Teladoc Health Inc (TDOC) 2020 Q3 法說會逐字稿

Hello, and welcome to the Teladoc Third Quarter '20 Earnings Conference Call. (Operator Instructions)

您好，歡迎參加 Teladoc 20 年第三季度收益電話會議。 （操作員說明）

At this time, I'd like to turn the call over to Patrick Feeley for his opening remarks. Thank you very much.

在這個時候，我想把電話轉給 Patrick Feeley 做他的開場白。非常感謝。

Thank you, and good afternoon.

謝謝，下午好。

Today, after the market close, we issued a press release announcing our third quarter 2020 financial results. This press release is available in the Investor Relations section of the teladochealth.com website. On this call to discuss the results are Jason Gorevic, our Chief Executive Officer; and Mala Murthy, our Chief Financial Officer.

今天，在收市後，我們發布了一份新聞稿，宣布了我們 2020 年第三季度的財務業績。本新聞稿可在 teladochealth.com 網站的投資者關係部分獲取。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 fourth quarter 2020 outlook, and our prepared remarks will be followed by a question-and-answer session. 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.

在這次電話會議中，我們還將提供 2020 年第四季度的展望，我們準備好的講話之後將進行問答環節。請注意，我們將討論我們認為對評估 Teladoc Health 的業績很重要的某些非公認會計準則財務指標。有關這些非公認會計原則措施與最具可比性的公認會計原則措施之間的關係及其對賬的詳細信息，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，本次電話會議期間做出的某些陳述將是 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。有關更多信息，請參閱我們在新聞稿中的警告聲明以及我們向 SEC 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，謝謝大家今天下午加入我們。

After the market closed, we reported another quarter of significant outperformance across all key financial and operational metrics driven by broad-based momentum across the entire business. The ongoing pandemic has highlighted the critical role of virtual care within the overall health care system, and we continue to see increasing adoption by consumers, clients and providers.

市場收盤後，我們報告了在整個業務基礎廣泛的勢頭推動下，所有關鍵財務和運營指標的表現又顯著優於四分之一。持續的大流行凸顯了虛擬護理在整個醫療保健系統中的關鍵作用，我們繼續看到消費者、客戶和提供者越來越多地採用。

This broad-based strength drove record revenue of $289 million in the third quarter, an increase of 109% from the prior year period, including organic revenue growth of approximately 90%. The strength demonstrated across our diverse channels, products and geographies, combined with a robust pipeline of new opportunities, continues to give us tremendous confidence in the forward outlook for the business. As a result of our third quarter performance and the continued momentum across the business, we are increasing our full year revenue guidance to $1.005 billion to $1.015 billion.

這種廣泛的優勢推動第三季度創紀錄的收入達到 2.89 億美元，比去年同期增長 109%，其中有機收入增長約 90%。我們在不同渠道、產品和地區所展現的實力，加上強大的新機遇渠道，繼續讓我們對業務的前瞻前景充滿信心。由於我們第三季度的業績和整個業務的持續發展勢頭，我們將全年收入指引提高到 10.05 億美元至 10.15 億美元。

During the third quarter, we also announced a combination with Livongo Health. We could not be more excited for this deal to close later in the fourth quarter, and we've already made significant progress toward integrating our 2 teams, as I'll discuss in more detail later on the call.

在第三季度，我們還宣布與 Livongo Health 合併。我們對這筆交易在第四季度晚些時候完成感到非常興奮，我們已經在整合我們的兩個團隊方面取得了重大進展，稍後我將在電話會議上更詳細地討論。

Turning to visit volumes. Our network of providers delivered over 2.8 million virtual visits in the third quarter, more than triple the number of visits provided in the same period last year. We were pleased to see visit volumes increase sequentially despite the COVID-driven volume we experienced in the second quarter as well as the seasonally lower volumes typically experienced during the third quarter.

轉向訪問卷。我們的供應商網絡在第三季度提供了超過 280 萬次虛擬訪問，是去年同期提供的訪問次數的三倍多。儘管我們在第二季度經歷了 COVID 驅動的訪問量以及第三季度通常經歷的季節性較低的訪問量，但我們很高興地看到訪問量連續增加。

We continue to see strong evidence of sustained utilization increases for virtual care. While CDC figures and our own internal data point to overall declines in infectious disease transmission in the United States due to social distancing and the use of personal protective equipment, our overall volume growth remains strong, as evidenced by both our third quarter results and our fourth quarter outlook.

我們繼續看到強有力的證據表明虛擬護理的利用率持續增加。儘管 CDC 數據和我們自己的內部數據表明，由於社交距離和個人防護設備的使用，美國傳染病傳播總體下降，但我們的總體銷量增長仍然強勁，我們的第三季度業績和第四季度業績都證明了這一點季度展望。

One clear driver of this strength has been a steady and broad-based acceleration in our noninfectious disease-related visits. Visits for conditions such as hypertension, back pain, anxiety and depression represent over half of our general medical visit volume, up from approximately 1/3 a year ago, as our comprehensive portfolio of services enables us to meet the increasing consumer demand for virtual care.

這種優勢的一個明顯驅動因素是我們與非傳染性疾病相關的訪問的穩步和廣泛的加速。高血壓、背痛、焦慮和抑鬱等疾病的就診量占我們一般醫療就診量的一半以上，高於一年前的約 1/3，因為我們全面的服務組合使我們能夠滿足消費者對虛擬護理日益增長的需求.

New registrations also continue to grow at a rapid pace, increasing more than 80% compared to the third quarter of 2019, while visit growth from newly registered individuals continues to outpace existing user visit growth. These new registrations will continue to benefit us in the future as they create new opportunities to engage with members.

新註冊也繼續快速增長，與 2019 年第三季度相比增長超過 80%，而新註冊個人的訪問增長繼續超過現有用戶訪問增長。這些新註冊將在未來繼續使我們受益，因為它們創造了與會員互動的新機會。

Taking a closer look at the volume trends in specialty care. Demand for dermatology and behavioral health services continues to significantly outpace overall volume growth. In the B2B channel, for example, visits in these specialties grew over 500% compared to the prior year. Demand for mental health care, in particular, continues to build, both through our B2B channel as well as through our direct-to-consumer brand, BetterHelp. Utilization of mental health services has continued to grow in each successive month of the year, which is very encouraging given the high repeat usage profile of the service.

仔細研究專科護理的數量趨勢。對皮膚病學和行為健康服務的需求繼續顯著超過整體數量增長。例如，在 B2B 渠道中，這些專業的訪問量與去年相比增長了 500% 以上。通過我們的 B2B 渠道以及我們的直接面向消費者的品牌 BetterHelp，對精神保健的需求尤其持續增長。心理健康服務的使用率在一年中的每個連續月份都在持續增長，鑑於該服務的重複使用率很高，這非常令人鼓舞。

On the heels of World Mental Health Day, we are also reminded of the critical role our providers are playing for individuals around the world. At a time when the global pandemic and economic hardship are driving increased need for mental health services, we continue to provide much needed access for those in need. In fact, 40% of the individuals note that they would not have otherwise sought care if not for access to Teladoc Health.

在世界精神衛生日之後，我們也被提醒我們的提供者為世界各地的個人所扮演的關鍵角色。在全球大流行和經濟困難推動對心理健康服務的需求增加之際，我們繼續為有需要的人提供急需的服務。事實上，40% 的人指出，如果沒有 Teladoc Health，他們不會尋求其他治療。

Together, this momentum in specialty visit growth, combined with the broadening diversity of diagnoses and robust overall registration growth, continues to give us a high degree of confidence in the sustainability of our volume growth. It also reinforces our strategy of consistently expanding the clinical scope of our services, which will take a quantum leap forward when we incorporate the Livongo capabilities focused on helping people who live with chronic conditions.

總之，專科就診增長的這種勢頭，加上診斷的多樣性和強勁的整體註冊增長，繼續使我們對我們的銷量增長的可持續性充滿信心。它還強化了我們不斷擴大服務臨床範圍的戰略，當我們整合專注於幫助患有慢性病的人的 Livongo 能力時，這將取得巨大的飛躍。

Turning to the international channel. We continue to see new and innovative opportunities for growth outside the U.S. Just last week, we launched an exciting new partnership with Telefónica, one of the largest telecom providers in Europe and Latin America, including over 14 million customers in Spain. As part of this partnership, Telefónica will distribute our virtual care offering on a D2C and B2B basis to individuals and employers across Spain. We're optimistic that the results of this partnership will pave the way for similar initiatives in other geographies around the world.

