NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
Note 1. Organization and Description of Business
Teladoc Health, Inc., together with its subsidiaries, is referred to herein as “Teladoc Health,” or the “Company,” and is the global leader in whole person virtual care focusing on forging a new healthcare experience with better convenience, outcomes, and value around the world. The Company’s mission is to empower all people everywhere to live their healthiest lives by transforming the healthcare experience.
The Company was incorporated in the State of Texas in June 2002 and changed its state of incorporation to the State of Delaware in October 2008. Effective August 10, 2018, Teladoc, Inc. changed its corporate name to Teladoc Health, Inc. The Company’s principal executive office is located in Purchase, New York.
Note 2. Basis of Presentation and Principles of Consolidation
The accompanying unaudited condensed consolidated financial statements for the nine months ended September 30, 2023 and 2022, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals) necessary for a fair presentation of the condensed consolidated results of operations, financial position and cash flows of Teladoc Health for the periods presented. However, the financial results for interim periods are not necessarily indicative of the results that may be expected for a full fiscal year or for any other future period.
Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles (“GAAP”) in the United States (“U.S.”) have been omitted or condensed pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). The information in this report should be read in conjunction with the Company’s Annual Report on Form 10-K filed with the SEC for the fiscal year ended December 31, 2022 (the “2022 Form 10-K”), which includes a complete set of footnote disclosures, including the Company’s significant accounting policies.
These consolidated financial statements include the results of Teladoc Health, as well as two professional associations and 10 professional corporations (collectively, the “THMG Association”).
Teladoc Health Medical Group, P.A., formerly Teladoc Physicians, P.A. (“THMG”), is party to a Services Agreement by and among it and the professional associations and professional corporations pursuant to which each professional association and professional corporation provides services to THMG. Each professional association and professional corporation is established pursuant to the requirements of its respective domestic jurisdiction governing the corporate practice of medicine.
The Company holds a variable interest in the THMG Association, which contracts with physicians and other health professionals in order to provide services to Teladoc Health. The THMG Association is considered a variable interest entity (“VIE”) since it does not have sufficient equity to finance its activities without additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if it has both power and benefits—that is, it has (1) the power to direct the activities of a VIE that most significantly impact the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has the power and rights to control all activities of the THMG Association and funds and absorbs all losses of the VIE and appropriately consolidates the THMG Association.
Total revenue and net loss for the VIE were $56.1 million and $0.0 million, and $57.5 million and $1.1 million, for the three months ended September 30, 2023 and 2022, respectively. Total revenue and net loss for the VIE were $176.6 million and $0.0 million, and $176.9 million and $3.9 million, for the nine months ended September 30, 2023 and 2022, respectively. The VIE’s total assets, all of which were current, were $263.5 million and $106.7 million at September 30, 2023 and December 31, 2022, respectively. The VIE’s total liabilities, all of which were current, were $312.1 million and $143.8 million at September 30, 2023 and December 31, 2022, respectively. The VIE’s total stockholders’ deficit was $48.6 million and $37.1 million at September 30, 2023 and December 31, 2022, respectively.
All intercompany transactions and balances have been eliminated.
Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business and economic factors, and various other assumptions that the Company believes are necessary to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained and as the Company’s operating environment evolves. The Company believes that estimates used in the preparation of these condensed consolidated financial statements are reasonable; however, actual results could differ materially from these estimates.
Changes in estimates are made when circumstances warrant. Such changes in estimates and refinements in estimation methodologies are reflected in the Condensed Consolidated Statements of Operations; if material, the effects of changes in estimates are disclosed in the Notes to Unaudited Condensed Consolidated Financial Statements.
Significant estimates and assumptions by management affect areas including the value and useful life of long-lived assets (including intangible assets), the value of goodwill, the capitalization and amortization of software development costs, deferred device and contract costs, allowances for sales and for doubtful accounts, and the accounting for business combinations. Other significant areas include revenue recognition (including performance guarantees and claims adjustments), the accounting for income taxes, contingencies, litigation and related legal accruals, the accounting for stock-based compensation awards, and other items as described in the Summary of Significant Accounting policies in this Quarterly Report and in the 2022 Form 10-K.
Recently Adopted Accounting Standards
In September 2022, the financial accounting standards board issued Accounting Standards Update (“ASU”) 2022-04, “Liabilities – Supplier Finance Programs (Subtopic 405-50) – Disclosure of Supplier Finance Program Obligations,” to provide guidance on disclosure requirements for supplier finance programs and improve information transparency by requiring the disclosure of key terms of the program, amounts outstanding that remain unpaid, a description of where those amounts are presented in the balance sheet, and a roll forward of any outstanding obligations. ASU 2022-04 is effective for annual reporting periods, including interim periods therein, beginning after December 15, 2022, except for the amendment on roll forward information, which is effective for fiscal years beginning after December 15, 2023. The adoption of ASU 2022-04 did not have any impact on the Company’s financial information.
Note 3. Revenue, Deferred Revenue, and Deferred Device and Contract Costs
The Company generates access fees from customers, which primarily consist of employers, health plans, hospitals and health systems, insurance and financial services companies (collectively “Clients”), as well as individual members who utilize the Company’s solutions, accessing its professional provider network, hosted virtual healthcare platform, and chronic care management platforms. Visit fee revenue is generated for general medical, expert medical service, and other specialty visits and is reported as a component of other revenue when disaggregated revenue is presented. Revenue associated with virtual healthcare device equipment sales included with the Company’s hosted virtual healthcare platform is also reported in other revenue.
The following table presents the Company’s revenues disaggregated by revenue source and also by geography (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Revenue by Type | | | | | | | |
Access fees | $ | 582,070 | | | $ | 540,079 | | | $ | 1,708,601 | | | $ | 1,550,146 | |
Other | 78,168 | | | 71,323 | | | 233,287 | | | 218,985 | |
Total Revenue | $ | 660,238 | | | $ | 611,402 | | | $ | 1,941,888 | | | $ | 1,769,131 | |
| | | | | | | |
Revenue by Geography | | | | | | | |
U.S. Revenue | $ | 569,322 | | | $ | 534,013 | | | $ | 1,672,770 | | | $ | 1,546,599 | |
International Revenue | 90,916 | | | 77,389 | | | 269,118 | | | 222,532 | |
Total Revenue | $ | 660,238 | | | $ | 611,402 | | | $ | 1,941,888 | | | $ | 1,769,131 | |
During the fourth quarter of 2022, the Company refined its definition of other revenue to capture revenues associated with visit fee, virtual healthcare device equipment sales, and its hosted virtual healthcare platform. Prior period amounts have been recast to conform with the current presentation.
