Teladoc Health Inc (TDOC) 2021 Q1 法說會逐字稿

Ladies and gentlemen, thank you for standing by. And welcome to the Teladoc First Quarter 2021 Earnings Conference Call. (Operator Instructions)

女士們，先生們，謝謝你們的支持。歡迎參加 Teladoc 2021 年第一季度收益電話會議。 （操作員說明）

I will now turn the conference over to Patrick Feeley, Vice President of Investor Relations. Please go ahead.

我現在將會議轉交給投資者關係副總裁 Patrick Feeley。請繼續。

Thank you, and good afternoon. Today, after the market closed, we issued a press release announcing our first quarter 2021 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，收市後，我們發布了一份新聞稿，宣布了我們 2021 年第一季度的財務業績。本新聞稿和隨附的幻燈片演示可在 teladochealth.com 網站的投資者關係部分獲取。

On this call to discuss the results are Jason Gorevic, our Chief Executive Officer; and Mala Murthy, our Chief Financial Officer. During this call, we will also provide our second quarter and full year 2021 outlook, and our prepared remarks will be followed by a question-and-answer session.

我們的首席執行官 Jason Gorevic 參加了這次討論結果的電話會議；和我們的首席財務官 Mala Murthy。在此電話會議期間，我們還將提供我們的第二季度和 2021 年全年展望，我們準備好的評論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 的業績很重要的非 GAAP 財務指標。有關這些非 GAAP 措施與最具可比性的 GAAP 措施及其調節之間關係的詳細信息，請參閱我們網站上發布的新聞稿。

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

此外，請注意，本次電話會議期間作出的某些陳述將是 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，這些因素可能導致實際結果Teladoc Health 與本次電話會議中明示或暗示的內容存在重大差異。有關更多信息，請參閱我們在新聞稿中的警告聲明和我們向美國證券交易委員會提交的文件，所有這些都可以在我們的網站上找到。

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

我現在想把電話轉給傑森。

Thanks, Patrick, and thank you, everyone, for joining us this afternoon. After the market closed, we reported another quarter of outperformance across key financial and operational metrics, driven by broad-based momentum throughout the business. The strength across our portfolio drove revenue of $454 million in the first quarter, an increase of 151% over the prior year, including organic revenue growth of 69% for legacy Teladoc. As a result of the momentum demonstrated across our channels and geographies and the continued development of the pipeline of new and expanded opportunities, we are raising our full year revenue guidance by $20 million to $1.97 billion to $2.02 billion for the year.

謝謝帕特里克，也謝謝大家今天下午加入我們。市場收盤後，在整個業務的廣泛發展勢頭的推動下，我們報告了關鍵財務和運營指標的另一個四分之一的優異表現。我們產品組合的優勢推動第一季度收入達到 4.54 億美元，比上年增長 151%，其中包括傳統 Teladoc 的有機收入增長 69%。由於我們的渠道和地區展現出的勢頭以及新的和擴大的機會管道的持續發展，我們將全年收入指導提高 2000 萬美元至 19.7 億美元至 20.2 億美元。

Turning to utilization. Our network of clinicians provided 3.2 million visits during the first quarter, representing more than 50% growth over the prior year's quarter despite a historically weak flu season. We continue to see significant strength in noninfectious disease and specialty visits with mental health volumes, in particular, driving growth in both B2B and DTC channels.

轉向利用率。我們的臨床醫生網絡在第一季度提供了 320 萬次就診，儘管流感季節歷來較弱，但比去年同期增長了 50% 以上。我們繼續看到非傳染病和心理健康專科就診的顯著優勢，特別是推動 B2B 和 DTC 渠道的增長。

We're also finding that specialty growth is acting as a gateway into multi-service usage. Our members who engage with specialty care are significantly more likely to utilize one of our other services. For example, members who had a specialty visit had 40% more general medical visits per member than those who use general medical alone. This is particularly encouraging given client trends toward multiproduct sales with over 40% of our members now having access to more than one product.

我們還發現專業增長正在成為多服務使用的門戶。我們從事專業護理的會員更有可能使用我們的其他服務之一。例如，與僅使用普通醫療的成員相比，進行專科就診的成員每名成員的普通醫療就診次數要多 40%。考慮到客戶傾向於多產品銷售的趨勢，我們 40% 以上的會員現在可以使用不止一種產品，這一點尤其令人鼓舞。

Membership in the Livongo chronic care suite of products grew 66% over the prior year as we added 62,000 new chronic care members in the quarter. And our share of wallet continues to expand as we gain deeper penetration within clients. As a result, we've seen year-over-year revenue expansion within all of our top 10 chronic care accounts in the first quarter. Particularly encouraging is that over 15% of chronic care members are now enrolled in more than one program compared to less than 5% a year ago.

Livongo 慢性病護理產品套件的會員人數比上一年增長了 66%，因為我們在本季度增加了 62,000 名新的慢性病護理會員。隨著我們在客戶中獲得更深入的滲透，我們的錢包份額繼續擴大。因此，我們在第一季度看到我們所有前 10 大長期護理賬戶的收入同比增長。特別令人鼓舞的是，超過 15% 的長期護理成員現在參加了一個以上的計劃，而一年前這一比例還不到 5%。

With over 40% of adults in the U.S. living with more than one chronic condition, the opportunity is significant. And we continue to execute on our whole-person care strategy to address the full spectrum of consumer health needs rather than just one particular disease.

在美國，超過 40% 的成年人患有不止一種慢性病，這個機會是巨大的。我們繼續執行我們的全人護理戰略，以解決消費者健康需求的全方位問題，而不僅僅是一種特定的疾病。

Enrollment in chronic care programs as a percentage of recruitables remained strong throughout 2020 and into the first quarter. Enrollment rates are consistent with Livongo's performance in recent years across the various books of business, which is a significant achievement given that we have been addressing meaningfully larger populations and, in some cases, population types that are newer to us, such as government employee benefit programs, Medicare Advantage populations and people with hypertension. The strong enrollment performance is a direct result of our investments in data science, which has consistently led to greater consumer engagement across populations.

在整個 2020 年和第一季度，慢性病護理計劃的註冊人數占應聘人員的百分比保持強勁。入學率與 Livongo 近年來在各種業務方面的表現一致，這是一項重大成就，因為我們一直在解決有意義的更大人口問題，在某些情況下，我們還應對較新的人口類型，例如政府僱員福利計劃、Medicare Advantage 人群和高血壓患者。強勁的入學表現是我們對數據科學投資的直接結果，這一直導致消費者在不同人群中的參與度更高。

As our differentiated and comprehensive product portfolio continues to resonate in the marketplace, we're seeing significant traction in both expanding our offering within existing clients as well as adding new clients. Earlier this month, we signed an extensive agreement to expand our relationship with a regional Blue Cross Blue Shield plan on the East Coast to offer our comprehensive whole-person virtual care solution to its members.

隨著我們差異化和全面的產品組合繼續在市場上引起共鳴，我們在現有客戶中擴展我們的產品以及增加新客戶方面都看到了巨大的吸引力。本月早些時候，我們簽署了一項廣泛的協議，以擴大我們與東海岸地區 Blue Cross Blue Shield 計劃的關係，為其成員提供全面的全人虛擬護理解決方案。

Beginning early next year, we will provide members access to our suite of products, including our virtual care solutions and a full suite of digital chronic care solutions across diabetes, hypertension, diabetes prevention and mental health. This deal is notable as it covers all of the plan's commercial books of business and represents another significant competitive takeaway. Moreover, it demonstrates the power of our broad and integrated suite of products and our proven ability to deliver industry-leading utilization and member engagement, which ultimately drives clinical and financial ROI for our clients.

從明年初開始，我們將為會員提供我們的產品套件，包括我們的虛擬護理解決方案和一整套涵蓋糖尿病、高血壓、糖尿病預防和心理健康的數字慢性護理解決方案。這筆交易值得注意，因為它涵蓋了該計劃的所有商業賬簿，代表了另一項重要的競爭優勢。此外，它展示了我們廣泛和集成的產品套件的力量，以及我們提供行業領先的利用率和會員參與度的成熟能力，最終為我們的客戶帶來臨床和財務投資回報。

In addition to a large pipeline of new and expansion opportunities, we continue to see opportunities for competitive takeaways, particularly in the health plan channel, as these clients look for enterprise platforms that can leverage technology and data at scale to deliver actionable insights.

除了大量新的和擴展的機會外，我們繼續看到競爭性外賣的機會，特別是在健康計劃渠道，因為這些客戶正在尋找能夠大規模利用技術和數據來提供可行見解的企業平台。

We're also seeing strong interest in our Primary360 offering from health plans, employers and even hospitals and health systems. And our vision to reimagine the primary care experience is gaining traction in the market. Our Primary360 pilots that launched earlier this year are progressing well and delivering encouraging results for clients and consumers. And we've already signed several additional deals expected to launch later this year.