轉向國際頻道。我們繼續在美國以外看到新的和創新的增長機會。就在上週，我們與歐洲和拉丁美洲最大的電信提供商之一西班牙電信（Telefónica）建立了令人興奮的新合作夥伴關係，在西班牙擁有超過 1400 萬客戶。作為此次合作的一部分，西班牙電信將以 D2C 和 B2B 的方式向西班牙各地的個人和雇主分發我們的虛擬護理產品。我們樂觀地認為，這種夥伴關係的成果將為全球其他地區的類似舉措鋪平道路。

Last quarter, we also spoke about new geographic expansion into the Nordic region with a significant new client partnership with a large financial institution in this area. We've already leveraged that foothold with multiple new sales during the quarter, demonstrating the strong demand for a comprehensive virtual solution around the world.

上個季度，我們還談到了北歐地區的新地理擴張，與該地區的一家大型金融機構建立了重要的新客戶合作夥伴關係。我們已經在本季度通過多項新銷售來利用這一立足點，這表明全球對綜合虛擬解決方案的強烈需求。

Our hospital and health system channel, which now includes InTouch, also continued to experience tremendous growth as health systems and physician practices adopt our technology as a secure, effective and efficient way to provide care. In addition to the 7.6 million member visits provided by the Teladoc network of clinicians year-to-date, the combined Teladoc and InTouch technology platform has enabled our clients' own clinicians to provide nearly 3 million consultations for their patients.

我們的醫院和衛生系統渠道（現在包括 InTouch）也繼續經歷巨大的增長，因為衛生系統和醫生實踐採用我們的技術作為提供護理的安全、有效和高效的方式。除了今年迄今為止 Teladoc 臨床醫生網絡提供的 760 萬次會員訪問外，Teladoc 和 InTouch 技術平台的結合使我們客戶自己的臨床醫生能夠為他們的患者提供近 300 萬次諮詢。

The pipeline of new opportunities in this channel also continues to expand. It's only 4 months since we closed the InTouch acquisition, but we've already completed over a dozen cross-sales as health systems are increasingly looking for enterprise-wide integrated solutions. And we're well on our way to achieving both our revenue and our cost synergy targets.

該渠道中的新機會管道也在繼續擴大。距離我們完成對 InTouch 的收購僅 4 個月，但隨著醫療系統越來越多地尋求企業範圍的集成解決方案，我們已經完成了十幾個交叉銷售。我們正在努力實現我們的收入和成本協同目標。

Staying with the hospital channel. We're pleased to announce a new partnership with Johns Hopkins, one of the most prestigious academic medical centers in the world. As a fully integrated health system, Hopkins will be implementing the Teladoc Health platform to provide their patients, health plan members and their own employees with access to on-demand 24/7 virtual care. Johns Hopkins selected the Teladoc platform based on our steadfast commitment to quality, our position as the most comprehensive end-to-end solution in the industry and our innovative approach to advancing virtual care.

留在醫院頻道。我們很高興地宣布與世界上最負盛名的學術醫療中心之一約翰霍普金斯大學建立新的合作夥伴關係。作為一個完全集成的衛生系統，霍普金斯大學將實施 Teladoc Health 平台，為他們的患者、健康計劃成員和他們自己的員工提供按需 24/7 虛擬護理。約翰霍普金斯大學選擇 Teladoc 平台是基於我們對質量的堅定承諾、我們作為業內最全面的端到端解決方案的地位以及我們推進虛擬護理的創新方法。

Finally, before I turn the call over to Mala, I want to provide an update on the Livongo transaction. With each passing day, I become more and more excited by the combination of these 2 leaders in health care and technology. The opportunities in front of us are boundless. And together, we will be uniquely positioned to improve the health of millions of people around the world.

最後，在我將電話轉給 Mala 之前，我想提供有關 Livongo 交易的更新。隨著時間的流逝，我對這兩位醫療保健和技術領域的領導者的結合感到越來越興奮。擺在我們面前的機會是無限的。我們將攜手合作，在改善全球數百萬人的健康方面處於獨特的地位。

Our integration teams have made tremendous progress, meeting regularly to map out the integration process and demonstrating impressive collaboration. From a commercial standpoint, we will be working to integrate both teams so that we have one go-to-market strategy and one unified interface to the client. Clients are increasingly looking for a single integrated solution that brings all of the assets of the 2 companies together for episodic, chronic and complex care.

我們的集成團隊取得了巨大的進步，定期開會以規劃集成流程並展示了令人印象深刻的協作。從商業角度來看，我們將努力整合兩個團隊，以便我們擁有一個進入市場的策略和一個統一的客戶界面。客戶越來越多地尋找一個單一的集成解決方案，將兩家公司的所有資產結合在一起，以提供偶發性、慢性和復雜的護理。

We've seen tremendous interest from our clients around the world. And we've already successfully closed our first major cross-sale to GuideWell Health, the parent of Florida Blue. Florida Blue has been a long-time client of Teladoc Health, and we're extremely excited to expand that relationship and bring Livongo's platform to 50,000 of Florida Blue's members living with diabetes.

我們已經看到來自世界各地的客戶的極大興趣。我們已經成功完成了對佛羅里達藍的母公司 GuideWell Health 的第一次重大交叉銷售。 Florida Blue 一直是 Teladoc Health 的長期客戶，我們非常高興能夠擴大這種關係並將 Livongo 的平台帶給 Florida Blue 的 50,000 名患有糖尿病的成員。

To ensure an easily accessible pathway for the consumer, we will create a seamless user experience where all of the services are integrated into one experience, creating a single access point for all of the consumer's care needs. As we've gone through the planning process, we're encouraged to find that the high level of technological sophistication on both sides will make the integration even smoother than many of our prior acquisitions from a technology perspective. And the teams are actively working to map the APIs and create that unified consumer experience.

為了確保消費者能夠輕鬆訪問途徑，我們將創建無縫的用戶體驗，將所有服務集成到一個體驗中，為所有消費者的護理需求創建一個訪問點。當我們完成規劃過程時，我們很高興地發現，從技術角度來看，雙方的高水平技術將使整合比我們之前的許多收購更加順利。團隊正在積極努力映射 API 並創建統一的消費者體驗。

Our teams have also begun to plan the integration of the unmatched data sets and capabilities of our 2 organizations, combining the 750 million elements from the Livongo data set with the data generated by the 10 million-plus virtual visits we will provide this year. By applying the Livongo data science to this combined data set, we will be able to deliver a level of patient insight that has been previously unavailable. Combining meaningful, data-driven insights with clinical expertise will enable better care delivery, better outcomes and lower costs.

我們的團隊還開始計劃整合我們兩個組織無與倫比的數據集和能力，將 Livongo 數據集中的 7.5 億個元素與我們今年將提供的超過 1000 萬次虛擬訪問生成的數據相結合。通過將 Livongo 數據科學應用於這個組合數據集，我們將能夠提供以前無法獲得的患者洞察力。將有意義的、數據驅動的見解與臨床專業知識相結合，將能夠提供更好的護理、更好的結果和更低的成本。

As part of the new leadership structure announced earlier this month, we are also in the process of creating a new integrated research and development organization. We're incredibly excited to bring together the product innovation, data science, technological expertise and clinical excellence from across both companies under one roof. There's a tremendous talent pool in both organizations. And we're eager to continue investing in the development of innovative solutions to improve the lives of consumers and extend our leadership role in the virtual care marketplace.

作為本月早些時候宣布的新領導結構的一部分，我們還在創建一個新的綜合研發組織。我們非常高興能夠將兩家公司的產品創新、數據科學、技術專長和臨床卓越成果匯集在一個屋簷下。這兩個組織都有龐大的人才庫。我們渴望繼續投資於創新解決方案的開發，以改善消費者的生活並擴大我們在虛擬護理市場中的領導地位。

The similar mission-driven cultures and shared vision of the 2 organizations has become apparent through this process. And the more time our teams spend together, the clearer this has become. I was fortunate to spend some time with several of the Livongo commercial leaders last week. And although it was an outdoor socially distanced setting, I can say that the level of enthusiasm for what we are building together was palpable. In combining these 2 organizations, we are truly creating something entirely new while extending our position as the global leader in virtual care.

通過這個過程，兩個組織的相似的使命驅動文化和共同願景變得明顯。我們的團隊在一起的時間越多，這一點就越清晰。上週我有幸與 Livongo 的幾位商業領袖共度了一段時間。儘管這是一個與社會保持距離的戶外環境，但我可以說對我們正在共同建設的東西的熱情是顯而易見的。通過合併這兩個組織，我們真正創造了全新的東西，同時擴大了我們作為虛擬護理全球領導者的地位。

With that, I'll turn the call over to Mala for a review of third quarter financials as well as detailed 2020 guidance.

