Teladoc Health, Inc. (TDOC) Earnings Call Transcript & Summary

Very pleased to welcome the management team from Teladoc, Chuck Divita, Chief Executive Officer; and Mala Murthy, Chief Financial Officer. Very much appreciate you taking the time to participate in the conference and look forward to getting an update on Teladoc here.

Great. Thanks for having us.

Maybe we'll start with, you've been CEO about a year. Maybe just start by giving us some of your reflections on how the past year has gone. And maybe if you could highlight some of the things that kind of surprised you positively and some of the areas that you're like, I don't know what I was getting myself into.

Yes. Actually, I celebrated my 1-year anniversary yesterday. So there was no cake or anything that showed up. But yes, 1 year yesterday. I'm as excited as I was when I came in, in terms of the potential that we have to use virtual care to impact some of the challenges that we have in health care. I think coming in, I was pretty informed about the company. I was a customer for many years, was a health plan executive, obviously, a market observer and through the interview process. So that was all there. I think when I came in, I was pleasantly surprised by a number of things. Clearly, the assets that we had, the level of talent, the market position that the company had built, all of that, but also saw some things that we needed to change and some opportunities and some challenges that we needed to address. So really been going through the company pretty deeply, obviously, meeting with customers and employees and investors and so forth and doing a deep dive on each one of our businesses, kind of what the position we have, what's the outlook, where we need to make investments and the strategy going forward. I think also early on making sure that we had an ability to set some appropriate expectations with the public markets. I'm sure you know this, but the first quarter that I joined, we made the decision to pull guidance on some of the elements of our guidance with some of the challenges in BetterHelp, didn't make that decision lightly, but we thought that was appropriate. But we also wanted to make sure we were sharing messages along the way in terms of where the company is, where we're headed, and we did ultimately reinstate guidance for 2025 and want to provide some longer-term outlook as well. And then in January, I think we were in a good spot to share some strategic priorities that we had, and we did that at a health care conference out West in early January, and we've been pretty focused on executing against those.

Yes. And maybe we could talk -- go into the strategy a little bit more because sometimes when a new CEO takes over, there's a digestion period and then there's an analyst meeting or some form of like the grand unveil of like what is the strategy going forward? What's the mark you want to put on the company? Is that something that you're planning to host? Or when do you think we'll hear kind of the Chuck Divita strategy version of Teladoc?

