Teladoc Health Inc (TDOC) 2025 Q2 法說會逐字稿

Good afternoon. Thank you for attending today's Teladoc Health second quarter 2025 earnings call. My name is Victoria and I'll be your moderator today. (Operator Instructions) I would now like to pass the conference over to Mike Minchak, Head of Investor Relations for Teladoc Health. Thank you may proceed.

午安.感謝您參加今天的 Teladoc Health 2025 年第二季財報電話會議。我叫維多利亞，今天我將擔任你們的主持人。（操作員指示）現在，我想將會議交給 Teladoc Health 投資者關係主管 Mike Minchak。謝謝，您可以繼續。

Thank you, and good afternoon. Today, after the market closes, we issued a press release announcing our second quarter 2025 financial results. This press release and the accompanying slide presentation are available in the Investor Relations section of the teladochealth.com website.

謝謝，下午好。今天，市場收盤後，我們發布了一份新聞稿，宣布了我們 2025 年第二季的財務表現。本新聞稿及隨附的幻燈片簡報可在 teladochealth.com 網站的投資者關係部分找到。

On this call to discuss our 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.

參加此次電話會議討論我們業績的有執行長 Chuck Divita 和財務長 Mala Murthy。在這次電話會議中，我們還將討論我們的展望，在我們準備好的發言之後將進行問答環節。

Please note that we will be discussing certain non-GAAP financial measures that we believe are important in evaluating our 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，我們將討論我們認為對評估我們的業績很重要的某些非 GAAP 財務指標。有關這些非公認會計準則指標與最具可比性的公認會計準則指標之間的關係及其對帳的詳細信息，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 our actual results to differ materially from those expressed or implied on this call.

此外，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。此類前瞻性陳述受風險、不確定性和其他因素的影響，可能導致我們的實際結果與本次電話會議中表達或暗示的結果有重大差異。

For additional information, please refer to our cautionary statement and our press release and our filings with the SEC, all of which are available on our website. I would now like to turn the call over to Chuck.

欲了解更多信息，請參閱我們的警示聲明、新聞稿和向美國證券交易委員會提交的文件，所有這些文件均可在我們的網站上查閱。現在我想把電話轉給查克。

Thanks, Mike. I'm pleased with our strong performance in the second quarter with consolidated revenue and adjusted EBITD both at the higher end of our guidance ranges. This reflects continued discipline execution and builds on our solid results from the first quarter.

謝謝，麥克。我對我們第二季度的強勁表現感到滿意，合併收入和調整後息稅折舊攤銷前利潤均處於我們預期範圍的較高水平。這體現了我們持續的紀律執行，並鞏固了我們第一季的穩健業績。

Based on our results and outlook for the second half of the year, we're narrowing our guidance range in 2025 consolidated revenue and adjusted EBITDA.

根據我們對下半年的業績和展望，我們縮小了 2025 年合併收入和調整後 EBITDA 的預期範圍。

Maya will provide more details on our performance and outlook later in the call. It's now been a year since I joined Teladoc Health, and I would like to take the opportunity to comment on the progress we've made and the direction of the company.

瑪雅將在稍後的電話會議中提供有關我們的業績和前景的更多細節。我加入 Teladoc Health 已經有一年了，我想藉此機會評論一下我們取得的進展和公司的發展方向。

It's been a transformative year in many respects as we've worked with urgency and purpose to improve performance and reposition the business.

從許多方面來看，這是變革的一年，因為我們迫切而有目的地努力提高績效並重新定位業務。

As I shared when I first joined, I saw the need to strengthen our market focus and increase the efficiency of our business, and we've taken decisive actions that have resulted in a more streamlined organization with greater agility and market orientation and a more efficient and scalable cost structure.

正如我加入之初所分享的，我看到了加強市場關注度和提高業務效率的必要性，並且我們已採取果斷行動，使組織更加精簡，具有更高的靈活性和市場導向性，以及更高效、更具可擴展性的成本結構。

I also shared the importance of accelerating innovation across our products and capabilities. We've made considerable progress in that regard, including a product innovation pipeline that's gaining momentum. Let me share some examples.

我還分享了加速我們的產品和能力創新的重要性。我們在這方面取得了長足的進步，包括正在蓬勃發展的產品創新管道。讓我分享一些例子。

We recently launched Well bound, a new employee assistance program offering for the US integrated care market.

我們最近推出了 Well bound，這是一項針對美國綜合護理市場的新型員工協助計畫。

It provides mental health and well-being support, including access to online therapy services from BetterHelp and seamless access to other available Teladoc services. While early, we're pleased with the level of interest we're seeing, and we look forward to building a position in the EAP market.

它提供心理健康和福祉支持，包括訪問 BetterHelp 的線上治療服務以及無縫訪問其他可用的 Teladoc 服務。雖然還處於早期階段，但我們對所看到的興趣程度感到高興，我們期待在 EAP 市場中佔有一席之地。

We're enhancing our cardio metabolic health program this year, including new connected devices, as well as registered dietitian access, sleep support, and other new features. And to further engage and support enrollees with rising risk and higher acuity conditions, we're developing additional clinical interventions leveraging our primary care specialist and care support teams.

我們今年正在加強我們的心臟代謝健康計劃，包括新的連接設備，以及註冊營養師訪問、睡眠支持和其他新功能。為了進一步吸引和支持風險增加和病情更嚴重的參保者，我們正在利用我們的初級保健專家和護理支援團隊開發額外的臨床幹預措施。

We believe that a comprehensive approach focused on both prevention and the progression of diabetes, hypertension, and obesity will have the greatest sustained impact on patient health and value for our clients.

我們相信，注重預防和控製糖尿病、高血壓和肥胖症發展的綜合方法將對患者健康和客戶價值產生最大的持續影響。

For our hospital and health system clients, we launched a new AI enabled virtual sitter solution fully integrated into our proprietary technology.

對於我們的醫院和醫療系統客戶，我們推出了一種完全整合到我們的專有技術中的新型人工智慧虛擬保姆解決方案。

This new offering extends and supports our clients' workforce capacity and their care delivery and patient safety objectives, including matters such as fall risk and patient elopement.

這項新產品擴展並支持了我們客戶的員工能力以及他們的護理服務和病人安全目標，包括跌倒風險和病人逃走等問題。

In our international integrated care business, we also continue to add new solutions, including hybrid care models for public health systems to support a variety of needs, including access to primary care and emergency department care in rural and remote communities. Product innovation will be an ongoing focus of our organization.

在我們的國際綜合護理業務中，我們也繼續增加新的解決方案，包括公共衛生系統的混合護理模式，以支持各種需求，包括農村和偏遠社區獲得初級護理和急診護理。產品創新將是我們組織持續關注的重點。

Over the past year we've also added important capabilities, including through strategic acquisitions.

在過去的一年裡，我們也增加了重要的能力，包括透過策略性收購。

Catapult Health strengthens our approach to preventative care through its virtual checkup and other solutions, as well as being an important and complementary engagement capability with other Teladoc services, and we recently acquired Uplift to support BetterHelp's entry into insurance, an important initiative I also shared when I joined the company.

Catapult Health 透過虛擬體檢和其他解決方案加強了我們的預防性護理方法，同時也是與其他 Teladoc 服務的重要補充互動能力，我們最近收購了 Uplift 以支持 BetterHelp 進入保險業，這也是我加入公司時分享的一項重要舉措。

I'll provide an update on our progress in this area in a moment.

我稍後會提供有關我們在這一領域進展的最新資訊。

Additionally, we strengthened operational execution, added new partnerships and collaborations, and made advancements in our technological infrastructure, all aimed at supporting our strategic priorities and our ability to deliver more services and value to customers.

此外，我們加強了營運執行，增加了新的合作夥伴關係，並改善了我們的技術基礎設施，所有這些都是為了支持我們的策略重點以及我們為客戶提供更多服務和價值的能力。

We've also had some noteworthy milestones, including exceeding 100 million US integrated care members, providing additional opportunities to grow our services over time.

我們也取得了一些值得注意的里程碑，包括超過 1 億美國綜合護理會員，這為我們的服務隨著時間的推移提供了額外的機會。

While there is important work ahead, I'm pleased with the progress overall, and I'm confident we're in a stronger position to execute in an evolving market. As we've all seen, the health care challenges are substantial.

雖然未來還有重要的工作要做，但我對整體進展感到滿意，我相信我們在不斷發展的市場中處於更有利的地位。正如我們所見，醫療保健挑戰十分嚴峻。

Affordability and rising costs, the impact of disease and chronic conditions, unmet mental health needs, provider pressures, and other issues continue to impact all stakeholders, and it's clear to us that virtual care can and must play a greater role going forward, given the extent and magnitude of these challenges.

負擔能力和不斷上漲的成本、疾病和慢性病的影響、未滿足的心理健康需求、提供者的壓力以及其他問題繼續影響著所有利益相關者，我們清楚地看到，鑑於這些挑戰的程度和規模，虛擬護理可以而且必須在未來發揮更大的作用。

Prior to 2020, virtual care was largely about convenience and access to quality, cost effective care. Teladoc led the way through technology, services, and scale, and also delivered during the pandemic.

2020 年之前，虛擬護理主要是為了方便以及獲得優質、經濟高效的護理。Teladoc 在技術、服務和規模方面處於領先地位，並且在疫情期間也實現了交付。

Now, virtual care has become widely adopted, and there's also been a proliferation of point solutions, adding to fragmentation and complexity.

現在，虛擬護理已被廣泛採用，點解決方案也大量湧現，從而增加了碎片化和複雜性。

Teladoc again led the way by taking an integrated approach across physical health, mental health, and chronic conditions, placing the whole patient at the center.

Teladoc 再次引領潮流，採取了涵蓋身體健康、心理健康和慢性病的綜合方法，將整個患者置於中心。

Looking ahead, we intend to build on our leadership position, our assets, clinical capabilities, and range of services with an intensified focus on orchestration across patients, providers, platforms, and partners, all aimed at enhancing the patient experience, improving outcomes, and delivering greater value.

