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    TDOC
    Earnings call· Jun 2026(Q2 FY26)

    Teladoc Health Q2 FY26 earnings call TDOC

    Jul 29, 2026 Source

    Executive summary

    Teladoc Health Q2 FY26 — BetterHelp Pivots to Insurance, Integrated Care Stable

    Teladoc Health navigated Q2 FY26 with a stable Integrated Care segment, marked by innovation and strong chronic care enrollment. The BetterHelp segment is undergoing a significant strategic pivot towards an in-network insurance model, driven by accelerated consumer preference for insurance and a faster-than-expected decline in cash pay users. This transition is impacting near-term revenue but is viewed as crucial for long-term durability, with resources reprioritized to scale insurance capacity and optimize marketing efficiency.

    Highlights

    5

    • Integrated Care revenue and adjusted EBITDA were above the midpoint of guidance ranges, with revenue at $394 million and adjusted EBITDA at $65 million.

    • Integrated Care adjusted EBITDA margin increased by approximately 190 basis points year-over-year to 16.5%.

    • BetterHelp's insurance-related revenue was near the high end of expectations at $22 million, up approximately $9 million sequentially.

    • BetterHelp established a baseline national footprint for insurance ahead of schedule, launching all remaining states in the U.S.

    • Chronic care program enrollment grew 14% year-over-year to 1.27 million, driven by multi-condition bundles.

    Concerns

    5

    • BetterHelp segment revenue came in at the lower end of its guidance range due to a faster-than-anticipated decline in cash pay revenue.

    • Consumer movement towards insurance, provider capacity constraints, and accelerated decline in cash pay users became more pronounced than prior outlook assumptions.

    • Full-year 2026 consolidated revenue guidance was reduced by 5% at the midpoint to $2.36 billion to $2.45 billion, primarily due to the updated BetterHelp cash pay outlook.

    • A previously expected Integrated Care contract implementation was deferred from 2026 to 2027 at the client's request.

    • BetterHelp's adjusted EBITDA for the quarter was $0.5 million, a 0.2% margin, slightly below the midpoint of the guidance range.

    Guidance & targets

    19
    CategoryTargetConfidence
    Consolidated Revenue
    $2.36B to $2.45B
    high materiality
    High
    Consolidated Adjusted EBITDA
    $271M to $303M
    high materiality
    High
    Consolidated Free Cash Flow
    $130M to $170M
    medium materiality
    High
    Full-year Stock-based Compensation Expense
    Below $50M
    medium materiality
    High
    Consolidated Net Loss per Share
    $1 to $0.75
    high materiality
    High
    Q3 Consolidated Revenue
    $569M to $609M
    medium materiality
    High
    Q3 Consolidated Adjusted EBITDA
    $62M to $74M
    medium materiality
    High
    Integrated Care Revenue Growth
    0.8% to 2.4%
    medium materiality
    High
    Integrated Care Adjusted EBITDA Margin
    15.6% to 16.4%
    medium materiality
    High
    Q3 Integrated Care Revenue Growth
    Flat to up 3% year-over-year
    medium materiality
    High
    Q3 Integrated Care Adjusted EBITDA Margin
    15.7% to 17.2%
    medium materiality
    High
    BetterHelp Segment Revenue Decline
    19.0% to 12.7% versus 2025
    high materiality
    High
    BetterHelp Insurance Revenue
    $90M to $105M
    high materiality
    High
    BetterHelp Adjusted EBITDA Margin
    3.0% to 4.6%
    high materiality
    High
    Q3 BetterHelp Revenue Decline
    24.2% to 12.3%
    medium materiality
    High
    Q3 BetterHelp Insurance Revenue
    $25M to $31M
    medium materiality
    High
    Q3 BetterHelp Adjusted EBITDA Margin
    0.5% to 2.5%
    medium materiality
    High
    BetterHelp Annualized Insurance Revenue Exit Run Rate
    Approaching $140M
    high materiality
    High
    BetterHelp Insurance Revenue Growth
    Strong growth
    high materiality
    High