Yes. Well, I mean, I'd like to take some time here to kind of unpack that a bit, if you will. The company has, as you said, coming in, having a year behind me, the company, I'm sure you all know this, but has played a really important, what I would call a pioneering role in the adoption and scaling of virtual care as we know it today and generated this market-leading position in the U.S. as well as operating globally as well. So with that in mind, there's 4 areas that we're focused on from a strategic perspective. And then I want to give some examples of what we're doing about that. The first in Integrated Care, particularly in the U.S., it's all about enhancing our offerings to drive more value for clients. Second, we want to leverage the scaled mental health position we have to serve more people. I think that's an important theme. Third, expand internationally. We've got tremendous growth opportunities ahead of us internationally and to seize on those opportunities. And fourth is around operational excellence, about efficiency and effectiveness of what we do. In Integrated Care, and particularly in the U.S., we have over 100 million members at this point that we've grown to, over 1 million people in our chronic condition management programs, over 12,000 customers of all shapes and sizes and a broad range of services, millions and millions of visits each year. While that's grown, we've also, I think, played a role in maturing the market and what the expectations of customers are. And so including this move from subscription-based models to more things that are payments based on utilization and levels of engagement and outcomes. And so that -- if you think about those levers, it's even more important for us that from a topline perspective and offsetting some of those mix shift changes. And so really looking at the various assets that we have, we think we're uniquely positioned in that environment. So how are we going after that? Three things I would point to. First, we brought together all of our different clinical capabilities. We have virtual care and chronic condition management, all those things. We brought those together in one unified team. Think of it as an integrated practice, if you will. And we're putting all of our solutions and products around that and our operating model to go after that from a unified perspective so that we can meet the broader patient needs. The second thing we're doing is we're taking all those -- the data and insights that we have with the scale that I mentioned, and we're really pointing that in the engagement capabilities in ways that we can activate additional, what I call, intervention initiatives, things like closing care gaps, reducing unnecessary specialist spend, the ability to activate programs, either ours or other people's programs. And all of that really aimed at driving utilization, engagement and outcomes. We've been sharing that with our clients along the way and feel good about how that's going to improve our value proposition going to '26. In mental health, post pandemic, there's been, I think, a much greater recognition of the importance of mental health and the mental health needs that are out there and the importance of mental health to physical health. We have in the U.S. Integrated Care business, over 60 million people have access to our mental health services there. And obviously, with BetterHelp, we have the largest direct-to-consumer virtual therapy business in the world. And so with that sort of secular tailwind in terms of mental health needs and the fact that virtual care has been very widely adopted in mental health, we think there's significant opportunities for us there. So in Integrated Care, it's all about these initiatives to drive greater access and ability to take on the market need there. So we see significant growth opportunities there. In BetterHelp, and I'm sure we'll touch on this, we're moving the model more and more into what we call benefits coverage. One of the first things, observations when I came in was we had this juggernaut that had been created, but frankly, missing the boat in the sense of that there's a lot of people that drop off that can't afford a direct-to-consumer model, and we want to make benefits coverage available. That's a major move that we're making there. And then the third thing we're doing is the BetterHelp team and Integrated Care are working on some joint product development. So we think, heading into 2026, we will have a much different trajectory around mental health. The third area, which is international expansion, we operate in many countries, in Europe, in the U.K. and in Canada. And we -- if you look at those markets and you add them up, they rival the size of the U.S., and they're underpenetrated in virtual care. So we have really 3 things we're focused on there. We see significant growth opportunity there. It's about 15% of the revenues of Integrated Care. We think we can grow that business upwards of 50% over the next few years. We are working with public health systems. As you know, a lot of those countries have public health models. We're bringing, actually, interestingly, leveraging technology we use in our hospital and health system business in the U.S. and bringing that to those markets and then expanding services on top of that. Second, we're working with global employers to bring virtual care there. And third, we're working on some hybrid models where we're bringing virtual care into the brick-and-mortar environment to drive growth there. So that's what we're doing internationally. And then the last thing around operational excellence, we're focused a lot on our cost structure. We've taken out significant costs, reduced technology and development expenditures, administrative costs, stock-based compensation, so the financial kinds of things. But also, we've got a complex business we run, and there's tons of opportunities to hone the engine. So I think when you zoom out, we've got -- I think the strategy is leveraging our strengths, leans into macro trends that are out there, we have the opportunity to create more value with virtual care, and I believe will drive better business value for our investors.

Excellent. Maybe we could go into a few of those in some more detail, and that was a very helpful overview. Maybe we start with Integrated Care. One of the things that I struggle with is thinking about the balance of going deep versus going wide. And I know that PMPM is not a metric that you give per se. But you look at the number of members you have and just divide by the revenue, it looks like low levels, it would either imply low PMPM or low utilization. And one of the things that I've sort of asked myself, and Eric, thinking about the business, is like there seems a lot of focus on this 100 million-plus member number, like is that really a relevant metric? Or like how do you think about member for member size versus depth of penetration within that member base?

Yes. I think it's a great question, so a couple of data points. The 100 million is important because that means the number of people that have access to your services. But because I mentioned before, this shift from subscription models to utilization models, it's somewhat of a less important metric. It's all around penetration of services against that. And if you think about 100 million people, I mean, easily estimated at $350 billion of total medical spend. And so our ability to -- and this is -- I mentioned before, the broad adoption of virtual care and sort of the maturity of the market and somewhat commoditization of some of that, with that kind of scope and our clinical position that we have, it's all about adding more value to those customers to access more of those dollars. So yes, that is an important metric. But I think the more important metric is the level of penetration of services that we can deliver over time. And we're going to do that by, like I said, bringing those teams together, going to customers and saying we can handle more of your health care needs than you've seen in the past.

