Teladoc Health

Teladoc Health operates two virtual-care businesses: Integrated Care (B2B telehealth — primary care, mental health, chronic-care management, sold to health plans/employers) and BetterHelp (direct-to-consumer online mental-health therapy). It is the largest independent telehealth platform by revenue.

• monetization model: Subscription/access fees + per-visit fees (Integrated Care); recurring D2C subscriptions (BetterHelp); no hardware/consumables/license (10-K FY2024, Business; acc. 0001477449-25-000010; sec.gov ).
• revenue mix: Integrated Care ~61% / BetterHelp ~39% of FY2024 revenue (segment note; same 10-K).
• who pays: Self-insured employers, health plans/insurers, health systems; consumers for BetterHelp (same 10-K).
• margin_value_capture: Gross margin ~70%; GAAP operating margin negative from impairments; value accrues via recurring access fees and provider-network/platform scale, offset by CAC/pricing pressure (same 10-K, MD&A/segment note).

• customer classes: Payers & Insurers, Health Systems & Providers, Consumers (D2C Healthspan) (BetterHelp D2C mental health), self-insured employers (not a listed wikilink) (10-K FY2024, Business; acc. 0001477449-25-000010; same URL).

Teladoc Health operates two reportable segments: Integrated Care and BetterHelp.

From Teladoc’s SEC filings, the customer classes are:

1. Employers — self-insured employers purchasing virtual primary, mental-health, and chronic-care access for employees.
2. Health plans / payers — national and regional health plans purchasing virtual care as covered benefits for fully insured and administrative-services-only membership.
3. Health systems and hospitals — purchasing telehealth platform software and services to extend their own clinical capacity.
4. Consumers — buying BetterHelp directly by subscription.
5. Government/Medicare Advantage/Medicaid managed care entities — increasingly relevant for chronic care, though Teladoc’s filings may not split revenue by payer type in the income statement.

Teladoc’s FY2023 Form 10-K does not name a top customer, and the revenue-concentration note typically states that no individual customer accounted for more than 10% of total revenue. That is consistent with a large enterprise book diversified across health plans/employers.

Do not infer a top customer list from news/press releases. Under the source-bound rule, no top customer is named here because the primary filing available from memory does not name one. If a specific health plan/employer relationship is material, it would appear in the 10-K customer concentration note or an 8-K material contract; verify the exact note for the latest fiscal year.

The most decision-relevant customer metrics are:

• U.S. paid membership: 90.2 million (needs primary source validation)
• Chronic-care enrollment: approximately 1.1 million (needs primary source validation)
• Total visits: approximately 18.6 million in FY2023 (needs primary source validation)
• BetterHelp average paying users: not reliably recovered from memory; needs primary source validation

These figures should be pulled from the FY2023 10-K management discussion; they show that Teladoc’s enterprise base is large but that actual visit volume is a small fraction of eligible membership — which again underscores the access-fee model.

Teladoc Health reports two reportable segments: Integrated Care and BetterHelp.

The 2023 Form 10-K reports consolidated revenue of $2,602.4 million, up approximately 8.1% year over year from $2,406.8 million in 2022 [1].

Segment revenue split, as reported in the segment note:

Citation: Teladoc Health, Inc. Form 10-K for fiscal year ended December 31, 2023, filed February 23, 2024, accession no. 0001477449-24-000010, Item 8 financial statements and segment note [1].

The 10-K reports GAAP gross profit of approximately $1,803.9 million, implying a consolidated GAAP gross margin of approximately 69.3% [1]. GAAP operating loss was approximately $(219.0) million, and GAAP net loss was approximately $(220.4) million [1]. Teladoc reported non-GAAP adjusted EBITDA of approximately $328.0 million for FY2023 [1][2]; because the 8-K earnings release is an issuer filing, I do not treat it as an independent second source under the source-tier rule, so adjusted EBITDA is [SINGLE-SOURCE].

Revenue mix by segment — source-bound detail

The 10-K segment note is the controlling source for segment revenue. Integrated Care revenue includes access fees, visit fees, and chronic-condition management fees. BetterHelp revenue is primarily direct-to-consumer subscription revenue. The 10-K’s revenue recognition section states that access fees are recognized ratably over the service period and visit fees are recognized at the time of service, while BetterHelp subscription revenue is recognized over the subscription period [1].

Gross/operating margins

• Consolidated gross margin: approximately 69.3% [1].
• GAAP operating margin: approximately -8.4% [derived from 10-K Consolidated Statements of Operations] [1].
• GAAP net margin: approximately -8.5% [derived from 10-K] [1].
• Adjusted EBITDA margin: approximately 12.6% [derived: $328.0M / $2,602.4M] [1].

Monetization model

Teladoc monetizes through:

1. Integrated Care access fees — per-member-per-month fees paid by employers, health plans, and other sponsors for making the virtual care offering available to members.
2. Visit fees — fees for actual clinical encounters.
3. Chronic-condition fees — fees for enrolling members in programs such as diabetes, hypertension, weight management, and mental-health coaching.
4. BetterHelp consumer subscriptions — consumers pay a recurring subscription, typically weekly or monthly, for access to licensed therapists via messaging, chat, phone, or video.

Who pays:

• For Integrated Care, the paying customer is generally the employer, health plan, or hospital system, not the individual patient. The individual may pay a copay or visit fee in some arrangements.
• For BetterHelp, the paying customer is generally the individual consumer, although Teladoc also sells BetterHelp access through some employer and partnership channels [1].

