，並已開始與選定的健康計劃和其他潛在合作夥伴進行探索性討論。正如我在第二季電話會議中提到的，這項措施正在採取謹慎的方法，主要重點仍然是改善直接面向消費者的結果。

In closing, let me highlight some key themes we're rallying around to drive the business going forward. The first is customer centricity. We operate and complex and evolving markets, and it's essential to understand the unique needs of our customers and in turn, be able to consistently deliver solutions that demonstrate value and support their objectives.

最後，讓我強調我們正在團結起來推動業務向前發展的一些關鍵主題。首先是以客戶為中心。我們經營複雜且不斷變化的市場，了解客戶的獨特需求至關重要，進而能夠始終如一地提供能夠展示價值並支持其目標的解決方案。

Second, we intend to further leverage technology to drive greater scale and differentiation and to deliver a more integrated experience for our members and providers. We will focus our technology investments against key business priorities and balance overall spent with benefit realization objectives.

其次，我們打算進一步利用技術來推動更大的規模和差異化，並為我們的會員和提供者提供更整合的體驗。我們將把技術投資重點放在關鍵業務優先事項上，並平衡整​​體支出與效益實現目標。

Third, clinical excellence will continue to be a core pillar in what we do and how we differentiate our solutions in the market. We will build on a strong track record that we already established as a company to further inform our product roadmap, and how we enable and deliver services and generate results for our customers and patients.

第三，臨床卓越性將繼續成為我們所做工作以及如何使我們的解決方案在市場上脫穎而出的核心支柱。我們將建立在我們作為一家公司已經建立的良好記錄的基礎上，進一步告知我們的產品路線圖，以及我們如何為我們的客戶和患者提供和提供服務並產生結果。

And fourth, we're embracing a high-performance culture, one that has a bias to action on collaboration and innovation, all in the pursuit of serving our customers and driving long-term shareholder value. We are going through a lot of changes as a company and as an industry, and culture will play a critical role in shaping our future.

第四，我們正在擁抱一種高績效文化，這種文化偏向協作和創新行動，所有這些都是為了追求服務客戶並推動長期股東價值。作為一家公司和一個行業，我們正在經歷很多變化，文化將在塑造我們的未來方面發揮關鍵作用。

We're already taking actions in support of these areas and the priorities I outlined earlier. As we close out the year and move into 2025, we remain focused on our financial performance while also making investments to strengthen our position and ability to unlock future growth potential. I'm gratified by the progress we're making and with our overall results for the quarter.

我們已經採取行動支持這些領域和我之前概述的優先事項。 2025 年即將結束，我們將繼續專注於財務業績，同時進行投資以加強我們的地位和能力，釋放未來的成長潛力。我對我們所取得的進展以及本季的整體業績感到滿意。

And with that, I'll turn it over to Mala.

有了這個，我會把它交給馬拉。

Thank you, Chuck, and good afternoon, everyone. Third quarter consolidated revenue of $641 million decreased 3% year over year. Third quarter adjusted EBITDA was $83.3 million, down 6% year-over-year and represented a margin of 13%. Consolidated net loss per share in the third quarter was $0.19 compared to a net loss per share of $0.35 in the third quarter of 2023.

謝謝你，查克，大家下午好。第三季合併營收為 6.41 億美元，年減 3%。第三季調整後 EBITDA 為 8,330 萬美元，年減 6%，利潤率為 13%。第三季合併每股淨虧損為 0.19 美元，而 2023 年第三季每股淨虧損為 0.35 美元。

Net loss per share in the third quarter included amortization of acquired intangible of $0.3 per share pre-tax and stock-based compensation expense of $0.2 per share pretax. Additionally, during the quarter, we also recorded a $3.6 million charge or $0.02 per share pretax related to severance costs as well as lease termination costs as we continue to act upon expense efficiency opportunities.

第三季每股淨虧損包括每股稅前收購無形資產攤提 0.3 美元，以及每股稅前股票補償費用 0.2 美元。此外，在本季度，我們還記錄了與遣散費以及租賃終止成本相關的 360 萬美元費用或每股稅前 0.02 美元，因為我們繼續利用費用效率機會。

Third quarter free cash flow was $79 million, up approximately 16% on a year-over-year basis. We ended the quarter with over $1.2 billion in cash and cash equivalents on the balance sheet. Turning to our segment results. Integrated Care segment revenue of $384 million increased 2.5% over the prior year period and was above the top end of our guidance range.

第三季自由現金流為 7,900 萬美元，較去年同期成長約 16%。本季末，我們資產負債表上的現金和現金等價物超過 12 億美元。轉向我們的部門業績。綜合護理部門營收為 3.84 億美元，比去年同期成長 2.5%，高於我們指導範圍的上限。

During the quarter, we benefited from the resolution of a prior period billing adjustments with a large client, which added roughly 115 basis points to revenue growth. Our virtual care business saw strong growth in visit revenue has increased membership drove additional visit volume.

在本季度，我們受益於與一個大客戶的前期帳單調整的解決方案，這使收入增長了大約 115 個基點。我們的虛擬護理業務的訪問收入強勁增長，會員數量的增加推動了訪問量的增加。

US integrated care segment membership at quarter end was 93.9 million members above the high end of our guidance range, increasing by 4% year-over-year and by approximately 1.5 million members sequentially.

截至季末，美國綜合護理細分市場會員數為 9,390 萬，高於我們指導範圍的上限，年增 4%，季增約 150 萬。

Chronic Care ended the quarter with total program enrollment of [1.18 million], up approximately 5% year-over-year and up slightly sequentially, driven by enrollments from both existing and new clients. Our international integrated care operations continue to show strong momentum with revenue growth in the high teens on a constant currency basis.

本季末，慢性病照護計畫總註冊人數為 [118 萬人]，年增約 5%，較上季小幅成長，主要得益於現有客戶和新客戶註冊人數的推動。我們的國際綜合護理業務持續表現出強勁的勢頭，以固定匯率計算，營收成長約十幾歲。

We are seeing continued success in winning large B2B clients, moving into adjacent verticals that we believe will deliver new opportunities for growth. Average integrated care revenue per US member of $1.36 was flat sequentially and down by $0.05 versus the prior year's third quarter. As we have previously discussed, this dynamic is largely mix driven as a result of onboarding a sizable amount of new members in our general medical products.

我們看到在贏得大型 B2B 客戶方面不斷取得成功，進入相鄰的垂直領域，我們相信這將帶來新的成長機會。美國會員平均綜合護理收入為 1.36 美元，與上一季持平，比去年第三季下降 0.05 美元。正如我們之前所討論的，這種動態很大程度上是由混合驅動的，因為我們的普通醫療產品中引入了大量新成員。

These members typically contribute less to our average revenue per member initially, although we see opportunity to cross-sell additional products next strategy and generate additional visit volume over time.

這些會員最初對我們每位會員的平均收入的貢獻通常較小，儘管我們看到了下一個策略交叉銷售其他產品並隨著時間的推移產生額外訪問量的機會。

Third quarter integrated care adjusted EBITDA was $68 million and 8% increase over the third quarter of 2023. Adjusted EBITDA margin of 17.7% was well above our guidance range of 14.5% to 16% and represented growth of 96 basis points over the third quarter of 2023. We saw approximately 170 basis points of benefit to adjusted EBITDA margins from the previously discussed revenue adjustment as well as some favorability from OpEx timing.

第三季綜合護理調整後EBITDA 為6,800 萬美元，比2023 年第三季成長8%。季度成長96 個基點2023 年。

Turning to the BetterHelp segment. Third quarter of revenue of $257 million was down 10% versus the prior year and consistent with the baseline we had previously communicated. While there has been some variability across our channel, overall, customer acquisition costs in the third quarter have remained relatively stable, albeit at elevated levels. Revenue declined approximately 3% versus the second quarter.