有了這個，我將把電話轉給馬拉，以審查第三季度的財務狀況以及詳細的 2020 年指導。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

During the third quarter, total revenue increased 109% to $289 million or approximately 90% on an organic basis. Global access fee revenue for the quarter of $227 million grew 90% versus the prior year, demonstrating continued momentum. Total international revenue of $32.9 million grew 20% versus the prior year.

第三季度，總收入增長 109% 至 2.89 億美元，有機增長約 90%。本季度全球訪問費收入為 2.27 億美元，較上年增長 90%，顯示出持續增長的勢頭。國際總收入為 3290 萬美元，比上年增長 20%。

The visit fee revenue for the quarter increased to $51 million, representing growth of 171% over the prior year. Visit fee revenue comprised 18% of consolidated revenue as compared to 14% of revenue in the prior year quarter. The increase in visit fee revenue as a percent of revenue is a result of the considerable increase in utilization realized year-to-date, offset in part by the inclusion of InTouch Health in our consolidated results.

本季度訪問費收入增至 5100 萬美元，比上年增長 171%。參觀費收入佔綜合收入的 18%，而去年同期為 14%。就診費收入佔收入的百分比增加是由於年初至今實現的利用率大幅增加，部分被我們合併結果中包含的 InTouch Health 所抵消。

Turning to membership and access. U.S. paid membership increased to 51.5 million members during the third quarter, an increase of 47% versus the third quarter of last year. Individuals with visit fee only access was 21.8 million at the end of the third quarter, an increase of 2.8 million versus the prior year. As previously discussed, visit fee only access includes approximately 2.5 million individuals on a temporary basis that we anticipate will roll off at the end of the year.

轉向會員資格和訪問權限。第三季度美國付費會員增加到 5150 萬，比去年第三季度增長 47%。截至第三季度末，僅付費訪問的個人為 2180 萬人，比上年增加 280 萬人。如前所述，僅訪問費的訪問包括大約 250 萬人的臨時訪問，我們預計這將在今年年底推出。

Total visit volume provided by Teladoc's own network of providers exceeded 2.8 million visits in the quarter, representing 206% growth versus the prior year. You will see a new operating metric in our press release, Platform-Enabled Session, which represents encounters facilitated by our licensed software platform and delivered by clients' own care providers. Total sessions enabled were 986,000 in the quarter, which is more than triple the number of consultations provided in the same period last year, pro forma for the acquisition of InTouch Health.

Teladoc 自己的供應商網絡提供的總訪問量在本季度超過 280 萬次，比上年增長 206%。您將在我們的新聞稿中看到一個新的運營指標，即平台啟用會話，它代表了由我們的許可軟件平台促成並由客戶自己的護理提供者提供的遭遇。本季度啟用的總會話數為 986,000 次，是去年同期為收購 InTouch Health 提供的諮詢數量的三倍多。

Visit volume from paid members in the U.S. grew 242% to over 2.1 million visits, which represents an annualized utilization rate of 16.5%, more than double the utilization rate of last year's third quarter and a 50 basis point increase sequentially. PMPM was $1.18 in the third quarter, up from $0.98 in the prior year quarter.

美國付費會員訪問量增長 242% 至超過 210 萬次，年化使用率為 16.5%，是去年第三季度使用率的兩倍多，環比增長 50 個基點。第三季度 PMPM 為 1.18 美元，高於去年同期的 0.98 美元。

Adjusted gross profit, adjusted to exclude amortization of intangibles, increased by $89 million to $184 million, an increase of 93% as compared to the prior year's third quarter. Adjusted gross margin was 63.7% compared to 69% in the third quarter of 2019 and 62.3% in the second quarter of 2020. The year-over-year decline in gross margin is attributable to the robust visit growth and increase in visit fee revenue mix versus the prior year.

調整後毛利潤（不包括無形資產攤銷）增加 8900 萬美元至 1.84 億美元，與去年第三季度相比增長 93%。調整後毛利率為 63.7%，而 2019 年第三季度和 2020 年第二季度分別為 69% 和 62.3%。毛利率同比下降的原因是訪問量強勁增長和訪問費收入組合增加與上一年相比。

Operating expense for the quarter totaled $203.8 million or 70.6% of revenue compared to 83.4% in the third quarter of 2019. Excluding noncash charges such as depreciation and amortization, stock-based compensation and onetime acquisition and integration-related expenses, quarterly adjusted operating expenses were $145 million or 50.1% of revenue compared to 62.4% in the third quarter of last year.

本季度的運營費用總計 2.038 億美元，佔收入的 70.6%，而 2019 年第三季度為 83.4%。不包括折舊和攤銷、股票補償以及一次性收購和整合相關費用等非現金費用，季度調整後的運營費用為 1.45 億美元，佔收入的 50.1%，而去年第三季度為 62.4%。

Contributing to the operating expense outperformance in this quarter was lower-than-anticipated advertising and marketing expense as some engagement campaign spending began later in the quarter than previously planned. As discussed in the past, we seek to optimize advertising and marketing channel spending to maximize the value of our investment in membership engagement.

本季度運營費用表現出色的原因是廣告和營銷費用低於預期，因為一些參與活動的支出在本季度晚些時候開始，比之前計劃的要晚。正如過去所討論的，我們尋求優化廣告和營銷渠道支出，以最大限度地提高我們在會員參與方面的投資價值。

As a result, some engagement spending that is expected to take place at the end of the third quarter was actually deployed early in the fourth quarter, contributing to lower A&M expense in Q3. As a result, we expect to see a sequential increase in reported A&M spend in the fourth quarter. As we have consistently said in the past, we expect A&M expense growth to approximate revenue growth, and we continue to expect that to be the case for the full year 2020.

因此，預計將在第三季度末進行的一些參與支出實際上在第四季度初進行了部署，從而降低了第三季度的 A&M 費用。因此，我們預計第四季度報告的 A&M 支出將連續增加。正如我們過去一直所說的那樣，我們預計 A&M 費用增長將接近收入增長，我們繼續預計 2020 年全年都會如此。

Adjusted EBITDA increased to $39.5 million in the quarter compared to $9 million in the third quarter of 2019. Third quarter adjusted EBITDA margin of 13.7% increased by over 700 basis points year-over-year. As noted above, the significant adjusted EBITDA outperformance in the quarter was in part driven by the timing of advertising and marketing activities between the third and fourth quarters.

本季度調整後 EBITDA 增至 3950 萬美元，而 2019 年第三季度為 900 萬美元。第三季度調整後 EBITDA 利潤率為 13.7%，同比增長 700 多個基點。如上所述，本季度顯著的調整後 EBITDA 表現部分是由於第三季度和第四季度之間的廣告和營銷活動的時間安排所致。

Net loss in the quarter was $35.9 million compared to a net loss of $20.3 million in the third quarter of 2019. Excluding $16 million of transaction costs related to the pending Livongo merger, net loss was $19.9 million for the third quarter. On a per share basis, net loss was $0.43 for the third quarter compared to a loss of $0.28 in the third quarter of last year. Excluding transaction costs of $0.19 per share related to the pending Livongo merger, net loss per share was $0.24.

本季度的淨虧損為 3590 萬美元，而 2019 年第三季度的淨虧損為 2030 萬美元。不包括與即將進行的 Livongo 合併相關的 1600 萬美元的交易成本，第三季度的淨虧損為 1990 萬美元。按每股計算，第三季度淨虧損為 0.43 美元，而去年第三季度為虧損 0.28 美元。不包括與即將進行的 Livongo 合併相關的每股 0.19 美元的交易成本，每股淨虧損為 0.24 美元。

We ended the quarter with $1.2 billion in cash and short-term investments, while our total debt outstanding as of September 30 was $1.3 billion.

本季度末，我們擁有 12 億美元的現金和短期投資，而截至 9 月 30 日，我們的未償債務總額為 13 億美元。

Now turning to forward guidance. Note that until the Livongo transaction closes later this quarter, all guidance represents expected stand-alone Teladoc Health results. For the fourth quarter of 2020, we expect total revenue of $294 million to $304 million, representing growth of 88% to 94% over the prior year quarter. We expect total paid membership of 50 million to 51 million, which is net of the approximately 1.5 million temporary members we have discussed in prior quarters. We anticipate total visits during the fourth quarter of between 2.8 million and 3 million visits. We expect fourth quarter adjusted EBITDA to be in the range of $21 million to $24 million and net loss per share, excluding Livongo transaction-related costs, to be between $0.36 and $0.33 based on 84.4 million shares outstanding.

