Pineal Capital Management called on Teladoc Health Inc. (NYSE: TDOC) to implement a share buyback program of at least $200 million and conduct a strategic review that could include separating its two main business segments.

In an open letter dated March 31, 2026, the investment firm criticized Teladoc's board for slow decision-making and poor capital allocation, including the 2020 Livongo acquisition. Pineal Capital noted that Teladoc trades at approximately 4.18 times 2026 enterprise value-to-EBITDA despite being what it called the global leader in virtual healthcare.

The firm highlighted that Teladoc's stock has declined more than 90% from pre-COVID highs while basic shares outstanding increased from about 90 million in 2020 to 177 million as of December 2025. Pineal Capital stated the company has never conducted share buybacks in its public history.

Teladoc operates through two segments: Integrated Care, serving employers and health plans, and BetterHelp, a mental health platform. The company serves more than 100 million lives and generated over $1.1 billion in mental health-related revenue in 2025, according to the letter.

Pineal Capital pointed to recent policy changes, including permanent coverage of virtual care in high-deductible health plans and a $50 billion Rural Health Transformation Program, as potential growth drivers. The firm noted BetterHelp's insurance-supported revenue run-rate reached approximately $28 million by the end of 2025, with guidance for a $100 million exit run-rate in 2026.

The investment firm referenced the recent Talkspace acquisition at multiples of 3.0 times revenue and 25 times EBITDA, compared to Teladoc's current multiples of 0.47 times revenue and 4.18 times EBITDA based on consensus estimates.

Pineal Capital warned that Teladoc's depressed valuation makes it vulnerable to an opportunistic takeover and urged the board to take action before losing control to an unwelcome acquirer.