Teladoc Health Inc (TDOC) 2020 Q4 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Teladoc Health Fourth Quarter 2020 Conference Call.

女士們，先生們，感謝你們的支持，歡迎來到 Teladoc Health 2020 年第四季度電話會議。

(Operator Instructions) Please be advised that today's conference is being recorded.

（操作員說明）請注意，今天的會議正在錄製中。

(Operator Instructions) I would now like to hand the conference over to Mr. Patrick Feeley, Vice President of Investor Relations.

（操作員說明）我現在想將會議交給投資者關係副總裁 Patrick Feeley 先生。

Please go ahead.

請繼續。

Thank you, and good afternoon.

謝謝，下午好。

Today after the market closed, we issued a press release announcing our fourth quarter and full year 2020 financial results.

今天收市後，我們發布了一份新聞稿，宣布了我們 2020 年第四季度和全年的財務業績。

This press release is available in the Investor Relations section of the teladochealth.com website.

本新聞稿可在 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.

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。

During this call, we will also provide our first quarter and full year 2021 outlook, and our prepared remarks will be followed by a question-and-answer session.

在此電話會議期間，我們還將提供 2021 年第一季度和全年展望，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.

請注意，我們將討論某些我們認為對評估 Teladoc health 績效很重要的非 GAAP 財務指標。

Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release that is posted on our website.

有關這些非 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, and such forward-looking statements are subject to risks, uncertainties and other factors that could cause the actual results for Teladoc health to differ materially from those expressed or implied on this call.

此外，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、不確定性和其他可能導致實際結果的因素的影響Teladoc Health 與本次電話會議中明示或暗示的內容存在重大差異。

For additional information, please refer to our cautionary statement in our press release and our filings with the SEC, all of which are available on our website.

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.

謝謝帕特里克，也謝謝大家今天下午加入我們。

2020 was a transformational year for Teladoc Health and for the role of virtual care within the broader health care industry.

2020 年對於 Teladoc Health 以及虛擬護理在更廣泛的醫療保健行業中的作用而言是轉型的一年。

We delivered needed health care to millions of consumers in the midst of the coronavirus pandemic and completed 2 significant acquisitions that together, under Teladoc Health, are defining a new category of whole person virtual care.

在冠狀病毒大流行期間，我們為數百萬消費者提供了所需的醫療保健服務，並完成了 2 項重大收購，在 Teladoc Health 的領導下，這兩項收購共同定義了全新的全人虛擬護理類別。

Taken together, we dramatically accelerated our mission to empower all people everywhere to live their healthiest lives by transforming the health care experience.

總之，我們大大加快了我們的使命，即通過改變醫療保健體驗，讓世界各地的所有人都能過上最健康的生活。

We delivered over $1 billion in revenue for the year, provided over 10.5 million virtual visits.

我們當年實現了超過 10 億美元的收入，提供了超過 1050 萬次虛擬訪問。

And our license platform solution enabled an additional 3.9 million visits for our clients' own clinicians pro forma for InTouch.

我們的許可平台解決方案為我們客戶自己的臨床醫生預估 InTouch 增加了 390 萬次訪問。

We onboarded a record 15 million new paid members in 2020.

我們在 2020 年加入了創紀錄的 1500 萬新付費會員。

And over the last 18 months, we've added 25 million paid members and 11 million members with BFO access; a remarkable result.

在過去的 18 個月裡，我們增加了 2500 萬付費會員和 1100 萬俱有 BFO 訪問權限的會員；一個了不起的結果。

During the fourth quarter, we saw broad-based strength across our business, which drove revenue of $383 million, an increase of 145% over the prior year; and organic growth of 79%, excluding the additions of InTouch Health and Livongo.

在第四季度，我們看到了我們業務的廣泛實力，推動收入達到 3.83 億美元，比上年增長 145%；有機增長 79%，不包括 InTouch Health 和 Livongo 的增加。

The strength across our channels, products and geographies, combined with a robust pipeline of new opportunities, gives us tremendous confidence in the near-term and the long-term outlook for the business.

我們在渠道、產品和地域方面的實力，加上大量新機遇，使我們對業務的近期和長期前景充滿信心。

As we enter a new year, we have never been better positioned to meet the increasingly sophisticated expectations of consumers, clients and providers.

在我們進入新的一年之際，我們處於前所未有的有利地位，可以滿足消費者、客戶和供應商日益複雜的期望。

We are heartened by the progress that has been made in delivery of the coronavirus vaccines and expect some return to normalcy, coupled with strong continued demand for virtual care, well exceeding pre-pandemic levels.

我們對在提供冠狀病毒疫苗方面取得的進展感到鼓舞，並預計一些疫苗會恢復正常，再加上對虛擬護理的持續強勁需求，遠遠超過大流行前的水平。

The strategic investments we made during 2020 to expand the breadth and depth of our capabilities have uniquely positioned us to serve the growing client and consumer demand for virtual care.

我們在 2020 年為擴大我們能力的廣度和深度而進行的戰略投資使我們具有獨特的優勢，可以滿足客戶和消費者對虛擬護理不斷增長的需求。

And have accelerated our path to realizing our vision of becoming consumers' trusted destination for whole person health.

並加速了我們實現成為消費者值得信賴的全人健康目的地的願景。

The expansion of our capabilities in the hospital and health system market, including the acquisition of InTouch, positions us as the leader in that channel.

我們在醫院和衛生系統市場的能力擴展，包括對 InTouch 的收購，使我們成為該渠道的領導者。

Our enterprise solution enables the full suite of virtual care regardless of the consumers' needs across any location.

我們的企業解決方案支持全套虛擬護理，無論消費者在任何地點的需求如何。

Whether through one of our over 11,000 facility-based care locations or directly to the consumer's home via a mobile device, our platform enables our clients to provide virtual care for a broad spectrum of use cases, from high-acuity critical care in the ICU, to post-discharge follow-up and urgent care visits.

無論是通過我們超過 11,000 個基於設施的護理地點之一，還是通過移動設備直接到消費者家中，我們的平台都使我們的客戶能夠為廣泛的用例提供虛擬護理，從 ICU 中的高危重症護理，到出院後的隨訪和緊急護理訪問。

We see growing demand as health systems around the globe look for an enterprise-wide secure integrated virtual care solution.

隨著全球衛生系統都在尋找企業範圍內的安全集成虛擬護理解決方案，我們看到需求不斷增長。

During the fourth quarter, we continued to make strong progress in bringing our platform solution to international markets with multiple new deals, including a new contract supporting critical care programs for a large network of hospitals in Germany.

在第四季度，我們通過多項新交易在將我們的平台解決方案推向國際市場方面繼續取得重大進展，其中包括一項支持德國大型醫院網絡重症監護計劃的新合同。

Our expanded capabilities in the management of chronic disease have uniquely positioned us to deliver on the promise of whole person care.

我們在慢性病管理方面的擴展能力使我們能夠以獨特的方式實現全人護理的承諾。

The combination with Livongo extends our leadership position and enhances our opportunity to redefine the future of virtual care, leveraging technology and data at unmatched scale to drive better outcomes and lower costs while delivering a better consumer experience.

與 Livongo 的結合擴大了我們的領導地位，並增加了我們重新定義虛擬護理未來的機會，以無與倫比的規模利用技術和數據來推動更好的結果和更低的成本，同時提供更好的消費者體驗。

We have the capabilities to deliver and manage care virtually across the spectrum for consumers, ranging from wellness and prevention to coordination of care for people living with chronic conditions, to high acuity for those dealing with critical illness.

我們有能力為消費者提供和管理幾乎整個範圍內的護理，從健康和預防到協調慢性病患者的護理，再到應對危重疾病的高度敏銳度。

The combination is resonating in the marketplace, and we have signed multiple cross-sales since closing the Livongo transaction.

這種結合在市場上引起了共鳴，自從完成 Livongo 交易以來，我們已經簽署了多項交叉銷售。

We highlighted the GuideWell and Tyson Foods deal on our last earnings call as well as a regional health plan cross-sale last month.

我們在上次財報電話會議上強調了 GuideWell 和 Tyson Foods 的交易，以及上個月的區域健康計劃交叉銷售。

We have now signed over a dozen new cross-sales since the close of the transaction.

自交易結束以來，我們現在已經簽署了十多項新的交叉銷售。

And the pipeline of new opportunities has more than doubled in just the past 3 months.

在過去的 3 個月裡，新機會的管道增加了一倍多。

The early indicators give me tremendous confidence that we will deliver on the revenue synergies that we highlighted when we announced the transaction.

早期指標讓我充滿信心，相信我們將實現我們在宣布交易時強調的收入協同效應。

Our industry-leading breadth and depth of capabilities comes together to underpin our innovative virtual primary care offering, Teladoc Primary360.

我們行業領先的廣度和深度的能力共同支持我們創新的虛擬初級保健產品 Teladoc Primary360。

Primary360 is a full credit differentiated whole person solution that leverages our capabilities to provide and coordinate care using a team-based approach and brings together health care providers across multiple specialties.

