Teladoc Health Inc (TDOC) 2022 Q1 法說會逐字稿

Good afternoon. Thank you for attending today's Teladoc 2022 First Quarter Earnings Conference Call. My name is Nate, and I will be your moderator for today's call. (Operator Instructions)

下午好。感謝您參加今天的 Teladoc 2022 年第一季度收益電話會議。我的名字是 Nate，我將擔任今天電話會議的主持人。 （操作員說明）

I'd like to now pass the conference over to our host, Patrick Feeley, with Teladoc. Patrick, please go ahead.

我現在想將會議轉交給我們的主持人 Patrick Feeley，他和 Teladoc 一起工作。帕特里克，請繼續。

Thank you and good afternoon. Today, after the market closed, we issued a press release announcing our first quarter 2022 financial results. This press release and the accompanying slide presentation are available on the Investor Relations section of the teladochealth.com website. On this call to discuss the results are Jason Gorevic, Chief Executive Officer; and Mala Murthy, Chief Financial Officer. During this call, we will also provide our second quarter and full year 2022 outlook, and our prepared remarks will be followed by a question-and-answer session.

謝謝你，下午好。今天，在市場收盤後，我們發布了一份新聞稿，宣布了我們 2022 年第一季度的財務業績。本新聞稿和隨附的幻燈片可在 teladochealth.com 網站的投資者關係部分獲取。在這次電話會議上討論結果的是首席執行官 Jason Gorevic；和首席財務官 Mala Murthy。在這次電話會議中，我們還將提供我們的第二季度和 2022 年全年展望，我們準備好的發言之後將是問答環節。

Please note that we will be discussing certain non-GAAP financial measures that we believe are important in evaluating Teladoc Health's performance. Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release that is posted on our website.

請注意，我們將討論我們認為對評估 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. Good afternoon and thank you for joining us. Well, I'm pleased to report that we met our guidance for Q1 revenue and adjusted EBITDA. As you saw in our earnings release this afternoon, we revised down our revenue and adjusted EBITDA outlook for the full year. Although I'll spend most of my prepared comments discussing how the market dynamics we are currently seeing in the direct-to-consumer mental health and chronic care markets have influenced our revised outlook for 2022, I do think it's important to do so in the context of our broader business.

謝謝，帕特里克。下午好，感謝您加入我們。好吧，我很高興地報告我們達到了我們對第一季度收入和調整後 EBITDA 的指導。正如您在今天下午發布的財報中看到的那樣，我們下調了收入並調整了全年的 EBITDA 前景。儘管我將用我準備好的大部分評論來討論我們目前在直接面向消費者的心理健康和慢性護理市場中看到的市場動態如何影響我們對 2022 年的修訂前景，但我確實認為這樣做很重要我們更廣泛的業務背景。

Coming out of the first quarter, Teladoc continues to be the leading brand in the digital health space. Our unmatched scale, solid fundamentals and strong balance sheet with over $830 million in cash leaves us well positioned to build upon our market leadership by delivering innovative new solutions to transform the way consumers interact with the health care system. We remain confident in and committed to our whole-person care strategy. And our interactions with clients and prospects confirm that it is the future of digital health.

從第一季度開始，Teladoc 繼續成為數字健康領域的領先品牌。我們無與倫比的規模、堅實的基本面和強勁的資產負債表以及超過 8.3 億美元的現金使我們能夠通過提供創新的新解決方案來改變消費者與醫療保健系統互動的方式，從而鞏固我們的市場領先地位。我們仍然對我們的全人護理戰略充滿信心並致力於。我們與客戶和潛在客戶的互動證實了這是數字健康的未來。

As the industry matures, we're seeing our most progressive clients embracing our integrated approach for their health care needs. I'll speak to that momentum later in my remarks. But what's notable is that we continue to see growth across all our services even if the level of growth in some areas is lower than our prior expectations.

隨著行業的成熟，我們看到我們最先進的客戶採用我們的綜合方法來滿足他們的醫療保健需求。我將在稍後的發言中談到這種勢頭。但值得注意的是，即使某些領域的增長水平低於我們之前的預期，我們的所有服務仍將繼續增長。

As you think about the road ahead for Teladoc Health, we remain committed to making necessary ongoing investments and delivering on innovation because the market is moving fast. Achieving full integration of our member experience and delivering several last-mile enhancements to our Primary360 offering remain high on that list. We're certainly disappointed to lower guidance today. However, we continue to believe we're the best positioned company in health care and technology to transform the health care experience.

當您考慮 Teladoc Health 的未來道路時，我們將繼續致力於進行必要的持續投資並實現創新，因為市場正在快速發展。實現我們會員體驗的全面整合併為我們的 Primary360 產品提供最後一英里的增強功能在該列表中仍然名列前茅。我們當然對今天降低指導感到失望。然而，我們仍然相信我們是醫療保健和技術領域最能改變醫療保健體驗的公司。

With that, let me spend some time walking through what led us to reassess our outlook for the balance of 2022, starting with our direct-to-consumer mental health service, BetterHelp. Over the past several weeks, we've seen lower-than-expected yield on marketing spend for BetterHelp, which is a reversal of the trends we experienced exiting 2021 and in the early part of 2022.

有了這個，讓我花一些時間來回顧一下導致我們重新評估我們對 2022 年餘額的展望，從我們直接面向消費者的心理健康服務 BetterHelp 開始。在過去的幾周里，我們看到 BetterHelp 的營銷支出收益率低於預期，這與我們在 2021 年和 2022 年初所經歷的趨勢相反。

One example of this is paid search advertising, where we've seen a notable increase in rates for keywords associated with online therapy. We believe the biggest driver of this dynamic is smaller private competitors pursuing what we think are low- or no-return customer acquisition strategies in an attempt to establish market share. Some of those same providers are also exploiting the temporary suspension of certain regulations associated with the national health emergency concerning the prescription of controlled substances.

這方面的一個例子是付費搜索廣告，我們已經看到與在線治療相關的關鍵字的比率顯著增加。我們認為，這種動態的最大驅動力是較小的私人競爭對手追求我們認為低迴報或無回報的客戶獲取策略，以試圖建立市場份額。其中一些供應商也在利用與國家衛生緊急情況相關的某些法規的暫時中止，這些法規涉及受控物質的處方。

We believe these strategies are unsustainable in the long term. This dynamic is likely to persist at least throughout the remainder of this year, however, resulting in growth and margin contribution from BetterHelp that is below our expectation in February.

我們認為這些策略從長遠來看是不可持續的。然而，這種動態可能至少在今年剩餘時間內持續存在，導致 BetterHelp 的增長和利潤率貢獻低於我們 2 月份的預期。

The good news is that unlike smaller market participants, we operate at a scale that allows us to continue investing in the direct-to-consumer market to drive both strong growth and returns, and we can drive growth while remaining disciplined in our member acquisition strategy. Furthermore, our push to diversify customer acquisition channels in recent years has left us better positioned to operate within this environment. No single channel accounts for more than 25% of newly acquired members for BetterHelp. So for example, we are less reliant on paid search as a source of new members than in the past.

好消息是，與較小的市場參與者不同，我們的運營規模使我們能夠繼續投資直接面向消費者的市場，以推動強勁的增長和回報，我們可以在推動增長的同時保持對會員獲取戰略的約束.此外，我們近年來推動客戶獲取渠道多樣化，使我們能夠更好地在這種環境中運營。在 BetterHelp 新獲得的成員中，沒有任何一個渠道佔超過 25%。例如，我們不像過去那樣依賴付費搜索作為新成員的來源。

While the dynamics in the direct-to-consumer market were only a modest drag on our first quarter revenue, given the persistency of these trends over the past several weeks and the broader economic backdrop, we've incorporated this updated view into our forward outlook, including an assumed 10% lower revenue yield per dollar of ad spend for the full year. To be clear, we continue to expect strong growth and margin contribution from BetterHelp, albeit below our prior expectations.

雖然直接面向消費者市場的動態對我們第一季度的收入只有適度的拖累，但鑑於過去幾週這些趨勢的持續性以及更廣泛的經濟背景，我們已將這一最新觀點納入我們的前瞻性展望，包括假設全年每 1 美元廣告支出的收入收益率會降低 10%。需要明確的是，我們繼續期待 BetterHelp 的強勁增長和利潤率貢獻，儘管低於我們之前的預期。

Our revised revenue guidance range for 2022 assumes BetterHelp will grow in the upper half of our long-term target range for mental health revenue growth of 30% to 40% per year. In chronic care, we have more clarity on the cadence of onboardings from the large health plan client that we discussed last quarter. We remain on track for population launches with this client and other recently signed deals over the course of 2022. However, we're also seeing our chronic care sales pipeline develop more slowly than anticipated.

我們修訂後的 2022 年收入指導範圍假設 BetterHelp 將在我們的心理健康收入每年增長 30% 至 40% 的長期目標範圍的上半部分增長。在慢性護理方面，我們對上個季度討論的大型健康計劃客戶的入職節奏更加清晰。在 2022 年期間，我們將繼續與該客戶和其他最近簽署的交易進行人口啟動。但是，我們也看到我們的慢性護理銷售渠道的發展速度比預期的要慢。

Last October, we discussed 2 trends in the marketplace that we saw leading to an elongated selling cycle. The first was in the employer market, where we saw benefit managers focused on COVID and return to work, which we felt was contributing to a longer decision-making process. The second was a large pipeline of health plan deals that were simply harder to predict when it comes to timing given the size and complexity of those clients.