我們還看到健康計劃、雇主甚至醫院和衛生系統對我們的 Primary360 產品表現出濃厚的興趣。我們重新構想初級保健體驗的願景在市場上越來越受歡迎。我們今年早些時候啟動的 Primary360 試點項目進展順利，為客戶和消費者帶來了令人鼓舞的結果。我們已經簽署了幾項預計將於今年晚些時候推出的額外交易。

Our comprehensive virtual care solution also continues to gain momentum in the international marketplace. During the quarter, we signed a strategic partnership with Generali Hong Kong, a leading insurance carrier in the region, to offer our virtual care solutions to its members across Asia.

我們全面的虛擬護理解決方案也在國際市場上繼續獲得發展勢頭。在本季度，我們與該地區領先的保險公司 Generali Hong Kong 簽署了戰略合作夥伴關係，向其在亞洲的會員提供我們的虛擬護理解決方案。

In Australia, we recently announced a partnership with MetLife to offer access to a customized platform across our comprehensive virtual care service to MetLife's members in the region. In the hospital and health system market, our industry-leading enterprise platform solution continues to see strong demand around the world.

在澳大利亞，我們最近宣布與大都會人壽建立合作夥伴關係，為該地區的大都會人壽會員提供跨我們綜合虛擬護理服務的定制平台。在醫院和衛生系統市場，我們行業領先的企業平台解決方案在全球範圍內持續受到強勁需求。

In addition to new and expanded enterprise deals domestically, we reached multiple new agreements this quarter with health systems in Europe and Asia as our strategy to take the InTouch capabilities to the international arena continues to pay dividends.

除了國內新的和擴展的企業交易外，本季度我們還與歐洲和亞洲的衛生系統達成了多項新協議，因為我們將 InTouch 功能推向國際舞台的戰略繼續帶來回報。

Similarly, the pipeline of opportunities to bring the Livongo suite of chronic care products to the provider market continues to grow, particularly among hospitals that are increasingly bearing risk through ACOs and their own health plans. And we've now signed several deals to bring our chronic care solutions to the health system market.

同樣，將 Livongo 系列慢性病護理產品引入供應商市場的機會也在不斷增加，尤其是在通過 ACO 及其自身健康計劃承擔越來越多風險的醫院中。我們現在已經簽署了幾項協議，將我們的慢性病護理解決方案引入衛生系統市場。

Turning to an update on integration. We've made considerable progress across our key work streams. As we previously noted, our commercial organization has been fully integrated with sales teams selling across the entire whole-person portfolio of products since early this year. We've now closed several deals for our new integrated mental health product that combines the Teladoc therapists and psychiatrists with the Livongo digital mental health capabilities to deliver a market-leading solution.

轉向集成更新。我們在關鍵工作流中取得了相當大的進展。正如我們之前指出的那樣，自今年年初以來，我們的商業組織已與銷售整個全人產品組合的銷售團隊完全整合。我們現在已經為我們新的綜合心理健康產品完成了幾筆交易，該產品將 Teladoc 治療師和精神科醫生與 Livongo 數字心理健康功能相結合，以提供市場領先的解決方案。

Earlier this month, we also enabled the first wave of members to access and register for Livongo programs from within the Teladoc app. This is an important first step toward creating a seamless member experience that will allow us to engage with members more effectively across programs.

本月早些時候，我們還使第一批成員能夠從 Teladoc 應用程序中訪問和註冊 Livongo 計劃。這是創建無縫會員體驗的重要的第一步，這將使我們能夠更有效地跨項目與會員互動。

Additionally, we recently enabled capabilities for clinicians to refer members into Livongo chronic care programs from within the Teladoc provider workflow, leveraging our combined data to deliver clinically relevant insights that aid in decision-making and get consumers the right care at the right time.

此外，我們最近還為臨床醫生提供了從 Teladoc 供應商工作流程中將成員轉介到 Livongo 慢性病護理計劃的功能，利用我們的綜合數據提供臨床相關的見解，以幫助做出決策並在正確的時間為消費者提供正確的護理。

We're making significant investments to integrate and enhance our technology platform to capitalize on our robust data and behavioral science capabilities across the entire organization. Data is a significant part of what underpins our ability to provide a highly personalized experience and deliver longitudinal virtual care that's fully integrated with our digital solutions. The investments we're making in data capabilities will enable us to drive greater consumer engagement, expand the breadth and depth of our product offerings and consistently increase the value we provide to consumers, providers and clients. Our ability to deliver data-driven insights, combined with clinical expertise at scale, will further our vision of becoming consumers' trusted destination for whole-person health.

我們正在進行大量投資來整合和增強我們的技術平台，以利用我們在整個組織中強大的數據和行為科學能力。數據是支撐我們提供高度個性化體驗和提供與我們的數字解決方案完全集成的縱向虛擬護理能力的重要組成部分。我們在數據能力方面的投資將使我們能夠推動更多的消費者參與，擴大我們產品供應的廣度和深度，並持續增加我們為消費者、供應商和客戶提供的價值。我們提供數據驅動的見解的能力，結合大規模的臨床專業知識，將進一步推動我們成為消費者值得信賴的全人健康目的地的願景。

Finally, while we're on the topic of innovation and data science, I'd like to welcome Claus Jensen as our new Chief Innovation Officer. With more than 20 years of experience leading digital transformation at enterprise health care and technology organizations, Claus has deep experience across product innovation, information systems, health informatics and data products. I'm extremely pleased to have Claus join our team and look forward to his leadership and contributions to our growth.

最後，在我們討論創新和數據科學的話題時，我要歡迎 Claus Jensen 成為我們的新首席創新官。 Claus 在企業醫療保健和技術組織領導數字化轉型方面擁有 20 多年的經驗，在產品創新、信息系統、健康信息學和數據產品方面擁有豐富的經驗。我非常高興 Claus 加入我們的團隊，並期待他的領導能力和對我們發展的貢獻。

And with that, I'll turn the call over to Mala for a review of the first quarter as well as detailed guidance.

有了這個，我會把電話轉給 Mala 來審查第一季度以及詳細的指導。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

During the first quarter, total revenue increased 151% to $454 million or 69%, excluding acquired revenue. Total U.S. revenue for the quarter was $416 million, representing growth of 175% over the prior year's quarter. Total international revenue of $38 million increased 29% over the prior year.

第一季度，總收入增長 151% 至 4.54 億美元或 69%，不包括收購收入。本季度美國總收入為 4.16 億美元，比去年同期增長 175%。國際總收入為 3800 萬美元，比上年增長 29%。

Access fee revenue for the first quarter increased 183% year-over-year to $388 million and comprised 86% of total revenue, up from 76% in the prior year's quarter. The increase in access fee revenue as a percent of total revenue is primarily due to the acquisition of Livongo and InTouch Health, both of which generates the majority of their revenue from subscription access fees.

第一季度的接入費收入同比增長 183% 至 3.88 億美元，佔總收入的 86%，高於上年同期的 76%。訪問費收入佔總收入百分比的增加主要是由於收購了 Livongo 和 InTouch Health，這兩家公司的大部分收入都來自訂閱訪問費。

Visit fee revenue for the first quarter increased 24% year-over-year to $54 million and comprised 12% of total revenue as compared to 24% of revenue in last year's quarter.

第一季度的訪問費收入同比增長 24% 至 5400 萬美元，佔總收入的 12%，而去年同期為 24%。

Turning to membership and access. We ended the quarter with U.S. paid membership of 51.5 million members, an increase of 20% over the prior year's quarter. Note that as we discussed on last quarter's earnings call, the approximately 1.5 million temporary members that were onboarded during the pandemic rolled off during the first quarter and are now excluded from our membership count. Individuals with visit fee-only access was 22 million at the end of the first quarter.

轉向成員資格和訪問。我們在本季度結束時擁有 5150 萬名美國付費會員，比去年同期增長 20%。請注意，正如我們在上一季度的財報電話會議上討論的那樣，在大流行期間加入的大約 150 萬臨時會員在第一季度退出，現在不包括在我們的會員人數中。第一季度末，僅支付訪問費的個人為 2200 萬。

Total chronic care enrollment, which includes unique individuals enrolled in one or more of our chronic care programs, was 658,000 members as of the first quarter, a 66% increase over the 396,000 members as of the prior year's first quarter pro forma for the merger with Livongo.

