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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 10-Q

 

(Mark One)

 

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the quarterly period ended March 31, 2025

 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the transition period from to

Commission File Number: 001-39515

 

American Well Corporation

(Exact name of registrant as specified in its charter)

 

 

Delaware

20-5009396

(State of incorporation)

(I.R.S. Employer
Identification Number)

 

75 State Street, 26th Floor

Boston, MA 02109

(Address of registrant’s principal executive offices)

(617) 204-3500

(Registrant’s telephone number, including area code)

 

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class

 

Trading Symbol(s)

 

Name of each exchange on which registered

Class A common stock,
par value of $0.01 per share

 

AMWL

 

The New York Stock Exchange

 

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definition of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer

 

Accelerated filer

 

Non-accelerated filer

 

Smaller reporting company

 

 

Emerging growth company

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No ☒

 

As of April 14, 2025, the number of shares of the registrant’s Class A common stock outstanding was 14,162,309, the number of shares of the registrant’s Class B common stock outstanding was 1,369,518 and the number of shares of the registrant’s Class C common stock outstanding was 277,777.

 

 

 


 

American Well Corporation

QUARTERLY REPORT ON FORM 10-Q

For the period ended March 31, 2025

TABLE OF CONTENTS

 

Page

PART I

Financial Information

3

Item 1.

Financial Statements

3

 

Condensed Consolidated Balance Sheet as of March 31, 2025 (unaudited) and December 31, 2024

3

 

Condensed Consolidated Statement of Operations and Comprehensive Loss (unaudited) for the three months ended March 31, 2025 and 2024

4

 

Condensed Consolidated Statement of Stockholders’ Equity (unaudited) for the three months ended March 31, 2025 and 2024

5

 

Condensed Consolidated Statement of Cash Flows (unaudited) for the three months ended March 31, 2025 and 2024

6

Notes to the Unaudited Condensed Consolidated Financial Statements

7

Item 2

Management’s Discussion and Analysis of Financial Condition and Results of Operations

19

Item 3.

Quantitative and Qualitative Disclosures About Market Risk

29

Item 4.

Controls and Procedures

30

PART II

Other Information

31

Item 1.

Legal Proceedings

31

Item 1A.

Risk Factors

31

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

31

Item 3.

Defaults Upon Senior Securities

31

Item 4.

Mine Safety Disclosures

31

Item 5.

Other Information

32

Item 6.

Exhibits

32

 

 

 

 


 

PART I - FINANCIAL INFORMATION

Item 1. Financial Statements

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED BALANCE SHEETS

(in thousands, except share and per share amounts)

(unaudited)

 

 

March 31, 2025

 

 

December 31, 2024

 

Assets

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

Cash and cash equivalents

 

$

222,411

 

 

$

228,316

 

Accounts receivable ($450 and $616, from related parties and net of
   allowances of $
6,975 and $7,236, respectively)

 

 

72,004

 

 

 

71,885

 

Inventories

 

 

2,530

 

 

 

2,858

 

Deferred contract acquisition costs

 

 

2,564

 

 

 

2,513

 

Prepaid expenses and other current assets

 

 

11,991

 

 

 

11,421

 

Total current assets

 

 

311,500

 

 

 

316,993

 

Restricted cash

 

 

795

 

 

 

795

 

Property and equipment, net

 

 

336

 

 

 

376

 

Intangible assets, net

 

 

90,789

 

 

 

101,538

 

Operating lease right-of-use asset

 

 

6,386

 

 

 

7,203

 

Deferred contract acquisition costs, net of current portion

 

 

5,359

 

 

 

5,350

 

Other assets

 

 

3,581

 

 

 

2,213

 

Investment in minority owned joint venture (Note 2)

 

 

722

 

 

 

1,500

 

Total assets

 

$

419,468

 

 

$

435,968

 

Liabilities and Stockholders’ Equity

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

Accounts payable

 

$

6,432

 

 

$

5,015

 

Accrued expenses and other current liabilities

 

 

39,143

 

 

 

49,326

 

Operating lease liability, current

 

 

3,723

 

 

 

3,690

 

Deferred revenue ($126 and $198 from related parties, respectively)

 

 

57,429

 

 

 

53,232

 

Total current liabilities

 

 

106,727

 

 

 

111,263

 

Other long-term liabilities

 

 

1,205

 

 

 

1,170

 

Operating lease liability, net of current portion

 

 

3,573

 

 

 

4,511

 

Deferred revenue, net of current portion ($0 and $10 from related parties, respectively)

 

 

2,189

 

 

 

2,780

 

Total liabilities

 

 

113,694

 

 

 

119,724

 

Commitments and contingencies (Note 11)

 

 

 

 

 

 

Stockholders’ equity:

 

 

 

 

 

 

Preferred stock, $0.01 par value; 100,000,000 shares authorized, no shares issued
   or outstanding as of March 31, 2025 and as of December 31, 2024

 

 

 

 

 

 

Common stock, $0.01 par value; 1,000,000,000 Class A shares authorized, 14,137,621
   and
13,922,877 shares issued and outstanding, respectively; 100,000,000 Class B
   shares authorized,
1,369,518 shares issued and outstanding; 200,000,000 Class C
   shares authorized
277,777 issued and outstanding as of March 31, 2025 and as of
   December 31, 2024

 

 

158

 

 

 

156

 

Additional paid-in capital

 

 

2,294,608

 

 

 

2,286,380

 

Accumulated other comprehensive income

 

 

(16,183

)

 

 

(15,840

)

Accumulated deficit

 

 

(1,984,629

)

 

 

(1,965,924

)

Total American Well Corporation stockholders’ equity

 

 

293,954

 

 

 

304,772

 

Non-controlling interest

 

 

11,820

 

 

 

11,472

 

Total stockholders’ equity

 

 

305,774

 

 

 

316,244

 

Total liabilities and stockholders’ equity

 

$

419,468

 

 

$

435,968

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

3


 

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

(in thousands, except share and per share amounts)

(unaudited)

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Revenue

 

 

 

 

 

 

($432 and $872 from related parties, respectively)

 

$

66,833

 

 

$

59,522

 

Costs and operating expenses:

 

 

 

 

 

 

Costs of revenue, excluding depreciation and amortization of intangible assets

 

 

31,574

 

 

 

41,153

 

Research and development

 

 

22,102

 

 

 

26,680

 

Sales and marketing

 

 

12,576

 

 

 

25,726

 

General and administrative

 

 

23,192

 

 

 

32,757

 

Depreciation and amortization expense

 

 

7,800

 

 

 

8,238

 

Total costs and operating expenses

 

 

97,244

 

 

 

134,554

 

Loss from operations

 

 

(30,411

)

 

 

(75,032

)

Interest income and other income (expense), net

 

 

2,688

 

 

 

3,784

 

Gain on divestiture

 

 

10,713

 

 

 

 

Loss before expense from income taxes and loss from
   equity method investment

 

 

(17,010

)

 

 

(71,248

)

Expense from income taxes

 

 

(568

)

 

 

(1,275

)

Loss from equity method investment

 

 

(778

)

 

 

(926

)

Net loss

 

 

(18,356

)

 

 

(73,449

)

Net income (loss) attributable to non-controlling interest

 

 

348

 

 

 

(1,344

)

Net loss attributable to American Well Corporation

 

$

(18,704

)

 

$

(72,105

)

Net loss per share attributable to common stockholders,
   basic and diluted

 

$

(1.19

)

 

$

(4.94

)

Weighted-average common shares outstanding, basic and diluted

 

 

15,672,373

 

 

 

14,591,020

 

Net loss

 

$

(18,356

)

 

$

(73,449

)

Other comprehensive income (loss), net of tax:

 

 

 

 

 

 

Foreign currency translation

 

 

(343

)

 

 

(563

)

Comprehensive loss

 

 

(18,699

)

 

 

(74,012

)

Less: Comprehensive loss attributable to
   non-controlling interest

 

 

348

 

 

 

(1,344

)

Comprehensive loss attributable to American Well Corporation

 

$

(19,047

)

 

$

(72,668

)

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

4


 

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

(in thousands, except share amounts)

(unaudited)

 

 

 

Common Stock

 

 

Additional
Paid-In

 

 

Accumulated
Other
Comprehensive

 

 

Accumulated

 

 

American Well
Corporation
Stockholders’

 

 

Noncontrolling

 

 

Total
Stockholders’

 

 

 

Shares

 

 

Amount

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Equity

 

 

Interest

 

 

Equity

 

Balances as of January 1, 2025

 

 

15,570,172

 

 

$

156

 

 

$

2,286,380

 

 

$

(15,840

)

 

$

(1,965,924

)

 

$

304,772

 

 

$

11,472

 

 

$

316,244

 

Vesting of restricted stock units, including units with a market condition

 

 

137,838

 

 

 

1

 

 

(1

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares repurchased and retired

 

 

(177

)

 

 

 

 

 

 

 

 

 

 

 

(1

)

 

 

(1

)

 

 

 

 

 

(1

)

Issuance of stock under employee stock purchase plan

 

 

77,083

 

 

 

1

 

 

543

 

 

 

 

 

 

 

 

 

544

 

 

 

 

 

 

544

 

Stock-based compensation expense

 

 

 

 

 

 

 

 

7,686

 

 

 

 

 

 

 

 

 

7,686

 

 

 

 

 

 

7,686

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

(343

)

 

 

 

 

 

(343

)

 

 

 

 

 

(343

)

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(18,704

)

 

 

(18,704

)

 

 

348

 

 

 

(18,356

)

Balances as of March 31, 2025

 

 

15,784,916

 

 

 

158

 

 

 

2,294,608

 

 

 

(16,183

)

 

 

(1,984,629

)

 

 

293,954

 

 

 