去年 10 月，我們討論了導致銷售週期延長的市場中的 2 個趨勢。第一個是在雇主市場，我們看到福利經理專注於 COVID 並重返工作崗位，我們認為這有助於延長決策過程。第二個是大量的健康計劃交易，考慮到這些客戶的規模和復雜性，在時間安排方面更難預測。

At the beginning of this year, we were encouraged by very strong fourth quarter bookings and a robust late-stage pipeline. However, as we progressed through the first part of the year, we're seeing clear signs of the slower bookings pace continuing.

今年年初，我們對非常強勁的第四季度預訂量和強勁的後期管道感到鼓舞。然而，隨著我們在今年上半年的進展，我們看到了預訂速度放緩的明顯跡象。

In addition to the factors we discussed last fall, we're seeing clients inundated with a number of new smaller point solutions, which has created noise in the marketplace. While in the near term we expect this noise to persist, we believe our broad integrated approach to virtual and digital care delivery is a competitive advantage that positions Teladoc to be the long-term winner in the space.

除了我們去年秋天討論的因素外，我們還看到客戶被大量新的小型單點解決方案所淹沒，這在市場上引起了轟動。雖然在短期內，我們預計這種噪音會持續存在，但我們相信我們廣泛的虛擬和數字護理交付集成方法是一項競爭優勢，使 Teladoc 成為該領域的長期贏家。

In the meantime, we are in the process of taking a closer look at some of these forces that are impacting the near-term conversion of pipeline to revenue, and we'll continue to make adjustments as necessary to address them. So while the pipeline is large and as of the end of the first quarter, the late-stage pipeline has grown significantly as compared to the first quarter of last year, we're not seeing deals progress at the pace that we expected.

與此同時，我們正在仔細研究影響管道近期轉化為收入的一些因素，我們將繼續進行必要的調整以解決這些問題。因此，儘管管道很大，截至第一季度末，後期管道與去年第一季度相比已顯著增長，但我們並沒有看到交易的進展速度達到我們預期的速度。

It's still somewhat early in the selling season, but based on how the pipeline has developed over the first 4 months of the year, we felt it was prudent to update our forecast. Our revised 2022 guidance assumes chronic care revenue growth on a percentage basis in the low to mid-teens. When comparing the impact to guidance from the items we've just discussed, approximately 3/4 of the reduction to our 2022 revenue outlook is driven by lower expected growth at BetterHelp with the remainder primarily attributed to the lower expected revenue from our suite of chronic care products.

銷售季節仍處於早期階段，但根據今年前 4 個月管道的發展情況，我們認為更新我們的預測是謹慎的。我們修訂後的 2022 年指導假設慢性護理收入在中低端的百分比基礎上增長。在將影響與我們剛剛討論過的項目的指導進行比較時，我們 2022 年收入前景的減少約 3/4 是由於 BetterHelp 的預期增長較低，其餘主要歸因於我們的慢性病套件的預期收入較低護理產品。

For adjusted EBITDA, approximately 2/3 of the reduction is driven by lower yield on advertising spend from BetterHelp. The remainder of the revision is driven primarily by our lower chronic care revenue outlook as well as a modest increase in our assumption for wage growth due to higher inflation as we grow our headcount in technology and development.

對於調整後的 EBITDA，大約 2/3 的減少是由於 BetterHelp 的廣告支出收益率下降所致。修訂的其餘部分主要是由於我們較低的慢性護理收入前景以及我們對工資增長的假設適度增加，原因是我們增加了技術和開發方面的員工人數，導致通脹上升。

As a result of these updates, we now expect revenue of $2.4 billion to $2.5 billion and adjusted EBITDA of $240 million to $265 million for fiscal year 2022. We believe these ranges appropriately capture the reasonable risks and potential upside. We are not providing today any guidance with respect to periods after 2022, and we're evaluating whether there will be effects to our long-term revenue growth outlook.

由於這些更新，我們現在預計 2022 財年的收入為 24 億美元至 25 億美元，調整後的 EBITDA 為 2.4 億美元至 2.65 億美元。我們認為這些範圍適當地反映了合理的風險和潛在的上行空間。我們今天沒有就 2022 年之後的時期提供任何指導，我們正在評估是否會對我們的長期收入增長前景產生影響。

As I said at the top of the call, despite the change in our 2022 outlook, we remain confident in our position as the leader in the digital health space. Our key competitive advantage is our market-leading depth and breadth of capabilities. And those capabilities underpin our strategy to bring broad integrated solutions to the market that meet the full set of needs for clients and members.

正如我在電話會議的開頭所說，儘管我們對 2022 年的展望發生了變化，但我們仍然對我們作為數字健康領域領導者的地位充滿信心。我們的主要競爭優勢是我們市場領先的能力深度和廣度。這些能力鞏固了我們的戰略，即為市場帶來廣泛的綜合解決方案，滿足客戶和會員的全部需求。

During the first quarter, we continue to make progress against that whole-person strategy. A key linchpin of our ability to deliver upon the promise of whole-person virtual care is our market-leading virtual primary care product, Primary360. Primary360 is designed to act as the front door to care for our members. It opens pathways to Teladoc's own ecosystem of digital and virtual solutions and coordinates care with third-party providers within a health plan or employer's network when needed.

在第一季度，我們繼續在全人戰略方面取得進展。我們能夠兌現全人虛擬護理承諾的關鍵關鍵是我們市場領先的虛擬初級保健產品 Primary360。 Primary360 旨在充當照顧我們會員的前門。它開闢了通往 Teladoc 自己的數字和虛擬解決方案生態系統的途徑，並在需要時與健康計劃或雇主網絡內的第三方提供者協調護理。

We continue to be excited about the momentum we're seeing in Primary360. Last quarter, we talked about a growing pipeline of Primary360 deals. And over the past 2 months, we've made important progress moving deals through the pipeline. We've seen particularly strong interest from our health plan clients, many of whom are looking to combine Primary360 with our whole-person suite of telehealth, mental health and chronic condition support to create Virtual First care models for their members. I expect to have additional notable Primary360 deals to announce as we progress through the rest of the year as health plans and employers look to provide their populations with innovative solutions that make primary care more convenient and accessible.

我們繼續對我們在 Primary360 中看到的勢頭感到興奮。上個季度，我們談到了不斷增長的 Primary360 交易渠道。在過去的 2 個月裡，我們在通過管道推進交易方面取得了重要進展。我們已經看到我們的健康計劃客戶特別強烈的興趣，他們中的許多人希望將 Primary360 與我們的遠程醫療、心理健康和慢性病支持的全人套件相結合，為其成員創建虛擬優先護理模式。隨著健康計劃和雇主希望為他們的人群提供創新的解決方案，使初級保健更加方便和可及，我預計隨著我們在今年剩餘時間的進展，還會宣布更多值得注意的 Primary360 交易。

We also recently announced an important new partnership with Northwell Health, unseating an incumbent competitor in the process. Many of you in the New York metro area are familiar with Northwell as New York's largest health care provider with 22 hospitals and over 800 outpatient facilities. Northwell's virtual enterprise strategy will leverage our single integrated platform that spans consumer and provider-to-provider applications both within the 4 walls of Northwell's facilities for high-acuity and emergency care and directly into the patient's home.

我們最近還宣布與 Northwell Health 建立重要的新合作夥伴關係，在此過程中取代現有競爭對手。紐約都會區的許多人都熟悉 Northwell，它是紐約最大的醫療保健提供者，擁有 22 家醫院和 800 多個門診設施。 Northwell 的虛擬企業戰略將利用我們的單一集成平台，該平台涵蓋消費者和供應商到供應商的應用程序，既位於 Northwell 的高敏度和緊急護理設施的 4 堵牆內，也直接進入患者家中。

Northwell will also leverage our partnership with Microsoft to streamline clinical collaboration and communication among Northwell clinicians. This deal underscores the value of our Microsoft relationship and demonstrates the power of our integrated platform, which allows clients to operate within one platform for all their virtual care use cases.

Northwell 還將利用我們與 Microsoft 的合作夥伴關係來簡化 Northwell 臨床醫生之間的臨床協作和溝通。這筆交易強調了我們與微軟的關係的價值，並展示了我們集成平台的力量，它允許客戶在一個平台內為他們的所有虛擬護理用例進行操作。

With that, I'll turn the call over to Mala for a review of the first quarter and our second quarter and full year 2022 guidance.

有了這個，我將把電話轉給 Mala，以審查第一季度、第二季度和 2022 年全年的指導。

Thank you, Jason, and good afternoon, everyone. During the first quarter, total revenue increased 25% year-over-year to $565 million. Substantially, all of that growth was organic. We ended the quarter with U.S. paid membership of 54.3 million members, an increase of 680,000 members over the fourth quarter. Individuals with visit fee only access was 25.2 million at the end of the first quarter, representing an increase of 950,000 individuals. The total number of our unique members enrolled in one or more of our chronic care programs was 731,000 as of the first quarter, an increase of 78,000 enrollees over the prior year's quarter. 27% of our chronic care members are now enrolled in more than one program, up from 15% in the first quarter of 2021. This helped drive total chronic care program enrollment to over 900,000, an increase of more than 140,000 or 19% over the prior year.