截至第一季度，包括參加我們的一個或多個長期護理計劃的獨特個人在內的長期護理註冊總數為 658,000 名成員，比去年第一季度合併後的 396,000 名成員增長了 66%利文戈。

Average PMPM was $2.24 in the first quarter, up from $0.87 in the prior year's first quarter and $1.76 in the fourth quarter. Of the $0.48 sequential increase in PMPM, roughly half was driven by the contribution of an extra month of Livongo revenue in the first quarter.

第一季度的平均 PMPM 為 2.24 美元，高於去年第一季度的 0.87 美元和第四季度的 1.76 美元。在 PMPM 0.48 美元的環比增長中，大約一半是由第一季度 Livongo 收入增加一個月的貢獻推動的。

We provided 3.2 million visits in the quarter, as Jason mentioned, through our network of clinicians, representing 56% growth over the prior year's first quarter. Platform-enabled sessions, which represents encounters facilitated by our license revenue platform and provided by our clients' own clinicians, was an additional 1.1 million in the quarter.

正如 Jason 提到的，我們通過我們的臨床醫生網絡在本季度提供了 320 萬次訪問，比去年第一季度增長了 56%。支持平台的會話代表了由我們的許可收入平台促進並由我們客戶自己的臨床醫生提供的會面，在本季度增加了 110 萬。

The annualized utilization rate for our members was 19.6% in the first quarter, a 620-basis-point increase over the prior year's first quarter and a 190-basis-point increase sequentially over the fourth quarter.

第一季度我們會員的年化利用率為 19.6%，比去年第一季度增長 620 個基點，比第四季度增長 190 個基點。

Adjusted gross profit, which excludes depreciation and amortization of intangibles, increased to $308 million, an increase of 184% as compared to the prior year's first quarter. Adjusted gross margin was 67.8% compared to 60% in the first quarter of 2020. The 780-basis-point increase in adjusted gross margin is primarily attributable to the higher gross margin profile associated with Livongo revenue.

扣除無形資產折舊和攤銷後的調整後毛利增至 3.08 億美元，與去年第一季度相比增長 184%。調整後的毛利率為 67.8%，而 2020 年第一季度為 60%。調整後的毛利率增長 780 個基點主要是由於與 Livongo 收入相關的毛利率較高。

Gross profit and adjusted gross profit in the first quarter of 2021 include the benefit of approximately $7 million in lower expenses on Livongo devices attributable to purchase accounting adjustments related to the merger.

2021 年第一季度的毛利和調整後的毛利包括因與合併相關的採購會計調整而導致 Livongo 設備費用減少約 700 萬美元的收益。

Adjusted EBITDA increased to $56.6 million in the quarter compared to $10.7 million in Q1 of 2020. Adjusted EBITDA in the first quarter includes the benefit of approximately $7 million attributable to purchase accounting adjustments mentioned previously. The adjusted EBITDA outperformance in the first quarter was driven in part by strong access fee revenue growth and better operating expense performance as we continue to make progress against cost synergies, including integrating back-office functions, streamlining processes and consolidating vendors.

本季度調整後的 EBITDA 增至 5660 萬美元，而 2020 年第一季度為 1070 萬美元。第一季度調整後的 EBITDA 包括前文提到的採購會計調整帶來的約 700 萬美元收益。第一季度調整後的 EBITDA 表現出色部分是由於訪問費收入強勁增長和運營費用表現更好，因為我們繼續在成本協同效應方面取得進展，包括整合後台功能、簡化流程和整合供應商。

As discussed previously, we anticipate reinvesting cost synergies back into the growth of the business over the remainder of the year. Overall, we continue to have a high degree of confidence in our ability to achieve our multiyear revenue and cost synergy targets.

如前所述，我們預計在今年剩餘時間內將成本協同效應重新投資到業務增長中。總體而言，我們繼續對我們實現多年收入和成本協同目標的能力充滿信心。

Net loss in the quarter was $199.6 million compared to a net loss of $29.6 million in the first quarter of 2020. The larger net loss was primarily attributable to increased stock-based compensation, amortization of acquired intangibles and income tax adjustments, primarily related to the merger with Livongo.

本季度淨虧損為 1.996 億美元，而 2020 年第一季度為淨虧損 2960 萬美元。較大的淨虧損主要歸因於股票薪酬增加、收購的無形資產攤銷和所得稅調整，主要與與 Livongo 合併。

On a per share basis, net loss was $1.31 for the first quarter compared to a loss of $0.40 in the first quarter of last year. Net loss per share includes a deferred income tax valuation adjustment of $0.57, amortization of acquired intangibles of $0.30 and stock-based compensation expense of $0.57.

按每股計算，第一季度淨虧損為 1.31 美元，而去年第一季度為虧損 0.40 美元。每股淨虧損包括 0.57 美元的遞延所得稅估值調整、0.30 美元的收購無形資產攤銷和 0.57 美元的股票補償費用。

We ended the quarter with $723 million in cash and short-term investments, while our total recorded debt outstanding as of March 31 was $1.4 billion.

本季度結束時，我們擁有 7.23 億美元的現金和短期投資，而截至 3 月 31 日，我們記錄在案的未償還債務總額為 14 億美元。

Now turning to forward guidance. For the full year 2021, we now expect revenue to be in the range of $1.97 billion to $2.02 billion, up $20 million from prior guidance, driven by strong growth in per member per month fees as well as higher expected utilizations, particularly among specialty visits.

現在轉向前瞻性指導。對於 2021 年全年，我們現在預計收入將在 19.7 億美元至 20.2 億美元之間，比之前的指導高出 2000 萬美元，這是由於每個會員每月費用的強勁增長以及更高的預期利用率，尤其是專科就診.

We expect adjusted EBITDA in 2021 in the range of $255 million to $275 million, including an approximately $20 million benefit from lower expenses on Livongo devices attributable to purchase accounting adjustments related to the Livongo merger.

我們預計 2021 年調整後的 EBITDA 在 2.55 億美元至 2.75 億美元之間，其中包括因與 Livongo 合併相關的採購會計調整而導致的 Livongo 設備支出減少帶來的約 2000 萬美元收益。

As we've previously discussed, we expect increased spending over the course of the year as we invest in the growth of the business, particularly in new product launches and expansions into new markets, the integration of Livongo and the development of our integrated data platform. We now expect total visits in 2021 to be between 12.5 million and 13.5 million visits, representing growth of 18% to 27% over the prior year.

正如我們之前所討論的那樣，隨著我們投資於業務增長，特別是新產品發布和新市場擴張、Livongo 的整合以及我們集成數據平台的開發，我們預計今年的支出會增加.我們現在預計 2021 年的總訪問量將在 1250 萬到 1350 萬之間，比上一年增長 18% 到 27%。

For the second quarter of 2021, we expect revenues of $495 million to $505 million, representing growth of 105% to 110% over the prior year's quarter. We expect total paid membership in the range of $52 million to $53 million and anticipate total visits during the second quarter of between 3.2 million and 3.4 million visits.

對於 2021 年第二季度，我們預計收入為 4.95 億美元至 5.05 億美元，比去年同期增長 105% 至 110%。我們預計付費會員總數在 5200 萬至 5300 萬美元之間，預計第二季度的總訪問量在 320 萬至 340 萬之間。

We expect second quarter adjusted EBITDA to be in the range of $61 million to $64 million, including an approximately $6 million benefit from lower expenses on Livongo devices attributable to purchase accounting adjustments related to the Livongo merger.

我們預計第二季度調整後的 EBITDA 將在 6100 萬美元至 6400 萬美元之間，其中包括因與 Livongo 合併相關的採購會計調整而導致的 Livongo 設備支出減少帶來的約 600 萬美元收益。

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

有了這個，我會把電話轉回 Jason 的結束語。

Thanks, Mala. Before I turn the call over to Q&A, I want to take a moment to acknowledge the hard work of our team members around the world. This week, we were very pleased to be recognized in Time Magazine's first-ever compilation of the 100 Most Influential Companies. Our inclusion along other global leaders is a meaningful recognition of our 4,500 colleagues and a direct result of all that we do for our members and clients every day.

謝謝，馬拉。在將電話轉為問答環節之前，我想花點時間感謝我們全球團隊成員的辛勤工作。本週，我們很高興在時代雜誌首次評選的 100 家最具影響力公司中獲得認可。我們與其他全球領導者一起加入是對我們 4,500 名同事的有意義的認可，也是我們每天為我們的成員和客戶所做的一切的直接結果。

As always, thank you for your continued interest in Teladoc Health. And with that, we'll open the call for questions. Operator?

一如既往，感謝您對 Teladoc Health 的持續關注。有了這個，我們將開始提問。操作員？

(Operator Instructions) And your first question comes from Lisa Gill with JPMorgan.