11,820

 

 

 

305,774

 

 

 

 

Common Stock

 

 

Additional
Paid-In

 

 

Accumulated
Other
Comprehensive

 

 

Accumulated

 

 

American Well
Corporation
Stockholders’

 

 

Noncontrolling

 

 

Total
Stockholders’

 

 

 

Shares

 

 

Amount

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Equity

 

 

Interest

 

 

Equity

 

Balances as of January 1, 2024

 

 

14,423,903

 

 

$

145

 

 

$

2,237,502

 

 

$

(15,650

)

 

$

(1,757,778

)

 

$

464,219

 

 

$

15,967

 

 

$

480,186

 

Vesting of restricted stock units

 

 

326,743

 

 

 

3

 

 

(3

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issuance of stock under employee stock purchase plan

 

 

53,675

 

 

 

1

 

 

955

 

 

 

 

 

 

 

 

 

956

 

 

 

 

 

 

956

 

Stock-based compensation expense

 

 

 

 

 

 

 

 

16,228

 

 

 

 

 

 

 

 

 

16,228

 

 

 

 

 

 

16,228

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

(563

)

 

 

 

 

 

(563

)

 

 

 

 

 

(563

)

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(72,105

)

 

 

(72,105

)

 

 

(1,344

)

 

 

(73,449

)

Balances as of March 31, 2024

 

 

14,804,321

 

 

 

149

 

 

 

2,254,682

 

 

 

(16,213

)

 

 

(1,829,883

)

 

 

408,735

 

 

 

14,623

 

 

 

423,358

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

5


 

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands, except share and per share amounts)

(unaudited)

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Cash flows from operating activities:

 

 

 

 

 

 

Net loss

 

$

(18,356

)

 

$

(73,449

)

Adjustments to reconcile net loss to net cash used in operating activities:

 

 

 

 

 

 

Depreciation and amortization expense

 

 

7,801

 

 

 

8,236

 

Provisions for credit losses

 

 

(204

)

 

 

883

 

Amortization of deferred contract acquisition costs

 

 

644

 

 

 

585

 

Amortization of deferred contract fulfillment costs

 

 

218

 

 

 

85

 

Inventory write-off

 

 

125

 

 

 

 

Net gain on divestiture

 

 

(10,713

)

 

 

 

Stock-based compensation expense

 

 

7,339

 

 

 

16,238

 

Loss on equity method investment

 

 

778

 

 

 

926

 

Deferred income taxes

 

 

(6

)

 

 

(5

)

Changes in operating assets and liabilities, net of acquisition:

 

 

 

 

 

 

Accounts receivable

 

 

(7,274

)

 

 

(27,506

)

Inventories

 

 

328

 

 

 

74

 

Deferred contract acquisition costs

 

 

(675

)

 

 

(947

)

Prepaid expenses and other current assets

 

 

(786

)

 

 

(1,611

)

Other assets

 

 

(302

)

 

 

262

 

Accounts payable

 

 

1,428

 

 

 

1,851

 

Accrued expenses and other current liabilities

 

 

(8,978

)

 

 

33

 

Deferred revenue

 

 

3,525

 

 

 

14,589

 

Net cash used in operating activities

 

 

(25,108

)

 

 

(59,756

)

Cash flows from investing activities:

 

 

 

 

 

 

Purchases of property and equipment

 

 

(9

)

 

 

(75

)

Capitalized software development costs

 

 

 

 

 

(2,818

)

Investment in less than majority owned joint venture

 

 

 

 

 

(1,715

)

Purchases of investments

 

 

(1,000

)

 

 

 

Proceeds from divestiture, net of cash divested

 

 

20,400

 

 

 

 

Net cash used in investing activities

 

 

19,391

 

 

 

(4,608

)

Cash flows from financing activities:

 

 

 

 

 

 

Proceeds from employee stock purchase plan

 

 

544

 

 

 

956

 

Payments for the purchase of treasury stock

 

 

(1

)

 

 

 

Net cash provided by financing activities

 

 

543

 

 

 

956

 

Effect of exchange rates changes on cash, cash equivalents, and restricted cash

 

 

(731

)

 

 

(31

)

Net decrease in cash, cash equivalents, and restricted cash

 

 

(5,905

)

 

 

(63,439

)

Cash, cash equivalents, and restricted cash at beginning of period

 

 

229,111

 

 

 

372,833

 

Cash, cash equivalents, and restricted cash at end of period

 

$

223,206

 

 

$

309,394

 

Cash, cash equivalents, and restricted cash at end of period:

 

 

 

 

 

 

Cash and cash equivalents

 

 

222,411

 

 

 

308,599

 

Restricted cash

 

 

795

 

 

 

795

 

Total cash, cash equivalents, and restricted cash at end of period

 

$

223,206

 

 

$

309,394

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

Cash paid for income taxes

 

$

827

 

 

$

630

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

6


 

AMERICAN WELL CORPORATION

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(in thousands, except share and per share amounts)

(unaudited)

1. Organization and Description of Business

American Well Corporation (the “Company”) was incorporated under the laws of the State of Delaware in June 2006. The Company is headquartered in Boston, Massachusetts. The Company is a leading enterprise software company enabling digital delivery of care for healthcare’s key stakeholders. The Company empowers our clients with the core technology and services necessary to successfully develop and distribute virtual care programs that meet their strategic, operational, financial and clinical objectives under their own brands.

Reverse Stock Split

On June 18, 2024, the Company’s stockholders approved a reverse stock split of its Class A common stock, Class B common stock and Class C common stock (collectively, the "common stock") at a ratio ranging from 1-for-10 to 1-for-20, with the exact ratio determined by the Company’s Board of Directors. On June 28, 2024, the Company's Board of Directors approved a 1-for-20 reverse stock split (Reverse Split) of its common stock that became effective on July 10, 2024. The Reverse Stock Split did not change the Company's authorized number of shares of common stock. The Reverse Stock Split did not change the par value of the common stock and, therefore the Company reclassified an amount equal to the reduction in the number of shares of common stock at par value to additional paid-in capital. No fractional shares were issued in connection with the Reverse Split, and stockholders who would otherwise have been entitled to receive a fractional share instead received a cash payment equal to the fraction of a share of common stock in lieu of such fractional share. Proportionate adjustments were made to the number of shares authorized under the Company’s equity incentive plans, the number of shares subject to any award or purchase right under the Company’s equity incentive plans, and the exercise price or purchase price with respect to any stock option award or purchase right under the Company’s equity incentive plans, see Note 8. All shares of the Company’s common stock, stock-based instruments and per-share data included in these condensed consolidated financial statements have been retroactively adjusted as though the Reverse Stock Split has been effected prior to all periods presented.

 

2. Summary of Significant Accounting Policies

There have been no material changes to the significant accounting policies described in the Company’s Form 10-K for the fiscal year ended December 31, 2024, that have had a material impact on the consolidated financial statements and related notes.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) and applicable rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting of normal recurring accruals and adjustments) necessary for the fair statement of the Company’s financial position, results of operations and cash flows at the dates and for the periods indicated. The interim results for the three months ended March 31, 2025 are not necessarily indicative of results for the full 2025 calendar year or any other future interim periods. The information included in the interim financial statements should be read in conjunction with the annual consolidated financial statements and accompanying notes included in the Form 10-K.

The unaudited condensed consolidated financial statements include the accounts of American Well Corporation, its wholly-owned subsidiaries, those of professional corporations, which represent variable interest entities in which American Well has an interest and is the primary beneficiary (“PC”), and National Telehealth Network (“NTN”), an entity in which American Well controls fifty percent or more of the voting shares (see Note 5). Intercompany accounts and transactions have been eliminated in consolidation.

The Company’s reporting currency is the U.S. dollar. The Company determines the functional currency of each subsidiary based on the currency of the primary economic environment in which each subsidiary operates. Items included in the financial statements of such subsidiaries are measured using that functional currency. Foreign currency denominated monetary assets and liabilities are remeasured into U.S. dollars at current exchange rates and foreign currency denominated nonmonetary assets and liabilities are remeasured into U.S. dollars at historical exchange rates. Gains or losses from foreign currency remeasurement and settlements are included in interest income and other income (expense), net in the condensed consolidated statements of operations and comprehensive loss.

7


 

For consolidated entities where American Well owns or is exposed to less than 100% of the economics, the net loss attributable to noncontrolling interests is recorded in the condensed consolidated statements of operations and comprehensive loss equal to the percentage of the economic or ownership interest retained in each entity by the respective non-controlling party. The noncontrolling interests are presented as a separate component of stockholders’ deficit in the condensed consolidated balance sheets.

Use of Estimates

The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenue and expenses during the reported periods. Significant estimates and assumptions reflected in these condensed consolidated financial statements include, but are not limited to, revenue recognition, the estimated customer relationship period that is used in the amortization of deferred contract acquisition costs, the valuation of assets and liabilities acquired in business combinations, goodwill, the useful lives of intangible assets and property and equipment and the valuation of common stock awards. The Company bases its estimates on historical experience, known trends, and other market-specific or other relevant factors that it believes to be reasonable under the circumstances. On an ongoing basis, management evaluates its estimates, as there are changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. Actual results may differ from those estimates or assumptions.

Segment Information

The Company’s chief operating decision maker (CODM), its Chief Executive Officer, is provided financial information presented on a consolidated basis for purposes of allocating resources and evaluating financial performance. The Company operates and manages its business as one reportable and operating segment. In addition, substantially all of the Company’s revenue and long-lived assets are attributable to operations in the United States for all periods presented.

