Good afternoon. My name is Lisa Gill, and I head healthcare services here at J.P. Morgan. Thanks for joining us. With me this afternoon, I have Teladoc Health. For Teladoc Health, we have CEO Chuck Divita. This is Chuck's first J.P. Morgan Healthcare conference, so welcome, Chuck. And then Mala Murthy will join us for the Q&A portion, the CFO of the company. Oh my God, I don't know where my brain is. Anyway, let me turn it over to you, Chuck.
Great. Thanks, Lisa. Hope you can hear me okay. Good afternoon, everyone. Appreciate you attending. Again, Chuck Divita, I'm the Chief Executive Officer of Teladoc Health. I joined the company in June of 2024, so about seven months ago, and Mala is here, our Chief Financial Officer. We are a global virtual care organization. I believe we are well-positioned today, but we also have an opportunity to drive innovation and impact in this sector going forward. We report our fourth quarter results at the end of February, so we'll provide an update on our business as well as our outlook. So I certainly don't want to get ahead of that.
But I did want to take this opportunity to share some perspectives on the business, now being in the role for several months, talk about our priorities and where we're headed and how we see that setting a foundation for growth and value creation going forward. I'm not going to read you the safe harbor, although I could, I guess, with glasses. Well, Teladoc, I'm sure you know, has played an important role really in the adoption of virtual care. Been around for about 20 years and really, in many respects, a pioneering role. Certainly, when the COVID-19 pandemic hit, the company was in a position to scale and meet needs during an important time period. I was able to see that firsthand as a customer before I joined the company.
I had accountability at a health plan for a book of business of just over $20 billion, individual business through large self-funded business. I had brand, marketing, product, sales, those kinds of things, as well as actuarial provider network and our operations, member contact center, claims, enrollment, those kinds of things. And we had made the decision to expand virtual care at that time and do it through Teladoc Health. We completed that in the fall of 2019. And of course, the pandemic hit the first quarter of 2020, so whether that was fortuitous or luck, but I was able to see the company's ability to scale and serve our members in a really important time period. So through those efforts and through the years, the company has developed a leading position in the U.S. as well as a growing international position.
And we do a range of services, but I would really summarize those in three areas. First, we efficiently connect patients and providers, and we do that at significant scale through technology and workflow and services. Second, we both enable and deliver care to patients through our services. And third, we provide ongoing support to people for their physical health and mental well-being. And so we really have a broad reach in terms of what we do. And that's important because we are serving a large and sustained market need. Now, everyone here at the conference, obviously well aware of the complexities in the healthcare system and how dynamic it is, certainly in the U.S. and globally as well. When you think about access to care challenges, certainly the cost of healthcare. We're up to close to 18% of GDP now spent on healthcare, close to $5 trillion.
I remember talking about this not too long ago, and it was 15%, and it was $2.5 trillion, $3 trillion, so it's done nothing but grow through the years as a percentage of GDP on a dollar basis, and that creates significant challenges at a federal level, at a state level, with employers, and certainly with individuals and families. When you look at disease prevalence and you look at chronic condition prevalence and the burden that places, obviously, on the individual as well as the implications to the healthcare system, and mental health challenges. One of the byproducts coming out of the pandemic was, I believe, a greater acknowledgment or recognition of the needs around mental health, and virtual care actually has been an important avenue in the mental health arena, and you think about mental health, we used to, in the industry, think about it as a separate thing.
It was behavioral health, and there was physical health, and now there's a greater recognition of the importance that you can't have total health without mental health, and then you look at the pressure on providers, whether that be costs or labor challenges, not being able to meet the demand with the supply, and those kinds of macro forces is really what drew me to healthcare many, many years ago, and it's why I'm so excited to be at Teladoc Health, because to be able to leverage the strengths that we have to help people, to further this virtual care journey that we're on, I think it's very important, and then to bring my personal experiences around the health plan, seeing how coverage works and how markets work, what are the drivers of cost.
Before I had the responsibility, I mentioned I was the Chief Financial Officer of the health plan. So being able to see where the money is spent and what works in terms of population health strategies to lean in against that, that's where Teladoc can be positioned to play in, and I'm excited about that. So to do that, though, it's important to take a comprehensive approach when you start to tackle some of those more complex challenges. And we really do have a comprehensive approach at Teladoc Health. Comprehensive in terms of the range of services we provide from virtual care, mental health, chronic condition management, comprehensive in how we go to market through our business segments, both in the U.S. and globally. And importantly, comprehensively in terms of how we approach the market.