（操作員說明）您的第一個問題來自摩根大通的 Lisa Gill。

I just really want to start with your most recent thoughts on competition. As we think about some of the comments that you talked about displacing others, with some of your business wins, the idea of whole care, talking about both employers as well as health plans, looking for someone that has a deep embedded enterprise platform, we get a lot of questions around how do we think about Amazon Care, the fact that MDLive has been sold to Cigna, doctors on demand and grand rounds coming together. So can you just maybe just level the playing field for who are you seeing when you're out there winning these pieces of business and how you think about how that competitive landscape has really shifted and changed over the last couple of years?

我真的很想從你最近對競爭的想法開始。當我們考慮您談到的一些關於取代他人的評論、您的一些業務勝利、整體護理的想法、談論雇主和健康計劃、尋找擁有深入嵌入式企業平台的人時，我們關於我們如何看待 Amazon Care、MDLive 已出售給 Cigna、按需醫生和大查房的事實，我們收到了很多問題。那麼，當你在那裡贏得這些業務時，你能不能為你看到的人創造公平的競爭環境，以及你如何看待過去幾年競爭格局的真正變化和變化？

Sure. Thanks, Lisa. We focus on our competitive advantages. And our competitive advantages, as you mentioned, are around the broadest set of clinical solutions, ranging from acute episodic to specialty care, chronic care and complex care as well as being across all of the customer channels, ranging from employers to health plans, to hospitals and health systems and on a direct-to-consumer basis.

當然。謝謝，麗莎。我們專注於我們的競爭優勢。正如您所提到的，我們的競爭優勢圍繞著最廣泛的臨床解決方案，從急性發作到專科護理、慢性護理和復雜護理，以及跨越所有客戶渠道，從雇主到健康計劃，到醫院和衛生系統，並直接面向消費者。

More and more, and I think this is really characterized by the makeup of our pipeline, clients are looking for comprehensive multiproduct solutions. They're not looking for point solutions that they have to integrate themselves to stitch together and get the benefit of that. And I think the data that we talked about today about multi-product usage and specialty usage, in particular, being a gateway and driving higher general medical visits is the consumer proof point behind that.

越來越多的客戶正在尋找全面的多產品解決方案，我認為這確實以我們管道的構成為特徵。他們不是在尋找點解決方案，他們必須將自己整合起來才能縫合在一起並從中受益。而且我認為我們今天談論的關於多產品使用和專業使用的數據，特別是作為網關和推動更高的一般醫療訪問的數據是其背後的消費者證明點。

There's really nobody in the market who comes close to the comprehensive solution for both acute episodic and chronic care as well as the range of both digital and professional services in terms of our clinicians that we can bring to bear. And we see that in our pipeline based on the fact that it's characterized by larger deals than we've ever seen before. Multiproduct deals are sort of the preponderance of the pipeline. And we see it in the competitive takeaways that we have booked, as we mentioned on the call, a large East Coast Blues plan as well as other very large opportunities in the pipeline.

就我們的臨床醫生而言，市場上真的沒有人能夠接近急性發作和慢性護理的綜合解決方案，以及數字和專業服務的範圍。我們在我們的渠道中看到了這一點，因為它的特點是比我們以前見過的交易規模更大。多產品交易在某種程度上是管道的優勢。正如我們在電話會議上提到的那樣，我們在預訂的競爭性外賣中看到了這一點，這是一個大型東海岸藍調計劃以及其他非常大的機會。

With respect to the moves in the market that you've seen, you'll recall last summer when we announced the Livongo acquisition, we talked about the fact that the market had accelerated and that we foresaw the strategic chessboard moving. And ours was a move to put the leaders together in the market to create an unmatched solution. And bringing together InTouch, Livongo and Teladoc certainly does that. And there is no comparable move that we didn't foresee.

關於你所看到的市場走勢，你會記得去年夏天我們宣布收購 Livongo 時，我們談到了市場加速發展的事實，我們預見到了戰略棋盤的移動。我們的舉措是將市場上的領導者聚集在一起，以創建一個無與倫比的解決方案。將 InTouch、Livongo 和 Teladoc 結合在一起當然可以做到這一點。而且沒有我們沒有預見到的可比舉措。

In some cases, we've seen success and increased interest as some of those smaller competitors have gone to health plans. And for the most part, one health plan doesn't want to buy from another competing health plan. And then in other cases, the moves in the market have been somewhat antagonistic toward the health plans in an effort to disintermediate them. It's always been our view to work with the health care system, not against it. And that's proven to be beneficial for us as we align with our partners and bring them greater value.

在某些情況下，我們看到了成功並增加了人們的興趣，因為其中一些較小的競爭對手已經轉向健康計劃。在大多數情況下，一個健康計劃不想從另一個競爭健康計劃購買。然後在其他情況下，市場的走勢在某種程度上與健康計劃背道而馳，以努力消除它們。我們一直認為與醫療保健系統合作，而不是反對它。事實證明，這對我們有利，因為我們與合作夥伴結盟並為他們帶來更大的價值。

So all of those moves are sort of within the realm of what we expected. And I'm not going to call out individual solutions that you mentioned or competitors that you mentioned. But for the most part, many of them, we almost never bump into, and some of the new entrants, we're just not seeing gain traction.

因此，所有這些舉措都在我們預期的範圍內。我不會點出你提到的個別解決方案或你提到的競爭對手。但在大多數情況下，我們幾乎從未遇到過其中的許多人，而一些新進入者，我們只是沒有看到獲得牽引力。

Just as a quick follow-up because you did say the word pipeline several times in that conversation, and you know I love to ask about that as we think about the forward year. Is there anything that you can give us around the size of the pipeline versus previous years or quantify it in any way as we think about going into this next year for 2022?

就像快速跟進一樣，因為你在那次談話中多次提到管道這個詞，而且你知道我喜歡在我們考慮未來一年時問這個問題。在我們考慮進入 2022 年的明年時，您是否可以提供有關管道規模與往年相比的任何信息，或者以任何方式對其進行量化？

Yes. Sure. So I would say a few things. One, as you recall, 2 months ago when we reported the fourth quarter and full year results, we talked about the fact that our pipeline of new members was about 50% larger than at the same time last year. It has only grown since then, and it has also moved along in terms of the deal stage.

是的。當然。所以我想說幾句。一，正如您所記得的，兩個月前，當我們報告第四季度和全年業績時，我們談到了一個事實，即我們的新成員渠道比去年同期增加了約 50%。從那時起，它才有所發展，並且在交易階段也取得了進展。

So you'll also recall that we said that it was characterized by a larger sort of gross opportunity, but they were earlier-stage deals. And we've seen those deals move along the pipeline as we would have expected. Obviously, one of those materialized into a very significant sale for us, and we have others in very late stage.

所以你還會記得我們說過它的特點是更大的總機會，但它們是早期的交易。我們已經看到這些交易按照我們的預期進行。顯然，其中一個對我們來說實現了非常重要的銷售，我們還有其他處於後期階段。

The other thing is that we are seeing more large multiproduct deals than we've ever seen before. And I'm very, very encouraged by faster than I would have expected opportunities arising for the Livongo suite of products into the hospital and health system channel. That's moving along faster than I would have expected.

另一件事是，我們看到了比以往任何時候都多的大型多產品交易。我非常非常鼓舞 Livongo 產品套件進入醫院和衛生系統渠道的速度比我預期的要快。這比我預期的要快。

And then maybe last, we've talked about our Primary360 offering. That pipeline has also increased materially since just 2 months ago, and we see large deals moving along there. So when we look -- and you'll recall that it's very unusual for us to raise guidance at this time in the year. We did it last year, but that was in the face of the massive wave that we saw of COVID hitting the states. But we've really -- I don't think before that, we've ever increased our guidance at this time in the year. And so I think the increase in our revenue guidance for this year is both based on the performance we're seeing today as well as the expectations that we have going forward.

也許最後，我們已經討論了我們的 Primary360 產品。自 2 個月前以來，該管道也大幅增加，我們看到大宗交易正在那裡進行。所以當我們看 - 你會記得我們在今年的這個時候提高指導是非常不尋常的。我們去年做到了，但那是在我們看到 COVID 席捲各州的巨大浪潮面前。但我們真的 - 我不認為在那之前，我們在今年的這個時候增加了我們的指導。因此，我認為我們今年收入指引的增加既基於我們今天看到的表現，也基於我們對未來的期望。

And your next question comes from Sean Wieland with Piper Sandler.

你的下一個問題來自 Sean Wieland 和 Piper Sandler。

So I'm most interested in this whole-person care at the Blues plan you mentioned. I know you said it includes your whole book of business, but I'd really like to know beyond that. What role are you taking on to really coordinate the care, especially across medical and behavioral? And are the economics on a contract like this any different than standard economics?