Deferred Revenue
Deferred revenue represents billed, but unrecognized revenue, and is comprised of fees received in advance of the delivery or completion of the services and amounts received in instances when revenue recognition criteria have not been met. The Company records deferred revenue when cash payments are received in advance of the Company’s performance obligation to provide services. Deferred revenue is derived from 1) upfront payments for a device, which is amortized ratably over the expected member enrollment period; 2) upfront payments for certain services where payment is required for future periods before the service is delivered to the member, which is recognized when the services are provided; and 3) upfront payments from third-party financing companies with whom the Company works to provide certain Clients with a rental option, which is recognized over the rental period. Deferred revenue that will be recognized during the next twelve-month period is recorded as current deferred revenue and the remaining portion is recorded as non-current deferred revenue.
Deferred revenue, current plus long-term, was $112.3 million at September 30, 2023, a net decrease of $1.4 million from December 31, 2022, and $111.3 million at September 30, 2022, a net increase of $9.3 million from December 31, 2021. These changes were driven by increased cash payments received in advance of satisfying performance obligations, offset by revenue recognized that had been included in the deferred revenue balance at the beginning of the period. The amount of revenue recognized in the periods that was included in the opening current deferred revenue was $88.6 million and $68.2 million for the nine months ended September 30, 2023 and 2022, respectively.
The Company expects to recognize $65.3 million of revenue throughout the remainder of 2023, $36.1 million of revenue in the year ending December 31, 2024, and the remaining balance thereafter related to future performance obligations that are unsatisfied or partially unsatisfied as of September 30, 2023.
Deferred Device and Contract Costs
Deferred device and contract costs are classified as a component of prepaid expenses and other current assets or other assets, depending on term, and consisted of the following (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
Deferred device and contract costs, current | $ | 31,352 | | | $ | 29,956 | |
Deferred device and contract costs, noncurrent | 17,999 | | | 8,404 | |
Total deferred device and contract costs | $ | 49,351 | | | $ | 38,360 | |
Deferred device and contract costs were as follows (in thousands):
| | | | | |
| Deferred Device and Contract Costs |
Beginning balance as of December 31, 2022 | $ | 38,360 | |
Additions | 45,567 | |
Cost of revenue recognized | (34,576) | |
Ending balance as of September 30, 2023 | $ | 49,351 | |
Note 4. Fair Value Measurements
The carrying value of the Company’s cash equivalents, short-term investments, accounts receivable, accounts payable, and accrued liabilities approximates fair value due to their short-term nature.
The Company measures its financial assets and liabilities at fair value at each reporting period using a fair value hierarchy that requires it to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value.
A financial instrument’s classification within the fair value hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Three levels of inputs may be used to measure fair value:
Level 1—Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.
Level 2—Include other inputs that are directly or indirectly observable in the marketplace.
Level 3—Unobservable inputs that are supported by little or no market activity.
The Company measures its cash equivalents at fair value on a recurring basis. The Company classifies its cash equivalents within Level 1 because they are valued using observable inputs that reflect quoted prices for identical assets in active markets and quoted prices directly in active markets.
The following tables present information about the Company’s assets and liabilities that are measured at fair value on a recurring basis using the above input categories (in thousands):
| | | | | | | | | | | | | | | | | |
| September 30, 2023 |
| Level 1 | | Level 2 | | Total |
Cash and cash equivalents | $ | 1,030,527 | | | $ | 0 | | | $ | 1,030,527 | |
| | | | | | | | | | | | | | | | | |
| December 31, 2022 |
| Level 1 | | Level 2 | | Total |
Cash and cash equivalents | $ | 918,182 | | | $ | 0 | | | $ | 918,182 | |
There were no transfers between fair value measurement levels during any of the periods presented.
Note 5. Inventories
Inventories consisted of the following (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
Raw materials and purchased parts | $ | 23,854 | | | $ | 30,126 | |
Work in process | 902 | | | 433 | |
Finished goods | 18,847 | | | 31,977 | |
Inventory reserve | (7,687) | | | (6,194) | |
Total inventories | $ | 35,916 | | | $ | 56,342 | |
Note 6. Prepaid Expenses and Other Current Assets
Prepaid expenses and other current assets consisted of the following (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
Prepaid expenses | $ | 62,248 | | | $ | 63,159 | |
Deferred device and contract costs, current | 31,352 | | | 29,956 | |
Other receivables | 12,875 | | | 25,091 | |
Other current assets | 8,307 | | | 12,104 | |
Total prepaid expenses and other current assets | $ | 114,782 | | | $ | 130,310 | |
Note 7. Goodwill
Goodwill consisted of the following (in thousands):
| | | | | | | | | | | | | | | | | |
| Teladoc Health Integrated Care | | BetterHelp | | Total |
Balance as of December 31, 2022 and September 30, 2023 | $ | 0 | | | $ | 1,073,190 | | | $ | 1,073,190 | |
Goodwill is net of accumulated impairment losses of $13.4 billion, of which $12.3 billion was recognized prior to the Company reorganizing its reporting structure to include two reportable segments on October 1, 2022 and $1.1 billion was recognized on the goodwill assigned to the Teladoc Health Integrated Care segment.