展望未來，我們打算鞏固我們的領導地位、資產、臨床能力和服務範圍，更加重視患者、供應商、平台和合作夥伴之間的協調，旨在增強患者體驗、改善治療結果並提供更大的價值。

We're uniquely positioned to advance this important work, and we're prioritizing investments that are aligned with this vision, and we plan to deliver on it through our four strategic priorities.

我們擁有獨特的優勢來推進這項重要工作，我們正在優先考慮符合這一願景的投資，並計劃透過我們的四大戰略重點來實現這一目標。

First, we're enhancing our integrated care offerings, particularly in the US, to drive a greater impact on both clinical outcomes and the cost equation.

首先，我們正在加強我們的綜合護理服務，特別是在美國，以對臨床結果和成本方程式產生更大的影響。

We'll support our growth objectives through continued product innovation, and we intend to launch new and enhanced offerings across our portfolio on a sustained basis.

我們將透過持續的產品創新來支持我們的成長目標，並且我們打算持續在我們的產品組合中推出新的和增強的產品。

Leveraging our millions of engagement points in new and unique ways, advancing clinical intervention opportunities, and orchestrating care more holistically, we intend to deliver greater value for clients and the people we serve.

透過以全新獨特的方式利用我們數百萬個參與點，推進臨床幹預機會，並更全面地協調護理，我們旨在為客戶和我們服務的人提供更大的價值。

Second, we're further leveraging our skilled mental health position. In addition to new products such as Wellbound, we have several initiatives underway to expand mental health access and our ability to serve more needs.

其次，我們進一步發揮我們熟練的心理健康地位。除了 Wellbound 等新產品外，我們還在實施多項舉措，以擴大心理健康服務的覆蓋範圍並滿足更多需求。

This includes momentum and integrated care, where we saw a 13% year over year increase in mental health visits in the US during the second quarter and in Better Health, where we'll be building on our unparalleled consumer position by adding insurance capabilities to grow and expand our market opportunity.

這包括動力和綜合護理，我們在第二季度看到美國的精神健康就診量同比增長了 13%，在 Better Health 方面，我們將透過增加保險能力來鞏固我們無與倫比的消費者地位，以擴大和拓展我們的市場機會。

On that front, I would like to take a moment to provide an update on BetterHelp's insurance coverage initiative.

在這方面，我想花點時間介紹一下 BetterHelp 的保險覆蓋計劃的最新情況。

As we've shared, we believe insurance will leverage BetterHelp's strong consumer activation, experience, and scale. While having a positive impact on conversion rates, the number of user sessions, and return on advertising spend over time.

正如我們所分享的，我們相信保險將利用 BetterHelp 強大的消費者活化力、經驗和規模。同時對轉換率、用戶會話數量以及廣告支出的長期回報產生正面影響。

With ongoing headwinds in the consumer cash pay business, we see insurance coverage as essential to the stability and growth outlook for better health. And we believe we can meaningfully scale insurance over time.

隨著消費者現金支付業務持續面臨阻力，我們認為保險覆蓋對於改善健康的穩定和成長前景至關重要。我們相信，隨著時間的推移，我們可以大幅擴大保險規模。

Were being methodical in our approach to ensure the long-term success of this business. This includes ensuring a robust and scalable operating infrastructure, growing our network of credentialed mental health professionals, and supporting and expanding our payer relationships and corresponding membership coverage.

我們採取有條不紊的方法來確保這項業務的長期成功。這包括確保強大且可擴展的營運基礎設施、擴大我們的認證心理健康專業人員網絡以及支持和擴大我們的付款人關係和相應的會員覆蓋範圍。

From an operating infrastructure standpoint, the BetterHelp and uplift teams are partnering in a seamless way.

從營運基礎設施的角度來看，BetterHelp 和 uplift 團隊正在以無縫方式合作。

Execution is progressing well, including unifying the platforms and experience and ability to leverage and scale the combined capabilities.

執行進展順利，包括統一平台和經驗以及利用和擴展綜合能力的能力。

In late June, we began a soft launch of Better Health Insurance in a single state, laying the groundwork for a methodical ramp of the business over the next several quarters.

6 月底，我們開始在一個州試運行“更好的健康保險”，為未來幾季業務的有序發展奠定了基礎。

We're encouraged by the early results, including the performance of our technology, the strength, reliability, and durability of the insurance processes, and growth of the insurance provider network.

我們對早期成果感到鼓舞，包括我們技術的性能、保險流程的強度、可靠性和耐用性，以及保險提供者網路的成長。

We see significant opportunities to access and leverage BetterHelp's expansive network of 35,000 therapists to support growth in the insurance network.

我們看到了利用 BetterHelp 龐大的 35,000 名治療師網絡來支持保險網絡成長的重大機會。

As a reminder, BetterHelp's therapists are all fully licensed and with a master's degree or higher. The network averages eight years of experience and consistently delivers results, including over 70% of patients reporting symptom reduction within 12 weeks.

提醒一下，BetterHelp 的治療師都擁有完全執照並擁有碩士或更高學位。該網絡平均擁有八年的經驗，並持續提供成果，其中超過 70% 的患者報告在 12 週內症狀減輕。

As well as high satisfaction rates, including over 80% of patients that would recommend their therapist to others. In this regard, we've begun an initial outreach to many of our Better Health therapists to join the insurance network, and we're seeing good interest.

滿意度很高，其中超過 80% 的患者願意向其他人推薦他們的治療師。在這方面，我們已經開始初步接觸許多「更好的健康」治療師，邀請他們加入保險網絡，並且我們看到了濃厚的興趣。

To date over 2000 have engaged and are now in various stages of the credentialing process. This outreach will continue as we look to complement and further build uplifts already robust base of over 1,500 mental health professionals.

迄今為止，已有 2,000 多人參與，目前正處於認證過程的不同階段。我們將繼續進行外展活動，以補充和進一步提升我們現有的超過 1,500 名心理健康專業人員組成的強大隊伍。

We're also seeing success in further expanding payer relationships. Uplift broad arrangements covering over 100 million lives, and over the past few months we have signed additional new contracts adding over 15 million lives.

我們也看到了進一步擴大付款人關係的成功。提升廣泛的安排涵蓋了超過 1 億人的生命，在過去的幾個月裡，我們又簽署了額外的新合同，涵蓋了超過 1500 萬人的生命。

We'll provide further updates on progress during the third quarter call. Our third strategic priority is international growth. Our international business now accounts for over 15% of our consolidated revenue, and we see continued growth potential.

我們將在第三季電話會議上提供有關進展的進一步更新。我們的第三個策略重點是國際成長。我們的國際業務目前占我們合併收入的 15% 以上，並且我們看到了持續的成長潛力。

We already operate a robust international business and integrated care that has delivered steady double digit growth and is well positioned to meet diverse needs across countries, markets, and client segments, including leveraging our hospital health system technologies to support public health systems in several countries.

我們已經經營著強大的國際業務和綜合護理，實現了穩定的兩位數成長，並能夠滿足不同國家、市場和客戶群的多樣化需求，包括利用我們的醫院衛生系統技術來支援多個國家的公共衛生系統。

We continue to evaluate opportunities to increase our position across both existing and new geographies. fourth, we're highly focused on operational excellence to consistently deliver for clients and to achieve our business and financial objectives.

我們將繼續評估在現有地區和新地區提升我們地位的機會。第四，我們高度注重卓越運營，始終如一地為客戶提供服務並實現我們的業務和財務目標。

We've made considerable progress in driving operational excellence, including a highly successful client implementation season for 2025, coming off of a very challenging one in 2024. This was also a key priority when I joined.

我們在推動卓越營運方面取得了長足的進步，包括在經歷了極具挑戰性的 2024 年後，於 2025 年取得了巨大的成功。這也是我加入時的首要任務。

With respect to cost efficiency, as noted last quarter, we're tracking modestly ahead of our cost savings and productivity targets. We've made meaningful progress across several areas, including technology and development, administrative costs, and stock-based compensation, and we'll continue to make progress while balancing the need to invest in our strategic priorities.

關於成本效率，正如上個季度所指出的，我們正在略微領先於成本節約和生產力目標。我們在技術和開發、管理成本和股票薪酬等多個領域取得了有意義的進展，我們將繼續取得進展，同時平衡對策略重點的投資需求。

In closing, I'm encouraged by our first half performance. We're making progress against each of our key strategic priorities, and our teams continue to operate with focus, urgency, and discipline.

最後，我對我們上半年的表現感到鼓舞。我們在每項關鍵策略重點上都取得了進展，我們的團隊繼續以專注、緊迫和紀律的方式開展工作。

We're committed to maintaining a balanced approach by delivering solid financial performance and investing in the products and capabilities important to our future.

我們致力於透過提供穩健的財務表現並投資於對我們的未來至關重要的產品和能力來保持平衡的方法。

While broader market dynamics continue to impact healthcare and the operating environment, I remain confident in our strategy and our ability to return the company to an overall growth trajectory over time, including through the initiatives I have outlined. With that, I'll turn it over to Mala.

儘管更廣泛的市場動態繼續影響醫療保健和營運環境，我仍然對我們的策略以及我們隨著時間的推移使公司恢復整體成長軌蹟的能力充滿信心，包括透過我所概述的舉措。說完這些，我就把麥克風交給瑪拉。

Thank you, Chuck, and good afternoon, everyone. Second quarter consolidated revenue was $631.9 million near the high end of the guidance range and down 1.6% year over year, driven by a decline at Better Health offset to some extent by growth in integrated care revenue.

謝謝你，查克，大家下午好。第二季綜合收入為 6.319 億美元，接近指引範圍的高端，年減 1.6%，因為 Better Health 收入的下降在一定程度上被綜合護理收入的成長所抵消。

Adjusted EBITDA of $69.3 million was also at the upper end of the guidance range and represented a margin of 11%. Net loss per share was $0.19 compared to a net loss per share of $4.92 in the second quarter of 2024, which included a $4.64 related to a pre-tax non-cash goodwill impairment charge.