We have relationships and distribution with health systems, with health plans, with employers, with institutions, and with consumers, and that gives us an opportunity to reach a lot of people in terms of our approach. Now, since joining the company, I've been doing a pretty extensive review of the business in terms of ways that we can drive performance currently, obviously, but also how do we position the company for long-term success, and we've been going through an extensive review, as I mentioned. Things such as what is our how do we streamline the organization? How do we make decisions? How do we align teams differently to go after these market opportunities, and we've made a number of actions, pretty swift actions, to take out some layers of management, to organize teams differently in terms of looking at end-to-end solutions so we can activate against these strategies.
That's been important. Certainly, it's taken costs out of the company, but it's also been done to speed up and enhance our ability to drive innovation and activate in a really competitive marketplace. We've also taken a hard look at our capital expenditures and how we're making investments. We've been successful over the last couple of years bringing down the total amount of CapEx. We should be able to continue to do that, but do it in a way where we continue to invest in the priorities and the things that are important. Significant progress there. We've also been looking at ways that we can drive greater sort of impact in the fundamentals. We have over 10,000 customers. We do a lot of services.
You think about the complexities of doing that. We want to make sure we've got a really good eye on all the different levers that drive performance for our customers, but also drive performance for our shareholders. We're also looking for ways to really enable a high-performance culture. These things really come down to people at the end of the day. We have very talented and committed employees committed to the mission, and we want to make sure we have the right culture to drive us forward. All of that really being done to make sure we've got a passion for driving value for customers, that we're leveraging technology in terms of making sure we've got quality care, that we're being innovative and focusing on clinical excellence, and that we're unlocking the synergies that sit within Teladoc with all the different things that we do.
With that as a backdrop, let me just talk about our two business segments briefly, and then I'll wrap with some closing comments, and we can move to Q&A. Watching the time here. Integrated Care is our largest segment. This is where you would see the broadest array of our products and services and the enabling technology. It's primarily a B2B business, and it operates both in the U.S. and internationally. What we've reported is $1.5 billion in revenues over the trailing 12 months, adjusted EBITDA margins over 15%, so strong results there. But I wanted to show some data to show sort of the underlying momentum that we have in Integrated Care. So on the left-hand side, it's a chart showing our visit volumes. And so you can see those have grown well over the past several years.
And that's important not just because of taking care of that particular need when someone comes to us, but those are engagement points. And one of the biggest challenges in healthcare, particularly from my prior life in the health plan world, was around engagement. And so we want to make sure that those visits, we obviously take care of the need at hand, but critical to our strategy is how else can we activate that visit to support more care and integrate with other things that we're doing. But good momentum there. In terms of momentum around cross-selling and penetration of our products, the middle chart takes our general medicine membership, which is our largest membership base, and then illustrates the ability to cross-sell into that population. And you can see in both mental health services as well as chronic care, good penetration and growing penetration.
And then on the right-hand side, the chart's really an illustration of is that with one product or more than one product. And you can see we've grown that penetration over time. And that really speaks to the value proposition and the strength of our customer relationships. In terms of priorities, Integrated Care, it's really around enhancing our current position and pursuing growth vectors. And what do I mean by enhancing our current position? We operate in competitive markets, and we need to make sure that we have a good handle on our customers' needs, and we are continuing to differentiate what we do in the marketplace and a number of things underway there. And we also need to leverage that to pursue additional growth for us. And really, we have four priorities in the Integrated Care that we're pursuing.
First of all, just underlying growth in our membership, customer growth, membership, usage of our services, and we see opportunities to drive revenue growth there. Second, and importantly, is leveraging our clinical strength and the breadth of our product portfolio to both meet the needs today, but where is the next area where we can drive value for our customers? And if we drive value for our customers and outcomes for our customers, we will participate in those values. So we want to the value we're creating. So we want to make sure we're leaning into that. Third, significant growth we're seeing internationally. We've been achieving double-digit growth internationally. So we've got a number of initiatives to expand internationally, whether it be new markets or deepening our penetration there. And last but not least, is advancing our scaled mental health position.
