Dive Brief:
- Teladoc Health projects membership in its business-to-business integrated care unit will decline this year, in part due to the expiration of enhanced Affordable Care Act subsidies, management said during a fourth-quarter earnings call Wednesday.
- The company expects 97 million to 100 million members in U.S. integrated care in 2026, down from 101.8 million at the end of last year.
- Teladoc expects the decline will be driven by enrollment reductions at some client health plans in government programs, which were impacted by the lapse of more generous financial assistance for ACA coverage, CEO Chuck Divita said on the call.
Dive Insight:
Over the past year, Teladoc has focused on a strategic transition to drive long-term growth, prioritizing international expansion, improving operating efficiency, enhancing its integrated care business and better leveraging its mental health assets.
The company is also shifting focus from subscription to visit-based revenue in integrated care, including through a new offering that provides virtual care for a wider range of conditions 24 hours a day and seven days a week.
However, though the company has seen “strong underlying growth” in visit revenue, it hasn’t been enough to “offset that headwind that’s come in subscription revenue,” Divita said.
The shift to visit-based revenue could also be a headwind, analysts noted.
“We remain hesitant with ongoing model uncertainty as [Teladoc] navigates a transition from stable, fee-based subscription revenue to a more volatile visit-based model,” Leerink Partners analyst Michael Cherny wrote in a Wednesday note.
The impact of the shift to visit revenue could also be compounded by membership declines linked to the expiration of more generous ACA subsidies, he added.
Last year, membership in integrated care programs grew 9%, while enrollment in chronic care management programs declined by 1%. Integrated care revenue increased 3% to $1.6 billion last year, while adjusted earnings before interest, taxes, depreciation and amortization rose 3% to $239.2 million.
In 2026, Teladoc expects revenue in the integrated care segment to grow by 0.4% to 3.9% in 2026, the company said in its earnings release.
The company also said it’s made headway accepting insurance at direct-to-consumer mental health business BetterHelp. The initiative is key to “improving investor sentiment” in Teladoc, William Blair analyst Ryan Daniels wrote in a Wednesday note.
BetterHelp now accepts insurance in 20 states, plus Washington, D.C., and the unit generated $13 million in revenue from insurance last year, Divita said on the earnings call. The segment expects to earn between $75 million to $90 million in revenue from insurance this year.
Still, the unit continued to face financial challenges in 2025. BetterHelp’s revenue fell 9% year over year to $950.4 million, while adjusted EBITDA fell by 46% to $41.9 million. The mental health segment’s average paying users declined 5% in 2025.
Additionally, BetterHelp will likely continue to face headwinds among consumers paying cash for services, “driven both by a challenging consumer backdrop” and the company’s decision to reduce ad spending and grow its insurance offering, Divita said.
Overall, Teladoc reported $2.53 billion in revenue in 2026, down about 2% from the previous year. The telehealth firm posted a net loss of $200.3 million, compared with a loss of $1 billion in 2024.
Teladoc expects $2.47 billion to $2.59 billion in revenue for 2026, and projects a net loss per share between $1.10 and $0.70.