Primary360 是一個完全信用差異化的全人解決方案，它利用我們的能力使用基於團隊的方法提供和協調護理，並將跨多個專業的醫療保健提供者聚集在一起。

Primary360 goes beyond just enabling virtual visits; rather, it's a reimagining of the entire primary care experience, and it positions us to become the trusted health care destination for the consumer regardless of what they need for both their mental and physical health.

Primary360 不僅僅支持虛擬訪問；相反，它是對整個初級保健體驗的重新構想，它使我們成為消費者值得信賴的醫療保健目的地，無論他們的身心健康需要什麼。

The results of our first virtual primary care pilot launched during the second quarter of last year have been highly encouraging.

我們在去年第二季度啟動的第一個虛擬初級保健試點的結果非常令人鼓舞。

We're seeing over 30% consumer engagement and incredibly high satisfaction, with an NPS of over 90.

我們看到超過 30% 的消費者參與度和令人難以置信的高滿意度，NPS 超過 90。

Over 40% of hypertension and pre-hypertension diagnoses and over 25% of diabetes and pre-diabetes diagnoses made by our clinicians have been first-time diagnoses.

超過 40% 的高血壓和高血壓前期診斷以及超過 25% 的糖尿病和糖尿病前期診斷是我們臨床醫生的首次診斷。

This allows our clinicians and members to begin addressing the progression of disease and creates an opportunity for us to introduce the Livongo capabilities to those consumers early in their journey, which will ultimately drive better outcomes for consumers and lower the overall cost of care.

這使我們的臨床醫生和會員能夠開始解決疾病的進展問題，並為我們創造機會，讓我們能夠在消費者旅程的早期就向他們介紹 Livongo 的功能，這最終將為消費者帶來更好的結果並降低整體護理成本。

Last month, we launched additional Primary360 pilots with multiple new partners, and the amount of interest from new potential clients has been incredibly strong.

上個月，我們與多個新合作夥伴一起啟動了額外的 Primary360 試點項目，新潛在客戶的興趣非常濃厚。

We have a pipeline of well over 100 opportunities, ranging from Fortune 1000 employers to large payers looking to partner on Virtual First health plans.

我們擁有 100 多個機會的管道，從財富 1000 強雇主到希望在 Virtual First 健康計劃上合作的大型付款人。

In fact, just last week, we signed another new partnership with a very large employer expected to launch later this year.

事實上，就在上週，我們與一家預計將於今年晚些時候啟動的大型雇主簽署了另一項新的合作夥伴關係。

We are making excellent progress on our integration efforts.

我們在整合方面取得了出色的進展。

Our commercial organization is now fully integrated, and our teams responsible for cross-selling have been collaborating for months.

我們的商業組織現在已經完全整合，我們負責交叉銷售的團隊已經合作了幾個月。

A few weeks ago, we virtually hosted our Annual Global Growth Summit, bringing together over 700 teammates across our commercial organization, including our new teammates from InTouch Health and Livongo.

幾週前，我們幾乎舉辦了年度全球增長峰會，匯集了我們商業組織的 700 多名隊友，包括來自 InTouch Health 和 Livongo 的新隊友。

This annual summit is a great opportunity to not only equip our commercial teams with the tools they need to effectively communicate our leading value proposition in the marketplace, but to share best practices and learn from one another.

這次年度峰會是一個很好的機會，不僅可以讓我們的商業團隊獲得有效傳達我們在市場上領先的價值主張所需的工具，還可以分享最佳實踐並相互學習。

The integration of our data platform and assets also continues to progress as we work to unlock the power of our combined data sets.

隨著我們努力釋放組合數據集的力量，我們的數據平台和資產的整合也在繼續取得進展。

We are now capturing 2 million blood glucose data points per week, and our clinicians are responding to over 100,000 patient messages via text and chat and providing over 30,000 visits on average every day.

我們現在每週捕獲 200 萬個血糖數據點，我們的臨床醫生通過文本和聊天回复超過 100,000 條患者消息，平均每天提供超過 30,000 次訪問。

We are also making significant investments to integrate our products and services.

我們還進行了大量投資以整合我們的產品和服務。

For example, we see a tremendous opportunity for a new integrated behavioral health product that combines the capabilities of both Livongo and Teladoc.

例如，我們看到了結合 Livongo 和 Teladoc 功能的新型集成行為健康產品的巨大機遇。

This innovative offering will pair the highly scalable, personalized self-directed digital care programs of Livongo's myStrength platform with access to the expertise and convenience of Teladoc's virtual network of clinicians.

這一創新產品將 Livongo myStrength 平台的高度可擴展、個性化的自主數字護理計劃與 Teladoc 虛擬臨床醫生網絡的專業知識和便利相結合。

With this integrated offering, we will create a new digital front door to behavioral health care, further breaking down barriers to mental health by allowing consumers to find the right care at the right time, increasing access and improving outcomes.

通過這種集成產品，我們將為行為保健創建一個新的數字前門，通過讓消費者在正確的時間找到正確的護理、增加訪問和改善結果，進一步打破心理健康的障礙。

We are already seeing tremendous excitement from clients globally for this next-generation behavioral health offering and expect to launch it more broadly in the market by the end of the year.

我們已經看到全球客戶對這種下一代行為健康產品的極大興奮，並期望在今年年底前在市場上更廣泛地推出它。

Before I turn the call over to Mala to discuss our results and forward guidance in more detail, I want to talk briefly regarding our outlook for 2021.

在我將電話轉給 Mala 更詳細地討論我們的結果和前瞻性指導之前，我想簡要談談我們對 2021 年的展望。

Following a transformative 2020 and with the significant momentum we have entering this year, we feel extremely confident in our outlook for 2021.

在經歷了變革性的 2020 年之後，隨著我們進入今年的勢頭強勁，我們對 2021 年的前景充滿信心。

For the full year, we expect revenue to be in the range of $1.95 billion to $2.0 billion, representing growth of 80 or approximately 40% to 43% pro forma for the acquisition of Livongo.

對於全年，我們預計收入將在 19.5 億美元至 20 億美元之間，相當於收購 Livongo 的預計增長 80% 或約 40% 至 43%。

This robust growth is the result of the broad-based momentum we continue to see across our business, including growth in utilization, a robust and growing pipeline of multi-product sales, including strong demand for our whole person chronic care programs, continued strength in the direct-to-consumer channel, increasing demand for our license platform in the health system market, growth in international markets and new member additions.

這種強勁的增長是我們繼續在我們的業務中看到的廣泛勢頭的結果，包括利用率的增長、強勁且不斷增長的多產品銷售渠道，包括對我們整個人長期護理計劃的強勁需求、持續的實力直接面向消費者的渠道、衛生系統市場對我們的許可平台的需求不斷增加、國際市場的增長和新成員的增加。

With that, I'll turn the call over to Mala for a review of the fourth quarter as well as detailed 2021 guidance.

有了這個，我將把電話轉給 Mala 來審查第四季度以及詳細的 2021 年指導。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

Before I get into the details of the results, I would like to note that following the close of the Livongo transaction, we are streamlining some of our reported metrics.

在詳細介紹結果之前，我想指出，在 Livongo 交易結束後，我們正在簡化我們報告的一些指標。

Our revenue disclosure will continue to be broken out between access fee revenue, visit fee revenue and other revenue.

我們的收入披露將繼續在訪問費收入、訪問費收入和其他收入之間進行細分。

Each of those revenue buckets is further broken out into U.S. and international.

這些收入桶中的每一個都進一步細分為美國和國際。

Our visit volume metrics are aligned with our revenue disclosure, including both U.S. and international visit volumes, which is aligned with how we manage the business.

我們的訪問量指標與我們的收入披露一致，包括美國和國際訪問量，這與我們管理業務的方式一致。

We are also adding a new metric: chronic care enrollment, which captures the total unique individuals enrolled in the Livongo suite of chronic care programs.

我們還添加了一個新指標：慢性病護理註冊人數，它包含了在 Livongo 慢性病護理項目套件中註冊的唯一個體總數。

This metric is based on a count of total unique members, so members utilizing multiple solutions are only counted once.

該指標基於唯一身份成員的總數，因此使用多個解決方案的成員只被計算一次。

Turning to fourth quarter results.

轉向第四季度業績。

Total revenue increased 145% to $383 million or 79% on an organic basis.

總收入有機增長 145% 至 3.83 億美元或 79%。

U.S. access fee revenue for the quarter was $283 million, representing growth of 188% over the prior year's quarter.

本季度美國接入費收入為 2.83 億美元，較上年同期增長 188%。

Total international revenue of $34 million grew 16% versus the prior year.

國際總收入為 3400 萬美元，比上年增長 16%。

Visit fee revenue for the fourth quarter increased 80% year-over-year to $53 million, and comprised 14% of total revenue as compared to 19% of revenue in the prior year's quarter.

第四季度的訪問費收入同比增長 80% 至 5300 萬美元，佔總收入的 14%，而去年同期為 19%。

The decrease in visit fee revenue as a percent of total revenue is due to the acquisitions of Livongo and InTouch Health, both of which generate a significant majority of revenue from subscription access fees.

