Our chronic care program enrollments are one of the key components of our whole person virtual care platform that we believe positions us to drive greater engagement with our platforms and increased revenue.
We believe that favorable existing secular trends in the healthcare industry were accelerated by the impacts of the COVID-19 pandemic, driving greater consumer awareness and use of virtual care and increased adoption by employers, health plans, hospitals and health systems, healthcare providers, and individuals.
We further believe that increasing our membership is an integral objective that will provide us with the ability to continually innovate our services and support initiatives that will enhance members’ experiences.
Excluding the impact from acquisitions, revenue increased 40%, driven primarily by BetterHelp.
We believe that our ability to increase the revenue generated from each member over time is also a key indicator of our increasing market adoption, the growth of our business, and future revenue potential.
As it relates to the BetterHelp segment:BetterHelp Paying Users.
Therefore, we believe that our ability to add new members and retain existing members, and to increase utilization and penetration further into existing and new health plan Clients is a key indicator of our increasing market adoption, the growth of our business, and our future revenue potential.
For the year ended December 31, 2022, we increased revenue 18% to $2,406.8 million, reflecting a 21% increase in revenue derived from access fees, primarily from BetterHelp.
We believe that our ability to add new paying users and retain existing users is a key indicator of the increasing market adoption of BetterHelp, the growth of that business, and future revenue potential.
Margin %11.2%16.9% (568)bpsBetterHelp total revenues increased by $298.4 million, or 41%, to $1,019.6 million for the year ended December 31, 2022, driven by a 37% increase in average monthly paying users.
Our ability to efficiently reach new potential paying users through various advertising channels helped us to increase BetterHelp paying users by 37% to 0.42 million as of December 31, 2022, compared to 0.31 million as of December 31, 2021.As it relates to the Company: Seasonality.
The increase in net revenues was primarily driven by higher chronic care enrollment and adoption, as well as higher telemedicine product revenue.
Teladoc Health is the global leader in whole person virtual care focused on forging a new healthcare experience with better convenience, outcomes, and value around the world.We were founded on a simple, yet revolutionary idea: that everyone should have access to the best healthcare, anywhere in the world on their terms.
During 2022, we experienced positive operating cash flow and we continue to anticipate increasing positive operating cash flow results for 2023.We believe that our existing cash and cash equivalents will be sufficient to meet our working capital, capital expenditure, and contractual obligation needs for at least the next 12 months.
Margin %9.8%11.1% (123)bpsIntegrated Care total revenues increased by $73.0 million, or 6%, to $1,373.9 million for the year ended December 31, 2022.
We have completed multiple acquisitions since our inception, which we believe have expanded our distribution capabilities and broadened our service offering.On October 30, 2020, we completed the merger with Livongo, a leading provider to empower people with chronic conditions to live better and healthier lives.
As a result of this dynamic we have typically experienced fewer new member additions and the strongest operating income performance in the fourth quarter.
By geography, total revenue for the U.S. was $2,101.0 million and for International was $305.8 million for the year ended December 31, 2022, reflecting increases of 18% and 18%, respectively, compared to the year ended December 31, 2021.Other revenue, which predominately includes visit fees, and to a lesser extent, revenues from the sales of our telehealth solutions for hospitals and health systems.
Total access fees increased $892.9 million, or 105%.
Our business and operational models are designed to be highly scalable and leverage variable costs to support revenue-generating activities.
Total revenue was $2,032.7 million for the year ended December 31, 2021, compared to $1,094.0 million for the year ended December 31, 2020, an increase of $938.7 million, or 86%.
In 2021, revenue increased 86% to $2,032.7 million, which included an incremental $500.0 million from acquired businesses.For the year ended December 31, 2022, 87% and 13% of our revenue was derived from access fees and other revenues, respectively.
We believe that the presentation of these financial measures enhances an investor’s understanding of our financial performance.
Total access fees increased $363.6 million, or 21%.
Also contributing to the increase in total revenue was other revenue, which totaled $292.5 million during the year ended December 31, 2021, compared to $246.7 million for the year ended December 31, 2020, an increase of $45.8 million, or 19%, primarily reflecting visit revenues and a full year’s sales of our telehealth solutions for hospitals and health systems.Cost of Revenue (exclusive of depreciation and amortization, which is shown separately below).
Total revenue was $2,406.8 million for the year ended December 31, 2022, compared to $2,032.7 million for the year ended December 31, 2021, an increase of $374.1 million, or 18%.
As a result of seasonal cold and flu trends, we historically have experienced our highest level of visit and other fee revenue during the first and fourth quarters of each year.
U.S. Integrated Care members increased by 5.8 million to 83.3 million at December 31, 2022, compared to the same period in 2021.