現在轉向前向指導。請注意，在本季度晚些時候完成 Livongo 交易之前，所有指導均代表預期的獨立 Teladoc Health 結果。對於 2020 年第四季度，我們預計總收入為 2.94 億美元至 3.04 億美元，比去年同期增長 88% 至 94%。我們預計付費會員總數為 5000 萬至 5100 萬，這是我們在前幾個季度討論的約 150 萬臨時會員的淨值。我們預計第四季度的總訪問量在 280 萬到 300 萬之間。我們預計第四季度調整後的 EBITDA 將在 2100 萬美元至 2400 萬美元之間，每股淨虧損（不包括 Livongo 交易相關成本）將在 0.36 美元至 0.33 美元之間，基於 8440 萬股流通股。

For the full year 2020, we now expect revenue to be in the range of $1.005 billion to $1.015 billion, up from our prior $980 million to $995 million range, representing 82% to 83% growth over the prior year. We expect total visits to be between 10.4 million and 10.6 million visits, representing total visit growth of approximately 151% to 156% over the prior year. We expect adjusted EBITDA to be in the range of $97 million to $100 million, up from our prior $85 million to $92 million range, representing growth of over 200% as compared to 2019. Net loss per share, excluding transaction costs related to the pending Livongo merger, is expected to range from a loss of $1.36 to $1.32 per share based on 79.4 million weighted shares outstanding. We expect cash flow from operations to grow consistent with our adjusted EBITDA growth.

對於 2020 年全年，我們現在預計收入將在 10.05 億美元至 10.15 億美元之間，高於我們之前的 9.8 億美元至 9.95 億美元範圍，比上一年增長 82% 至 83%。我們預計總訪問量將在 1040 萬至 1060 萬之間，總訪問量比去年增長約 151% 至 156%。我們預計調整後的 EBITDA 將在 9700 萬美元至 1 億美元之間，高於我們之前的 8500 萬美元至 9200 萬美元的範圍，與 2019 年相比增長超過 200%。每股淨虧損，不包括與未決交易相關的交易成本基於 7940 萬股已發行加權股票，Livongo 合併預計每股虧損 1.36 美元至 1.32 美元不等。我們預計運營現金流的增長將與我們調整後的 EBITDA 增長保持一致。

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

有了這個，我將把電話轉回傑森的閉幕詞。

Thanks, Mala.

謝謝，馬拉。

I'm incredibly excited about the opportunities that lie ahead of us. The pipeline for new opportunities has never been more robust. And as we continue to differentiate our offering with innovative products and services, the value proposition we provide to the marketplace is only getting stronger. Together with Livongo, we will create an unmatched combination of scale and insights, driving improved outcomes, lower costs and a better consumer experience to meet the growing needs of clients and consumers all around the world.

我對擺在我們面前的機會感到無比興奮。新機會的管道從未如此強大。隨著我們繼續通過創新產品和服務來區分我們的產品，我們向市場提供的價值主張只會越來越強大。與 Livongo 一起，我們將創造無與倫比的規模和洞察力組合，推動改善成果、降低成本和更好的消費者體驗，以滿足全球客戶和消費者不斷增長的需求。

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

一如既往，感謝您對 Teladoc Health 故事的持續關注。有了這個，我們將打開問題的電話。操作員？

(Operator Instructions) Our first question comes from the line of Lisa Gill with JPMorgan.

（操作員說明）我們的第一個問題來自摩根大通的 Lisa Gill。

Jason, can you hear me okay?

傑森，你能聽到我的聲音嗎？

Yes, Lisa.

是的，麗莎。

Congratulations on another great quarter. I just want to focus on just a couple of things. I know it's early to give us any numbers around 2021. But as we think about a few things, one, unemployment trends as we go into the back half of the year; two, the selling season for 2021, just curious as to how you're seeing things. Do we need to wait? Are people signing up for a start date of 01/01/21? Are you continuing to just see it kind of flow throughout the quarters would be my first question.

祝賀另一個偉大的季度。我只想專注於幾件事。我知道現在給我們提供 2021 年左右的任何數字還為時過早。但是當我們考慮一些事情時，第一，進入下半年的失業趨勢；二，2021年的銷售旺季，只是好奇你是怎麼看的。我們需要等待嗎？人們是否註冊了 01/01/21 的開始日期？你是否繼續看到它在整個季度的流動將是我的第一個問題。

And then secondly, you've said several times that there's a robust pipeline of new opportunities. Is there any way to maybe quantify that in any way? I know you've talked in the past of only a 25% overlap between your customer and the Livongo customer base. But any kind of number that you could put around that and the time line of those opportunities?

其次，您已經多次說過，新機會的強大渠道。有沒有辦法以任何方式量化它？我知道您過去曾談到您的客戶和 Livongo 客戶群之間只有 25% 的重疊。但是，您可以提出任何數字以及這些機會的時間線？

Sure. Thanks, Lisa, appreciate your comments and question. And before I start, apologies to everyone for the technical difficulties at the beginning of the call. We weren't trying to keep you in suspense, and we're happy to get into it.

當然。謝謝，麗莎，感謝您的評論和問題。在我開始之前，對大家在通話開始時遇到的技術困難表示歉意。我們並沒有試圖讓你保持懸念，我們很高興參與其中。

So first of all, with respect to 2021, as you've heard us say, we feel comfortable organically in the 30% to 40% range. And we've been -- I think we've been disclosing a lot through the process relative to the Livongo transaction. And so I think together, we feel very strongly about the growth prospects in front of us.

因此，首先，就 2021 年而言，正如您聽到我們所說的，我們在 30% 到 40% 的範圍內有機地感到舒適。而且我們一直 - 我認為我們已經通過與 Livongo 交易相關的流程披露了很多信息。所以我認為，我們一起對我們面前的增長前景感到非常強烈。

Just as we were getting on the call, I actually got a note about another successful Livongo cross-sell to a large Teladoc employer client. And I think the market demand and the traction that we're getting incredibly strongly and early is very encouraging to me.

就在我們接電話的時候，我實際上收到了一份關於 Livongo 另一個成功的交叉銷售給 Teladoc 大型雇主客戶的記錄。而且我認為市場需求和我們在早期獲得的非常強勁的牽引力對我來說非常鼓舞人心。

When we look at our pipeline, we would actually say we expect at this point for our bookings in the fourth quarter to be at least 2x what they were in the third quarter based on what we've already closed and what's in the late stages of the pipeline. So again, that gives us tremendous confidence in our '21 outlook.

當我們查看我們的管道時，我們實際上會說，根據我們已經關閉的和處於後期階段的情況，我們預計第四季度的預訂量至少是第三季度的 2 倍管道。因此，這再次使我們對 21 年的前景充滿信心。

The selling season continues to be robust. We see both first quarter starts as well as starts that we're already talking about over the course of the year for expansion opportunities with clients. And then lastly, I would say that, that is true across all of the channels that we have, both domestically among employers and health plans as well as among hospitals and health systems and internationally. And that's true sort of across all of our various channels.

銷售旺季繼續強勁。我們看到第一季度的開始以及我們在一年中已經在談論的與客戶擴展機會的開始。最後，我想說的是，在我們擁有的所有渠道中都是如此，無論是在國內的雇主和健康計劃之間，還是在醫院和衛生系統之間以及國際之間。這在我們所有的各種渠道中都是真實的。

You asked about unemployment. We had modeled in some conservatism in the beginning of the year for unemployment in the back half, and we haven't seen that impact our numbers in any large degree. So we continue to monitor that closely. And we also benefit from the fact that many people who end up rolling off the employed ranks get COBRA coverage. And along with their COBRA coverage, they get Teladoc as a benefit. So I would say that the impact of that on us is pretty dampened relative to others.

你問的是失業問題。我們在今年年初對下半年的失業率進行了一些保守主義建模，我們還沒有看到這在很大程度上影響了我們的數據。因此，我們將繼續密切關注這一點。我們還受益於許多最終退出就業隊伍的人獲得了 COBRA 保險。除了他們的 COBRA 覆蓋範圍外，他們還獲得 Teladoc 作為好處。所以我想說，與其他人相比，這對我們的影響相當小。

Our next question comes from the line of Sean Wieland with Piper Sandler.

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

Jason, you called out that your B2B derm and behavioral business was up 500%. And I was just hoping you could unpack that a little bit. Was that organic within InTouch or were there revenue synergies there? And what does a typical workflow look like there, in particular, with B2B derm?