調整後的 EBITDA 為 6,930 萬美元，也處於指導範圍的上限，利潤率為 11%。每股淨虧損為 0.19 美元，而 2024 年第二季每股淨虧損為 4.92 美元，其中包括與稅前非現金商譽減損費用相關的 4.64 美元。

Net loss per share in the second quarter of 2025 included amortization of intangibles of $0.50 per share pre-tax. And stock-based compensation expense of $0.13 per share pre-tax. These items were partially offset by a discrete tax benefit of $0.06 per share.

2025 年第二季每股淨虧損包括稅前每股 0.50 美元的無形資產攤銷。股票薪資費用為每股稅前 0.13 美元。這些項目被每股 0.06 美元的單獨稅收優惠部分抵消。

Free cash flow was $61 million in the second quarter, slightly ahead of the prior year period. On a year to day basis, free cash flow increased by $11 million compared to the same period last year.

第二季自由現金流為 6,100 萬美元，略高於去年同期。與去年同期相比，自由現金流增加了 1,100 萬美元。

We ended the quarter with $618 million in cash and cash equivalents. After retiring $551 million in convertible senior notes that during the quarter. Turning to our segment results, integrated care segment revenue of $391.5 million increased 3.7% over the prior year period and exceeded the high end of our guidance range.

本季末，我們的現金和現金等價物為 6.18 億美元。在本季度贖回了 5.51 億美元的可轉換優先票據之後。談到我們的分部業績，綜合護理分部收入為 3.915 億美元，較上年同期增長 3.7%，超過了我們預期範圍的高端。

We saw good growth in visit revenue and continued strong performance in our international business which then delivered mid-teens growth on a constant currency basis. Catapult contributed approximately 240 basis points to sediment growth. Foreign exchange also contributed roughly 50 basis points to growth in the quarter.

我們的訪問收入成長良好，國際業務持續表現強勁，以固定匯率計算實現了中等幅度的成長。Catapult 對沉積物生長貢獻了約 240 個基點。外匯也為本季的成長貢獻了約50個基點。

Underlying fundamentals continue to trend favourably. US integrated care segment membership at quarter end was 102.4 million members towards the high end of our guidance range and up 11% year over year.

基本面持續呈現良好趨勢。本季末，美國綜合護理部門會員人數為 1.024 億，接近我們指引範圍的高端，年增 11%。

While US integrated care virtual visit volume increased by 6% versus the prior year period. Chronic care program enrolment at quarter end was [$1.12 million], down versus the first quarter due to the previously discussed contract loss.

美國綜合護理虛擬就診量較去年同期增加了 6%。本季末慢性病照護計畫登記金額為 [112 萬美元]，由於先前討論的合約損失，較第一季有所下降。

Excluding the impact of this loss, underlying program enrolment would have increased by a low single digit percentage on a sequential basis. Second quarter integrated care adjusted EBITDA was $57.5 million which represented a margin of 14.7% and was at the high end of our guidance range.

排除此損失的影響，基礎項目入學人數將按連續的個位數百分比增長。第二季綜合護理調整後的 EBITDA 為 5,750 萬美元，利潤率為 14.7%，處於我們指導範圍的高端。

This benefited from revenue flow through, which was partially offset by higher op effects in the quarter, including marketing spends and legal fees. While this compares to an adjusted EBITDA margin of 17% in the prior period.

這得益於收入流，但該收入流被本季更高的營運效應（包括行銷支出和法律費用）部分抵消。而這與上一時期 17% 的調整後 EBITDA 利潤率相比有所下降。

Recall that we had cited a roughly 340 basis points tailwinds to adjusted EBITDA margins in the second quarter of 2024 from performance-based revenue, variable compensation costs, and the timing of certain marketing and other operating expenses.

回想一下，我們曾指出，基於績效的收入、可變薪酬成本以及某些行銷和其他營運費用的時間安排將為 2024 年第二季度的調整後 EBITDA 利潤率帶來約 340 個基點的順風。

Moving to the Better Health segment, second quarter revenue was $240.4 million up slightly sequentially and just above the midpoint of our guidance range. Foreign exchange contributed approximately 45 basis points to year over year growth, while Uplift contributed roughly 100 basis points.

轉向更好的健康部門，第二季度收入為 2.404 億美元，環比略有增長，略高於我們指導範圍的中點。外匯對年成長貢獻了約 45 個基點，而 Uplift 貢獻了約 100 個基點。

Second quarter, average paying users declined by roughly [$9,000] sequentially to [$388,000] and were 5% lower versus the second quarter of 2024.

第二季度，平均付費用戶數較上季下降約 [9,000 美元] 至 [388,000 美元]，與 2024 年第二季相比下降了 5%。

Despite encouraging early progress on our insurance and international initiatives, we continue to see headwinds in the underlying US cash pay business. While the year over year decline has moderated relative to 2024 levels, US cash pay users saw a high single digit percentage decline versus the second quarter of 2024.

儘管我們的保險和國際計劃取得了令人鼓舞的早期進展，但我們仍然看到美國現金支付業務面臨阻力。雖然與 2024 年的水平相比，同比降幅有所緩和，但與 2024 年第二季度相比，美國現金支付用戶數量出現了較高的個位數百分比降幅。

Last quarter, we pointed to a slight uptick in churn rates, which we believe was reflective of softening consumer sentiment and uncertainty around the macro environment.

上個季度，我們指出客戶流失率略有上升，我們認為這反映了消費者情緒的疲軟和宏觀環境的不確定性。

That trend continued through the second quarter while we also saw an increase in customer acquisition costs and fewer gross user ads. We believe these factors and consumer interest in accessing therapy through insurance coverage is impacting the cash pay business.

這一趨勢持續到了第二季度，同時我們也看到客戶獲取成本的增加和總用戶廣告的減少。我們認為這些因素以及消費者透過保險獲得治療的興趣正在影響現金支付業務。

We believe that validates our insurance acceptance initiative with uplift meaningfully accelerating our effort. We continue to believe the unification of customer acquisition funnel between cash care and insurance coverage will allow us to more effectively leverage better health advertising and marketing budgets.

我們相信，這驗證了我們的保險接受計劃，並顯著加快了我們的努力。我們始終相信，現金護理和保險覆蓋之間的客戶獲取管道的統一將使我們能夠更有效地利用更好的健康廣告和行銷預算。

And leads to a lower acquisition cost per user over time. While not enough to offset the headwinds in the US cash pay business. International users were up by a high single digit percentage over the second quarter of 2024.

並隨著時間的推移降低每個用戶的獲取成本。雖然不足以抵銷美國現金支付業務面臨的阻力。2024 年第二季度，國際用戶數量增加了個位數百分比。

With more attractive customer acquisition costs, we plan to continue reallocating advertising spend to those markets. While still early, our localized launches continue to see good month over month growth in users. And we are evaluating opportunities for additional localized market launches over the balance of 2025.

隨著客戶獲取成本更具吸引力，我們計劃繼續將廣告支出重新分配到這些市場。儘管還處於早期階段，但我們的在地化發布仍然見證了用戶數量的逐月增長。我們正在評估 2025 年餘下時間進軍更多在地化市場的機會。

Insurance revenue totalled $2.4 million for the quarter, which was in line with expectations and attributable to uplift as we continue to build out the operating infrastructure to support the future scaling of our better health insurance business.

本季保險收入總計 240 萬美元，符合預期，這歸因於我們繼續建造營運基礎設施以支持未來更好的健康保險業務的擴展。

BetterHelp adjusted EBITDA was $11.9 million in the second quarter. Adjusted EBITDA margin of 4.9% was in the upper half of our guidance range of 2.5% to 5.25%. The margin declines on a year over year basis was mainly due to lower revenue and incremental investments to advance the insurance initiative.

BetterHelp 第二季調整後的 EBITDA 為 1,190 萬美元。調整後的 EBITDA 利潤率為 4.9%，處於我們 2.5% 至 5.25% 的指導範圍的上半部分。利潤率年減主要是由於收入下降和為推進保險計劃而增加的投資。

Turning to guidance we now expect 2025 consolidated revenue of $2.501 billion to $2.548 billion. But the midpoint increasing slightly versus our prior range with an increase in integrated care outpacing a lower better health outlook.

談到指導，我們現在預計 2025 年綜合收入為 25.01 億美元至 25.48 億美元。但中點與我們先前的範圍相比略有增加，綜合護理的成長超過了較低的更好的健康前景。

Adjusted EBITDA is expected to be in the range of $263 million to $294 million. The midpoint of this range is slightly below the previous outlook, impacted by similar segment dynamics, and now incorporating the anticipated impact of tariffs, which I will speak about momentarily.

調整後的 EBITDA 預計在 2.63 億美元至 2.94 億美元之間。該範圍的中點略低於先前的展望，受到類似細分市場動態的影響，現在又考慮了關稅的預期影響，我稍後會談到這一點。

Fully free cash flow guidance of $170 million to $200 million remains unchanged. We now expect 2025 stock-based compensation expense in the range of $95 million to $105 million approximately $10 million below our prior outlook, and a continued area of focus for us.

1.7 億美元至 2 億美元的完全自由現金流指引保持不變。我們現在預計 2025 年股票薪資支出將在 9,500 萬美元至 1.05 億美元之間，比我們先前預期的低約 1,000 萬美元，這也是我們持續關注的領域。

For the third quarter, we expect consolidated revenue in the range of $614 million to $636 million and adjusted EBITDA in the range of $56 million to $70 million.

對於第三季度，我們預計綜合營收將在 6.14 億美元至 6.36 億美元之間，調整後 EBITDA 將在 5,600 萬美元至 7,000 萬美元之間。

Drilling down into the segments, starting with integrated care, we are raising and narrowing our full year 2025 revenue items, which we now expect to be up 1.75% to 3.25% year on year.

深入到各個細分市場，從綜合護理開始，我們正在提高和縮小 2025 年全年收入項目，目前我們預計將年增 1.75% 至 3.25%。

Versus our prior guidance of flat to up 3%. The increase of 100 basis points at the midpoint reflects our strong first half performance relative to guidance, coupled with updated assumptions on foreign exchange.