Variable Interest Entities

The Company evaluates its ownership, contractual and other interests in entities to determine if it has any variable interest in a variable interest entity (“VIE”). These evaluations are complex and involve judgment. If the Company determines that an entity in which it holds a contractual or ownership interest is a VIE and that the Company is the primary beneficiary, the Company consolidates such entity in its condensed consolidated financial statements. The primary beneficiary of a VIE is the party that meets both of the following criteria: (i) has the power to make decisions that most significantly affect the economic performance of the VIE; and (ii) has the obligation to absorb losses or the right to receive benefits that in either case could potentially be significant to the VIE. Management performs ongoing reassessments of whether changes in the facts and circumstances regarding the Company’s involvement with a VIE will cause the consolidation conclusion to change. Changes in consolidation status are applied prospectively.

The aggregate carrying value of total assets and total liabilities included on the condensed consolidated balance sheets for the PCs after elimination of intercompany transactions were $26,313 and $328, respectively, as of March 31, 2025 and $34,050 and $2,053, respectively as of December 31, 2024.

Total revenue included on the condensed consolidated statements of operations and comprehensive loss for the PCs after elimination of intercompany transactions was $9,667 and $17,580 for the three months ended March 31, 2025 and 2024, respectively. Net loss included on the condensed consolidated statements of operations and comprehensive loss was not material for the three months ended March 31, 2025 and 2024.

Investment in Minority Owned Joint Venture

The Company and Cleveland Clinic partnered to form a joint venture, under the name CCAW, JV LLC, to provide broad access to comprehensive and high acuity care services via digital care delivery. The Company does not have a controlling financial interest in CCAW, JV LLC, but it does have the ability to exercise significant influence over the operating and financial policies of CCAW, JV LLC. Therefore, the Company accounts for its investment in CCAW, JV LLC using the equity method of accounting. The joint venture is considered a variable interest entity under ASC 810-10, but the Company is not the primary beneficiary as it does not have the power to direct the activities of the joint venture that most significantly impact its performance. The Company’s evaluation of ability to impact performance is based on Cleveland Clinic’s managing directors and Cleveland Clinic’s ability to appoint and remove the chairperson who has the ability to cast the tie breaking vote on the most significant activities.

In 2020, the Company contributed $2,940 as its initial investment for a 49% interest in CCAW, JV LLC. The agreement also required aggregate total capital contributions by the Company up to an additional $11,800 in two phases. During the three months

8


 

ended March 31, 2025, the Company did not make any capital contributions. During the three months ended March 31, 2024, the Company made a capital contribution of $1,715.

For the three months ended March 31, 2025 and 2024, the Company recognized a loss of $778 and $926 as its proportionate share of the joint venture’s results of operations, respectively. Accordingly, the carrying value of the equity method investment as of March 31, 2025 and December 31, 2024 was $722 and $1,500, respectively.

Simple Agreement for Future Equity

On March 11, 2025, the Company made a minority investment of $1,000 in Aingelz, Inc. (“Aingelz”) utilizing a Simple Agreement for Future Equity ("SAFE"). The SAFE provides the Company with the right to participate in future equity financings of the entity and will automatically convert into shares of preferred stock at a discount price or conversion price as defined in the agreement. This investment is a minority investment, intended to support artificial intelligence development. The Company has no control in this entity.

The SAFE is accounted for under measurement alternative in accordance with Accounting Standards Codification ("ASC") 321, Investments — Equity Securities, which is cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. Each period the Company assesses relevant transactions to identify observable price changes, and the Company regularly monitors these investments to evaluate whether there is an indication of impairment. The Company evaluates whether an investment’s fair value is less than its carrying value using an estimate of fair value, if such an estimate is available. For periods in which there is no estimate of fair value, the Company evaluates whether an event or change in circumstances has occurred that may have a significant adverse effect on the value of the investment. Changes in the fair value of the investment are recorded as net appreciation in fair value of investment in the Consolidated Statements of Operations. As of March 31, 2025, the investment in Aingelz was $1,000, and is included in Other Assets on the condensed consolidated balance sheet. The Company has not recognized any upward or downward adjustments resulting from observable price changes in identical or similar investments for the three months ended March 31, 2025.

Concentrations of Credit Risk and Significant Clients

Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash, cash equivalents, investments and accounts receivable. The Company invests its excess cash with large financial institutions. Cash and cash equivalents are invested in highly rated money market funds. At times, the Company’s cash balances with individual banking institutions are in excess of federally insured limits. The Company’s investments are invested in U.S. government agency bonds. The Company has not experienced any losses on its deposits of cash, cash equivalents or investments. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking relationships.

The Company performs ongoing assessments and credit evaluations of its clients to assess the collectability of the accounts based on a number of factors, including past transaction experience, age of the accounts receivable, review of the invoicing terms of the contracts, and recent communication with clients. The Company has not experienced significant credit losses from its accounts receivable. As of March 31, 2025, two clients accounted for 65% and 10% respectively, of outstanding accounts receivable, and as of December 31, 2024, two clients accounted for 47% and 13% of outstanding accounts receivable.

During the three months ended March 31, 2025, sales to two clients represented 30% and 16% of the Company’s total revenue. During the three months ended March 31, 2024, sales to one client represented 29% of the Company’s total revenue.

Intangible Assets

Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired and reported net of accumulated amortization, separately from goodwill. Definite-lived intangible assets, which primarily consist of customer relationships, contractor relationships, technology and trade name, are stated at historical cost and amortized over the assets’ estimated useful lives. Intangible assets are re-evaluated whenever events or changes in circumstances indicate that their estimated useful lives may require revision and/or the carrying value of the related asset group may not be recoverable by its projected undiscounted cash flows. If the carrying value of the asset group is determined to be unrecoverable, an impairment charge would be recognized in an amount equal to the amount by which the carrying value of the asset group exceeds its fair value. The Company did not identify a triggering event in the three months ended March 31, 2025 and 2024. No impairments were identified during the three months ended March 31, 2025 and 2024.

9


 

Impairment of Long-Lived Assets

Long-lived assets consist primarily of property and equipment and intangible assets. Long-lived assets to be held and used are tested for recoverability whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. Factors that the Company considers in deciding when to perform an impairment review include significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets, among others. When testing for asset impairment, the Company groups assets and liabilities at the lowest level for which cash flows are separately identifiable. If an impairment review is performed to evaluate a long-lived asset group for recoverability, the Company compares forecasts of undiscounted cash flows expected to result from the use and eventual disposition of the long-lived asset group to its carrying value. An impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of an asset group are less than the asset’s carrying amount. The impairment loss would be based on the excess of the carrying value of the impaired asset group over its fair value. The Company did not identify a triggering event in the three months ended March 31, 2025 and 2024. No impairments were identified during the three months ended March 31, 2025 and 2024.

Recently Issued Accounting Pronouncements and Disclosure Rules

In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which includes amendments to improve income tax disclosures primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures.

In November 2024, the FASB issued ASU No. 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of income statement expenses (“ASU 2024-03”), which requires disaggregated information about certain income statement expense line items on an annual and interim basis. ASU 2024-03 is effective for annual periods beginning after December 15, 2026 and interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted and can be applied prospectively or retrospectively. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures.

3. Segment Information

The Company operates and manages its business as one reportable and operating segment. The Company’s enterprise platform and software as a service solutions enable hybrid care delivery for our customers. The measure of segment assets is reported on the balance sheet as total consolidated assets. In addition, the Company derives revenue primarily in the United States and manages the business activities on a consolidated basis.

The Company generates revenues from the use of our enterprise platform and software as a service in the form of recurring subscription fees for use. We also generate revenue from the performance of patient visits and other related professional services and hardware sales. The accounting policies are the same as those described in the summary of significant accounting policies.

The Company’s chief operating decision maker (CODM), its Chief Executive Officer, reviews financial information presented on a consolidated basis and decides how to allocate resources based on net loss. Consolidated net loss is used for evaluating financial performance. The monitoring of budgeted versus actual results are used in assessing performance of the Company and in establishing management’s compensation.

The significant expense categories and amounts align with information that is regularly provided to the CODM. Significant segment expenses, which represent the difference between revenue and net loss, consist of the following:

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Employee compensation

 

 

41,584

 

 

 

53,735

 

Consulting costs

 

 

5,845

 

 

 

8,856

 

Provider cost

 

 

14,259

 

 

 

19,618

 

Stock-based compensation expense

 

 

7,686

 

 

 

16,228

 

Other segment expense items (1)

 

 

27,870

 

 

 

36,117

 

Total costs and operating expenses

 

 

97,244

 

 

 

134,554

 

(1) Other segment expense items primarily include hosting, hardware, corporate compliance, severance, strategic transformation costs, amortization, depreciation and overhead expenses.

10


 

4. Revenue

The following table presents the Company’s revenues disaggregated by revenue source:

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Platform subscription

 

$

32,212

 

 

$

24,855

 

Visits

 

 

26,625

 

 

 

31,078

 

Other

 

 

7,996

 

 

 

3,589

 

Total Revenue

 

$

66,833

 

 

$

59,522

 

 

Accounts Receivable, Net

Accounts receivable primarily consist of amounts billed currently due from clients. Accounts receivable are presented net of an allowance for credit losses, which is an estimate of amounts that may not be collectible. In determining the amount of the allowance at each reporting date, the Company makes judgments about general economic conditions, historical write-off experience and any specific risks identified in client collection matters, including the aging of unpaid accounts receivable and changes in client financial conditions. Account balances are written off after all means of collection are exhausted and the potential for non-recovery is determined to be probable. Adjustments to the allowance for credit losses are recorded as general and administrative expenses in the condensed consolidated statements of operations and comprehensive loss.