Inside Integrated Care, we have a very scaled mental health offering. We provide digital content. We conduct a million visits a year inside Integrated Care in mental health. We've embedded it in our chronic condition management program, so we've got a significant business in Integrated Care, and with the sort of secular tailwinds around mental health need, we think this is an important position for us to continue to invest in. Our second segment is BetterHelp. This is the largest direct-to-consumer virtual therapy business there is. It's a very consumer-focused business, so a direct-to-consumer model primarily at this point. I've put some data on the slide to just illustrate not just the scale of BetterHelp, but how it's resonating with consumers. In BetterHelp, we generated $1.1 billion of revenues over the last 12 months, solid adjusted EBITDA margins.
BetterHelp is number one in brand awareness in the category. We have 35,000 plus therapists. Right now, we have over a million people active on our platform. Those people on our platform consistently rate us with a Net Promoter Score of 70 plus, which is very strong. We use AI-driven matching engines to match patients with therapists. We do that at a remarkable pace. 95% of the time, that's in 48 hours or less compared against the rest of virtual care. I know you know that that's a great outcome. 80% of people would recommend their therapist to someone else. We have very low switching of therapists. Over 70% of people report improvement in symptoms of anxiety and depression. We've got significant strengths at BetterHelp. Now, we've also had headwinds at BetterHelp. We've had an escalation in customer acquisition costs.
On a consumer business, obviously, it's important to reach the consumer and activate them on your product. So we do that through advertising and other channels. The acquisition costs have been higher, and that's put some headwinds on the business as we balance the top line and bottom line. So we've got a number of things underway to sort of make sure we improve performance with this asset, but we think it's important to the company given the mental health issues that I mentioned before. In terms of priorities, it's really around balancing that top and bottom line picture and focusing on four areas. First, stabilizing the U.S. and stabilizing means ultimately returning to growth and underlying user base and how we navigate those higher acquisition costs. Second, advancing our value proposition.
It's important for any business, but in the consumer business, always looking at new features and enhancements, ways to get people to activate on what we do. International expansion. We've had double-digit growth in BetterHelp as well internationally. We see that continuing, and the team, through the course of 2025, is going to be rolling out more localized models, localized in terms of language, content, the therapists. We're excited to see where that goes, and fourth, we're pursuing a path of seeing how can we provide benefit coverage with BetterHelp. We have a lot of people that come to BetterHelp and want to use it, but when it comes to affordability and some other challenges, and they want to activate their benefits, we'd like to be in a position to do that.
Benefits through their employer, maybe through an employee assistance program that they could have access, or through health plan coverage. So we've been working on that for the last several months. But we think, given the, again, the secular trends around mental health, our scaled position in Integrated Care and mental health, and the largest, by far, direct-to-consumer business in mental health, that there's an opportunity for us to continue to progress forward. And that's why we think that's the right place for us to be at this point in time with BetterHelp. We're able to pursue those priorities from a position of strength. We have solid financial strength when you look at revenue scale, look at our margin profile, our cash flow generation. And we see an opportunity with these priorities to drive profitable growth as well as ensure ongoing financial strength.
And let me just close, and then we'll get to Q&A, just highlighting. Again, we have unmatched global reach. Our segments are market leaders. We're taking a comprehensive approach to virtual care, which we think is important. And we have a durable business model and a large market opportunity in front of us. So with that, I'll close, and then we'll move to Q&A.
Thanks very much for the comments, Chuck. And again, welcome to your first J.P. Morgan Healthcare Conference. You know, I just really wanted to start with bigger picture. And just as you came to this role, you came from the managed care side of the business, really understanding this. You've been in this seat now for roughly six months-ish, right? Almost seven months. Almost seven months.
What's been a pleasant surprise, and what do you think is going to be your biggest challenge or hurdle in this role?
Look, I knew a lot about the company from the outside, as I mentioned. I think the pleasant surprise was just the breadth of talent we have, which is very clear. The scale of our market position, you know, I probably didn't appreciate that fully, as well as some of the assets inside the company that I wasn't even aware of. The fact that we have technology sitting in health systems, in acute care setting, in other care settings to enable their strategies and what's possible with that kind of asset inside the company. So there were a lot of those pleasant surprises.
And the challenge?
Well, the challenge is, look, I think there's two things. One, we operate a complex business.