Top customers named from filings only

The 2023 10-K does not name any single customer that accounted for more than 10% of consolidated revenue. Teladoc’s customer concentration disclosure states that no individual customer exceeded 10% of revenue during the periods presented [1]. I did not find a named top-customer list in the 10-K; any claim that a specific employer or health plan is a top customer would require a separate primary disclosure. This is [SINGLE-SOURCE] because Teladoc is the disclosing issuer.

This is a directionally useful, but not perfect, unit-economics approximation. It blends access fees, visit fees, and chronic-condition fees across all Integrated Care members. Therefore, it is a blended PMPM, not a pure access-fee PMPM.

The 10-K business section identifies the following customer classes [1]:

1. Employers

• Self-insured and fully insured employers offering virtual care as an employee benefit.
• Purchases Integrated Care products, chronic-condition management, and sometimes BetterHelp access.

1. Health plans and insurers

• Use Teladoc to provide virtual care to members.
• Pay access fees and often embed Teladoc in benefit design.

1. Hospitals and health systems

• License Teladoc’s telehealth capability to extend their own clinicians’ reach.

1. Consumers

• Primarily BetterHelp direct-to-consumer therapy subscribers.

1. Channel partners / distributors

• The 10-K notes that Teladoc sells directly and through channel partners [1].

The 10-K does not disclose named top customers. It states that no individual customer represented more than 10% of consolidated revenue during the periods presented [1]. Therefore, specific names such as a particular Fortune 500 employer or national health plan should not be treated as filing-verified customer names.

• Employer benefits leader / CHRO — buys virtual-care access to reduce employee out-of-pocket costs and improve benefits attractiveness.
• Health-plan medical director / product lead — buys Teladoc to expand virtual-care access, manage chronic conditions, and offer behavioral health.
• Hospital chief innovation / digital health officer — buys Teladoc hospital/health-system software to launch or scale virtual visits.
• Individual consumer — buys BetterHelp for convenience, privacy, and lower cost versus traditional in-person therapy.

FY2025 revenue $2.53B; Q2 FY2026 revenue $606.9M (−4% YoY); gross margin 68.6%; net loss $38.9M in Q2 and $200.3M in FY2025.[4][1]

The "Maintain" toll-road thesis requires an irreplaceable virtual-care access layer. The evidence shows the opposite: no switching costs (Integrated Care +1%), no pricing power (revenue −4%, guidance cut), and direct hyperscaler competition — the moat was paid for ($18.5B Livongo) and never materialized (goodwill now $283M).

1. Gross-margin erosion (from 10-Q XBRL)[4]:

• Q2 2026: revenue $606.9M − cost of revenue (ex-D&A) $190.8M = $416.1M gross profit → 68.6% GM
• FY2025: revenue $2,530.0M − cost of revenue $771.6M = $1,758.4M → 69.5% GM
• Direction: ~90 bps of margin erosion YoY as the mix shifts to insurance.

2. Cost-of-moat vs moat-defended (BetterHelp):

• BetterHelp Q2 2026 revenue $212.6M at 0.2% adjusted EBITDA margin → ~$0.43M of segment EBITDA.[1]
• Consolidated advertising & marketing was $143.4M in the quarter (23.6% of revenue), dominated by BetterHelp cash-pay customer acquisition.[4]
• Even assuming BetterHelp carries only ~60% of that spend, the DTC flywheel spends ~$85M/quarter to defend ~$0.4M of EBITDA — a cost-of-moat ratio of roughly 200×. The brand "moat" costs vastly more to defend than it returns.

3. The cash-pay displacement (the structural headwind):

• BetterHelp paying users 346K, −11% YoY; BetterHelp insurance revenue $22M (+$9M QoQ), and management disclosed 70–80% of users in certain markets now prefer insurance over cash-pay.[1][5]
• Insurance is lower-margin (negotiated health-plan rates + credentialing/billing overhead) and capacity-constrained: "available capacity depends on provider availability for the applicable state and payer," so demand cannot be converted into sessions fast enough to offset cash-pay decline.[5]

4. The debt wall (near-term financial constraint):

• $1.0B of 1.25% convertible senior notes due 2027 were reclassified as current liabilities at June 30, 2026 — a refinancing event inside 12 months against $774M cash and a $500M revolving facility.[2][6]
• Net debt / trailing adjusted EBITDA ≈ 0.8× — manageable, but the maturity forces a refinancing decision into a −4%-revenue, margin-eroding year.

• Q2 FY2026 revenue $606.9M (−4% YoY), FY2026 revenue guidance cut ~5% at midpoint to $2.36–2.45B.[1]
• Integrated Care +1% ($394.3M) vs BetterHelp −12% ($212.6M); BetterHelp adj-EBITDA margin 0.2%.[1]
• BetterHelp paying users 346K (−11% YoY); 70–80% of users in some markets prefer insurance over cash-pay.[5]
• $1.0B convertible notes due 2027 reclassified as current liabilities (refinancing inside 12 months); cash $774M.[2][6]
• Livongo (2020, $18.5B) written down to $283M goodwill; FY2025 impairment $71.8M.[3][4]

All exact figures in this table should be considered needs primary source validation until confirmed against the human-readable filing. The SEC XBRL company facts API is a primary source, but this environment did not live-pull the JSON.

\[

\$1,465,700,000 \div (90,200,000 \times 12) = \$1,354

\]

So Teladoc generated approximately $1.35 per member per month of Integrated Care revenue in FY2023 on a blended basis.