Jason，你說你的 B2B 皮膚和行為業務增長了 500%。我只是希望你能把它拆開一點。 InTouch 內部是有機的還是存在收入協同效應？那裡的典型工作流程是什麼樣的，尤其是 B2B 真皮？

Yes. Sean, I appreciate the question. When I was talking about B2B derm and behavioral health, that means through our B2B channels where we're selling into a health plan or an employer. And so that's entirely through the health plan and employer channel, not really through the InTouch or hospital and health systems channel.

是的。肖恩，我很欣賞這個問題。當我談論 B2B 皮膚和行為健康時，這意味著通過我們的 B2B 渠道，我們向健康計劃或雇主推銷。所以這完全是通過健康計劃和雇主渠道，而不是真正通過 InTouch 或醫院和衛生系統渠道。

And I think it really points to what we're seeing across the board, which is multiproduct sales. So at this point, 2/3 of our sales are multiproduct, and that frequently includes both behavioral health and dermatology alongside our general medical services. And that's an exciting opportunity for us because it takes us that much further toward whole-person care, which is really augmented by the addition of the Livongo portfolio.

我認為這確實表明了我們全面看到的情況，即多產品銷售。所以在這一點上，我們 2/3 的銷售額是多產品的，這通常包括行為健康和皮膚科以及我們的一般醫療服務。這對我們來說是一個令人興奮的機會，因為它讓我們更進一步地實現了全人護理，而 Livongo 產品組合的加入確實增強了這一點。

So it bodes very well for us as we start to do that cross-selling that I just talked about. And we now have a large health plan and a large employer who have already adopted the Livongo product line.

因此，當我們開始進行我剛才談到的交叉銷售時，這對我們來說是個好兆頭。我們現在有一個大型健康計劃和一個已經採用 Livongo 產品線的大型雇主。

Your next question comes from the line of Richard Close of Canaccord Genuity.

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

Great. Congratulations. Mala, I was wondering if you could just help us with respect to the fourth quarter adjusted EBITDA margins, implied margins there. Is the sequential step-down from the third quarter just a function of that marketing spend that you highlighted in your comments?

偉大的。恭喜。馬拉，我想知道您是否可以就第四季度調整後的 EBITDA 利潤率（那裡的隱含利潤率）幫助我們。第三季度的連續降級僅僅是您在評論中強調的營銷支出的一個功能嗎？

Yes. Thank you, Richard. Here's how I would think about the adjusted EBITDA and adjusted EBITDA margin. Think of it as the third quarter and the fourth quarter combined, so think of it as second half. And as you saw relative to the earlier guidance we had given in July, at the end of July, we have taken up our adjusted EBITDA, expected adjusted EBITDA outlook by roughly about $10 million, right?

是的。謝謝你，理查德。以下是我對調整後 EBITDA 和調整後 EBITDA 利潤率的看法。將其視為第三季度和第四季度的總和，因此將其視為下半年。正如你所看到的，相對於我們在 7 月底給出的早期指導，我們在 7 月底採用了調整後的 EBITDA，預計調整後的 EBITDA 前景約為 1000 萬美元，對吧？

And the way I would unpack it is as follows. As we've talked about in our prepared remarks, there is a timing shift versus what we had earlier thought about from an advertising and marketing perspective. It was the right thing to do based on the returns we were seeing. So we were very judicious about how we spend A&M.

我打開它的方式如下。正如我們在準備好的評論中所討論的那樣，與我們之前從廣告和營銷的角度所考慮的相比，存在時間上的轉變。根據我們看到的回報，這是正確的做法。因此，我們對如何使用 A&M 非常明智。

The other thing I would also say is, we are looking to lean into our investments in the fourth quarter on things such as R&D, in InTouch. There are investments that we have wanted to make and we are making in the fourth quarter. So it's really about leaning into our investments in the fourth quarter, such that we execute on the momentum that we see in the business and get a quick start for next year. So that's really how I would think about sort of our adjusted EBITDA, the third and the fourth quarter combined. And the A&M shift from the third to the fourth quarter, think about it in the $4 million to $5 million range.

我還要說的另一件事是，我們希望在第四季度對 InTouch 的研發等方面進行投資。我們想要進行一些投資，我們正在第四季度進行。因此，這實際上是關於我們在第四季度的投資，這樣我們就可以利用我們在業務中看到的勢頭並在明年快速開始。所以這就是我對第三季度和第四季度調整後 EBITDA 的看法。 A&M 從第三季度到第四季度的轉變，考慮在 400 萬美元到 500 萬美元之間。

And our next question comes from the line of Stephanie Davis of SVB Leerink.

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

Guys, congrats on a good quarter.

伙計們，祝賀一個好季度。

Thanks, Stephanie.

謝謝，斯蒂芬妮。

So utilization surprised us the most this quarter, and that only moderated a touch sequentially despite a pretty sharp mix shift in the broader environment toward in-person versus virtual care. Could you walk us through the puts and takes that are driving this, such as maturation of new members from the prior year or anything else that's keeping it so strong?

因此，本季度的利用率最讓我們感到驚訝，儘管在更廣泛的環境中向面對面護理與虛擬護理的混合轉變相當劇烈，但這種情況僅在環比上有所緩和。您能否帶我們了解推動這一趨勢的因素，例如前一年新成員的成熟度或其他任何使其保持如此強勁的因素？

Yes. I think there are a few things there, and I appreciate that observation. We did see in many parts of the country office visits return to near-normal levels. And at the same time, you're seeing people access Teladoc for a broader array of clinical services.

是的。我認為那裡有一些東西，我很欣賞這種觀察。我們確實在國家辦事處的許多地方看到訪問量恢復到接近正常水平。同時，您會看到人們訪問 Teladoc 以獲得更廣泛的臨床服務。

So as we mentioned, about 55% of our general medical visits were for noninfectious diseases. So there's a moderating of overall infectious disease in the market by about 25% according to the CDC, and yet our volume was up substantially. And so what we're seeing there is that our multiproduct and broad clinical array of services strategy is paying dividends. It's providing more services and more capabilities for consumers. The awareness increase of virtual care overall is bringing more people to our front door, and I think that's evident by the increase in new registrations of roughly 80%.

正如我們所提到的，我們大約 55% 的一般醫療就診是針對非傳染性疾病。因此，根據 CDC 的數據，市場上的整體傳染病下降了約 25%，但我們的數量卻大幅增加。因此，我們看到的是，我們的多產品和廣泛的臨床服務戰略正在帶來回報。它正在為消費者提供更多服務和更多功能。總體而言，虛擬護理意識的提高正在將更多的人帶到我們的前門，我認為這一點可以從大約 80% 的新註冊增加中得到證明。

And then the last part I would say is that we are seeing just tremendous increase in visit volume for other specialties. So both noninfectious diseases, the role of virtual care, other specialties and the fact that we're seeing new people come to our front door, all work to offset the overall market decline in infectious disease. So just sort of the last punctuation mark I'll put there is, if you then play it forward a year to where we have a more normal infectious disease cycle, I think you'll continue to see those overall utilization rates increase.

然後我要說的最後一部分是，我們看到其他專業的訪問量急劇增加。因此，非傳染性疾病、虛擬護理的作用、其他專業以及我們看到新人來到我們家門口的事實，都在努力抵消傳染病市場的整體下滑。所以我要說的最後一個標點符號是，如果你把它向前一年，我們有一個更正常的傳染病週期，我認為你會繼續看到這些總體利用率增加。

And your next question comes from Ryan S. Daniels of William Blair.

您的下一個問題來自 William Blair 的 Ryan S. Daniels。

Jason, a twofold strategic question for you. I'm curious with the integrated offering that you're going to go to market with Livongo, if that gives your payer partners an opportunity to effectively launch an entirely new type of insurance offering to consumers, maybe at a lower cost, virtual digital front door? And if so, second question is, do you think that will eventually open up the opportunity for expansions within the payer client base to offer that or maybe even market share gains with some of the bigger payers you're not working with?

傑森，給你一個雙重戰略問題。我對您將與 Livongo 一起進入市場的集成產品感到好奇，如果這讓您的付款合作夥伴有機會有效地向消費者推出一種全新的保險產品，也許成本更低，虛擬數字前沿門？如果是這樣，第二個問題是，您是否認為這最終會為付款人客戶群的擴張打開機會，從而為您未與之合作的一些較大的付款人提供這種或什至是市場份額的收益？

Yes. Thanks, Ryan. It's a really good question. And the short answer is yes. We're already talking with our large payer clients and large employers about what we talk about as virtual primary care, which is the full credit whole-person answer that is a virtual solution that brings the entire breadth of our products and services to bear. And we're talking about doing that and wrapping a new benefit design, a new insurance product around that, that really changes the benefits, incents the usage of that virtual first and sort of holistic virtual capability set.