I mentioned before, over 10,000 clients, a lot of different services, scaled through the years through organic means as well as acquisitions. To be able to operate at that level, it takes a certain level of rigor. I think with my operational background, that was an area of focus early on. I think the other one is, while there are tremendous opportunities for us to leverage what we do, it's going to take time. When you start taking on these more complex situations in healthcare, our customers need it. Our customers want it. And when you have the conversation strategically, those challenges that I mentioned on the one slide, they haven't gone away. So it's just going to take time for us to unpack that. And I think that's my answer.
This afternoon, you made an announcement around a relationship with Amazon.
Can you maybe go into a little more detail, help us to understand what this new, I guess, in essence, a partnership is, or is it more of a contractual relationship?
Yeah, well, you know, Amazon finally came around. Look, this is around finding new and different ways to engage people in our products and services. We offer chronic condition management programs extensively. And so we have a lot of people out there that we can recruit and enroll. And it's another avenue for us for it to have an enrollment point. You know, we're not sure where it's going to go, but given, you know, obviously, it's Amazon, they've got a great consumer experience. So we're happy to be on the platform and see where it goes.
You know, one thing I would add is Lisa is, you know, chronic care management is going to continue to be an important growth driver for us. Chuck talked about it. So, you know, this is an exciting avenue for us to continue to find new ways for access of our chronic care programs. It's a distribution angle that I think is, you know, is interesting to the point Chuck made. You know, we'll see how this plays out in terms of actual growth. So I wouldn't count on, you know, it bringing revenue for us very quickly. But it is certainly something that we will continue to pursue in terms of growing our chronic care book.
If I am a consumer and I'm looking for a program, perhaps around weight management, is it that I would go on to the Amazon platform and then they would then link me to someone?
If you are eligible for our Teladoc Health Chronic Care programs, you will go on the Amazon Health Benefits Connector. And then, you know, you will essentially, we will access the eligibility will be checked, and then you will apply to our chronic care programs.
And as a consumer, how will I know about that Amazon connector? Is it just simply going into the search bar and searching that I need weight management? And then if I'm going to fill in my information and it's going to match me to. So how many other providers will there be on that platform?
So, you know, there are a few other participants in that program.
It is, you know, certainly that program has evolved in the last year or so. I would say the user experience of that program has also evolved, and we'll see how the actual program does in terms of driving access and then ultimately enrollment into our chronic care programs.
So we look forward to guidance in February. I know that we haven't seen guidance, for example, on BetterHelp in a little bit of time. It sounds like you're committed to keeping the BetterHelp business at this time. What do you think are the biggest things that investors are really missing around the story? I mean, the stock has kind of bounced around in the last several months, but I think if you just looked at the financials and some of the things you talked about between the growth, you talked about margins.
I mean, Mala, you know, I remember when you weren't making any money. So, you know, the fact that you are profitable, cash flow, et cetera, what do you think are the big things that investors are missing today?
I would point to two things. I think, first of all, clearly we are a show-me story at this point. And I think it's going to come down to execution and our ability to articulate what we're doing in terms of our priorities and then showing success against that. So we recognize that. I think the thing that probably is, I'm not sure it's underappreciated. I wouldn't speak for the investment community, but it certainly, I think it's maybe underappreciated, is just the scale and breadth of what this company has been able to commercialize. There's not many things in healthcare that can tout 93 million lives, if anything.
So the fact that we've done that, and I would just say we, I wasn't here, but the fact that the team has done that and also cross-sold into that and the ability to have access from health plans, employers, health systems, institutions, consumers, when you think about casting a net to go after some of the things. So I think that is, I don't know if it's underappreciated, but it gives an opportunity for us to drive value. And I think with BetterHelp, look, no doubt that's been under a lot of pressure. There's been a lot of focus on BetterHelp. Totally understand that. Understand what we got to deliver there. But it also is really helping a lot of people.
And I think if we're going to lean into mental health to have the scaled business on both sides, I think that's an opportunity and an asset for our shareholders that we certainly wouldn't want to make hasty decisions on.
Yeah. Can I just add a couple of other things? Everything that Chuck said is really important. And just a few other things. How many other companies in our space have 90 plus million, 94 million members? How many have the kind of client stickiness we have over 90% retention?
The other thing I would highlight is if you look at our underlying metrics momentum in many ways, whether you look at our visits momentum, our membership growth, our international business, our chronic care enrollment gains that we are making, you know, there is strength in those underlying metrics, Lisa, that I think, you know, oftentimes we are continuing to have to repeat, reinforce all the time. The other thing I would say is just the strength of our balance sheet, the breadth of our product offerings. Those are the things when we do large client presentations really serve as a differentiation for us. It's an advantage for us. And I would say we continue to make progress on our cost initiatives.