所以我對你提到的 Blues 計劃中的全人護理最感興趣。我知道你說它包括你的整個業務簿，但我真的很想知道除此之外的內容。您在真正協調護理方面扮演什麼角色，尤其是在醫療和行為方面？像這樣的合同的經濟學與標準經濟學有什麼不同嗎？

So the -- what we said is it's for the entire commercial book of this Blues plan and that we're selling our full suite of telehealth and chronic care solutions. We will also bring to bear, as we mentioned, the integration within a single app of the ability to -- for the consumer to get access to the full set of services as well as the ability for our clinicians to refer across those solutions.

所以——我們所說的是這個藍調計劃的整個商業書籍，我們正在銷售我們的全套遠程醫療和慢性護理解決方案。正如我們提到的，我們還將在單個應用程序中實現集成——讓消費者能夠訪問全套服務，以及讓我們的臨床醫生參考這些解決方案的能力。

So we have now executed on the first wave of that integration. That will continue to develop over the course of this year, and we'll launch this service for them early next year. And that resonates and that was part of the thesis behind bringing together all of these assets under one roof. And it's a significant competitive advantage when we're going out to, in this case, displace a competitor.

所以我們現在已經執行了第一波整合。這將在今年繼續發展，我們將在明年初為他們推出這項服務。這引起了共鳴，這是將所有這些資產集中在一個屋簷下的論點的一部分。當我們要出去時，這是一個重要的競爭優勢，在這種情況下，取代競爭對手。

With respect to the economics, there are certainly some economies that we get from selling all of our solutions or a full suite into a single client. It's one data feed for multiple products. And Sean, as we mentioned, we get benefit from higher utilization when people use our specialty products. So we are able to bring it to bear at a more competitive price because of the economies that we get out of it. And ultimately, we drive higher revenue per user because they're using multiple services.

在經濟方面，我們將所有解決方案或全套解決方案出售給單個客戶肯定會帶來一些經濟效益。它是多種產品的一個數據源。肖恩，正如我們提到的，當人們使用我們的特色產品時，我們會從更高的利用率中獲益。因此，由於我們從中獲得的經濟效益，我們能夠以更具競爭力的價格來承擔它。最終，我們提高了每個用戶的收入，因為他們使用多種服務。

And your next question comes from Sean Dodge with RBC Capital.

你的下一個問題來自 RBC Capital 的 Sean Dodge。

Jason, on the Primary360 program, you mentioned the pipeline there increasing. Can you give us a sense of how quickly you think offerings like that, the virtual primary care, could ramp? Maybe what kind of adoption do you think you can achieve of it over the next few years? And then you've said before, the revenue opportunity for member there is much larger. Can you put any bookends around that and any quantification? Maybe in some of the pilots, how much did virtual primary care -- Primary360 enhanced revenue per member?

Jason，在 Primary360 計劃中，你提到那裡的管道在增加。你能告訴我們你認為像虛擬初級保健這樣的產品可以多快地增加嗎？也許您認為在接下來的幾年中可以實現什麼樣的採用？然後你之前說過，會員的收入機會要大得多。你能圍繞它放一些書擋和任何量化嗎？也許在一些試點中，虛擬初級保健——Primary360 增加了多少每個成員的收入？

Yes. So the pipeline is very strong. We've already closed deals among several Fortune 1000s to launch in the second half of this year, and we expect to roll out nationally over -- in the first quarter next year. We've always said we don't expect it to be a material contributor to our revenue this year. And we've taken that into account even as we've increased our guidance for this year. We do expect it to be a meaningful contributor next year and to increase over time.

是的。所以管道非常強大。我們已經與幾家財富 1000 強公司達成交易，將於今年下半年推出，我們預計明年第一季度將在全國推出。我們一直說我們預計它不會對我們今年的收入做出重大貢獻。即使我們增加了今年的指導，我們也考慮到了這一點。我們確實希望它在明年成為一個有意義的貢獻者，並隨著時間的推移而增加。

When we talk about the revenue opportunity per member, it's still a mixed bag when we talk about what's in the pipeline and what clients are looking for. Some of them are happy with a higher PMPM and higher visit fees that reflect the increased value at each one of those visits and the increased intensity at each one of those visits. Others are looking for more sort of value-based arrangements, including leading up to more risk arrangements where we have the opportunity to really benefit from the savings that we generate.

當我們談論每個成員的收入機會時，當我們談論管道中的內容和客戶正在尋找的內容時，它仍然是一個混合包。他們中的一些人對更高的 PMPM 和更高的訪問費用感到滿意，這反映了每次訪問的價值增加和每次訪問強度的增加。其他人正在尋找更多基於價值的安排，包括導致更多風險安排，我們有機會真正從我們產生的儲蓄中受益。

We're going to migrate into those over time. That's not going to be the preponderance of arrangements in the short term. But I do think that that's where we're going to go. And I think we have a unique opportunity and capability to do that because of our scale relative to anyone else in the market.

隨著時間的推移，我們將遷移到那些。這不會是短期內的主要安排。但我確實認為那是我們要去的地方。而且我認為我們有獨特的機會和能力來做到這一點，因為我們相對於市場上其他任何人的規模。

The other thing I'd also add, Sean, is it's one of the reasons why as we think about PMPM over the sort of medium to long term, it is an opportunity for us to expand our PMPM because, by its very nature, if you think about Primary360, it is multi-product. So we will be looking to capture economics, both from the expansion of PMPM because of that and the incremental population.

肖恩，我還要補充的另一件事是，這是我們在中長期考慮 PMPM 的原因之一，這是我們擴展 PMPM 的機會，因為就其本質而言，如果你想想Primary360，它是多產品的。因此，我們將尋求從 PMPM 的擴張和人口增量中獲取經濟學。

And your next question comes from Ryan Daniels with William Blair.

你的下一個問題來自 Ryan Daniels 和 William Blair。

Jason, wanted to follow up on the strength in the behavioral business. It sounds like from our channel checks that that's one area, in particular, that not only has benefited, unfortunately, due to COVID with an increase in need for care, but also more insurers and employers wanting that, and then more of a sustained movement towards telehealth versus in-person visits as it is truly conversational and maybe has less stigma, et cetera. So I'm curious if you can just dive a little bit more into what you're seeing in that market, both in the D2C and then the more emerging B2B market for the organization?

傑森，想跟進行為業務的實力。從我們的渠道檢查來看，這似乎是一個特別的領域，不幸的是，由於 COVID 的增加，護理需求增加，而且更多的保險公司和雇主也希望如此，而且更多的是持續的運動與面對面訪問相比，遠程醫療更受歡迎，因為它是真正的對話，並且可能具有更少的恥辱感，等等。所以我很好奇您是否可以更深入地了解您在該市場中看到的內容，包括 D2C 以及組織的新興 B2B 市場？

Yes, Ryan, you're exactly right. Mental health continues to be the fastest-growing specialty in our portfolio. And we are seeing the need for that service continuing to increase, the attraction of our products continuing to increase. I mentioned, we're bringing together at Livongo, digital assets with our therapists and psychiatrists capabilities into a single offering. And that's clearly resonating in the market.

是的，瑞安，你完全正確。心理健康仍然是我們投資組合中增長最快的專業。我們看到對這項服務的需求在不斷增加，我們產品的吸引力也在不斷增加。我提到過，我們正在 Livongo 將數字資產與我們的治療師和精神病學家的能力結合到一個單一的產品中。這顯然在市場上引起了共鳴。

We talked last year, Ryan, about growing our B2B mental health visits by over 500% in 2020. And we're on track to more than double that this year as well, even after that incredibly explosive growth in 2020. So that should give you an idea of how much traction we're getting.

瑞安，我們去年談到了到 2020 年我們的 B2B 心理健康訪問量將增加 500% 以上。即使在 2020 年出現令人難以置信的爆炸性增長之後，我們今年也有望增加一倍以上。所以這應該給你知道我們得到了多少牽引力。

The other thing that I think is meaningful is that we mentioned that over 40% of our members now have access to multiple specialties. And certainly, mental health is the sort of leading second product, if you will, to general medical.

另一件我認為有意義的事情是，我們提到超過 40% 的會員現在可以訪問多個專業。當然，如果您願意的話，心理健康是領先於普通醫療的第二大產品。

On the direct-to-consumer side, we also continue to see just surging demand for that product. We also see the utilization continuing to shift toward more live interactions. What used to be many years ago, a service that was focused primarily on tech space interactions, has migrated to more live interactions between the therapist and the consumer. And our ability to continue to scale that, I think, is a credit to the team, to the therapists who work with us and to the scalability of the platform. It also enables us to continue to bring significant value to consumers at an attractive price point, both for the consumer and one that is economically advantageous for us.