Changes in the allowance for credit losses were as follows:

 

 

 

Three Months Ended March 31, 2025

 

 

Year Ended December 31, 2024

 

Allowance for credit losses, beginning of the period

 

$

7,236

 

 

$

2,291

 

Provisions

 

 

(203

)

 

 

7,093

 

Write-offs

 

 

(58

)

 

 

(2,148

)

Allowance for credit losses, end of the period

 

$

6,975

 

 

$

7,236

 

 

The Company has rights to consideration for services completed but not billed at the reporting date. Unbilled receivables are classified as receivables when the Company has the right to invoice the client. The amount of unbilled accounts receivable included within accounts receivable on the condensed consolidated balance sheet was $12,299 and $13,628 as of March 31, 2025 and December 31, 2024, respectively.

Deferred Revenue

Contract liabilities consist of deferred revenue and include billings in advance of performance under the contract. Such amounts are recognized as revenue over the contractual period. For the three months ended March 31, 2025 and 2024, the Company recognized revenue of $19,844 and $15,947, respectively, that was included in the corresponding contract liability balance at the beginning of the periods presented.

Changes in the Company’s deferred revenue balance for the three months ended March 31, 2025 and year ended December 31, 2024 were as follows:

 

 

Three Months Ended March 31, 2025

 

 

Year Ended December 31, 2024

 

Total deferred revenue, beginning of the period

 

$

56,012

 

 

$

52,456

 

Additions

 

 

41,006

 

 

 

130,559

 

Recognized

 

 

(37,400

)

 

 

(127,003

)

Total deferred revenue, end of the period

 

$

59,618

 

 

$

56,012

 

 

 

 

 

 

 

 

Current deferred revenue

 

 

57,429

 

 

 

53,232

 

Non-current deferred revenue

 

 

2,189

 

 

 

2,780

 

Total

 

$

59,618

 

 

$

56,012

 

 

11


 

Transaction Price Allocated to Remaining Performance Obligations

As of March 31, 2025 and December 31, 2024, the aggregate amount of the transaction price allocated to remaining performance obligations was $124,274 and $143,529, respectively. The substantial majority of the unsatisfied performance obligations will be satisfied over the next three years.

As it pertains to the March 31, 2025 amount, the Company expects to recognize 71% of the transaction price in the 12 month period ended March 31, 2026, in its condensed consolidated statement of operations and comprehensive loss with the remainder recognized thereafter.

5. National Telehealth Network

In 2012, the Company and an affiliate of Elevance Health Inc. formed National Telehealth Network LLC ("NTN") to expand the availability and adoption of telemedicine. The Company did not have a controlling financial interest in NTN, but it had the ability to exercise significant influence over the operating and financial policies of NTN. Therefore, the Company accounted for its investment in NTN using the equity method of accounting through December 31, 2015.

On January 1, 2016, the Company made an additional investment in NTN, which increased its ownership percentage above 50%. The Company also obtained the right to elect the Chairman of NTN, who has the ability to cast the tie-breaking vote in all decisions. Therefore, on January 1, 2016, the Company obtained control over NTN and has the power to direct the activities that most significantly impact NTN’s economic performance. This step-acquisition was accounted for as a business combination and the results of the operations of NTN from January 1, 2016, have been included in the Company’s condensed consolidated financial statements. However, because the Company owns less than 100% of NTN, the Company recognizes net loss attributable to non-controlling interest in the condensed consolidated statements of operations and comprehensive loss equal to the percentage of the ownership interest retained in NTN by the respective non-controlling party.

The proportionate share of the loss attributed to the non-controlling interest amounted to $348 and $1,344 for the three months ended March 31, 2025 and 2024, respectively.

The carrying value of the non-controlling interest was $11,820 and $11,472 as of March 31, 2025 and December 31, 2024, respectively.

6. Fair Value Measurements

Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable:

Level 1—Quoted prices in active markets for identical assets or liabilities.
Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data.
Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques.

12


 

The following tables presents the Company’s fair value hierarchy for its assets and liabilities that are measured at fair value on a recurring basis and indicate the level within the fair value hierarchy of the valuation techniques the Company utilized to determine such fair value:

 

 

 

March 31, 2025

 

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

Money market funds

 

$

122,105

 

 

$

 

 

$

 

 

$

122,105

 

Total financial assets:

 

$

122,105

 

 

$

 

 

$

 

 

$

122,105

 

 

 

 

December 31, 2024

 

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

Money market funds

 

$

140,639

 

 

$

 

 

$

 

 

$

140,639

 

Total financial assets:

 

$

140,639

 

 

$

 

 

$

 

 

$

140,639

 

 

The Company’s cash equivalents were invested in money market funds and were valued based on Level 1 inputs. During the three months ended March 31, 2025, there were no transfers between fair value measurement levels. Interest income for the three months ended March 31, 2025 and 2024 was $1,564 and $3,798, respectively.

Nonrecurring Fair Value Measurements

The Company measures the fair value of certain assets, including investments in privately held companies without readily determinable fair values, on a nonrecurring basis when events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable.

7. Divestiture

On January 8, 2025 (the "Closing Date"), the Company and the Company's wholly owned subsidiary, Aligned Telehealth, LLC ("Aligned") entered into an asset purchase agreement relating to the sale of all property and assets owned, leased or licensed by Aligned that are primarily used or held for use in connection with the Company’s business of providing telepsychiatry services to hospitals and correctional programs (the "APC Business"), subject to certain specified exclusions such as cash. In connection with such purchase and sale, the buyer assumed specified contracts and the related accounts receivable and all accounts payable and accrued expenses of the APC Business, and Dr. Cynthia Horner transferred the ownership of Asana Integrated Medical Group (“Asana” and together with Aligned, “APC”), the affiliated clinical partner of Aligned, to a doctor affiliated with the buyer.

The divestiture was completed on Closing Date, and the total consideration was comprised of (i) an upfront cash payment of $20,714, subject to customary adjustments and (ii) an additional cash payment (the “Additional Payment”) equal to 0.4x the buyer and its affiliates’ aggregate revenues arising from the provision of the APC Business to current customers and potential customers in the sales pipeline of APC during the twelve-month period immediately following the closing, subject to certain exclusions. The Additional Payment is considered seller contingent consideration and the Company has made an accounting policy election to account for the Additional Payment when realizable.

We divested the APC Business as it was determined the offering no longer fit our goals around profitability and growth. Streamlining our service offerings will enable us to focus our resources on the Converge platform, strategic customers, and our path to profitability. The divestiture of APC did not represent a strategic shift that would have a major effect on the Company's consolidated results of operations, and therefore, its results of operations were not reported as discontinued operations.

As of the Closing Date, the carrying amounts of the following major assets were derecognized from our condensed consolidated balance sheet:

 

Accounts receivable

$

7,413

 

 

Intangibles, net

 

3,687

 

 

Other liabilities

 

(1,413

)

 

Net assets divested

$

9,687

 

 

 

13


 

APC generated revenues of $459 in 2025, through the Closing Date, and $6,529 during the three months ended March 31, 2024. Given that we operate our business as a single reporting unit, we are unable to reasonably determine stand-alone costs and related earnings or loss before income taxes attributable to the APC business.

Upon completion of the divestiture of APC, the Company recognized a gain of $10,713 during the three months ended March 31, 2025. As the Company is in a loss position, no income tax expense related to the taxable gain was recognized during the three months ended March 31, 2025.

8. Intangible Assets

Identified intangible assets consist of the following:

 

 

 

Gross
Amount

 

 

Accumulated
Amortization

 

 

Carrying
Value

 

 

Weighted
Average
Remaining
Life

 

March 31, 2025

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

66,873

 

 

$

(32,739

)

 

 

34,134

 

 

 

5.8

 

Tradename

 

 

14,100

 

 

 

(8,136

)

 

 

5,964

 

 

 

3.0

 

Technology

 

 

89,547

 

 

 

(62,921

)

 

 

26,626

 

 

 

2.2

 

Internally developed software

 

 

40,314

 

 

 

(16,249

)

 

 

24,065

 

 

 

3.8

 

 

$

210,834

 

 

$

(120,045

)

 

$

90,789

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gross
Amount

 

 

Accumulated
Amortization

 

 

Carrying
Value

 

 

Weighted
Average
Remaining
Life

 

December 31, 2024

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

80,437

 

 

$

(41,199

)

 

 

39,238

 

 

 

5.7

 

Contractor relationships

 

 

535

 

 

 

(370

)

 

 

165

 

 

 

4.0

 

Trade name

 

 

13,731

 

 

 

(7,404

)

 

 

6,327

 

 

 

3.2

 

Technology

 

 

88,350

 

 

 

(58,606

)

 

 

29,744

 

 

 

2.4

 

Internally developed software

 

 

40,314

 

 

 

(14,250

)

 

 

26,064

 

 

 

3.7

 

 

$

223,367

 

 

$

(121,829

)

 

$

101,538

 

 

 

 

 

The Company capitalized nothing in the three months ended March 31, 2025 and $2,818 in the three months ended March 31, 2024, related to internally developed software to be sold as a service incurred during the application development stage. The Company is amortizing these costs over the expected lives of the related services. Amortization expense related to intangible assets for the three months ended March 31, 2025 and 2024 was $7,749 and $8,144, respectively.

 

 

9. Accrued Expenses and other current liabilities

Accrued expenses and other current liabilities consist of the following:

 

 

 

March 31, 2025

 

 

December 31, 2024

 

Employee compensation and benefits

 

$

15,886

 

 

$

25,988

 

Professional services

 

 

3,255

 

 

 

3,791

 

Provider services

 

 

8,451

 

 

 

9,461

 

Other

 

 

11,551

 

 

 

10,086

 

Total

 

$

39,143

 

 

$

49,326

 

 

14


 

10. Stockholders’ Equity

Undesignated Preferred Stock

The Company’s Amended and Restated Certificate of Incorporation authorizes the issuance of 100,000,000 shares of undesignated preferred stock, par value of $0.01 per share, with rights and preferences, including voting rights, designated from time to time by the board of directors. No shares of preferred stock were issued or outstanding as of March 31, 2025 and December 31, 2024.

