Teladoc Health Reports Third Quarter 2024 Results


PURCHASE, NY, Oct. 30, 2024 (GLOBE NEWSWIRE) -- Teladoc Health, Inc. (NYSE: TDOC), the global leader in whole-person virtual care, today reported financial results for the three months ended September 30, 2024 (“Third Quarter 2024”). Unless otherwise noted, percentage and other changes are relative to the three months ended September 30, 2023 (“Third Quarter 2023”).

Third Quarter 2024 Highlights

  • Third Quarter 2024 revenue of $640.5 million, down 3% year-over-year
  • Third Quarter 2024 net loss of $33.3 million, or $0.19 per share
  • Third Quarter 2024 adjusted EBITDA of $83.3 million, down 6% year-over-year
  • Integrated Care segment revenue of $383.7 million, up 2% year-over-year, and adjusted EBITDA margin improved to 17.7%
  • BetterHelp segment revenue of $256.8 million, down 10% year-over-year, and adjusted EBITDA margin of 5.9%

“I am pleased with our third quarter results, which demonstrate our commitment to consistent execution, and I remain excited about our potential. I see many strengths to build upon as we advance initiatives aimed at strengthening our business and unlocking future growth opportunities,” said Chuck Divita, Chief Executive Officer of Teladoc Health.

“As we close out 2024, we are moving with urgency and making changes to more effectively leverage our leadership position in the complex and dynamic markets we serve. There is more work ahead of us, and 2025 will be an important repositioning year. Our focus remains on delivering consistent performance and driving long term shareholder value,” Divita added.

Key Financial Data
($ in thousands, except per share data, unaudited)
 Three Months Ended   Nine Months Ended  
 September 30,   September 30,  
  2024   2023  Change  2024   2023  Change
Revenue$640,508  $660,238  (3)% $1,929,083  $1,941,888  (1)%
            
Net loss$(33,276) $(57,073) 42% $(952,836) $(191,478) N/M
Net loss per share, basic and diluted$(0.19) $(0.35) 46% $(5.61) $(1.17) N/M
            
Adjusted EBITDA (1)$83,255  $88,757  (6)% $235,876  $213,677  10%

See note (1) in the Notes section that follows.
N/M not meaningful

Third Quarter 2024

Revenue decreased 3% to $640.5 million from $660.2 million in Third Quarter 2023. Access fees revenue decreased 5% to $555.3 million and other revenue grew 9% to $85.2 million. U.S. revenue decreased 6% to $536.2 million and International revenue grew 15% to $104.3 million.

Teladoc Health Integrated Care ("Integrated Care") segment revenue increased 2% to $383.7 million in Third Quarter 2024 and BetterHelp segment revenue decreased 10% to $256.8 million.

Net loss totaled $33.3 million, or $0.19 per share, for Third Quarter 2024, compared to $57.1 million, or $0.35 per share, for Third Quarter 2023. Results for Third Quarter 2024 included stock-based compensation expense of $34.0 million, or $0.20 per share pre-tax, and amortization of acquired intangibles of $51.1 million, or $0.30 per share pre-tax. Net loss for Third Quarter 2024 also included $3.6 million, or $0.02 per share pre-tax, of restructuring costs, related to severance costs and costs associated with office space reduction.

Results for Third Quarter 2023 primarily included stock-based compensation expense of $52.9 million, or $0.32 per share pre-tax, and amortization of acquired intangibles of $69.2 million, or $0.42 per share pre-tax.

Adjusted EBITDA(1) decreased 6% to $83.3 million, compared to $88.8 million for Third Quarter 2023. Integrated Care segment adjusted EBITDA increased 8% to $68.0 million in Third Quarter 2024 and BetterHelp segment adjusted EBITDA decreased 41% to $15.2 million in Third Quarter 2024.

GAAP gross margin, which includes amortization of intangible assets and depreciation of property and equipment, was 67.2% for Third Quarter 2024, compared to 68.6% for Third Quarter 2023.

