Teladoc(TDOC) - 2024 Q3 - Earnings Call Transcript

Financial Data and Key Metrics - Q3 2024 consolidated revenue was $641 million, a 3% YoY decrease [24] - Q3 2024 adjusted EBITDA was$ 83.3 million, down 6% YoY, with a margin of 13% [24] - Q3 2024 net loss per share was $0.19, compared to$ 0.35 in Q3 2023 [25] - Q3 2024 free cash flow was $79 million, up 16% YoY [26] - Cash and cash equivalents at the end of Q3 2024 were over$ 1.2 billion [26] Business Segment Performance Integrated Care - Q3 2024 revenue was $384 million, up 2.5% YoY, exceeding guidance [27] - U.S. Integrated Care membership reached 93.9 million, up 4% YoY and 1.5 million sequentially [28] - Chronic Care program enrollment was 1.18 million, up 5% YoY [29] - International Integrated Care revenue grew in the high-teens on a constant currency basis [29] - Adjusted EBITDA for Integrated Care was$ 68 million, up 8% YoY, with a margin of 17.7% [32] BetterHelp - Q3 2024 revenue was $257 million, down 10% YoY [33] - Average paying users declined by 2% sequentially and 13% YoY [34] - Adjusted EBITDA for BetterHelp was$ 15.2 million, down from $26 million in Q3 2023 [36] - Adjusted EBITDA margin for BetterHelp was 5.9%, down 320 basis points YoY [36] Market Performance - U.S. market faces high medical cost trends and customer demand for more value from virtual care [13] - International Integrated Care shows strong momentum with geographic expansion and market penetration [15] - BetterHelp is focusing on stabilizing U.S. results and growing internationally [17] Strategic Direction and Industry Competition - Company is streamlining leadership, rationalizing priorities, and improving execution to address operational challenges [10] - Focus on enhancing value proposition in U.S. Integrated Care through virtual visits and chronic condition management [14] - International Integrated Care is a core priority for growth, with investments planned [15] - BetterHelp is exploring initiatives to allow consumers to access coverage benefits, with discussions underway with health plans [18] - Company is leveraging technology to drive scale, differentiation, and integrated member/provider experiences [20] - Clinical excellence remains a core pillar, with a focus on product roadmap and service delivery [21] Management Commentary on Operating Environment and Future Outlook - Company is navigating a challenging U.S. market with high medical cost trends and customer demand for value [13] - Management is confident in the company's ability to unlock growth potential through strategic investments [23] - For 2025, the company expects revenue growth in line with Q4 2024 projections, with continued margin expansion [47] - BetterHelp is expected to face tough comps in 2025 due to elevated customer acquisition costs [51] - Company is committed to maintaining adjusted EBITDA margins in 2025 in line with 2024 levels [50] Other Important Information - Company recorded a$ 3.6 million charge related to severance and lease termination costs in Q3 2024 [26] - Q4 2024 guidance for Integrated Care revenue is flat to up 2.5%, with adjusted EBITDA margin between 12.25% and 13.75% [38] - Full-year 2024 adjusted EBITDA margin is expected to be 14.9% to 15.3%, with adjusted EBITDA dollars up approximately 20% YoY [39] - U.S. Integrated Care membership guidance for 2024 is raised to 93.5 to 94.5 million [40] Q&A Session Summary Question: BetterHelp's transition to fee-for-service model - Company is focused on stabilizing the U.S. business and improving profitability [58] - Discussions with health plans and partners are underway to enable consumers to access coverage benefits [59] - Transition is being approached methodically to ensure investments align with returns [60] Question: Competitive landscape in virtual care - Company emphasizes its scale and ability to deliver virtual visits efficiently [61] - Membership growth supports cross-selling opportunities through the land-and-expand strategy [63] Question: 2025 selling season and retention - Bookings are lower YoY, particularly in the health plan space, due to market pressures [67] - Retention rate remains above 90%, but is slightly lower than prior years [66] - Company is focusing on driving enrollment, visit volume, and pricing strategies to grow revenue [72] Question: BetterHelp's payer-sponsored arrangements - BetterHelp remains primarily a direct-to-consumer model, with initiatives to explore coverage benefits [76] - Company is leveraging existing B2B relationships to advance discussions with payers [78] Question: Investments and repositioning for 2025 - Company is evaluating capital allocation to align with strategic priorities and balance investments with returns [81] - Investments are expected to improve revenue growth and operating metrics, such as CCM conversion rates [82] Question: BetterHelp user count stabilization - Stabilization in user count is driven by international ad spend and stable retention/churn metrics [87] - Q4 ad spend will be reduced, but less sharply than in prior years, impacting Q1 2025 user growth [88] Question: 2025 revenue growth and margin outlook - Company expects 2025 revenue growth to be consistent with Q4 2024 projections, with flat to slightly up margins [91] - Investments in 2025 will focus on strengthening the business and adapting to market demands [49] Question: Product improvements and retention - Company is focusing on improving performance management and product integration to drive better outcomes [100] - Investments in capabilities will enhance the value of virtual visits and align with health plan strategies [103] Question: Utilization trends in Integrated Care - Visit revenue growth is strong, driven by membership gains and accretive visit volumes [113] - Company expects continued growth in visit revenue and engagement as new members are onboarded [114] Question: Tech and development spend - Company is rationalizing tech and development spend to align with strategic priorities and create efficiencies [118] - Overall spend is expected to decrease over time, freeing up capacity for future investments [119] Question: G&A expense step-up in Q4 - G&A increase in Q4 is due to one-off investments and is not expected to continue into 2025 [122] - Company will manage expense base relative to revenue growth across both Integrated Care and BetterHelp [122]