在直接面向消費者方面，我們也繼續看到對該產品的需求激增。我們還看到利用率繼續轉向更多的現場互動。多年前，一項主要專注於技術空間互動的服務，已經遷移到治療師和消費者之間更多的現場互動。我認為，我們繼續擴大規模的能力是團隊、與我們合作的治療師以及平台可擴展性的功勞。它還使我們能夠繼續以極具吸引力的價格為消費者帶來重要價值，無論是對消費者還是對我們在經濟上有利的價格。

Our next question comes from Stephanie Davis with SVB Leerink.

我們的下一個問題來自 SVB Leerink 的斯蒂芬妮戴維斯。

Congratulations on the quarter once again. It's been about 6 months since the Livongo deal closed. So I was hoping we can get an update on the platform integration side. Where are you on the back end? And when could we see an integrated front end to really bring the platforms together from a user experience standpoint?

再次祝賀本季度。自 Livongo 交易完成以來已經過去了大約 6 個月。所以我希望我們能在平台集成方面獲得更新。你在後端哪裡？從用戶體驗的角度來看，我們什麼時候才能看到真正將平台整合在一起的集成前端？

Yes. Well, thank you, Stephanie. I appreciate your comments. We're very excited about the progress of integration. We mentioned the rapid progress on the commercial side, and I think the team has just done incredible work to bring that together. Breaking up territories and reallocating and bringing to market a comprehensive and unified suite is hard work, and the team has done just a tremendous job.

是的。好吧，謝謝你，斯蒂芬妮。感謝您的評論。我們對整合的進展感到非常興奮。我們提到了商業方面的快速進步，我認為團隊剛剛完成了令人難以置信的工作來將其整合在一起。打破地域、重新分配和將全面統一的套件推向市場是一項艱鉅的工作，而團隊所做的工作非常出色。

The -- we mentioned that we have now launched the first wave of consumers who can access the Livongo capabilities and products through the Teladoc app. That's really just the first step. I would expect early next year to have a completely redesigned user experience that integrates all of those capabilities and really sort of optimizes the experience for the consumer and optimizes the sort of funnel, if you will, into those different products.

我們提到我們現在已經推出了第一批消費者，他們可以通過 Teladoc 應用程序訪問 Livongo 的功能和產品。這真的只是第一步。我預計明年年初將有一個完全重新設計的用戶體驗，它集成了所有這些功能，真正優化了消費者的體驗，並優化了漏斗的類型，如果你願意的話，進入那些不同的產品。

The provider integration is material because we believe that providers referring into those programs will be a significant source of consumer engagement, which, of course, drives -- directly drives revenue in those products.

提供商集成很重要，因為我們相信引用這些程序的提供商將成為消費者參與的重要來源，這當然會推動 - 直接推動這些產品的收入。

And then on the back end, you asked about the data platform. And the data integration is really critical. We just have an incredible treasure trove of data. And the more we can integrate the 12 million-plus -- 12.5 million-plus visits that we'll do this year and all of the data from those visits with the more than 2 million blood glucose readings a week we get, for example, as well as the -- from all the other products, it just makes everything much more powerful, much more personalized for the consumer and much more able to move the needle on consumer behavior change, which results in better outcomes and more ROI for our clients.

然後在後端，您詢問了數據平台。數據集成真的很關鍵。我們只是擁有令人難以置信的數據寶庫。我們越能整合我們今年將進行的超過 1200 萬 - 超過 1250 萬次訪問以及來自這些訪問的所有數據以及我們每週獲得的超過 200 萬個血糖讀數，例如，以及——與所有其他產品相比，它只是讓一切都變得更強大，對消費者來說更加個性化，並且更有能力推動消費者行為的改變，從而為我們的客戶帶來更好的結果和更高的投資回報率.

So we are deep in that process. And I'm really excited that Claus Jensen is joining us. We spent some time today just talking about the vision for what that can be. And I think we're going to really get the benefit of bringing the teams together and his leadership as well.

所以我們深入這個過程。我真的很高興 Claus Jensen 加入我們。我們今天花了一些時間來討論未來的願景。而且我認為我們將真正受益於將團隊團結在一起以及他的領導力。

I'd also add, Stephanie. The good thing is we have a very, very clear road map. And we have spent a fair amount of time as a leadership team, prioritizing that road map, so that the investments we've put against that, as we have talked about, I expect 2021 to be an investment year, it is stacked and aligned against those very clear priorities in the R&D road map. Whether it be in terms of data integration, as you asked, recognizing a unique member from an eligibility and an identity perspective, that requires deep integration. And I would say we are well on our way to do it.

我還要補充一點，斯蒂芬妮。好消息是我們有一個非常非常清晰的路線圖。作為一個領導團隊，我們花了相當多的時間來優先考慮該路線圖，以便我們針對該路線圖進行的投資，正如我們所談到的，我預計 2021 年將是一個投資年，它是堆疊和對齊的反對研發路線圖中那些非常明確的優先事項。無論是在數據集成方面，如您所問，從資格和身份的角度識別一個獨特的成員，都需要深度集成。我會說我們正在努力做到這一點。

And your next question comes from Daniel Grosslight with Citi.

你的下一個問題來自花旗銀行的 Daniel Grosslight。

Just a couple of questions around BetterHelp specifically. I think last quarter, you mentioned that you had started to sell that into the EAP. So I was curious how that will work alongside your traditional B2B behavioral health platform. And then on the DTC side, we've heard that CAC remain pretty elevated in behavioral specifically, particularly for paid search. Curious how that's impacting your marketing strategy this year and if there's any changes to the previously mentioned 50% revenue growth in BetterHelp.

只是關於 BetterHelp 的幾個問題。我想上個季度，你提到你已經開始將其出售給 EAP。所以我很好奇這將如何與您的傳統 B2B 行為健康平台一起工作。然後在 DTC 方面，我們聽說 CAC 在行為方面仍然相當高，特別是對於付費搜索。想知道這對您今年的營銷策略有何影響，以及之前提到的 BetterHelp 收入增長 50% 是否有任何變化。

Yes. Actually, we continue to see revenue per dollar spent on customer acquisition increase in our DTC channels. That continues to get more efficient as we use -- as we sort of optimize the channels as well as -- look, I think we are benefiting from the fact that the market acceptance of getting therapy virtually has increased substantially. And so awareness of that as a service and acceptance of that as a service also provides a tailwind that I believe helps in addition to all of the test and learn that we've gotten over the course of the last several years. So we're not seeing a challenge relative to customer acquisition cost in that channel.

是的。實際上，我們繼續看到在我們的 DTC 渠道中用於客戶獲取的每美元收入增加。隨著我們使用 - 隨著我們優化渠道以及 - 看，我認為我們正在受益於市場對虛擬治療的接受度大幅提高這一事實。因此，意識到這是一種服務並接受它作為一種服務也提供了一種順風，我相信除了所有的測試和了解我們在過去幾年的過程中得到的幫助之外，它也會有所幫助。因此，我們沒有看到與該渠道的客戶獲取成本相關的挑戰。

The EAP services actually are always alongside behavioral health services that are built into the benefit package. It's really not an or; it's an and for most large employers. And there are different buyers on the health plan side. So most of the large insurers also offer an EAP and sell them together. And some of them were selling our commercial behavioral health B2B services into the same health plan that's also bundling our BetterHelp capabilities into their EAP.

EAP 服務實際上總是與福利包中內置的行為健康服務一起提供。這真的不是一個或；對於大多數大型雇主來說，這是一個。健康計劃方面有不同的買家。因此，大多數大型保險公司也提供 EAP 並將它們一起出售。他們中的一些人將我們的商業行為健康 B2B 服務出售到同一個健康計劃中，該計劃還將我們的 BetterHelp 功能捆綁到他們的 EAP 中。

The EAP generally has limited number of visits. And so the recipe there is that we are there for the consumer to provide them with those visits. And then if they exhaust that benefit, they have the option of rolling in on a direct-to-consumer basis. So that becomes an opportunity for us to continue the relationship with the consumer.

EAP 通常訪問次數有限。因此，我們在那裡的秘訣是讓消費者為他們提供這些訪問。然後，如果他們用盡了這種好處，他們可以選擇直接面向消費者。因此，這成為我們繼續與消費者建立關係的機會。

And coming back to your question on CAC and as Jason mentioned, the efficiencies that we continue to see in that, we monitor, as we have said, lot of metrics across our business, including our DTC. And we continue to see gains in terms of better retention, and that drives greater lifetime value. So there are sort of the underlying levers that drive the revenue growth are still strong.

回到你關於 CAC 的問題，正如 Jason 提到的，我們繼續看到效率，正如我們所說的，我們監控我們業務的許多指標，包括我們的 DTC。我們繼續看到更好的保留率方面的收益，這推動了更大的生命週期價值。因此，有一些推動收入增長的潛在槓桿仍然強勁。

And your next question comes a George Hill from Deutsche Bank.

