Roughly 80% of users who sign up or start the registration process for Teladoc’s (NYSE: TDOC) direct-to-consumer mental health platform, BetterHelp, never become active users.

Teladoc CEO Chuck Divita, attributes the drop-off to the cash-pay nature of the business.

“The consumer has been under a lot of pressure,” Divita said during a presentation at the 46th Annual Goldman Sachs Healthcare Conference today. “These are people who have an awareness of BetterHelp, have a need, start the registration process, take the quiz and so forth, but when it comes down to this is what the product and cost, there is a significant drop-off and the thing that people refer to most is the out of pocket cost.”

The company is looking to remedy this issue by offering BetterHelp as a covered benefit and inking deals with payers and employers. In April, the company acquired digital mental health startup UpLift for $45 million, aiming to expand its virtual mental health services and offer care on an in-network basis.

Switching to an in-network model can capture some of those users who register but never become clients. In 2024, approximately 4 million people sign up or start the registration process with BetterHelp.

“If it’s in a network, we think we’re going to have a material impact in terms of our conversion rate,” Divita said. “If you take just a one percentage point net increase in conversion off of the 80% that go away, it’s like $40 million in revenue. So it’s a massive opportunity for us and that’s why we’ve been pushing hard to get into that insurance space.”

You are not the first to pass this way

BetterHelp isn’t the first virtual mental health company to change lanes from a fully direct-to-consumer to B2B model.

BetterHelp competitor Talkspace (Nasdaq: TALK) is reaping the benefits of its change in focus. Talkspace increased its payer business by 33% in the first quarter of 2025. Meanwhile, Talkspace’s D2C business is declining as it continues to see an increase in members using their insurance benefits at checkout. The strategy has helped Talkspace, which was once at risk of being delisted by the Nasdaq, turn around its business and post five consecutive profitable quarters.

Talkspace CEO John Cohen has even noted that going in-network could help insulate the company from a potential market slowdown or recession.