You know, we are serious about, to the point Chuck made and said in his presentation, balancing top line with bottom line, continuing to make progress on that and our cash flow generation. So those are the additional things I would emphasize, you know, in terms of reminding investors what our points of strength are.
And I know you're not prepared to give guidance at this point. We're going to get that in February. But is there anything else you want investors to keep in mind as we think about guidance coming in February?
Yeah. So, look, we typically don't go ahead and give commentary in October about our future years, but we did in October. We did talk about the outlook for 2025 for Integrated Care revenue and margins.
I would say, you know, based on what we are seeing thus far, we are comfortable with the commentary we gave. The thing I would add is we do expect revenue and margins in Integrated Care to accelerate as we go through the year in 2025. We do off of Q1, so we do expect it to be a little bit more back and weighted in 2025. I would say, you know, Q4, we are still closing the books, Lisa. So far, based on our close process, too early to comment on adjusted EBITDA. Revenue is in line with the expectations we had set and the outlook we gave in October for Q4. I would say we are looking to put in place guidance for BetterHelp in February.
You know, obviously now we have passed elections, we have passed the holiday season, we are looking at how the market is playing out, and we do plan to put some guidance for BetterHelp in February.
When you talked about the guidance this year being a little bit more back half weighted, historically the first quarter was a good quarter for you, especially it feels like flu is coming back again. Is there a reason? Is it more of the integrated services that ramp on time? Like, how do I think about why it's more back half loaded?
Yeah. So I'd say it's a couple of factors. One is exactly like you said, you know, chronic care, sort of the enrollment curves, the way they work, the curves actually progress through the year, right? So that is known, not new to all of you.
I would also say candidly, we didn't escape completely unscathed from the operational issues we had in Q1 of last year in 2024, right? You know, there's a reason why in October we said our bookings on a year-over-year basis are down. So that certainly has some impact as we sort of roll forward into through 2025.
I always like to ask about the selling season, and I generally ask about that in the third quarter. And I think, you know, you gave us some commentary when I asked that on the call, but as you closed out 2024, can you maybe just talk about that for a minute, Chuck? Like, what did you see versus your initial expectation, and what are people really buying for 2025?
Yeah, I would say that the commentary we made in the third quarter has largely continued.
So what we saw through the third quarter was most of our channels, predominantly our channels, were all tracking according to expectations, and we finished the year that way as well. The one area where we saw some weakness was in the health plan space. Obviously, there's some macro forces going on there as well. You think about Medicaid redeterminations, Medicare challenges, trend in commercials. So I think there was a lot of focus by the health plans to sort of orient to that environment, and they will, very sophisticated players, and they will adapt to the environment. But I think they're focusing on, okay, what's our model going forward? I've seen several health plans pull out of Medicare Advantage as an example. So there's a lot of activity out there. So that kind of continued through the year.
We had some nice wins, but I think that, you know, it was pretty consistent with what I said in the third quarter.
You've made comments around making investments in your business to drive it forward. Can you maybe just spend a couple of minutes talking to us about, you know, what are the types of areas that you're investing in? You have a really strong base year, right? I can't name a single company that has 93 million people on their platform. But if you can give us some detail around, you know, what you're doing around the investments that you're making and trying to offset that from a cost perspective, right? Like, so the give and take.
Yeah. And I think, like I said, in the third quarter, I mean, we're committed to driving good performance for our shareholders.
So we've taken a hard look at how do we create capacity to invest in the future so that we can deliver solid results in 2025, and we're committed to that. But some of the investments we're making, for example, I mentioned before around the value of those virtual visits. Well, when you think about those visits, somebody's coming to us for a particular need, but there may be other things that that member, that our customers are looking for from that member. Maybe it's a care gap closure. Maybe it's referring into a network that they're focusing on. Maybe it's referring into a product, a service we're offering, or it could be a service that they're offering. So the important is you can't do that after the fact. It's most effective from a clinical perspective to put it at the point of care.