你的下一個問題來自德意志銀行的喬治希爾。

Jason, you kind of talked about a clear product road map, but the space continues to evolve pretty rapidly as it relates to partnerships and M&A. I guess so can you talk about the opportunity these guys don't touch and maybe how you think about moving up the value chain into higher dollar cost areas as it relates to your clients?

傑森，你談到了一個清晰的產品路線圖，但這個領域在與合作夥伴關係和併購相關的過程中繼續快速發展。我想你能談談這些人沒有觸及的機會嗎？也許你是如何考慮將價值鏈向上移動到與你的客戶相關的更高美元成本的領域？

Yes, thanks, George. Yes, we will continue to expand the scope of our clinical portfolio. And you saw us earlier this year make some announcements around chronic kidney disease. I think you'll continue to see us develop along the cardiometabolic continuum, which, of course, to your point, has higher dollar impact and, therefore, a higher economic opportunity for us to make an impact.

是的，謝謝，喬治。是的，我們將繼續擴大我們的臨床產品組合的範圍。你看到我們今年早些時候發布了一些關於慢性腎病的公告。我認為你會繼續看到我們沿著心臟代謝連續體發展，當然，就你的觀點而言，這具有更高的美元影響，因此，我們有更大的經濟機會產生影響。

And again, our focus is on whole-person care. And so there are things that you can do remotely. There are things that you can't do remotely. I think you'll see -- my guess is we'll continue to see more of a trend toward at-home diagnostics. And that provides us with an opportunity to expand the scope of what we do and the value we can deliver for the consumer. And then the opportunity for us to bring our Livongo solutions as they increase in scope into both the hospital and health system channel as well as internationally will continue to provide us with opportunities.

同樣，我們的重點是全人護理。所以有些事情你可以遠程做。有些事情是您無法遠程完成的。我想你會看到——我猜我們會繼續看到更多的家庭診斷趨勢。這為我們提供了一個機會，可以擴大我們的工作範圍以及我們可以為消費者提供的價值。然後，我們有機會將我們的 Livongo 解決方案引入醫院和衛生系統渠道以及國際範圍，這將繼續為我們提供機會。

So I don't see an end to our continuing expansion. And as always, we'll look at that in terms of build, buy and partner.

所以我認為我們的持續擴張不會結束。和往常一樣，我們將從構建、購買和合作夥伴的角度來看待這個問題。

And your next question comes from Jailendra Singh with Crédit Suisse.

你的下一個問題來自 Crédit Suisse 的 Jailendra Singh。

Actually, Jason, you talked about the faster-than-expected opportunities in the Livongo business within the hospital and health system market. These hospitals, health systems you have been successful in contracting with, were they -- have those been existing clients to Livongo? Were they were available to employees of their health system? Or these are organic contract wins? Just maybe help us understand a little bit more about the -- your differentiation there about what you're resonating with these health system clients.

事實上，傑森，你談到了醫院和衛生系統市場中 Livongo 業務的機會快於預期。這些醫院，你已經成功與之簽約的衛生系統，他們 - 那些是 Livongo 的現有客戶嗎？醫療系統的員工可以使用它們嗎？或者這些是有機合同勝利？只是也許可以幫助我們更多地了解——您在與這些衛生系統客戶產生共鳴方面的差異化。

Yes. Most of them are cross-sells where we're bringing the Livongo capabilities into our existing hospital and health system clients on the Teladoc and InTouch side. The big move and the big shift, Jailendra, is moving from the HR department, which is where Livongo used to sell, into the C-suite because the C-suite of the hospital or health system is focused on their at-risk population, either within their ACO or within their own sort of owned or captive health plan.

是的。其中大部分是交叉銷售，我們將 Livongo 的功能引入我們現有的醫院和衛生系統客戶的 Teladoc 和 InTouch 方面。重大舉措和重大轉變，Jailendra，正在從 Livongo 過去銷售的人力資源部門轉移到 C-suite，因為醫院或衛生系統的 C-suite 專注於他們的高危人群，無論是在他們的 ACO 內，還是在他們自己擁有的或專屬的健康計劃內。

So whether that means that they're in a direct contracting relationship or they've stood up a health plan or they have a JV or an ACO relationship with a health plan, more and more of the hospitals are going at risk for populations and their ability to discharge one of their patients with the Livongo capabilities is a massive step-up in terms of their capabilities and ability to avoid readmissions, avoid exacerbations and avoid higher-cost members.

因此，無論這意味著他們是直接簽約關係，還是他們制定了健康計劃，或者他們與健康計劃有 JV 或 ACO 關係，越來越多的醫院正面臨人口和他們的風險就他們的能力和避免再次入院、避免惡化和避免高成本成員的能力而言，能夠讓他們的一名患者出院是一個巨大的進步。

And your next question comes from Richard Close with Canaccord Genuity.

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

Jason, a lot of time spent on the fourth quarter call on membership. And in your answer to Lisa's pipeline question, you ended with the raised guidance. However, the membership guidance didn't change. So on these takeaway deals that you're referencing, does that provide upside to 2021 potentially? Or should we think of it more as 2022 start business?

傑森，很多時間都花在了第四季度的會員電話會議上。在你對 Lisa 的管道問題的回答中，你以提高的指導結束。但是，會員指南沒有改變。那麼，在您提到的這些外賣交易中，這是否有可能為 2021 年提供上行空間？還是我們應該更多地將其視為 2022 年開始營業？

Yes. Yes. So thanks, Richard. It's a good question. I would say the membership increases, and the sales that we're closing over the course of this year will have a much bigger impact on 2022 than on 2021. And actually, I have great confidence in what 2022 looks like based on the current status of our pipeline and our line of sight into significant deals.

是的。是的。所以謝謝，理查德。這是個好問題。我想說的是，會員數量增加了，而我們今年關閉的銷售額對 2022 年的影響將比對 2021 年的影響大得多。實際上，根據目前的狀況，我對 2022 年的情況很有信心我們的管道和我們對重大交易的視線。

Where we're likely to see upside in 2021 is in increased Livongo chronic care enrollment. We've factored in essentially no flu season in the back half of this year. So if we were to see a more normal flu season in the back half of this year, that would be upside to our revenue numbers. And of course, on our DTC channel, that's performing incredibly well. And if that were to accelerate, it would also provide upside in '21.

我們在 2021 年可能看到的好處是 Livongo 慢性病護理註冊人數增加。我們已經考慮到今年下半年基本上沒有流感季節。因此，如果我們在今年下半年看到一個更正常的流感季節，那將有利於我們的收入數字。當然，在我們的 DTC 頻道上，它的表現非常出色。如果這種情況加速，它也會在 21 年提供上行空間。

And your next question comes from Charles Rhyee with Cowen.

你的下一個問題來自 Charles Rhyee 和 Cowen。

Jason, one of your competitors today talked about opening their platform, particularly for third-party developers to add additional capabilities. I think they're working with Google Cloud as well. Can you talk about sort of how you think about the broader ecosystem going forward and maybe some of the opportunities that presents for you guys in that kind of area as you think about -- you talked earlier about buyer-build kind of decision-making on investments. Can you talk about sort of that with the Teladoc platform? And can you remind us -- I don't know if you've talked about sort of who you're using as a cloud partner, but maybe you can just remind us that as well.

Jason，您的一位競爭對手今天談到了開放他們的平台，特別是為第三方開發人員添加額外的功能。我認為他們也在與穀歌云合作。你能談談你如何看待未來更廣泛的生態系統嗎？也許你認為在那個領域為你們提供的一些機會 - 你之前談到了買方建立的決策投資。您能談談 Teladoc 平台嗎？你能否提醒我們——我不知道你是否談到過你正在使用誰作為雲合作夥伴，但也許你也可以提醒我們這一點。

Sure. On the cloud side, we're a multi-platform. So we don't work with only one cloud provider. Rather, we work across cloud providers to sort of take advantage of the best of all of them. And we think it's best to be able to be a little bit more diversified.

當然。在雲端，我們是一個多平台。所以我們不會只與一家云提供商合作。相反，我們跨雲提供商工作，以利用他們中最好的。我們認為最好能夠更加多樣化。

And then with respect to the platform and my vision of what we want to own and partner and open, I see it as concentric circles, where there are things that we really want to own and deeply integrate because that's going to deliver on the vision of whole-person care. It's going to best impact the outcomes from a clinical perspective as well as a financial perspective for the consumer and the client. And it is integral to the consumer experience.

