Teladoc Health NYSE: TDOC reported first-quarter 2026 results that Chief Executive Officer Chuck Divita said came in above the midpoint of the company’s guidance for both revenue and Adjusted EBITDA, driven by solid performance in Integrated Care and continued progress scaling BetterHelp’s insurance offering.
Management points to market shifts and product upgrades
Divita framed the quarter against an evolving U.S. virtual care landscape, highlighting a continued shift among clients away from subscription-based access and toward visit-based arrangements. He characterized that transition as a near-term headwind that Teladoc is working to convert into an opportunity by “expand[ing] our role and the impact we can have through each visit and interaction with Teladoc Health.”
As part of that effort, Divita said the company “significantly enhanced” its flagship 24/7 care product earlier this year, including expanded condition coverage, specialist support for clinicians, real-time prescription benefit checks, and a broader ability to connect patients to in-network care. He noted multiple health plans have already adopted the enhanced offering and said Teladoc expects “a moderation in the revenue headwinds” tied to the subscription-to-visit migration, with the company expecting to “exit the year with this moving to a net tailwind.”
Divita also emphasized Teladoc’s investments in artificial intelligence, pointing to the company’s Pulse Intelligence engine and enhancements to its Prism provider platform. He said Teladoc is developing new products for release later in 2026 that will combine its clinical services with AI-enabled capabilities, with an update expected on the second-quarter call.
Q1 results: revenue of $614M, Adjusted EBITDA of $58M
Divita reported consolidated first-quarter revenue of $614 million and Adjusted EBITDA of $58 million, a 9.5% margin. Net loss per share was $0.36, which he said included pre-tax per share impacts from amortization of intangible assets ($0.50), stock-based compensation ($0.08), and restructuring costs ($0.07).
Free cash flow was a net outflow of $26 million, which Divita attributed to “historical seasonality.” Teladoc ended the quarter with $751 million in cash and cash equivalents. Divita added that net debt to trailing Adjusted EBITDA was under 0.9x, while gross debt to trailing Adjusted EBITDA was 3.6x.
Integrated Care: modest revenue growth, margin expansion
Integrated Care revenue increased 1.5% year over year to $395 million, coming in toward the upper end of guidance. Divita said acquisitions contributed roughly 170 basis points to growth, while a high single-digit increase in visit revenue was “largely offset by lower subscription revenues.” International revenues grew double digits, including a 30% increase from hybrid care models that place virtual services into physical settings.
U.S. Integrated Care membership ended the quarter at 101.2 million, above the high end of guidance. Divita said the company maintained its full-year outlook, which anticipates moderation as health plans face potential enrollment changes. When asked about Affordable Care Act-related enrollment dynamics, Divita said Teladoc was “surprised to see a little bit higher enrollment in the first quarter,” but kept its expectations for moderation later in the year and reiterated it did not see the ACA-related shifts having a “material impact” on revenues or visits.
Chronic Care program enrollment finished at 1.2 million, up about 1% sequentially and 4% year over year. Divita attributed that to increased adoption of multi-condition bundles, which he later said are “now about 70% of what we’re doing there.”
Integrated Care Adjusted EBITDA rose 12% to $56 million, a 14.2% margin that Divita said was slightly above the high end of guidance and about 130 basis points higher than the first quarter of 2025. He cited revenue upside and “disciplined cost management,” which more than offset gross margin pressure tied to the shift toward visit-based arrangements.
On the second-quarter outlook, Investor Relations Vice President Michael Minchak said about a third of Integrated Care’s first-quarter beat versus the midpoint of guidance was due to timing and non-recurring items. He cited a pull-forward from an earlier booking, implementation delays that moved some expected second-quarter contracts to the second half, and a slightly lower FX impact than previously assumed. Divita later said the delayed implementations were “more of a timing thing” and that the company had “good line of sight” to implementing them in the second half.
BetterHelp: insurance expansion offsets cash-pay pressure
BetterHelp revenue declined 9% year over year to $218 million as the direct-to-consumer (cash-pay) business remained under pressure. That was partially offset by $13 million in insurance-based revenue, which Divita said was up $6 million sequentially and at the high end of expectations. Average paying users declined 9% to 361,000, reflecting a mid-teens decline in the U.S. partially offset by high single-digit growth in non-U.S. markets.