轉向 BetterHelp 部分。第三季營收為 2.57 億美元，比上年下降 10%，與我們先前溝通的基準一致。儘管我們的通路存在一些變化，但總體而言，第三季的客戶獲取成本仍然相對穩定，儘管處於較高水平。營收較第二季下降約 3%。

Average paying users declined by 2% sequentially and were down 13% versus the prior year. The decline in revenue and average paying users in the third quarter was a result of fewer growth reserves added to the platform as we again made a deliberate decision to refrain from pursuing inefficient member base growth. Importantly, average revenue per user, churn rates, and member retention have all been fairly stable for the course of 2024.

平均付費用戶較上年下降 2%，較前一年下降 13%。第三季營收和平均付費用戶的下降是由於平台增加的成長儲備減少所致，因為我們再次深思熟慮地決定不追求低效的會員基礎成長。重要的是，到 2024 年，每位用戶的平均收入、流失率和會員保留率都相當穩定。

We started to see some early signs of stability in the paying user account with slightly positive momentum in the third quarter as the monthly user account at the end of September was modestly above that at the end of the month of June. BetterHelp adjusted EBITDA was $15.2 million in the third quarter, down from $26 million in the prior year and $25.5 million in the second quarter of 2024.

我們開始看到付費用戶帳戶出現一些穩定的早期跡象，並在第三季度出現略微積極的勢頭，因為 9 月底的月度用戶帳戶略高於 6 月底的月度用戶帳戶。 BetterHelp 第三季調整後 EBITDA 為 1,520 萬美元，低於上一年的 2,600 萬美元和 2024 年第二季的 2,550 萬美元。

Adjusted EBITDA margin of 5.9% decreased approximately 320 basis points versus the prior year and was down from 9.6% in the second quarter. Factors driving the decline includes the impact of lower revenue this quarter, coupled with some additional ad spend in particular in the international markets at a favorable return, which helped drive the stability in the monthly user comes.

調整後 EBITDA 利潤率為 5.9%，較上年同期下降約 320 個基點，低於第二季的 9.6%。推動下降的因素包括本季收入下降的影響，再加上一些額外的廣告支出，特別是在國際市場上的良好回報，這有助於推動每月用戶數的穩定。

Now let me turn to guidance. For the fourth quarter, we expect integrated care segment's revenue to be flat to up 2.5%. We expect adjusted EBITDA margin between 12.25% and 13.75%. The lower sequential margin in 4Q reflects our strong third quarter margin as well as incremental investments we plan to make in the fourth quarter to advance the priorities Chuck had discussed earlier.

現在讓我談談指引。對於第四季度，我們預計綜合護理部門的營收將持平至成長 2.5%。我們預計調整後 EBITDA 利潤率在 12.25% 至 13.75% 之間。第四季較低的連續利潤率反映了我們強勁的第三季利潤率以及我們計劃在第四季度進行的增量投資，以推進查克之前討論的優先事項。

We expect these incremental investments to drive or roughly 125 basis point headwind to adjusted EBITDA margins in the fourth quarter. Our fourth quarter guidance implies full year our integrated care revenue growth in the low to mid single-digit range, which has remained unchanged over the course of 2024. Based on the performance to date and fourth quarter outlook, full year adjusted EBITDA margin is now expected to be in the range of 14.9% to 15.3%, with the midpoint in line with the midpoint of our initial guidance provided in February.

我們預計這些增量投資將推動第四季調整後 EBITDA 利潤率下降約 125 個基點。我們第四季度的指導意味著全年我們的綜合護理收入增長將在低至中個位數範圍內，並且在2024 年期間保持不變。調整後的EBITDA 利潤率預計在 14.9% 至 15.3% 範圍內，中點與我們 2 月提供的初步指引的中點一致。

At the midpoint of this range, adjusted EBITDA dollars would be up approximately 20% in 2024 versus 2023. In addition, with third quarter coming in above guidance, we are raising our US integrated care member of our guidance range and now expect to end the year at 93.5 million to 94.5 million members. For BetterHelp, while we are encouraged by the improved stability seen in the third quarter, based on the factors mentioned in the second quarter, we are not reinstating formal segment revenue.

在此範圍的中點，調整後的EBITDA 美元在2024 年將比2023 年增長約20%。 ，現在預計將結束年會員人數為 9350 萬至 9450 萬。對於 BetterHelp 來說，雖然我們對第三季穩定性的改善感到鼓舞，但基於第二季提到的因素，我們不會恢復正式的部門收入。

Our adjusted EBITDA guidance for the fourth quarter of full year. Therefore, to help level set from a modeling standpoint, we offer the following three points. First, the election season has led to some uncertainty. Although as we approach November, this has not had a significant impact at this stage. However, the holiday season does present an additional area of uncertainty.

我們調整後的全年第四季 EBITDA 指引。因此，為了從建模的角度幫助設定水平，我們提供以下三點。首先，選舉季帶來了一些不確定性。儘管接近 11 月，但現階段這還沒有產生重大影響。然而，假期確實帶來了額外的不確定性。

Second, as we had discussed on the second quarter call, the customer acquisition costs remain at current levels. We would expect second half revenue to be down low double digits. We anticipate the year-over-year decline in the fourth quarter to be generally consistent with the third quarter. And third, while we historically have seen a sizable sequential step-up and adjusted EBITDA dollars and margins in the fourth quarter versus the third quarter, we have already been cutting back on US ad spend thus far in 2024, while we are also investing incrementally across our international business and Betterhealth.

其次，正如我們在第二季電話會議上所討論的那樣，客戶獲取成本仍保持在當前水準。我們預計下半年收入將下降兩位數。我們預計第四季的年減將與第三季基本一致。第三，雖然從歷史上看，第四季的EBITDA 美元和利潤率與第三季相比出現了大幅連續成長和調整後的利潤，但2024 年到目前為止，我們已經在削減美國廣告支出，同時我們也逐步投資涵蓋我們的國際業務和 Betterhealth。

And therefore, the sequential decline in ad spend from the third to the fourth quarter will be less significant this year, which we expect would lead to a much smaller step up in fourth quarter adjusted EBITDA. Based on our decision to not reinstate formal guidance for the better health segment, we are therefore not offering guidance for consolidated revenue, adjusted EBITDA, net loss per share or free cash flow for the fourth quarter or full year 2024.

因此，今年第三季到第四季廣告支出的環比下降幅度將較小，我們預計這將導致第四季度調整後 EBITDA 的增幅小得多。基於我們決定不恢復對更好健康領域的正式指導，因此我們不會提供 2024 年第四季度或全年的合併收入、調整後 EBITDA、每股淨虧損或自由現金流的指導。

As we look ahead, we wanted to provide you some color on the trends we are seeing in the business that are shaping the 2025 outlook. First, within the integrated care segment, the selling season in the US extends through the fourth quarter, and we continue to aggressively work our pipeline. Our retention rate remains above 90%, but it's down slightly versus prior years.

展望未來，我們希望為您提供一些關於我們在塑造 2025 年前景的業務趨勢方面的資訊。首先，在綜合護理領域，美國的銷售季節持續到第四季度，我們繼續積極開發我們的產品線。我們的保留率仍保持在 90% 以上，但與往年相比略有下降。

Bookings are tracking lower than this point in the prior year, which we believe reflects the challenging backdrop more broadly, including with respect to health plans due to various market developments. That said, we believe contribution from new and existing customers will lead to increases in membership and visit volumes.

預訂量低於去年的這一點，我們認為這更廣泛地反映了充滿挑戰的背景，包括由於各種市場發展而導致的健康計劃。也就是說，我們相信新舊客戶的貢獻將導致會員數量和訪問量的增加。

Our international integrated care business has delivered steady and predictable results over the past few years, outpacing overall segment revenue growth, and we expect strong growth to continue next year. Taken together, these factors could lead to 2025 full year revenue growth that is consistent with the range of growth we are projecting in the fourth quarter of 2024.