Note 8. Intangible Assets, Net and Certain Cloud Computing Costs
Intangible assets, net consisted of the following (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Useful Life | | Gross Value | | Accumulated Amortization | | Net Carrying Value | | Weighted Average Remaining Useful Life (Years) |
September 30, 2023 | | | | | | | | | |
Client relationships | 2 years to 20 years | | $ | 1,456,027 | | | $ | (364,027) | | | $ | 1,092,000 | | | 12.7 |
Trademarks | 2 years to 15 years | | 324,675 | | | (156,655) | | | 168,020 | | | 6.8 |
Software | 3 years to 5 years | | 416,417 | | | (137,176) | | | 279,241 | | | 2.5 |
Technology | 4 years to 7 years | | 341,672 | | | (152,631) | | | 189,041 | | | 3.9 |
Intangible assets, net | | | $ | 2,538,791 | | | $ | (810,489) | | | $ | 1,728,302 | | | 9.5 |
December 31, 2022 | | | | | | | | | |
Client relationships | 2 years to 20 years | | $ | 1,458,384 | | | $ | (291,993) | | | $ | 1,166,391 | | | 13.5 |
Trademarks | 2 years to 15 years | | 325,171 | | | (98,303) | | | 226,868 | | | 7.0 |
Software | 3 years to 5 years | | 294,629 | | | (78,373) | | | 216,256 | | | 2.7 |
Technology | 4 years to 7 years | | 343,067 | | | (115,817) | | | 227,250 | | | 4.7 |
Intangible assets, net | | | $ | 2,421,251 | | | $ | (584,486) | | | $ | 1,836,765 | | | 10.4 |
The following table presents the Company's amortization of intangible assets expense by component (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Acquired intangibles | $ | 69,189 | | | $ | 48,676 | | | $ | 172,210 | | | $ | 148,327 | |
Capitalized software | 22,645 | | | 9,524 | | | 58,995 | | | 23,176 | |
Amortization of intangible assets expense | $ | 91,834 | | | $ | 58,200 | | | $ | 231,205 | | | $ | 171,503 | |
During the three months ended September 30, 2023, the Company initiated a strategy to transition the majority of its chronic condition management Clients and members to the Teladoc Health brand on a phased basis, with a smaller subset continuing to be served under the Livongo trade name beyond 2024. In connection with the brand strategy, the Company has accelerated the amortization associated with the Livongo trademark, increasing amortization expense in the years ending December 31, 2023 and 2024, with corresponding reductions thereafter. The change in accounting estimate resulted in additional amortization expense of $18.6 million, or $0.11 per basic and diluted share for both the three and nine months ended September 30, 2023.
Periodic amortization that will be charged to expense over the remaining life of the intangible assets as of September 30, 2023 was as follows (in thousands):
| | | | | |
Years Ending December 31, | |
2023 | $ | 100,248 | |
2024 | 344,537 | |
2025 | 260,330 | |
2026 | 199,008 | |
2027 and thereafter | 824,179 | |
| $ | 1,728,302 | |
Net cloud computing costs are recorded in other assets within the balance sheets. As of September 30, 2023 and December 31, 2022, those costs were $38.2 million and $25.4 million, respectively. The associated expense for cloud
computing costs is amortized in general and administration expense and was $0.6 million and $0.6 million for the three months ended September 30, 2023 and 2022, respectively, and was $2.4 million and $1.1 million for the nine months ended September 30, 2023 and 2022, respectively.
Note 9. Accrued Expenses and Other Current Liabilities
Accrued expenses and other current liabilities consisted of the following (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
Professional fees | $ | 9,235 | | | $ | 10,152 | |
Consulting fees/provider fees | 17,598 | | | 16,407 | |
Client performance guarantees and accrued rebates | 31,615 | | | 18,687 | |
Interest payable | 5,781 | | | 1,480 | |
Income tax payable | 757 | | | 3,817 | |
Insurance | 4,662 | | | 5,981 | |
Lease abandonment obligation - current | 5,650 | | | 3,247 | |
Marketing and advertising | 43,078 | | | 35,055 | |
Operating lease liabilities – current | 10,787 | | | 13,592 | |
Franchise and sales taxes | 17,086 | | | 10,183 | |
Staff augmentation | 4,006 | | | 3,391 | |
Other | 42,298 | | | 46,701 | |
Total | $ | 192,553 | | | $ | 168,693 | |
Note 10. Convertible Senior Notes
Outstanding Convertible Senior Notes
As of September 30, 2023, the Company had three series of convertible senior notes outstanding. The issuances of such notes originally consisted of (i) $1.0 billion aggregate principal amount of 1.25% convertible senior notes due 2027 (the “2027 Notes”), issued on May 19, 2020 for net proceeds to the Company of $975.9 million after deducting offering costs of approximately $24.1 million, (ii) $287.5 million aggregate principal amount of 1.375% convertible senior notes due 2025 (the “2025 Notes”), issued on May 8, 2018 for net proceeds to the Company of $279.1 million after deducting offering costs of approximately $8.4 million, and (iii) $550.0 million aggregate principal amount of 0.875% convertible senior notes due 2025 that were issued by Livongo Health, Inc. (“Livongo”) on June 4, 2020 for which the Company agreed to assume all of Livongo’s rights and obligations (the “Livongo Notes;” and together with the 2027 Notes and the 2025 Notes, the “Notes”).
The following table presents certain terms of the Notes that were outstanding as of September 30, 2023:
| | | | | | | | | | | | | | | | | |
| 2027 Notes | | 2025 Notes | | Livongo Notes |
Principal Amount Outstanding as of September 30, 2023 (in millions) | $ | 1,000.0 | | | $ | 0.7 | | | $ | 550.0 | |
Interest Rate Per Year | 1.25 | % | | 1.375 | % | | 0.875 | % |
Fair Value as of September 30, 2023 (in millions) (1) | $ | 796.9 | | | $ | 0.3 | | | $ | 502.6 | |
Fair Value as of December 31, 2022 (in millions) (1) | $ | 768.2 | | | $ | 0.3 | | | $ | 480.6 | |
Maturity Date | June 1, 2027 | | May 15, 2025 | | June 1, 2025 |
Optional Redemption Date | June 5, 2024 | | May 22, 2022 | | June 5, 2023 |
Conversion Date | December 1, 2026 | | November 15, 2024 | | March 1, 2025 |
Conversion Rate Per $1,000 Principal Amount as of September 30, 2023 | 4.1258 | | 18.6621 | | 13.9400 |
Remaining Contractual Life as of September 30, 2023 | 3.7 years | | 1.6 years | | 1.7 years |
(1)The Company estimates the fair value of its Notes utilizing market quotations for debt that have quoted prices in active markets. Since the Notes do not trade on a daily basis in an active market, the fair value estimates are based on market observable inputs based on borrowing rates currently available for debt with similar terms and average maturities. The Notes are classified as Level 2 within the fair value hierarchy, as defined in Note 4. “Fair Value Measurements.”