與我們先前預測的持平至上漲 3% 相比。中間點增加 100 個基點，反映了我們上半年相對於指引的強勁表現，以及對外匯的更新假設。

We continue to expect to contribute approximately 200 basis points to full year revenue growth. We are narrowing our full year 2025 adjusted EBITDA margin guidance to 14.5% to 15.25% versus our prior range of 14.3% to 15.3%, which is up slightly at the midpoint.

我們仍預計將為全年營收成長貢獻約 200 個基點。我們將 2025 年全年調整後 EBITDA 利潤率預期從先前的 14.3% 至 15.3% 縮小至 14.5% 至 15.25%，中間值略有上升。

As previously discussed, this includes a roughly 40 basis points headwind from the catapult position, excluding catapult solution. Adjusted EBITDA margin would be up slightly year over year at the midpoint of the guidance range.

如前所述，這包括來自彈射器位置的大約 40 個基點的逆風，不包括彈射器解決方案。調整後的 EBITDA 利潤率將比去年同期略有上升，達到指導範圍的中點。

Our guidance of $101 million to $103 million US integrated care members remains unchanged. Last quarter we provided a preliminary view on the potential impact of tariffs.

我們對美國綜合護理會員 1.01 億至 1.03 億美元的指導保持不變。上個季度，我們對關稅的潛在影響給出了初步看法。

The initial estimate we provided, which was not included in our prior guidance, given the fluidity of the situation, was based on proposed rates at the time, including a 145% China tariff and the impact of our mitigation efforts.

我們提供的初步估計是基於當時提議的稅率，包括 145% 的中國關稅和我們緩解措施的影響，但考慮到情況的變化，該估計未包含在我們先前的指導中。

Based on the latest information, we now estimate an unfavourable adjusted EBITDA impact in 2025 of approximately $3 million which is now included in our guidance ranges. This reflects a partial year of impact based on the timing of new rates and inventory on hand.

根據最新消息，我們現在估計 2025 年調整後的 EBITDA 的不利影響約為 300 萬美元，這已包含在我們的指導範圍內。這反映了基於新利率和現有庫存的時間對部分年份的影響。

We continue to evaluate additional levers to mitigate the impact of tariffs now and into the future. This includes assessing alternative sourcing arrangements to diversify our supply chain, which we think is a prudent long-term action.

我們將繼續評估其他手段來減輕當前和未來關稅的影響。這包括評估替代採購安排以實現我們的供應鏈多樣化，我們認為這是一項審慎的長期行動。

For the third quarter, we expect integrated care segment revenue growth to be down 0.5% to up 2.25% and adjust the margin in the range of 14% and 15.5%. Recall that the third quarter of 2024 had included a favourable resolution of a prior period billing adjustment, which will drive a roughly 115 basis points headband to revenue growth and roughly 95 basis points headbands to adjusted EBITDA margin in the third quarter of 2025.

對於第三季度，我們預計綜合護理部門的收入成長將下降 0.5% 至上升 2.25%，利潤率將在 14% 至 15.5% 之間調整。回想一下，2024 年第三季已經對前期帳單調整做出了有利的決議，這將推動 2025 年第三季的營收成長約 115 個基點，調整後的 EBITDA 利潤率成長約 95 個基點。

Importantly, we assume a return to growth in chronic care program enrolment in the third quarter, driven in part by continued growth in our weight management program, which was augmented by the addition of one of our largest customers at the start of 2025.

重要的是，我們假設第三季慢性病照護計畫的註冊人數將恢復成長，部分原因是我們的體重管理計畫持續成長，而 2025 年初我們最大的客戶之一的加入又進一步增強了體重管理計畫的成長。

Regarding the second half cadence. Our updated guidance implies a sequential step up in revenue in the fourth quarter, driven largely by typical seasonality related to infectious diseases, as well as contribution from new business implementation.

關於下半場的節奏。我們更新後的指引意味著第四季度營收將環比成長，這主要得益於與傳染病相關的典型季節性以及新業務實施的貢獻。

It also implies a sequential increase in adjusted EBITDA dollars driven by the revenue increase coupled with discipline cost control.

這也意味著，在收入增加和嚴格成本控制的推動下，調整後的 EBITDA 將持續增加。

Moving to BetterHelp. We are narrowing our revenue guidance range with a revised midpoint reflecting ongoing headwinds in our US cafe business.

轉向 BetterHelp。我們正在縮小收入預期範圍，修改中點以反映我們美國咖啡業務持續面臨的阻力。

Although still in the early stages, we are encouraged by the progress of our insurance initiative, which we view as a critical driver for restoring long-term growth in the BetterHelp business.

儘管仍處於早期階段，但我們對保險計劃的進展感到鼓舞，我們認為這是恢復 BetterHelp 業務長期成長的關鍵驅動力。

We now expect a year over year revenue decline of 6.8% to 9.2% in 2025. Compared to a prior outlook of a 3.75% to 9.75% decrease.

我們現在預計 2025 年營收將年減 6.8% 至 9.2%。相比之下，先前預測的降幅為 3.75% 至 9.75%。

Our guidance continues to reflect approximately $10 million in insurance revenue for 2025, net, if any, makeshifts from the existing cash pay business.

我們的指導意見繼續反映出 2025 年保險收入約為 1000 萬美元，如果有的話，是現有現金支付業務的臨時收入。

We expect a more meaningful revenue contribution in 2026 as we continue to methodically scale operations and expand our ail therapist network over the next 6 to 12 months while steadily enabling access across additional days.

我們預計 2026 年的收入貢獻將更加顯著，因為我們將在未來 6 到 12 個月內繼續有條不紊地擴大營運規模並擴展我們的治療師網絡，同時穩步實現更多天數的就診。

We now expect a better health adjusted EBITDA margin of 4% to 5.5% for the full year with the midpoints down 75 basis points versus our prior guidance.

我們現在預計全年健康調整後的 EBITDA 利潤率將達到 4% 至 5.5%，中間值比我們先前預期的下降 75 個基點。

This revision primarily reflects the flow to impact of a lower revenue outlook, partially offset by incremental G&A reductions as we continue to prioritize investments that support the growth of our insurance initiative.

此次修訂主要反映了較低收入前景的影響，但由於我們繼續優先考慮支持保險計劃增長的投資，因此增量一般及行政費用的減少部分抵消了這一影響。

We remain focused on balancing top line growth with bottom line discipline. While we will not pursue inefficient customer acquisitions. We are committed to maintaining strong traffic to better health in preparation for the broader insurance rollout.

我們仍然致力於平衡營收成長與利潤紀律。雖然我們不會追求低效率的客戶獲取。我們致力於維持「更好的健康」的強勁流量，為更廣泛的保險推廣做好準備。

For the third quarter, we are guiding to better health segment revenue down 5% to 9.75% year over year and an adjusted EBITDA margin of 1% to 3.75%, reflecting the early investment phase of scaling our insurance initiatives.

對於第三季度，我們預計健康醫療部門收入將年減 5% 至 9.75%，調整後的 EBITDA 利潤率將為 1% 至 3.75%，這反映了我們擴大保險計劃的早期投資階段。

Lastly, our balance sheet remains strong. We retired $551 million in convertible senior notes that came due in the second quarter with cash on hand. The $1 billion convertible note maturing in June 2027 is our only remaining debt outstanding.

最後，我們的資產負債表依然強勁。我們用手頭上的現金償還了第二季到期的 5.51 億美元可轉換優先票據。2027 年 6 月到期的 10 億美元可轉換票據是我們唯一剩餘的未償債務。

We remain comfortable with our leverage as net debt to trading adjusted EBITDA stood at 1.1 times at quarter end. We continue to believe our strong cash balance, cash flow generation, and business position provides us with optionality in the future.

我們對我們的槓桿率仍然感到滿意，因為季度末的淨債務與交易調整後的 EBITDA 比率為 1.1 倍。我們仍然相信，我們強大的現金餘額、現金流產生和業務地位為我們未來的發展提供了選擇權。

Separately, in mid-July, we entered into a new $300 million revolving credit facility, which enhances our financial and operational flexibility. At the current time, there is nothing drawn on the facility, and we have no immediate plans to use it.

另外，7月中旬，我們達成了一項新的3億美元循環信貸協議，增強了我們的財務和營運彈性。目前，該設施尚未投入使用，我們也沒有立即使用它的計劃。

Our capital allocation priorities remain unchanged. First, we look to maintain a strong balance sheet and an appropriate net leverage profile. Second, we will invest in the business to support our strategy to both organic and inorganic initiatives. And third, we will evaluate share repurchases as a potential use of cash.

我們的資本配置重點維持不變。首先，我們希望維持強勁的資產負債表和適當的淨槓桿狀況。其次，我們將對業務進行投資，以支持我們的有機和無機舉措策略。第三，我們將評估股票回購作為現金的潛在用途。

With that, let me turn the call back to Chuck.

說完這些，讓我把電話轉回給查克。

Thanks, Mala. We continue to believe that virtual care can be a performance multiplier within the health care ecosystem, helping to address key challenges and that Teladoc Health is well positioned to play a key role in doing so. Just last week, we hosted our Annual Teladoc Health Forum event in Nashville, which brought together health care thought leaders, virtual care advocates and innovators from across the globe to share their experiences, exchange perspectives discuss strategies and offer insights into the further advancement of virtual care.

謝謝，瑪拉。我們始終相信，虛擬護理可以成為醫療保健生態系統中的績效倍增器，幫助解決關鍵挑戰，而 Teladoc Health 完全有能力在其中發揮關鍵作用。就在上週，我們在納許維爾舉辦了年度 Teladoc 健康論壇活動，匯集了來自世界各地的醫療保健思想領袖、虛擬護理倡導者和創新者，分享他們的經驗，交流觀點，討論策略，並為虛擬護理的進一步發展提供見解。

And spending time with many of our clients and partners in attendance, I was encouraged with the level of interest in deepening our partnerships and further collaborating to help them achieve their goals now and into the future.