訪問費收入佔總收入百分比的下降是由於收購了 Livongo 和 InTouch Health，這兩家公司的絕大部分收入都來自訂閱訪問費。

Turning to membership and access.

轉向成員資格和訪問。

We ended the quarter with U.S. paid membership of 51.8 million members, an increase of 41% year-over-year.

本季度末，我們的美國付費會員人數為 5180 萬，同比增長 41%。

Individuals with visit fee-only access was $21.3 million at the end of the fourth quarter.

截至第四季度末，僅支付訪問費的個人人數為 2130 萬美元。

Total chronic care enrollment, which includes individuals enrolled in one of our chronic care programs, was 596,000 members, an increase of more than 40,000 members sequentially.

長期護理註冊總人數（包括參加我們的一項長期護理計劃的個人）為 596,000 名成員，比上一季度增加了 40,000 多名成員。

We provided 3 million visits in the quarter through our Teladoc network of clinicians, representing 139% growth versus the prior year.

我們在本季度通過我們的 Teladoc 臨床醫生網絡提供了 300 萬次訪問，比上一年增長了 139%。

Platform-enabled sessions, which represents encounters facilitated by our licensed software platform and provided by our clients' own clinician, was an additional 1.1 million in the quarter.

支持平台的會議，代表由我們的許可軟件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。

More than 4x the number of sessions in the same period last year pro forma for the acquisition of InTouch Health.

為收購 InTouch Health 而備考的會議次數是去年同期的 4 倍多。

As I mentioned earlier, we have streamlined our visit metrics to better align with how we manage the business and our focus on driving utilization and delivering value for clients and members regardless of payment model.

正如我之前提到的，我們已經簡化了我們的訪問指標，以更好地符合我們管理業務的方式以及我們對提高利用率和為客戶和會員提供價值的關注，而不管支付模式如何。

The annualized utilization rate for our paid members was 17.7% in the fourth quarter, an 825-basis-point increase over the last year's fourth quarter and a 120-basis-point increase sequentially.

我們付費會員的年化利用率在第四季度為 17.7%，比去年第四季度增長 825 個基點，環比增長 120 個基點。

PMPM was $1.76 in the fourth quarter, up from $0.91 in the prior year's fourth quarter, with over half of the increase driven by the inclusion of Livongo in our consolidated results.

第四季度 PMPM 為 1.76 美元，高於去年第四季度的 0.91 美元，其中超過一半的增長是由於將 Livongo 納入我們的綜合業績。

Adjusted gross profit, which excludes depreciation and amortization of intangibles, increased to $260 million, an increase of 157% as compared to the prior year's fourth quarter.

扣除無形資產折舊和攤銷後的調整後毛利增至 2.6 億美元，與去年第四季度相比增長 157%。

Adjusted gross margin was 67.9% compared to 64.6% in the fourth quarter of 2019.

調整後的毛利率為 67.9%，而 2019 年第四季度為 64.6%。

Gross profit and adjusted gross profit include the benefit of $5.4 million in lower expenses on Livongo devices attributable to purchase accounting adjustments related to the merger.

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 設備費用減少的 540 萬美元收益。

Adjusted EBITDA increased to $50.4 million in the quarter compared to $15.2 million in the fourth quarter of 2019.

本季度調整後的 EBITDA 增至 5040 萬美元，而 2019 年第四季度為 1520 萬美元。

Fourth quarter adjusted EBITDA margin of 13.1% increased by 340 basis points year-over-year.

第四季度調整後的 EBITDA 利潤率為 13.1%，同比增長 340 個基點。

Adjusted EBITDA includes a benefit of $5.4 million attributable to purchase accounting adjustments mentioned previously.

調整後的 EBITDA 包括前文提到的採購會計調整帶來的 540 萬美元收益。

Net loss in the quarter was $394 million compared to a net loss of $19 million in the fourth quarter of 2019.

本季度淨虧損為 3.94 億美元，而 2019 年第四季度淨虧損為 1900 萬美元。

Fourth quarter net loss includes $57.6 million in transaction costs as well as $331.7 million of noncash accelerated stock-based compensation expense related to the merger with Livongo.

第四季度淨虧損包括 5760 萬美元的交易成本以及與 Livongo 合併相關的 3.317 億美元非現金加速股票補償費用。

On a per share basis, net loss was $3.07 for the fourth quarter compared to a loss of $0.26 in the fourth quarter of last year.

按每股計算，第四季度淨虧損為 3.07 美元，而去年第四季度為虧損 0.26 美元。

Fourth quarter net loss per share includes $0.45 of transaction costs, as well as $2.59 of noncash accelerated stock-based compensation related to the merger with Livongo.

第四季度每股淨虧損包括 0.45 美元的交易成本，以及與 Livongo 合併相關的 2.59 美元非現金加速股票補償。

Excluding all transaction-related costs and tax benefits, the per share loss in the fourth quarter would have been $0.27.

排除所有與交易相關的成本和稅收優惠，第四季度的每股虧損為 0.27 美元。

We ended the quarter with $787 million in cash and short-term investments, while our total recorded debt outstanding as of December 31 was $1.4 billion.

本季度結束時，我們擁有 7.87 億美元的現金和短期投資，而截至 12 月 31 日，我們記錄在案的未償債務總額為 14 億美元。

Now turning to forward guidance.

現在轉向前瞻性指導。

For the full year 2021, we expect revenue to be in the range of $1.95 billion to $2.0 billion, as Jason mentioned, representing growth of 78% to 83% over the prior year, or 40% to 43% fully pro forma for the acquisition of Livongo.

對於 2021 年全年，我們預計收入將在 19.5 億美元至 20 億美元之間，正如 Jason 提到的那樣，比上年增長 78% 至 83%，或 40% 至 43% 完全預估收購利文戈。

Our confidence in that strong revenue growth is underpinned by: first, continued growth in utilization, particularly among noninfectious disease-related visits such as hypertension, lower back pain, anxiety and depression.

我們對收入強勁增長的信心得到了支持：首先，利用率持續增長，特別是與非傳染性疾病相關的就診，如高血壓、腰痛、焦慮和抑鬱。

During the fourth quarter, approximately 75% of our bit volume was related to noninfectious diseases, up from 50% in the fourth quarter of last year as our visit mix continues to diversify, a trend that has continued into the new year.

在第四季度，我們約 75% 的位量與非傳染病有關，高於去年第四季度的 50%，因為我們的訪問組合繼續多樣化，這一趨勢一直持續到新的一年。

We've also seen tremendous growth in new registrations over the past year with newly registered individuals growing at twice the rate of new member additions.

在過去的一年裡，我們還看到新註冊人數的巨大增長，新註冊個人的增長速度是新成員增加速度的兩倍。

Registered member growth creates opportunity for deeper engagement and is a leading indicator of forward utilization.

註冊會員的增長為更深入的參與創造了機會，並且是未來利用率的領先指標。

Growth in specialty visits has been particularly strong, led by growth in behavioral health, which experienced visit growth of over 500% in 2020 as the growth in visits accelerated throughout the course of the year.

在行為健康增長的帶動下，專科就診的增長尤為強勁，隨著全年就診人數的加速增長，2020 年專科就診人數增長了 500% 以上。

All of that comes together to give us tremendous confidence in our visit volume outlook, and you can see that reflected in our strong visit volume guidance.

所有這些加在一起使我們對訪問量前景充滿信心，您可以在我們強大的訪問量指導中看到這一點。

We expect total visit volume to be between 12 million and 13 million visits this year, representing growth of 13% to 23%.

我們預計今年的總訪問量將在 1200 萬至 1300 萬之間，增長 13%至 23%。

Second, we have built a robust and growing pipeline of multi-product sales, including strong demand for our whole person chronic care program.

其次，我們已經建立了強大且不斷增長的多產品銷售渠道，包括對我們的全人長期護理計劃的強勁需求。

In 2020, 2/3 of Teladoc deals were multiproduct deals.

2020 年，2/3 的 Teladoc 交易是多產品交易。

And our experience shows that client retention, member engagement, and PMPM growth are all significantly stronger for clients that use more than one of our products.

我們的經驗表明，對於使用我們不止一種產品的客戶來說，客戶保留率、會員參與度和 PMPM 增長都明顯更強。

Next, in the direct-to-consumer channel, our BetterHelp brand has also continued to significantly outperform, delivering over $300 million of revenue in 2020.

接下來，在直接面向消費者的渠道中，我們的 BetterHelp 品牌也繼續表現出色，在 2020 年實現了超過 3 億美元的收入。

We expect another year of robust growth of at least 50% in 2021 as we continue to gain scale and expand our leadership position in that channel.

隨著我們繼續擴大規模並擴大我們在該渠道的領導地位，我們預計 2021 年將再次實現至少 50% 的強勁增長。

Fourth, continued new member additions at both existing and new clients.