All of the Notes are unsecured obligations of the Company and rank senior in right of payment to the Company’s indebtedness that is expressly subordinated in right of payment to such Notes; equal in right of payment to the Company’s liabilities that are not so subordinated; effectively junior in right of payment to any of the Company’s secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities incurred by the Company’s subsidiaries.
Holders may convert all or any portion of their Notes in integral multiples of $1,000 principal amount, at their option, at any time prior to the close of business on the business day immediately preceding the applicable conversion date only under the following circumstances:
•during any quarter (and only during such quarter), if the last reported sale price of the shares of Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding quarter is greater than or equal to 130% of the conversion price for the applicable Notes on each applicable trading day;
•during the five business day period after any ten consecutive trading day period (or five consecutive trading day period in the case of the Livongo Notes) in which the trading price was less than 98% of the product of the last reported sale price of Company’s common stock and the conversion rate for the applicable Notes on each such trading day;
•upon the occurrence of specified corporate events described under the applicable indenture; or
•if the Company calls the applicable Notes for redemption, at any time until the close of business on the second business day immediately preceding the redemption date.
On or after the applicable conversion date, until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of such Notes, regardless of the foregoing circumstances.
The 2027 Notes and the 2025 Notes are convertible into shares of the Company’s common stock at the applicable conversion rate shown in the table above. Upon conversion, the Company will pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and shares of the Company’s common stock, the amount of cash and shares of the Company’s common stock due
upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 25 consecutive trading day observation period.
The Livongo Notes are convertible at the applicable conversion rate shown in the table above into “units of reference property,” each of which is comprised of 0.592 of a share of the Company’s common stock and $4.24 in cash, without interest. Upon conversion, the Company will pay or deliver, as the case may be, cash, units of reference property, or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and units of reference property, the amount of cash and units of reference property, if any, due upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 40 consecutive trading day observation period.
For each Note series, the Company may redeem for cash all or part of the Notes, at its option, on or after the applicable optional redemption date shown in the table above (and prior to the 41st scheduled trading day immediately preceding the maturity date in the case of the Livongo Notes) if the last reported sale price of its common stock exceeds 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading days ending on, and including, the trading day immediately preceding the date on which the Company provides notice of the redemption. The redemption price will be the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any. In addition, calling any 2027 Note or 2025 Note for redemption on or after the applicable optional redemption date will constitute a make-whole fundamental change with respect to that Note, in which case the conversion rate applicable to the conversion of that Note, if it is converted in connection with the redemption, will be increased in certain circumstances as described in the applicable indenture. If the Company undergoes a fundamental change (as defined in the applicable indenture) at any time prior to the maturity date of the Livongo Notes, holders will have the right, at their option, to require the Company to repurchase for cash all or any portion of their Livongo Notes at a fundamental change repurchase price equal to 100% of the principal amount of the Livongo Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date.
The Company accounts for each Note series at amortized cost within the liability section of its condensed consolidated balance sheets. The Company has reserved an aggregate of 8.7 million shares of common stock for the Notes.
The net carrying values of the Notes consisted of the following (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
2027 Notes | | | |
Principal | $ | 1,000,000 | | | $ | 1,000,000 | |
Less: Debt discount, net (1) | (12,886) | | | (15,430) | |
Net carrying amount | 987,114 | | | 984,570 | |
| | | |
2025 Notes | | | |
Principal | 725 | | | 725 | |
Less: Debt discount, net (1) | (6) | | | (7) | |
Net carrying amount | 719 | | | 718 | |
| | | |
Livongo Notes | | | |
Principal | 550,000 | | | 550,000 | |
Less: Debt discount, net (1) | 0 | | | 0 | |
Net carrying amount | 550,000 | | | 550,000 | |
| | | |
Total net carrying amount | $ | 1,537,833 | | | $ | 1,535,288 | |
(1)Included in the accompanying condensed consolidated balance sheets within convertible senior notes and amortized to interest expense over the expected life of the Notes using the effective interest rate method.
The following table sets forth total interest expense recognized related to the Notes (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
2027 Notes | 2023 | | 2022 | | 2023 | | 2022 |
Contractual interest expense | $ | 3,125 | | $ | 3,125 | | $ | 9,375 | | $ | 9,375 |
Amortization of debt discount | $ | 851 | | $ | 838 | | $ | 2,542 | | $ | 2,502 |
Total | $ | 3,976 | | $ | 3,963 | | $ | 11,917 | | $ | 11,877 |
Effective interest rate | 1.6 | % | | 1.6 | % | | 1.6 | % | | 1.6 | % |
| | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
2025 Notes | 2023 | | 2022 | | 2023 | | 2022 |
Contractual interest expense | $ | 2 | | $ | 2 | | $ | 7 | | $ | 7 |
Amortization of debt discount | $ | 1 | | $ | 1 | | $ | 2 | | $ | 2 |
Total | $ | 3 | | $ | 3 | | $ | 9 | | $ | 9 |
Effective interest rate | 1.8 | % | | 1.8 | % | | 1.8 | % | | 1.8 | % |
| | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
Livongo Notes | 2023 | | 2022 | | 2023 | | 2022 |
Contractual interest expense | $ | 1,203 | | $ | 1,203 | | $ | 3,609 | | $ | 3,609 |
Amortization of debt discount | $ | 0 | | $ | 0 | | $ | 0 | | $ | 0 |
Total | $ | 1,203 | | $ | 1,203 | | $ | 3,609 | | $ | 3,609 |
Effective interest rate | 0.9 | % | | 0.9 | % | | 0.9 | % | | 0.9 | % |
Note 11. Leases
The Company has operating leases for facilities, hosting co-location facilities, and certain equipment under non-cancelable leases in the U.S. and various international locations. The leases have remaining lease terms of less than one to nine years, with options to extend the lease term from one to five years. At the inception of an arrangement, the Company determines whether the arrangement is, or contains, a lease based on the terms covering the right to use property, plant or equipment for a stated period of time. For new and amended leases beginning in 2020 and after, the Company separately allocates the lease (e.g., fixed lease payments for right-to-use land, building, etc.) and non-lease components (e.g., common area maintenance) for its leases.
