Teladoc Health Inc. (NYSE:TDOC) saw its shares rise 4% on Tuesday after activist investor Pineal Capital Management publicly urged the company to initiate a share buyback program and undertake a strategic review of its businesses.
In an open letter dated March 31, Pineal called for a share repurchase plan of at least $200 million and proposed that Teladoc consider splitting its two main operating units. The investor criticized the board for what it described as slow decision-making and poor choices in capital allocation, singling out the 2020 acquisition of Livongo as an example.
Pineal’s letter included a set of valuation and operational metrics it considered concerning. The firm noted that Teladoc currently trades at roughly 4.18 times projected 2026 enterprise value-to-EBITDA. It also highlighted that the company’s share price has fallen by 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. According to Pineal, Teladoc has never repurchased shares since becoming a public company.
The company operates through two segments: Integrated Care, which serves employers and health plans, and BetterHelp, a mental health platform. Teladoc reports it serves more than 100 million lives, and Pineal noted the company produced over $1.1 billion in mental health-related revenue in 2025.
Pineal’s letter also pointed to recent policy shifts it sees as potential tailwinds, including permanent coverage of virtual care in high-deductible health plans and a $50 billion Rural Health Transformation Program. The investor highlighted BetterHelp’s insurance-supported revenue run-rate as reaching about $28 million by the end of 2025, and noted guidance for a $100 million exit run-rate in 2026.
To illustrate relative valuation, Pineal referenced recent transaction multiples, calling out the Talkspace acquisition at multiples of 3.0 times revenue and 25 times EBITDA. By contrast, Pineal presented Teladoc’s consensus-based multiples as approximately 0.47 times revenue and 4.18 times EBITDA. The firm warned that such depressed valuation levels could make Teladoc attractive to an opportunistic acquirer.
What happened today: Teladoc shares rose 4% following Pineal Capital’s public appeal for a buyback and strategic review.
Next steps noted by Pineal: launch a buyback of at least $200 million and evaluate separating Integrated Care and BetterHelp.
Details in this report reflect the content of Pineal Capital Management’s March 31 letter and Teladoc-related metrics cited within that letter.