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Segments | 12 Months Ended
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Dec. 31, 2025
Segment Reporting [Abstract] |
Segments | 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, segment expenses, and Adjusted EBITDA. The CODM reviews annual-operating-plan-to-actual variances for these measures on a regular basis to assess the performance of the segments and to make decisions about allocating resources. The Company does not include the following items in segment expenses and Adjusted EBITDA: provision for income taxes; interest income; interest expense; other expense (income), net; depreciation of property and equipment; amortization of intangible assets; restructuring costs; acquisition, integration, and transformation charges; goodwill impairment; and stock-based compensation. Although these amounts are excluded from segment Adjusted EBITDA, they are included in reported consolidated net loss and are included in the reconciliations that follow. 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: 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. 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 tables present the financial results of the Company's reportable segments, along with reconciliations of the segments' total consolidated Adjusted EBITDA to the consolidated net loss for the periods indicated (in thousands):
Year Ended December 31, 2025 | Integrated Care |  | BetterHelp |  | Consolidated
Revenue | $ | 1,579,610 |  |  | $ | 950,367 |  |  | $ | 2,529,977 |
Cost of revenue, exclusive of depreciation, amortization, and stock-based compensation (1) | 516,326 |  |  | 253,185 |  |  |
Advertising and marketing, exclusive of stock-based compensation (1) | 130,023 |  |  | 518,455 |  |  |
Other segment expenses (2) | 694,039 |  |  | 136,854 |  |  |
Adjusted EBITDA | $ | 239,222 |  |  | $ | 41,873 |  |  | 281,095 |
Less adjustments to reconcile to consolidated net loss: |  |  |  |  |
Stock-based compensation |  |  |  |  | 80,414 |
Goodwill impairments |  |  |  |  | 71,763 |
Acquisition, integration, and transformation costs |  |  |  |  | 9,010 |
Restructuring costs |  |  |  |  | 18,785 |
Amortization of intangible assets |  |  |  |  | 350,764 |
Depreciation of property and equipment |  |  |  |  | 13,314 |
Other expense (income), net |  |  |  |  | (10,369) |
Interest expense |  |  |  |  | 19,714 |
Interest income |  |  |  |  | (36,770) |
Loss before provision for income taxes |  |  |  |  | (235,530) |
Provision for income taxes |  |  |  |  | (35,208) |
Net loss |  |  |  |  | $ | (200,322) |
Year Ended December 31, 2024 | Integrated Care |  | BetterHelp |  | Consolidated
Revenue | $ | 1,528,870 |  |  | $ | 1,040,704 |  |  | $ | 2,569,574 |
Cost of revenue, exclusive of depreciation, amortization, and stock-based compensation (1) | 474,955 |  |  | 271,533 |  |  |
Advertising and marketing, exclusive of stock-based compensation (1) | 134,453 |  |  | 558,759 |  |  |
Other segment expenses (2) | 686,560 |  |  | 132,603 |  |  |
Adjusted EBITDA | $ | 232,902 |  |  | $ | 77,809 |  |  | 310,711 |
Less adjustments to reconcile to consolidated net loss: |  |  |  |  |
Stock-based compensation |  |  |  |  | 145,951 |
Goodwill impairments |  |  |  |  | 790,000 |
Acquisition, integration, and transformation costs |  |  |  |  | 1,743 |
Restructuring costs |  |  |  |  | 20,355 |
Amortization of intangible assets |  |  |  |  | 363,365 |
Depreciation of property and equipment |  |  |  |  | 10,183 |
Other expense (income), net |  |  |  |  | 6,035 |
Interest expense |  |  |  |  | 23,803 |
Interest income |  |  |  |  | (57,071) |
Loss before provision for income taxes |  |  |  |  | (993,653) |
Provision for income taxes |  |  |  |  | 7,592 |
Net loss |  |  |  |  | $ | (1,001,245) |
Year Ended December 31, 2023 | Integrated Care |  | BetterHelp |  | Consolidated
Revenue | $ | 1,468,794 |  |  | $ | 1,133,621 |  |  | $ | 2,602,415 |
Cost of revenue, exclusive of depreciation, amortization, and stock-based compensation (1) | 440,996 |  |  | 313,572 |  |  |
Advertising and marketing, exclusive of stock-based compensation (1) | 131,738 |  |  | 541,815 |  |  |
Other segment expenses (2) | 704,189 |  |  | 141,985 |  |  |
Adjusted EBITDA | $ | 191,871 |  |  | $ | 136,249 |  |  | 328,120 |
Less adjustments to reconcile to consolidated net loss: |  |  |  |  |
Stock-based compensation |  |  |  |  | 201,550 |
Goodwill impairments |  |  |  |  | — |
Acquisition, integration, and transformation costs |  |  |  |  | 21,110 |
Restructuring costs |  |  |  |  | 16,942 |
Amortization of intangible assets |  |  |  |  | 325,933 |
Depreciation of property and equipment |  |  |  |  | 11,138 |
Other expense (income), net |  |  |  |  | (4,445) |
Interest expense |  |  |  |  | 22,282 |
Interest income |  |  |  |  | (46,782) |
Loss before provision for income taxes |  |  |  |  | (219,608) |
Provision for income taxes |  |  |  |  | 760 |
Net loss |  |  |  |  | $ | (220,368) |
(1)The significant segment expense categories and amounts align with the information that is regularly provided to the CODM. (2)Other segment expenses for the corresponding reportable segment includes sales expenses, technology and development expenses, and general and administrative expenses, each exclusive of stock-based compensation. Geographic data for long-lived assets (representing property and equipment, net) were as follows (in thousands):
| As of
| December 31, |  | December 31,
| 2025 |  | 2024
United States | $ | 22,796 |  |  | $ | 25,686 |
International | 4,176 |  |  | 3,801 |
Total long-lived assets | $ | 26,972 |  |  | $ | 29,487 |

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 21 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-21 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name 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