A：Operational improvements and client service enhancements have led to a strengthening in net promoter scores across the board in the US integrated care business as indicated by client survey data.

A：The company remains committed to driving the next evolution of virtual care and believes that strategic priorities, investments, and product innovations will provide opportunities to drive greater value and impact going forward.

A：Mala stepping down as CFO after playing a pivotal role in shaping Teladoc's financial strategy and strategic growth initiatives is acknowledged, and the company thanks her for her contributions and wishes her well in her next chapter.

A：The key figures from the third quarter results include consolidated revenue of $626 million, a net loss per share of 28 cents, and pre-tax free cash flow of $68 million. The company ended the quarter with $726 million in cash and cash equivalents.

A：Integrated care revenue was $390 million, up 1.5% over the prior year period, and US integrated care membership ended the quarter at 102.5 million members, up 9% year over year.

A：Integrated care adjusted EBITDA was $66 million, with a script margin above the high end of the guidance range. The upside in the quarter reflects revenue mix, flow-through, and continued cost discipline including hiring deferral.

A：The Better Health segment had third quarter revenue of $236.9 million, with adjusted EBITDA of $4 million and a margin of 1.6%. The year-over-year decline was primarily driven by lower revenue and investments for the insurance rollout.

A：The updated guidance for 2025 includes consolidated revenue of $2.510 billion to $2.539 billion, adjusted EBITDA of $270 million to $287 million, free cash flow of 170 million to 185 million, and stock-based compensation expense of 85 million to 95 million. The full year net loss per share guidance range has been narrowed with the midpoint remaining unchanged.

A：The full year 2025 revenue and adjusted EBITDA guidance range has been raised and narrowed. The expected revenue growth is now 2.4% to 3.5% over 2024, with adjusted EBITDA expected to be 15% to 15.4%, and a rough estimate of a $2 million headwind to Adjusted EBITDA due to the tower situation.

A：The expected range for the adjusted EBITDA margin for the full year is 3.8% to 4.6%. The anticipated sequential margin improvement is driven by a typical seasonal pullback in advertising spend during the holiday period, with a projected fourth quarter adjusted EBITDA margin of 5.5% to 8.6%.

A：At the end of the quarter, Betterhelp had a strong balance sheet with $726 million in cash and equivalents and net debt to EBITDA less than 1.0x at quarter end. A recent acquisition completed in August was telecare for $17 million in net cash.

A：The company was named one of Time magazine's top health tech companies of 2025, ranking highly in the telehealth and treatment category based on financial performance, reputation analysis, and online presence.

A：For 2026, the company is anticipating a repositioning year focused on driving higher levels of performance, product innovation, and making visits and member touch points more valuable. There have been discussions with clients regarding new products and enhancements in virtual care, chronic care, and mental health. The company has taken actions to innovate and is seeing more strategic conversations with plan sponsors regarding the value proposition and performance measures. As a result, there is an expectation to participate in the value created if certain measures are met, which should differentiate the company.

A：The transition to insurance offerings is expected to bring pricing pressure but may also be offset by lower customer acquisition costs. The impact on profitability is expected to be directional, and while the company remains excited about the growth in the Better Help international business, the insurance business is also a focus area. The guidance provided for Q4 and the growth in user and revenue for Better Health International in the third quarter are key factors to consider. However, specific details on the impact of the transition on the profitability of the business are not provided.

A：The key metrics such as conversion rates, number of sessions, and user growth are trending in line with what was expected during the early days of the rollout.

A：The U.S. direct to consumer cash pay business is challenged by heavy competition from other market participants who offer insurance.

A：Better Help, as a scale player with over 4 million users, drives a significant amount of traffic to the top of the funnel through its advertising. However, the challenge is converting users and the progress in insurance is expected to help drive greater conversion and gain efficiencies in cost of acquisition.

A：Better Help's business model will continue to be a mix of direct to consumer cash pay and insurance as a payment option. Over time, there is potential for efficiencies to be gained in cost of acquisition as insurance takes on a larger role in the business.