Common Stock

In the three months ended March 31, 2025 and 2024, no shares of Class B common stock were converted to Class A common stock. As of March 31, 2025, the par value of the Class A, Class B and Class C shares was $141, $14, and $3, respectively. As of December 31, 2024 the par value of the Class A, Class B and Class C shares was $139, $14 and $3, respectively.

 

 

 

 

 

 

March 31, 2025

 

 

December 31, 2024

 

 

 

Shares Authorized

 

 

Shares Issued and Outstanding

 

 

Shares Issued and Outstanding

 

Class A

 

 

1,000,000,000

 

 

 

14,137,621

 

 

 

13,922,877

 

Class B

 

 

100,000,000

 

 

 

1,369,518

 

 

 

1,369,518

 

Class C

 

 

200,000,000

 

 

 

277,777

 

 

 

277,777

 

 

 

 

1,300,000,000

 

 

 

15,784,916

 

 

 

15,570,172

 

 

As of March 31, 2025 and December 31, 2024, the Company had reserved 5,285,419 and 4,622,750 shares of common stock for the exercise of outstanding stock options, the vesting of restricted stock units, the vesting of performance-based market condition share awards, and the number of shares remaining available for future grant, respectively.

Stock Plans

The Company maintains the 2006 Employee, Director and Consultant Stock Plan as amended and restated (the “2006 Plan”), the 2020 Equity Incentive Plan (the “2020 Plan”) and 2024 Inducement Plan (the “2024 Plan”), together, the “Plans,” under which it has granted incentive stock options, non-qualified stock options, cash based awards, restricted stock units and performance stock units to employees, officers, and directors of the Company. In connection with the adoption of the 2020 Plan, the then-remaining shares of common stock reserved for grant or issuance under the 2006 Plan became available for issuance under the 2020 Plan, and no further grants will be made under the 2006 Plan.

Stock Options

Activity under the Plans is as follows:

 

 

 

Number of
Shares

 

 

Weighted
Average
Exercise Price

 

 

Weighted Average
Remaining
Contractual
Term (Years)

 

 

Aggregate
Intrinsic Value

 

Outstanding as of January 1, 2025

 

 

427,710

 

 

$

103.49

 

 

 

3.7

 

 

$

 

Forfeited

 

 

(12,444

)

 

$

102.92

 

 

 

 

 

 

 

Outstanding as of March 31, 2025

 

 

415,266

 

 

$

103.51

 

 

 

3.5

 

 

$

 

Vested and expected to vest as of December 31, 2024

 

 

427,351

 

 

$

103.48

 

 

 

3.7

 

 

$

 

Vested and expected to vest as of March 31, 2025

 

 

414,912

 

 

$

103.50

 

 

 

3.5

 

 

$

 

Options exercisable as of December 31, 2024

 

 

427,490

 

 

$

103.49

 

 

 

3.7

 

 

$

 

Options exercisable as of March 31, 2025

 

 

415,046

 

 

$

103.50

 

 

 

3.5

 

 

$

 

 

No options were granted in the three months ended March 31, 2025 and 2024.

15


 

Restricted Stock Units

Activity for the restricted stock units is as follows:

 

 

 

Shares

 

 

Weighted Average
Grant Date
Fair Value

 

Unvested as of January 1, 2025

 

 

1,354,040

 

 

$

30.01

 

Granted

 

 

730,589

 

 

 

10.30

 

Vested

 

 

(137,838

)

 

 

44.29

 

Forfeited

 

 

(136,088

)

 

 

31.09

 

Unvested as of March 31, 2025

 

 

1,810,703

 

 

$

20.88

 

 

The total grant date fair value of RSU’s granted for the three months ended March 31, 2025 and 2024 was $7,524 and $30,313, respectively. Restricted stock units vest over the service period of one to four years. The aggregate intrinsic value of restricted stock units vested for the three months ended March 31, 2025 and 2024 was $1,302 and $7,508, respectively.

Restricted Stock Units with a Market Condition

Activity for the restricted stock units with a market condition is as follows:

 

 

 

Shares

 

 

Weighted Average
Grant Date
Fair Value

 

Unvested as of January 1, 2025

 

 

775,880

 

 

$

39.51

 

Cancelled/Forfeited

 

 

(20,578

)

 

 

43.73

 

Unvested as of March 31, 2025

 

 

755,302

 

 

$

39.40

 

There were no performance-based market condition share awards granted during the three months ended March 31, 2025 and 2024.

Long-term Incentive Awards

As part of his employment agreement, the chief financial officer ("CFO") was granted a long term incentive award, under which a total of $5,000 can be earned. The award is eligible to vest in four equal annual tranches on the anniversary of the CFO's start date, subject to employment and certain performance and market conditions being met. The award will be paid out in cash unless the board of directors determines the amount should be paid out in shares. The Company accounted for these awards as liability-based awards ("Liability Awards"). The fair value of the Liability Awards is estimated using a Monte Carlo simulation model which uses various assumptions, the grant date fair value of the first annual tranche of the Liability Awards, granted on February 5, 2025, was $590. For the three months ended March 31, 2025 the Liability Awards were valued with the following inputs:

 

 

Three Months Ended March 31,

 

 

 

2025

 

Risk-free rate

 

Various

 

Term to end of performance period (yrs)

 

 

0.56

 

Baseline Stock Price

 

$

10.17

 

Expected volatility

 

 

95

%

Expected dividend yield

 

 

0

%

The Liability Awards is recorded as deferred compensation in Accrued expenses and other current liabilities on the Condensed Consolidated Balance Sheet. Compensation expense was recognized on a straight-line basis over the performance period, with the amount recognized fluctuating as a result of the awards being remeasured to fair value at the end of each reporting period due to their liability-award classification. The Company recognized $123 of compensation expense related to the bonus award for the three months ended March 31, 2025, with the remaining fair value to be taken over the term to end of performance period.

16


 

2020 Employee Stock Purchase Plan

During the three months ended March 31, 2024, the Company issued 53,675 shares under the ESPP. During the three months ended March 31, 2025, the Company issued 77,083 shares under the ESPP. As of March 31, 2025, 351,740 shares remained available for issuance.

Stock-Based Compensation

Stock-based compensation expense, related to all of the Company's stock-based awards, was classified in the condensed consolidated statements of operations and comprehensive loss as follows:

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Cost of revenues

 

$

263

 

 

$

397

 

Research and development

 

 

1,610

 

 

 

2,009

 

Selling and marketing

 

 

607

 

 

 

1,778

 

General and administrative

 

 

5,206

 

 

 

12,044

 

Total

 

$

7,686

 

 

$

16,228

 

 

As of March 31, 2025, the unrecognized stock-based compensation expense related to unvested common stock-based awards was $26,714, which is expected to be recognized over a weighted-average period of 1.9 years.

11. Commitments and Contingencies

Indemnification

The Company’s arrangements generally include certain provisions for indemnifying clients against third-party claims asserting infringement of certain intellectual property rights in the ordinary course of business. The Company also regularly indemnifies clients against third-party claims that the company’s products or services breach applicable law or regulation or from claims resulting from a breach of the business associate agreement in place with the client. In addition, the Company indemnifies its officers, directors and certain key employees while they are serving in good faith in their capacities. Through March 31, 2025 and December 31, 2024, there have been no claims under any indemnification provisions.

Litigation

From time to time, and in the ordinary course of business, the Company may be subject to various claims, charges, and litigation. As of March 31, 2025 and December 31, 2024, the Company did not have any pending claims, charges or litigation that it expects would have a material adverse effect on its consolidated financial position, results of operations or cash flows.

12. Income Taxes

As a result of the Company’s history of net operating losses (“NOL”), the Company continues to maintain a full valuation allowance against its domestic net deferred tax assets. For the three months ended March 31, 2025, the Company recognized an income tax expense of $568, primarily due to federal, state and foreign income tax expense. During the three months ended March 31, 2024, the Company recorded income tax expense of $1,275, primarily due to federal, state and foreign income tax expense.

13. Related-Party Transactions

Cleveland Clinic

Cleveland Clinic is a related party because a member of the Company’s board of directors is an executive advisor to Cleveland Clinic. As of March 31, 2025 and December 31, 2024, the Company held current deferred revenue of $66 and $153, respectively from contracts with this client. As of March 31, 2025 and December 31, 2024, amounts due from Cleveland Clinic were $49 and $216, respectively.

During the three months ended March 31, 2025 and 2024, the Company recognized revenue of $62 and $470, respectively, from contracts with this client.

17


 

CCAW, JV LLC

CCAW, JV LLC is a related party because it is a joint venture formed between the Company and Cleveland Clinic for which the Company has a minority owned interest in. During the year ended December 31, 2020, the Company made an initial investment in CCAW, JV LLC of $2,940 for its less than 50% interest in the joint venture. During the three months ended March 31, 2025, the Company made capital contributions of $- related to a portion of the phase one capital commitment.

As of March 31, 2025 and December 31, 2024, the Company held current deferred revenue of $60 and $55, respectively, from contracts with this client. As of March 31, 2025 and December 31, 2024, there was $401 and $400 due from CCAW, JV LLC, respectively.

During the three months ended March 31, 2025 and 2024, the Company recognized revenue of $370 and $402 from contracts with this client, respectively.