So David, and let me add to that. Look, if you think about it's a question we think about constantly, right? How do we make progress on our revenue per Integrated Care member, PMPM, however you want to call it? And I'd say a few things. First of all, if you look at the metrics we have put up on a -- think of it on a same-store sales basis, if you were to normalize for the very significant increase in membership we've had over the past many quarters, in Q1 alone, it was a 12% year-over-year growth in members, right? And that follows many quarters of membership growth. On a same-store sales basis, we actually are slightly increasing our revenue per Integrated Care member. So the point is, the broader point is, the way we are going to grow our revenue per member, to the point that Chuck made, is around a few things. For several quarters now, we have been following what we call our land and expand. So we land typically with our core telehealth, and then, over time, we expand into our other products and services, which are largely revenue accretive, right? So they will add to our overall revenue per Integrated Care member. Why do we think there is massive opportunity for that? It's basically the data we have shown over the past few quarters. So if you think about as of July of -- mid-July of last year, our mental health penetration into our own gen med base is 62%. Now that's a significant improvement in terms of access versus the 49% it was 2 years prior to that. But it still shows you there's opportunity for us to penetrate further. Chronic care, 20%, tons of opportunity for us to penetrate further. And I would say to you the work we are doing using our data capabilities, our AI capabilities, is around how do we engage more? How do we do better predictive modeling to be able to fully utilize the 100 million-plus member assets we have. How many other companies are there that have access to such an enormous base of membership? So it is about growing engagement, growing visits and utilization. It is about taking advantage of the base of recruitables we have, which is the people who have access to our chronic care programs and actually enrolling them with our engagement capabilities, and being able to bring them the broad base of chronic care programs we have. One of the things we talk to our clients about all the time is around the fact that we offer the breadth. And so the fact that we are able to offer both physical and mental health care services, is what is going to ultimately expand that revenue per member.

And is there a way to think about, I don't know, sort of silly marketing terms, TAM to SAM of like the 100 million, like what percent are actively engaged, however you define that, just to get a more sort of, I don't know, a more narrow picture of what utilization looks like?

Yes. So first of all, if you think about just the sort of SAM, just with our members and the services that we offer, safe to say that, in the U.S., we are talking about tens of billions of opportunity there, right? So there is a very, very large and fertile ground for us to take advantage of, one would estimate around $100 billion plus of that. And to point Chuck made, our international is about the same size of that. Utilization levels, I would say, are still in the, call it, the mid-single digits to -- mid- to high single digits.

How do you define that?

It's basically the percentage of the frequency of use based on the membership over the base of members we have. That's our visit utilization. On enrollment, it's slightly different. It's basically how many of our members who have access to recruitables actually engage in our products and services. So I would say to you, in both instances, we have tremendous opportunity in terms of with the people who have access to our programs using our capabilities to drive usage. Now what is actually going to drive that enrollment and usage? It's everything that Chuck said, right? It is about bringing differentiated and higher-value services and making us increasingly more relevant. And that is all that we are focused on from an investment, from an org structure, all of those things that Chuck just talked about from a strategic priorities perspective to be able to get at that.

Yes. I think, like I said before, we've got a market that Teladoc played a premier role in terms of even laying the groundwork regulatory-wise to get virtual care. And we had a lot of adoption, obviously, with the pandemic, and fortunately, companies like Teladoc were there. But you've seen post-pandemic sort of the maturity of the market. And so what we're going after is, with bringing those teams together like I mentioned, is how do we widen the aperture of the things that we can do so that we can serve more needs of people and create more value, and I think that's what we're going after.

And maybe we could talk a little bit to BetterHelp. I want to come back to some of the acquisitions like Catapult in a second because I think that is very consistent with the strategy here. But maybe just on BetterHelp, it's been obviously a transition from cash pay only to now providing the option to move on to a covered program. And then I think on the February call, you talked about other engagement models, either pay per use or pay monthly. What is -- maybe just give us an update on how the business model has evolved?

Yes. I'll make a few comments. I think, first of all, with BetterHelp, it's the most widely recognized brand out there. It's not -- it's hard to find someone that hasn't necessarily had some level of awareness in that. And in the U.S., we have about 4 million people that sign up or start the registration process with BetterHelp. So it's massively larger than anything else close to it. However, over 80% of people drop off and don't become active users, and it's because it's cash pay and it's expensive. And obviously, the consumer has been under a lot of pressure.

And that's like the 4 million January gym enrollment type phenomenon, and then teeters off...

No, throughout the year.

Throughout the year.

Yes, throughout the year. And these are people that have an awareness, obviously, BetterHelp, have a need, start the registration process, give us their e-mail, take the quiz and so forth. But when it comes down to sort of like this is what the product can cost, et cetera, you have a significant drop-off. And the thing that people refer to most is obviously the out-of-pocket costs that come with that. And even with that, it's still close to a $1 billion business. So if you think about taking -- bringing benefit coverage to say we now can offer you the consumer the ability to use your benefit coverage, obviously, if you're -- if it's in network, we think we're going to have a material impact in terms of our conversion rate. You take just a 1 percentage point net increase in conversion off of the 80% that go away, it's like $40 million in revenue. So it's a massive opportunity for us, and so that's why we've been pushing hard to get into that insurance space. And we can touch more on that. I think the other things with BetterHelp, the other point you mentioned, because it's such a massive consumer activation machine, if you will, has a really highly engaging platform, a 70 Net Promoter Score, 35,000 therapists and so forth, it's like, well, if they're going to continue to innovate their products, different pricing models and different features, et cetera. And the last thing I would say, and then we can take it wherever you'd like to go, is about 20% of the revenues of the company right now are internationally. So we're still going to operate on a D2C basis internationally, and we see continued growth opportunities there because the mental health issues aren't just unique to the U.S., it's a global issue as well.