在與眾多客戶和合作夥伴見面的過程中，我深受鼓舞，因為他們對深化合作夥伴關係、進一步合作以幫助他們實現現在和未來的目標表現出濃厚的興趣。

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

這樣，我們就可以回答您的問題了。操作員？

(Operator Instructions) David Roman, Goldman Sachs.

（操作員指示）高盛的 David Roman。

A lot of moving parts here, so I'll try to make sure I limit it here to one question. I guess you've talked about over the past year, Chuck, the transition away from a subscription model to a pay per visit or pay-per-use model that does, to some extent, of course the underlying performance of the business. And I know you went through a few metrics on the call, but maybe you could unpack a little bit what's going on there? And where we are in that transition, if you can give us a sense of is that a 2025 event? Does that extend into 2026? And how you're thinking about measuring success in that initiative?

這裡有很多活動部件，所以我會盡量確保將其限制為一個問題。查克，我想你在過去一年裡談到了從訂閱模式向按訪問付費或按使用付費模式的轉變，這在一定程度上當然會影響業務的基本表現。我知道您在電話中討論了一些指標，但也許您可以稍微解釋一下那裡發生了什麼？我們處於這種轉變的哪個階段，您能否告訴我們，這是 2025 年發生的事件嗎？這會延續到 2026 年嗎？您認為如何衡量該計劃的成功？

Yeah, I appreciate the question. This transition has been going on for a few years now in earnest because post-pandemic, obviously, with the broad adoption and maturity of the market, and that's continued. In 2025, we now are at a point where more than 50%, the majority of our revenues in virtual care are coming from visit-based arrangements versus subscription based.

是的，我很感謝你提出這個問題。這種轉變已經認真進行了幾年，因為疫情過後，顯然隨著市場的廣泛採用和成熟，而且這種轉變還在繼續。到 2025 年，我們的虛擬護理收入將有超過 50% 的大部分來自基於訪問的安排，而不是基於訂閱。

So there's more room to go there, probably, but we've sort of reached a place where it's the majority. And it varies a little bit by product line in mental health, we're now at about 70% that are visit-based. So you'll start to see, over time, more of that underlying growth in visits, which is a good thing and translate into revenue

因此，可能還有更多的發展空間，但我們已經達到了主導的水平。在心理健康領域，產品線略有不同，目前約有 70% 是基於就診的。因此，隨著時間的推移，你會看到訪問量的潛在增長，這是一件好事，並會轉化為收入

Great, thank you very much.

太好了，非常感謝。

Richard Close, Cannacord Genuity.

理查德·克洛斯（Richard Close），Cannacord Genuity。

Yes, Congratulations on the progress maybe on BetterHelp in insurance. First, can you discuss how you see the margin difference between cash pay and insurance, I guess, longer term? And then second, you launched -- I think you said launching insurance in one state, a soft launch. How are you thinking about the rollout going forward? Is that just a state by state basis?

是的，恭喜 BetterHelp 在保險領域的進展。首先，您能否討論一下您如何看待現金支付和保險之間的長期利潤差異？其次，您推出了——我想您說過在一個州推出保險，這是一種軟啟動。您對於未來的推廣有何想法？這僅僅是各州的情況嗎？

So, thank you, Richard, for the question. Look, on the margins for insurance, if you think about the legacy cash pay business in BetterHelp, we have always said that the gross margins for that business are in the range of overall Teladoc Health margins, right? It's always been around the high 60s, early 70s type of gross margin.

所以，感謝理查德提出這個問題。你看，關於保險利潤率，如果你考慮一下 BetterHelp 中傳統的現金支付業務，我們一直說該業務的毛利率在 Teladoc Health 整體利潤率的範圍內，對嗎？它的毛利率一直維持在 60 年代末到 70 年代初左右。

Relative to that, as we have thought about insurance, we recognize that it is going to be lower than that those levels. It's a little bit early for us to comment on exactly where it is going to reach equilibrium in the longer term. But there are enough public proxies out there that will tell you that it is a lot lower than those levels.

相對於此，正如我們考慮保險一樣，我們認識到它將低於那些水平。現在評論長期內究竟會在何處達到平衡還為時過早。但有足夠多的公共代理會告訴你，它比那些水平低得多。

Having said that, what we are focused on is the fact that we have 4 million plus consumers coming at the top of the funnel, if you go. So the advertising spend that we have, the scale of it attracts that scale of consumers seeking therapy.

話雖如此，我們關注的是這樣一個事實：如果你去的話，我們有超過 400 萬的消費者處於漏斗的頂端。因此，我們的廣告支出及其規模吸引了大量尋求治療的消費者。

And we believe that offering the choice of insurance acceptance side by side with cash pay, which is what is live on our platform now in one state, as we talked about, is going to allow for greater conversion than we have with just cash pay. So that is the investment thesis we have that we will continue to make progress on as we scale this initiative. Chuck?

我們相信，如果能同時提供保險接受和現金支付的選擇，就像我們之前提到的那樣，目前我們平台在一個州已經實現了這一功能，那麼相比單純的現金支付，轉換率會更高。這就是我們的投資論點，隨著我們擴大這項計劃，我們將繼續取得進展。查克？

Yeah. And I'll talk a bit about the rollout. So I guess think of it this way, supply and demand. We know the demand out there, one, the unmet mental health, the adoption of the virtual modality in terms of therapy and just the size and scale of BetterHelp. So what we want to do is make sure we are preserving that user experience, which BetterHelp is known for, as we turn this on, obviously, the scale is pretty massive.

是的。我將稍微談談推出的情況。所以我想這樣想，供給和需求。我們知道有這樣的需求：一是未滿足的心理健康問題，二是採用虛擬治療方式，三是 BetterHelp 的規模。因此，我們想要做的是確保我們能夠保留用戶體驗，這是 BetterHelp 所聞名的，當我們啟用它時，顯然規模是相當巨大的。

So the demand side will be there as we turn that on. The supply side, we also want to make sure that we have the right level of therapists, potentially in the network to meet the demand in the way that we want. Behind the scenes, we are continuing to build that network out beyond the single state so that as we ramp further, we'll be able to turn on multiple markets over time. So I wouldn't necessarily think about it state by state per se because we're going to reach a point where we're going to be able to activate multiple markets. But we do want to take it methodically here at the start to make sure all the capabilities that we've built in place are working.

因此，當我們啟動這個機制時，需求方就會存在。在供應方面，我們還希望確保我們擁有適當水平的治療師，以我們想要的方式在網路中滿足需求。在幕後，我們正在繼續建立超越單一州的網絡，以便隨著我們進一步發展，我們將能夠隨著時間的推移進入多個市場。因此，我不一定會逐州考慮這個問題，因為我們將達到能夠激活多個市場的程度。但我們確實希望從一開始就有條不紊地進行，以確保我們已建立的所有功能都能發揮作用。

The good news is they work quite well, and we're in a position now where we're behind the scenes building the supply side.

好消息是它們運作得相當好，我們現在可以在幕後建立供應方。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

Thanks very much. Good afternoon. Chuck, I wanted to go back to where you ended the call today. You talked about virtual health care can be a performance multiplier to help address key challenges in the evolving health care landscape. Clearly, following managed care, we see at right now from a cost perspective as a former managed care executive.

非常感謝。午安.查克，我想回到你今天結束通話的地方。您談到虛擬醫療保健可以提高績效，並幫助解決不斷發展的醫療保健領域中的關鍵挑戰。顯然，按照管理式醫療，我們目前從成本角度來看管理式醫療，就像一位前管理式醫療主管一樣。

What do you think are some of the biggest opportunities for Teladoc to help to really drive the cost -- bend the cost curve going forward? And maybe if you could just spend a minute some of the takeaways from last week.

您認為 Teladoc 在真正降低成本——扭轉未來成本曲線方面有哪些最大的機會？也許您可以花一點時間來回顧上週的一些收穫。

And is it talking more to providers? Is it talking to employers? Is it talking to the managed care organizations? What do you see are some of the biggest opportunities?

它是否與供應商進行了更多對話？是在跟雇主談話嗎？這是在與管理式醫療機構對話嗎？您認為最大的機會有哪些？

Yeah, thanks for the question. I think, first of all, if you go back to where sort of virtual care took off, like I said in my prepared remarks around access and convenience. And that's still an issue access to care, whether it's primary care, specialist care, it varies pretty significantly.

是的，謝謝你的提問。我認為，首先，如果你回顧虛擬護理開始興起的地方，就像我在關於訪問和便利性的準備好的演講中所說的那樣。獲得醫療服務仍然是一個問題，無論是初級醫療還是專科醫療，差異都很大。

So I think access will continue to be a place where virtual care can support the ecosystem. I think where the next sort of generation of that is -- and the reality of it each individual, all of us are unique. We have our own health care situation and needs and expectations and health care is also local.

因此我認為訪問將繼續成為虛擬護理可以支持生態系統的地方。我認為下一代是這樣的——事實上我們每個人都是獨一無二的。我們有自己的醫療保健狀況、需求和期望，而且醫療保健也是地方性的。

And so I think over time, the reason why we've been investing in the technology we are and the approach we have is because we think we have an ability to partner with the local delivery systems more and more over time to advance our customers' strategies. So we have a number of things underway to do that.

因此，我認為，隨著時間的推移，我們之所以一直在投資現有的技術和方法，是因為我們認為我們有能力隨著時間的推移越來越多地與當地交付系統合作，以推進我們客戶的策略。因此，我們正在採取多項措施來實現這一目標。

And I think then extending that longitudinal care capability to help complement the system sometimes will be on point for those services and other times, we'll be playing a complementary role. And I do think that's where it's going to evolve over time. I think with respect to the forum, it was a great event. I mean there was a lot of excitement. We shared a lot about the progress we're making.

我認為，擴展縱向照護能力以幫助補充系統有時會對這些服務有所幫助，而其他時候，我們將發揮補充作用。我確實認為隨著時間的推移它會朝著那個方向發展。我認為就論壇而言，這是一個偉大的活動。我的意思是有很多令人興奮的事情。我們分享了很多我們所取得的進展。

I would say uniformly a lot of the things that you study in health care are alive and well. They're very concerned about the affordability issues, cost increases, provider capacity shortages and sort of the dynamics that are at play.