第四，繼續增加現有和新客戶的新成員。

We expect to grow paid membership to 52 million to 54 million members in 2021, which is net of the approximately 1.5 million COVID-related temporary members that have rolled off during the first quarter, as previously disclosed.

我們預計到 2021 年，付費會員人數將增加到 5200 萬至 5400 萬，這不包括之前披露的在第一季度減少的約 150 萬與 COVID 相關的臨時會員。

We expect visit fee-only access to be available to an additional 22 million to 23 million individuals.

我們預計另外 2200 萬至 2300 萬個人可以使用僅支付訪問費用的訪問權限。

We also see increasing demand for our hospital and health system platform solution as these organizations look to invest in robust, secure and purpose-built telehealth capabilities.

我們還看到對我們的醫院和衛生系統平台解決方案的需求不斷增加，因為這些組織希望投資於強大、安全和專門構建的遠程醫療功能。

We expect organic growth in this channel at the high end of the 20% to 30% target range we provided last year upon the closing of the InTouch acquisition.

我們預計該渠道的有機增長將達到我們去年在完成 InTouch 收購後提供的 20% 至 30% 目標範圍的高端。

And last but not least, accelerating growth in the international market, driven by increased penetration in existing geographies and expansion into new regions.

最後但同樣重要的是，在現有地區滲透率提高和向新地區擴張的推動下，國際市場加速增長。

We expect adjusted EBITDA in 2021 in the range of $255 million to $275 million, representing an increase of over 100% at the midpoint.

我們預計 2021 年調整後的 EBITDA 將在 2.55 億美元至 2.75 億美元之間，中點增幅超過 100%。

And including an approximately $20 million benefit from lower expenses on Livongo devices attributable to purchase accounting adjustments related to the Livongo merger.

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。

The expected growth in adjusted EBITDA is driven by the contribution from a full year of Livongo as well as the overall strength across channels, partially offset by investments back into the business, including the integration of Livongo as well as new product development and enhancements to existing products.

調整後 EBITDA 的預期增長是由 Livongo 全年的貢獻以及跨渠道的整體實力推動的，部分被業務投資所抵消，包括 Livongo 的整合以及新產品開發和現有產品的增強產品。

For the first quarter of 2021, we expect total revenue of $445 million to $455 million, representing growth of approximately 150% over the prior year's quarter.

對於 2021 年第一季度，我們預計總收入為 4.45 億美元至 4.55 億美元，比上年同期增長約 150%。

We expect total paid membership in the range of $51 million to $52 million, which is net of the approximately 1.5 million temporary members discussed in prior quarters that have rolled off subsequent to year-end.

我們預計付費會員總數將在 5100 萬至 5200 萬美元之間，這不包括前幾個季度討論的約 150 萬臨時會員，這些臨時會員已在年底後退出。

We anticipate total visits during the first quarter of between 2.9 million and 3.1 million visits.

我們預計第一季度的總訪問量在 290 萬到 310 萬之間。

We expect first quarter adjusted EBITDA to be in the range of $45 million to $48 million, including an approximate $7 million benefit from lower expenses on Livongo devices attributable to purchase accounting adjustments related to the Livongo transaction.

我們預計第一季度調整後的 EBITDA 將在 4500 萬美元至 4800 萬美元之間，其中包括因與 Livongo 交易相關的採購會計調整而導致的 Livongo 設備支出減少帶來的約 700 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.

謝謝，馬拉。

In closing, I want to thank the entire Teladoc team for their amazing commitment to serving our clients and members around the world during a challenging year.

最後，我要感謝整個 Teladoc 團隊在充滿挑戰的一年中為我們的全球客戶和成員提供服務的驚人承諾。

Over the past 12 months, we've seen a monumental change in consumer expectations for the way they access and experience health care as virtual care has firmly entered the mainstream.

在過去的 12 個月裡，隨著虛擬醫療穩步成為主流，我們看到消費者對獲得和體驗醫療保健方式的期望發生了巨大變化。

As a company, we've responded by significantly expanding our capabilities to meet the rising demands of clients and consumers around the world while extending our leadership position by delivering, enabling and empowering virtual care.

作為一家公司，我們通過顯著擴展我們的能力來滿足全球客戶和消費者不斷增長的需求，同時通過提供、支持和授權虛擬護理來擴大我們的領導地位。

As always, thank you all for your continued interest in Teladoc Health.

一如既往，感謝大家對 Teladoc Health 的持續關注。

And with that, we'll open the call for questions.

有了這個，我們將開始提問。

Operator?

操作員？

(Operator Instructions) First question comes from Lisa Gill with JPMorgan.

（操作員說明）第一個問題來自摩根大通的 Lisa Gill。

Congratulations on a great year, Jason.

祝賀你度過了美好的一年，傑森。

I just really want to understand just a couple of really quick things.

我真的很想了解一些非常快速的事情。

You gave us so much information.

你給了我們這麼多信息。

But the first, which is around U.S. paid members, retention rates, competition in the marketplace.

但首先是圍繞美國付費會員、保留率、市場競爭。

I know I usually ask about the selling season, but I know it's a little early for that right now.

我知道我通常會詢問銷售季節，但我知道現在說這個有點早。

But just really want to understand how you're thinking about the competitive market right now around what you saw on the retention side because you clearly added a lot of new business.

但只是真的想了解您現在如何圍繞您在保留方面看到的內容來考慮競爭市場，因為您顯然增加了很多新業務。

And then secondly, you did talk about dozens of cross-sell, Livongo pieces of business in 2021 that are included in 2021.

其次，您確實談到了 2021 年包括在 2021 年的數十項交叉銷售、Livongo 業務。

Is there any way to quantify that so we can start to think about reaching that $0.5 billion goal that you set when you made the transaction?

有什麼方法可以量化它，以便我們可以開始考慮實現您在進行交易時設定的 5 億美元目標嗎？

Yes.

是的。

Thanks, Lisa.

謝謝，麗莎。

Let me start with retention rates and the competitive landscape.

讓我從保留率和競爭格局開始。

And then I'll talk a little bit about the cross-selling situation.

然後我會談談交叉銷售的情況。

With respect to retention rates, they continue to be at high levels, consistent with historic levels, which have always been in sort of the low to mid-90s.

關於保留率，它們繼續處於高水平，與歷史水平一致，歷史水平一直處於 90 年代的低至中期。

We continue to see that.

我們繼續看到這一點。

And in fact, what we're seeing is the pipeline is growing actually faster than we've seen in previous years.

事實上，我們看到的是管道的增長速度實際上比我們前幾年看到的要快。

When I look at our membership opportunities, sort of the growth opportunities in our pipeline, the membership opportunity is up over 50% relative to the same time last year.

當我查看我們的會員機會時，我們管道中的某種增長機會，與去年同期相比，會員機會增加了 50% 以上。

And I think that that's really indicative of the market and clients recognizing the value of the full solution that we have and the unique position that we occupy.

我認為這確實表明市場和客戶認識到我們擁有的完整解決方案的價值以及我們所佔據的獨特地位。

And I've had a number of large client discussions over the last several weeks as we start to move into this selling season and we start to talk about the opportunity of the full credit answer, sort of that full solution across all of our product portfolio, and it is truly differentiated.

過去幾週，隨著我們開始進入這個銷售旺季，我與許多大客戶進行了討論，我們開始討論完全信用答案的機會，即涵蓋我們所有產品組合的完整解決方案，而且是真正的差異化。

So I was just talking to a regional Blue plan, who, I believe, we will take away from a competitor who has a much narrower set of products and can't compete in the evolving landscape and sort of the new paradigm that we've created.

所以我只是在和一個區域性的藍色計劃交談，我相信，我們將從一個產品範圍更窄且無法在不斷變化的環境和我們已經建立的新範式中競爭的競爭對手手中奪走創建。

With respect to the cross-selling, what I think we said is over a dozen cross-sells.

關於交叉銷售，我想我們說的是十幾個交叉銷售。

Those will roll on over the course of 2021.

這些將在 2021 年繼續進行。

And I would say we'll have some impact on the back half of the year, but relatively small in the back half of this year.

我會說我們會在今年下半年產生一些影響，但在今年下半年相對較小。

What we're really looking at is impact on 2022.

我們真正關注的是對 2022 年的影響。

And we still feel very good, in fact, better than we've ever felt before, about the prospects for our revenue synergies.

對於我們收入協同效應的前景，我們仍然感覺非常好，事實上，比以往任何時候都好。

Just sort of characterizing the cross-sell opportunities.

只是描述交叉銷售機會的特徵。

We look at the pipeline today versus the pipeline just sort of the middle of last quarter.

我們看看今天的管道與上個季度中期的管道。

And remember, we started commercial collaboration long before we closed the Livongo transaction.

請記住，我們早在完成 Livongo 交易之前就開始了商業合作。

And we've more than doubled the pipeline of cross-sell opportunities.

而且我們已經將交叉銷售機會的管道增加了一倍多。

So I feel very, very good about it.