The Company leases office space under non-cancelable operating leases in the U.S. and various international locations. The future minimum lease payments under non-cancelable operating leases were as follows (in thousands):
| | | | | |
Operating Leases: | As of September 30, 2023 |
2023 | $ | 3,881 | |
2024 | 11,909 | |
2025 | 9,273 | |
2026 | 8,082 | |
2027 | 5,967 | |
2028 and thereafter | 14,674 | |
Total future minimum payments | 53,786 | |
Less: imputed interest | (8,646) | |
Present value of lease liabilities | $ | 45,140 | |
| |
Accrued expenses and other current liabilities | $ | 10,787 | |
Operating lease liabilities, net of current portion | $ | 34,353 | |
The Company rents certain information systems to selected qualified customers under arrangements that qualify as either sales-type lease or operating lease arrangements. Leases have terms that generally range from two to five years.
The Company recorded certain restructuring costs related to lease impairments and the related charges due to the abandonment and/or exit of excess leased office space. However, the lease liabilities related to these spaces remain an outstanding obligation of the Company as of September 30, 2023. See Note. 12, “Restructuring,” for further information.
Note 12. Restructuring
The Company has substantially completed the previously reported actions to restructure its operations to reduce operating costs. The Company accounts for restructuring costs in accordance with ASC Subtopic 420-10, "Exit or Disposal Cost Obligations" and ASC Section 360-10-35, "Property, Plant and Equipment-Subsequent Measurement." The costs are recorded to the "Restructuring costs" line item within the Company's Condensed Consolidated Statements of Operations and Other Comprehensive Loss as they are recognized.
During the three months ended September 30, 2023, the Company recorded $0.4 million of restructuring costs, of which $0.2 million was related to adjustments for severance estimates and $0.2 million was related to adjustments for estimates related to the reduction of office space. During the nine months ended September 30, 2023, the Company recorded $16.0 million of restructuring costs, of which $7.9 million was related to employee transition, severance payments, employee benefits, and related costs and $8.1 million was related to costs associated with office space reductions, including $4.9 million of right-of-use asset impairment charges. The portion of these amounts to be settled by cash disbursements was accounted for as a restructuring liability under the line item "Accrued expenses and other current liabilities" in the Company's Condensed Consolidated Balance Sheets.
The table below summarizes the accrual and charges incurred with respect to the Company's restructuring, with the severance related portion included in the line item "Accrued compensation" and the lease termination related portion
included in the line item "Accrued expenses and other current liabilities" in the Company's Condensed Consolidated Balance Sheet as of September 30, 2023 (in thousands):
| | | | | | | | | | | | | | | | | |
| Restructuring Plan |
| Severance | | Lease Termination | | Total |
Accrued Balance, December 31, 2022 | $ | 796 | | | $ | 3,247 | | | $ | 4,043 | |
Additions | 7,871 | | | 3,309 | | | 11,180 | |
Cash payments | (7,345) | | | (906) | | | (8,251) | |
Accrued Balance, September 30, 2023 | $ | 1,322 | | | $ | 5,650 | | | $ | 6,972 | |
Note 13. Common Stock and Stockholders’ Equity
Stock Plans
The Company’s 2023 Incentive Award Plan and 2023 Employment Inducement Incentive Award Plan (collectively, the “2023 Plans”) provide for the issuance of incentive and non-statutory options and other equity-based awards to its employees and non-employee service providers. Previously, the Company’s 2015 Incentive Award Plan, 2017 Employment Inducement Incentive Award Plan and Livongo Acquisition Incentive Award Plan (together with the 2023 Plans, collectively, the “Plans”) also provided for the issuance of such awards. The Company had 14,658,357 shares available for grant under the 2023 Plans at September 30, 2023.
All stock-based awards to employees are measured based on the grant-date fair value, or replacement grant date fair value in relation to the Livongo transaction, and are generally recognized on a straight line basis in the Company’s Condensed Consolidated Statements of Operations over the period during which the employee is required to perform services in exchange for the award (generally requiring a four-year vesting period for each stock option and a three-year vesting period for each restricted stock unit (“RSU”)). The Company recognizes the forfeiture of stock-based awards as they occur.
Stock Options
Options issued under the Plans are exercisable for periods not to exceed 10 years, and vest and contain such other terms and conditions as specified in the applicable award document. Options to buy common stock are issued under the Plans, with exercise prices equal to the closing price of shares of the Company’s common stock on the New York Stock Exchange on the date of award.
Stock option activity under the Plans was as follows (in thousands, except share and per share amounts and years):
| | | | | | | | | | | | | | | | | | | | | | | |
| Number of Shares Outstanding | | Weighted- Average Exercise Price | | Weighted- Average Remaining Contractual Life in Years | | Aggregate Intrinsic Value |
Balance at December 31, 2022 | 4,243,934 | | $ | 27.79 | | | 6.10 | | $ | 19,541 | |
Stock option grants | 87,554 | | $ | 24.27 | | | N/A | | |
Stock options exercised | (171,888) | | $ | 8.28 | | | N/A | | $ | 2,993 | |
Stock options forfeited | (116,323) | | $ | 50.27 | | | N/A | | |
Balance at September 30, 2023 | 4,043,277 | | $ | 27.89 | | | 5.53 | | $ | 9,600 | |
Vested or expected to vest at September 30, 2023 | 4,043,277 | | $ | 27.89 | | | 5.53 | | $ | 9,600 | |
Exercisable at September 30, 2023 | 3,053,345 | | $ | 25.49 | | | 4.47 | | $ | 9,600 | |
The total grant-date fair value of stock options granted during the three months ended September 30, 2023 and 2022 were $0.4 million and $0.3 million, respectively. The total grant-date fair value of stock options granted during the nine months ended September 30, 2023 and 2022 were $1.2 million and $24.9 million, respectively.
The Company estimates the fair value of stock options granted using the Black-Scholes option pricing model.
The assumptions used are determined as follows:
Volatility. The expected volatility was derived from the historical stock volatilities of the Company’s stock over a period equivalent to the expected term of the stock option grants.
Expected Term. The expected term represents the period that the stock-based awards are expected to be outstanding. When establishing the expected term assumption, the Company utilizes historical data.
Risk-Free Interest Rate. The risk-free interest rate is based on U.S. Treasury zero-coupon issues with terms similar to the expected term on the options.
Dividend Yield. The Company has never declared or paid any cash dividends and does not plan to pay cash dividends in the foreseeable future and, therefore, it used an expected dividend yield of zero.