我們的國際綜合護理業務在過去幾年中取得了穩定且可預測的業績，超過了整體部門收入的成長，我們預計明年將繼續強勁增長。總而言之，這些因素可能會導致 2025 年全年營收成長，這與我們預測的 2024 年第四季的成長範圍一致。

Turning to margins, our 2024 guidance implies strong margin expansion. We have realized benefits from ongoing progress we are making against cost savings and productivity initiatives and expect benefits to continue to accrue next year. We view 2025 as being an important repositioning year for the company, as we execute against strategic initiatives aimed at strengthening of the business and aligned with the priorities that Chuck has laid out earlier.

談到利潤率，我們的 2024 年指導意味著利潤率將強勁擴張。我們已從成本節約和生產力計劃方面取得的持續進展中獲益，並預計明年將繼續產生效益。我們認為 2025 年是公司重新定位的重要一年，因為我們執行旨在加強業務的策略性舉措，並與 Chuck 早期制定的優先事項保持一致。

Actions we are taking to position the company for long-term success will require incremental investments as we build out various products and capabilities. These will help enhance our value proposition and more effectively support client objectives as we adapt to evolving market demand and pricing dynamics in the core virtual care business. We expect these investments to ultimately unlock growth opportunities into the future and position the company to deliver sustainable, improved performance.

我們為使公司長期成功而採取的行動將需要在我們建立各種產品和能力時進行增量投資。當我們適應核心虛擬護理業務不斷變化的市場需求和定價動態時，這些將有助於增強我們的價值主張並更有效地支持客戶目標。我們預計這些投資最終將釋放未來的成長機會，並使公司能夠實現可持續、改進的績效。

Importantly, we remain committed to managing the business to an appropriate level of performance and endeavor to maintain adjusted EBITDA margins in 2025, generally in line with 2024 levels. Next, BetterHelp continues to be a business in transition. We faced tough year-over-year comps in 2025, resulting from decline and paying users in our existing business over the course of 2024, due to higher customer acquisition costs, which we expect to remain elevated in 2025 and steady with current levels.

重要的是，我們仍然致力於將業務管理到適當的績效水平，並努力在 2025 年保持調整後的 EBITDA 利潤率與 2024 年的水平基本一致。接下來，BetterHelp 仍然是一家轉型中的企業。我們在2025 年面臨著艱難的同比業績，這是由於客戶獲取成本較高，導致2024 年現有業務的付費用戶減少和付費用戶減少，我們預計客戶獲取成本將在2025 年保持較高水平，並穩定在當前水平。

Traction from our various initiatives, including insurance acceptance, further international expansion, and product enhancements should contribute incrementally helping to ameliorate headwinds in the existing business and leading to greater stability in revenue on a quarter over quarter basis as we progress over the course of the fiscal year. Our focus will be on prudently managing the top and bottom line, and we won't pursue inefficient growth in our user base to ensure margin stability going forward.

我們各種措施的牽引力，包括保險承保、進一步的國際擴張和產品增強，應該會逐步有助於改善現有業務的不利因素，並隨著我們在財政過程中的進展，使收入在季度與季度之間較穩定。我們的重點將是審慎管理營收和利潤，我們不會追求用戶群的低效率成長，以確保未來利潤率的穩定。

Finally, I wanted to wrap up with some quick thoughts on capital allocation. We have a high degree of financial flexibility with over $1.2 billion in cash and cash equivalents on the balance sheet as of the end of the third quarter. With respect to the convertible bond coming due in June 2025, we currently anticipate retiring that with cash on hand at maturity.

最後，我想總結一些關於資本配置的快速想法。我們擁有高度的財務彈性，截至第三季末，資產負債表上的現金和現金等價物超過 12 億美元。對於將於 2025 年 6 月到期的可轉換債券，我們目前預計在到期時用手頭現金償還該債券。

We are still formulating our outlook for 2025 and beyond, including investments targeted to strengthen and differentiate our position. We believe our strong cash position, cash flow generation, and business position provides us with optionality in the future.

我們仍在製定 2025 年及以後的展望，包括旨在加強和差異化我們地位的投資。我們相信，我們強大的現金狀況、現金流產生和業務狀況為我們提供了未來的選擇。

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

說完，我會把電話轉回給查克。

Thanks, Mala. Looking ahead, we will continue to evaluate all aspects of our business and move with urgency on opportunities to drive higher levels of performance and position the company for long-term success. Revenue growth, profitability, cash flow generation, and maintaining a strong balance sheet, our key priorities as we make moves to advance our strategy. We are committed to business success and shareholder value creation. I look forward to sharing further details on our ongoing progress in the coming months.

謝謝，馬拉。展望未來，我們將繼續評估業務的各個方面，並緊急尋找機會，以推動更高水準的業績，並使公司取得長期成功。收入成長、獲利能力、現金流產生和維持強勁的資產負債表是我們推進策略的關鍵優先事項。我們致力於商業成功和股東價值創造。我期待在未來幾個月分享有關我們正在進行的進展的更多細節。

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

至此，我們將開放提問。操作員？

(Operator Instructions)

（操作員說明）

Stephanie Davis, Barclays.

史蒂芬妮戴維斯，巴克萊銀行。

Thank you for taking my question. I was hoping we could gain a little bit more on that BetterHelp fee-for-service transition. How loaded than back-end transition, how long do you think payer contracting will take? And is giving you have a lot of these payer relationships and integrate care, have you had any early conversations with payer clients about how the transition zone you're planning out?

感謝您回答我的問題。我希望我們能夠在 BetterHelp 按服務付費的過渡中獲得更多收益。後端過渡的負載有多大，您認為付款人簽約需要多長時間？如果您擁有大量的付款人關係並整合護理，您是否與付款人客戶進行早期對話，以了解您如何規劃過渡區？

Yes, thanks for the question. I think first of all, just want to underscore the importance of us maintaining our focus on it as a consumer oriented business model. I think we are very focused on managing the top line of the profitability of the business, making sure we have the US business stabilize and so forth. So I just want to make sure that that has underscored as a priority.

是的，謝謝你的提問。我認為首先，只是想強調我們保持專注於以消費者為導向的商業模式的重要性。我認為我們非常專注於管理業務獲利能力，確保我們的美國業務穩定等等。所以我只想確保這一點已被強調為優先事項。

With respect to the initiative to create an ability for consumers to access their benefit coverage that's progressing. Many of the internal capabilities that are needed are on target. We are, as I mentioned in the last quarter, doing that both internally as well as through partnerships to progress there. And we have already started some discussions with select health plans as well as other partners to advance that.

關於讓消費者能夠獲得福利的舉措正在取得進展。所需的許多內部功能都已達到目標。正如我在上個季度提到的，我們正在內部以及透過合作夥伴關係來實現這一目標。我們已經開始與選定的健康計劃以及其他合作夥伴進行一些討論，以推動這一進程。

So yeah, that's progressing along. But again, we're going to take a measured approach to that initiative and make sure that as we make investments and roll that out there that are being very methodical format.

是的，這一切正在取得進展。但同樣，我們將對該計劃採取審慎的方法，並確保在我們進行投資和推出時採用非常有條理的格式。

And a follow up, just a quick one I have to ask because I just came from health conference. We see a lot of players saying they're looking to just wrap up with what you guys are doing and virtual care. We heard a lot about the clients pushing back on PMPM by We've continued to gain market share and lives and integrated care. So I just kind of love to hear what you're seeing on the ground and how you're navigating that.

還有一個後續問題，只是我必須問的一個快速問題，因為我剛參加完健康會議。我們看到很多玩家表示他們希望結束你們正在做的事情和虛擬護理。我們聽到很多關於客戶反對 PMPM 的消息，因為我們不斷獲得市場份額、生命和全面護理。所以我很想聽聽你們在實地看到的情況以及你們是如何應對的。

Look, I think just a few things I would touch on one of the virtual visit business has been widely adopted now. And if you look at how the how many people have access to those services, whether through companies like ours and others, whether it's through brick and mortar, so it's pretty well widely available.