我想說的是，你們在醫療保健領域研究的許多東西仍然活躍且健康。他們非常關心負擔能力問題、成本增加、供應商能力短缺以及正在發揮作用的動態問題。

Certainly in the health plan world, a lot of uncertainty with respect to some of the changes that are under underway. And I think there was a, I would say, a good level of interest in the strategic direction we're taking and how we're approaching this issue. So I think the level of partnership is going to be even deeper going forward, and I think we're going to build on it in the coming months.

當然，在健康計劃領域，正在進行的一些變化存在著許多不確定性。我認為大家對我們所採取的策略方向以及我們如何處理這個問題有相當的興趣。因此我認為未來雙方的合作將會更加深入，我認為我們將在未來幾個月內在此基礎上進一步發展。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑、派珀·桑德勒。

Hi guys, thank you so much for the detail. I have something maybe you could talk about 2026 for your chronic care solutions, in particular. Where are we in the selling season for the chronic care solutions, excuse me. And then just -- could you describe any kind of competitive efforts that you've noticed so far, retreats maybe that are expected to impact retention competitive takeaways in pricing next year? Thank you.

大家好，非常感謝你們的詳細解釋。我可以向您介紹 2026 年您的慢性病照護解決方案。請問，我們現在處於慢性病照護解決方案的銷售季節的哪個階段？然後——您能否描述一下到目前為止您注意到的任何競爭努力，這些努力可能會影響明年定價中的保留競爭優勢？謝謝。

Yeah. I'll just make some general comments here. I think, first of all, a lot of the things that we've said in prior quarters are -- continue to be the case. We've got employer channel continues to, I would say, largely be in line with our expectations at this point in the year. We do have continued pressure on the health plan channel for all the reasons that we've given.

是的。我在這裡只發表一些一般性的評論。我認為，首先，我們在前幾個季度所說的很多事情現在仍然有效。我想說，我們的雇主管道在很大程度上繼續符合我們今年的預期。由於上述所有原因，我們確實對健康計劃管道施加了持續的壓力。

And I think we've had a good level of interest across all of our solutions, Chronic Care included. We've added some accounts, including health plans with respect to Medicare Advantage. Mala mentioned that we added last year coming into this year in weight management. So there's good activity, there is good interest. I will say there's some pause and some hesitation in terms of big moves by some of the players as they sort through their strategies.

我認為我們對所有解決方案都表現出了濃厚的興趣，包括慢性病護理。我們添加了一些帳戶，包括與醫療保險優勢計劃相關的健康計劃。Mala 提到，我們去年增加了體重管理，今年也增加了體重管理。因此，這裡有良好的活動，也有良好的興趣。我想說的是，有些球員在製定策略時，對於重大舉措有一些停頓和猶豫。

Where we're focused really back to the product innovation point is how do we expand the level of services. And I think with this new cardiometabolic health program that we're rolling out to meet a variety of needs. If you think about a patient, we sort of carve people up into these conditions, well, it's a whole person.

我們真正關注的產品創新點是如何擴大服務水準。我認為我們推出的這個新的心臟代謝健康計劃可以滿足各種需求。如果你考慮病人，我們會把人分成不同的情況，嗯，這是一個完整的人。

And so they're going to move through the journey of maybe it's a wait issue some other kinds of acuity that happens during the cycle of that person's life. And so this program really is trying to be there in a more holistic way for those people.

因此，他們將經歷一段旅程，這可能是等待問題，也可能是在該人的生命週期中發生的其他類型的敏銳度。因此，該計劃確實試圖以更全面的方式為這些人提供幫助。

And I think the features and enhancements that we put in place will be attractive to our customers.

我認為我們所採用的功能和增強功能將對我們的客戶具有吸引力。

I think where we're headed, though, is really leveraging what is, I think, one of our greatest strengths, which is our clinical capabilities. As a provider, we have primary care. We have specialist care, we have care teams.

我認為，我們的目標實際上是利用我們最大的優勢之一，即我們的臨床能力。作為服務提供者，我們提供初級保健服務。我們有專科護理，我們有護理團隊。

And I think when you're dealing with people with hypertension and diabetes and obesity and those kinds of things, the ability to support them clinically, if they're not on the right path, I think, is where we can add value to the patient as well as to our clients.

我認為，當你與患有高血壓、糖尿病、肥胖症等疾病的人打交道時，如果他們沒有走上正確的道路，我們就有能力在臨床上為他們提供支持，這就是我們可以為患者和客戶增加價值的地方。

Jessica, what I would also add is, it's not a surprise, the chronic care market is a highly competitive market, it is a fast moving, fast changing market. We know that, we are absolutely already, with a cardio metabolic product that we have that Chuck mentioned, adding to the clinical capabilities that Chuck mentioned that certainly gives us, confidence in growing momentum in the chronic care business over time.

潔西卡，我還想補充一點，這並不奇怪，慢性病護理市場是一個競爭激烈的市場，是一個快速發展、快速變化的市場。我們知道，我們已經擁有了查克提到的心臟代謝產品，加上查克提到的臨床能力，這無疑讓我們對慢性病護理業務隨著時間的推移而增長的勢頭充滿信心。

The other thing I would also say is, if you think about our 102+ million member base and what that represents in terms of cross-selling opportunities. If you think about the scale of recruitable with chronic disease, and need for chronic plan of care management that we already have.

我還想說的是，如果你考慮我們超過 1.02 億的會員基礎以及這在交叉銷售機會方面代表著什麼。如果您考慮一下患有慢性病的可招募人數規模，以及我們現有的慢性病照護管理計畫的必要性。

That I would say is sort of the, in some ways the demand side that we already have for us to be able to continue to grow and penetrate. We've talked about the fact that our penetration levels are still relatively low in the membership base we have.

我想說的是，從某種程度上來說，這就是我們已經擁有的需求方，以便我們可以繼續成長和滲透。我們已經討論過這樣一個事實：我們的會員滲透率仍然相對較低。

So if you combine the innovation that we are bringing in from the product side, together with the scale of opportunity in terms of the in the recruitable and the member base we have, those are the assets that we are going to use combined with our engagement cap and enrolment capability, and we are investing in that as well.

因此，如果將我們從產品方面引入的創新與我們在可招募人員和會員基礎方面的機會規模結合起來，這些就是我們將要結合我們的參與上限和註冊能力使用的資產，我們也在投資。

Daniel Grosslight. Citi.

丹尼爾·格羅斯萊特。花旗。

Hi, thanks for taking the question. Mala. you mentioned that you expect a meaningful revenue contribution from BetterHelp insurance coverage in 2026. I was hoping you could provide a bit more color on that and the cadence we should expect throughout next year. And similarly, if there's any significant investments you need to make to kind of scale that in 2016 and the cadence of those investments? Thanks.

你好，謝謝你回答這個問題。Mala，您提到您預計 2026 年 BetterHelp 保險將帶來可觀的收入貢獻。我希望您能對此提供更多細節，以及我們明年應該期待的節奏。同樣，您是否需要進行任何重大投資來擴大 2016 年的規模以及這些投資的節奏？謝謝。

Yeah. So what I would say, Daniel, let me sort of start with your second question first because we need to invest to be able to scale the insurance revenues. So we already are making investments, right? Remember, when we announced the uplift acquisition back in April, we actually had taken down our adjusted EBITDA. And the reason we did that was because of the investments we needed to make.

是的。所以我想說，丹尼爾，讓我先從你的第二個問題開始，因為我們需要投資來擴大保險收入。所以我們已經開始投資了，對嗎？請記住，當我們在四月宣布提升收購時，我們實際上已經降低了調整後的 EBITDA。我們這樣做的原因是我們需要進行投資。

Those investments are essentially in -- think of it in two ways. One is just scaling up the number of people we need, the talent we need to be able to run this business within the BetterHelp segment. It's not an initiative any longer, it's a business. And the second is absolutely scaling up the operational capabilities, the back-end capabilities, billing, coding, all of that. So those are the kinds of investments we are making.

這些投資本質上是──從兩個方面來思考。一是擴大我們所需的人數，也就是在 BetterHelp 部門內經營這項業務所需的人才。這不再是一項倡議，而是一門生意。第二是絕對擴大營運能力、後端能力、計費、編碼等等。這些就是我們正在進行的投資。

We've already started on making those investments, and we are going to make investments in the back half of this year between Q3 and Q4. And I expect people continue to do more of it at probably a more modest level into the first half of next year.

我們已經開始進行這些投資，並將在今年下半年第三季和第四季之間進行投資。我預計，到明年上半年，人們可能會繼續以更溫和的程度做更多這樣的事。

In terms of your second question on how this will pace, I would say, look, we have said from the outset back in April, we expect the revenue for insurance to scale and fully ramp up over the 6 to 12 month period, right? And we have told you this year, we expect insurance to be about $10 million in revenue. I think we need to see how this paces through this year, Daniel, and get more proof points. As we said, we have launched in one state. Early signs of progress are good.

關於你的第二個問題，即這一進程將如何進行，我想說，你看，我們從 4 月份一開始就說過，我們預計保險收入將在 6 到 12 個月內擴大並全面上升，對嗎？我們告訴過你們，今年我們預計保險收入約為 1000 萬美元。丹尼爾，我認為我們需要看看今年的進展情況，並獲得更多的證據。正如我們所說，我們已經在一個州推出了該產品。早期的進展跡像是好的。

We are hitting and checking off on all the metrics that we expect to see at about this point. But we need to see more proof points. And what I would say is expect us to give a progress update in October. And in February, every time we talk to you on earnings calls, we will give you a progress update on how things are going and how the scaling is going to case in through 2026.

我們正在達到並核對我們期望此時看到的所有指標。但我們需要看到更多的證據。我想說的是，我們預計在十月更新進展。每年二月，每當我們在收益電話會議上與您交談時，我們都會向您提供進度更新，說明事情的進展以及到 2026 年的擴展情況。

Jailendra Singh, Truist.