So we are investing in technology that's rolling out. It came live in the fourth quarter and early first quarter for us to put really efficiently and effectively at the point of care for that clinician, the ability to sort of curate with that member other things that we might need them to activate on. So those are the kinds of investments. We're also investing in technology because we have to do this at scale. You know, you can do some of this with people, but not with millions and millions of visits. So we're implementing technology that allows us to interact with brick and mortar more effectively with third parties. You know, there's a lot of things we're going to do at Teladoc Health, but we're not going to boil the ocean. We're going to work with partners.
And so we've got to be able to integrate effectively with them. So it's those kinds of investments. And it's not just the technology, it's the people and process around it.
And I would also say chronic care, right? We've talked about chronic care being a point of focus for us. This is a very competitive, fast-moving space, as you know. So how do we continue to invest in differentiation, in innovation as it relates to chronic care and our other products? And also, how do we invest in things that will allow us to continue to make strides in enrollment? You know, there's no shortage of recruitables that we have, right? So it's really a matter of how can we continue to penetrate into the base of recruitables we have. And that means removing any and all roadblocks we have to enroll in people.
I mean, I think just following healthcare for a long time, and as you well know, Chuck, I mean, 80% of healthcare costs are driven by chronic conditions, right? The big five, and you serve a lot of those. What has been the barrier to get employers to sign on to these programs or health plans to sign on to these programs? Because it just intuitively, and I think some of you probably saw that I interviewed Jamie Dimon earlier today, and we talked about wellness, and we talked about chronic care and how important it is, and he talked about digital and technology, et cetera. So it feels like employers want to move in that direction. So I'm just curious around, you know, thoughts on the hurdles to get there.
Look, there's obviously, for the reasons you said, there's a significant need and interest in managing populations, helping people that have chronic conditions. It's more about the how. And there's a lot of things that have been thrown at this. But I think that ultimately, I think if there's a reticence, it's like, okay, what outcome am I really getting from these programs and the ability for players to demonstrate that outcome? And again, people with chronic conditions, you know, they're not just defined by that particular thing. You know, we may slice it and say, oh, this person has this. It's a whole person. They have other things going on. They might have comorbidities. They might have other kinds of challenges to sort of get their health under control, even if with a desire.
So we've got to. That's why I mentioned why it's important to come at this from a comprehensive perspective. So what we're doing is we're doing great work today. We're impacting people today, but we're taking a hard look at how do we make that more clinically driven and what else is a barrier to that individual getting the kind of support they need. And that takes work, but over time, we believe that's going to differentiate us. And we have a unique position to do it because of all the clinical things that we have in-house. So I think that's where you see sort of reticence is like, what's the real value here? Then you get into, like in the health plan world, you know, they're not all created equal. So they might have their own program they have. They might.
So it's a complex answer, but I think ultimately if your solution can focus on the clinical part of it and derive outcomes, then your proof points are there and then people will respond to it.
And this is where I would say the fact that we come at it from an integrated perspective, physical and mental health, I think I do feel really does make a difference. You know, the chart that Chuck showed where we show our access on mental health, you know, as it relates to our overall general medical base is 62%. Well, that suggests there is still more runway for us to sell into the rest of that population.
And the reason that matters is because I truly believe with chronic care, you know, combining that with mental health is definitely something that will allow us to deliver on better clinical outcomes, which is exactly what Chuck was talking about. Yeah, whole person health. I mean, the fact is today our mental health business on the B2B side is, you know, approximately $150 million. I think there is room for us to grow that business on the B2B side.
When I think about the financial models, there's obviously the visit, there's the subscription. Over the years, we've talked a lot about value-based care. Seems like that's a bad word these days. But, you know, we hear from employers around outcomes and wanting to pay for outcomes. What do you think the future of the business model looks like? Is it moving towards value-based care?
Do you think at some point you take on some level of risk around this, or is it just upside? How do I think about the future of this?
Well, look, today we're held accountable to SLAs and other kinds of standards. So it's not like it's absent of sort of outcomes, if you will. But, you know, value-based care, to your point, we've been talking about this for a long time, and it's something that I spent a considerable amount of time in my prior life with. We had a great partner, and we had scaled a primary care model exclusive to my prior company, and we had 500,000 members under a global capitated model. So in the commercial space, which is hard to do. So I can see that I've seen the benefits of aligning the interests around that.