謝謝你，傑森，大家下午好。第一季度，總收入同比增長 25% 至 5.65 億美元。基本上，所有這些增長都是有機的。截至本季度末，我們的美國付費會員人數為 5430 萬，比第四季度增加了 68 萬。第一季度末，僅憑參觀費進入的人數為2520萬人，增加了95萬人。截至第一季度，參加我們的一個或多個慢性護理計劃的獨特會員總數為 731,000 人，比去年同期增加了 78,000 人。現在，我們 27% 的慢性護理成員參加了多個計劃，高於 2021 年第一季度的 15%。這有助於推動慢性護理計劃的總註冊人數超過 900,000 人，比去年增加了 140,000 多人或 19%去年。

Average U.S. revenue per member per month was $2.52 in the first quarter, up 21% from $2.09 in the prior year's quarter. Visit fee revenue for the first quarter of $68 million increased 12% year-over-year. During the first quarter, we provided 4.5 million visits through our network of clinicians, up 35% over the prior year's quarter. The biggest contributor to this growth was strength in mental health utilization.

第一季度美國每位會員每月平均收入為 2.52 美元，比去年同期的 2.09 美元增長 21%。第一季度的參觀費收入為 6800 萬美元，同比增長 12%。在第一季度，我們通過我們的臨床醫生網絡提供了 450 萬次就診，比去年同期增長 35%。這種增長的最大貢獻者是心理健康利用的力量。

Adjusted EBITDA was $54.5 million in the first quarter compared to $56.6 million in the prior year's first quarter and at the high end of our guidance range. As a reminder, our first quarter 2021 adjusted EBITDA included a $6.9 million benefit related to purchase accounting adjustments. As discussed on last quarter's call, it's typical for us to see a ramp-up in advertising spend and a lower margin in the first quarter as we take advantage of lower media pricing following the conclusion of the more expensive holiday season, and that was the case this year. It's important to note that in 2021, this seasonality was less pronounced due to a weaker advertising market during the onset of the pandemic.

第一季度調整後的 EBITDA 為 5450 萬美元，而去年第一季度為 5660 萬美元，處於我們指導範圍的高端。提醒一下，我們 2021 年第一季度調整後的 EBITDA 包括與採購會計調整相關的 690 萬美元收益。正如上一季度電話會議所討論的那樣，我們通常會看到第一季度廣告支出的增加和較低的利潤率，因為我們利用了在更昂貴的假期結束後較低的媒體定價，這就是今年的案例。值得注意的是，在 2021 年，由於大流行開始期間廣告市場疲軟，這種季節性不太明顯。

Net loss per share in the first quarter was $41.58 compared to a net loss per share of $1.31 in the first quarter of last year. Net loss per share in the first quarter includes a noncash goodwill impairment charge of $41.11 per share or $6.6 billion. The goodwill impairment was triggered by the sustained decline in Teladoc Health share price, with the valuation and size of the impairment charge driven by a combination of recent market-based factors, such as an increased discount rate and the decreased market multiples for a relevant peer group of high-growth digital health care companies as well as updates to our forecasted cash flows consistent with the revised guidance disclosed today. Also included in net loss per share was stock-based compensation expense of $0.38 per share and amortization of acquired intangibles of $0.31 per share. We ended the quarter with $839 million in cash and short-term investments on the balance sheet.

第一季度每股淨虧損為 41.58 美元，而去年第一季度每股淨虧損為 1.31 美元。第一季度每股淨虧損包括每股 41.11 美元或 66 億美元的非現金商譽減值費用。商譽減值是由 Teladoc Health 股價持續下跌引發的，減值費用的估值和規模是由近期基於市場的因素共同推動的，例如貼現率提高和相關同行的市場倍數下降集團的高增長數字醫療保健公司以及我們預測現金流的更新與今天披露的修訂指南一致。每股淨虧損還包括每股 0.38 美元的股票補償費用和每股 0.31 美元的收購無形資產攤銷。我們在本季度末的資產負債表上有 8.39 億美元的現金和短期投資。

Now turning to forward guidance. For the full year 2022, we expect revenue to be in the range of $2.4 billion to $2.5 billion, representing growth of 18% to 23% over the prior year. We expect total U.S. paid membership of 54 million to 56 million members, representing growth of 1% to 5% year-over-year with the remainder of revenue growth driven by expanding revenue per member. We expect total visits in 2022 to be between 18.5 million and 19.5 million visits, representing growth of 20% to 27% over the prior year. We expect adjusted EBITDA in 2022 to be in the range of $240 million to $265 million, representing an adjusted EBITDA margin of 10% to 10.6% compared to a 12% margin in 2021 after normalizing for last year's purchase price accounting benefit. As discussed, the decline in consolidated margin is primarily a function of lower expected results from BetterHelp and our suite of chronic care products and a modest increase in expected wage rate inflation.

現在轉向前向指導。對於 2022 年全年，我們預計收入將在 24 億美元至 25 億美元之間，比上年增長 18% 至 23%。我們預計美國付費會員總數將達到 5400 萬至 5600 萬，同比增長 1% 至 5%，其餘的收入增長將由每位會員的收入增長推動。我們預計 2022 年的總訪問量將在 1850 萬至 1950 萬之間，比上一年增長 20% 至 27%。我們預計 2022 年調整後的 EBITDA 將在 2.4 億美元至 2.65 億美元之間，調整後的 EBITDA 利潤率為 10% 至 10.6%，而去年的購買價格會計收益正常化後，2021 年的利潤率為 12%。如前所述，綜合利潤率的下降主要是由於 BetterHelp 和我們的慢性護理產品套件的預期結果較低以及預期工資率通脹適度增加所致。

For the second quarter of 2022, we expect revenue of $580 million to $600 million, representing growth of 15% to 19% over the prior year's quarter. As discussed on our last earnings call, in contrast to prior years, we continue to expect the cadence of new chronic care enrollees to be more heavily weighted to the back half of the year.

對於 2022 年第二季度，我們預計收入為 5.8 億美元至 6 億美元，比去年同期增長 15% 至 19%。正如我們在上次財報電話會議上所討論的那樣，與往年相比，我們繼續預計新的慢性護理登記者的節奏將在今年下半年得到更大的權重。

We expect total U.S. paid membership in the second quarter of 54 million to 55 million. Total second quarter visits are expected to be between 4.4 million and 4.6 million visits, representing year-over-year growth of 20% to 26%. We expect second quarter adjusted EBITDA to be in the range of $39 million to $49 million. The lower expected sequential adjusted EBITDA in the second quarter is primarily a function of a lower contribution from direct-to-consumer mental health and increased engagement spending in support of new chronic care population launches.

我們預計第二季度美國付費會員總數為 5400 萬至 5500 萬。第二季度的總訪問量預計在 440 萬至 460 萬之間，同比增長 20% 至 26%。我們預計第二季度調整後的 EBITDA 將在 3900 萬美元至 4900 萬美元之間。第二季度預期的環比調整後 EBITDA 較低主要是由於直接面向消費者的心理健康的貢獻較低以及為支持新的慢性護理人群推出而增加的參與支出。

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. We hold ourselves to a high standard, and there's no question we're disappointed with our revised outlook today. However, as I mentioned earlier, we remain highly confident that our whole-person integrated approach is the right one. The depth and breadth of our integrated product offering is unmatched. As the clear leader in the industry, we believe that only comprehensive integrated solutions like ours can truly deliver upon the promise of better outcomes, a better experience and more efficient care for clients and consumers.

謝謝，馬拉。我們堅持高標準，毫無疑問，我們對今天修訂後的前景感到失望。然而，正如我之前提到的，我們仍然堅信我們的全人整合方法是正確的。我們提供的集成產品的深度和廣度是無與倫比的。作為行業中的明確領導者，我們相信只有像我們這樣的綜合集成解決方案才能真正兌現為客戶和消費者帶來更好結果、更好體驗和更高效服務的承諾。

We've methodically built the broadest set of virtual and digital health capabilities available in the market today, and we'll continue to innovate and build upon those capabilities to expand our lead and execute against the tremendous opportunity ahead.

我們有條不紊地建立了當今市場上最廣泛的虛擬和數字健康能力，我們將繼續創新並在這些能力的基礎上擴大我們的領先地位，並在未來的巨大機遇中執行。

With that, we'll open the call for questions. Operator?

有了這個，我們將打開問題的電話。操作員？

(Operator Instructions) Our first question goes to Lisa Gill with JPMorgan.

（操作員說明）我們的第一個問題是摩根大通的 Lisa Gill。

I'll keep my question to just one area, Jason, but I might have multiple parts here. I just really want to understand a little bit better on what's happening in the mental health area. You talked about the last few weeks where customer acquisition costs, paid searches being much higher. Is this all one driven based on competition?

Jason，我將把我的問題保留在一個領域，但我可能在這裡有多個部分。我只是真的想更好地了解心理健康領域正在發生的事情。你談到了過去幾週的客戶獲取成本，付費搜索要高得多。這一切都是基於競爭嗎？

Two, you talked a little bit about higher wages, but what are we seeing as far as demand and competition for clinicians? And then thirdly, if I look at the revised EBITDA and the margins being down roughly 300 basis points versus what your expectations were before, are you spending even more incrementally when we think about that customer acquisition cost on the mental health side as I -- I know you and Mala called out that 2/3 of the impact is coming from BetterHelp.