聽著，我想我要談的幾件事之一就是虛擬訪問業務現在已經被廣泛採用。如果你看看有多少人可以存取這些服務，無論是透過我們和其他公司這樣的公司，還是透過實體，所以它是相當廣泛可用的。

I think one of the things that's important though is we operate at such scale in terms of the ability to deliver and deploy that match people with providers and be able to do that within a certain timeframe meeting meeting the requirements, and that's difficult to match. And I think that that's recognized in the market in that it's why you continue to see our membership grow. So we understand that that's a competitive space, but we believe that our value proposition still remains stronger.

我認為重要的事情之一是，我們以如此規模運營，能夠提供和部署將人員與提供者相匹配的能力，並且能夠在滿足要求的特定時間範圍內做到這一點，這是很難匹配的。我認為這已得到市場的認可，這就是為什麼我們的會員數量不斷增長的原因。因此，我們知道這是一個競爭激烈的領域，但我們相信我們的價值主張仍然更強大。

I would also add, Stephanie, this is where on the fact that we are adding members at the rate that we are doing this quarter was another strong quarter of membership growth are we have added 3.7 million lives year over year and 1.5 million sequentially. That essentially is the fuel for our land and expand strategy, which essentially, we get these license members on our platform. And it allows a fertile ground to cross-sell additional products over time.

我還要補充一點，史蒂芬妮，事實上，我們以本季度的速度增加會員，這是會員成長的另一個強勁季度，我們同比增加了 370 萬人，環比增加了 150 萬人。這本質上是我們土地和擴張策略的燃料，本質上，我們在我們的平台上獲得了這些許可成員。隨著時間的推移，它為交叉銷售其他產品提供了肥沃的土壤。

Thank you, guys.

謝謝你們，夥計們。

Lisa Gill, JPMorgan.

麗莎·吉爾，摩根大通。

Thanks very much, good afternoon.

非常感謝，下午好。

I just want to follow up on some of the comments that you made on the 2025 selling season. So as you think about today, I think mala made a comment when that you expected revenue growth to be similar to the fourth quarter, which would be flat to 2.5%, which is below your total 2024 guidance. So I'm just curious on a few things. one, you talked about retention still above 90%, but that's lower than what you've seen historically, so where are you losing business to?

我只想跟進您對 2025 年銷售季節的一些評論。因此，正如您今天所想，我認為 Mala 發表了評論，當時您預計收入增長將與第四季度相似，將持平至 2.5%，低於您的 2024 年總體指導。所以我只是對一些事情感到好奇。第一，您談到保留率仍然高於 90%，但這低於您歷史上看到的水平，那麼您的業務流失到哪裡了？

And then secondly, how do we think about that land and expand opportunity? What's your expectation around membership growth based on what you've seen thus far for the 2025 selling season?

其次，我們如何看待這片土地並擴大機會？根據您迄今為止對 2025 年銷售季的觀察，您對會員成長有何預期？

And then lastly, you also talked about bookings being a little bit lower, is that specific to chronic care? Or is there anything else that we should be thinking about when we think about the 2025 selling season?

最後，您還談到預訂量有點低，這是慢性病護理特有的嗎？或者說，當我們思考 2025 年的銷售季節時，還該考慮什麼？

I'll make some comments and then have Mala jump in. I think first of all, that the team is very active in evaluating opportunities to close out the year strong. Most of the channels that we have are in line with prior levels at this point in terms of booking. Where we're seeing, I would say the most headwind is in the health plan space.

我會發表一些評論，然後請 Mala 介入。目前，我們擁有的大多數管道在預訂方面都與先前的水平一致。從我們所看到的情況來看，我想說最大的阻力來自健康計畫領域。

And I think as you know, well, there's several things that are playing out there and as companies adjust their strategies to the changing market, I would say the health plans are very adept at navigating through that and and that will settle in. But certainly can have some pressure in the near term, as I would say, generally speaking, a pretty simple difficult belt-tightening going on there, and I would expect that to continue into 2025.

我認為正如你所知，有幾件事正在發生，隨著公司根據不斷變化的市場調整策略，我想說健康計劃非常擅長解決這個問題，並且這一點將會解決。可能會面臨一些壓力，正如我所說，一般來說，那裡正在發生相當簡單而困難的勒緊褲腰帶，我預計這種情況將持續到2025 年。

I think the trends in terms of rising medical costs, other pressures are sort of tailwinds for businesses like ours, but that also means that there might be some headwinds in the near term here. So I think that's really where we're mostly seeing it. The other comment I would make in terms of most of our, at least the majority of our bookings and pipeline are in the CCM space. So I think that carries over with that comment as well. Mala?

我認為醫療費用上漲的趨勢以及其他壓力對像我們這樣的企業來說是一種順風，但這也意味著短期內可能會遇到一些阻力。所以我認為這確實是我們最常看到的地方。我要發表的另一條評論是，我們的大部分（至少是我們的大部分預訂和管道）都在 CCM 領域。所以我認為這也適用於該評論。馬拉？

Yes. Thanks, Chuck. Lisa, what I would add is, first of all, we are, I would say, still in the midst of the heavy part of our selling season, so we have a little more work to chop from a time perspective, and we continue to have productive conversations with our clients.

是的。謝謝，查克。麗莎，我要補充的是，首先，我想說，我們仍然處於銷售旺季的高峰期，因此從時間角度來看，我們還有更多工作要做，我們將繼續與我們的客戶進行富有成效的對話。

We wanted to sort of give you all a view on what are the trends and the dynamics that we are seeing thus far, and how does that set us up for at least preliminarily for revenue growth next year, you mentioned the 0% to 2.5% in Integrated Care.

我們想讓大家了解我們迄今為止所看到的趨勢和動態，以及這如何為我們明年的收入成長（您提到的 0% 到 2.5%）做好準備在綜合護理中。

I would say just a couple of other things. It is certainly chronic care is the preponderance of our overall bookings. So to the extent that we are seeing the trends we are seeing, it certainly is inclusive of Chronic Care.

我只想說幾件事。當然，長期照護是我們整體預訂的主要部分。因此，就我們所看到的趨勢而言，它肯定包括慢性病護理。

And the last thing I would say is when we think about our revenue growth I'd just remind you all, certainly, bookings is important. And we have other levers to grow revenue. And we, with under Chuck's leadership and with the investments we are making, are leaning on all of those levers.

我要說的最後一件事是，當我們考慮我們的收入成長時，我只想提醒大家，預訂當然很重要。我們還有其他手段來增加收入。在查克的領導下，透過我們正在進行的投資，我們正在依靠所有這些槓桿。

Those include driving greater enrollment, it includes certainly more visit volume. And this is where the point that Chuck made around increasing the value for every visit and every interaction really does matter. Certainly, looking at pricing surgically, all of those are levers that we would use when we think about growing revenue next year.

這些包括推動更多的入學人數，當然也包括更多的訪問量。這就是查克關於增加每次訪問和每次互動的價值的觀點真正重要的地方。當然，從手術定價來看，當我們考慮明年的收入成長時，所有這些都是我們會使用的槓桿。

Okay, thanks for the comments.

好的，謝謝您的評論。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑，派珀·桑德勒。

Thank you for the question. I was hoping to just understand that you engage payers around coverage for BetterHelp. How is the competitive landscape developing? Are payers intent to have maybe one virtual behavioral health partner? Do they want as broad a network as possible? Are they aggressively negotiating fee-for-service rates? And just any nuances you'd call out between commercial and Medicare Advantage.

謝謝你的提問。我只是希望了解您讓付款人參與 BetterHelp 的承保範圍。競爭格局如何發展？付款人是否打算擁有虛擬行為健康夥伴？他們想要盡可能廣泛的網路嗎？他們是否正在積極協商服務費率？以及您在商業和 Medicare Advantage 之間提出的任何細微差別。

And then just I'm curious about the SG&A burden on Teladoc in a payer-sponsored arrangement, just because I would imagine Teladoc needs to spend to some extent to generate utilization and fee-for-service rates. So just how should we think about the SG&A burden on you all as you migrate this to a payer pay model?