Okay. So maybe touch on international here. Maybe just to highlight some of the key markets that you're going after and where you are kind of in the development curve, both of the market, right? As you pointed out, telehealth is much lower penetrated outside the United States even in developed markets. Where are you in that kind of progression?

Yes. I think, first of all, in the Integrated Care -- both businesses operate globally, but on the Integrated Care side, which I was referring to earlier, we operate in a number of different countries. But a lot of that concentration sits in Europe, U.K. and Canada. We have a local model, so we have teams there that really understand the local dynamics and what those client needs are and market needs are. And we're doing some really innovative things. I'm really proud of those teams. So one thing as an example, and this is really a cross business synergy that they realized, we have these devices and software that we use in acute care settings, over 15,000 care locations globally, if you go to our website, you'll see pictures of some of these devices that sit in there, worked on Telestroke, bringing TeleNICU and all these really kind of complex use cases. So the team is -- because those are public health systems in a lot of those countries, they're bringing that technology. So we're getting, obviously, a sale with respect to the technology and then we're bringing virtual services alongside of it and getting a multiplier effect. That's been very successful in terms of a differentiation against other people that are doing virtual care there, but the opportunity to expand services. So each country is different, but we're approaching it sort of in a market relevant way. Another thing that I think is really interesting the team is doing and creating, I think, a lot of upside is what we're calling these hybrid models. So again, bringing technology to bear, but partnering with their brick-and-mortar locations. So for example, a location might have a nurse there that's working with the patient, and we're bringing the clinician and the specialist in with them. So internationally, it's underpenetrated, large TAMs, they're different markets, but we see an opportunity to materially grow that business over the next few years.

And as you kind of wrap that together, I asked this question on the last call, very poorly, but you kind of wrap this all together, how do you get the topline growth rate to accelerate?

Yes. Well, I think -- let me take it in some pieces. The international business, the topline is growing. It's been growing double digits. It's going to continue to grow there. BetterHelp, it's all about balancing out this direct-to-consumer and insurance model. Again, we think that's going to position -- a much different position for 2026 in terms of the growth posture, both the international growth, but also the acceleration of the benefit coverage that's out there. And then when you think about the U.S. Integrated Care business, which is probably what most people think about when they think about Teladoc, it's all about the things that we mentioned. The topline headwind we have is this move from subscription models to these utilization models. Our underlying utilization is growing. It's been growing. Visits are growing and usage of services is growing. But we've got that mix shift that's been going on. Ultimately, where we get the underlying topline growth is going to be what I said, it's all about engagement, utilization and creating value for our customers. So I think I touched on that. But that's where you will see the move. But just know, over the last few years, because of the maturity of the market, that mix shift from subscriptions to visit-based models has had a headwind at the topline.

And what is the rough mix today between subscriptions and visit base?

I don't think we've publicly shared that, but it's -- if you think about the history of Teladoc and other virtual care, it was all about subscription models because it was new and customers needed to be able to predict what it was and businesses like Teladoc needed to have visibility to cash flows and all those kinds of things. And post-pandemic, it's really shifted. So the majority of our business is on a visit base now versus a subscription base.

And do you think the big chunks of that transition kind of fade behind us after 2025 so you can get that business back to growth next year? Is that a fair way to think about it?

I think we're going to continue to see some level of shift going on there. I think it's moderating because of just the magnitude of the past few years. But I think it's still a bit of a headwind. So that's why we've been sharing more information in terms of what's the underlying growth of the business? What are visits doing? Ultimately, if that's how we're going to get paid, how is utilization going? But yes, I think we're going to see that pivot going forward.

And I think it makes a ton of sense. I think that dynamic around the subscription model was a real thorn in the side of benefit managers, especially coming out of COVID as you saw lower rates of utilization of many of these services. And that's probably why you've seen many companies in this space end up in very challenging positions, because you have all these subscriptions that people are paying and then no one is using it.