第二，您談到了更高的工資，但就臨床醫生的需求和競爭而言，我們看到了什麼？第三，如果我查看修改後的 EBITDA 並且利潤率與您之前的預期相比下降了大約 300 個基點，當我們考慮心理健康方面的客戶獲取成本時，您是否會增加支出，因為我 -我知道你和 Mala 指出 2/3 的影響來自 BetterHelp。

Yes. So I'll talk the competitive landscape and the environment and what we're seeing in the BetterHelp AA business. Mala can talk to the overall margin outlook and our outlook for '22 adjusted EBITDA.

是的。所以我會談談競爭格局和環境，以及我們在 BetterHelp AA 業務中看到的情況。 Mala 可以談談整體利潤率前景和我們對 22 年調整後 EBITDA 的前景。

When I look at the direct-to-consumer mental health business, we are seeing lower-than-expected yield on marketing spend over the past several weeks. It's really -- as I look at January and February, we saw the cost per new acquired member trending in line with our prior expectations, which is a decline from December. But that turned around against us in March, and we began to see increases in cost per acquisition and a corresponding decline in revenue yield on our advertising dollar.

當我查看直接面向消費者的心理健康業務時，我們發現過去幾週營銷支出的收益率低於預期。真的——當我查看 1 月和 2 月時，我們看到每個新獲得成員的成本趨勢與我們之前的預期一致，比 12 月有所下降。但這種情況在 3 月份對我們不利，我們開始看到每次收購成本增加，而我們的廣告收入相應下降。

There were 2 primary channels that drove that: number one is paid search, and number two is paid social media. I would say that we strongly attribute that to smaller private competitors who have been recently well funded with a rash of venture capital money flowing into that space and making what we would consider to be economically irrational decisions.

有兩個主要渠道推動了這一點：第一是付費搜索，第二是付費社交媒體。我想說，我們強烈將此歸因於較小的私人競爭對手，他們最近獲得了充足的資金，大量風險資本流入該領域，並做出了我們認為在經濟上不合理的決定。

The good news for us is that we're able to pull back on that without decimating the business. And as you heard from my comments, we still expect sort of the high end of our range in terms of growth for BetterHelp. And I'll give you an example. In paid search, our CPA was up 20% in March versus January and February, and paid search represents somewhere between 20% and 25% and of our newly acquired members in the first quarter.

對我們來說，好消息是我們能夠在不影響業務的情況下收回這一點。正如您從我的評論中聽到的那樣，就 BetterHelp 的增長而言，我們仍然期望我們範圍的高端。我會給你一個例子。在付費搜索中，我們的 CPA 在 3 月份與 1 月和 2 月相比增長了 20%，付費搜索佔第一季度新獲得的會員的 20% 到 25% 之間。

So the second part that I referenced in my prepared remarks actually ironically relates to an article I saw in the Journal today that you may have seen about CVS and Walgreens were using to fill prescriptions for Adderall and other controlled substances from some direct-to-consumer telehealth, but specifically mental telehealth, companies. Obviously, we don't do that. And we believe -- we know that some companies are exploiting the temporary suspension of the regulations that prohibit the prescription of controlled substances during the national health emergency.

因此，我在準備好的評論中引用的第二部分實際上與我今天在《華爾街日報》上看到的一篇文章有關，你可能已經看到了關於 CVS 和 Walgreens 正在使用一些直接面向消費者的 Adderall 和其他受控物質的處方遠程醫療，尤其是心理遠程醫療公司。顯然，我們不這樣做。我們相信 - 我們知道一些公司正在利用在國家衛生緊急情況期間暫時中止禁止開具受控物質處方的規定。

That -- for better or for worse, that puts us at a bit of a competitive disadvantage relative to those who do. We don't think either of those practices, either bidding up the search auctions or prescribing controlled substances is a sustainable practice. And we're going to continue to focus on running a long-term profitable growth business.

那 - 無論好壞，這使我們相對於那些這樣做的人處於競爭劣勢。我們認為，無論是競標搜索拍賣還是開出受控物質，這兩種做法都不是可持續的做法。我們將繼續專注於經營長期盈利的增長業務。

Mala -- maybe just one more comment on BetterHelp, and then Mala can talk about overall outlook on adjusted EBITDA. Lisa, you asked about wage inflation and access or availability of clinicians for BetterHelp. Neither one of those is a constraint on our growth that led to our change in the outlook for the rest of this year. Really, it's those 2 things: it's the increase in customer acquisition and the -- facing competitors who are exploiting those suspensions in the regulations.

Mala - 也許只是對 BetterHelp 的評論，然後 Mala 可以談論調整後 EBITDA 的整體前景。麗莎，您詢問了 BetterHelp 的工資上漲以及臨床醫生的訪問或可用性。這些都不是我們增長的限制因素，這導致我們改變了今年剩餘時間的前景。真的，這是兩件事：這是客戶獲取的增加和 - 面臨的競爭對手正在利用法規中的這些暫停。

Yes. And Lisa, to your question -- let me address the profit question overall and as it relates to BetterHelp as well. So as we talked about in our prepared remarks, approximately 2/3 of the revision in the guidance we have made to adjusted EBITDA is driven by BetterHelp. The remaining -- the 1/3 is driven by chronic care as well as a modest increase in wage inflation.

是的。還有麗莎，關於你的問題——讓我從整體上解決利潤問題，因為它也與 BetterHelp 相關。因此，正如我們在準備好的評論中談到的那樣，我們對調整後的 EBITDA 所做的指導中大約 2/3 的修訂是由 BetterHelp 驅動的。剩下的 1/3 是由長期護理以及工資通脹的適度增長推動的。

And so for BetterHelp, the reduction is really about -- in margin is about lower-than-expected yield. We talked about the CPA increase of 10%. So that is driving the reduced margin. To be clear, as we said, the margins for BetterHelp are still attractive as -- vis-à-vis the enterprise margins.

所以對於 BetterHelp 來說，減少實際上是關於 - 利潤率是關於低於預期的收益率。我們談到了 CPA 增加了 10%。這導致利潤率下降。需要明確的是，正如我們所說，BetterHelp 的利潤率仍然具有吸引力——相對於企業利潤率而言。

The one thing I would say directly to the question you asked, if you think about BetterHelp ad spend and marketing spend and you think about the increase in CPA, what it means from a -- how it's flowing through our financials is it's similar in spend. It just means less revenue because of the lower yield.

對於您提出的問題，我要直接說的一件事是，如果您考慮 BetterHelp 廣告支出和營銷支出，並且考慮 CPA 的增加，這意味著它是如何通過我們的財務流動的，它在支出方面是相似的.由於收益率較低，這僅意味著收入減少。

Our next question goes to Ryan Daniels with William Blair.

我們的下一個問題是與威廉布萊爾一起向瑞安丹尼爾斯提問。

I guess my follow-up would be regarding to the other form of weakness in the chronic care management. I'm hoping you can dive into that a little bit more. And I guess my curiosity is somewhat similar to the funding we've seen in that space with a lot more on-site health care providers that also offer telehealth, some of the navigation companies combining resources to provide telehealth with their solutions.

我想我的後續行動將關注慢性護理管理中的另一種形式的弱點。我希望你能再深入一點。我想我的好奇心有點類似於我們在該領域看到的資金，更多的現場醫療保健提供者也提供遠程醫療，一些導航公司結合資源以提供遠程醫療及其解決方案。

Is it becoming a more competitive market as well? Is that part of the noise? Or is it really more difficulty in getting the attention of larger employers as they deal with return to work such that you think this is truly more of a transitory headwind for that segment?

它是否也成為一個更具競爭力的市場？那是噪音的一部分嗎？或者，在他們處理重返工作崗位時，要吸引大雇主的注意力真的更困難，以至於你認為這對於該領域來說確實是一個暫時的逆風？

Yes. Thanks, Ryan. Appreciate the question. I'll go through the various dynamics that we're seeing in the chronic care market that we believe are elongating the sales cycle. And I'll just reiterate what I said before, and we continue to see a larger pipeline of later-stage deals that are, unfortunately for us, taking long to get to close.

是的。謝謝，瑞恩。欣賞這個問題。我將介紹我們在慢性護理市場中看到的各種動態，我們認為這些動態正在延長銷售週期。我將重申我之前所說的話，我們繼續看到更大的後期交易渠道，不幸的是，這些交易對我們來說需要很長時間才能完成。

So back in October, we talked about a few trends. Certainly benefit managers distracted by COVID and return to work, we believe that, that is continuing. Also on the positive side for us, we exited 2021 with a record quarter of bookings in the fourth quarter and a very strong late-stage pipeline that persisted into the first quarter.

所以早在 10 月份，我們就談到了一些趨勢。當然，被 COVID 分心並重返工作崗位的管理人員會受益，我們認為，這種情況仍在繼續。對我們來說也是積極的一面，我們在 2021 年結束時第四季度的預訂量創下歷史新高，並且持續到第一季度的後期管道非常強勁。

As we moved through the first few months of the year, we're just not seeing those deals get to closure as the sales process continues to elongate. There is some of that, that is competitive noise because of more competitors that are essentially, I would say, giving the buyer more things to think about and consider. I also believe very strongly that if I step back, we're a little bit caught in the middle in terms of the time line.