Jailendra Singh，Truist。

Thank you and thanks for taking my questions. Chuck, I appreciate you're spending some time on recapping the progress the company has made and all the initiatives you have put in place and actions you've taken over the past one year. But where we stand now?

謝謝您，也謝謝您回答我的問題。查克，我很感激你花時間回顧公司的進展以及你在過去一年中實施的所有舉措和採取的行動。但我們現在的處境如何？

Do you believe that you have all the pieces in place to get the company back on revenue and EBITDA growth and potentially accelerate in the coming years. And I completely understand all the integration and business traction still ahead of us. But just curious about your view if you still think there's some work needed for organic and inorganic product expansion? or I mean any restructuring?

您是否相信您已經做好了一切準備，讓公司的收入和 EBITDA 恢復成長，並有可能在未來幾年加速成長？我完全理解我們面前仍存在的所有整合和業務牽引問題。但我只是好奇您的觀點，您是否仍然認為有機和無機產品的擴展還需要做一些工作？或者我的意思是任何重組？

Yeah, I appreciate the question. I'm not sure I would say we're ever going to be done in a highly competitive, dynamic complex market, particularly in the US in terms of advancing the vision strategy. So I wouldn't want to set that expectation. I think we've made considerable progress from the technology we put in place, we now have the ability to surface information across each one of our care engagement, whether it's Catapult, our Gen Med visits, our coaches or mental health providers.

是的，我很感謝你提出這個問題。我不確定我們是否會在競爭激烈、充滿活力的複雜市場中取得成功，特別是在美國推動願景策略方面。所以我不想設定這樣的期望。我認為我們在所採用的技術方面已經取得了長足的進步，現在我們有能力在每一次護理活動中展示信息，無論是 Catapult、我們的 Gen Med 訪問、我們的教練還是心理健康提供者。

We can action and surface information there that for the next best action. So there's a lot of things that I think we put in place. Clinically, we come from a strong position with all the history the company has. However, there's additional capabilities we're going to put in place to be able to continue to develop new intervention models for these individuals with chronic conditions.

我們可以採取行動並在那裡顯示訊息，以便採取下一步最佳行動。所以我認為我們已經實施了很多措施。從臨床角度來看，憑藉公司悠久的歷史，我們佔有有利地位。然而，我們將採取更多措施，繼續為這些患有慢性病的人開發新的干預模式。

So I think you're going to see us continue to invest organically as well as if we think there are places that could accelerate our progress, we're going to look for those opportunities just like we did with Catapult. That was a really nice strategic complementary acquisition. It's resonating with our clients. They understand why we did it, one, because of their own capabilities, which is quite effective. But the opportunity to use that as another point of engagement for people that aren't engaged in their health care and to get them aware of their health care conditions, and get them plugged into whether it's a Teladoc services or get them a care plan.

因此，我認為你會看到我們繼續進行有機投資，如果我們認為有些地方可以加速我們的進步，我們就會尋找這些機會，就像我們對 Catapult 所做的那樣。這是一次非常好的策略互補性收購。它引起了我們客戶的共鳴。他們明白我們為什麼這麼做，一是因為他們自身的能力，這樣做還是比較有效的。但這可以作為另一個接觸點，讓尚未參與醫療保健的人了解自己的醫療保健狀況，並讓他們了解 Teladoc 服務或護理計劃。

So I think there are going to be continued investments that we're going to make to be able to have a sustainable growth path in the US and attack some of those bigger challenges that the health care system has. We're well positioned to do it, but we aren't finished yet.

因此我認為我們將繼續進行投資，以確保美國實現可持續的成長，並應對醫療保健系統面臨的一些更大的挑戰。我們已經做好了充分的準備，但我們還沒有完成。

I think the other thing I would say, and I'll enter this with BetterHelp, as we've seen from the last many number of quarters, that's been a business that's been very challenging on the consumer front, notwithstanding all of its strengths. So making a move like uplift and being able to demonstrate progress on insurance, we do believe that, that transition over time is going to position BetterHelp to return to a growth trajectory. So I think both integrated care and BetterHelp, we've made some really good progress, and I think we're going to build on it.

我想說的另一件事是，我將以 BetterHelp 為例，正如我們從過去多個季度所看到的那樣，儘管 BetterHelp 擁有諸多優勢，但在消費者方面，這項業務一直面臨著巨大的挑戰。因此，採取像提升這樣的措施並能夠展示保險方面的進展，我們確實相信，隨著時間的推移，這種轉變將使 BetterHelp 重回成長軌跡。因此，我認為綜合護理和 BetterHelp 都取得了一些非常好的進展，我認為我們將在此基礎上繼續努力。

Elizabeth Anderson, Evercore.

伊麗莎白·安德森，Evercore。

Hi guys, good afternoon. Thanks so much for the question. One of the highlights in the quarter, it looks like, which is for me, at least, is like the strong international growth as part of the broader strategy. Can you talk about given that you have a variety of opportunities across your portfolio as you've highlighted, the BetterHelp, et cetera. How think about that. Is there any sort of change in terms of the emphasis you're putting on that business given the lower acquisition cost that Mala you mentioned? Or do you see that as sort of continuing along the path that you sort of previously described for us?

大家好，下午好。非常感謝您的提問。看起來，本季的一大亮點，至少對我來說，就是強勁的國際成長，這是更廣泛策略的一部分。鑑於您強調的投資組合中有各種各樣的機會，您能否談談 BetterHelp 等等。怎麼想呢。鑑於您提到的 Mala 收購成本較低，您對該業務的重視程度是否有任何變化？或者您認為這是沿著您之前為我們描述的道路繼續前進？

Thanks. Yeah. So when we think about our international business, we need to think about it both on the integrated care side as well as on the better health side. So, on the integrated care side, Elizabeth, what I see this business performing at is very reliably. In the mid-teens, including this quarter, it was in the mid-teens on a constant currency basis, actually higher, high 10s on a reported basis because of foreign exchange tailwinds.

謝謝。是的。因此，當我們考慮國際業務時，我們需要從綜合護理方面和更好的健康方面來考慮。因此，伊麗莎白，在綜合護理方面，我認為這項業務的表現非常可靠。包括本季在內，以固定匯率計算，這一數字處於十幾歲的中間水平，實際上由於外匯順風，按報告計算，這一數字更高，達到十幾二十幾。

And you know this is a business that is looking at and working with clients around the world, Canada, UK, Europe, Australia, those are the countries that we have a strong B2B international business presence in. We have clients, who have been with us for a long time, for many years, and we have a robust relationship with them. And then the last thing I'd point out is what Chuck said in his prepared remarks. We are making real progress in working with the public health systems in Canada. We are expanding province by province, for example, in Canada.

你知道，這是一家關注並與世界各地的客戶合作的企業，加拿大、英國、歐洲、澳大利亞，這些國家都是我們擁有強大的 B2B 國際業務的國家。我們擁有與我們合作多年的客戶，並且與他們保持著穩固的關係。最後我要指出的是查克在準備好的發言中所說的話。我們在與加拿大公共衛生系統的合作方面取得了真正的進展。我們正在逐省擴張，例如在加拿大。

They were part of our client event last week, and we talked, they talked about how pleased they are with the partnership with us and let's say Newfoundland as an example, new Labradors and other province where we have expanded. So that's sort of the work we are doing on the integrated care side.

他們參加了我們上週的客戶活動，我們進行了交談，他們談到了與我們的合作有多高興，例如紐芬蘭、新拉布拉多和我們已經擴展的其他省份。這就是我們在綜合護理方面所做的工作。

On the BetterHelp side, the way I would think about international is, so there are two sub-parts to it. The first is, we have now been in what I would call English speaking countries internationally for a few years in better health. Now think about those as the UK, Canada. What we are now doing starting really this year is expanding into other countries with a localized platform and product experience. This is still, I would say, relatively new.

在 BetterHelp 方面，我對國際化的思考方式是，它有兩個子部分。首先，我們現在已經在我稱之為英語國家的國際上生活了幾年，身體狀況也更好。現在想想英國、加拿大。從今年開始，我們真正要做的事情就是透過在地化的平台和產品體驗向其他國家擴張。我想說，這仍然相對較新。

And we are seeing good, signs of progress, one of which is, you, we said in our prepared remarks, the growth in users, in the quarter was high single digits. So I say this because this is, we will continue to build on this localization initiative we have in international for better health.

我們看到了良好的進展跡象，其中之一就是，我們在準備好的發言中說過，本季用戶數量的成長率達到了高個位數。我這樣說是因為我們將繼續在國際上推動在地化舉措，以促進人類健康。

I expect us to roll out into additional countries. We are also learning candidly from launching these localized experiences, it does require us to think about the experience with consumers, the therapists, etc. So it's, we are taking learnings as we have launched in these countries and building it into the next wave, if you will, of countries that we are planning to launch one.

我希望我們能拓展到更多的國家。我們也從推出這些在地化體驗中坦誠地學習，它確實要求我們思考消費者、治療師等方面的體驗。所以，我們正在吸取我們在這些國家推出的經驗教訓，並將其應用到下一波我們計劃推出的國家。

More point on the integrated care part of international and I appreciate you raising that. It's a, I think. Of an often underappreciated part of Teladoc. We have an amazing team. They are structured to really understand the unique local market needs and opportunities, and they are very creative at coming up with solutions that make sense for that market.

關於國際綜合護理部分的更多觀點，我很感謝您提出這一點。我認為是的。這是 Teladoc 中經常被低估的部分。我們擁有一支出色的團隊。他們的組織結構能夠真正理解獨特的當地市場需求和機遇，並且能夠創造性地提出適合該市場的解決方案。

An example is that I think is really a great proof point. They're using our hospital and health system technology, our devices. If you go to our website, you can see the pictures of those devices. They're using those in creative ways with those public health systems, and I was very gratified when they take those devices and they're helping keep emergency departments open in rural communities.