然後，我對由付款人贊助的安排中 Teladoc 的 SG&A 負擔感到好奇，只是因為我認為 Teladoc 需要花費一定程度的資金來產生利用率和服務費率。那麼，當你們將其遷移到付款人付費模式時，我們應該如何考慮你們所有人的 SG&A 負擔呢？

Yes. And again, I'll underscore a point I made earlier the predominance of the business at BetterHelp is going to be consumer. It's a consumer-driven model. It's where their strengths are. It's where a great business has been created there. So that is going to be the main focus here.

是的。我要再次強調我之前提出的一點：BetterHelp 的業務主導地位將是消費者。這是一種消費者驅動的模式。這就是他們的優勢所在。那裡創造了偉大的事業。這將是這裡的主要焦點。

What we're trying to do is explore of those consumers that are wanting to engage with BetterHelp and want to access benefit coverage, how do we most effectively do that. So it's a little bit of a different angle on the challenge. That's why we're being very methodical in terms of how we're rolling it out. so that we can identify those areas where we can do that.

我們正在嘗試做的是探索那些想要參與 BetterHelp 並想要獲得福利保險的消費者，我們如何最有效地做到這一點。所以對於挑戰的角度有點不同。這就是為什麼我們在推出它時非常有條理。以便我們能夠確定哪些領域可以做到這一點。

Now there are definitely capabilities that are needed to do that. And that's why we're approaching it, I think, in a pretty smart way in a methodical way to develop the capabilities we need internally to make the experience right and work with others to bring the other capabilities to bear. So I think that we are being methodical about it. And we are -- but again, we are going to be primarily a direct-to-consumer model for the foreseeable future.

現在肯定需要具備做到這一點的能力。我認為，這就是為什麼我們正在以一種非常聰明的方式、有條不紊的方式來處理它，以開發我們內部所需的能力，以提供正確的體驗，並與其他人合作，發揮其他能力。所以我認為我們對此是有條不紊的。我們是——但同樣，在可預見的未來，我們將主要成為直接面向消費者的模式。

And what I would add, Jessica, is the way we are approaching this, certainly methodically. The investments that we are making for the back-end capabilities that Chuck has referenced in his prepared remarks and just now.

潔西卡，我要補充的是我們處理這個問題的方式，當然也是有條不紊的。我們正在為後端功能的投資，查克在他準備好的演講中和剛才提到的。

We are going to do that methodically over time. Seeing the progress that we are making in the market, we certainly are having conversations with payers. We are absolutely leveraging the relationships that we have already on our B2B side.

隨著時間的推移，我們將有條不紊地做到這一點。看到我們在市場上取得的進展，我們當然正在與付款人進行對話。我們絕對會利用 B2B 方面已有的關係。

And the last point I'll make is, when you think about SG&A for this, aside from the investments for capabilities, the way we approach think about this is we are spending advertising and marketing spend to bring consumers in, right? This is a way for us to actually get more consumers in because we offer them another choice to essentially take advantage of the BetterHelp platform and product. So think of it as a way for us to leverage the marketing spend, we have across consumers using it a different way.

我要說的最後一點是，當你考慮SG&A 時，除了能力投資之外，我們考慮這個問題的方式是我們花費廣告和行銷支出來吸引消費者，對吧？這是我們真正吸引更多消費者參與的一種方式，因為我們為他們提供了另一種選擇，可以本質上利用 BetterHelp 平台和產品。因此，請將其視為我們利用行銷支出的一種方式，我們讓消費者以不同的方式使用它。

Got it. Thank you.

知道了。謝謝。

Michael Cherny, Leerink Partners.

邁克爾·切爾尼，Leerink Partners。

I'll just stick with one here. Chuck, Mala, you talked about some of these investments you're making in terms of repositioning the business for growth. As you think about the measurement period during '25, how are you going to judge the success or lack thereof of these investments as we think about -- I'm not trying to get into a long-term guidance discussion, but the philosophical approach towards this reinvesting, reposition the business and where your signposts are to see if the investments you're making are leading to the returns that you want or not.

我就在這裡堅持一個。 Chuck、Mala，你們談到了為了重新定位業務以實現成長而進行的一些投資。當你思考 25 年的衡量時期時，你將如何判斷這些投資的成功或失敗，正如我們所思考的那樣——我並不是想進行長期指導討論，而是哲學方法為了進行再投資，請重新定位業務以及你的路標所在，看看你所做的投資是否會帶來你想要的回報。

Yes. Great question. So every year, we go through as a leadership team a fairly detailed extensive exercise to really think about our overall capital allocation and making sure that it does 2 things.

是的。很好的問題。因此，每年，我們作為領導團隊都會進行相當詳細的廣泛練習，以真正考慮我們的整體資本配置並確保它做兩件事。

One, it aligns against strategic priorities, both near and long term. And second, we look at balancing the investments and the level of investments with both the timing and the amount of the returns, right? When will we expect to see the benefits over time.

第一，它與近期和長期的策略優先事項保持一致。其次，我們著眼於平衡投資和投資水準與回報的時間和金額，對吧？隨著時間的推移，我們什麼時候才能看到好處。

We are going through that planning process as we speak to look at both the near term and the longer term. And we are going through the exercise of sort of looking at it vis-a-vis the priorities that Chuck talked about in his prepared remarks.

當我們談論近期和長期時，我們正在經歷這個規劃過程。我們正在嘗試將其與查克在準備好的演講中談到的優先事項進行比較。

Ultimately, what I would say, Mike, is it will translate into both financial metrics and importantly, operating metrics, right? So how do these investments improve and further help us feather in additional revenue growth over time. But also, how does this help from CCM conversion, right? We have a broad base of recruitable as we engage and contract with our clients, how do we get greater conversion of that, which will translate into enrollment gains as an example.

最終，麥克，我想說的是，它會轉化為財務指標，更重要的是，轉化為營運指標，對吧？那麼這些投資如何改進並進一步幫助我們隨著時間的推移實現額外的收入成長。而且，這對 CCM 轉換有何幫助，對嗎？當我們與客戶接觸並簽訂合約時，我們擁有廣泛的可招募基礎，我們如何獲得更大的轉化，這將轉化為註冊收益為例。

So that's the planning exercise that we are going through. We aren't done yet. It is the usual process that we are in the midst of. But I would expect that, that is what is going to -- that is what all of this planning will result in a set of both financial, but much more importantly, operating metrics that gives us confidence in the financial outcomes.

這就是我們正在進行的規劃工作。我們還沒完成。這是我們所處的通常過程。但我預計，這就是將會發生的事情——這就是所有這些規劃將產生的一系列財務指標，但更重要的是，營運指標讓我們對財務結果充滿信心。

Perfect. Thank you.

完美的。謝謝。

Sean Dodge, RBC Capital Markets.

肖恩·道奇，加拿大皇家銀行資本市場部。

So on BetterHelp, Mala, you mentioned seeing user count show some signs of stabilizing with the September count, I think you said in line with where it was at June. Is there any more color you can share on what was helping drive that trend reversal over the quarter?

因此，在 BetterHelp、Mala 上，您提到看到用戶數量顯示出一些與 9 月份的數量相比趨於穩定的跡象，我認為您所說的情況與 6 月份的情況一致。對於推動本季趨勢逆轉的因素，您還有什麼可以分享的嗎？

Was that mostly from higher new user adds? Or did you see any improvement in retention or churn? And then I know there's some seasonal dynamics at year-end, but anything else that kind of gives you confidence we could continue to see that metric now remain stable?

這主要是來自更高的新用戶添加嗎？或者您發現保留率或流失率有任何改善？然後我知道年底會出現一些季節性動態，但還有其他什麼能讓您有信心我們可以繼續看到該指標現在保持穩定嗎？

Yes. Sean, just a little bit of a double-click into that. So one, we certainly are, as we have spoken of making international priority from a BetterHelp perspective. We have talked about incremental ad spend internationally. That is certainly a driver in us getting new user additions to the platform, which is the driver of stabilizing user count at the end of the quarter vis-a-vis in September versus June.