當我們度過今年的前幾個月時，我們只是沒有看到這些交易隨著銷售過程繼續延長而完成。其中有一些是競爭噪音，因為更多的競爭對手本質上是，我想說，讓買家有更多的東西去思考和考慮。我也非常堅信，如果我退後一步，就時間線而言，我們會有點卡在中間。

So I think we are in a transition phase from buyers buying individual point solutions to buying true integrated whole-person, multi-condition offerings. We also historically, as organizations -- as our legacy organizations, Livongo competed head-to-head with single point solutions against various point solutions in the market but not really on the basis of multi-condition, full whole-person care solutions. And over the last 12-plus months, we've been working on integrating the Livongo products into our whole-person care experience.

因此，我認為我們正處於從購買個人單點解決方案到購買真正集成的全人、多條件產品的過渡階段。從歷史上看，我們作為組織——作為我們的傳統組織，Livongo 以單點解決方案與市場上的各種單點解決方案進行了正面競爭，但並不是真正基於多條件、全人護理解決方案。在過去的 12 多個月裡，我們一直致力於將 Livongo 產品整合到我們的全人護理體驗中。

And admittedly, we're not done with that yet. We are deep into that process, and we have line of sight to the finish line, but we don't have proof points behind it because we're not finished with it. We're getting great feedback. And what we're seeing, and I think is evidenced by the fact that in the first quarter, 78% of our sales were multiproduct sales. The market is responding really well to it. And I think the other evidence of that is the strength of our Primary360 product and the reception we're getting to that. But we're still early in that process.

誠然，我們還沒有完成。我們深入這個過程，我們可以看到終點線，但我們沒有證據支持它，因為我們還沒有完成它。我們得到了很好的反饋。我們所看到的，我認為第一季度我們 78% 的銷售額是多產品銷售這一事實證明了這一點。市場對此反應非常好。我認為這方面的另一個證據是我們 Primary360 產品的實力以及我們正在接受的情況。但我們仍處於該過程的早期階段。

So we're convinced that that's the right strategy. And we're committed to completing the integration, really delivering a unified multidimensional, multi-condition solution to the market. And we're going to continue to invest in that. So while in the near term, we're disappointed with our performance and the outlook for the rest of this year, we do remain confident in our strategy and our position in the market. In the meantime, we are taking a closer look at some of the dynamics that are impacting the conversion of our pipeline, and we're going to continue to make adjustments as necessary to address them.

因此，我們確信這是正確的策略。我們致力於完成整合，真正為市場提供統一的多維度、多條件的解決方案。我們將繼續對此進行投資。因此，儘管在短期內，我們對我們的表現和今年剩餘時間的前景感到失望，但我們對我們的戰略和我們在市場中的地位仍然充滿信心。與此同時，我們正在仔細研究影響我們管道轉換的一些動態，我們將繼續進行必要的調整以解決這些問題。

Our next question goes to Sandy Draper with Guggenheim.

我們的下一個問題是古根海姆的桑迪德雷珀。

And maybe, Jason, just sort of a related question to Ryan. One of the things I've been trying to think through is in this wage inflation environment. As I think about human resources, people trying to attract talent, they may be having to pay higher wages, higher bonuses, signing bonuses, et cetera. Do you have any sense, is that impacting maybe people's willingness to -- as you said, the long term, it may make a lot of sense to do these larger bundled buys, but there's a dollar cost upfront. And do you think there's a sense of, in this environment, people not wanting to add on additional services because they're saying, "We're going to have to pay out cash to people in order to get them on board or higher?" I'm just trying to understand if you think that's a dynamic that's happening out there in the marketplace.

也許，傑森，只是對瑞恩的一個相關問題。我一直在努力思考的一件事就是在這種工資膨脹的環境中。當我想到人力資源時，人們試圖吸引人才，他們可能不得不支付更高的工資、更高的獎金、簽約獎金等等。你有什麼意義嗎，這可能會影響人們的意願——正如你所說，從長遠來看，進行這些更大的捆綁購買可能很有意義，但前期需要支付美元成本。在這種環境下，您是否認為人們不想增加額外的服務，因為他們說：“我們將不得不向人們支付現金，以便讓他們加入或獲得更高的服務？ "我只是想了解您是否認為這是市場上正在發生的動態。

Yes. Thanks, Sandy. I understand the question. I don't think that's a primary driver of people making -- of employers not making a decision. It is possible that, that will drive employers to make more purchase decisions through their health plans. One of the areas that I think we're seeing is that HR departments are getting squeezed because there's so much going on with respect to return to office, dealing with the Great Resignation and all of the hiring and allocating resources to talent acquisition and retention that we may end up seeing more employers buying these solutions through their health plan.

是的。謝謝，桑迪。我明白這個問題。我不認為這是人們做出決定的主要驅動力——雇主沒有做出決定。這可能會促使雇主通過他們的健康計劃做出更多的購買決定。我認為我們看到的一個領域是人力資源部門正在受到擠壓，因為在重返辦公室、處理大辭職以及所有招聘和分配資源以獲取和保留人才方面有很多事情要做。我們最終可能會看到更多的雇主通過他們的健康計劃購買這些解決方案。

I do think that, that is overall beneficial for us because we're seeing significant traction for these products with the health plans who then we have to make a second sale through that health plan into their self-insured employers. So we're early in the year to see that pipeline develop. So it's a little too soon for me to say that that's -- to say that with certainty. But if I'm reading the tea leaves, that would be my bias.

我確實認為，這對我們來說總體上是有利的，因為我們看到這些產品與健康計劃的巨大吸引力，然後我們必須通過該健康計劃向他們的自我保險雇主進行第二次銷售。因此，我們在年初就可以看到該管道的發展。因此，我現在說這有點太早了 - 肯定地說。但如果我正在閱讀茶葉，那將是我的偏見。

Our next question goes is Sean Dodge with RBC Capital Markets.

我們的下一個問題是加拿大皇家銀行資本市場的 Sean Dodge。

Going back to BetterHelp. Jason, I know you've all been talking about experimenting with some different models there designed to help improve retention or longevity on the platform. I think you've talked before about flexible models you use, where people can ramp up and down based on how much they want to use without having to churn off. Are there any updates you can provide around those? And as you test these, how effective are you finding them to be in? And maybe when do you expect to launch some of these kind of more larger scale?

回到 BetterHelp。 Jason，我知道你們都在談論嘗試一些不同的模型，這些模型旨在幫助提高平台上的保留率或壽命。我想你之前已經談到過你使用的靈活模型，人們可以根據他們想要使用的數量來增加和減少使用量，而不必放棄。您可以提供有關這些的任何更新嗎？當你測試這些時，你發現它們的效果如何？也許你預計什麼時候會推出一些更大規模的產品？

Yes. Thanks, Sean. We do see a consistent improvement in the BetterHelp metrics and the BetterHelp business, unfortunately, in the last 6 weeks with the exception of customer acquisition cost. The -- so specifically, I would say, LTV is up modestly. Retention has been stable to improving over the last couple of years. Conversion rates on leads and visits to our registration pages have been stable. Brand awareness is strong, and we really have the leading brand in the space.

是的。謝謝，肖恩。不幸的是，在過去 6 周中，我們確實看到 BetterHelp 指標和 BetterHelp 業務的持續改善，但客戶獲取成本除外。 - 所以具體來說，我會說，LTV 適度上升。在過去的幾年裡，留存率一直穩定在提高。潛在客戶的轉化率和對我們註冊頁面的訪問量一直保持穩定。品牌意識很強，我們確實擁有該領域的領先品牌。

And we do continue to innovate around things like group therapy, which enable a one-to-many relationship between therapists and consumers. And every quarter, we test literally dozens of new tactics, product features, pricing structures. And I think that's one of the things that has continued to help drive that business forward with the tremendous growth that it's had.

我們確實繼續圍繞團體治療等事物進行創新，這使得治療師和消費者之間能夠建立一對多的關係。每個季度，我們都會測試數十種新策略、產品功能、定價結構。我認為這是繼續幫助推動該業務取得巨大增長的原因之一。

We also do continue to expect significant growth out of that business, right? We're still projecting growth in that business in the high 30s percentage-wise. So I do feel like we're getting good yield out of our efforts to continue to refine the product and optimize it. Unfortunately, in this circumstance, it doesn't overcome the change in the environment for consumer advertising. And we continue to take a disciplined approach to that. So we are not going to overspend our way through that and follow the lead of irrational competition.

我們也確實繼續期待該業務的顯著增長，對嗎？我們仍然預計該業務的增長將達到 30 多歲的百分比。因此，我確實覺得我們通過繼續改進和優化產品的努力獲得了不錯的收益。不幸的是，在這種情況下，它並沒有克服消費者廣告環境的變化。我們將繼續對此採取有紀律的方法。因此，我們不會過度消費並追隨非理性競爭的步伐。

Yes. I would also add, the scale that we operate in, the scale at which the BetterHelp business operates in, that continues to grow. And we continue to expand on the diversity of the acquisition channels we have. So the operating metrics that Jason talked about, the diversity of the channels we have, all of those are still very much intact.

是的。我還要補充一點，我們經營的規模，BetterHelp 業務的經營規模，還在繼續增長。我們繼續擴大我們擁有的收購渠道的多樣性。所以傑森談到的運營指標，我們擁有的渠道的多樣性，所有這些都仍然非常完整。

As we said in our prepared remarks, this is a business that's growing in the high 30s. So again, very robust growth. There are the trends that we are seeing over the last few weeks since February that is certainly making us come to you with revised guidance relative to the earlier expectations of growth that we had.