Yes. I think it's -- if you think about the U.S. health care system, we're really moving more to where the rest of the U.S. health care system works, which is a utilization. We pay for what you do kind of thing. That's why it's very important, these moves we're making, so that we can not just -- not just about utilization of what we do today, but ultimately, increasing the funnel of things that we can do and the care that we can do, there's much more runway for us. Now we have to invest in that, create those capabilities and some of the things that I touched on earlier, but that's what we're going after. Yes, utilization is going to drive the revenue growth of the company, but it's also the expansion of services as well.

And the expansion of services effectively means higher -- is seen through higher revenue per member?

It should because we're doing more things for the member. We've got a somewhat narrow scope in virtual care generally of what is done, but I think there's more that can be done.

And maybe we can talk about the chronic disease management business, the chronic care business for a second. It is becoming what appears to be more competitive. There are a number of players all over, LinkedIn in various degrees of promotional activity. How do you see kind of retaining your leadership position? I think on a member basis at 1 million, you still sit above where most other companies likely are in their development. But how do you retain your leadership position and -- or potentially grow it?

Yes. So a few comments. I mean, first of all, the prevalence of chronic conditions is still quite widespread, and the burden that it places on those individuals as well as on the cost of health care system. And the care delivery system isn't really fully set up to do that longitudinal care for people with chronic conditions. So there's plenty of need for these. But as you point out, because of that need and that market opportunity, there's been a lot of competition that's come in, particularly in areas where we operate. I think we've had a long history of focusing on cardiometabolic health, different parts of that equation: diabetes, hypertension, weight and so forth. And so we think we're well positioned in that regard. I think to your point, while there's a need and while there's a lot of competition, we need to continue to innovate what we do. And I think we are uniquely positioned with the breadth of clinical things that we can do, because we're a provider, to drive greater value and impact than just a pure digital health approach, and that's what we're going after.

And I would also say this is where the assets that we have, I would say, give us a pretty unique position competitively, David. Think of the scale that we have, the fact that, to your point, over 1 million already enrolled, the fact that we have the many millions more recruitables. The amount of data that we have with all of the interactions that we do is a real advantage. This is where acquisitions like Catapult can really also help us, right? That is one of the things we said when we talked about the deal and the strategic rationale for the deal. And it actually allows us increasingly to address chronic conditions and chronic diseases proactively. So we are putting -- we have the assets in place and we're building on it to be able to go after it in a much more aggressive way.

And maybe it's a good segue to talk about M&A. I think this does -- there are a lot of assets out there, I think at relatively attractive sticker prices based on what you've done so far and given some of the dynamics in this market. You did Catapult, you did UpLift, I think, pretty reasonable sizes. But how are you thinking about M&A as kind of a key lever here?

Yes, if you don't mind, let me just make a few comments on both those acquisitions, and then I'll respond on M&A. I think with UpLift, hopefully, it was pretty clear with the opportunity in terms of insurance coverage, and that was going to be a nice accelerant for us. We were making really good progress, I think, organically for sure, capabilities, talent, having those network conversations. But we saw this entrepreneurial company, great team, had built insurance capabilities, had over 100 million lives under contract, but were challenged by the scale. And we certainly bring plenty of scale in terms of BetterHelp. So we're really excited about what we're going to do there and we've got, I think, tremendous opportunity to make a significant dent in that market. With respect to Catapult, as Mala said, that was really -- if you think about Integrated Care and just health care more broadly, one of the biggest challenges in health care is engagement, and also preventative care. It's made for sick care as opposed to preventative care. So we found this company that entrepreneurial, had developed this really consumer-focused, really easy to use diagnostic capability, including some in-home testing, some blood draw, some other kinds of things, and a really engaging experience and screening process that's looking at mental health, looking at conditions and so forth. And then you send that kit in, and you then have a visit with a nurse that goes through and develops a care plan for you. And what we found -- what they found, and what we found too, is of the people that they see, a significant portion, that's the only care opportunity they have. So from a preventative standpoint, that was it. They don't have primary care, significant people with mental health issues that aren't being addressed. A lot of chronic conditions there. People finding out for the first time that they've got out of control sugar and blood pressure. And then the ability and that trust to sort of make them aware of things they need to do for their health. We ran a pilot -- this is why we were very excited. We ran a pilot and said, okay, so if they're a Teladoc Health member that has access to some of our programs, you've now got this engagement with this patient, make them aware of this program and if it makes sense for them and it's appropriate, see if you can enroll them in there. Very high adoption rate. So it's just another place for us to meet people where they are, help them with preventative care, identify conditions and get them plugged in. And I'm very excited. The team is doing great. They're hitting every milestone and measure we've created for them. And from an M&A perspective, with those strategic themes I mentioned, we're at an important point in the company, this pivotal time. And we're going to make investments not just for the short term, but things that we think are going to start to increase that TAM, start to increase the scope and range of what we can do, and we think that's the right place to deploy our capital. Obviously, we've got a balanced approach. Mala has talked about this in the past in terms of our debt that's out there, and we just recently paid off our 2025 notes. So we're going to be balanced with our capital allocation. But M&A should play an important role if it's on point with our strategy.