是的。肖恩，只需雙擊一下即可。所以，我們確實是這樣，正如我們已經談到從 BetterHelp 的角度考慮國際優先事項一樣。我們已經討論過國際上增量廣告支出。這無疑是我們為平台增加新用戶的一個驅動因素，也是季度末用戶數量相對於 6 月穩定的驅動因素。

We are also seeing the remaining operating metrics, whether it be retention, churn, et cetera, largely stable as we have gone through 2024. So it really is the new user growth adds that is being helped by the investments that we are making.

我們也看到，剩餘的營運指標，無論是留存率、流失率等，在 2024 年都基本上保持穩定。

Now the one thing that I would also just remind you all is Q4 is certainly one quarter from a seasonal perspective where we do judiciously modulate our ad spend just because we have typically seen seasonally higher and ad spend in the fourth quarter.

現在，我還要提醒大家的一件事是，從季節性角度來看，第四季度肯定是一個季度，我們明智地調整了我們的廣告支出，只是因為我們通常會看到第四季度的季節性成長和廣告支出。

So we said in our prepared remarks that we will pull back on our ad spend in the fourth quarter relative to the third quarter, just not as sharply as we have done in prior years. sorry, in prior quarters because we have been relatively disciplined as we have gone through this year in deal quarters from an ad spend perspective.

因此，我們在準備好的發言中表示，我們將相對於第三季削減第四季的廣告支出，只是不會像前幾年那樣大幅削減。抱歉，在前幾個季度，因為從廣告支出的角度來看，我們在今年的交易季度中一直相對自律。

What I will say is when we do pull back on ad spend as we do in the fourth quarter, that certainly has an impact on 4Q, but it will also, as always, have some impact as we roll into Q1 of next year. That is a very typical pattern that we see at spend versus member count. And as we, again, go through the year next year, even with the assumption that we see at pricing levels stay elevated, we are assuming they stay stable at elevated levels, we will see stabilization as we go through the year next year.

我要說的是，當我們像第四季一樣縮減廣告支出時，這肯定會對第四季度產生影響，但隨著我們進入明年第一季度，它也會一如既往地產生一些影響。這是我們在支出與會員數量方面看到的非常典型的模式。當我們再次經歷明年時，即使我們假設物價水準保持在高位，我們也假設物價水準保持穩定在高位，我們將在明年看到穩定。

Okay, thanks and thanks for the detail.

好的，謝謝並感謝您的詳細資訊。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，康托費茲傑拉。

I was hoping that you could help us with a few of the moving pieces as we think about the jumping off point from 4Q. So how much of the 125 basis points in investment spend is something that would continue going forward?

當我們考慮從 4Q 開始的起點時，我希望您能幫助我們解決一些令人感動的問題。那麼，125 個基點的投資支出中有多少是會持續下去的呢？

Should we think about a benefit from ad spend just moving out of an election quarter, an election year? And then all of the pricing strategy and mix shift that you spoke to, maybe you could help us with what is a clean jumping off point? And what are the orders of magnitude of how influential these pieces are on getting to your guide of flat margins in '25?

我們是否應該考慮選舉季度或選舉年結束後廣告支出的好處？然後，您談到的所有定價策略和組合轉變，也許您可以幫助我們了解什麼是乾淨的起點？這些文章對 25 年平利指南的影響有多大？

Sarah, I would say look, those are details that we certainly will provide when we come out with more detailed guidance for 2025 in February. I would say we have given you all enough of a ZIP code for full year next year as we think about both revenue growth and adjusted EBITDA margins for integrated care.

Sarah，我想說的是，當我們在 2 月推出更詳細的 2025 年指南時，我們肯定會提供這些細節。我想說，當我們考慮綜合護理的收入成長和調整後的 EBITDA 利潤率時，我們已經為您提供了明年全年的足夠郵遞區號。

And we have given you some color for how we expect the BetterHelp business to roll through next year. I'm going to leave it at that for now. I will be certainly happy to answer questions and post this call.

我們已經為您提供了一些關於我們預計 BetterHelp 業務明年將如何發展的資訊。我暫時就這樣吧。我當然很樂意回答問題並發布此電話。

(technical difficulty)

（技術難度）

Hi, Can you hear us?

嗨，你聽得到我們說話嗎？

Hi, can you hear?

嗨，你聽得到嗎？

oh, yes, we can hear you now, sorry.

哦，是的，我們現在可以聽到你的聲音，抱歉。

Jailendra Singh, Truist Securities.

Jailendra Singh，Truist 證券公司。

Thank you and thanks for taking my questions. I want to go back to 2025 comments about growth of flat to up for Integrated segment. Does that comment assume you end the selling season down year-over-year like you're trending at this point? Or is there assumption built in, in terms of some acceleration as we close the year? And related to that comment, as you're calling out growth in membership and visit volumes, but are you seeing any offset from product mix for any pricing headwinds, which would cause those favorable trends to result in like flat to slightly up growth?

謝謝您並感謝您回答我的問題。我想回到 2025 年關於綜合業務成長持平到上升的評論。該評論是否假設您在銷售季節結束時同比下降，就像您目前的趨勢一樣？或者是否存在內建的假設，即在年底時會出現某種加速？與該評論相關的是，當您呼籲會員和訪問量增長時，您是否看到產品組合對任何定價逆風的抵消，這將導致這些有利的趨勢導致增長持平或略有上升？

Yes, Jailendra, first of all, can you hear us?

是的，Jailendra，首先，你能聽到我們說話嗎？

Yes, we can say.

是的，我們可以說。

Okay. Great. So two-part answer. First is we are seeing, as we said in our prepared remarks, a decline in absolute bookings on a year-over-year basis. As we stand at this point in the selling season relative to -- at about the same point last year.

好的。偉大的。所以答案分為兩個部分。首先，正如我們在準備好的評論中所說，我們看到絕對預訂量比去年同期下降。與去年同期相比，我們正處於銷售季節的這個階段。

Now as we also said, there is still time left in the year, and we are continuing to aggressively pursue all the opportunities that are in our pipeline with obviously an intent to convert as much of the pipeline to bookings. We thought it would be important to give you all at least some early flavor for where our bookings are coming through and therefore, how that might show up in our Integrated Care revenue growth next year.

現在，正如我們所說，今年還剩下時間，我們將繼續積極尋求管道中的所有機會，顯然是為了將盡可能多的管道轉化為預訂。我們認為，至少讓大家提前了解我們的預訂情況，以及這將如何影響我們明年的綜合護理收入成長，這一點很重要。

The second thing I would say is in terms of your question around membership and visits. It is absolutely true that with the increase in membership that we are seeing, we certainly are seeing robust visit revenue growth. And that has been factored in as has the bookings challenges that we are having, they've both been factored in into the flat to up 2.5% range that we are seeing right now for Integrated Care next year.

我要說的第二件事是關於你關於會員資格和訪問的問題。毫無疑問，隨著我們所看到的會員數量的增加，我們肯定會看到強勁的訪問收入成長。這已經被考慮在內，我們所面臨的預訂挑戰也已被考慮在內，它們都被計入了我們現在看到的明年綜合護理增長 2.5% 的持平範圍內。

Just to put a final point on visit revenue, we certainly -- if you look at the third quarter of this year, visit revenue has been in the -- up solidly both from a volume perspective as well as a revenue perspective on Integrated Care -- on the integrated care side, certainly fueled by the membership gains that we've had. And that, I would expect that to continue next year, and that's been factored in.

最後一點關於就診收入，我們當然——如果你看看今年第三季度，從綜合護理的數量角度和收入角度來看，就診收入一直在穩步增長—— - 在綜合護理方面，這當然受到我們所擁有的會員成長的推動。我預計這種情況將在明年繼續下去，這一點已經被考慮在內。

Okay. Thank you.

好的。謝謝。

Richard Close, Canaccord.