BetterHelp Adjusted EBITDA was $2 million, a 0.9% margin, down from 3.2% a year earlier. Divita attributed the decline to lower cash-pay revenue and “the timing of investments” supporting insurance expansion, partially offset by a 12% year-over-year reduction in advertising and marketing expense.
Divita provided multiple operational updates on the insurance rollout, describing the UpLift acquisition as providing “important capabilities, talent, and a baseline of insurance contracts.” He said Teladoc is live with BetterHelp insurance in 30 states and Washington, D.C., has credentialed and enrolled more than 6,000 providers, and has increased insurance contracted lives to more than 150 million—up 30 million since year-end 2025.
He cited early engagement data showing insurance-covered users averaging about 20% more sessions than cash-pay users in their first 90 days, and said funnel conversion is stronger when users enter insurance information during onboarding. Divita also pointed to differences between more mature insurance markets and cash-only markets, stating that in states where insurance was live by the third quarter of 2025, BetterHelp is seeing “a nearly 800 basis point improvement in revenue performance” compared with cash-pay-only markets, which he described as net of expected cannibalization.
BetterHelp’s insurance-covered sessions are running at more than 14,000 per week, which Divita said equates to an annualized revenue run rate of over $75 million. He added that Teladoc now expects to exit 2026 with an insurance run rate of $125 million or more and said the company expects to be “substantially” nationwide by year-end 2026.
Divita acknowledged capacity as a constraint, noting that while BetterHelp has a therapist network of more than 30,000, “not all of them wanna do insurance.” He said the company continues to recruit therapists and is “urgently activating” the network. He also said BetterHelp’s AI-assisted clinical documentation is reducing administrative burden, with more than 300,000 notes generated since launch and an estimated 15 minutes saved per session.
Guidance reiterated; BetterHelp insurance outlook raised
For full-year 2026, Teladoc reiterated consolidated guidance of $2.48 billion to $2.58 billion in revenue, $267 million to $306 million in Adjusted EBITDA, and $130 million to $170 million in free cash flow, with Divita saying the midpoints were unchanged. The company expects stock-based compensation expense to be below $55 million, which Divita said would represent a decline of more than 30% from 2025 and more than 70% since 2023. Net loss per share guidance is $1.05 to $0.75.
Second-quarter consolidated guidance calls for revenue of $597 million to $626 million and Adjusted EBITDA of $55 million to $67 million.
- Integrated Care: Q2 revenue expected to range from down 1.75% to up 1.75% year over year, with Q2 Adjusted EBITDA margin of 14.7% to 16.0%. Full-year Integrated Care Adjusted EBITDA margin guidance remains 15.1% to 16.1%.
- BetterHelp: The company narrowed its 2026 BetterHelp revenue outlook to a decline of 6.5% to 1.0% year over year, while increasing expected full-year insurance revenue to $90 million to $105 million (a $15 million increase from prior expectations). Q2 BetterHelp revenue is expected to be down 11.75% to down 5.25%, including insurance revenue of $18 million to $22 million, with Adjusted EBITDA margin guided to -0.5% to +1.5%.
Divita also reiterated Teladoc’s intention to address its 2027 convertible notes in two phases, including paying down a substantial portion with available cash and securing new term debt “potentially before year-end,” followed by paying off the remainder with cash at maturity in 2027. Separately, he said the company’s CFO search is ongoing and that Teladoc is evaluating several candidates.
About Teladoc Health NYSE: TDOC
Teladoc Health, Inc is a leading global provider of virtual healthcare services, offering on-demand medical consultations via phone, video, and mobile app platforms. The company connects patients with licensed physicians and specialists for non-emergency medical issues, mental health support, dermatology, and chronic condition management. By leveraging digital technologies and data analytics, Teladoc aims to enhance accessibility, reduce healthcare costs, and improve patient outcomes through personalized care plans and remote monitoring.
Teladoc's service portfolio includes general medical visits, behavioral health sessions, expert medical services for complex cases, and wellness programs designed to support chronic disease management such as diabetes, hypertension, and heart disease.
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