Yes. Listen, I think we think about our overall capital spend, David, in a balanced way between organic and inorganic, right? So we will invest appropriately in our data and analytics, and engagement. We've talked a lot about engagement and engaging the customer. Product enhancements that we talked about the increasing competitive marketplace. Absolutely, we will focus on innovation. We have the right team in place. The fact that we have now brought all of the clinical organizations together is going to help that as well. And inorganically, as we think about the priorities, we will focus on if there are any tuck-ins around engagement, if there is anything that will expand the aperture in terms of services, what Chuck talked about. International, is there anything interesting? But it's always going to be a strong strategic rationale and it has to make sense for us in terms of driving our topline growth on a sustained basis. That's essentially what we'd be looking for.

Got it. And then maybe we'll sort of close on profitability. I think, obviously, some of the acquisitions you've done this year created a little bit of a headwind to adjusted EBITDA after a few years of improvement. I don't know if we have tariffs anymore or not. But tariffs obviously was, I think, on the purchase of equipment to serve the -- mostly the chronic care members. But help us think about the trajectory of adjusted EBITDA margins and where those can go?

Yes. So look, I would say if you think about the adjusted EBITDA, we have driven, I would consider, strong adjusted EBITDA margin over the past few years really on the back of being disciplined in terms of costs, driving productivity initiatives, driving cost takeout. We have talked about the fact that we will continue to do so. We are modestly above our targets for this year. And it's never a one and done. We will continue to do that. We made a lot of strides under Chuck's leadership in terms of streamlining the organization and flattening the top of the house, if you will. We'll continue to look at our overall org structure, David. But at the end of the day, if you think about our overall adjusted EBITDA trajectory, it's going to be on the back of how do we drive our topline and all of the things that Chuck talked about, right, driving more value for all of the interactions that we have, driving more engagement and enrollment. And it will be around being disciplined and continually rightsizing our organization. If you think about our costs, we are taking continuously scrutinizing technology development, G&A, our stock-based compensation. We have shown tremendous progress in terms of stock-based compensation over the last 2, 3 years and sort of bringing it under a certain ZIP code. So we will continue to do things like that to drive our adjusted EBITDA.

And do you think you'll be at a point where you can commit to some level of annual improvement, 50 to 100 basis points of sustained improvement? When do you think you'll be able to give targets like that?

Yes. So look, if you think about what we are driving this year, if you were to take out on the innovation side -- the Integrated Care side, if you were to take out the dilution from Catapult, we are essentially at a flat margin on a year-over-year basis. This after considerable adjusted EBITDA margin expansion over the last 2 years, right? So I would say, look, we are repositioning the company under Chuck's leadership. We have articulated, Chuck just articulated all the key things that he's focused on prioritizing in order to reposition the company. We are hard at work as we speak pulling that together in terms of what does that mean in terms of our overall trajectory going forward. And I expect over the next few quarters, we will give you all a calibration in terms of what does that resulted in terms of how it repositions the top and the bottom line.

Yes. And I would say from a philosophical standpoint, obviously, we're looking to create efficiencies, but also to create capacity to invest during this important moment in time. We've taken T&D, technology development down, but we've also invested in technology. We built what we call the Teladoc Health Prism Care delivery platform that's putting -- be able to service information at the point of care, integrate with third parties, deploy AI into our workflow. So we're really just trying to rationalize the spend, rationalize the portfolio, make investments, but also making sure we can deliver appropriate bottom line results. So while it was flat year-over-year in terms of the EBITDA margin, like Mala said, we've been able to self-fund, if you will, significant investments that are important to the business.

Excellent. Well, I think with that, we are out of time. Chuck and Mala, thank you for making the trip, and look forward to your next update in late July.

Great. Thank you.

Thank you, David.