The fair value of each option grant was estimated on the date of grant using the Black-Scholes option-pricing model with the following assumptions and fair value per share:
| | | | | | | | | | | |
| Nine Months Ended September 30, |
| 2023 | | 2022 |
Volatility | 65.58% - 68.22% | | 56.69% - 67.95% |
Expected term (in years) | 4.3 | | 4.1 |
Risk-free interest rate | 3.68% - 4.34% | | 1.13% - 3.46% |
Dividend yield | 0% | | 0% |
Weighted-average fair value of underlying stock options | $13.42 | | $17.72 |
For the three months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to stock options granted of $2.3 million and $2.4 million, respectively. For the nine months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to stock options granted of $7.0 million and $18.0 million, respectively.
As of September 30, 2023, the Company had $16.7 million in unrecognized compensation cost related to non-vested stock options, which is expected to be recognized over a weighted-average period of approximately 2.04 years.
Restricted Stock Units
The fair value of RSUs is determined on the date of grant. The Company records compensation expense in the consolidated statements of operations on a straight-line basis over the vesting period for RSUs. The vesting period for employees and members of the Board of Directors ranges from 1 year to 3 years.
RSU activity under the Plans was as follows:
| | | | | | | | | | | |
| RSUs | | Weighted-Average Grant Date Fair Value Per RSU |
Balance at December 31, 2022 | 6,481,669 | | $ | 63.63 | |
Granted | 7,121,431 | | $ | 26.56 | |
Vested and issued | (2,448,261) | | $ | 71.64 | |
Forfeited | (1,094,153) | | $ | 50.48 | |
Balance at September 30, 2023 | 10,060,686 | | $ | 36.64 | |
Vested and unissued at September 30, 2023 | 43,118 | | $ | 56.25 | |
Non-vested at September 30, 2023 | 10,017,568 | | $ | 36.67 | |
The total grant-date fair value of RSUs granted during the three months ended September 30, 2023 and 2022 was
$7.5 million and $18.8 million, respectively. The total grant-date fair value of RSUs granted during the nine months ended September 30, 2023 and 2022 was $189.2 million and $293.5 million, respectively.
For the three months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to RSUs of $51.9 million and $53.7 million, respectively. For the nine months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to RSUs of $148.8 million and $147.8 million, respectively.
As of September 30, 2023, the Company had $292.1 million in unrecognized compensation cost related to non-vested RSUs, which is expected to be recognized over a weighted-average period of approximately 1.91 years.
Performance Stock Units
Stock-based compensation costs associated with the Company’s RSUs subject to performance criteria (“PSUs”) are initially determined using the fair market value of the Company’s common stock on the date the awards are granted (service inception date). The vesting of these PSUs is subject to certain performance conditions and a service requirement ranging from 1 year to 3 years. Stock-based compensation costs associated with these PSUs are re-assessed each reporting period based upon the estimated performance attainment on the reporting date until the performance conditions are met. The ultimate number of PSUs that are issued to an employee is the result of the actual performance of the Company at the end of the performance period compared to the performance targets and generally ranges from 0% to 200% of the initial grant. Stock compensation expense for PSUs is recognized on an accelerated tranche by tranche basis for performance-based awards.
PSU activity under the Plans was as follows:
| | | | | | | | | | | |
| Shares | | Weighted-Average Grant Date Fair Value Per PSU |
Balance at December 31, 2022 | 629,672 | | $ | 99.07 | |
Granted | 1,297,725 | | $ | 26.90 | |
Vested and issued | (117,966) | | $ | 153.96 | |
Forfeited | (27,049) | | $ | 46.52 | |
Performance adjustment (1) | (283,282) | | $ | 0.00 | |
Balance at September 30, 2023 | 1,499,100 | | $ | 37.00 | |
Vested and unissued at September 30, 2023 | 0 | | $ | 0.00 | |
Non-vested at September 30, 2023 | 1,499,100 | | $ | 37.00 | |
(1)Based on the Company's 2022 results, PSUs were attained at rates ranging from 0% to 86.25% of the target award.
During the three months ended September 30, 2023 and 2022, the Company did not grant any PSUs. The total grant-date fair value of PSUs granted during the nine months ended September 30, 2023 and 2022 was $34.9 million and $35.0 million, respectively.
For the three months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to PSUs of $2.6 million and $3.1 million, respectively. For the nine months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to PSUs of $9.9 million and $12.5 million, respectively.
As of September 30, 2023, the Company had $36.2 million in unrecognized compensation cost related to non-vested PSUs, which is expected to be recognized over a weighted-average period of approximately 1.8 years.
Employee Stock Purchase Plan
In July 2015, the Company adopted the 2015 Employee Stock Purchase Plan (“ESPP”) in connection with its initial public offering. At the Company’s 2023 annual meeting of stockholders, the Company’s stockholders approved an amendment to the ESPP to increase the number of shares of the Company’s common stock available for issuance under the ESPP by 3,000,000. A total of 4,113,343 shares of common stock were reserved for issuance under this plan as of September 30, 2023. The Company’s ESPP permits eligible employees to purchase common stock at a discount through
payroll deductions during defined offering periods. Under the ESPP, the Company may specify offerings with durations of not more than 27 months and may specify shorter purchase periods within each offering. Each offering will have one or more purchase dates on which shares of its common stock will be purchased for employees participating in the offering. An offering may be terminated under certain circumstances. The price at which the stock is purchased is equal to the lower of 85% of the fair market value of the common stock at the beginning of an offering period or on the date of purchase.
During the three months ended September 30, 2023 and 2022, the Company did not issue any shares under the ESPP. During the nine months ended September 30, 2023 and 2022, the Company issued 271,736 shares and 148,609 shares, respectively, under the ESPP. As of September 30, 2023, 3,121,353 shares remained available for issuance.
For the three months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to the ESPP of $1.2 million and $0.9 million, respectively. For the nine months ended September 30, 2023 and 2022, the Company recorded stock-based compensation related to the ESPP of $3.6 million and $2.0 million, respectively.
As of September 30, 2023, the Company had $0.5 million in unrecognized compensation cost related to the ESPP, which is expected to be recognized over a weighted-average period of approximately 0.1 years.