Adjusted gross margin(1) was 71.9% for Third Quarter 2024, compared to 71.8% for Third Quarter 2023.

Nine Months Ended September 30, 2024

Revenue decreased 1% to $1,929.1 million from $1,941.9 million in the first nine months of 2023. Access fees revenue decreased 2% to $1,672.1 million, and other revenue grew 10% to $257.0 million. U.S. revenue decreased 3% to $1,624.6 million, and International revenue grew 13% to $304.5 million for the first nine months of 2024.

Revenue for the Integrated Care segment increased 5% to $1,138.2 million and for the BetterHelp segment decreased 8% to $790.9 million in the first nine months of 2024.

Non-cash goodwill impairment charge of $790.0 million was recorded in the first nine months of 2024 and was attributable to changes in estimates of future cash flows related to the company’s BetterHelp segment. The non-cash charge had no impact on the provision for income taxes.

Net loss totaled $952.8 million, or $5.61 per share, for the first nine months of 2024, compared to $191.5 million, or $1.17 per share, for the first nine months of 2023. Results for the first nine months of 2024 included a non-cash goodwill impairment charge of $790.0 million, or $4.65 per share pre-tax, stock-based compensation expense of $118.5 million, or $0.70 per share pre-tax, restructuring costs of $14.8 million, or $0.09 per share pre-tax, primarily related to severance costs, and amortization of acquired intangibles of $179.4 million, or $1.06 per share pre-tax.

Results for the first nine months of 2023 primarily included stock-based compensation expense of $154.7 million, or $0.94 per share pre-tax, and amortization of acquired intangibles of $172.2 million, or $1.05 per share pre-tax. Net loss for the first nine months of 2023 also included $16.0 million, or $0.10 per share pre-tax, of restructuring costs related to the abandonment of certain excess leased office space.

Adjusted EBITDA(1) increased 10% to $235.9 million, compared to $213.7 million for the first nine months of 2023. Integrated Care segment adjusted EBITDA increased 32% to $179.7 million in the first nine months of 2024 and BetterHelp segment adjusted EBITDA decreased 28% to $56.1 million in the first nine months of 2024.

GAAP gross margin, which includes depreciation and amortization, was 66.6% for the first nine months of 2024, compared to 68.0% for the first nine months of 2023.

Adjusted gross margin(1) was 70.8% for the first nine months of 2024 and 2023.

Capex and Cash Flow

Cash flow from operations was $110.2 million in Third Quarter 2024, compared to $105.6 million in Third Quarter 2023, and was $207.8 million in the first nine months of 2024, compared to $219.9 million in the first nine months of 2023. Capitalized expenditures and capitalized software development costs (together, “Capex”) were $31.1 million in Third Quarter 2024, compared to $37.6 million in Third Quarter 2023, and were $94.4 million for the first nine months of 2024, compared to $119.8 million for the first nine months of 2023. Free cash flow was $79.0 million in Third Quarter 2024, compared to $68.0 million in Third Quarter 2023, and was $113.4 million for the first nine months of 2024, compared to $100.1 million for the first nine months of 2023.

Financial Outlook

The outlook provided for the Integrated Care segment is based on current market conditions and expectations and what we know today. Accordingly, we believe our outlook ranges provide a reasonable baseline for future financial performance.

Integrated Care

For the fourth quarter of 2024, we expect 
Revenue growth percentage (year-over-year)0% - 2.5%
Adjusted EBITDA margin12.25% - 13.75%
U.S. Integrated Care Members (2)93.5 - 94.5 million
  
For the full year of 2024, we expect 
Revenue growth percentage (year-over-year)Low single digits to mid-single digits
Adjusted EBITDA margin14.9% - 15.3%
U.S. Integrated Care Members (2)93.5 - 94.5 million


Earnings Conference Call

The Third Quarter 2024 earnings conference call and webcast will be held Wednesday, October 30, 2024 at 4:30 p.m. E.T. The conference call can be accessed by dialing 1-833-470-1428 for U.S. participants and using the access code #781291. For international participants, please visit the following link for global dial-in numbers: https://www.netroadshow.com/events/global-numbers?confId=72270. A live audio webcast will also be available online at http://ir.teladoc.com/news-and-events/events-and-presentations/. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.