所以我對此感覺非常非常好。

We've taken, I would say, a relatively conservative view of the contribution from the revenue synergies in 2021 and believe that those will materialize much more significantly in '22 and beyond.

我想說，我們對 2021 年收入協同效應的貢獻持相對保守的看法，並相信這些將在 22 年及以後更顯著地實現。

Next question comes from Sandy Draper with Truist Securities.

下一個問題來自 Truist Securities 的 Sandy Draper。

I would also echo congratulations on a very strong year.

我也要對非常強勁的一年表示祝賀。

Jason, from a high level, one of the things I know we used to talk about is you were really focused on the higher visit fee or higher visit growth then access fee growth because back, this is pre-COVID, you were really showing the power of your ability to drive utilization and show the value of the platform.

傑森，從高層次上講，我知道我們曾經討論過的一件事是你真的專注於更高的訪問費用或更高的訪問增長，然後是訪問費用增長，因為回到過去，這是 COVID 之前，你真的展示了您推動利用率和展示平台價值的能力。

Post COVID, I'm just wondering when you think longer-term, is it really -- because you ship post COVID plus the diversity of the model, is it really more about excess de-growth and that will grow faster than membership?

後 COVID，我只是想知道你什麼時候考慮更長期的問題，是不是真的——因為你發布後 COVID 加上模型的多樣性，它真的更多地是關於過度的去增長，並且會比會員增長更快？

I'm just trying to think about how you think, and maybe Mala, chime in as well, thinking about that growth dynamic because it clearly decoupled with COVID, but would love to just get your thoughts on driving new business and the growth?

我只是想想想你是怎麼想的，也許 Mala 也插話，考慮這種增長動力，因為它顯然與 COVID 脫鉤，但很想知道你對推動新業務和增長的想法嗎？

Is it around the visit volume versus the access fee?

是圍繞訪問量還是訪問費？

Yes.

是的。

No, I appreciate the question, and it is -- it's a complicated question, right?

不，我很欣賞這個問題，這是一個複雜的問題，對吧？

Because I think visit volume will continue to grow at a more rapid rate than membership well.

因為我認為訪問量將繼續以比會員更快的速度增長。

But I think what you're going to see with the significantly increased sort of per member subscription fees that we get with the Livongo business, you're going to see the revenue grow faster on the subscription access fees, right?

但我認為，隨著我們從 Livongo 業務中獲得的每位會員訂閱費的顯著增加，你會看到訂閱訪問費的收入增長更快，對吧？

So there's a little bit of a mix there.

所以那裡有一點混合。

I think one of the things that I would look at and makes me really bullish on the future of our continued visit volume growth is the fact that this year, we saw visits grow 140% year-over-year in spite of the fact that infectious disease visits decreased by 17%.

我認為我會關注並讓我真正看好我們訪問量持續增長的未來的一件事是，今年我們看到訪問量同比增長 140%，儘管傳染性疾病就診減少了 17%。

So we have this situation where people are coming to us for a much broader array of reasons.

所以我們有這種情況，人們出於更廣泛的原因來找我們。

We're seeing our mental health visits increase dramatically, over 500% through our B2B channel, for example, dermatology, similarly.

我們看到我們的心理健康訪問急劇增加，通過我們的 B2B 渠道增加了 500% 以上，例如，皮膚科。

And yet, we're facing a historically low flu season because of social distancing and mask wearing.

然而，由於保持社交距離和戴口罩，我們正面臨歷史上較低的流感季節。

We've taken that into account in the guidance that we gave for 2021, and we're even contemplating it as we look into the first half of '20.

我們在 2021 年的指導中考慮到了這一點，我們甚至在展望 20 年上半年時也在考慮這一點。

And because I think it's really not until the back half of '22 that you're going to see us return to a more sort of normalized flu -- cold and flu season.

因為我認為直到 22 年下半年你才會看到我們回到更正常化的流感——感冒和流感季節。

So all of that's taken into consideration as we think about the long-term growth.

因此，當我們考慮長期增長時，所有這些都被考慮在內。

So hopefully, that clarifies a little bit, right?

所以希望這能澄清一點，對吧？

Visit volume grows faster than membership, and yet subscription access fees are likely to grow faster than visit fees.

訪問量的增長速度快於會員的增長速度，但訂閱訪問費的增長速度可能快於訪問費的增長速度。

Yes.

是的。

And Sandy, it's a great question.

桑迪，這是一個很好的問題。

What I would add is, if you think about the growth of both of those revenues, just to reinforce what I said in our prepared remarks in terms of why do we have confidence in the growth of both access fee revenue and visit revenue, it's sort of a few different factors, right?

我要補充的是，如果你考慮這兩項收入的增長，只是為了加強我在準備好的發言中所說的話，即為什麼我們對訪問費收入和訪問收入的增長充滿信心，這是一種幾個不同的因素，對吧？

One is on the access fee growth, to Jason's point around, it is a much bigger base with the addition of Livongo and InTouch, most of those feed are access fee revenue, as we've talked about.

一是關於訪問費的增長，就 Jason 的觀點而言，隨著 Livongo 和 InTouch 的加入，它的基礎要大得多，正如我們所討論的那樣，其中大部分是訪問費收入。

And so the growth there is going to be driven by our strong pipeline of multiproduct sales.

因此，我們強大的多產品銷售渠道將推動那裡的增長。

We've talked about our growth in specialties.

我們已經談到了我們在專業領域的發展。

Continued growth in our chronic condition programs.

我們的慢性病項目持續增長。

And then the growth in ATS and InTouch and our license platform solution, all of that is going to feed our access fee revenue growth.

然後是 ATS 和 InTouch 以及我們的許可平台解決方案的增長，所有這些都將促進我們的訪問費收入增長。

And then to the point that Jason made around what's driving visit revenue, it will really be the gains we continue to make in utilization.

然後 Jason 圍繞推動訪問收入的因素做出了貢獻，這實際上是我們在利用率方面繼續取得的收益。

You saw from our results, we saw a very strong increase in utilization in the fourth quarter, over 800 points relative to fourth quarter of 2019, and sequentially, much over 100 points in relation to the -- with respect to the third quarter.

你從我們的結果中看到，我們看到第四季度的利用率有非常強勁的增長，相對於 2019 年第四季度增加了 800 多點，並且相對於第三季度連續增加了 100 多點。

So we will continue to drive growth and utilization.

因此，我們將繼續推動增長和利用率。

And that will obviously feed visit revenue growth.

這顯然會促進訪問收入的增長。

The growth in utilization is on the back of the significant increase in growth that we are seeing in noninfectious diseases.

使用率的增長是基於我們在非傳染性疾病中看到的顯著增長。

It was about 75% of our visit volume mix in the fourth quarter.

這大約是我們第四季度訪問量組合的 75%。

So we're seeing strong growth there.

所以我們在那裡看到了強勁的增長。

We've talked about the growth that we are seeing in specialty, whether it be mental health, would be derm, so that is going to continue to drive the utilization.

我們已經談到了我們在專業領域看到的增長，無論是心理健康，還是皮膚，所以這將繼續推動利用率。

So all of those factors is what is underpinning our confidence in both the access fee revenue growth as well as the visit revenue growth.

因此，所有這些因素都支撐了我們對訪問費收入增長和訪問收入增長的信心。

Next question comes from Sean Wieland with Piper Sandler.

下一個問題來自 Sean Wieland 和 Piper Sandler。

And I guess a follow-up to Sandy, just to go a little bit deeper.

我想是桑迪的後續行動，只是為了更深入一點。

So clearly, membership growth is moderating in the outlook.

很明顯，會員增長前景正在放緩。

And I'd just like to know, is that a factor of overall market penetration of virtual care?

我只想知道，這是虛擬護理整體市場滲透的一個因素嗎？

Do you think that there's opportunities longer-term to continue to grow membership?

您認為從長遠來看是否有機會繼續增加會員人數？

And then related to that, you called out, Mala, new registrations.

然後與此相關的是，Mala，你呼籲新註冊。

What percent of members today are registered numbers?

今天有多少會員是註冊會員？

So let me speak first, Sean, to the question of membership growth.

肖恩，讓我先談談會員增長的問題。

We added 15 million members last year and 25 million members in the last 2 years.

我們去年增加了 1500 萬會員，過去兩年增加了 2500 萬會員。

That's a staggering number.

這是一個驚人的數字。

And I think what gives me confidence in the continued membership growth is what I mentioned earlier, which is that if you look at our gross pipeline, the membership growth opportunity is actually 50% larger than it was at this time last year.

我認為讓我對會員持續增長充滿信心的是我之前提到的，如果你看看我們的總管道，會員增長機會實際上比去年這個時候大 50%。

It's just that the -- those are earlier in the selling process, right?

只是——那些在銷售過程的早期，對吧？

So we've had to sort of refill the pipeline, if you will, after just an explosive year last year.

因此，如果您願意的話，我們不得不在去年經歷了爆炸性的一年之後重新填充管道。

And so we take a relatively conservative view of the membership growth given the earlier stage, and yet the growth opportunity is 50% larger than it was at this time last year.

