Teladoc Health, Inc.

Thank you and good afternoon. Today, after the market close, we issued a press release announcing our first quarter 2024 financial results. This press release and the accompanying slide presentation are available in the investor relations section

of the TeladocHealth.com website. On this call to discuss the results are Mala Murthy, our Acting Chief Executive Officer and Chief Financial Officer, and Laser Kornwasser, our President of Enterprise Growth and Global Markets. During this call, we will also discuss our 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. 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. I would now like to turn the call over to Mala.

Thank you, Adam, and thanks, everyone, for joining us today. Before we begin, I'd like to take a moment to reflect on the recent leadership changes at Teladoc Health. First off, on behalf of Teladoc's more than 5,000 employees, board of directors, and executive leadership team, I would like to extend our deepest gratitude to Jason Gorovec for his accomplishments over the past 15 years. Jason leaves a tremendous legacy, having firmly established Teladoc as the industry leader in whole person virtual care. As we mentioned in our February earnings call, Teladoc is in a time of transition. And as part of this evolution, the board of directors decided that it was time to look for a new leader for our company, someone to help us write the next chapter in our growth story. The board search for a successor is well underway and our permanent CEO is expected to be named later this year. The board has appointed me to serve as CEO while they conduct the search and I'm honored to play this role for a company whose work I believe in so deeply. In the meantime, however, We are wasting no time in identifying and seizing opportunities to leverage our significant assets and capabilities. As an organization, our focus is on accelerating growth on both the top and bottom lines over the medium and longer term. And my focus as acting CEO is to ensure that our strategy continues to be supported by the appropriate level of investment, that our leadership team is executing on our priorities, and that we are accelerating the pace of change and innovation across our business. With that, turning now to a review of our first quarter performance. I'm pleased to report a solid start to the year across the business, exceeding our financial and operating guidance for both consolidated revenue and adjusted EBITDA in the first quarter. Our team remains laser focused on our key initiatives, which include building upon our market leadership position, driving increased product penetration through our large installed base of over 90 million virtual care members, and accelerating our bottom line performance. This focus is evident in our first quarter results. In the integrated care segment, we are pleased to see continued strong interest in our whole person care suite of products. First quarter integrated care revenue grew 7.8% year over year to $377 million, benefiting from high single digit growth in our chronic care book of business, as well as strong visit revenues driven by increased infectious disease activity as well as an 8% increase in membership year over year. Chronic care enrollment remained strong, up 9% year over year in the first quarter. BetterHelp revenue of $269 million declined 3.7% versus a difficult comparison in the first quarter of last year. BetterHelp also generated modestly lower revenue on a sequential basis, driven in part by a decline in paying users following our typical pullback in ad spend in the fourth quarter, which is the most expensive time of the year in our marketing channels. Additionally, as expected, the lower returns on our social media advertising spend we experienced in the second half of 2023 persisted in the first quarter and are impacting our year-over-year growth rates in the first half of this year. We are making progress to improve our yield on advertising spend which contemplates not only cost per acquisition, but also retention and other factors as well. I will speak to our efforts to reinvigorate growth in our better health business later in the call. We continue to make progress on our bottom line performance. with first quarter consolidated adjusted EBITDA margin of 9.8%, improving 140 basis points year-over-year, and adjusted EBITDA of $63 million, growing nearly 20% year-over-year. We are executing against our cost-saving and productive initiatives, and we remain on track to deliver $43 million in cost savings on a GAAP basis for our business in 2024 and a total of $85 million in 2025. The breadth of our product portfolio continues to drive productive conversations with both prospective and existing clients. Two-thirds of our bookings in the quarter came from cross-selling into our existing book of business, with the remaining third coming from new clients, reflecting a continuation of our cross-selling momentum over the past several quarters along with an acceleration in bookings from new business. Both existing and prospective clients are demonstrating increased interest in our Chronic Care Plus bundle solution, and we remain optimistic about our ability to drive increased product penetration through our install base of nearly 92 million members over the next several years. In Q1, we saw another example of our land and expand strategy playing out as we added our diabetes program into a large health benefits provider, a client who had previously only purchased our telehealth