然後關於平台以及我對我們想要擁有、合作和開放的願景，我將其視為同心圓，其中有我們真正想要擁有和深度整合的東西，因為這將實現我們的願景全人關懷。從臨床角度以及消費者和客戶的財務角度來看，它將對結果產生最好的影響。它是消費者體驗不可或缺的一部分。

Then there's a set of things in what I think of as the next circle that are areas where we need deep partnership because it's really important to the consumer experience, but they're not assets that we want to own for all kinds of reasons, either it's not part of our core competencies or it's not a beneficial economic model. But we do think that there's opportunity for deep partnership in order to optimize the consumer experience.

然後在我認為的下一個圈子中有一組東西是我們需要深入合作的領域，因為這對消費者體驗非常重要，但出於各種原因，它們也不是我們想要擁有的資產，或者它不是我們核心競爭力的一部分，也不是一種有益的經濟模式。但我們確實認為有機會建立深入的合作夥伴關係以優化消費者體驗。

And then there are many things outside of that where I believe we will open the opportunity for other curated, right? So I'm not going to -- I don't intend to open the platform for integration to all comers. I think it's our responsibility, quite frankly, to curate that set of -- in the third ring, but also areas where we can bring value to the consumer as well as value to those third-parties by providing access to that large population that we serve. And I think the fact that we have really an unmatched population and meaningfully larger scale than anyone else in the market makes us the ideal partner.

然後還有很多事情，我相信我們會為其他策劃人打開機會，對吧？所以我不會 - 我不打算向所有參與者開放集成平台。坦率地說，我認為我們有責任在第三環中策劃這一系列，但也包括我們可以為消費者帶來價值的領域，以及通過提供接觸我們的大量人口的渠道，為那些第三方帶來價值的領域服務。而且我認為，我們確實擁有無與倫比的人口和比市場上任何其他公司都大得多的規模這一事實使我們成為理想的合作夥伴。

And your next question comes from Allen Lutz with Bank of America.

你的下一個問題來自美國銀行的 Allen Lutz。

Mala, you said that you expect increased spending over the course of the year. Where specifically is that increase coming from? Is that from the Primary360 rollout? Is that from BetterHelp? And then also, is that an absolute increase or as a percent of revenue?

Mala，你說過你預計今年的支出會增加。這種增長具體來自哪裡？這是來自 Primary360 的推出嗎？是來自 BetterHelp 的嗎？然後，這是絕對增長還是佔收入的百分比？

Yes, it's a great question. We talked about the R&D road map and the fact that, especially now with cloud coming in, even more so, we will want to invest against the clear road map we have. So I would say the investments will be against that, whether it be an integrated data platform, whether it be the unified product experience that we intend to deliver. Definitely, Primary360 is a big bet for us. It is something that -- as Jason talked about, it's a multiyear ramp, and it will require investments. So that is definitely something.

是的，這是一個很好的問題。我們談到了研發路線圖以及這樣一個事實，尤其是現在隨著雲的出現，我們更希望根據我們現有的清晰路線圖進行投資。所以我想說投資將反對這一點，無論是集成數據平台，還是我們打算提供的統一產品體驗。毫無疑問，Primary360 對我們來說是一個很大的賭注。正如傑森所說，這是一個多年的斜坡，需要投資。所以這絕對是什麼。

We will continue to invest in behavioral health, whether it be on the B2B side or on the DTC side. So that will continue to be an investment for us. So that would be -- those are the kinds of areas that we are looking at from an investment perspective.

我們將繼續投資於行為健康，無論是在 B2B 方面還是在 DTC 方面。因此，這將繼續成為我們的一項投資。所以這就是 - 這些是我們從投資角度來看的領域。

Going to your second question on percentage of revenue versus absolute, we look -- I think about it really in both ways. At the end of the day, what I'm looking at is what are the priorities we have? How do we stack them? And most importantly, what are the returns? What are the ROIs against those investments? And can I see the very clear payback for the investments we make?

關於收入百分比與絕對收入的第二個問題，我們看 - 我真的從兩個方面考慮它。歸根結底，我關注的是我們的優先事項是什麼？我們如何堆疊它們？最重要的是，回報是多少？這些投資的投資回報率是多少？我能否看到我們所做投資的非常明顯的回報？

Definitely, I -- it will have to be -- I do look at percentage of revenue. At the end of the day, we have margins to manage and grow importantly. But I also look at what is the dollar investment and what priorities is feeding.

當然，我 - 必須 - 我確實會看收入的百分比。歸根結底，我們有重要的利潤來管理和增長。但我也看什麼是美元投資以及優先考慮的是什麼。

Your next question comes from Kevin Caliendo with UBS.

你的下一個問題來自瑞銀的 Kevin Caliendo。

This is Adam Noble on for Kevin. I just want to circle back a little bit to your comments around the PMPM in the quarter. I think you mentioned that of the $0.48 sequential jump versus 4Q, half of that came from the extra month of Livongo. So kind of you're $0.24 beyond that. And I'm curious if you could break that $0.24 down between the growth in behavioral business, the sequential growth just in the chronic care business itself as well as up-sells and other dynamics.

這是凱文的亞當諾布爾。我只想回顧一下您在本季度對 PMPM 的評論。我想你提到了與第四季度相比連續上漲 0.48 美元，其中一半來自 Livongo 的額外月份。好樣的，你還多了 0.24 美元。我很好奇你是否可以在行為業務的增長、慢性護理業務本身的連續增長以及追加銷售和其他動態之間打破這 0.24 美元。

Yes, Adam. We don't provide very specific breakout on the different components of our business and, therefore, the different components of PMPM. But what I will say more generally is I do -- we have -- with the numbers that we have given out in our prepared remarks, you can see the sort of the buckets of drivers that drove the expansion in PMPM. And as we have talked about the overarching trends in the business, whether it be multi-product, whether it be multi-service usage, and I would say, even with the addition of Livongo now, those are all key drivers of the continued expansion in PMPM that I do foresee.

是的，亞當。我們沒有對我們業務的不同組成部分以及 PMPM 的不同組成部分提供非常具體的細分。但我要更籠統地說的是，我確實——我們有——根據我們在準備好的發言中給出的數字，你可以看到推動 PMPM 擴張的驅動因素。當我們談到業務的總體趨勢時，無論是多產品，還是多服務使用，我想說，即使現在加入了 Livongo，這些都是持續擴張的關鍵驅動力在我預見到的 PMPM 中。

Yes. Maybe I'll give you just a couple of stats. Some of them we talked about in our prepared remarks, and some of them may be incremental. But we talked about the fact that now 15% of our chronic care members are using more than one product, up from -- yes, that's more than tripled since a year ago. And we're now at the point where about 1/3 of our chronic care clients are buying more than one product from us, up from about 18% a year ago, right? So when we talk about multi-product sales, it's across really our entire portfolio, both on the chronic care as well as acute.

是的。也許我會給你幾個統計數據。我們在準備好的評論中談到了其中一些，其中一些可能是漸進的。但我們談到了這樣一個事實，即現在我們 15% 的慢性病護理成員正在使用不止一種產品，比——是的，這是一年前的三倍多。現在，大約 1/3 的長期護理客戶從我們這裡購買了不止一種產品，高於一年前的 18%，對吧？因此，當我們談論多產品銷售時，它實際上涉及我們的整個產品組合，包括慢性病和急性病。

And then maybe lastly, I think an important data point is what is our -- and this really gets to my point about the pipeline. But what's our revenue per client look like? And our revenue per chronic care client is up 33% versus a year ago, right? So when you combine all of those, you can understand how we're not only getting more revenue per client, but we're also getting more revenue per member. And all of that contributes to increasing PMPM.

然後也許最後，我認為一個重要的數據點是我們的 - 這真的讓我明白了關於管道的觀點。但是我們每個客戶的收入是什麼樣的？我們每個長期護理客戶的收入比一年前增長了 33%，對嗎？因此，當您將所有這些結合起來時，您就會明白我們如何不僅從每位客戶那裡獲得更多收入，而且還從每位會員那裡獲得更多收入。所有這些都有助於增加 PMPM。

And by the way, it also shows that there is significant runway to continue to expand, right? So the fact is it's grown, as Jason said, from 5% to 15%, but there is enormous runway ahead of us. Same thing if you think about the clients that we are contracting with. So the point is we have made progress, and there is significant room to continue that expansion.

順便說一句，這也表明有重要的跑道可以繼續擴大，對吧？所以事實是，正如傑森所說，它已經從 5% 增長到 15%，但我們面前還有巨大的跑道。如果您考慮與我們簽約的客戶，情況也是如此。所以關鍵是我們已經取得了進展，並且有很大的空間可以繼續擴張。

And that is all the time we have for questions. Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.

這就是我們提問的全部時間。女士們，先生們，今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。