Teladoc sees insurance rollout in 7 states and narrows 2025 guidance while strengthening integrated care

Earnings Call Insights: Teladoc Health (TDOC) Q3 2025

MANAGEMENT VIEW

* CEO Charles Divita stated that "our third quarter consolidated revenue and adjusted EBITDA both came in above the midpoint of our respective guidance ranges," highlighting the company's execution and progress on strategic priorities. He emphasized continued innovation in integrated care, noting that "over 100 million people have access to one or more of our services," and pointed to enhancements in the Prism care delivery platform, which now enables providers to address gaps in care and activate programs based on member eligibility.
* Divita discussed a 4% sequential growth in chronic care program enrollment and introduced AI-enabled clinical intervention pilots for rising and high-risk populations, with plans to bring these innovations to market in 2026. He also highlighted the integration of Catapult, stating it enhances engagement earlier in members' health journeys and creates cross-sell opportunities for Teladoc's broader offerings.
* The CEO reported that "visit-based revenues in 2025 now comprise over 50% of our U.S. virtual care revenues compared to approximately 40% in 2023," and said this mix shift is expected to moderate in impact going forward. For mental health, B2B visits achieved double-digit growth, with BetterHelp generating over $150 million in total revenue, excluding its entry into insurance-covered benefits.
* Divita shared that BetterHelp's insurance rollout, supported by the UpLift acquisition, is now live in 7 states and D.C., with several more states planned in 2025. He noted that "key metrics at this point are in line with our expectations, including conversion rates, user growth and sessions per user." The company also acquired Telecare in Australia to expand its international integrated care business.
* The CEO announced that CFO Mala Murthy will be stepping down next month, recognizing her role in shaping Teladoc's financial strategy.
* CFO Mala Murthy stated, "consolidated revenue of $626 million above the midpoint of our guidance range. Revenue declined 2.2% year-over-year as growth in our Integrated Care segment was offset by a decline at BetterHelp. Adjusted EBITDA of $70 million was at the high end of our guidance range, representing 11.2% margin." She also cited a net loss per share of $0.28, which included a noncash goodwill impairment charge of $0.07 per share pretax.

OUTLOOK

* Murthy reported that Teladoc now expects 2025 consolidated revenue of $2.510 billion to $2.539 billion and adjusted EBITDA of $270 million to $287 million. Free cash flow is expected in the range of $170 million to $185 million.
* Integrated Care segment revenue is projected to be up 2.4% to 3.5% over 2024, with the midpoint 40 basis points higher than previous guidance, partly due to the Telecare acquisition and strong year-to-date performance. Adjusted EBITDA margin guidance for Integrated Care was raised to 15% to 15.4%.
* The BetterHelp revenue outlook was narrowed to the lower half of the prior range, now expecting a year-over-year decline of 8% to 9.2%. The company anticipates $12 million to $14 million in 2025 insurance revenue for BetterHelp and updated segment adjusted EBITDA margin guidance to 3.8% to 4.6%.

FINANCIAL RESULTS

* Teladoc reported consolidated revenue of $626 million and adjusted EBITDA of $70 million. Net loss per share was $0.28, which included a $0.07 per share goodwill impairment charge.
* Integrated Care revenue reached $390 million, up 1.5% year-over-year, while BetterHelp revenue was $236.9 million, including about $4 million from insurance. U.S. Integrated Care membership ended at 102.5 million, up 9% year-over-year, and chronic care enrollment grew to 1.17 million. Integrated Care adjusted EBITDA was $66 million, representing a 17% margin.
* Free cash flow was $68 million for the quarter, with cash and equivalents at $726 million, up $47 million sequentially.

Q&A

* Lisa Gill, JPMorgan, asked about traction for 2026 sales and contracting changes. Divita responded, "I think we've made good progress on all of those fronts...the environment is in line with what we've spoken about previously, solid overall results in the employer channels really across the solutions and ongoing challenges in the health plan sector."
* Jamie (for David Roman, Goldman Sachs) inquired about BetterHelp margins amid the insurance transition. Murthy explained, "metrics that we are looking to see in the BetterHelp insurance rollout...are trending in line with what we were expecting. Still early days yet, but we are beginning to see the...operating metrics in line with our expectations."
* Jessica Tassan, Piper Sandler, asked about customer acquisition cost efficiencies as insurance grows. Murthy noted, "there certainly will be over time, potential efficiencies to be gained on our CAC, on our cost of acquisition."
* Daniel Grosslight, Citi, asked about Catapult-driven cross-references. Divita described Catapult's integration as "resonating with the customer base substantially, including with the health plans."
* Eduardo Ron, Truist, sought updates on insurance sign-up mix and 2027 convert plans. Murthy said it's too early for detailed conversion metrics but "it is our intent along the way as this scales and seasons, we will provide updates."
* Additional analyst questions addressed marketing spend cadence, pricing trends for PMPM renewals, payer reimbursement discussions, capacity planning for BetterHelp therapists, and chronic care enrollment opportunities, with management generally indicating stable trends and ongoing investments.

SENTIMENT ANALYSIS

* Analysts focused on the pace of insurance rollout, profitability, cost discipline, and product adoption, displaying a neutral to slightly cautious tone as they pressed for details on margins, client renewals, and conversion rates.
* Management maintained a confident tone in prepared remarks, emphasizing execution and innovation, but acknowledged market headwinds and early stages for new initiatives. In Q&A, responses were generally measured, with some caution regarding the timing of insurance scaling and chronic care growth. The CEO used phrases like "I think we've made good progress" while Murthy was transparent about "still early days yet" on insurance metrics.
* Compared to the previous quarter, both analysts and management maintained a similar tone, with management expressing slightly more confidence in product rollout progress and continued cost discipline, while analysts sustained a focus on execution risks and competitive pressures.

QUARTER-OVER-QUARTER COMPARISON

* Integrated Care revenue growth guidance was raised modestly, while BetterHelp's outlook was narrowed and reflects a larger decline due to U.S. cash pay headwinds.
* Management highlighted ongoing progress in insurance rollout, now live in 7 states versus a single state soft launch last quarter. Chronic care enrollment returned to sequential growth after a prior period decline.
* The tone of management's remarks continued to emphasize innovation, operational improvement, and international expansion, with additional detail provided about new pilots, product enhancements, and acquisition contributions (Catapult and Telecare).
* Analysts focused more on the insurance transition impact, cost structure, and selling season outcomes relative to the previous quarter, pressing for specifics on margin and revenue ramp expectations.

RISKS AND CONCERNS

* Management cited ongoing headwinds in the U.S. BetterHelp cash pay business, macroeconomic uncertainty, and competitive pressures, especially from competitors offering insurance.
* Tariffs remain a fluid risk, with a $3 million headwind to adjusted EBITDA estimated, and management is evaluating alternative sourcing strategies.
* Analysts expressed concerns about the pace of insurance conversion, client retention, and margin volatility as the product mix shifts.

FINAL TAKEAWAY

Teladoc Health's third quarter reflected progress in strategic initiatives, including a broadened insurance rollout for BetterHelp and continued innovation in integrated and chronic care offerings. While Integrated Care performance and cost discipline strengthened guidance, persistent challenges in BetterHelp's U.S. cash pay segment and macro uncertainty weighed on the outlook. Management remains focused on leveraging recent acquisitions, expanding service offerings, and scaling insurance in additional states, with the expectation that these efforts will drive sustainable growth and improved client value over time.

Read the full Earnings Call Transcript [https://seekingalpha.com/symbol/tdoc/earnings/transcripts]

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