因此，我們對早期的會員增長持相對保守的看法，但增長機會比去年同期大 50%。

So I think that gives me significant confidence over the longer term.

所以我認為這讓我對長期前景充滿信心。

We still have 65 million members worth of white space within existing clients.

我們在現有客戶中仍有 6500 萬會員的空白空間。

So I feel very, very good about continued membership growth.

所以我對持續的會員增長感覺非常非常好。

And we look at it over sort of a multiyear or not a quarter-by-quarter question.

我們通過多年或不是逐季度的問題來看待它。

Yes.

是的。

And to your second question, Sean, we, as you know, do not break out what you asked.

關於你的第二個問題，肖恩，正如你所知，我們不會打破你的問題。

We have given you a lot of information.

我們已經給了你很多信息。

As was pointed out earlier in the call, we don't give you every piece of information.

正如在電話中早些時候指出的那樣，我們不會向您提供所有信息。

So that's not something we've broken out.

所以這不是我們已經打破的東西。

We have talked, as you mentioned, about the increase in first-time registrants and how that contributes to our overall visit growth, not only in the year that they first time register, but also that, that enters the flywheel and we get them repeat utilization, especially among multiple products.

正如您所提到的，我們已經討論了首次註冊者的增加以及這對我們整體訪問量增長的貢獻，不僅在他們第一次註冊的那一年，而且進入飛輪，我們讓他們重複利用率，尤其是在多種產品之間。

Yes.

是的。

And it's important that registrations, as we have talked about, is running well ahead of membership addition growth, right?

重要的是，正如我們所討論的那樣，註冊人數遠遠超過會員人數的增長，對吧？

So that is also important as we continue to drive utilization in '21.

因此，隨著我們繼續推動 21 世紀的利用率，這也很重要。

Next question comes from Stephanie Davis with SVB Leerink.

下一個問題來自 SVB Leerink 的 Stephanie Davis。

I feel like everyone else, congrats on the quarter.

我和其他人一樣，祝賀這個季度。

Congrats on the guide.

恭喜指導。

Thank you, Stephanie.

謝謝你，斯蒂芬妮。

Jason, you talked about of really strong international dynamic on your prepared remarks.

傑森，你在準備好的發言中談到了真正強大的國際動態。

I was hoping that you could talk a little bit more about maybe what pockets of geographies were you seeing the biggest strength and how the competitive dynamics differ in that market.

我希望您能多談談您認為哪些地區的實力最強，以及該市場的競爭動態有何不同。

Yes, absolutely.

是的，一點沒錯。

I'm really excited about our international products prospects.

我對我們的國際產品前景感到非常興奮。

And we're just starting to really hit our stride and activate the international channels for the InTouch solutions, and we're seeing tremendous interest in the international markets for the Livongo products.

我們才剛剛開始真正大步向前並激活 InTouch 解決方案的國際渠道，我們看到了國際市場對 Livongo 產品的巨大興趣。

So -- and you know how large those opportunities are.

所以 - 你知道這些機會有多大。

So with respect to the geographies, we're seeing good growth in Europe, both on the continent as well as in the U.K. where we continue to see the South American markets and especially Brazil as very exciting opportunities.

因此，就地域而言，我們在歐洲看到了良好的增長，無論是在歐洲大陸還是在英國，我們都繼續將南美市場，尤其是巴西視為非常令人興奮的機會。

The Brazilian market is characterized by a very tech-savvy population, and it's a market where private health insurance is rather prevalent.

巴西市場的特點是人口非常精通技術，而且是一個私人醫療保險相當普遍的市場。

Specifically in Europe, we launched with Telefónica, and that continues to be a very, very strong relationship.

特別是在歐洲，我們與 Telefónica 合作推出了該產品，並且這種關係將繼續保持非常非常牢固的關係。

We're very bullish on the prospects for that relationship.

我們非常看好這種關係的前景。

And then, of course, we launched over the past year in the Nordic region.

然後，當然，我們在過去一年中在北歐地區推出。

So right now, those are probably our primary growth areas.

所以現在，這些可能是我們的主要增長領域。

We continue to have a strong and steady footprint in Canada and Australia and New Zealand.

我們繼續在加拿大、澳大利亞和新西蘭擁有強大而穩定的足跡。

And so from my perspective, I'm very, very bullish there.

所以從我的角度來看，我非常、非常看好那裡。

The -- I believe that unlocking some of those markets for the Livongo capabilities will be a game changer in terms of the role of the international markets in our book of business.

我相信，就國際市場在我們業務簿中的作用而言，為 Livongo 功能解鎖其中一些市場將改變遊戲規則。

Next question comes from Richard Close with Canaccord Genuity.

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

I assume you can hear me okay?

我想你能聽到我說話好嗎？

Yes, perfect.

是的，完美。

Excellent.

出色的。

So I was going to drill down on membership, but that's been hammered on here.

所以我打算深入了解成員資格，但這裡已經強調了這一點。

But can we talk a little bit about primary care, Jason, and how you're thinking about that?

但我們能談談初級保健嗎，Jason，以及你是如何考慮的？

Obviously, the comments on the pilots were positive.

顯然，對飛行員的評論是積極的。

How do we think about the business model for primary care?

我們如何看待初級保健的商業模式？

What metrics you're focused in on there?

您在那里關注哪些指標？

And then does it shift the revenue model more from an episodic type of payment or to more recurring?

那麼它是將收入模式更多地從偶發式支付轉變為更經常性的支付嗎？

Or just overall, how does that model evolve?

或者只是總體而言，該模型是如何演變的？

Yes.

是的。

I appreciate the question, Richard.

我很欣賞這個問題，理查德。

We're really excited about the prospects for Primary360.

我們對 Primary360 的前景感到非常興奮。

We have a very, very large and diverse pipeline of opportunities for that model.

對於該模型，我們擁有非常非常龐大且多樣化的機會渠道。

And it ranges, honestly, from higher PMPMs plus a wider variety of visit fees because, of course, a 30-minute introductory visit with a new primary care relationship is going to be worth more than an annual check in or a symptomatic visit, for example.

老實說，它的範圍從更高的 PMPM 到更廣泛的訪問費用，因為，當然，對新的初級保健關係進行 30 分鐘的介紹性訪問將比年度檢查或對症訪問更有價值，因為例子。

Having said that, we're also talking to a number of health plans about putting in quality metrics and incorporating more value-based reimbursement associated with our ability to move the needle on quality of care.

話雖如此，我們也正在與一些健康計劃討論如何制定質量指標，並納入更多與我們提高護理質量的能力相關的基於價值的報銷。

And I think that will start with small steps along the lines of documented improvement in screening -- rates of screening and appropriate preventative care, and move toward more impactful outcomes-based measurement and, ultimately, the opportunity for us to enter into risk-sharing arrangements or share of savings arrangements with some of the payers.

我認為這將從沿著記錄在案的篩查改進——篩查率和適當的預防保健方面的小步驟開始，然後轉向更有影響力的基於結果的衡量，並最終讓我們有機會進行風險分擔與某些付款人的安排或分享儲蓄安排。

We're already having those discussions, but we're also very cognizant that we need to step carefully into that and make sure that we have the right data to be able to enter into those relationships with eyes wide open and know where we can make the biggest impact.

我們已經在進行這些討論，但我們也非常清楚，我們需要謹慎地參與其中，並確保我們擁有正確的數據，以便能夠睜大眼睛進入這些關係，並知道我們可以在哪裡做最大的影響。

So I think you'll see an evolution of that model.

所以我認為你會看到該模型的演變。

But in all of those cases, a significantly higher revenue per member for those who were serving with our Primary360 product.

但在所有這些情況下，對於使用我們的 Primary360 產品服務的人來說，每個成員的收入要高得多。

Next question comes from Sean Dodge with RBC Capital Markets.

下一個問題來自 RBC Capital Markets 的 Sean Dodge。

Maybe on the average PMPM, the sequential change was pretty significant even, Mala, what you expect excluding the lift from the Livongo inclusion there.

也許在平均 PMPM 上，連續變化甚至非常顯著，Mala，你所期望的不包括 Livongo 包含的提升。

If we set Livongo aside, can you give us a sense of how much that was driven by multiproduct sales versus maybe something like repricing or true-ups related to the visits included contracts?

如果我們把 Livongo 放在一邊，你能告訴我們有多少是由多產品銷售驅動的，而不是像重新定價或與訪問包括合同相關的調整？

Yes.

是的。

So what we have -- what we've shared with you is, as you said, there was a pretty significant increase in the PMPM, as you saw $1.76 in the quarter compared to $1.18 sequentially at $0.91.

所以我們所擁有的 - 我們與您分享的是，正如您所說，PMPM 有相當顯著的增長，因為您看到本季度為 1.76 美元，而上一季度為 1.18 美元，為 0.91 美元。

So a very significant increase.

所以這是一個非常顯著的增長。

The way I would think about it is a lot of it was because of the addition of Livongo, to be clear.