solution. We are also seeing growing interest in our weight management solution from employers who are grappling with rising costs for GLP-1s and employee demand for these products. The addition of approximately 2.2 million members on a sequential basis since Q4 represents additional greenfield opportunity for future cross-sell and product penetration. And with more than $1 billion in cash and cash equivalents on our balance sheet, our financial strength continues to be another differentiator for our company and provides us with significant capacity and flexibility to invest and innovate in our business. We also continue to see growing benefits from our early and ongoing commitment to data and artificial intelligence, with AI models now integrated across nearly all aspects of our business. From provider matching to enrollment optimization to member engagement, this automation is helping us not only reach our revenue and profitability goals, but also achieve our mission of improving health by reaching more consumers. One exciting example is our use of generative AI in member engagement to create hyper-personalized content for individuals to get them signed up for Teladoc services they need and then keep them on track. Our pilots with this AI use case, while still being carefully studied, are already delivering significant improvement in member engagement over prior approaches. I would now like to spend a few minutes reviewing our first quarter financial results in detail. First quarter consolidated revenue increased 3% year-over-year to $646 million, while first quarter adjusted EBITDA was $63 million, representing a margin of 9.8%. First quarter financial performance benefited from higher revenues in our integrated care segment and improved expense control. Turning to segment results, integrated care revenue increased 8% year-over-year to $377 million in the quarter, with growth relatively balanced across the portfolio. First quarter integrated care adjusted EBITDA was $47.7 million, representing a 260 basis point expansion in margins to 12.6%. The marginal performance relative to guidance was largely driven by strong chronic care program enrollment during the first quarter, which, combined with better expense control, helped deliver improved gross margins and bottom line performance. Total chronic care program enrollment was 1.12 million at the end of the first quarter, representing growth of 9% year over year. Total U.S. integrated care members grew 6.9 million over the prior year representing 8% growth and grew by 2.2 million sequentially to 91.8 million. Average integrated care revenue per U.S. member of $1.38 was down one cent over the prior year's first quarter. reflecting the timing of new client onboarding and enrollment ramp. The onboarding of large populations and our expanding membership base represent a long runway for continued cross-selling of our chronic care and other B2B products as we execute against our land and expand strategy. First quarter BetterHelp segment revenue decreased 4% year-over-year to $269 million driven by an 11% decrease in paying users. First quarter BetterHelp adjusted EBITDA was $15.5 million, representing a margin of 5.7%. As we have discussed previously, the first quarter is typically the seasonally weakest quarter from a margin perspective for our BetterHelp business, as marketing expense ramps up following the fourth quarter holiday season. As such, We continue to expect the first quarter to be the low point of the year for better health segment margins and we expect consistent quarter over quarter margin improvement through the course of 2024. Consolidated net loss per share in the first quarter was 49 cents compared to a net loss per share of 42 cents in the first quarter of 2023. Net loss per share in the first quarter includes stock-based compensation of $42.3 million, or 25 cents per share, restructuring charges primarily related to severance of $9.7 million, or 6 cents per share, and amortization of acquired intangibles of $64.2 million, or 38 cents per share. During the first quarter, free cash flow was a net outflow of $27 million compared to a net outflow of $32 million in the first quarter of 2023. As a reminder, the first quarter is our seasonally lowest cash flow quarter given the payment of annual incentive compensation. We ended the quarter with $1.1 billion in cash and cash equivalents on the balance sheet. Turning now to forward guidance, beginning with our integrated care segment. We expect integrated care revenue in the second quarter to be between 2% and 5% versus the prior year period. As a reminder, in our first quarter call, we called out a delay in launching our B2B consumer engagement efforts due to a technical issue in mapping new client populations. with an expected cumulative negative impact of $20 million for the full year, particularly in the second and third quarters. The impact of this delay, coupled with strong year-over-year first quarter chronic care results and the seasonal fall-off of infectious disease-driven visit revenues versus the first quarter, is expected to result in a lower year-over-year second quarter growth rate compared to our first quarter results. For the full year, As previously guided we expect integrated care revenues to be in the low to mid single digits reflecting higher revenues in the second half versus the first half of the year. Do you primarily to the enrollment ramp and chronic care and a growing contribution from the nearly 6 million new integrated care members. We have added since the