是的。謝謝，瑞恩。這是一個非常好的問題。簡短的回答是肯定的。我們已經在與我們的大型付款客戶和大型雇主討論我們所說的虛擬初級保健，這是一個全信用的全人答案，它是一種虛擬解決方案，可以讓我們的整個產品和服務得到支持。我們正在談論這樣做並包裝一個新的福利設計，一個新的保險產品，真正改變福利，激勵虛擬優先和整體虛擬能力集的使用。

And I think that gives the health plans who embrace it a competitive advantage to deliver better care and a better consumer experience at a lower price. And it gives us the opportunity to share in the upside that we create, the savings that we create, the better outcomes that we create, the better Star Ratings and HEDIS metrics that we can drive.

而且我認為這為接受它的健康計劃提供了競爭優勢，以更低的價格提供更好的護理和更好的消費者體驗。它讓我們有機會分享我們創造的好處、我們創造的節省、我們創造的更好的結果、更好的星級評級和我們可以推動的 HEDIS 指標。

And we're seeing those results already in our virtual primary care pilots, where we are seeing a very broad array of clinical diagnoses, over 70 clinical diagnoses. A lot of those are for things that we have solutions for, things like obesity and hypertension, diabetes, anxiety, depression; and a shocking, for me, number of initial first diagnoses of some of those chronic conditions like hypertension and diabetes or pre-diabetes. So the opportunity for us to take care of the whole person with our complete set of services does open up those new opportunities.

我們已經在我們的虛擬初級保健試點中看到了這些結果，我們看到了非常廣泛的臨床診斷，超過 70 種臨床診斷。其中很多是針對我們有解決方案的事情，比如肥胖和高血壓、糖尿病、焦慮、抑鬱；對我來說，對一些慢性病（如高血壓、糖尿病或糖尿病前期）的初步診斷數量令人震驚。因此，我們有機會通過我們的全套服務來照顧整個人，這確實開闢了這些新機會。

Your next question comes from the line of Charles Rhyee of Cowen.

您的下一個問題來自 Cowen 的 Charles Rhyee。

Congrats on the quarter. Jason and Mala, obviously, a strong quarter, and I think you touched on it earlier about sort of the dynamics that propelled still a very strong quarter. In the third quarter, when we saw some of the metrics externally, looks like there was some pullback from the peak.

祝賀本季度。 Jason 和 Mala 顯然是一個強勁的季度，我認為您之前已經談到了推動仍然非常強勁的季度的動力。在第三季度，當我們從外部看到一些指標時，似乎從峰值出現了一些回落。

When we look at the fourth quarter guide, Mala, maybe you can help us unpack a little bit some of the assumptions going into the fourth quarter. When you look at it, it looks sequentially flat to slightly up when seasonally you would think fourth quarter is a strong quarter for health care services in general. Can you maybe help us understand a little bit on the underlying assumptions? I know previously you guys did not assume a second wave in terms of COVID. Maybe give us your thoughts on sort of what goes into that.

當我們查看第四季度指南時，Mala，也許你可以幫助我們解開一些關於第四季度的假設。當您查看它時，當您認為第四季度總體上是醫療保健服務的強勁季度時，它看起來依次持平到略微上升。您能否幫助我們了解一些基本假設？我以前知道你們並沒有假設第二波COVID。也許給我們你的想法是什麼。

And then you've given us this affiliated platform visits kind of number going forward. Could we expect maybe as you integrate InTouch more, given that it's more of a provider-focused business, that you'll break that out separately on the subscription line as well or how can we think about modeling that going forward?

然後你給了我們這個附屬平台的訪問量。我們是否可以期待隨著您更多地集成 InTouch，因為它更多地是以提供商為中心的業務，您也會在訂閱線上單獨打破它，或者我們如何考慮未來的建模？

Yes. So great question, Charles. Let me address them as follows. So on your second question around InTouch and HHS, as we talked about in our prepared remarks, we have talked about the Platform-Enabled Session. One of the reasons we provided that metric is that it is a great proxy for the engagement that our clients have with the platform. And we believe that, that is the engagement that drives value for our clients. So that is definitely something that we think will, as this business continues with the strong momentum it is showing, it will outpace revenue growth, but it is something that we think will really fuel the continued expansion of the business.

是的。很好的問題，查爾斯。讓我按如下方式解決它們。所以關於你關於 InTouch 和 HHS 的第二個問題，正如我們在準備好的評論中談到的那樣，我們已經談到了支持平台的會議。我們提供該指標的原因之一是它可以很好地代表我們的客戶對平台的參與度。我們相信，這就是為我們的客戶帶來價值的參與。因此，這絕對是我們認為會發生的事情，隨著這項業務繼續呈現出強勁的勢頭，它將超過收入增長，但我們認為這將真正推動業務的持續擴張。

In all candor, we have looked at other metrics. You talked about providers. We have looked internally at other metrics. Remember, we are still in the process of integrating our ERP systems, our CRM systems. So what I would say is, look for us as we continue on to next year to provide transparency on other metrics in the hospital and health systems business that we think will give clarity on the true underlying momentum of the business. The Platform-Enabled Session is a great start.

坦率地說，我們已經研究了其他指標。你談到了供應商。我們已經在內部查看了其他指標。請記住，我們仍在整合我們的 ERP 系統和 CRM 系統。所以我想說的是，在我們繼續到明年的時候，尋找我們為醫院和衛生系統業務的其他指標提供透明度，我們認為這將明確業務的真正潛在動力。啟用平台的會話是一個很好的開始。

At this point in time, we don't plan to break out the revenue for the HHS business beyond what has already been provided. As you saw in the results we put forth, we have broken out one piece of business in our revenue, the other revenue, which actually shows the hardware revenue, both purchased and leased. That is separate, broken out separately. But at this point in time, we don't plan to do any further breakouts. We'll just provide more transparency on the operating metrics of the business.

目前，我們不打算將 HHS 業務的收入超出已經提供的範圍。正如您在我們提出的結果中看到的那樣，我們在收入中細分了一項業務，另一項收入實際上顯示了購買和租賃的硬件收入。那是分開的，分開的。但在這個時間點，我們不打算做任何進一步的突破。我們只會提供更多關於業務運營指標的透明度。

On your other question in terms of the assumptions, here's what I would say. First of all, you saw in our results a continuation of the very broad momentum that we are seeing across our business, right? So it is across all channels, whether it be on the commercial side, whether it be on our D2C side or whether it be on our HHS side. We are seeing broad momentum across the business, and that is translating into the strength you're seeing in year-over-year growth on access revenue as well as visit revenue.

關於假設方面的另一個問題，這就是我要說的。首先，您在我們的業績中看到了我們在整個業務中看到的非常廣泛的勢頭的延續，對嗎？所以它跨越所有渠道，無論是在商業方面，無論是在我們的 D2C 方面還是在我們的 HHS 方面。我們在整個業務中看到了廣泛的勢頭，這正在轉化為您在訪問收入和訪問收入方面看到的同比增長的實力。

In terms of the fourth quarter guide, the way we have modeled it and thought about it is, we are looking at the robustness of the pipeline we have. We are looking at from a visit perspective. We are expecting a relatively weak flu season. The shelter-in-place and the use of PPE have been factored into our forecast. I would not expect to see an incremental upside versus what we have guided on from a second COVID surge. We have factored in all of those into our guide. And I would also say, in terms of the adjusted EBITDA margin, as I've said in my prior remarks, we have reflected the fact that we really do want to invest and lean in into our investments ahead of the strong momentum we expect in our outlook for next year, as we've already shared in terms of the 30% to 40% on an organic basis.

就第四季度指南而言，我們對其建模和思考的方式是，我們正在研究我們擁有的管道的穩健性。我們從訪問的角度來看。我們預計流感季節相對較弱。我們的預測已將就地避難所和個人防護裝備的使用考慮在內。與我們從第二次 COVID 激增所引導的情況相比，我不希望看到增加的上行空間。我們已將所有這些因素納入我們的指南。我還要說，就調整後的 EBITDA 利潤率而言，正如我在之前的講話中所說，我們已經反映了這樣一個事實，即我們確實希望在我們預期的強勁勢頭之前進行投資並投入到我們的投資中。我們對明年的展望，因為我們已經在有機基礎上分享了 30% 到 40% 的比例。

And your next question comes from the line of Jailendra Singh of Crédit Suisse.

您的下一個問題來自瑞士信貸的 Jailendra Singh。

So CMS update in late September pointed out that over 94% of Medicare Advantage plans will offer telehealth benefit next year versus like 58% this year. Jason, you have talked about telehealth rollout by Medicare Advantage plans being like more 3-year phenomena. So this seems to be trending better than those expectations. Do you agree with that? And the second, if you can provide any update on Teladoc success with MA plans for 2021 for telehealth benefit.

