Earnings Call Insights: Teladoc Health (TDOC) Q4 2025
Management View
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CEO Charles Divita described the quarter as a “solid finish to 2025 as well as progress we’ve made across our strategic priorities.” He reported consolidated revenue of $642 million and adjusted EBITDA of $84 million with a 13% margin for the quarter. Net loss per share was $0.14, including amortization of intangible assets and stock-based compensation.
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Divita highlighted Integrated Care revenue of $409 million, a 4.7% increase over the prior year, and noted that acquisitions of Catapult Health and TeleCare contributed to growth. Chronic Care program enrollment reached 1.19 million, and U.S. integrated care membership ended at 101.8 million.
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The CEO emphasized advancements in the U.S. Integrated Care segment, referencing the launch of the “enhanced 24/7 care offering” and ongoing innovations in chronic care programs supported by “new AI-enabled stratification capabilities.” Divita also spotlighted new connected devices, in-home testing, and product pipeline advancements.
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He discussed scaling BetterHelp’s insurance offering, now live in 20 states and Washington D.C., with more than 4,500 credentialed and enrolled providers and “an annualized revenue run rate of over $40 million.” Partnerships were announced with AARP and Walmart, alongside international expansion into France, Germany, the Netherlands, Spain, and Austria.
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Divita outlined investments in AI: “Pulse brings together and unifies our extensive data, provides context, applies intelligence and most importantly, connects AI-driven insights to activation and orchestration in support of patient care.”
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Operational excellence was cited as a key focus, with successful client implementations and ISO 9001 certification for key U.S. integrated care processes.
Outlook
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Teladoc expects full year 2026 consolidated revenue between $2.47 billion and $2.59 billion. Adjusted EBITDA is forecast in the range of $266 million to $308 million, reflecting 2% year-over-year growth at the midpoint. Full year free cash flow is projected at $130 million to $170 million, factoring in BetterHelp’s insurance growth and lower net interest income.
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Stock-based compensation is anticipated to fall below $60 million, down at least $20 million year-over-year. For Q1 2026, consolidated revenue guidance is $598 million to $620 million with adjusted EBITDA between $50 million and $62 million.
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Integrated Care revenue is expected to grow 0.4% to 3.9% over 2025, with a full year adjusted EBITDA margin of 15.1% to 16.1%. U.S. integrated care members are forecast to range from 97 million to 100 million by year end.
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BetterHelp 2026 revenue is guided down 7% to down 0.5% versus 2025, with insurance revenue expected at $75 million to $90 million and an exit annualized revenue run rate above $100 million. Direct-to-consumer revenue is projected down 14% to 9%, while international is expected to see double-digit growth.
Financial Results
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Consolidated revenue for Q4 2025 was $642 million. Adjusted EBITDA for the quarter was $84 million. Net loss per share was $0.14. Full year consolidated revenue was $2.53 billion with adjusted EBITDA of $281 million, an 11.1% margin. Free cash flow for the year was $167 million, and cash and equivalents stood at $781 million.
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Integrated Care segment revenue for Q4 was $409 million. Adjusted EBITDA for Integrated Care was $65 million, with a 16% margin. Chronic Care program enrollment reached 1.19 million, and U.S. integrated care membership finished at 101.8 million.
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BetterHelp Q4 revenue was $233 million. Adjusted EBITDA increased to $18 million, with a margin of 7.9%. Full year BetterHelp revenue was $950 million, down 9% year-over-year. Insurance revenue for the full year was $13 million.
Q&A
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David Roman, Goldman Sachs: Asked about stabilizing the business and the path to consistent revenue growth. CEO Divita responded, “this headwind from subscriptions to visits has continued to be a factor…we do see that moderating and ultimately visit growth being a driver of growth.” He added, “getting BetterHelp turned around and really leaning into the market opportunity in integrated care…is how I would answer that.”
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Richard Close, Canaccord: Queried cross-sell trends in Chronic Care and new product traction. Divita explained that “our ability to manage across conditions is a selling factor…we’re seeing continued good interest in our weight programs and our bundled products.”
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Daniel Grosslight, Citi: Asked about BetterHelp EBITDA ramp. Divita stated, “the level of advertising spend, the most material mover there,” with Vice President Michael Minchak noting that investments to scale insurance impact the first half.
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Sarah James, Cantor: Requested assumptions differentiating the high and low end of 2026 guidance. Divita answered, “guidance ranges in BetterHelp being wider because of the changes we’re making there…in Integrated Care, it’s a little bit tighter.”
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Jailendra Singh, Truist: Sought feedback from 2027 RSP discussions. Divita said, “the macro environment…continues to sort themselves out,” but “we’re having much stronger renewed conversations with health plans…about how our suite of services…can really uniquely help them in the things that are challenging them the most.”
Sentiment Analysis
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Analysts displayed a cautious and probing tone, focusing on organic growth, guidance assumptions, EBITDA trajectory, and the path to stabilization, signaling persistent skepticism about near-term revenue acceleration and margin expansion.
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Management maintained a confident stance, often referencing ongoing progress and new opportunities. Divita used phrases like “we do see that moderating” and “I do believe there’s growth potential in the business,” while also acknowledging existing headwinds. The tone was consistent with prior quarters but slightly more assertive about AI and insurance scaling.
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Compared to the previous quarter, analysts remained persistently focused on BetterHelp’s transition, insurance rollout, and growth inflection, while management increased emphasis on operational rigor, AI innovations, and international opportunities.
Quarter-over-Quarter Comparison
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Guidance language shifted to focus on moderating impacts from the transition to visit-based revenue in Integrated Care and a more optimistic outlook for visit revenue growth.
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The previous quarter highlighted segment-level growth and product innovation but did not provide as much detail on AI deployment and international expansion.
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Analysts in both quarters pressed on organic growth, profitability levers, and insurance scaling. Management’s tone has grown more forward-leaning regarding AI’s impact and insurance’s role in BetterHelp’s trajectory.
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Key metrics revealed Integrated Care revenue growth and a ramp in insurance sessions and coverage, while BetterHelp’s revenue decline rate is expected to moderate.
Risks and Concerns
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Management pointed to ongoing macroeconomic challenges, affordability, rising medical costs, and uncertainty related to government programs such as the Affordable Care Act.
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A $5 million to $7 million tariff headwind is expected in 2026, up from $3 million in 2025, with ongoing monitoring of tariff impacts.
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Potential membership declines in U.S. Integrated Care due to ACA subsidy expirations and Medicaid changes were acknowledged, but management indicated utilization and visit growth could offset revenue impacts.
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Analysts raised concerns about the transition to insurance in BetterHelp, potential margin pressure from reduced ad spend, and the sustainability of insurance-driven growth.
Final Takeaway
Teladoc Health enters 2026 with a focus on advancing AI-driven care models, scaling BetterHelp’s insurance offering, and driving international growth, while maintaining operational rigor and cost controls. The company projects stable consolidated revenue and adjusted EBITDA for the coming year, with strategic priorities centered on innovation in virtual care, managing macro headwinds, and leveraging new partnerships and technology investments to support future growth and performance.