我認為這個例子確實是一個很好的證明點。他們正在使用我們的醫院和醫療系統技術以及我們的設備。如果您造訪我們的網站，您可以看到這些設備的圖片。他們以創意的方式將這些技術應用於公共衛生系統，當他們使用這些設備並幫助農村社區的急診室保持開放時，我感到非常欣慰。

We're talking about life and death stuff, keeping access available to populations in remote areas. So we're very proud of the work that's happening internationally and there's a lot of learnings that we're, looking to import to the US and vice versa over time, and I think it's an important part of the company.

我們正在談論生死攸關的問題，確保偏遠地區的居民能夠獲得醫療服務。因此，我們對國際上進行的工作感到非常自豪，我們希望隨著時間的推移將許多經驗引入美國，反之亦然，我認為這是公司的重要組成部分。

Sarah E. James, Cantor Fitzgerald.

莎拉·E·詹姆斯，康托·菲茨杰拉德。

You said earlier that you expected BetterHelp to exit the year flat with the prior year. Can you talk a little bit more about what's changed relative to your and will BetterHelp to guarantee a growth mode in 2026?

您之前說過，您預計 BetterHelp 今年的業績將與去年持平。您能否再多談談相對於您而言發生了哪些變化，以及 BetterHelp 是否會保證 2026 年的成長模式？

Yeah. I think it's a really good question, Sarah, and let me sort of give you a little bit of a longer answer on that to set the overall context.

是的。莎拉，我認為這是一個非常好的問題，讓我給你一個更長的答案來設定整體背景。

So, as we have always said, when we talk about better health, especially our guidance, our revenue guidance range incorporates a range of expectations, right? It's based on many factors, our ability to drive user growth. Looking at what the macro backdrop looks like, the consumer sentiment, we had talked in the April learning call about softening, potentially softening consumer sentiment, customer acquisition costs, churn rates, etc.

因此，正如我們一直所說的那樣，當我們談論更好的健康時，特別是我們的指導，我們的收入指導範圍包含了一系列的預期，對嗎？它基於許多因素，即我們推動用戶成長的能力。看看宏觀背景，消費者情緒，我們在四月的學習電話會議上談到了消費者情緒的疲軟、潛在疲軟、客戶獲取成本、客戶流失率等。

In the second quarter we did see incremental pressure in our US cash business from lower retention, so higher churn and fewer gross user ads additions, okay? And that is what led to the lower user count that we reported, about 9,000 lower sequentially.

在第二季度，我們確實看到美國現金業務因保留率較低而面臨越來越大的壓力，因此流失率較高，總用戶廣告增加較少，好嗎？這就是我們報告的用戶數量下降的原因，比上一季減少了約 9,000 人。

And if you, if we, as we've analysed what's contributed to that, we believe that these, this is actually being driven by more consumers using insurance for their mental health needs, for mental health therapy, and an increase in advertising by other virtual mental health companies that offer insurance coverage.

如果你，如果我們，正如我們分析過的原因一樣，我們認為，這實際上是由越來越多的消費者使用保險來滿足他們的心理健康需求、進行心理健康治療，以及其他提供保險的虛擬心理健康公司增加的廣告所推動的。

So we now assume that these trends are going to remain consistent for the balance of the year. And you know that is what is incorporated in the guidance range that we have now provided.

因此我們現在假設這些趨勢將在今年餘下時間內保持一致。您知道這就是我們現在提供的指導範圍所包含的內容。

So as such, we've revised our outlook, which we've obviously now talked about, we have narrowed it and brought the sort of midpoint down if you will.

因此，我們修改了我們的展望，顯然我們現在已經討論過了，我們已經縮小了範圍，並且如果你願意的話，降低了中間點。

And it now assumes year over year revenue growth towards the lower end of our previous guidance, revenue guidance.

現在預計年收入成長率將接近我們先前預期收入成長率的低端。

And if you think about what that also means based on the third quarter guidance and the updated 2025 guidance, what it means is that the implied high end of the 4th quarter guidance range does not contemplate a return to flat year over year growth in the fourth quarter, okay? Just to be sort of spelling it out very clearly.

如果你思考一下，根據第三季度指引和更新後的 2025 年指引，這意味著什麼，那麼這意味著第四季度指引範圍的隱含高端並不代表第四季度恢復同比持平的增長，好嗎？只是為了把它說得非常清楚。

Now Adding to that is the fact that we have insurance where we are seeing encouraging early signs, but we have talked about the fact that it needs time to scale. We continue to expect $10 million of insurance revenue this year, as we have talked about, and we are pleased with, the scaling of that overall initiative.

現在，除此之外，我們還看到了令人鼓舞的早期跡象，但我們已經討論過它需要時間來擴大規模。正如我們之前所討論的，我們預計今年的保險收入將達到 1000 萬美元，並且我們對整個計劃的擴大感到滿意。

So, all of this put together, what I would say is, as I think about next year, we need to see how these different things pan out, how insurance scales in 2026, and provides the necessary offset for the cash pay business, especially in the US. That's a little bit of a longer view of how we are seeing the puts and takes in the BetterHelp business.

所以，綜合所有這些，我想說的是，當我考慮明年時，我們需要看看這些不同的事情如何發展，保險在 2026 年的規模如何，並為現金支付業務提供必要的抵消，特別是在美國。這是我們對 BetterHelp 業務的投入和產出的長遠看法。

Charles Rhyee, TD Cowen.

查爾斯·瑞伊（Charles Rhyee），考恩（Cowen）TD。

Yeah, thanks. Yes, thanks for taking the question. Chuck, maybe I want to ask, Lisa's question, maybe a little bit in the reverse. Obviously, during COVID, the use of virtual care skyrocketed in part because that was the only options. We also recognized the great demand for behavioural health services as well, and better help filled an important, a need during that period of time, since then, we, we've seen the use of virtual care drop, fairly dramatically. You mentioned, obviously, you talked about sort of the opportunities of where virtual care can be used.

是的，謝謝。是的，感謝您提出這個問題。查克，也許我想問麗莎的問題，也許稍微反過來問一下。顯然，在 COVID 期間，虛擬護理的使用量激增，部分原因是因為這是唯一的選擇。我們也意識到對行為健康服務的巨大需求，更好的幫助滿足了那段時期的一個重要需求，從那時起，我們看到虛擬護理的使用量急劇下降。您顯然提到了虛擬護理的應用機會。

I know it's another question. I think you talked about sort of penetration rates remain relatively low. I think Chuck, you also talked about healthcare being very local and it's very individual for people as well. What are the big challenges that you see in, I guess the question really is, what has been really the limiting factor then in getting sort of that penetration up?

我知道這是另一個問題。我認為您談到的滲透率仍然相對較低。我認為查克，你也談到醫療保健是非常本地化的，而且對每個人來說也是非常個人化的。您認為最大的挑戰是什麼？我想真正的問題是，在實現這種滲透率的過程中，真正的限制因素是什麼？

Is it really at the provider level and changing how they deliver care and is that maybe more of a More of a systemic thing and just how the workflows are designed or is it at the payer level where, how benefits are designed and sort of set up, or is it really just a consumer level of just people wanting to In person with someone just, you can have this innovation and I guess the question really is more what's in your control versus what is it more that you have to wait for the market to, come around to a certain extent. Thanks.

它真的發生在提供者層面並改變他們提供醫療服務的方式嗎？這是否更像是一個系統性的東西，僅僅是工作流程是如何設計的？還是發生在付款人層面，福利是如何設計和設置的？或者它真的只是一個消費者層面，人們只是想親自與某人聯繫，你就可以擁有這種創新，我想問題更多的是你能控制什麼，還是你必須等待市場在某種程度上復甦。謝謝。

Yeah, I appreciate the question. So, a couple of things. I think you're going to see over time, continued recognition that there's not enough primary care in the United States and I think virtual, there's at least a more openness to. Virtual primary care, and I think that you'll see that continue on. I think the bigger part of your question though is, and this is kind of how we're thinking about it if you recall back when I joined, I started highlighting this, we have millions and millions of engagement points each year through the various visits that we do.

是的，我很感謝你提出這個問題。所以，有幾件事。我認為隨著時間的推移，人們會不斷認識到美國的初級保健不足，我認為虛擬醫療至少會更加開放。虛擬初級保健，我認為你會看到這種情況繼續下去。我認為你的問題更重要的部分是，如果你還記得我加入時我們是如何考慮這個問題的，我就開始強調這一點，我們每年透過各種訪問獲得數以百萬計的參與點。

Those were previously seen as visits. I see them as engagement points, so that's why we put this technology in place that allows us to start activating different strategies to create value for clients in that way. So maybe it's that same visit, but I can also address a care GAAP closure. Maybe I can also help that individual get.

這些以前被視為訪問。我將它們視為參與點，因此我們採用這項技術，使我們能夠開始啟動不同的策略，以這種方式為客戶創造價值。因此，也許是同一次訪問，但我也可以解決護理 GAAP 關閉問題。也許我也可以幫助那個人。

Get navigate them to the next best action. Maybe I can resolve things more holistically than I do today with respect to bringing specialists to the table and a provider consult. So there are ways that we can make this engagement points more impactful, more valuable to clients.

引導他們採取下一個最佳行動。也許我可以比現在更全面地解決問題，例如請專家來討論並諮詢提供者。因此，我們可以採取一些方法，讓這些參與點對客戶更有影響力、更有價值。

And I think the virtual care system up until now has been set up to do. It's been very transactional in many ways, and I think trying to create a little bit more of a longitudinal opportunity is really where we're going to be able to drive more volume and more impact.

我認為到目前為止虛擬護理系統已經建立起來了。它在許多方面都具有很強的交易性，我認為嘗試創造更多縱向機會才是我們真正能夠推動更多交易量、產生更大影響力的地方。

Thank you for your question. That will close our question and answer session for today. That concludes today's call. Thank you for your participation and enjoy the rest of your day.

感謝您的提問。今天的問答環節就到此結束了。今天的電話會議到此結束。感謝您的參與並祝您今天過得愉快。