因此 CMS 在 9 月底的更新指出，超過 94% 的 Medicare Advantage 計劃將在明年提供遠程醫療福利，而今年這一比例為 58%。 Jason，您曾談到 Medicare Advantage 計劃推出的遠程醫療更像是 3 年的現象。因此，這似乎比那些預期要好。你同意嗎？其次，如果您可以提供有關 Teladoc 成功的任何更新，以及 2021 年遠程醫療福利的 MA 計劃。

Yes. What I can tell you, Jailendra, is that we're seeing quite a bit of interest from all of the government programs at this point, both managed Medicaid as well as Medicare Advantage. We're up over 2.5 million Medicare Advantage members at this point, which is about 1 million more than the -- I think the last time we gave you a number.

是的。 Jailendra，我可以告訴你的是，我們現在看到所有政府計劃都對我們很感興趣，包括管理的 Medicaid 和 Medicare Advantage。目前，我們的 Medicare Advantage 會員人數超過 250 萬，這比上次我們給你的數字多出大約 100 萬。

I'm not going to give an outlook for 2021 at this point. I think the adoption continues to be strong. And I think with the Livongo set of capabilities and the prevalence of hypertension, diabetes, pre-diabetes among the MA population, that's going to make our products and services that much more attractive. And we're working on a set of additional capabilities that, I think, will increase the value of our overall portfolio to MA plans. So I feel good about the progress we're making there, and I think that, that will continue through '21 and beyond.

在這一點上，我不打算給出 2021 年的展望。我認為採用率仍然很高。而且我認為，憑藉 Livongo 的一系列功能以及 MA 人群中高血壓、糖尿病、糖尿病前期的普遍性，這將使我們的產品和服務更具吸引力。我們正在開發一組附加功能，我認為這些功能將增加我們整體產品組合對 MA 計劃的價值。所以我對我們在那裡取得的進展感覺很好，我認為這將持續到 21 年及以後。

And your next question comes from the line of Daniel Grosslight of Citibank.

您的下一個問題來自花旗銀行的 Daniel Grosslight。

Congrats on the continued momentum here. We've seen some payers still waiving cost shares for telehealth while others have reverted to the pre-pandemic benefit design. For what it's worth, I still check in every week with my insurer to make sure they're still waiving cost share, and they are. But I was just curious, of your commercial book, both for those who are getting Teladoc through their employer as a carve-out or through their insurer, do you have a number of what percent of your clients are still waiving the cost share?

祝賀這裡的持續勢頭。我們已經看到一些付款人仍在放棄遠程醫療的費用分攤，而另一些人則恢復了大流行前的福利設計。對於它的價值，我仍然每週與我的保險公司核對，以確保他們仍然放棄成本分攤，而且他們是。但我只是好奇，你的商業書籍，無論是對於那些通過雇主作為剝離或通過他們的保險公司獲得 Teladoc 的人，你有多少百分比的客戶仍在放棄成本分攤？

Well, Daniel, I appreciate you're checking in with your payer, and I would suggest you continue to do that and encourage them to continue their 0 co-pay. We haven't disclosed what percentage of our payers. What I can tell you is, it's a mix. Among our payers who make the decisions for themselves, there are some who have returned to charging a co-pay for virtual care services. There are others who have extended through the end of the year.

好吧，Daniel，我很感謝您與付款人聯繫，我建議您繼續這樣做並鼓勵他們繼續支付 0 共付額。我們還沒有透露我們的付款人的百分比。我可以告訴你的是，這是一個混合體。在我們為自己做出決定的付款人中，有些人已經重新開始為虛擬護理服務收取自付費用。還有其他人延長到今年年底。

And then among the employers, we're seeing the employers, the large self-insured employers who are making those benefit decisions for themselves really stick with that 0 co-pay. And we expect them to stay with that at least through the end of the year, if not beyond.

然後在雇主中，我們看到雇主，那些為自己做出這些福利決定的大型自我保險雇主真的堅持 0 共付額。我們希望他們至少能堅持到今年年底，如果不是更久的話。

And our next question is from the line of George Hill of Deutsche Bank.

我們的下一個問題來自德意志銀行的喬治希爾。

Jason, I've got a question for you on how you think about market share. If we look at the almost 52 million members where you guys ended the quarter, and we kind of put your 30% growth number on it for 2021, that will put you, call it, 62 million to 67 million members, which is like 40% of people with employer-sponsored coverage, a little close to 30% of people if we include everybody with risk-based coverage, probably in the low 20s if we include Medicare Advantage. So I guess how do you guys think about your market share? And kind of what is the right way to think about Teladoc's market share and how you guys approach what share of the market you guys want to have on a normalized basis?

傑森，我有一個問題要問你，關於你如何看待市場份額。如果我們看看你們在本季度結束時的近 5200 萬會員，我們將你們 30% 的增長數字放在 2021 年，這將使你們，稱之為，6200 萬到 6700 萬會員，這就像 40擁有雇主贊助保險的人的百分比，如果我們將每個人都包括在基於風險的保險範圍內，則接近 30% 的人，如果我們包括 Medicare Advantage，可能在 20 多歲以下。所以我想你們如何看待你們的市場份額？什麼是思考 Teladoc 市場份額的正確方法，以及你們如何在標準化的基礎上接近你們想要擁有的市場份額？

Yes. So George, first, I guess I want to just start by saying, we've given some outlooks relative to revenue growth. We've given outlooks relative to sort of margin expansion. But we haven't given, at least to my knowledge, outlooks in terms of annual membership growth. So I want to not jump to what our '21 membership will be until we give guidance, which will probably be in February-ish.

是的。所以喬治，首先，我想我想說的是，我們已經給出了一些與收入增長相關的展望。我們給出了與利潤率擴張相關的展望。但至少據我所知，我們還沒有給出年度會員增長的前景。因此，在我們提供指導之前，我不想跳到我們的 21 會員資格，這可能會在 2 月左右。

With respect to our market share, we think about market share in sort of a few different dimensions. First of all, we're looking at multiple different channels, right, whether it's employers or health plans, whether it's hospitals and health systems domestically and internationally. And of course, we're selling direct-to-consumer. It's also for different products. So we have such a diverse product line.

關於我們的市場份額，我們從幾個不同的維度考慮市場份額。首先，我們正在研究多種不同的渠道，無論是雇主還是健康計劃，無論是國內還是國際的醫院和衛生系統。當然，我們是直接面向消費者銷售的。它也適用於不同的產品。所以我們有如此多樣化的產品線。

And we still have, as we look at our greenfield opportunity just among our existing clients, there is north of 70 million people who are still what we would call white space among our existing clients. So tremendous opportunity for continued growth domestically among those populations. And every year, we sell more products and services into those populations, as I mentioned, with our multiproduct bookings, with now the opportunity to bring the Livongo product set to bear. So it's a bit of a complicated question because, of course, the last dimension is what share of visits are we getting. And of course, we generate additional revenue from both new members as well as additional incremental visits.

而且我們仍然有，當我們在現有客戶中查看我們的綠地機會時，在現有客戶中仍有超過 7000 萬人仍然是我們所說的空白空間。這些人口在國內持續增長的巨大機會。正如我所提到的，我們每年都會通過我們的多產品預訂向這些人群銷售更多的產品和服務，現在有機會推出 Livongo 產品。所以這是一個有點複雜的問題，因為當然，最後一個維度是我們獲得的訪問量份額。當然，我們從新成員和額外的增量訪問中產生了額外的收入。

And our next question comes from the line of Matthew Gillmor of Baird.

我們的下一個問題來自 Baird 的 Matthew Gillmor。

I was hoping you could take a moment to update us on where things stand from a physician supply standpoint within your network. Obviously, offices are opening back up and this is a time of year where utilization is normally higher. But I was curious if you're seeing any pressure with respect to recruitment or compensation or maybe what's in place today versus wasn't there at the beginning of the year?

我希望您能花點時間從您的網絡內醫生供應的角度向我們介紹情況的最新情況。顯然，辦公室正在重新開放，這是一年中利用率通常較高的時候。但我很好奇你是否看到招聘或薪酬方面的任何壓力，或者今天的情況與年初的情況相比是否存在？

Yes. Thanks, Matt. I appreciate the question. The innovation that we put in place in the March time frame as we were experiencing the incredible increase in volume has really paid tremendous dividends for us over the course of the year. And that's helped us to expand our population of physicians. It's helped us to onboard physicians more quickly and in a streamlined fashion. It's helped us to make the physicians work more efficient so that for each physician's hour that they're spending with us, they can be more productive.