second quarter of last year. From an adjusted EBITDA perspective, we expect a 12 to 14 percent margin in the second quarter, and we continue to expect 150 to 250 basis points of margin expansion for the full year, reflecting revenue-driven operating leverage and the impact of our cost-saving initiatives. As it relates to U.S. integrated CARE membership, we expect 92 to 93 million members for the second quarter, and 92 to 94 million members for the full year, an increase from previous guidance after adding 2 million members in the first quarter. Turning now to our BetterHelp segment. For the second quarter, we expect BetterHelp revenues to be in the range of a negative 8% to negative 4% over the prior year period. Our second quarter guidance reflects challenging cost per acquisition through early Q1, which caused us to pull back on our advertising dollars in the quarter in keeping with our goal of balancing growth and margin. These factors led to a decline in users in Q1, which is impacting our Q2 revenue growth rate on top of a difficult comparison relative to the second quarter of 2023. However, we are seeing signs of stabilization in our cost per acquisition in more recent weeks, which gives us increased confidence in the back half of the year for a better health business something I will speak to momentarily. For the full year, we continue to expect flat to low single-digit revenue growth in BetterHelp. We do expect BetterHelp growth to accelerate in the second half of the year. I'd like to take a moment to discuss what's giving us increased confidence in the future of our BetterHelp business, which has been challenged in recent quarters. Late last year, we brought in new leadership for BetterHelp. who have helped inject a broader and more global perspective on growth levers for this business. We are seeing improvements in retention and in our international business, which are helping offset some of the impact from higher CPAs in the US by improving our overall yield on advertising spend. The success we are starting to see with these levers, along with the efforts in select international geographies that we expect to ramp in the second half of the year, give us confidence in our second half BetterHelp outlook. We expect these initiatives to lead to meaningfully higher membership growth and improve customer retention versus the first half. We are excited about the international opportunity, particularly in select English-speaking geographies that are relatively under-penetrated compared to the U.S. market, which will allow us to reallocate some advertising and marketing dollars at a higher marginal return as we continue to build out our infrastructure in those markets. Given these dynamics throughout the year, we expect BetterHelp revenue growth for the full year to be in the flat to low single digit range as previously guided, despite our lower first half growth. I would also note that we have thoroughly pressure tested the assumptions that underpin our BetterHelp guidance for the rest of the year. We take several factors into account when developing both the low end and the high end of the range, including recent trends in advertising yields, channel dynamics, consumer sentiment, and other macro factors, and we have taken a close look at each one of these. That said, the impact of difficult to predict macro events creates unknowns as it pertains to our yield on advertising in the second half of the year, And we will continue to provide updates on the trends that we are seeing in upcoming earnings calls. From a margin perspective, we expect BetterHelp adjusted EBITDA margins to be in the 9% to 10% range in the second quarter and continue to expect margins to be flat, plus or minus 50 basis points for the full year. The sequential margin improvements that we expect to see over the course of the year primarily reflect the cumulative effect of new members added over the course of the year, the cadence of advertising spending, including the typical seasonal pullback in the fourth quarter, and innovation-driven improvements in our yield on advertising spend. On a consolidated basis, we expect second quarter revenue of $635 million to $660 million, and adjusted EBITDA of $70 million to $80 million. Our full year guidance remains unchanged, with the exception of the increase to our US integrated care membership that I've mentioned previously. We continue to expect consolidated revenue to be in the range of $2.635 billion to $2.735 billion for the full year, representing revenue growth of 1% to 5%, along with consolidated adjusted EBITDA of $350 million to $390 million representing growth of 7% to 19% on a year-over-year basis. We expect full-year free cash flow of $210 million to $240 million, driven by both the growth in adjusted EBITDA and an expected decline in capitalized software development costs. We are also maintaining our prior EPS guidance for the full year. Lastly, we are reiterating the three-year outlook that we provided you on our earnings call in February. In closing, I want to recognize my executive team and our broader leadership team for leaning in during this time of change. I've been incredibly pleased with their continued focus on living our values and delivering for our members and clients this year, especially over the past several weeks. We've had a solid start to the year. and are poised to deliver significant growth in the second half of 2024. I remain focused on our strategy, our execution, and on our people. With that, we will open it up for questions. Operator?