理查德·克洛斯，Canaccord。

Thank you for the questions. Chuck, can you talk a little bit more about improving the products that you called out? And I guess, Mala also called out the evolving market demand. Is there anything specific that you need to do on the product front to improve retention with clients or sign new business. Just curious, anything specific there.

謝謝你的提問。 Chuck，您能多談談如何改進您提出的產品嗎？我想，馬拉也指出了不斷變化的市場需求。您需要在產品方面採取什麼具體措施來提高客戶保留率或簽訂新業務嗎？只是好奇，有什麼具體的東西嗎？

Yes. I think there's a few things that I would point out. One is, and some of these investments we're speaking of as well as I alluded to in my prepared remarks about improving the performance management of these things is we've sold and have a lot of business in-house today.

是的。我想有幾件事我要指出。一是，我們正在談論的一些投資以及我在準備好的關於改善這些事物的績效管理的評論中提到的一些投資是我們已經出售的，並且今天有很多內部業務。

And what we want to make sure is that we are generating appropriate performance out of what we have today. So for example, making sure we're activating visits appropriately with the broad reach that we have, that we are enrolling and activating and retaining chronic condition management members.

我們想要確保的是，我們正在從現有的基礎上產生適當的績效。例如，確保我們在廣泛的影響範圍內適當地啟動訪問，確保我們正在招募、激活和留住慢性病管理成員。

So a lot of the things that we're doing are actually going to be improving our ability to drive more consistent performance and I believe even better performance going forward, even though we do a good job. There's a lot of recruitable out there for us to activate and we're working on strategies right now to do that.

因此，我們正在做的很多事情實際上都是為了提高我們的能力，以推動更一致的績效，我相信未來會有更好的績效，儘管我們做得很好。有很多可招募的人員可供我們激活，我們現在正在製定策略來做到這一點。

So I think that, coupled with, what I would say, more normal product features and enhancements depending on which product as well as how they work in a more integrated fashion together. That's an area of focus, and I think we're going to make some good progress there.

因此，我認為，再加上我想說的，更正常的產品功能和增強功能取決於哪種產品以及它們如何以更整合的方式一起工作。這是一個重點領域，我認為我們將在這方面取得一些良好進展。

I would also say in terms of the comment around making visits more valuable, I think over time, again, back to the comments I made earlier around sort of the broad adoption already of virtual visits is how do we make those visits more impactful to the patient and how do we make those visits more impactful for the client that's enabling that access the health plans have certain objectives and strategies that they are trying to get everyone in the delivery system to line up to support. And we are part of that delivery system, and we should be, over time, be able to activate consistent with their strategies. That creates value.

我還想說，關於使訪問更有價值的評論，我認為隨著時間的推移，再次回到我之前圍繞虛擬訪問已經廣泛採用的評論，我們如何使這些訪問對人們產生更大的影響患者以及我們如何使這些訪問對客戶產生更大的影響，從而使他們能夠獲得健康計劃，他們有一定的目標和策略，他們試圖讓交付系統中的每個人都排隊支援。我們是該交付系統的一部分，隨著時間的推移，我們應該能夠按照他們的策略進行啟動。這創造了價值。

There are capabilities that we are building that will be in place for 2025 that will put more information at the point of care and allow us to activate against that. It's a little bit longer of a journey, but not that far along in terms of when we'll start to see some benefit of that.

我們正在建立的一些功能將於 2025 年到位，這些功能將在護理點提供更多信息，並允許我們針對這些信息進行激活。這是一個有點長的旅程，但就我們何時開始看到它的一些好處而言，還沒有那麼遠。

So I think there's many things that we're focused on, including as we close out the year, to make sure that even with the information we've shared around 2025 bookings and retention, we're certainly not stopping there, and we're certainly working on things to impact 2025.

因此，我認為我們專注於很多事情，包括在今年結束時，以確保即使我們分享了 2025 年預訂和留存情況的信息，我們也肯定不會就此止步，而且我們肯定會致力於影響2025 年的事情。

Okay, thank you.

好的，謝謝。

Glen Santangelo, Jefferies.

格倫桑坦傑洛，傑弗里斯。

Thanks for taking my questions. Chuck, I just wonder to follow-up. I mean when we talk about the selling season, it sounds like retention is a little bit lower. Bookings are a little bit lower, and you're making some investments and maybe positioning '25 as a transition year.

感謝您回答我的問題。查克，我只是想跟進一下。我的意思是，當我們談論銷售季節時，聽起來保留率有點低。預訂量有點低，您正在進行一些投資，並且可能將 25 年定位為過渡年。

I mean, you've been on board now for almost five months. And on this call, you sort of laid out some pretty broad-based themes, but I guess I'm trying to really understand and maybe you can elaborate a little bit more clearly is what you're doing that you think is meaningfully different than your predecessor?

我的意思是，你已經在船上快五個月了。在這次電話會議上，你提出了一些相當廣泛的主題，但我想我正在努力真正理解，也許你可以更清楚地闡述你正在做的事情，你認為與你的前任？

Because it kind of sounds like the Board and the senior management believe you have the right assets and strategy, maybe it's just an operational issue and maybe some of these investments will fix some of those operations. It's just not clear to me, I guess, what's meaningfully different. So any sort of elaboration of clarity would be helpful.

因為聽起來董事會和高階管理層認為您擁有正確的資產和策略，也許這只是營運問題，也許其中一些投資將解決其中一些營運問題。我想我只是不清楚有什麼有意義的不同。因此，任何形式的清晰闡述都會有所幫助。

Yes. I'll give you some examples. One of the first observations I had coming in is an area where I think we were timing innovation and we were impacting our performance. And beyond what happened earlier in the year, which you know had an impact on retention.

是的。我舉一些例子給你聽。我首先觀察到的一個領域是，我認為我們正在掌握創新時機，並且正在影響我們的績效。除了今年早些時候發生的事情之外，您知道這對保留率產生了影響。

So that's been discussed before. But I'll give you a tangible example. When you look at the responsibilities around market requirements, product development, delivery of the solution in terms of day-to-day and managing performance against that those all were in four separate leaders. And when you click down below that, multiples of areas that are had accountability for pieces and parts of delivering what we delivered.

所以這之前已經討論過了。但我會給你一個具體的例子。當你審視市場需求、產品開發、解決方案的日常交付以及績效管理等方面的職責時，這些職責都由四個獨立的領導者承擔。當你點擊下面的按鈕時，會發現多個領域對我們所交付的內容負責。

We have now brought that under a singular structure. We've been able to generate millions of dollars of annual savings as a result of those moves and sped up our effectiveness, and you've seen that come through in our results this quarter.

我們現在將其置於單一結構之下。由於這些舉措，我們每年節省了數百萬美元，並提高了我們的效率，您已經在我們本季的業績中看到了這一點。

So there are a number of tangible things that we are doing in that regard. Some of the capabilities that I've been talking about they don't exist at the company today and didn't exist, but they will enable us to take advantage of the business that we've already sold. So there's a number of things that we have done over the last several months. that I think have already demonstrated some effectiveness in our results as well as position us better for the future.

因此，我們在這方面正在做一些切實的事情。我一直在談論的一些功能在公司現在並不存在，也不存在，但它們將使我們能夠利用我們已經出售的業務。因此，過去幾個月我們做了很多事。我認為這已經在我們的成果中展示了一些有效性，並使我們為未來做好了更好的準備。

Okay. Thanks for the comments.

好的。感謝您的評論。

Charles Rhyee, TD Cowen.

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

Yes, thanks for taking the questions. I wanted to ask about sort of what you're seeing in terms of utilization within the Integrated Care segment. I think if you did simple math, it looks like maybe the utilization as a percent of total members is down sort of year-over-year.

是的，感謝您提出問題。我想問一下您在綜合護理領域的使用率方面所看到的情況。我想如果你做了簡單的數學計算，看起來會員總數的使用率可能會逐年下降。

Maybe how much of that is just you have just a lot of new members coming on board? And if that's the case, maybe what is sort of that kind of penetration, maybe a same-store basis look like for clients that have been on the platform for over a year and how is that trending?