About Teladoc Health

Teladoc Health empowers all people everywhere to live their healthiest lives by transforming the healthcare experience. As the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person’s health journey. Teladoc Health leverages more than two decades of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals. For more information, please visit www.teladochealth.com.

Cautionary Note Regarding Forward-Looking Statements

This press release contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements can be identified by words such as: “anticipate,” “intend,” “plan,” “believe,” “project,” “estimate,” “expect,” “may,” “should,” “will” and similar references to future periods. Examples of forward-looking statements include, among others, statements we make regarding future financial or operating results, future numbers of members, BetterHelp paying users or clients, litigation outcomes, regulatory developments, market developments, new products and growth strategies, and the effects of any of the foregoing on our future results of operations or financial condition.

Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: (i) changes in laws and regulations applicable to our business model; (ii) changes in market conditions and receptivity to our services and offerings, including our ability to effectively compete; (iii) results of litigation or regulatory actions; (iv) the loss of one or more key clients or the loss of a significant number of members or BetterHelp paying users; (v) changes in valuations or useful lives of our assets; (vi) changes to our abilities to recruit and retain qualified providers into our network; (vii) the impact of and risk related to impairment losses with respect to goodwill or other assets; and (viii) the success of our operational review of the company to achieve a more balanced approach to growth and margin. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to, our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, as filed with the SEC.

Any forward-looking statement made by us in this press release is based only on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

 
TELADOC HEALTH, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except share and per share data, unaudited)
 
 Three Months Ended
September 30,
 Nine Months Ended
September 30,
  2024   2023   2024   2023 
Revenue$640,508  $660,238  $1,929,083  $1,941,888 
Costs and expenses:       
Cost of revenue (exclusive of depreciation and amortization, which are shown separately below) 179,745   185,960   562,342   566,607 
Advertising and marketing 177,462   186,152   531,061   541,698 
Sales 47,465   52,309   152,267   160,329 
Technology and development 72,383   84,289   230,522   258,583 
General and administrative 114,245   115,716   335,494   355,702 
Goodwill impairment       790,000    
Acquisition, integration, and transformation costs 457   5,824   1,287   16,848 
Restructuring costs 3,580   411   14,753   16,043 
Amortization of intangible assets 86,906   91,834   276,825   231,205 
Depreciation of property and equipment 2,666   2,468   7,203   8,345 
Total costs and expenses 684,909   724,963   2,901,754   2,155,360 
Loss from operations (44,401)  (64,725)  (972,671)  (213,472)
Interest income (15,326)  (12,606)  (42,840)  (33,075)
Interest expense 5,660   5,646   16,957   16,744 
Other (income) expense, net (2,239)  1,792   (1,306)  (2,908)
Loss before provision for income taxes (32,496)  (59,557)  (945,482)  (194,233)
Provision for income taxes 780   (2,484)  7,354   (2,755)
Net loss$(33,276) $(57,073) $(952,836) $(191,478)
        
Net loss per share, basic and diluted$(0.19) $(0.35) $(5.61) $(1.17)
        
Weighted-average shares used to compute basic and diluted net loss per share 171,496,282   165,119,379   169,824,993   164,079,194 


Stock-based Compensation Summary

Compensation expense for stock-based awards were classified as follows (in thousands):

 Three Months Ended
September 30,
 Nine Months Ended
September 30,
  2024  2023  2024  2023
Cost of revenue (exclusive of depreciation and amortization, which are shown separately)$1,075 $1,464 $3,782 $4,060
Advertising and marketing 3,856  4,399  11,023  11,527
Sales 5,204  9,110  20,124  27,055
Technology and development 8,152  14,566  27,134  42,984
General and administrative 15,760  23,406  56,416  69,082
Total stock-based compensation expense (3)$34,047 $52,945 $118,479 $154,708

See note (3) in the Notes section that follows.


