Teladoc Health (TDOC 1.73%), a leader in the growing field of telemedicine, reported its first-quarter results on Tuesday.

Revenue continues to grow at a brisk pace thanks to strong membership gains and increasing utilization rates. On the downside, Teladoc's net loss expanded during the quarter thanks to rising costs.

Teladoc first-quarter results: The raw numbers

Metric Q1 2019 Q1 2018 Year-Over-Year Growth
Revenue $128.6 million $89.6 million 43%
Adjusted EBITDA (loss) $1.2 million ($1.4 million) N/A
Net income ($30.2 million) ($23.9 million) N/A
Earnings per share ($0.43) ($0.39) N/A

Data source: Teladoc Health. Earnings per share are on a fully diluted basis.

Man sitting at laptop talking to doctor with X-ray in her hands

Image source: Getty Images.

What happened with Teladoc this quarter?

  • Subscription revenue in the U.S. grew 33% to $81 million. International subscription revenue more than doubled to $30 million.
  • Consolidated visit-fee revenue grew 26% to $22.6 million. The bulk of the gains were driven by growth in U.S. paid visits.
  • Organic revenue growth, which strips out the effects of acquisitions, was 23%.
  • Total revenue of $128.6 million came in at the high end of management's guidance range. 
  • Gross margin declined by 470 basis points to 65.3%. The decline is attributable to the mix of revenue and the effect of acquisitions.
  • Cash balance at quarter end was $480 million. Total debt was $563 million.
  • Per member per month (PMPM) fees, which are paid to Teladoc each month by insurers, grew 3% to $1.03 when compared with the year-ago period. Management was quick to point out that this number is weighed down by the effect of acquisitions since it takes time for acquired members to grow comfortable using telemedicine services.

Teladoc also acquired MedecinDirect during the quarter. This company, based in Paris, expands Teladoc's footprint in Europe. The company also stated that the go-live date for its recently announced Teladoc Telemedicine Services in Canada is scheduled for the third quarter of 2019.

Looking beyond the financials, Teladoc's membership and usage numbers showed that the company continues to make good progress with adoption:

  • U.S. paid membership grew 28% to 26.7 million. On an organic basis, U.S. paid membership growth would have been 23%.
  • U.S. visit-fee-only access, which are consumers with access to Teladoc's network who are not fully covered by insurers, grew 7% to 10.2 million.
  • Total global visits grew 75% to 1.06 million.  

Check out the latest Teladoc earnings call transcript.

What management had to say

On the call with investors, CEO Jason Gorevic said insurers are increasingly willing to offer telemedicine services to their members:

As traditional players wrestle with how to make virtual care at the front door to the healthcare system, it's becoming increasingly clear to me that Teladoc Health is uniquely positioned to equip them to achieve their goals. Due to the broad scope of our clinical services, our ability to address the widest array of consumer healthcare needs through a single intuitive interphase, and importantly, our proven ability to drive consumer adoption. Our growth of over 3 million paid members in Q1 2019 through the health-plan channel is proof of our continued success.

Looking forward

Gorevic noted that the company's "pipeline of new business opportunities across all our channels has never been stronger."

Related to that opportunity, he shared the following guidance with investors about the upcoming quarter:

Metric Q2 2019 Guidance Q2 2018 Actual Growth at Midpoint
Revenue $128 million to $131 million $94.6 million 37%
Adjusted EBITDA $5 million to $7 million $2.7 million 122%
EPS (loss) ($0.42) to ($0.44) ($0.40) N/A

Data source: Teladoc Health.

Management also took the opportunity to reaffirm guidance for the full year 2019:

Metric 2019 Guidance 2018 Actual Growth at Midpoint
Revenue $535 million to $545 million $417.9 million 29%
Adjusted EBITDA (loss) $25 million to $35 million ($35.3 million) N/A
EPS ($1.52) to ($1.66) ($1.47) N/A

Data source: Teladoc Health.

Gabe Cappucci, Teladoc's chief accounting officer, also reaffirmed that the company expects to be cash flow positive for the first time in 2019.