Total compensation costs for stock-based awards were recorded as follows (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Cost of revenue (exclusive of depreciation and amortization, which is shown separately) | $ | 1,464 | | | $ | 675 | | | $ | 4,060 | | | $ | 4,994 | |
Advertising and marketing | 4,399 | | | 3,614 | | | 11,527 | | | 10,523 | |
Sales | 9,110 | | | 11,064 | | | 27,055 | | | 33,845 | |
Technology and development | 14,566 | | | 16,936 | | | 42,984 | | | 50,116 | |
General and administrative | 23,406 | | | 23,373 | | | 69,082 | | | 67,620 | |
Total stock-based compensation expense | 52,945 | | | 55,662 | | | 154,708 | | | 167,098 | |
Capitalized stock-based compensation expense | 5,028 | | | 4,561 | | | 14,606 | | | 13,404 | |
Total stock-based compensation | $ | 57,973 | | | $ | 60,223 | | | $ | 169,314 | | | $ | 180,502 | |
Note 14. Provision for Income Taxes
The Company recorded income tax benefits of $2.5 million and $2.8 million for the three and nine months ended September 30, 2023, respectively. The tax benefits recorded were the result of the current period book loss, primarily offset by valuation allowances and the tax shortfall associated with the stock-based compensation awards that vested in the year.
The Company recorded income tax benefits of $1.2 million and $2.0 million for the three and nine months ended September 30, 2022, respectively.
Note 15. Legal Matters
From time to time, Teladoc Health is involved in various litigation matters arising in the normal course of business, including the matters described below. The Company consults with legal counsel on those issues related to litigation and seeks input from other experts and advisors with respect to such matters. Estimating the probable losses or a range of probable losses resulting from litigation, government actions, and other legal proceedings is inherently difficult and requires an extensive degree of judgment, particularly where the matters involve indeterminate claims for monetary damages, may involve discretionary amounts, present novel legal theories, are in the early stages of the proceedings, or are subject to appeal. Whether any losses, damages, or remedies ultimately resulting from such matters could reasonably have a material effect on the Company’s business, financial condition, results of operations, or cash flows will depend on a number of variables, including, for example, the timing and amount of such losses or damages (if any) and the structure and type of any such remedies. As of the date of these financial statements, Teladoc Health’s management does not expect any litigation matter to have a material adverse impact on its business, financial condition, results of operations, or cash flows.
On August 27, 2021, a purported securities class action complaint (City of Hialeah Employees’ Retirement System v. Teladoc Health, Inc., et.al.) was filed in the Circuit Court of Cook County, Illinois against the Company and certain of the Company’s current and former officers and directors. The complaint was brought on behalf of a purported class consisting of all persons who acquired shares of Teladoc Health common stock issued in the Company's 2020 merger with Livongo. The complaint asserted violations of Sections 11, 12(a)(2) and 15 of the Securities Act based on allegedly false or misleading statements and omissions with respect to the registration statement and prospectus filed in connection with the Livongo merger. The complaint sought certification as a class action, unspecified compensatory damages plus interest and attorneys’ fees, rescission or a rescissory measure of damages and equitable or other relief. On January 18, 2022, the case was voluntarily dismissed without prejudice in the Circuit Court of Cook County, Illinois and on January 26, 2022, was refiled in the Supreme Court of the State of New York. The refiled case includes substantially the same allegations. On August 23, 2023, the court granted the defendants' motion to dismiss the complaint.
On June 6, 2022, a purported securities class action complaint (Schneider v. Teladoc Health, Inc., et. al.) was filed in the U.S. District Court for the Southern District of New York against the Company and certain of the Company’s officers. The complaint was brought on behalf of a purported class consisting of all persons or entities who purchased or otherwise acquired shares of the Company’s common stock during the period October 28, 2021 through April 27, 2022. The complaint asserted violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated thereunder based on allegedly false or misleading statements and omissions with respect to, among other things, the Company’s business, operations, and prospects. The complaint seeks certification as a class action and unspecified compensatory damages plus interest and attorneys’ fees. On August 2, 2022, a duplicative purported securities class action complaint (De Schutter v. Teladoc Health, Inc., et.al.) was filed in the U.S. District Court for the Eastern District of New York. The claims and parties in De Schutter were substantially similar to those in Schneider. The De Schutter case was transferred on consent to the Southern District court, and the Schneider and De Schutter actions have now been consolidated under the caption In re Teladoc Health, Inc. Securities Litigation. On August 23, 2022, the court appointed Leadersel Innotech ESG as lead plaintiff pursuant to the Private Securities Litigation Reform Act of 1995. The lead plaintiff filed an amended complaint on September 30, 2022, on behalf of a purported class consisting of all persons or entities who purchased or otherwise acquired shares of the Company’s common stock during the period February 24, 2021 to July 27, 2022, and filed a second amended complaint on December 6, 2022, on behalf of a purported class consisting of all persons or entities who purchased or otherwise acquired shares of the Company’s common stock during the period February 11, 2021 to July 27, 2022. On July 5, 2023, the court granted the defendants’ motion to dismiss the complaint. The Company believes that it has substantial defenses, and the Company and its named officers intend to defend any appeal or further proceedings in the lawsuit vigorously.
On August 9, 2022, a verified shareholder derivative complaint (Vaughn v. Teladoc Health, Inc., et.al.) was filed in the U.S. District Court for the Southern District of New York against the Company as a nominal defendant and certain of the Company’s officers and directors. The complaint asserts violations of Section 10(b) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated thereunder, breach of fiduciary duty, aiding and abetting breach of fiduciary duty, unjust enrichment, and waste of corporate assets in connection with factual assertions similar to those in the purported securities class action complaints described above. The complaint seeks damages to the Company allegedly sustained as a result of the acts and omissions of the named officers and directors and seeks an order directing the Company to reform and improve the Company’s corporate governance. On September 6, 2022, a duplicative verified stockholder derivative complaint (Hendry v. Teladoc Health, Inc., et. al.) was filed in the U.S. District Court for the Southern District of New York. The claims and parties in Hendry were substantially similar to those in Vaughn. The Vaughn and Hendry actions have now been consolidated under the caption In re Teladoc Stockholder Derivative Litigation, and a consolidated complaint was filed on November 29, 2022. The consolidated complaint also asserts violations of Section 14(a) of the Securities Exchange Act of 1934. The parties subsequently stipulated to transfer the action to the U.S. District Court for the District of Delaware, and on December 22, 2022 the parties agreed, and the Court ordered, to stay all proceedings until final resolution, including exhaustion of appeals, of the motion to dismiss filed in the purported securities class action complaint described above.