Revenues

 Three Months Ended   Nine Months Ended  
 September 30,   September 30,  
($ in thousands, unaudited) 2024  2023 Change  2024  2023 Change
Revenue by Type           
Access fees$555,275 $582,070 (5)% $1,672,097 $1,708,601 (2)%
Other 85,233  78,168 9%  256,986  233,287 10%
Total Revenue$640,508 $660,238 (3)% $1,929,083 $1,941,888 (1)%
            
Revenue by Geography           
U.S. Revenue$536,161 $569,322 (6)% $1,624,563 $1,672,770 (3)%
International Revenue 104,347  90,916 15%  304,520  269,118 13%
Total Revenue$640,508 $660,238 (3)% $1,929,083 $1,941,888 (1)%


Summary Operating Metrics

Consolidated

 Three Months Ended    Nine Months Ended   
 September 30,    September 30,   
(In millions)2024 2023 Change 2024 2023 Change
Total Visits4.1 4.4 (7)% 12.9 14.0 (8)%


Integrated Care

 As of September 30,  
(In millions)2024 2023 Change
U.S. Integrated Care Members (2)93.9 90.2 4%
Chronic Care Program Enrollment (4)1.179 1.122 5%


 Three Months Ended    Nine Months Ended   
 September 30,    September 30,   
 2024 2023 Change 2024 2023 Change
Average Monthly Revenue
Per U.S. Integrated Care Member (5)
$1.36 $1.41 (4)% $1.37 $1.40 (2)%


BetterHelp

 Average for    Average for   
 Three Months Ended    Nine Months Ended   
 September 30,    September 30,   
(In millions)2024 2023 Change 2024 2023 Change
BetterHelp Paying Users (6)0.398 0.459 (13)% 0.407 0.467 (13)%

See notes (2), (4), (5), and (6) in the Notes section that follows.


Operating Results by Segment (see note (7) in the Notes section that follows)

The following table presents operating results by reportable segment for the periods indicated:

 Three Months Ended   Nine Months Ended  
 September 30,   September 30,  
($ in thousands, unaudited) 2024   2023  Change  2024   2023  Change
Teladoc Health Integrated Care           
Revenue$383,666  $374,416  2% $1,138,198  $1,084,438  5%
Adjusted EBITDA$68,039  $62,805  8% $179,741  $135,900  32%
Adjusted EBITDA Margin % 17.7%  16.8%    15.8%  12.5%  
            
BetterHelp           
Therapy Services$250,588  $281,204  (11)% $773,373  $845,420  (9)%
Other Wellness Services 6,254   4,618  35%  17,512   12,030  46%
Total Revenue$256,842  $285,822  (10)% $790,885  $857,450  (8)%
Adjusted EBITDA$15,216  $25,952  (41)% $56,135  $77,777  (28)%
Adjusted EBITDA Margin % 5.9%  9.1%    7.1%  9.1%  



TELADOC HEALTH, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands, unaudited)
 
 Nine Months Ended
September 30,
  2024   2023 
Cash flows from operating activities:   
Net loss$(952,836) $(191,478)
Adjustments to reconcile net loss to net cash flows from operating activities:   
Goodwill impairment 790,000    
Amortization of intangible assets 276,825   231,205 
Depreciation of property and equipment 7,203   8,345 
Amortization of right-of-use assets 7,144   8,325 
Provision for allowances for doubtful accounts 2,199   4,935 
Stock-based compensation 118,479   154,727 
Deferred income taxes 611   (6,658)
Other, net 5,212   9,761 
Changes in operating assets and liabilities:   
Accounts receivable 3,675   (696)
Prepaid expenses and other current assets 2,849   14,070 
Inventory (8,328)  18,246 
Other assets 1,439   (18,362)
Accounts payable (5,851)  (21,670)
Accrued expenses and other current liabilities 13,980   17,075 
Accrued compensation (35,943)  433 
Deferred revenue (10,456)  (1,261)
Operating lease liabilities (8,088)  (7,133)
Other liabilities (336)  75 
Net cash provided by operating activities 207,778   219,939 
Cash flows from investing activities:   
Capital expenditures (4,658)  (10,060)
Capitalized software development costs (89,750)  (109,781)
Net cash used in investing activities (94,408)  (119,841)
Cash flows from financing activities:   
Net proceeds from the exercise of stock options 2,711   1,423 
Proceeds from employee stock purchase plan 3,721   8,597 
Cash received for withholding taxes on stock-based compensation, net (176)  2,609 
Other, net (2)   
Net cash provided by financing activities 6,254   12,629 
Net increase in cash and cash equivalents 119,624   112,727 
Effect of foreign currency exchange rate changes 567   (382)
Cash and cash equivalents at beginning of the period 1,123,675   918,182 
Cash and cash equivalents at end of the period$1,243,866  $1,030,527 


