Telehealth company Teladoc Health (TDOC 0.62%) is down 44% over the past six months, underperforming the broader stock market. The company recently reported its Q2 earnings for the 2021 fiscal year, and investors are wondering whether it's positioned for a comeback. Here are three key takeaways from earnings that might signal brighter days ahead for shareholders.

1. Business is holding up well against COVID-19 comparables

The pandemic forced people to make sudden and dramatic changes to their lives, one of which was the rapid adoption of telehealth. While patients were largely shut out of office visits, Teladoc saw a large surge in its business -- in Q2 2020, when the first wave of the pandemic was at its height, Teladoc's U.S. paid memberships grew to 51.5 million, up 92% from 2019. Visits grew 203% year over year to more than 2.7 million. This fueled 85% revenue growth to $241 million over 2019.

This huge uptick in business created tough comparable numbers for 2021, with many investors fearing that Teladoc would certainly see its business reverse after such a big 2020. Instead, Teladoc has continued to grow, and while Q2 2021 paid U.S. memberships only increased 1% to 52 million, visits grew 28% over 2020. Revenue accelerated from last year, hitting $503 million, a year-over-year increase of 109%.

Elderly patient consulting with a doctor online.

Image source: Getty Images.

The pandemic continues as the delta variant spreads. Still, with much of the U.S. having resumed in-office visits and procedures, all of this solid activity on the back of a tremendous 2020 could signal that Teladoc's business is not a pandemic-driven fluke after all.

2. The underlying business is profitable

Investors are looking for the company's financials to improve as Teladoc grows. Management reported a net loss of $133.8 million for the 2021 second quarter, wider than the loss of $25.7 million from a year ago.

But looking closer at the numbers will reveal many special charges related to Teladoc's merger with Livongo last summer, including stock-based compensation and accounting charges. Teladoc posted a $66.8 million profit on an adjusted EBITDA basis, up 154% from a year ago.

As Teladoc gets bigger, revenue continues to expand faster than the company's expenses. This shows up in the gross margin, which was 68.1% in Q2 2021 versus 62.3% the prior year. Investors should look to see whether gross margin continues to improve in the quarters to come.

3. Primary360 and myStrength are the future

Telehealth is a competitive field and is seen by some as a commodity, which may have hurt investor sentiment toward Teladoc over the past year. But the real story behind Teladoc is the chronic care systems the company is building.

In 2015, Teladoc acquired online counseling and therapy services company BetterHelp for $4 million, and more recently, in 2020, Livongo, a data-based chronic care treatment company, for $18.5 billion. Combining these companies' technology with Teladoc's telehealth network has resulted in the company's personalized, "whole-person" care services -- Primary360 for general health and myStrength for mental health.

These programs are just beginning to roll out, so they'll play a more significant role in the company's results in 2022 and beyond. Meanwhile, Teladoc is continuing to leverage its existing network to build relationships. It signed a deal with health insurer Health Care Service Corporation to give that company's 17 million insured members access to Teladoc's whole-person healthcare services.

It's still too early to determine how successful Teladoc will be with Primary360 and myStrength. Investors will need to monitor enrollment growth over the coming quarters.

Is Teladoc a buy?

The stock is near 52-week lows after its steady six-month decline. Management is forecasting full 2021 revenue at $2 billion, so Teladoc's price-to-sales ratio is 11.5. This seems like an inexpensive valuation for a company growing revenue at 109% and operating in the massive healthcare space.

On the other hand, the valuation also signals that investors are not yet sold on Teladoc's ability to execute its goals regarding personalized healthcare. This valuation could provide a margin of safety for investors, as the steep decline is already pricing in a bit of failure -- meaning success could result in strong returns. Only time will tell, but Teladoc seems to be heading in the right direction after this quarter.