正如我們在準備好的評論中所說，這是一項在 30 年代高增長的業務。再次，非常強勁的增長。自 2 月以來的過去幾週，我們看到了一些趨勢，這無疑使我們向您提供了相對於我們之前對增長的預期的修訂指導。

Our next question goes to Richard Close with Cannacord Genuity.

我們的下一個問題是與 Cannacord Genuity 的 Richard Close。

Maybe to dive into Ryan's question a little bit more on the chronic side. Was there any impact with respect to Omada becoming the preferred vendor at Express Scripts with respect to the lowered guidance on the chronic side? And also on the chronic, you mentioned point solutions. Is it something where since you don't have the full integration of all the solutions on chronic with the whole-person health that that's definitely leading to people not -- or you not being able to close those deals?

也許在慢性方面更深入地探討瑞恩的問題。對於 Omada 成為 Express Scripts 的首選供應商，降低慢性方面的指導是否有任何影響？在慢性問題上，你提到了點解決方案。是不是因為你沒有將慢性病的所有解決方案與全身健康完全整合，這肯定會導致人們沒有——或者你無法完成這些交易？

Yes. So Richard, thanks for the question. With respect to Omada and Express, we really don't see a significant impact from that at all. I would say no to the question, is that the source of the challenge there. With respect to our outlook, as is typically the case, our guidance incorporates a little bit of in-year revenue, a modest amount of in-year revenue contribution from deals that we expect to sign and launch within the current year.

是的。所以理查德，謝謝你的問題。關於 Omada 和 Express，我們真的看不到任何重大影響。我會對這個問題說不，是那裡挑戰的根源。關於我們的展望，通常情況下，我們的指導包含了一點年內收入，以及我們預計在本年度簽署和啟動的交易的少量年內收入貢獻。

Our prior guidance assumed a low single-digit percentage point contribution from in-year revenue, meaning deals that we signed and launched within the same year. We felt that, that guidance range adequately captured the downside risk from a relatively modest contribution to the overall revenue. But we're seeing that pipeline just move more slowly than anticipated. So we've removed the significant majority of that from our outlook.

我們之前的指導假設年內收入的貢獻率只有個位數百分比，這意味著我們在同年簽署和啟動的交易。我們認為，該指導範圍充分捕捉了對整體收入貢獻相對較小的下行風險。但我們看到這條管道的移動速度比預期的要慢。因此，我們已經從我們的展望中刪除了其中的絕大部分。

As I think about that in the sort of grand scheme, as I said, it represents about 1/4 of the overall reduction in our outlook for revenue. I'm honestly not sure if we would have even -- if we would have made any reduction or modification to our outlook if it weren't consequent or commensurate with the change in our outlook for BetterHelp. So...

正如我所說的那樣，正如我所說的那樣，它代表了我們收入前景整體減少的 1/4 左右。老實說，我不確定我們是否會 - 如果我們對 BetterHelp 前景的改變不隨之發生或不相稱，我們是否會對我們的前景做出任何減少或修改。所以...

Yes. I mean I would also add from a profit perspective, as you see, it has a slightly -- it carries -- punches more weight from a profit perspective. If it were only that, we have cost levers, expense control levers that we would still have managed within and -- within the original guidance we gave.

是的。我的意思是我還要從利潤的角度補充，正如你所看到的，從利潤的角度來看，它有一點——它承載——更多的權重。如果只是這樣，我們仍然可以在我們提供的原始指導範圍內管理成本槓桿、費用控制槓桿。

And then, Richard, with respect to the maturity or where we are in terms of the integration of the chronic care solutions into our whole-person strategy, we are seeing incredibly strong -- we do a lot of market research, and we're in the middle of another study. We're seeing very, very strong response to that whole-person approach.

然後，理查德，關於成熟度或我們在將慢性護理解決方案整合到我們的全人戰略方面的位置，我們看到了令人難以置信的強大——我們進行了大量的市場研究，我們正在在另一項研究中。我們看到對這種全人方法的反應非常非常強烈。

But like I said, because it's still sort of on the verge of being finished with the integration, we don't have the proof points behind it. So people are waiting and anxious to see and the early adopters are buying, but we haven't yet hit the bulk of the market in terms of those who are waiting to see the impact that it will have. And I'm very, very confident in that impact. And we're starting to see, like I said, with large health plans we're buying in order to offer it to their large self-insured clients.

但是就像我說的那樣，因為它仍然處於完成集成的邊緣，所以我們沒有它背後的證據。因此，人們正在等待和急於看到，早期採用者正在購買，但就那些等待看到它產生的影響的人而言，我們還沒有進入大部分市場。我對這種影響非常非常有信心。正如我所說，我們開始看到我們購買的大型健康計劃是為了將其提供給他們的大型自我保險客戶。

Our next question goes to Stephanie Davis with SVB Securities.

我們的下一個問題是 SVB 證券的斯蒂芬妮戴維斯。

Jason, I know you've been asked this a bunch, but I'd love your strategic thoughts on the DTC cost arc because the 2 quarters you've ever missed both were DTC-driven. Is this solution going to be anything D2C strategy-related like the extra tail on wing of the private side funding? Or is it going to be less DTC entirely and more on accelerating the mix shift towards the B2B business? And with that in mind, what kind of leverage could you pull to accelerate that?

傑森，我知道你被問過很多這樣的問題，但我喜歡你對 DTC 成本弧的戰略想法，因為你錯過的兩個季度都是 DTC 驅動的。這個解決方案是否會與 D2C 戰略相關，例如私人資金的額外尾翼？還是會完全減少 DTC，而更多地加速向 B2B 業務的混合轉變？考慮到這一點，你可以利用什麼樣的槓桿來加速這一進程？

Levers to accelerate the B2B business? Yes. No, I think -- look, I think as you've seen from us, the significant majority of our investment in terms of R&D is going into our whole-person approach of integrating the products and services as well as where we focused our M&A dollars and put our balance sheet to work is on the B2B side of the business. We love the BetterHelp business and the growth that it generates. And we also know that over the long term, the gross margins on the B2B business tend to be higher, and that is a long-term sticky business.

加速 B2B 業務的槓桿？是的。不，我認為——看，我認為正如你從我們那裡看到的那樣，我們在研發方面的大部分投資都用於我們整合產品和服務的全人方法以及我們專注於併購的地方美元並讓我們的資產負債表發揮作用是在業務的 B2B 方面。我們熱愛 BetterHelp 業務及其帶來的增長。而且我們也知道，從長遠來看，B2B 業務的毛利率往往更高，這是一項長期粘性的業務。

So there's no question that we expect to see the fruits of our investment in the whole-person approach and the integration and the data platform work that we're doing yield benefits in the B2B market. And I have a lot of confidence in that based on the feedback that we get from our clients and prospects. We're just -- again, we're sort of on the journey to get there, and this is a big year of integration, and I expect to come out the other side of it with a significant opportunity based on an unmatched set of products in the markets.

因此，毫無疑問，我們希望看到我們對全人方法的投資以及我們正在做的集成和數據平台工作的成果在 B2B 市場中產生效益。根據我們從客戶和潛在客戶那裡獲得的反饋，我對此充滿信心。我們只是 - 再一次，我們正處於實現目標的旅程中，這是整合的重要一年，我希望能夠基於無與倫比的一套重要機會走出它的另一面市場上的產品。

Yes. And I would add, Stephanie, the dynamics in terms of the size of the opportunity, the addressable market, that's still unchanged, right, whether it be in any of the different conditions that we plan; Primary360, where we are seeing strong resonance as we go out and sell to clients, all of that is unchanged. What we are doing is, as we've talked about these different areas that we are spending, investing in from an R&D perspective, from a T&D perspective, it's important that we actually continue to stay focused on it. And we've always said those are going to drive long-term sustainable revenue growth. And I do think it's important that we continue to execute on it, focus on it. And as we always have done, we will continue to drive operating leverage in terms of expense controls and discipline in the business as we have always done.

是的。我要補充一點，斯蒂芬妮，就機會規模和潛在市場而言的動態，這仍然沒有改變，對，無論是在我們計劃的任何不同條件下； Primary360，當我們走出去向客戶銷售時，我們看到了強烈的共鳴，所有這些都沒有改變。我們正在做的是，正如我們已經談到我們正在花費的這些不同領域，從研發的角度，從 T&D 的角度進行投資，重要的是我們實際上繼續專注於它。我們一直說這些將推動長期可持續的收入增長。我確實認為重要的是我們繼續執行它，專注於它。正如我們一直以來所做的那樣，我們將一如既往地在費用控制和業務紀律方面提高運營槓桿。

Our next question goes to Daniel Grosslight with Citi.

我們的下一個問題是花旗的 Daniel Grosslight。

Given it seems that BetterHelp and chronic care pressures will persist for the remainder of the year, I'm curious how you're thinking about the quarterly cadence of margin expansion in the latter half of the year. I just looked at the midpoint of the guidance. It implies that the second half EBITDA margins will increase from around 7.5% in 2Q to around 12% for that second half. Can you?