The following table presents the selected cash flow information for the following quarters (in thousands, unaudited):

 Three Months Ended
September 30,
 2024   2023 
Net cash provided by operating activities$110,175  $105,601 
Net cash used in investing activities (31,148)  (37,647)
Net cash provided by financing activities 698   5,068 
Effect of foreign currency exchange rate changes 1,758   (1,190)
Net increase in cash and cash equivalents$81,483  $71,832 



CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands, except share and per share data, unaudited)
 
 September 30,
2024
 December 31,
2023
ASSETS   
Current assets:   
Cash and cash equivalents$1,243,866  $1,123,675 
Accounts receivable, net of allowance for doubtful accounts of $4,318 and $4,240 at September 30, 2024 and December 31, 2023, respectively 212,039   217,423 
Inventories 36,993   29,513 
Prepaid expenses and other current assets 115,738   118,437 
Total current assets 1,608,636   1,489,048 
Property and equipment, net 28,030   32,032 
Goodwill 283,190   1,073,190 
Intangible assets, net 1,496,698   1,677,781 
Operating lease—right-of-use assets 34,115   40,060 
Other assets 77,912   80,258 
Total assets$3,528,581  $4,392,369 
LIABILITIES AND STOCKHOLDERS’ EQUITY   
Current liabilities:   
Accounts payable$37,801  $43,637 
Accrued expenses and other current liabilities 188,095   178,634 
Accrued compensation 66,437   102,686 
Deferred revenue—current 88,325   95,659 
Convertible senior notes, net—current 550,723    
Total current liabilities 931,381   420,616 
Other liabilities 736   1,080 
Operating lease liabilities, net of current portion 36,896   42,837 
Deferred revenue, net of current portion 10,469   13,623 
Deferred taxes, net 50,846   49,452 
Convertible senior notes, net—non-current 990,551   1,538,688 
Total liabilities  2,020,879   2,066,296 
Commitments and contingencies   
Stockholders’ equity:   
Common stock, $0.001 par value; 300,000,000 shares authorized; 171,944,014 shares and 166,658,253 shares issued and outstanding as of September 30, 2024 and December 31, 2023 respectively 172   167 
Additional paid-in capital 17,726,127   17,591,551 
Accumulated deficit (16,181,491)  (15,228,655)
Accumulated other comprehensive loss (37,106)  (36,990)
Total stockholders’ equity 1,507,702   2,326,073 
Total liabilities and stockholders’ equity$3,528,581  $4,392,369 


Non-GAAP Financial Measures:

To supplement our financial information presented in accordance with generally accepted accounting principles in the United States (“GAAP”), we use certain non-GAAP financial measures to clarify and enhance an understanding of past performance, which include adjusted gross profit, adjusted gross margin, adjusted EBITDA, and free cash flow. We believe that the presentation of these financial measures enhances an investor’s understanding of our financial performance, and are commonly used by investors to evaluate our performance and that of our competitors. We further believe that these financial measures are useful to assess our operating performance and financial and business trends from period-to-period by excluding certain items that we believe are not representative of our core business, and that free cash flow reflects an additional way of viewing our liquidity that, when viewed together with GAAP results, provides management, investors, and other users of our financial information with a more complete understanding of factors and trends affecting our cash flows. We use these non-GAAP financial measures for business planning purposes and in measuring our performance relative to that of our competitors. We utilize adjusted EBITDA as a key measure of our performance.