很明顯，我認為這在很大程度上是因為 Livongo 的加入。

But even absent the addition of Livongo, we did see an expansion, a nice expansion in our PMPM in the quarter.

但即使沒有 Livongo 的加入，我們也確實看到了擴張，本季度我們的 PMPM 有了很好的擴張。

I don't want to break it out more specifically on how much of it came from a rerating of our visits included contracts, which, by the way, we have rerated through the year.

我不想更具體地說明其中有多少來自重新評估我們的訪問包括合同，順便說一下，我們已經重新評估了這一年。

As we went through the visit volumes through the year, we've talked about that, and that definitely did happen.

當我們審視全年的訪問量時，我們已經談到了這一點，而且這確實發生了。

But there are a lot of -- so I don't want to specifically break out the individual drivers, but what I will say is even excluding the impact of Livongo for the 2 months of the quarter, we actually did see a nice expansion in PMPM as we went through the fourth quarter.

但是有很多——所以我不想具體分析個別驅動因素，但我要說的是，即使不包括 Livongo 在本季度兩個月的影響，我們實際上確實看到了不錯的擴張我們經歷了第四季度時的 PMPM。

Next question comes from Daniel Grosslight with Citi.

下一個問題來自花旗銀行的 Daniel Grosslight。

I wanted to focus a little bit on Medicare, both on MA and in fee-for-service.

我想稍微關註一下 Medicare，包括 MA 和按服務收費。

I think in the third quarter, you mentioned you had around 2.5 million MA lives aboard.

我想在第三季度，你提到你在船上有大約 250 萬 MA。

And CMS mentioned, I think that around 21 million beneficiaries for the plan year 2021 will have access to some type of telehealth benefits.

CMS 提到，我認為 2021 年計劃中約有 2100 萬受益人將獲得某種類型的遠程醫療福利。

So curious if you can give us an update on the MA progress you've made during this past AEP.

很想知道您能否向我們介紹一下您在過去的 AEP 中取得的 MA 進展的最新情況。

And then on the fee-for-service side, there's been some noise out of the Inspector General's office about auditing some telehealth visits.

然後在按服務收費方面，監察長辦公室傳出了一些關於審計一些遠程醫療訪問的聲音。

And I don't know, it seems like the regulatory landscape in fee-for-service might be a little more uncertain.

而且我不知道，似乎按服務收費的監管環境可能更加不確定。

So curious to get your thought on that market in particular, which I suppose would go into your provider segment.

很想知道你對那個市場的想法，我想這會進入你的供應商領域。

And if the direct contracting within Medicare fee-for-service is going to have any impact on your strategy in that market.

如果 Medicare 按服務收費的直接合同會對您在該市場的戰略產生任何影響。

Yes.

是的。

I'll take the second one first and then Mala can speak a little bit to the progress we're making in terms of our Medicare membership.

我先講第二個，然後 Mala 可以談談我們在 Medicare 會員方面取得的進展。

The -- I think -- I continue to think that Medicare fee-for-service is primarily an opportunity for us with respect to our hospital and health systems business as hospital and health systems continue to lean in harder to providing virtual care for their membership and being reimbursed by CMS.

我認為 - 我仍然認為醫療保險按服務收費主要是我們在醫院和衛生系統業務方面的一個機會，因為醫院和衛生系統繼續更加努力地為他們的會員提供虛擬護理並由 CMS 報銷。

We continue to be very active in terms of working with CMS and various state legislators for that matter, on best practices when it comes to the regulatory environment.

在涉及監管環境的最佳實踐方面，我們將繼續非常積極地與 CMS 和各州立法者合作。

And we're very optimistic, actually.

事實上，我們非常樂觀。

We think that the winds are all blowing in the right direction.

我們認為風都在向正確的方向吹。

It's a rare bipartisan issue.

這是一個罕見的兩黨問題。

And we're collaborative with respect to making sure that there are the right guardrails around it because we think that it's important to have best practices proliferate with respect to not only payment models, but also the best care being delivered, and to make sure that the consumers' needs as well as the payers' needs, whether that's the federal government or a private health plan, are also being looked after.

我們在確保周圍有正確的護欄方面進行合作，因為我們認為重要的是，不僅要在支付模式方面，而且要在提供最佳護理方面推廣最佳實踐，並確保消費者的需求以及付款人的需求，無論是聯邦政府還是私人健康計劃，也都得到了照顧。

So we're very active on those fronts.

所以我們在這些方面非常活躍。

We're actually applying quite a bit of technology to that to be able to do things like use artificial intelligence to validate that a clinical visit took place and things like that.

我們實際上正在應用相當多的技術來做一些事情，比如使用人工智能來驗證是否進行了臨床訪問等等。

So I feel very good about the direction that, that's heading.

所以我對前進的方向感覺很好。

We continue to make progress in the Medicare Advantage market.

我們繼續在 Medicare Advantage 市場取得進展。

I don't know that we gave numbers updated with respect to our Medicare Advantage population.

我不知道我們是否提供了有關我們的 Medicare Advantage 人口的更新數字。

We'll continue to keep you apprised of that as we go through the quarters.

我們將在整個季度中繼續讓您了解這一點。

Yes.

是的。

And the only other thing I would add is as we've talked about, the 15 million member addition in 2020, we have talked about how we've seen nice growth in government, whether that includes Medicare Advantage or Medicaid.

我唯一要補充的是，正如我們所討論的那樣，2020 年將增加 1500 萬名成員，我們已經討論了我們如何看到政府的良好增長，無論是 Medicare Advantage 還是 Medicaid。

So it's -- so think of it more as we are seeing strong growth and membership addition across government.

所以它 - 所以更多地考慮它，因為我們看到整個政府的強勁增長和成員增加。

Maybe last thing I'd just mention is we're also seeing private Medicare, meaning Medicare populations from within large employers who come through the health plans.

也許我要提到的最後一件事是我們也看到了私人醫療保險，這意味著來自大型雇主內部的醫療保險人口通過健康計劃。

It's a part of the market that frequently isn't talked about, but we're seeing growth in some of those populations where the health plans are coming to us for those populations as well.

這是市場的一部分，經常沒有被談論，但我們看到一些人口的增長，這些人口的健康計劃也正在向我們走來。

Next question comes from Charles Ryhee with Cowen.

下一個問題來自 Charles Ryhee 和 Cowen。

Just to follow-up a little bit on Primary360 as it relates to membership guidance.

只是跟進一下 Primary360，因為它與會員指南有關。

Is it right to think that Primary360 members of that growth is a conversion of existing U.S. paid membership numbers?

認為 Primary360 會員的增長是現有美國付費會員數量的轉換是否正確？

Or is that be incremental within the membership growth?

還是會員增長中的增量？

And then secondly, on the utilization number, which was quite strong.

其次，關於利用率，它非常強大。

I know you don't give this number, but -- in the past, but can you give a sense on how much of those utilization is from repeat users versus bringing in first-time users?

我知道你沒有給出這個數字，但是 - 在過去，但是你能否說明這些利用率中有多少來自重複用戶與引入首次用戶？

Yes.

是的。

So I'll take the Primary360 membership and then Mala can talk a little bit about repeat utilization and registrations because I think, really, it's a question of new registrations.

所以我將獲得 Primary360 會員資格，然後 Mala 可以談談重複使用和註冊，因為我認為，這實際上是一個新註冊的問題。

The -- with respect to Primary360, the answer is actually both.

-- 關於 Primary360，答案實際上是兩者兼而有之。

So in some cases, we're going to existing clients to existing populations and we're making Primary360 available to them.

因此，在某些情況下，我們會將現有客戶提供給現有人群，並讓他們可以使用 Primary360。

And so we wouldn't newly count those members, right?

所以我們不會重新計算這些成員，對嗎？

They're already in our membership count.

他們已經在我們的會員人數中。

In other cases, there are new populations, where we're going to them and making our services available for the first time.

在其他情況下，有新的人群，我們會去他們那裡並首次提供我們的服務。

And the product that we're bringing to bear for them may be Primary360.

我們為他們帶來的產品可能是 Primary360。

It may also be Primary360 and other products alongside of it.

也可能是 Primary360 以及與之並列的其他產品。

So you may get some into our Primary360, driving that revenue.

因此，您可能會加入我們的 Primary360，從而推動收入增長。

And then other members may have other versions of the product, either on a sort of as-needed basis and/or they may have our chronic condition management programs.

然後其他成員可能有其他版本的產品，或者根據需要和/或他們可能有我們的慢性病管理計劃。

So I think you'll see it show up in different ways.

所以我想你會看到它以不同的方式出現。

What you can be confident, though, is we're only going to count a member once.

不過，您可以確信的是，我們只會對一個成員進行一次計數。

Yes.

是的。

And Charles, regarding your other question, we -- as you said, we don't break it out, but I'll just give you a few facts.

查爾斯，關於你的另一個問題，正如你所說，我們不會將其分解，但我只會給你一些事實。

The first is if you think about our visit volume in the quarter, about half of it actually came from first time users.