鑑於 BetterHelp 和慢性護理壓力似乎將在今年剩餘時間內持續存在，我很好奇您如何看待下半年利潤率擴張的季度節奏。我只是看著指導的中點。這意味著下半年 EBITDA 利潤率將從第二季度的 7.5% 左右增加到下半年的 12% 左右。你可以嗎？

Yes. It's a great question, Daniel. The way we are thinking about the progression of the margins is, again, while we have taken down our overall revenue guidance for the year, we still do expect the revenue to ramp through the year, right? So that is one of the drivers of margin expansion.

是的。這是一個很好的問題，丹尼爾。同樣，我們考慮利潤率增長的方式是，雖然我們已經取消了今年的整體收入指導，但我們仍然預計全年收入會增加，對吧？因此，這是利潤率擴張的驅動力之一。

The second thing is, as we have talked about on the last earnings call, on the DTC side of the business in BetterHelp, we did -- as is normal for us, we are heading up on the ad spend early in the year in Q1 and in the first part of the year. And the benefit of that is sort of a gift that keeps giving through the year as we get members and we keep those members, we retain those members and as we increase the LTV of those members. So that sort of -- think of it as an increasing impact financially as we go through the year.

第二件事是，正如我們在上次財報電話會議上談到的那樣，在 BetterHelp 業務的 DTC 方面，我們做到了——這對我們來說是正常的，我們將在今年年初的第一季度開始廣告支出並在今年上半年。這樣做的好處是一種禮物，隨著我們獲得會員並保留這些會員，我們保留這些會員並增加這些會員的 LTV，我們會在一年中不斷給予。因此，隨著我們這一年的發展，將其視為對財務的影響越來越大。

And then the last thing I would say is, the fact that we are expanding margins as we go from the beginning of the year towards the end of the year is something that is entirely consistent with what we've done every year. And as we think about the enrollment ramp and the fact that we are bringing on enrollees on the chronic care side as we go through the year, that is also something that is going to contribute to the expansion in adjusted EBITDA margins as we go through the year.

然後我要說的最後一件事是，我們從年初到年底都在擴大利潤這一事實與我們每年所做的完全一致。當我們考慮到入學人數的增加以及我們在這一年中招募慢性護理方面的參與者這一事實時，這也將有助於我們經歷調整後 EBITDA 利潤率的擴張年。

So what I would say to you is, the way we have thought about and the drivers of margin progression as we go through the year, those -- when we came out in February with our earlier guidance and the way we are thinking about it now, very much the same drivers, albeit the reduction in the revenue guidance.

所以我要對你說的是，我們在這一年中的思考方式和利潤率增長的驅動因素，那些——當我們在 2 月份發布之前的指導時，以及我們現在思考的方式，儘管收入指導有所減少，但驅動因素幾乎相同。

Our next question goes to Charles Rhyee with Cowen.

我們的下一個問題是與 Cowen 一起向 Charles Rhyee 提問。

Maybe to follow up on that, Mala. You talked about the components, and I know you don't want to talk past really 2022, but it sounds like what you're saying is that other than maybe a lower starting point here, the components for margin expansion is still largely intact. Can you remind us then maybe from the Analyst Day when you guys gave the sort of the 100 to 150 basis points of margin expansion sort of long term, what sort of the components were?

也許跟進，馬拉。您談到了組件，我知道您不想談論真正的 2022 年之後，但聽起來您的意思是，除了這裡的起點可能較低之外，利潤率擴張的組件在很大程度上仍然完好無損。你能否提醒我們，也許從分析師日開始，你們給出了 100 到 150 個基點的長期保證金擴張，是什麼組成部分？

Perhaps, what were you expecting from chronic care versus BetterHelp within those? So as we think about the revised outlook here and we kind of take out for-hire DTC costs, is this kind of range that you were projecting beforehand still sort of in the ballpark? Maybe help us out because it sounds like what you're saying is the long-term thesis in terms of margin levers is still there.

也許，您對慢性護理與 BetterHelp 的期望是什麼？因此，當我們在這裡考慮修改後的前景並且我們會扣除出租 DTC 成本時，您之前預測的這種範圍是否仍然在球場上？也許可以幫助我們，因為聽起來你所說的是關於保證金槓桿的長期論點仍然存在。

Yes. Charles, thanks. We are not in a position to provide an outlook beyond the guidance that we just gave, just given the rapidly evolving environment for virtual care, right? We've talked about the dynamics that have emerged over the last several weeks. And so we are in the process of reevaluating how these various dynamics discussed in the remarks that we just gave and we've addressed in our Q&A, how they affect our longer-term growth outlook. And we will give you all an update after we have completed our evaluation.

是的。查爾斯，謝謝。鑑於虛擬護理的快速發展環境，我們無法提供超出我們剛剛給出的指導的展望，對吧？我們已經討論了過去幾週出現的動態。因此，我們正在重新評估我們剛剛給出的評論中討論的這些各種動態以及我們在問答中討論的這些動態，它們如何影響我們的長期增長前景。完成評估後，我們會為大家提供更新。

What I will say is, with all of that said, we are confident from a long-term perspective in our strategy and positioning in the market, similar to what -- consistent with what Jason said a few minutes ago. I don't want to go into more details than that at this moment just given how much things have evolved.

我要說的是，綜上所述，從長遠的角度來看，我們對我們的戰略和市場定位充滿信心，類似於 - 與幾分鐘前傑森所說的一致。考慮到事情已經發展了多少，我現在不想詳細說明。

Our next question is to Jessica Tassan with Piper Sandler.

我們的下一個問題是與 Piper Sandler 一起向 Jessica Tassan 提問。

So just as we think about the 30% to 40% growth in behavioral, can you help us understand how much of that anticipated growth is membership-driven? And how much is pricing-driven?

因此，正如我們考慮 30% 到 40% 的行為增長一樣，您能否幫助我們了解預期增長中有多少是由會員驅動的？有多少是定價驅動的？

We typically will not go into the details. You're talking about BetterHelp? We typically will not go into the details of how much of it is membership-driven versus pricing-driven. That's a level of detail that we have not disclosed in the past.

我們通常不會詳細介紹。你說的是BetterHelp？我們通常不會詳細說明其中有多少是會員驅動與定價驅動的。這是我們過去沒有披露的詳細程度。

Our next question goes to Allen Lutz with Bank of America.

我們的下一個問題是美國銀行的 Allen Lutz。

I guess to go back to BetterHelp again, as you think about the advertising that you spent in the first quarter and you think about advertising as a percent of revenue, how should we think about that trending in the second quarter? And then over the course of the year? Is that something that's going to kind of continue to creep up? Or is 1Q kind of a peak level there based on what's embedded in the guide?

我想再次回到 BetterHelp，當您考慮您在第一季度花費的廣告並且您認為廣告佔收入的百分比時，我們應該如何看待第二季度的趨勢？然後在一年中？這是會繼續蔓延的東西嗎？還是根據指南中嵌入的內容，那裡的 1Q 是一種峰值水平？

So what we are -- what we have embedded in our full year forecast, Allen, as we've talked about, is a 10% increase in our cost of acquisition for the year. I would say, I don't want to go into a more detailed phasing of that as we go through the year. The only thing I would remind you of is things are -- the market is evolving. It is.

所以我們是什麼——我們在全年預測中嵌入了什麼，艾倫，正如我們所談到的，我們今年的採購成本增加了 10%。我想說，隨著我們這一年的發展，我不想進入更詳細的階段。我要提醒你的唯一一件事是——市場正在演變。這是。

There are various dynamics as we talked about. But typically, what we would say is we heavy up on advertising as we -- in the early part of the year. And what we have said in the past is if you think about 4Q and we go into the holiday season, in a typical year, 2020 was a non-normal year. But in an average typical year, we do tend to see much higher advertising costs and we sort of pull back because, again, we run the BetterHelp business in a highly ROI-driven way. So you should expect to see similar type of dynamics playing out as we go through the year.

正如我們所討論的，有各種動態。但通常情況下，我們會說我們在今年年初時會大力投放廣告。我們過去說過的是，如果您考慮 4Q 並且我們進入假日季節，在典型的一年中，2020 年是不正常的一年。但在一般的典型年份中，我們確實傾向於看到更高的廣告成本並且我們會有所回落，因為我們再次以高度 ROI 驅動的方式運營 BetterHelp 業務。因此，您應該期望在這一年中看到類似的動態。

Our next question goes to George Hill with Deutsche Bank.

我們的下一個問題是德意志銀行的喬治希爾。

I guess, Jason, I want to come back to the market dynamics that you talked about, about the employer market seemingly taking a pause and looking for somebody who can bring to bear kind of an entire suite solution. I think you called it the whole-person solution. And I guess my question is 2 parts. One is do you feel like that -- this is enough of a hiccup in the market that could impact the selling season for new business into 2023? And competitively, are you seeing a different group of competitors, whether it's one-off solutions that are trying to compete with you guys on a telemedicine basis? Or are you seeing the MCOs, and somebody else referenced once earlier, trying to cobble together their own suite of third-party solutions to compete against you guys? So I'm trying to understand, like is the competitive dynamic shifting in a different way? So I guess it's kind of sales season, your breadth, competitive dynamic.