Adjusted gross profit is our total revenue minus our total cost of revenue (exclusive of depreciation and amortization, which are shown separately) and adjusted gross margin is adjusted gross profit as a percentage of our total revenue.

Adjusted EBITDA consists of net loss before provision for income taxes; other (income) expense, net; interest income; interest expense; depreciation of property and equipment; amortization of intangible assets; restructuring costs; acquisition, integration, and transformation cost; goodwill impairment; and stock-based compensation.

Free cash flow is net cash provided by operating activities less capital expenditures and capitalized software development costs.

Our use of these non-GAAP terms may vary from that of others in our industry, and other companies may calculate such measures differently than we do, limiting their usefulness as comparative measures.

Non-GAAP measures have important limitations as analytical tools and you should not consider them in isolation, and they should not be considered as an alternative to net loss before provision for income taxes, net loss, net loss per share, net cash from operating activities or any other measures derived in accordance with GAAP. Some of these limitations are:

  • adjusted gross margin has been and will continue to be affected by a number of factors, including the fees we charge our clients, the number of visits and cases we complete, the costs paid to providers and medical experts, as well as the costs of our provider network operations center;
  • adjusted gross margin does not reflect the significant depreciation and amortization to cost of revenue;
  • adjusted EBITDA eliminates the impact of the provision for income taxes on our results of operations, and it does not reflect other (income) expense, net, interest income, or interest expense;
  • adjusted EBITDA does not reflect restructuring costs. Restructuring costs may include certain lease impairment costs, certain losses related to early lease terminations, and severance;
  • adjusted EBITDA does not reflect significant acquisition, integration, and transformation costs. Acquisition, integration and transformation costs include investment banking, financing, legal, accounting, consultancy, integration, fair value changes related to contingent consideration, and certain other transaction costs related to mergers and acquisitions. It also includes costs related to certain business transformation initiatives focused on integrating and optimizing various operations and systems, including upgrading our customer relationship management (CRM) and enterprise resource planning (ERP) systems. These transformation cost adjustments made to our results do not represent normal, recurring, operating expenses necessary to operate the business but, rather, incremental costs incurred in connection with our acquisition and integration activities;
  • adjusted EBITDA does not reflect goodwill impairment; and
  • adjusted EBITDA does not reflect the significant non-cash stock-based compensation expense which should be viewed as a component of recurring operating costs.

In addition, although amortization of intangible assets and depreciation of property and equipment are non-cash charges, the assets being depreciated and amortized will often have to be replaced in the future, and adjusted gross profit, adjusted gross margin, and adjusted EBITDA do not reflect any expenditures for such replacements.

We compensate for these limitations by using these non-GAAP measures along with other comparative tools, together with GAAP measurements, to assist in the evaluation of operating performance. Such GAAP measurements include net loss, net loss per share, net cash provided by operating activities, and other performance measures.

In evaluating these financial measures, you should be aware that in the future we may incur expenses similar to those eliminated in this presentation. Our presentation of these non-GAAP measures should not be construed as an inference that our future results will be unaffected by unusual or nonrecurring items.

The following is a reconciliation of gross profit, the most directly comparable GAAP financial measure, to adjusted gross profit:

Reconciliation of GAAP Gross Profit to Adjusted Gross Profit
(In thousands, unaudited)
 
 Three Months Ended
September 30,
 Nine Months Ended
September 30,
  2024   2023   2024   2023 
Revenue$640,508  $660,238  $1,929,083  $1,941,888 
Cost of revenue (exclusive of depreciation and amortization, which are shown separately below) (179,745)  (185,960)  (562,342)  (566,607)
Amortization of intangible assets and depreciation of property and equipment (30,237)  (21,088)  (82,695)  (55,094)
Gross Profit 430,526   453,190   1,284,046   1,320,187 
Amortization of intangible assets and depreciation of property and equipment 30,237   21,088   82,695   55,094 
Adjusted gross profit$460,763  $474,278  $1,366,741  $1,375,281 
        