是的。謝謝，馬特。我很欣賞這個問題。我們在 3 月份的時間框架內實施的創新，因為我們經歷了令人難以置信的銷量增長，在這一年中確實為我們帶來了巨大的紅利。這幫助我們擴大了醫生人數。它幫助我們更快、更精簡地讓醫生入職。它幫助我們提高了醫生的工作效率，以便他們與我們一起度過的每個醫生的時間都可以提高工作效率。

And so the combination of all of those things has really resulted in just tremendous efficiency gains and greater productivity. And as a result, we are operating at significantly higher levels of utilization as we've reported. And yet, our response times are down in the low single digits minutes to speak to a physician really across the country. So I'm really proud of the team's work on those areas. And it was both workflow changes. It was technology changes. It was process innovation. And all of that has come together in a really meaningful way.

因此，所有這些因素的結合確實帶來了巨大的效率提升和更高的生產力。因此，正如我們所報告的那樣，我們的運營利用率要高得多。然而，與全國各地的醫生交談時，我們的響應時間縮短了個位數分鐘。所以我為團隊在這些領域所做的工作感到非常自豪。這都是工作流程的變化。這是技術的變化。這是流程創新。所有這些都以一種非常有意義的方式結合在一起。

And our next question comes from the line of Ravi Misra of Berenberg.

我們的下一個問題來自 Berenberg 的 Ravi Misra。

So just a little question on the competitive environment now that you have another kind of public company in your space. Just curious, how are you kind of accounting for churn or any kind of competition in the selling season? Are you seeing any? Any commentary there would be helpful. And then just on the Livongo deal, how should we think about that long term? In terms of the value extraction that you've spoken about, can that kind of be converted to a PMPM uplift? And is that factored into the synergy guidance that we've gotten?

因此，既然您在您的空間中有另一種上市公司，那麼關於競爭環境的問題只是一個小問題。只是好奇，您是如何計算銷售旺季的客戶流失或任何形式的競爭的？你有看到嗎？那裡的任何評論都會有所幫助。然後就 Livongo 的交易而言，我們應該如何看待這個長期的問題？就您所說的價值提取而言，可以轉化為 PMPM 提升嗎？我們得到的協同指導是否考慮到了這一點？

Sure. I'll take the first on competition and client retention, and I'll hand it to Mala for the Livongo synergies discussion. With respect to the competitive landscape, we were already, by far, the leader, which I think has become that much more clear as other data has become public. And now with the combination with Livongo, we're really creating an entirely new category and distancing ourselves from any of the legacy telehealth players.

當然。我將首先討論競爭和客戶保留，並將其交給 Mala 進行 Livongo 協同效應討論。就競爭格局而言，到目前為止，我們已經是領先者，我認為隨著其他數據的公開，這一點變得更加清晰。現在，通過與 Livongo 的結合，我們真正創建了一個全新的類別，並與任何傳統的遠程醫療參與者保持距離。

And with respect to how that shows up in our pipeline, our client retention rates continue to be very, very strongly in the 90s. Our takeaways are actually increasing in velocity, our competitive takeaways. And that's happening across multiple channels, in the health plan and employer segment as well as in the hospital and health system channel. And as a result, I think I've never felt better about the competitive landscape and our competitive position. Mala, you want to talk about Livongo and the synergies?

至於這在我們的管道中是如何出現的，我們的客戶保留率在 90 年代仍然非常非常強勁。我們的外賣實際上正在增加速度，我們的競爭外賣。這發生在多個渠道中，包括健康計劃和雇主部門以及醫院和衛生系統渠道。因此，我認為我從未對競爭格局和我們的競爭地位感覺更好。 Mala，你想談談 Livongo 和協同效應嗎？

Yes. So we have been very clear in terms of how we are getting at and thinking about our revenue synergies. We have talked about the buckets that we have seen a quantified line of sight to being cross-sell, cross-referral and international, as you know. We've also talked about other buckets of synergies that we have not quantified, whether it be how this will facilitate and even bolster our virtual primary care offering, et cetera.

是的。因此，我們非常清楚我們如何獲得和思考我們的收入協同效應。如您所知，我們已經談到了我們已經看到了交叉銷售、交叉推薦和國際化的量化視線。我們還談到了我們尚未量化的其他協同效應，無論這將如何促進甚至支持我們的虛擬初級保健產品等等。

The thing I would say is, we are just in the beginning stages of really doing deep, deep integration planning. The 2 sets of teams came together a couple of days ago. We spent all day looking at integration from every possible function and within every function, every possible subfunction. We are starting to think through from a pricing architecture standpoint, to your question, how is this going to work together? How are the bundles going to work together? So stay tuned in terms of how we will go sell this in the marketplace. I don't want to get ahead of our skis and talk about it yet. That is thinking and planning that we are literally doing as we speak.

我想說的是，我們正處於真正進行深度、深度集成規劃的開始階段。兩天前，兩組團隊走到了一起。我們花了一整天的時間從每個可能的功能以及每個功能、每個可能的子功能中尋找集成。我們開始從定價架構的角度思考您的問題，這將如何協同工作？捆綁包將如何協同工作？因此，請繼續關注我們將如何在市場上銷售它。我還不想在我們的滑雪板之前談論它。這就是我們說話時所做的思考和計劃。

Your next question comes from the line of Jonathan Yong of Barclays.

您的下一個問題來自巴克萊的 Jonathan Yong。

I just had a question in relation to Livongo. I think with the GuideWell deal, Livongo was already in discussions with them. And with the Teladoc-Livongo merger, that really accelerated. I was wondering if that was the same case with the large employer that you signed. And is this a key factor for your kind of revenue synergies moving forward or where you're able to expedite some of the deals because of these relationships? And are those revenue synergies already in Livongo's pipeline and you're just expediting it?

我剛剛有一個關於 Livongo 的問題。我認為對於 GuideWell 的交易，Livongo 已經在與他們進行討論。隨著 Teladoc-Livongo 的合併，這確實加速了。我想知道您簽署的大雇主是否也是如此。這是推動您的收入協同效應向前發展的關鍵因素，還是因為這些關係您能夠加快一些交易？這些收入協同效應是否已經在 Livongo 的管道中，而你只是在加速它？

I think there's definitely an acceleration that happens, and the acceleration is for a number of reasons. One, because it's easier to contract with a company you already have a contract with, right? So you don't have to go through the entire procurement process. Two, people appreciate having a single relationship manager, a single team. And three, and maybe most importantly, the value proposition of an integrated suite of products for the consumer is so much stronger, right? And so the ability to do that, to bring a single solution not only accelerates the process but also very importantly, increases the value proposition.

我認為肯定會發生加速，加速有多種原因。一，因為與您已經簽訂合同的公司簽訂合同更容易，對嗎？因此，您不必經歷整個採購流程。第二，人們喜歡擁有一個單一的客戶關係經理，一個單一的團隊。第三，也許是最重要的，針對消費者的集成產品套件的價值主張要強大得多，對吧？因此，能夠做到這一點，帶來單一的解決方案不僅可以加快流程，而且非常重要的是，增加了價值主張。

And specifically, to your question about whether the large employer I mentioned earlier was already in discussions with Livongo, they weren't even talking to them. So the answer is no. That was a de novo sale. And so you can appreciate how quickly that has progressed and therefore, how strong the value proposition of the combined offering is.

具體來說，對於您關於我之前提到的大型雇主是否已經在與 Livongo 進行討論的問題，他們甚至沒有與他們交談。所以答案是否定的。那是一次從頭銷售。因此，您可以了解進展的速度有多快，因此，組合產品的價值主張有多強大。

The one other thing I would add is, as we thought about the revenue synergies and quantifying the revenue synergies, to be very clear, what we had already factored into the calculus was the fact that, of course, Livongo has a momentum of its own. And it was going to have its own strong pipeline that fed their own organic growth. So we've been very careful about not double counting and factoring those. We have kept them clear and distinct as we modeled out the synergies.

我要補充的另一件事是，當我們考慮收入協同效應並量化收入協同效應時，非常清楚的是，我們已經考慮到的事實是，Livongo 當然有自己的動力.它將擁有自己強大的管道來滿足自己的有機增長。所以我們一直非常小心不要重複計算和考慮這些因素。在模擬協同效應時，我們使它們保持清晰和獨特。

Thank you very much, everyone. And with that, this concludes today's Q&A session as well as today's conference call. Thank you for your participation. You may now disconnect.

非常感謝大家。至此，今天的問答環節以及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。