14. Net Loss per Share

Basic and diluted net loss per share attributable to common stockholders was calculated as follows:

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Numerator:

 

 

 

 

 

 

Net loss

 

$

(18,356

)

 

$

(73,449

)

Net loss attributable to non-controlling interest

 

 

348

 

 

 

(1,344

)

Net loss attributable to American Well Corporation

 

$

(18,704

)

 

$

(72,105

)

Denominator:

 

 

 

 

 

 

Weighted-average common shares outstanding—basic and diluted

 

 

15,672,373

 

 

 

14,591,020

 

Net loss per share attributable to common stockholders—basic and diluted

 

$

(1.19

)

 

$

(4.94

)

 

The Company’s potential dilutive securities, which include stock options, unvested restricted stock units and unvested performance market-based stock units, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, the weighted-average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to common stockholders is the same. The Company excluded the following potential common shares equivalents presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect:

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Unvested restricted stock units

 

 

1,810,703

 

 

 

1,882,275

 

Unvested performance market-based stock units

 

 

755,302

 

 

 

901,506

 

Options to purchase shares of common stock

 

 

415,266

 

 

 

490,931

 

 

 

 

2,981,271

 

 

 

3,274,712

 

 

15. Severance and strategic transformation costs

In 2024, the Company has executed a series of individual actions, referred to as strategic transformation actions. Strategic transformation costs include one-time employee termination benefits, strategic transformation consulting expenses, as well as other incremental costs resulting from these actions. Employee termination benefits are recorded in accordance with standard Company policy. Strategic transformation costs are recognized in the Company's condensed consolidated financial statements in accordance with GAAP. Charges are recorded when such actions are approved, communicated, and/or implemented. Amounts remaining to be paid for any strategic transformation costs are $3,939 and included in accrued expenses on the condensed consolidated balance sheet as of March 31, 2025.

In the three months ended March 31, 2025 and 2024, the Company recorded charges of $3,465 and $8,659, respectively, in connection with individual strategic transformation actions. For the three months ended March 31, 2025 and 2024 , these charges consist of $286 and $69 recorded as cost of sales, $1,824 and $1,536 recorded as research and development expense, $303 and $4,782 as sales and marketing expense, and $1,052 and $2,272 as general and administrative expenses, respectively.

18


 

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Special Note Regarding Forward-Looking Statements

This Quarterly Report on Form 10-Q contains forward-looking statements. All statements contained in this Quarterly Report on Form 10-Q other than statements of historical fact, including statements regarding our future results of operations, including descriptions of our business plan and strategies, are forward-looking statements. These statements often include words such as “anticipate,” “expect,” “suggests,” “plan,” “believe,” “intend,” “estimates,” “targets,” “projects,” “should,” “could,” “would,” “may,” “will,” “forecast,” or the negative of these terms, and other similar expressions, although not all forward-looking statements contain these words.

The forward-looking statements and projections are subject to and involve risks, uncertainties and assumptions and you should not place undue reliance on these forward-looking statements or projections. Although we believe that these forward-looking statements and projections are based on reasonable assumptions at the time they are made, you should be aware that many factors could affect our actual financial results or results of operations and could cause actual results to differ materially from those expressed in the forward-looking statements and projections.

Important factors that may materially affect such forward-looking statements and projections include the following:

weak growth and increased volatility in the digital care market;
our history of losses and the risk we may not achieve profitability;
inability to adapt to rapid technological changes;
our limited number of significant clients and the risk that we may lose their business;
increased competition from existing and potential new participants in the healthcare industry;
changes in healthcare laws, regulations or trends and our ability to operate in the heavily regulated healthcare industry;
compliance with regulations concerning personally identifiable information and personal health industry;
slower than expected growth in patient adoption of digital care and in platform usage by either clients or patients;
inability to grow our base of affiliated and non-affiliated providers sufficient to serve patient demand;
our ability to comply with federal and state privacy regulations and the significant liability that could result from a cybersecurity breach or our failure to comply with such regulations;
our ability to commence and complete any strategic transformation initiatives and the impact of such initiatives;
our ability to establish and maintain strategic relationships with third parties;
the impact of the seasonal viruses on our business or on our ability to forecast our business’s financial outlook;
the risk that the insurance we maintain may not fully cover all potential exposures; and
the continuation of the Defense Health Agency relationship beyond July of 2025 with comparable financial terms.

The foregoing list of factors is not exhaustive and does not necessarily include all of the important factors that could cause actual results to differ materially from those expressed in any of our forward-looking statements. The information in this Quarterly Report should be read carefully in conjunction with other uncertainties and potential events described in our Form 10-K filed with the SEC on February 12, 2025.

The forward-looking statements included in this Quarterly Report on Form 10-Q are made only as of the date of this Quarterly Report. Except as required by law or regulation, we do not undertake any obligation to update any forward-looking statements to reflect subsequent events or circumstances

19


 

Overview

Amwell is a leading enterprise platform and software company digitally enabling hybrid care. We empower health providers, payers, and innovators to achieve their digital ambitions, enabling a coordinated experience across in-person, virtual and automated care. We provide our clients with the core technology and services necessary to successfully develop and distribute digital care programs that meet their strategic, operational, financial and clinical objectives under their own brands. We offer our clients products to help weave digital care across all care settings. We bring technology and services that facilitate new models of care, strategic partnerships, consistent execution and better outcomes.

Founded in 2006, Amwell pioneered virtual healthcare. Today, Amwell extends digital care beyond telehealth, enabling care across in-person, virtual and automated modalities and providing an open, scalable platform that can flex and grow alongside our clients. We bring technology and services that facilitate new models of care, strategic partnerships, consistent execution and better outcomes. Together with our clients and innovation partners, we forge a new hybrid model of care delivery that adapts as needs evolve and makes care more accessible for all.

As of December 31, 2024, we powered the digital care programs of approximately 50 health plans, which collectively represent more than 80 million covered lives, as well as approximately 100 of the nation’s largest health systems. Since inception, we have powered approximately 34.4 million virtual care visits for our clients, including approximately 1.3 million in the three months ended March 31, 2025.

The Amwell ConvergeTM Platform

The Amwell Converge platform is the latest version of our enterprise platform software. We designed the platform to be future-ready, reliable, flexible, scalable, secure and integrated with other healthcare software systems. Our platform offers state-of-the-art data architecture and video capabilities, flexibility and scalability, as well as a user experience focused on the needs of patients, members and providers. It has been designed from the ground up with the holistic understanding that the future of care of any one person will inevitably blend a mix of in-person, virtual and automated care experiences. The telehealth of yesterday has grown to encompass hybrid care delivery models and the flow of data that drives healthcare.

The Amwell Convergeplatform delivers the digital capabilities that health systems and health plans care about — for example, virtual primary care, post-discharge follow-up, chronic condition management, virtual nursing — and aligns them into a single digital care operating system that aggregates all of the data from these care experiences to provide real-time insight. By providing a single platform for the digital distribution of care, our platform accelerates innovation and interoperability for health system and health plan clients as well as other healthcare innovators who aim to offer a seamless experience for providers, patients and members.

The Amwell Converge platform, our cloud-based enablement platform, is our go-forward strategy to digitally enable a scalable healthcare experience across all care settings. The development of the platform provides our customer base with an improved and more robust healthcare solution that is designed to connect seamlessly with clients' existing investments as well as Amwell-owned and partner programs.

Our Business Model

We sell our enterprise platform and software as a service solutions on a subscription basis, which with our modular platform architecture allows our clients to introduce innovative digital care use cases over time, expanding our subscription revenue opportunity. To support the enterprise platform and software as a service, we offer professional services on a fee-for-service basis and a range of patient and provider Carepoint devices and software that support hospital and home use cases and access to AMG, our affiliated medical group that provides clinical services on a fee-for-service basis. The combination of the enterprise platform, professional services and Carepoint hardware allows our clients to deploy digital care solutions across their full enterprise, deepening their relationships with existing and new patients and members through improved care access and coordination, cost and quality. Our contracts are typically three years in length but may be longer for our largest strategic client partners.

Total subscription fees received were $32.2 million and $24.9 million for the three months ended March 31, 2025 and 2024, respectively.

Health Systems

For health systems, our enterprise platform enables provider-to-provider virtual care for use cases ranging from stroke to virtual nursing and e-sitting. Our suite of Carepoint devices can enhance in-person care, whether the clients want to turn existing equipment such as televisions or iPads into digital access points or use Amwell CarepointTM carts and peripherals. Our enterprise platform also

20


 

helps extend care outside the care setting by enabling both on-demand and scheduled provider-to-patient care for a range of use cases. This includes, but is not limited to, urgent care, primary care, behavioral health, chronic disease management, and specialty follow-up care. To augment in-person and virtual care, our automated care programs and digital mental health services help clinicians and health plans engage patients, members, and consumers before, after, or in-between visits to improve care plan adherence and prevent costly escalations.

To supplement a health system’s own network of healthcare providers, health systems often choose to purchase clinical services from AMG to deliver care for certain specialties such as behavioral health therapy and general urgent care, or to simply operate as backup providers on nights and weekends. AMG services are provided on a fee-for-service basis.

Health Plans

For health plans, employers and government entities, our enterprise platform enables a member-centric hybrid care experience, seamlessly connecting with current technology investments and offering an open architecture that allows simple integration of future innovation. The platform enables a broad set of use cases, including primary, urgent, mental health, specialty, and chronic care. Our virtual primary care solution offers a primary care navigation hub that supports a whole-person, longitudinal care experience for members, integrating virtual visits with digital behavioral health tools and condition-specific automated care programs, with escalation back to virtual and/or in person care, if needed. Our urgent care solution helps members conveniently and effectively address unplanned care needs without visiting the emergency department or local urgent care facility, driving quality outcomes at a lower cost.

Our typical health plan contract includes a recurring subscription fee based on the number of members who have access to our enterprise software plus additional subscription fees associated with add-on programs that extend from urgent care services to longitudinal care. As the health plan expands its offerings on our enterprise software through additional programs or additional covered lives, there is a corresponding increase in subscription fees.