首先，如果您考慮一下我們本季度的訪問量，其中大約一半實際上來自首次用戶。

And as you know, that's always really helpful as we think about driving future utilization, right?

如您所知，當我們考慮推動未來的利用率時，這總是非常有幫助，對吧？

They try it once, and then they will repeat.

他們嘗試一次，然後他們會重複。

So that is something that is also a factor that underpins our confidence in driving utilization as we move forward.

因此，這也是支撐我們在前進過程中推動利用率的信心的一個因素。

So the fact that we are seeing registrations well outpace membership additions, the fact that about half of the volume came from first time users.

因此，事實上我們看到註冊人數遠遠超過會員人數的增加，事實上大約一半的數量來自新用戶。

And then the only other thing I would say is, when we were at JPMorgan in January, we did talk about how we are seeing the flywheel dynamics fueling durable growth, and we did talk about repeat visits, showing very nice, robust growth over the past few years.

然後我唯一要說的另一件事是，當我們 1 月份在摩根大通時，我們確實討論了我們如何看到飛輪動力推動持久增長，我們確實討論了重複訪問，顯示了非常好的、強勁的增長過去幾年。

I don't want to say more than that, but I would sort of think about the half of our visit volume coming from first-time users in the fourth quarter.

我不想多說，但我會考慮第四季度我們一半的訪問量來自首次用戶。

And that's true for the whole year.

全年都是如此。

So that was a trend.

所以這是一種趨勢。

That was in the fourth quarter.

那是在第四季度。

That was true, and it was true for the whole year as well.

確實如此，全年也是如此。

Next question comes from Jailendra Singh with Credit Suisse.

下一個問題來自瑞士信貸的 Jailendra Singh。

I just wanted to follow-up on BetterHelp.

我只是想跟進 BetterHelp。

Very strong trends there.

那裡的趨勢非常強勁。

Revenues in $300 million range, expected to grow 50% in 2021.

收入在 3 億美元左右，預計 2021 年將增長 50%。

With that business now becoming a very sizable piece of your overall company, I was wondering if you are willing to talk about margins on that business, how does that compare with overall corporate margins and long-term profitability opportunity there?

隨著該業務現在成為您整個公司的一個非常大的部分，我想知道您是否願意談論該業務的利潤率，與整體公司利潤率和那裡的長期盈利機會相比如何？

On a related part with several employers now expanding telebehavioral and mental health services.

與一些雇主相關的是，他們現在正在擴大遠程行為和心理健康服務。

Do you see that having any impact on your better health DTC side of the growth prospects?

您是否認為這對增長前景的健康 DTC 方面有任何影響？

So let me answer about the market dynamics around BetterHelp and then Mala can talk to margins and performance.

因此，讓我回答有關 BetterHelp 的市場動態，然後 Mala 可以談談利潤率和業績。

Yes, we really don't.

是的，我們真的不知道。

I think a couple of things, Jailendra.

Jailendra，我想了幾件事。

One, we've actually started taking BetterHelp into some B2B arrangements, in particular with respect to EAP plans.

第一，我們實際上已經開始將 BetterHelp 納入一些 B2B 安排，特別是在 EAP 計劃方面。

And that's turned out to be a very fruitful market for us.

事實證明，這對我們來說是一個非常富有成果的市場。

The second thing I would say is most people who are turning to BetterHelp either don't have adequate coverage or decide that they don't want to use that coverage, especially for reasons of expenses, honestly.

我要說的第二件事是，大多數求助於 BetterHelp 的人要么沒有足夠的承保範圍，要么決定他們不想使用該承保範圍，老實說，尤其是出於費用原因。

One of the value propositions of BetterHelp is that for a month's worth of therapy, you can get -- you can get therapy for a month, that would otherwise cost you in person, about the same for a single visit or maybe a 1.5 visit, if you're fortunate.

BetterHelp 的價值主張之一是，對於一個月的治療，你可以獲得——你可以接受一個月的治療，否則你將親自花費，單次訪問或 1.5 次訪問的費用大致相同，如果你幸運的話。

And so the value proposition is very, very strong.

因此，價值主張非常非常強大。

And it has always been the case and continues to be the case that many of the people who turn to BetterHelp wouldn't have otherwise gotten therapy, right?

許多求助於 BetterHelp 的人本來就不會得到治療，這一直都是，而且將繼續如此，對吧？

And so we continue to see that market be very, very sort of underpenetrated; the opportunity, very significant.

因此，我們繼續看到該市場的滲透率非常、非常低；機會，非常重大。

And so we don't see any slowing down of that in sight.

因此，我們看不到任何放緩的跡象。

And from a margin standpoint, Jailendra, I am really pleased with the progression in margins that, that aspect of our business has been making over the past few years.

從利潤率的角度來看，Jailendra，我對過去幾年我們業務的這一方面取得的利潤率增長感到非常滿意。

I obviously will not break out margin for any part of our business, but there has been really good progress in terms of margins.

我顯然不會為我們業務的任何部分突破利潤率，但在利潤率方面確實取得了很好的進展。

And it's really on the back of a few things, right?

這真的是在一些事情的背後，對吧？

Just to give you a little bit of color on what's driving the improvement in margins.

只是為了讓您了解推動利潤率提高的因素。

We are seeing improvement in lifetime value.

我們看到了生命週期價值的提高。

We are seeing improvement in retention and lower churn.

我們看到了保留率的提高和流失率的降低。

We are definitely looking at constantly innovating when it comes to different channels.

當涉及到不同的渠道時，我們肯定會不斷創新。

We do a lot of product improvements through the year.

我們在這一年裡做了很多產品改進。

We test different pricing as we go through the year.

我們在一年中測試不同的定價。

So there are a bunch of different levers that underpin the margin progression we are seeing.

因此，有許多不同的槓桿支撐著我們所看到的利潤增長。

And I have to say, if you think about revenue vis-à-vis the cost of acquisition, which is something that we are very, very keenly focused on, we're seeing some very strong improvements in that.

而且我不得不說，如果你考慮收入與收購成本的關係，這是我們非常非常關注的事情，我們會看到一些非常強大的改進。

So overall, I'm pleased with the margin progression for BetterHelp.

總的來說，我對 BetterHelp 的利潤增長感到滿意。

Next question comes from Donald Hooker with KeyBanc.

下一個問題來自 KeyBanc 的 Donald Hooker。

Thank you for the question.

感謝你的提問。

So I wanted to revisit the PMPM metric that you gave ex Livongo, I guess based on your comments model, it appears it was about $1.30, I think, from your comments or somewhere in that neighborhood.

所以我想重新審視你給前 Livongo 的 PMPM 指標，我想根據你的評論模型，我認為從你的評論或那個社區的某個地方來看，它似乎大約是 1.30 美元。

That keeps marching up.

那一直在前進。

Is there sort of a point in time where that sort of taps out?

是否有某種時間點可以讓這種情況消失？

Just wanted to think ahead.

只是想提前考慮。

Is that some kind of a driver for you over time?

隨著時間的推移，這對你來說是某種驅動力嗎？

Is there sort of a full stack of your services where that sort of stops rising somewhere out in the future?

是否有某種完整的服務堆棧在未來某個地方停止增長？

Or maybe another way to ask the question, is there a particular client with a very, very high PMPM that you can sort of highlight?

或者換一種提問方式，是否有某個客戶的 PMPM 非常非常高，您可以強調一下？

If you think about our PMPM, and the way I think about how that progresses, it really is about a couple of things.

如果您考慮我們的 PMPM，以及我對它的進展方式的思考，它實際上與幾件事有關。

One is we have actually shown case studies where as we sell multiple products and services, we actually see a market increase pre post PMPM, right?

一是我們實際上已經展示了案例研究，當我們銷售多種產品和服務時，我們實際上看到了 PMPM 之前的市場增長，對嗎？

So I would say the first is, it is about expanding our suite of products and services, which is what we have been doing over the past many years, right?

所以我想說的第一個是，它是關於擴展我們的產品和服務套件，這是我們過去多年一直在做的，對吧？

We've been steadily expanding our suite of products.

我們一直在穩步擴展我們的產品套件。

And then the second thing I would say is, it's also about expanding into products and services that are more longitudinal, not episodic, because that drives stickiness, it drives expansion in PMPM.

然後我要說的第二件事是，它還涉及擴展到更縱向的產品和服務，而不是偶發的，因為這會增加粘性，它會推動 PMPM 的擴展。

So the way I think about it is, if I look at the progression of our business and where we -- what we have done and where we are headed, and as I think about the growth of the various pieces of our business that underpin the 40% to 43% growth that we talked about, I actually feel we have all the right ingredients to continue to expand the PMPM.

因此，我的思考方式是，如果我審視我們業務的進展以及我們所做的工作和我們的發展方向，以及我對支撐我們業務的各個部分的增長的思考我們談到的 40% 到 43% 的增長，我實際上覺得我們擁有繼續擴大 PMPM 的所有正確要素。

And this does conclude the call for today.

這確實結束了今天的呼籲。

You may now disconnect.

您現在可以斷開連接。