Teladoc Health reported first-quarter 2026 results after the closing bell on Tuesday, with earnings and revenue coming in shy of analyst expectations. The market reacted swiftly, with shares falling over 11% in after-hours trading.
The virtual care company posted revenue of $613.8 million for the three months ended March 31, 2026, a 2% decline from the $629.4 million reported in the same period last year. Analysts had been looking for revenue closer to $623.1 million, meaning the headline number missed by roughly $9.3 million.
Earnings per share came in at a net loss of $0.36 on a GAAP basis, which was wider than the consensus estimate of a $0.32 loss per share. While the net loss improved from the $93.0 million loss recorded in Q1 2025, that year-ago figure had been inflated by a $59.1 million goodwill impairment charge that did not repeat in the current quarter.
Adjusted EBITDA of $58.2 million was essentially flat year-over-year and came in within the company's guided range, though the metric failed to provide a positive surprise.
Segment Performance and Key Metrics
The results revealed a clear divergence between Teladoc's two operating segments.
Integrated Care: Revenue grew 2% to $395.4 million, with adjusted EBITDA margin expanding to 14.2% from 12.9% in the prior year. This segment remains the more stable part of the business.
BetterHelp: Revenue declined 9% to $218.4 million, as average paying users dropped 9% to 361,000 from 397,000 a year ago. Adjusted EBITDA margin tumbled to just 0.9%, down from 3.2%. The company noted it is making progress scaling insurance acceptance within this direct-to-consumer mental health platform, but the numbers suggest the transition is still cost-intensive.
Total visits across the platform were flat at 4.4 million. U.S. Integrated Care members slipped 1% to 101.2 million, though average monthly revenue per member ticked up 2% to $1.30.
Cash flow from operations totaled $9.5 million, down from $15.9 million in the year-ago quarter, while capital expenditures and capitalized software development costs pushed free cash flow to a negative $26.3 million.
Outlook Holds the Midpoint, But Near-Term Pressure Remains
Teladoc management reaffirmed the midpoint of its full-year 2026 guidance, which it had originally provided in February. The full-year outlook calls for:
Revenue in the range of $2.481 billion to $2.576 billion
Adjusted EBITDA between $267 million and $306 million
Net loss per share of ($1.05) to ($0.75)
Free cash flow of $130 million to $170 million
For the second quarter of 2026, management projected revenue of $597 million to $626 million and adjusted EBITDA of $55 million to $67 million.
The midpoint of the Q2 revenue outlook ($611.5 million) is roughly in line with current analyst estimates of $637.3 million, though the low end of the range suggests management is hedging against continued headwinds in the BetterHelp segment. The Q2 adjusted EBITDA midpoint of $61 million appears broadly consistent with street expectations.