Our health plan clients also purchase clinical services that leverage our AMG network. These visit consultations are charged on a fee-for-service basis and range in price based on the type of consultation and the specialty of the provider.

Government Healthcare Services

We offer new tailored healthcare solutions for government clients that provide efficient and accessible care options to meet the diverse needs of government healthcare systems, personnel and their families.

The Amwell Converge platform enables government healthcare providers to extend care beyond traditional settings, reaching personnel wherever they are stationed. With both on-demand and scheduled care options, we support a wide range of healthcare needs, including urgent care, primary care, behavioral health, chronic disease management, and specialty consultations.

Visits

Amwell’s clinical affiliate AMG has built a network of providers who are licensed and credentialed to deliver care on our enterprise software across the entire United States. This clinical network is designed and operated in a way that allows us to meet the aggregate visit demand requirements of our health plan and health system clients, spanning a broad mix of specialties, including Family Medicine, Lactation, Nutrition, Psychiatry, Therapy and Women's Health.

AMG earns fee-for-service revenue for each episode of care delivered on our enterprise software by its providers with fees varying by physician specialty or clinical program. These clinical fees vary significantly per consultation or case based on the specialty and may require an additional module subscription.

Fees received from AMG-related visits were $26.6 million and $31.1 million for the three months ended March 31, 2025 and 2024, respectively.

Services & Carepoint Devices

We offer a full suite of paid, supporting services to our clients to enable their virtual care offerings, including professional services to facilitate virtual care implementation, workflow design, systems integration and service expansion. To help our clients promote adoption and utilization, we offer patient and provider engagement services through our internal digital engagement agency.

Amwell CarepointTM devices enable healthcare providers to leverage proprietary carts and transform existing tablets and TVs into digital access points in clinical settings, helping to address personnel shortages and access limitations. Our proprietary Carepoint devices coupled with our Carepoint Calling technology enables providers to deliver digital care into clinical locations, such as the emergency department, community hospitals, clinics, and hospital-at-home as well as into community settings such as retail stores,

21


 

employer sites, skilled nursing facilities, correctional facilities, and schools. Our Virtual Nursing and patient monitoring (eSitter) offerings leverage these Carepoint devices to augment on-site nurse teams with virtual staff, and leverage technology to increase patient safety and nurse efficiencies. These devices are built to rigorous safety and clinical standards and have advanced features including far-end camera controls, fleet monitoring and connectivity to a variety of peripherals, including diagnostic scopes and heart, lungs, stomach, and ear examination tools. Our Carepoint portfolio supports a range of uses, including multi-way video, phone connectivity and secure messaging to bring care teams to patients and members in the most efficient way possible.

Fees received from the provision of services and Carepoint devices were $8.0 million and $3.6 million for the three months ended March 31, 2025 and 2024, respectively.

Key Metrics and Factors Affecting Our Performance

We monitor the following key metrics to help us evaluate our business, identify trends affecting our business, formulate business plans and make strategic decisions. While these metrics present significant opportunities for us, they also represent the challenges that we must successfully address in order to grow our business and improve the results of our operations.

Digital Care Utilization

Digital and hybrid care utilization is a key driver of our business. A client’s overall utilization of its digital care platform provides an important measure of the value they derive and drives our business in three important ways. First, to the extent a client succeeds with its digital care program and sees good usage, they are more likely to renew and potentially expand their contract with us. Second, our health systems agreements typically include a certain number of visits conducted by their own providers annually and provide that as certain volume thresholds are exceeded, its annual license fees will rise to reflect this growing value. Third, to the extent that clients utilize provider services from AMG, Amwell derives revenue from clinical fees. We expect that our future revenues will be driven by the growing adoption of digital and hybrid care and our ability to maintain and grow market share within that market.

In the three months ended March 31, 2025, our clients completed a total of 1.3 million visits using our enterprise software, while in the three months ended March 31, 2024, 1.7 million visits were completed. AMG providers accounted for 29% and 24% of total visits performed using our enterprise software during the three months ended March 31, 2025 and 2024, respectively.

 

Total Overall Quarterly Visits

 

Quarter Ended

 

Overall Visits

 

 

Performed by Client Providers

 

March 31, 2025

 

 

1,300,000

 

 

 

71

%

December 31, 2024

 

 

1,360,000

 

 

 

72

%

September 30, 2024

 

 

1,380,000

 

 

 

76

%

June 30, 2024

 

 

1,500,000

 

 

 

76

%

March 31, 2024

 

 

1,665,000

 

 

 

76

%

December 31, 2023

 

 

1,650,000

 

 

 

73

%

Regulatory Environment

Our operations are subject to comprehensive United States federal, state and local regulations as well as international regulation in the jurisdictions in which we do business. Our ability to operate profitably will depend in part upon our ability, and that of our affiliated providers, to maintain all necessary licenses and to operate in compliance with applicable laws and rules. During the COVID-19 pandemic, state and federal regulatory authorities loosened or removed a number of regulatory requirements in order to increase the availability of digital care services. For example, changes were made to the Medicare and Medicaid programs (through waivers and other regulatory authority) to increase access to digital care services by, among other things, increasing reimbursement, permitting the enrollment of out of state providers and eliminating prior authorization requirements. Most Medicare reimbursement flexibilities have been extended through September 30, 2025, including a waiver for geographic site restrictions (patient may be located at home), the expansion of eligible provider types, and coverage for audio-only consults.

Seasonality

Visit volumes typically follow the annual flu season, rising during quarter four and quarter one and falling in the summer months. While we sell to and implement our solutions to clients year-round, we experience some seasonality in terms of when we enter into agreements with our clients and when we launch our solutions to members.

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Non-GAAP Financial Measures

In addition to our financial results determined in accordance with GAAP, we believe adjusted EBITDA, a non-GAAP measure, is useful in evaluating our operating performance. We use adjusted EBITDA to evaluate our ongoing operations and for internal planning and forecasting purposes. We believe that this non-GAAP financial measure, when taken together with the corresponding GAAP financial measures, provides meaningful supplemental information regarding our performance by excluding certain items that may not be indicative of our business, results of operations or outlook. In particular, we believe that the use of adjusted EBITDA is helpful to our investors as it is a metric used by management in assessing the health of our business and our operating performance. However, non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP. In addition, other companies, including companies in our industry, may calculate similarly-titled non-GAAP measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measure as a tool for comparison. A reconciliation is provided below for our non-GAAP financial measure to the most directly comparable financial measure stated in accordance with GAAP. Investors are encouraged to review the related GAAP financial measure and the reconciliation of this non-GAAP financial measure to their most directly comparable GAAP financial measures, and not to rely on any single financial measure to evaluate our business.

Adjusted EBITDA

Adjusted EBITDA is a key performance measure that our management uses to assess our operating performance. Because adjusted EBITDA facilitates internal comparisons of our historical operating performance on a more consistent basis, we use this measure for business planning purposes and in evaluating acquisition opportunities.

We calculate adjusted EBITDA as net loss adjusted to exclude (i) interest income and other income, net, (ii) gain on disposition, (iii) tax benefit and expense, (iv) depreciation and amortization, (v) stock-based compensation expense, (vi) severance and strategic transformation costs and (vii) capitalized software costs.

The following table presents a reconciliation of adjusted EBITDA from the most comparable GAAP measure, net loss, for the three months ended March 31, 2025 and 2024:

 

 

 

Three Months Ended March 31,

 

(in thousands)

 

2025

 

 

2024

 

Net loss

 

$

(18,356

)

 

$

(73,449

)

Add:

 

 

 

 

 

 

Depreciation and amortization

 

 

7,800

 

 

$

8,238

 

Interest income and other income (expense), net

 

 

(2,688

)

 

 

(3,784

)

Gain on divestiture

 

 

(10,713

)

 

 

 

Expense from income taxes

 

 

568

 

 

 

1,275

 

Stock-based compensation

 

 

7,686

 

 

 

16,228

 

Severance and strategic transformation costs(1)

 

 

3,465

 

 

 

8,659

 

Capitalized software costs

 

 

 

 

 

(2,818

)

Adjusted EBITDA

 

$

(12,238

)

 

$

(45,651

)

(1)
Severance and strategic transformation costs include expenses associated with the termination of employees and expenses that focus on transforming the strategy of the Company’s sales and growth organization as well as our overall cost structure during the three months ended March 31, 2025 and 2024.

Some of the limitations of adjusted EBITDA include (i) adjusted EBITDA does not properly reflect capital commitments to be paid in the future, and (ii) although depreciation and amortization are non-cash charges, the underlying assets may need to be replaced and adjusted EBITDA does not reflect these capital expenditures. Our adjusted EBITDA may not be comparable to similarly titled measures of other companies because they may not calculate adjusted EBITDA in the same manner as we calculate the measure, limiting its usefulness as a comparative measure. In evaluating adjusted EBITDA, you should be aware that in the future we will incur expenses similar to the adjustments in this presentation. Our presentation of adjusted EBITDA should not be construed as an inference that our future results will be unaffected by these expenses or any unusual or non-recurring items. Adjusted EBITDA should not be considered as an alternative to loss before benefit from income taxes, net loss, earnings per share, or any other performance measures derived in accordance with U.S. GAAP. When evaluating our performance, you should consider adjusted EBITDA alongside other financial performance measures, including our net loss and other GAAP results.

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Severance and strategic transformation costs

In the three months ended March 31, 2025 and 2024, the Company recorded charges of $3.5 million and $8.7 million, respectively, in connection with severance and strategic transformation costs. The Company has executed a series of individual actions designed to maintain or improve our operating results and profitability. The Company continues to evaluate potential actions and may incur additional strategic transformation costs in future periods.

