Teladoc Health Inc. (Teladoc (TDOC)) is having a rough Wednesday evening. The telehealth company reported its second-quarter results after the market closed, and investors are not happy. The stock is down about 25% in after-hours trading, dropping to $6.89. Ouch.

So what went wrong? Let's break it down.

The Numbers

Teladoc reported Q2 revenue of $606.9 million, which is down 4% from the same period last year. That missed the Street consensus estimate of $615.4 million, according to market data. Not a great start.

Breaking it down by segment: Integrated Care revenue was up 1% year-over-year to $394.3 million. That's fine, but nothing to write home about. The bigger problem is BetterHelp, the company's direct-to-consumer mental health platform. BetterHelp revenue fell 12% year-over-year to $212.6 million. Oof.

Geographically, U.S. revenue dropped 6% to $487.4 million, while international revenue grew 7% to $119.6 million. So at least there's some growth somewhere.

On the bottom line, Teladoc reported a loss of 21 cents per share, which actually beat the analyst estimate of a loss of 25 cents per share. So that's a bright spot, but it's not enough to offset the revenue miss and the gloomy outlook.

What the CEO Said

CEO Chuck Divita tried to put a positive spin on things. "We continue to make progress on the priorities we believe are most important to the long-term success of Teladoc Health," he said. He highlighted the launch of Teladoc One, a new connected care model, in the U.S. market during the quarter.

As for BetterHelp, the company said insurance revenue came in near the high end of expectations, but cash-pay revenue faced pressure in late May and early June. That's a headwind that doesn't seem to be letting up.

The Guidance That Hurt

Here's where things get really ugly. For the third quarter, Teladoc expects revenue between $569 million and $609 million. The Street was looking for $629.3 million. That's a big miss. The company also sees a Q3 loss of 30 to 20 cents per share, while analysts expected a loss of 18 cents.

For the full fiscal year, Teladoc raised its earnings per share guidance slightly — now expecting a loss of $1.00 to $0.75 per share, compared to the prior range of a loss of $1.05 to $0.75. But it slashed its revenue guidance. The company now expects full-year sales of $2.362 billion to $2.447 billion, down from the previous range of $2.481 billion to $2.576 billion. Analysts were looking for $2.508 billion.

Specifically, Teladoc expects Integrated Care revenue to grow just 0.8% to 2.4% for the year. And BetterHelp? It's looking at a revenue decline of 19.0% to 12.7%. That's a lot of red ink.

Stock Reaction

Teladoc stock is down 24.95% to $6.89 in after-hours trading. That puts it within spitting distance of its 52-week low of $4.40, and well below the high of $9.89. It's been a tough year for the stock, and this earnings report isn't helping.

For investors, the key takeaway is that Teladoc is still struggling to find its footing post-pandemic. The telehealth boom has faded, and the company is trying to pivot with new products like Teladoc One, but the market isn't buying it yet. The lowered guidance suggests more pain ahead, especially in the BetterHelp segment.

We'll see if the company can turn things around, but for now, it's a rough ride.