我想，傑森，我想回到你談到的市場動態，關於雇主市場似乎暫停並尋找可以帶來一整套解決方案的人。我想你稱之為全人解決方案。我想我的問題是兩部分。一個是你有這樣的感覺嗎？這足以影響到 2023 年新業務的銷售季節的市場小問題嗎？在競爭方面，您是否看到了一組不同的競爭對手，無論是一次性解決方案都試圖在遠程醫療的基礎上與你們競爭嗎？或者您是否看到 MCO 和之前提到的其他人試圖拼湊他們自己的第三方解決方案套件來與你們競爭？所以我試圖理解，競爭動態是否以不同的方式轉變？所以我想這是一個銷售季節，你的廣度，競爭動態。

Yes. George, I think it's too soon to tell what the impact will be on the selling season for 2023 business. What I can tell you is that we've seen a lot of very strong managed care opportunities move through our pipeline to the very late stages of that. The big health plans are embracing our services for multiple services, and we're contracting with them to be available for their large self-insured clients, which is a pipeline that will begin to develop now and then mature over the course of the summer into the really early fourth quarter.

是的。喬治，我認為現在說這將對 2023 年業務的銷售季節產生什麼影響還為時過早。我可以告訴你的是，我們已經看到很多非常強大的管理式醫療機會通過我們的管道進入到最後階段。大型健康計劃正在接受我們的多項服務，我們正在與他們簽訂合同，以便為他們的大型自保客戶提供服務，這是一個將開始發展的管道，然後在整個夏季成熟到真正的第四季度初。

I think the other part that is very encouraging to me is the reception that we're getting to Primary360. Primary360, Mala and I have always said, was going to be a very modest contributor to 2022 but then would ramp in '23 and '24 to become much more significant. I would say that it's progressing with our sales faster than both Mala and I had expected. We're seeing good traction with very large opportunities who are embracing that solution and that -- we believe very strongly that that's going to be an on-ramp as we talked about in November for our chronic care solutions. So when we talk about 78% of our sales being multiproduct sales, that's a self-reinforcing phenomenon where we get to multiple products, and therefore, multiple on-ramps to the full suite.

我認為對我來說非常鼓舞人心的另一部分是我們進入 Primary360 的接待。馬拉和我一直說，Primary360 將成為 2022 年的一個非常溫和的貢獻者，但隨後會在 23 年和 24 年變得更加重要。我想說，我們的銷售進展比 Mala 和我預期的要快。我們看到了良好的牽引力，擁有非常大的機會，他們正在接受該解決方案，並且我們非常堅信，正如我們在 11 月談到我們的慢性護理解決方案時那樣，這將成為一個入口。因此，當我們談到我們 78% 的銷售額是多產品銷售時，這是一種自我強化的現象，我們可以使用多種產品，因此需要多條通道通往全套產品。

Our next question goes to Stan Berenshteyn with Wells Fargo.

我們的下一個問題是富國銀行的 Stan Berenshteyn。

I guess on the direct-to-consumer mental health side, Jason, just to understand the comments you're making. So your business is being adversely impacted because you aren't getting patients that potentially seem to be seeking controlled substances when they're initiating a web search. And I understand that your business, you're not prescribing these medicines. So I guess my question is, why would someone who is suitable for BetterHelp instead end up signing up for these other competitors that you're discussing?

我想在直接面向消費者的心理健康方面，傑森，只是為了了解你所做的評論。因此，您的業務受到了不利影響，因為您沒有讓患者在開始網絡搜索時似乎正在尋找受控物質。而且我了解您的業務，您沒有開這些藥。所以我想我的問題是，為什麼適合 BetterHelp 的人最終會報名參加您正在討論的其他競爭對手？

Because they provide both online therapy and controlled substances. So it's a broader net. And it just provides access to a population who may make -- may be making decisions between multiple options. Again, we believe that that's a temporary issue because I believe that the prohibition will be reinstated -- on prescribing controlled substances is likely to be reinstated or it would take an actual change in the regulations. And again, I think that is a companion issue, where the bigger issue for us is the increase in the price of advertising in paid search and social.

因為他們提供在線治療和受控物質。所以這是一個更廣泛的網絡。它只是提供了對可能做出的人群的訪問——可能在多種選擇之間做出決定。同樣，我們認為這是一個暫時的問題，因為我相信禁令將會恢復——可能會恢復開具受控物質的規定，或者需要對法規進行實際更改。再說一次，我認為這是一個伴隨問題，對我們來說更大的問題是付費搜索和社交廣告價格的上漲。

Our next question goes to Elizabeth Anderson with Evercore. Since we're not getting any audio from Elizabeth, we will move on to the next question. Our next question is from Cindy Motz with Goldman Sachs.

我們的下一個問題是關於 Evercore 的 Elizabeth Anderson。由於我們沒有從伊麗莎白那裡得到任何音頻，我們將繼續討論下一個問題。我們的下一個問題來自高盛的 Cindy Motz。

I just wanted to get back to, I think it was Sandy's question, just if maybe some of this is not overriding like recessionary fears from some of your clients maybe in the chronic care segment, maybe watching wage inflation and different things pulling back a little. And then even with BetterHelp, even if -- when you think about it, maybe people are looking for a way to get whatever they can for a cheaper price at this point.

我只是想回到，我認為這是桑迪的問題，只是如果其中一些問題沒有像你的一些客戶可能在慢性護理領域的衰退恐懼那樣壓倒一切，也許是看著工資上漲和其他事情有所回落.然後即使有了 BetterHelp，即使 - 當你想到它時，也許人們現在正在尋找一種方法來以更便宜的價格獲得任何東西。

So whether it is those macro situations just because, I guess, the customer acquisition costs were supposedly coming down with BetterHelp. I know everything sounded very strong 6 weeks ago, and then here we are. And so just -- also to -- any way you could help us think about the margins -- the segment margins at all in relation to each other? You said, Mala, that the margins were still attractive with like BetterHelp, so I assume they are in chronic. But that would help us just to have sort of a long-term view about whether this is something macro-driven and not temporary.

因此，無論是那些宏觀情況，我猜想，BetterHelp 應該會降低客戶獲取成本。我知道 6 週前一切聽起來都很強大，然後我們就到了。所以只是 - 也是 - 你可以用任何方式幫助我們考慮邊距 - 段邊距彼此之間的關係？你說，馬拉，像 BetterHelp 這樣的利潤仍然很有吸引力，所以我認為它們是長期存在的。但這將有助於我們對這是否是宏觀驅動而不是暫時的事情有一種長期的看法。

Yes. Cindy, it is certainly possible that there are macro effects. We don't have evidence of it, and so we're not going to sit here and tell you that, that is definitely the source of a slowdown in the cadence of opportunities moving through our pipeline and getting to close.

是的。辛迪，當然有可能有宏觀效應。我們沒有證據，所以我們不會坐在這裡告訴你，這絕對是機會在我們的管道中移動並接近關閉的節奏放緩的根源。

On the BetterHelp side, again, we don't have clear evidence that recession or inflation or consumer sensitivity to pricing is the driver. We do have evidence of increasing ad costs that really changed between January and February and then as we moved into March, increased significantly. And it's been that way on a sustained basis since the beginning of March. So the -- we can only point to the things that we have clear evidence of and state with confidence. And I wouldn't disagree. That is a hypothesis. And quite frankly, we're working on trying to figure out how we test that hypothesis, among others.

在 BetterHelp 方面，我們沒有明確的證據表明衰退或通貨膨脹或消費者對定價的敏感性是驅動因素。我們確實有證據表明，廣告成本在 1 月和 2 月之間確實發生了變化，然後隨著我們進入 3 月，顯著增加。自 3 月初以來，這種情況一直持續存在。所以——我們只能指出我們有明確證據並有信心陳述的事情。我不會不同意。那是一個假設。坦率地說，我們正在努力弄清楚我們如何檢驗該假設等。

And Cindy, on your margin question, just a couple of comments. If I think about 1Q and gross margin and how that trended on a year-on-year basis, if you were to normalize for the purchase price accounting benefits, our gross margins were essentially flat year-over-year. And so I would say, if I think about our margin progression, as I said, I will not go beyond 2022 for all the reasons I mentioned. We are reevaluating across the board.

辛迪，關於你的邊際問題，只是幾條評論。如果我考慮第一季度和毛利率以及同比趨勢如何，如果你要對購買價格會計收益進行標準化，我們的毛利率與去年同期基本持平。所以我想說，如果我考慮到我們的利潤率進展，正如我所說，由於我提到的所有原因，我不會超過 2022 年。我們正在全面重新評估。

But I will say that we will -- as I have said before, we will look to maintain expense controls. We'll make the right investments that get us to long-term sustainable growth from a revenue standpoint. And I've always said that revenue scaling ultimately is the thing that will drive our long-term margin expansion. And as we increasingly go into value-based care arrangements, et cetera, we will also look to increase our gross profit dollars and our adjusted EBITDA profit dollars. All of that thinking is -- still holds. We do not break out the margins for different parts of our business since we report it as one.

但我會說我們會 - 正如我之前所說，我們將尋求維持費用控制。從收入的角度來看，我們將做出正確的投資，使我們實現長期可持續增長。而且我一直說，收入增長最終將推動我們的長期利潤率擴張。隨著我們越來越多地進入基於價值的護理安排等，我們還將尋求增加我們的毛利潤和調整後的 EBITDA 利潤。所有這些想法 - 仍然成立。由於我們將其報告為一個，因此我們不會將我們業務的不同部分的利潤分開。

This concludes today's Teladoc 2022 Q1 Earnings Conference Call. Thank you for your participation. You can now disconnect your lines

今天的 Teladoc 2022 年第一季度收益電話會議到此結束。感謝您的參與。您現在可以斷開線路