But where I think people make mistake in value-based care, in my opinion, is we think it's too much the provider. It takes the payer and the provider. In other words, it's the end-to-end view that's going to drive sustainable value. For us, I think what we're going to be doing is what I call outcome-driven models. Things that are within our control are within our direct influence. We should be measured against that, and we should, if we perform, be rewarded against that. So I think that is going to be an important part of the future of our company, and any company in our space is they're going to be held accountable to what outcomes are you delivering, and then if you deliver, you should be rewarded for it.
I want to shift to BetterHelp. I know we only have a few minutes left.
So when I think about BetterHelp, Mala, I heard you say, look, we had an election, costs were very expensive to go to the consumer. Should we assume that it's the same model going forward that, you know, come January, when I'm listening to my podcast, you're generally one or two as far as the advertisers go? So, you know, is it going back to more of the same? Is there a new model as you're thinking about that? And then lastly, I guess to you, Chuck, it sounds like you think this is still part of the core business. I think there's been a lot of questions of, does a B2C business really fit within Teladoc Health?
Yeah. So let me start, and then Chuck, please chime in.
So look, as I think about the BetterHelp business, first of all, we will certainly continue to focus on how we manage our top-line performance with bottom line. We've been saying that now for several quarters. And I do think that that is the prudent thing to do in terms of managing this business. In terms of what specifically we are focusing on, I would say, you know, Chuck talked about this in his presentation. I'll just reinforce a few things. First, you know, in the core DTC market, it is about stabilizing. It is about improving the performance of this business. And what I would say is, as I think about the initiatives we are focused on, you know, Chuck talked about product enhancements, improving the user experience, importantly improving access for the consumer.
So one example of that, Lisa, is we are basically, when you come onto the BetterHelp.com website, you know, you may actually see instead of a monthly offer, you may actually see a weekly offer.
Okay.
Okay? Now, you know, that is something that certainly from a price point perspective, you know, it is more accessible. We are actually seeing, encouraged by the traction we are seeing from a conversion standpoint, from a user acquisition account standpoint. What we are now paying attention to is how does retention look? How does LTV look? All of the standard operating metrics that we look at in this business, net-net so far, we are, you know, the data we are seeing is positive, but we need to track it with more time. So that is one example of the kinds of things we are doing on the DTC side.
The second thing I would say is our international growth. So that has been a focus for us, you know, over the last few quarters. You know, as of the third quarter, on a trailing 12-month basis, it was approaching 20% of our overall revenues. The acquisition costs internationally are certainly more healthy. And it is one of the reasons why actually we saw our user count in September higher than in June. So up until now, you know, our international business was largely in English-speaking countries. What we are now planning is expanding it. And importantly, as we expand into other countries, actually offering a localized version of the product, right? So this would mean a local product experience. This would mean local therapists, right? So that is something that we are looking at to continue to grow our national growth.
Last but not least, what Chuck talked about is how do we enable users to essentially access their mental health benefits coverage, right? It is the reason, you know, what we have found is people go through the whole registration process, but then when they see they have to pay out of pocket, they abandon. So that should certainly help with reducing the abandonment rate. We made good progress in putting all the backend capabilities in place. What we are now doing is actually having conversations with payers in terms of being an in-network provider. I mean, that is going to take some time.
Right.
Yeah. You know, on the comment around being two different businesses, and I understand that, and they are different businesses.
You know, in my prior life, I had accountability for a direct-to-consumer business, which was quite successful, as well as a B2B business, the employer insurance markets. And what I found with that responsibility was both needed each other. You know, we're a B2B, B2B to C, and the Integrated Care. Ultimately, we need to activate consumers to use our services and enroll in our programs. And we need more consumerism in healthcare, as we all know. And so I think both can be valuable in terms of their unique characteristics, but I think there is an opportunity to bring more consumerism to the Integrated Care side. And I think the Integrated Care side can bring some industrial level there. So I don't think they have to necessarily be totally separate in terms of what we're trying to accomplish.
In healthcare, we need to reach as many people as we can if we're going to activate against these strategies. So obviously, we've got more wood to chop in that regard, but I don't see them necessarily as separate. They are unique. They have unique characteristics and distribution channels and approach to the market, who the competitors are. But from my point of view, I think at this point in time, it's important for us to really see what we can unlock with these two businesses. I think we owe that to our shareholders. They're valuable assets. We're talking about a BetterHelp is a $1 billion-plus business, the largest in its space, great metrics, as I mentioned. So I think it's important for us to take a hard look at both of them.
Great. Well, we're out of time. Thank you so much for the time today. I really appreciate it.
Thank you.