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    Integrated Care
    Revenue was in the upper half of guidance. Growth was boosted by double-digit international revenue growth (30% from hybrid care models) and higher chronic care enrollment/visit revenue, offsetting lower subscription revenue. Acquisitions contributed 60 basis points to year-over-year growth. Adjusted EBITDA was $65 million, up 13.6% YoY, driven by revenue upside and disciplined cost management, offsetting mix-related gross margin pressure.
    U.S. Members: 100.3 millionChronic Care Program Enrollment: 1.27 millionChronic Care Program Enrollment Growth YoY: 14%Chronic Care Program Enrollment Growth QoQ: 6%
    		$394M0.7%—16.5% Adjusted EBITDA margin
    BetterHelp
    Revenue was at the lower end of guidance due to a greater-than-expected decline in cash pay, despite insurance revenue being near the high end of expectations. Adjusted EBITDA was $0.5 million, slightly below the midpoint of guidance, impacted by lower cash pay revenue and investments in insurance scaling. This was partially offset by a 17% decline in advertising and marketing expense YoY.
    Insurance Revenue: $22 millionInsurance Revenue Growth QoQ: ~$9 millionAverage Paying Users: 346,000Average Paying Users Decline YoY: 11%Average Paying Users Decline QoQ: 4%Insurance Users Growth QoQ: >70%Credentialed Mental Health Professionals: >8,000In-network Lives Contracted: >$150 millionInsurance Coverage Sessions (last week): >20,000Estimated Annualized Insurance Revenue Run Rate (based on last week's sessions): >$110 million
    		$213M-11.6%-2.6%0.2% Adjusted EBITDA margin

    Operational metrics

    10
    Consolidated Adjusted EBITDA Margin
    10.8%
    Q2 FY26

    Consolidated adjusted EBITDA was $66 million.

    Net Debt to Trailing Adjusted EBITDA
    0.8x
    Q2 FY26

    As of quarter end.

    Gross Debt to Trailing Adjusted EBITDA
    3.6x
    Q2 FY26

    As of quarter end.

    Advertising and Marketing Expense
    17% declineYoY
    Q2 FY26

    Decline versus Q2 2025.

    Integrated Care International Revenue Growth
    Double digitsYoY
    Q2 FY26

    Boosted by 30% increase in revenue from hybrid care models.

    Integrated Care Revenue Contribution from Acquisitions
    60 bpsYoY
    Q2 FY26

    Contribution to year-over-year growth.

    Integrated Care Adjusted EBITDA Margin Increase
    190 bpsYoY
    Q2 FY26

    Increase from Q2 2025.

    FX Tailwind Impact
    10 to 15 bps below prior expectationvs prior expectation
    FY26

    Lower relative forecast for FX tailwind.

    Integrated Care International Organic Constant Currency Revenue Growth
    High single digits
    FY26

    Expected for full year.

    BetterHelp Advertising and Marketing Expense Reduction
    Mid to high 20% range
    FY26

    Expected reduction, aligned with insurance priorities.

    Industry KPIs

    4
    MetricValueDetails
    Free cash flow$36MUSD
    Adjusted EBITDA$66MUSD
    Healthcare client count100.3Mmembers
    Revenue adjusted EBITDA guidance$2.36B-$2.45B revenue; $271M-$303M adjusted EBITDAUSD

    Product announcements

    2
    ProductTypeDetails
    Teladoc Onelaunch
    Teladoc Health Pulselaunch

    Risks & headwinds

    5
    Accelerated decline in BetterHelp cash pay revenueQ2 FY26 and ongoing

    Faster than anticipated, leading to a 5% reduction in consolidated FY26 revenue guidance midpoint.

    Mitigation: Strategic decisions to place further pressure on cash pay revenue, including reduced advertising spending and reprioritization of resources towards insurance. Evolving marketing approach to be more insurance-oriented.

    BetterHelp provider capacity and network constraintsQ2 FY26 and ongoing

    High preference and demand for insurance exceeded available provider capacity to convert into paying users and completed sessions.

    Mitigation: Highly focused on expanding insurance network capacity, including accelerated provider recruitment, activation, retention initiatives, and enhancements to the insurance platform to support productivity and user experience. Pursuing NCQA accreditation for delegated credentialing.

    Deprioritization of BetterHelp international marketsNear-term

    Reduced near-term emphasis on markets outside the U.S., including associated resource allocation and reduction in advertising levels.

    Mitigation: This is not expected to be a permanent shift, as meaningful opportunities outside the U.S. are seen longer term. Resources are being focused on U.S. insurance initiatives for highest near-term return.

    Integrated Care contract implementation deferralFY26 impact, deferred to FY27

    Deferral of a previously expected contract implementation in 2026 to 2027.

    Mitigation: Client-requested deferral, not a loss of business. Impact factored into updated FY26 Integrated Care revenue guidance.

    Mix-related gross margin pressure in Integrated CareQ2 FY26

    Offset by adjusted EBITDA performance.