Gross margin 67.2%  68.6%  66.6%  68.0%
Adjusted gross margin 71.9%  71.8%  70.8%  70.8%


The following is a reconciliation of net loss, the most directly comparable GAAP financial measure, to adjusted EBITDA:

Reconciliation of GAAP Net Loss to Adjusted EBITDA
(In thousands, unaudited)
 
 Three Months Ended
September 30,
 Nine Months Ended
September 30,
  2024   2023   2024   2023 
Net loss$(33,276) $(57,073) $(952,836) $(191,478)
Add:       
Provision for income taxes 780   (2,484)  7,354   (2,755)
Other (income) expense, net (2,239)  1,792   (1,306)  (2,908)
Interest expense 5,660   5,646   16,957   16,744 
Interest income (15,326)  (12,606)  (42,840)  (33,075)
Depreciation of property and equipment 2,666   2,468   7,203   8,345 
Amortization of intangible assets 86,906   91,834   276,825   231,205 
Restructuring costs 3,580   411   14,753   16,043 
Acquisition, integration, and transformation costs 457   5,824   1,287   16,848 
Goodwill impairment       790,000    
Stock-based compensation 34,047   52,945   118,479   154,708 
Total Adjustments 38,084   59,180   924,519   187,599 
Consolidated Adjusted EBITDA$83,255  $88,757  $235,876  $213,677 
        
Segment Adjusted EBITDA       
Teladoc Health Integrated Care$68,039  $62,805  $179,741  $135,900 
BetterHelp 15,216   25,952   56,135   77,777 
Consolidated Adjusted EBITDA$83,255  $88,757  $235,876  $213,677 


The following is a reconciliation of net cash provided by operating activities, the most directly comparable GAAP financial measure, to free cash flow:

Reconciliation of GAAP Net Cash Provided by Operating Activities to Free Cash Flow
(In thousands, unaudited)
 
 Three Months Ended Nine Months Ended
 September 30, September 30,
  2024   2023   2024   2023 
Net cash provided by operating activities$110,175  $105,601  $207,778  $219,939 
Capital expenditures (1,597)  (5,793)  (4,658)  (10,060)
Capitalized software development costs (29,551)  (31,854)  (89,750)  (109,781)
Capex (31,148)  (37,647)  (94,408)  (119,841)
Free Cash Flow$79,027  $67,954  $113,370  $100,098 


Notes:

  1. A reconciliation of each non-GAAP measure to the most comparable measure under GAAP has been provided in this press release in the accompanying tables. An explanation of these non-GAAP measures is also included under the heading “Non-GAAP Financial Measures.”

  2. U.S. Integrated Care Members represent the number of unique individuals who have paid access and visit fee only access to our suite of integrated care services in the U.S. at the end of the applicable period.

  3. Excluding the amount capitalized related to software development projects.

  4. Chronic Care Program Enrollment represents the total number of enrollees across our suite of chronic care programs at the end of the applicable period.

  5. Average monthly revenue per U.S. Integrated Care member is calculated by dividing the total revenue generated from the Integrated Care segment by the average number of U.S. Integrated Care Members (see note 2) during the applicable period.

  6. BetterHelp Paying Users represent the average number of global monthly paying users of our BetterHelp therapy services during the applicable period.

  7. We have two segments: Teladoc Health Integrated Care (“Integrated Care”) and BetterHelp. The Integrated Care segment includes a suite of global virtual medical services including general medical, expert medical services, specialty medical, chronic condition management, mental health, and enabling technologies and enterprise telehealth solutions for hospitals and health systems. The BetterHelp segment includes virtual therapy and other wellness services provided on a global basis which are predominantly marketed and sold on a direct-to-consumer basis.

Investors:
Michael Minchak
617-444-9612
ir@teladochealth.com

Media:
Chris Stenrud
860-491-8821
pr@teladochealth.com