On July 30, 2020, the Company’s subsidiary BetterHelp, Inc. (“BetterHelp”) received a Civil Investigative Demand from the U.S. Federal Trade Commission (“FTC”) as part of its non-public investigation to determine whether BetterHelp engaged in unfair business practices in violation of the Federal Trade Commission Act. In March 2023, BetterHelp and the FTC entered into a tentative settlement of all claims arising from the FTC’s investigation and agreed to a consent order that required the Company to make a $7.8 million payment to the FTC. The settlement, including the consent order, received final approval from the FTC on July 14, 2023.
There have been multiple putative class-action litigations filed against BetterHelp in connection with the above-referenced FTC settlement and consent order. The actions have been filed in California federal and state courts and in Canada. The cases are substantially similar, involving allegations of misleading patients as to BetterHelp’s use of patient data and associated alleged violations of law involving privacy, advertising, contract and tort. The Company believes that it has substantial defenses, and the Company intends to defend the lawsuits vigorously.
Note 16. Segments
ASC Subtopic 280-10, “Segment Reporting,” establishes standards for reporting information about operating segments. Operating segments are defined as components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker (“CODM”) in deciding how to allocate resources and assess performance. The Company’s Chief Executive Officer is the CODM and is responsible for reviewing financial information presented on a segment basis for purposes of making operating decisions and assessing financial performance.
The CODM measures and evaluates segments based on segment operating revenues together with Adjusted EBITDA. The Company excludes the following items from segment Adjusted EBITDA: provision for income taxes; other income, net; interest income; interest expense; depreciation and amortization; goodwill impairment; stock-based compensation; restructuring costs; and acquisition, integration and transformation charges. Although these amounts are excluded from segment Adjusted EBITDA, they are included in reported consolidated net loss and are included in the reconciliation that follows.
The Company’s computation of segment Adjusted EBITDA may not be comparable to other similarly titled metrics computed by other companies because all companies do not calculate segment Adjusted EBITDA in the same fashion.
Operating revenues and expenses directly associated with each segment are included in determining its operating results. Other expenses that are not directly attributable to a particular segment are based upon allocation methodologies, including the following: revenue, headcount, time and other relevant usage measures, and/or a combination of such.
The Company has two reportable segments: Teladoc Health Integrated Care and BetterHelp. The Integrated Care segment includes a suite of global virtual medical services including general medical, expert medical services, specialty medical, chronic condition management, mental health, and enabling technologies and enterprise telehealth solutions for hospitals and health systems. The BetterHelp segment includes virtual therapy and other wellness services provided on a global basis which are predominantly marketed and sold on a direct-to-consumer basis. Other reflects certain revenues and charges not related to ongoing segment operations.
The CODM does not review any information regarding total assets on a segment basis. Segments do not record intersegment revenues, and, accordingly, there is none to be reported. The accounting policies for segment reporting are the same as for the Company as a whole.
The following table presents revenues by segment (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Teladoc Health Integrated Care | $ | 374,416 | | | $ | 342,817 | | | $ | 1,084,438 | | | $ | 1,016,800 | |
BetterHelp | 285,822 | | | 265,150 | | | 857,450 | | | 742,638 | |
Other (1) | 0 | | | 3,435 | | | 0 | | | 9,693 | |
Total Consolidated Revenue | $ | 660,238 | | | $ | 611,402 | | | $ | 1,941,888 | | | $ | 1,769,131 | |
The following table presents Adjusted EBITDA by segment (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Teladoc Health Integrated Care | $ | 62,805 | | | $ | 38,880 | | | $ | 135,900 | | | $ | 91,467 | |
BetterHelp | 25,952 | | | 11,150 | | | 77,777 | | | 61,270 | |
Other (1) | 0 | | | 1,181 | | | 0 | | | (318) | |
Total Consolidated Adjusted EBITDA | $ | 88,757 | | | $ | 51,211 | | | $ | 213,677 | | | $ | 152,419 | |
___________________________
(1)Other reflects certain revenues and charges not related to ongoing segment operations.
The following table presents a reconciliation of segment Adjusted EBITDA to consolidated GAAP income before income taxes (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2023 | | 2022 | | 2023 | | 2022 |
Teladoc Health Integrated Care | $ | 62,805 | | | $ | 38,880 | | | $ | 135,900 | | | $ | 91,467 | |
BetterHelp | 25,952 | | | 11,150 | | | 77,777 | | | 61,270 | |
Other | 0 | | | 1,181 | | | 0 | | | (318) | |
Total consolidated Adjusted EBITDA | 88,757 | | | 51,211 | | | 213,677 | | | 152,419 | |
Adjustments to reconcile to GAAP net loss | | | | | | | |
Goodwill impairment | 0 | | | 0 | | | 0 | | | (9,630,000) | |
Interest income | 12,606 | | | 4,803 | | | 33,075 | | | 6,192 | |
Interest expense | (5,646) | | | (6,149) | | | (16,744) | | | (17,355) | |
Other expense (income), net | (1,792) | | | (1,571) | | | 2,908 | | | (2,607) | |
Depreciation and amortization | (94,302) | | | (62,008) | | | (239,550) | | | (180,312) | |
Stock-based compensation | (52,945) | | | (55,662) | | | (154,708) | | | (167,098) | |
Acquisition, integration, and transformation costs | (5,824) | | | (1,594) | | | (16,848) | | | (8,993) | |
Restructuring costs | (411) | | | (3,677) | | | (16,043) | | | (3,677) | |
Loss before provision for income taxes | (59,557) | | | (74,647) | | | (194,233) | | | (9,851,431) | |
Provision for income taxes | 2,484 | | | 1,171 | | | 2,755 | | | 1,971 | |
Net loss | $ | (57,073) | | | $ | (73,476) | | | $ | (191,478) | | | $ | (9,849,460) | |
Geographic data for long-lived assets (representing property, plant and equipment) were as follows (in thousands):
| | | | | | | | | | | |
| As of September 30, 2023 | | As of December 31, 2022 |
United States | $ | 28,536 | | | $ | 25,935 | |
Other | 4,351 | | | 3,706 | |
Total long-lived assets | $ | 32,887 | | | $ | 29,641 | |