也許其中有多少只是因為有很多新成員加入？如果是這樣的話，也許這種滲透率是什麼，也許對於已經在該平台上使用一年多的客戶來說，同店基礎是什麼樣子，趨勢如何？

And I guess, related to that is to the extent that you've talked in the past about driving more value-based arrangements, how would that show up in the numbers here and then maybe you can elaborate where the progress is there.

我想，與此相關的是，您過去曾談到推動更多基於價值的安排，這將如何顯示在此處的數字中，然後也許您可以詳細說明進展情況。

Yes. Charles, I'll sort of address it in a couple of different pieces. So first of all, going back to your question on business and utilization, a few things, right?

是的。查爾斯，我將透過幾個不同的部分來解決這個問題。首先，回到你關於業務和利用率的問題，有幾件事，對吧？

First, let's talk about a number of visits and sort of the utilization metric and equally importantly, talk about what that accrues in terms of revenue because they are both important. And what I would say to you is, certainly, you said it yourself, when you are adding the number of members that we have done at the pace we have done over the past several quarters.

首先，讓我們討論一下造訪次數和使用率指標，同樣重要的是，討論一下收入方面的成長，因為它們都很重要。我要對你說的是，當然，你自己也說過，當你按照我們過去幾季的速度增加成員數量。

Certainly, the engagement and the utilization metrics will take a little bit of time for us to fully unfurl across the new member base. What I am seeing in the results is that we are seeing strong visit volume growth.

當然，我們需要一點時間才能在新會員群中全面展開參與度和使用率指標。我在結果中看到的是，我們看到訪問量的強勁成長。

And importantly, we are seeing strong robust visit revenue growth. And that is certainly both the impact of the volume growth and the fact that we are seeing strength in accretive visit volumes such as on the mental health side, certainly seeing visit growth on Primary360.

重要的是，我們看到訪問收入強勁成長。這當然既是訪問量增長的影響，也是我們看到增加的訪問量（例如心理健康方面）的力量，尤其是 Primary360 上的訪問量增長的事實。

So we are seeing broad-based visit volume growth, and that is certainly turning into stronger visit revenue growth. So that is something that we will -- as I said in my answer to Jailendra's question, certainly something that we are -- I expect for us to continue to invest in, and I'm looking forward to seeing continued growth in that. And as how continue to see business certainly an engagement, improve across the broader member population that we have now.

因此，我們看到訪問量的廣泛增長，這肯定會轉化為更強勁的訪問收入增長。因此，正如我在回答 Jailendra 問題時所說，我們肯定會在這方面進行投資，我希望我們能夠繼續投資，並期待看到這方面的持續成長。至於如何繼續將業務視為一種參與，請改善我們現在擁有的更廣泛的會員群體。

Thank you.

謝謝。

Allen Lutz, Bank of America.

艾倫·盧茨，美國銀行。

Good afternoon and thanks for taking the questions.

下午好，感謝您提出問題。

I want to follow up on Glen's question. It's one for you, Chuck. Obviously, you're making some investments in 4Q, and that's going to continue into 2025.

我想跟進格倫的問題。這是給你的，查克。顯然，您將在第四季度進行一些投資，並將持續到 2025 年。

If we take a step back here and look at Teladoc today, there's about $425 million, $450 million being spent today on tech development and capitalized software, which I would assume has to be larger than some of your -- the majority of your peers. Is that the right amount for Teladoc to be spending on an annual basis?

如果我們退後一步，看看今天的 Teladoc，今天大約有 4.25 億美元，4.5 億美元用於技術開發和資本化軟體，我認為這一定比你們中的一些人——大多數同行都要多。 Teladoc 每年的支出金額是否適當？

And then as you've outlined some of the ways you're going to be evolving some of that, can you talk about maybe what percent of that spend is going to be redirected? Just trying to get a sense of how much of the capital deployment is going to be -- is going to evolve over, let's say, the next year or two?

然後，當您概述了您將要改進的一些方法時，您能否談談這筆支出的百分之多少將被重新定向？只是想了解未來一兩年內會有多少資本部署？

Yes. Thanks for the question. Well, my view is that we already are spending enough money on that space. So what we're looking to do, and we've been doing this pretty aggressively over the last several months is, what I call, rationalizing that portfolio, making sure it's aligned to the objectives and imperatives we have so that we can do both. We can bring that overall spend down over time, and we can free up capacity to instantiate capabilities that are going to be important to our future. So I would agree with you that, that's an area that's been continued focus.

是的。謝謝你的提問。嗯，我的觀點是我們已經在這個領域投入了足夠的錢。因此，我們正在尋求做的事情，在過去的幾個月裡我們一直在非常積極地做這件事，我稱之為合理化該投資組合，確保它與我們的目標和要求保持一致，以便我們能夠做到這兩點。隨著時間的推移，我們可以降低整體支出，並且可以釋放能力來實例化對我們的未來很重要的功能。所以我同意你的觀點，這是一個持續關注的領域。

Now I will say that the company has made good progress over the last couple of years in managing that spend. I think that's come down. The total T&D has come down. And I would expect that you would see us continue with that. And that's really the mode we're operating in, which is how do we create efficiencies so that we can create capacity to do both, deliver a solid financial performance for the company and make investments for the future? And that's the mindset and that's what we've been able to do.

現在我要說的是，該公司在過去幾年中在管理支出方面取得了良好進展。我想這已經下來了。總 T&D 有所下降。我希望您會看到我們繼續這樣做。這確實是我們正在採用的營運模式，即我們如何提高效率，以便我們能夠創造能力來實現這兩個目標，為公司提供穩健的財務表現並為未來進行投資？這就是我們的心態，也是我們能夠做到的。

Appreciate the color, thank you.

欣賞一下顏色，謝謝。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

Hi, guys. This is Sameer Patel on for Elizabeth Anderson.

嗨，大家好。這是伊麗莎白·安德森的薩米爾·帕特爾。

I just make a little bit more of a technical question. It looks like you guys saw a pretty big step up in G&A in the quarter. Should we view this as more of the normalized baseline and then maybe perhaps add a little bit from the portion of that 125 basis point investment in integrated care? Or is there something to call out around that step-up?

我只是問了一點技術問題。看來你們看到本季的一般行政費用有了相當大的進步。我們是否應該將其視為更多的標準化基線，然後也許可以從綜合護理的 125 個基點投資部分中增加一點？或者說，圍繞這項升級有什麼值得指出的嗎？

Yes. So Sameer, this is -- I would say that we had a few one-off investments that we put into the fourth quarter, as we talked about -- and so I would say take that as a onetime, not as something that you would expect to continue on from a run rate perspective.

是的。所以薩米爾，我想說的是，正如我們所討論的，我們在第四季度進行了一些一次性投資，所以我想說將其視為一次性投資，而不是您會做的事情從運行率的角度來看，預計會持續下去。

Look, as we think about 2025 and our overall expense base across the company, we will certainly be paying close attention to what is our expense base relative to our revenue growth, both on the Integrated Care side as well as the BetterHelp side. In our prepared comments, we have made plenty of comments around managing the business effectively, paying attention to both the top and the bottom line, continuing to focus on financial returns across the business. So I expect that as we finish our planning processes, we will certainly pay attention to every aspect of our -- of our base, expense base across all of the P&L line items.

看，當我們考慮 2025 年以及我們整個公司的整體費用基礎時，我們肯定會密切關注相對於收入增長的費用基礎，無論是綜合護理方面還是 BetterHelp 方面。在我們準備好的評論中，我們圍繞著有效管理業務、關注頂線和底線、繼續關注整個企業的財務回報等方面發表了大量評論。因此，我預計，當我們完成規劃流程時，我們肯定會專注於所有損益項目的基礎、費用基礎的各個方面。

Got it. Thank you.

知道了。謝謝。

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

謝謝。今天我們不會再回答任何問題。今天的電話會議到此結束。感謝大家的加入。現在您可以斷開線路