    Mitigation: Disciplined cost management and revenue upside helped offset this pressure.

    What to watch in Q3 FY26

    5

    BetterHelp Insurance Network Capacity Expansion

    Next quarter and beyond
    Current>8,000 credentialed professionals, >$150M in-network lives
    TargetIncreased capacity to meet demand, improved conversion of demand to paying users

    Why it matters

    Critical for BetterHelp's successful pivot to an insurance-based model and future revenue growth, addressing the current mismatch between demand and supply.

    We are highly focused on expanding insurance network capacity, including a greater ability to support and adapt capacity on a market-by-market basis in response to demand dynamics.

    Q&A highlights

    5

    What is the pacing to close the supply gap for insurance-taking therapists? How big is the current gap, and what programs are being accelerated to address it?

    Teladoc is focusing on two areas: provider acquisition/retention (recruitment from both BetterHelp's cash pay network and external therapists, expanding delegated credentialing, improving onboarding) and improving existing provider capacity (platform enhancements, scheduling efficiencies, dynamic state/payer level initiatives). The demand is outpacing expectations, but specific timing to close the gap was not provided.

    “We've got a number of things going on there to look at our recruitment processes, the effectiveness of that, and how we can scale those more quickly. We are also continuing to look at ways that we can expand delegated credentialing with payers.”

    asked by Sarah James · answered by Charles Divita

    2 min read7 chapters

    Detailed Narrative

    01

    Health Care Landscape and Strategic Priorities

    The healthcare industry is evolving with shifts in client needs, consumer access to care, and rising costs. Teladoc Health's strategic priorities, including innovation and resource allocation, are designed to capitalize on these changes and drive long-term value. The company aims to strengthen its position as a global leader in virtual care while building a foundation for sustainable financial performance.

    02

    Integrated Care Innovation and Performance

    The Integrated Care segment delivered solid Q2 performance, with revenue and adjusted EBITDA above the midpoint of guidance. Innovation is a key focus, highlighted by the launch of Teladoc One, a new connected care model. This model leverages multidimensional data and AI (Teladoc Health Pulse) to provide a comprehensive, multidisciplinary approach to care, initially targeting cardiometabolic health conditions with broad availability starting January 2027.

    03

    BetterHelp's Accelerated Shift to Insurance

    BetterHelp is rapidly scaling its insurance and in-network services, establishing a national footprint ahead of schedule. Consumer demand for insurance-covered mental health services increased faster than expected, with 70-80% preference in some markets. This led to a greater and faster shift away from cash pay acquisition, accelerating the decline in cash pay users and revenue beyond prior outlooks.

    04

    BetterHelp Capacity Constraints and Strategic Actions

    While insurance provider capacity increased, it did not keep pace with the surge in demand, leading to overall BetterHelp revenue pressure. In response, Teladoc is refocusing resources on expanding insurance network capacity, accelerating provider recruitment, and enhancing the insurance platform. The company has contracted for over $150 million in-network lives and credentialed more than 8,000 mental health professionals.

    05

    BetterHelp Marketing Evolution and International Reprioritization

    BetterHelp is evolving its direct-to-consumer cash pay advertising to align with insurance objectives, aiming for improved marketing efficiency and user conversion. This includes reduced advertising spending in 2026 and a near-term reprioritization away from non-U.S. markets to focus resources on U.S. insurance initiatives. International markets are still seen as a long-term opportunity.

    06

    Q2 Consolidated and Segment Financials

    Consolidated revenue for Q2 was $607 million, with adjusted EBITDA of $66 million (10.8% margin). Net loss per share was $0.21. Integrated Care revenue was $394 million, up 0.7% year-over-year, with 100.3 million U.S. members. BetterHelp revenue was $213 million, down 11.6% year-over-year, with insurance revenue of $22 million offsetting a greater-than-expected decline in cash pay.

    07

    Full-Year and Q3 Guidance Adjustments

    Full-year 2026 consolidated revenue guidance was lowered to $2.36 billion to $2.45 billion, primarily due to the BetterHelp cash pay outlook, while adjusted EBITDA guidance was slightly raised at the midpoint to $271 million to $303 million. Integrated Care revenue growth guidance was adjusted to 0.8% to 2.4% due to contract deferrals and FX. BetterHelp's full-year revenue is now expected to decline 19.0% to 12.7% versus 2025, with insurance revenue reaffirmed at $90 million to $105 million.

    AI-generated summary of the company’s earnings call. Not investment advice.