A：The Catapult acquisition has led to the creation of a larger funnel which is most relevant for chronic care solutions and P360 enrollment. It has facilitated the bundling and collaboration of services to engage more lives and address the needs of unengaged or mismanaged condition populations. The ability to reach people, raise awareness of their conditions, and integrate additional solutions has resonated across the company's services.

A：The company is in a scaling phase and does not provide detailed metrics on conversion. However, Virginia, the first state launched, has provided stable data. The intent is to update the market on the progress as the scale and data mature, without being able to share specific details at this stage, although it remains in line with initial expectations on the 2027 convert.

A：The company expects to generate free cash flow that will add to its cash balance and maintain a strong balance sheet with a well-managed overall leverage metric. Specific plans for 2027 will be influenced by organic investment decisions made in the following year.

A：The company's acquisition strategy aligns with the strategic priorities laid out by Chuck. They have been disciplined in organic investment and are actively planning various options to refinance the note in 2027, with decisions being made based on the rate environment and internal needs.

A：Investors should expect a step-down in marketing spend in the fourth quarter (4Q) of 2025 relative to the third quarter (3Q) of the same year, which is in line with past patterns. The pattern will be similar in the integrated care segment as well. Additionally, the company has decided to pull forward a modest amount of marketing spend into 4Q to support key priorities for the following year. However, the 4Q 2025 investment in marketing for integrated care is not expected to be as significant a step up as it was in 2024.

A：The company is seeing a mix shift towards fee for service, but pricing for customers renewing their PM subscriptions has not seen significant pressure. However, the competitive market could be a factor, and the company is aware of the need to consider the expansion of services and other factors.

A：The company has added several new payers to its book of business, resulting in millions of incremental lives covered under insurance plans. Further details on reimbursement discussions were not provided, but it was mentioned that the company will monitor short-term margins in the insurance business, which had been factored into their strategic position.

A：The company is focusing on margins while also capturing incremental users, sessions, and lifetime value, which are key to revenue growth and profit dollar growth. Investments in the revenue cycle and back-end capabilities are being made as the company scales quickly. As the credentialed network grows, it's expected that revenue will follow in terms of users and sessions, and the approach taken by the company is unique in terms of credentialing and integrating the therapist experience.

A：The company has had discussions with payers regarding the value of having a virtual capability and visit, and utilization relative to other market players. These strategic conversations are not just about visits but also about engagement points that drive savings and avoidance of unnecessary costs.

A：The speaker's company is expanding its script care offering to address more care needs for the member and reduce unnecessary specialist referrals by bringing a specialist consult to the table.

A：The member follow-up aspect offers opportunities for activation and participation in value, especially as the company migrates to a visit-based environment, leveraging their large number of annual visits as a strategic lever in the integrated care strategy.

A：The company is keeping up with the demand in the states that have been launched. They ensure adequate therapy for a strong user experience and access, and their scaling plan includes matching the therapist network to meet demand, which they believe they can do with the interest shown and the ability to credential therapists.

A：The company ensures it can meet demand by having adequate capacity, which is a key criteria before launching in a state. It matches the therapist network to demand and has been able to do so, ensuring a strong net promoter score and experience.

A：The sequential growth in chronic care enrollment was pleasing and met expectations. There's interest in program bundling and opportunities within already sold products. The company is working on innovations and clinical interventions for high-risk populations to improve health outcomes and engagement.

A：The company plans to continue building upon the progress seen in the third quarter by utilizing various levers and selling additional solutions to clients, before converting potential members.

A：The speaker indicates the need to provide more specific data on the percentage of patients still on therapy after one year to discuss continuity of care, emphasizing the potential influence of insurance coverage and ease of access to mental health services.

A：The overlap between integrated care and better health is seen in the launch of the new well bound product, which integrates support for a range of needs, including mental health. This product is seen as a key to bringing better help into the arena of integrated care.