Our strategic transformation actions include transformational consulting, headcount reductions, and other related transitional amounts to maintain our competitive footprint. Strategic transformation actions are generally funded within twelve months of initiation and are funded by cash flows from operating activities and existing cash balances. We plan to incur additional strategic transformation costs in order to align our recurring cost structure with our current revenue profile. The timing and amount of the incurrence of such future strategic transformation costs are dependent on market conditions, customer actions and other factors.

For further information, see Note 15, "Severance and strategic transformation costs," to the condensed consolidated financial statements included in this Report.

Components of Statement of Operations

Revenue

The Company has demonstrated the strength of our revenue as a direct result of the increasing acceptance of digital care, our penetration of the market, and the successful launch of new or expanded products that enable broadened applications for care delivered virtually. Revenue performance is reflective of the strong foundation that has been built, focused around health plans, health systems, and our provider network.

We generate revenues from the use of our enterprise platform and software as a service in the form of recurring subscription fees for use, and related services and Carepoint sales. We also generate revenue from the performance of AMG patient visits.

Cost of Revenues, Excluding Amortization of Intangible Assets

Cost of revenues primarily consist of hosting fees paid to our hosting providers, costs incurred in connection with our professional services, technical and hosting support, and costs for running our affiliated provider network operations team. These costs primarily include employee-related expenses (including salaries, bonuses, benefits, stock-based compensation and travel).

Cost of revenues are primarily driven by the size of our provider network and the hosting and technical support required to service our clients. Our business model is designed to be scalable and to leverage fixed costs to generate higher revenues. While we currently expect increased investments to support accelerated growth, we also expect increased efficiencies and economies of scale. Our quarterly cost of revenues as a percentage of revenues is expected to fluctuate from period to period depending on the interplay of these aforementioned factors.

Operating Expenses

Operating expenses consist of research and development, sales and marketing, and general and administrative expenses.

Research and Development Expenses

Research and development expenses include personnel and related expenses for software and hardware engineering, information technology infrastructure, security and compliance and product development (inclusive of stock-based compensation for our research and development employees). Research and development expenses also include the periodic outsourcing of similar functions to third party specialists. In recent years, we accelerated the expansion of our enterprise platform volume capacity and the development of additional functionality through new programs and modules. We have made an effort to optimize our resourcing structure with a mix of nearshore and offshore employees and contractors, resulting in a more efficient cost structure. While we have recognized an increase in the research and development expense throughout the prior years, the corresponding future revenue growth is expected to result in lower expenses as a percentage of revenue. We believe increased spending in prior years was a temporary investment to accelerate development of a more scalable and economically beneficial solution that will properly position the Company to benefit in the long term and have seen marked decline during 2025 as we return to normal levels of spend in future periods.

We expect research and development expense to decrease over the next year and then to remain flat in future periods. Our research and development expenses may fluctuate as a percentage of our total revenue from period to period due to the seasonality of our total revenue and the timing and extent of our research and development expenses based on customer demand and emerging market trends.

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Sales and Marketing Expenses

Sales expenses consist primarily of employee-related expenses, including salaries, benefits, commissions, travel and stock-based compensation costs for our employees engaged in commercial activities. We will continue to invest appropriately in sales expenses as we look to grow with new prospects and expand the business of our existing clients. We will continue to elevate the skills and impact of our sales personnel and related account management teams as we look to provide a differentiated and enhanced client experience to our growing client base as well as identifying new strategic market opportunities.

Marketing costs consist primarily of personnel and related expenses (inclusive of stock-based compensation) for our marketing staff that primarily support the sales organization and client engagement. Marketing costs also include third-party independent research, digital marketing campaigns, participation in trade shows, brand messaging, public relations costs, and the costs of communication materials that are produced to generate awareness and utilization of our enterprise platform and software as a service among our clients and their users.

We expect sales and marketing expense to decrease in the current year and then to remain flat in future periods. Our sales and marketing expenses will fluctuate as a percentage of our total revenue from period to period due to the seasonality of our total revenue and the timing and extent of our advertising and marketing expenses.

General and Administrative Expenses

General and administrative expenses include personnel and related expenses, and professional fees incurred by finance, legal, human resources, information technology, our executives, and executive administration staff. They also include stock-based compensation for employees in these departments and expenses related to auditing, consulting, legal, and corporate insurance.

We expect our general and administrative expenses to decrease in the current year and then remain relatively flat in future periods, based on the impact of cost savings measure put in place throughout 2024. Our general and administrative expenses may fluctuate as a percentage of our total revenue from period to period due to the timing of contracts with strategic customers and the timing and extent of our general and administrative expenses.

Depreciation and Amortization Expense

Depreciation and amortization expense includes the amortization of intangible assets and depreciation related to our fixed assets. Amortization of intangible assets consists of the amortization of acquisition-related intangible assets, which are customer relationships, contractor relationships, technology and trade names, as well as the amortization of capitalized software costs.

Interest Income and Other Income (Expense), Net

The balance of interest income and other income (expense), net, consists predominantly of interest income on our money-market and short-term investments. We did not incur material interest expenses in the period as there were no outstanding debts or notes payables.

Gain on divestiture

The Company and Aligned entered into an asset purchase agreement relating to the sale of all property and assets owned, leased or licensed by Aligned that are primarily used or held for use in connection with the APC Business. In connection with such purchase and sale, the buyer assumed specified contracts and the related accounts receivable and all accounts payable and accrued expenses of the APC Business, and Dr. Cynthia Horner transferred the ownership of Asana to a doctor affiliated with the buyer. We divested the APC Business as it was determined the offering no longer fit our goals around profitability and growth. Streamlining our service offerings will enable us to focus our resources on the Converge platform, strategic customers, and our path to profitability. The divestiture of APC did not represent a strategic shift that would have a major effect on the Company's consolidated results of operations, and therefore, its results of operations were not reported as discontinued operations.

Provision for Income Taxes

The income tax provision is primarily due to state and foreign income tax expense.

Deferred tax assets are reduced by a valuation allowance to the extent management believes it is not more likely than not to be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income. Management makes estimates and judgments about future taxable income based on assumptions that are consistent with our plans and estimates.

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Consolidated Results of Operations

The following table sets forth our summarized condensed consolidated statement of operations data for the three months ended March 31, 2025 and 2024 and the dollar and percentage change between the respective periods:

 

 

 

Three Months Ended March 31,

 

(in thousands)

 

2025

 

 

2024

 

 

Change

 

 

%

 

Revenue

 

$

66,833

 

 

$

59,522

 

 

$

7,311

 

 

 

12

%

Costs and operating expenses:

 

 

 

 

 

 

 

 

 

 

 

 

Costs of revenue, excluding depreciation and
   amortization of intangible assets

 

 

31,574

 

 

 

41,153

 

 

 

(9,579

)

 

 

(23

)%

Research and development

 

 

22,102

 

 

 

26,680

 

 

 

(4,578

)

 

 

(17

)%

Sales and marketing

 

 

12,576

 

 

 

25,726

 

 

 

(13,150

)

 

 

(51

)%

General and administrative

 

 

23,192

 

 

 

32,757

 

 

 

(9,565

)

 

 

(29

)%

Depreciation and amortization expense

 

 

7,800

 

 

 

8,238

 

 

 

(438

)

 

 

(5

)%

Total costs and operating expenses

 

 

97,244

 

 

 

134,554

 

 

 

(37,310

)

 

 

(28

)%

Loss from operations

 

 

(30,411

)

 

 

(75,032

)

 

 

44,621

 

 

 

(59

)%

Interest income and other income (expense), net

 

 

2,688

 

 

 

3,784

 

 

 

(1,096

)

 

 

(29

)%

Gain on divestiture

 

 

10,713

 

 

 

 

 

 

10,713

 

 

 

100

%

Loss before expense from income taxes and loss from
   equity method investment

 

 

(17,010

)

 

 

(71,248

)

 

 

54,238

 

 

 

(76

)%

Expense from income taxes

 

 

(568

)

 

 

(1,275

)

 

 

707

 

 

 

(55

)%

Loss from equity method investment

 

 

(778

)

 

 

(926

)

 

 

148

 

 

 

(16

)%

Net loss

 

 

(18,356

)

 

 

(73,449

)

 

 

55,093

 

 

 

(75

)%

Net income (loss) attributable to non-controlling interest

 

 

348

 

 

 

(1,344

)

 

 

1,692

 

 

 

(126

)%

Net loss attributable to American Well
   Corporation

 

$

(18,704

)

 

$

(72,105

)

 

$

53,401

 

 

 

(74

)%

 

Revenue

For the three months ended March 31, 2025, subscription revenue increased $7.3 million due to timing of revenue recognition related to arrangements with several strategic customers. Other revenue increased $4.4 million primarily related to professional services performed for our strategic customers. The sale of APC resulted in a decrease in visit revenue of $6.1 million in the three months ended March 31, 2025, which was partially offset by an increase in visit revenue of $2.1 million related to virtual primary care and special program visits.

Costs of Revenue, Excluding Amortization of Acquired Intangible Assets

For the three months ended March 31, 2025, the decrease in cost of revenue was primarily driven by a decrease in provider costs of $5.4 million, mainly due to the sale of APC. Employee costs decreased $3.4 million due to a headcount reduction of 16% period over period. There was also a decrease in third party related costs of $1.2 million. The decreases were partially offset by an increase in marketing services provided for customers of $1.5 million. The Company's cost savings measures continue to have a positive impact on gross margin.

Research and Development Expenses

For the three months ended March 31, 2025, there was a decrease in employee-related costs of $2.0 million (due to headcount reduction of 8% period over period and reduced stock compensation expense). There was also a decrease of $1.9 million in consulting spend as the peak development of the Amwell Converge platform is complete.

Sales and Marketing Expenses

For the three months ended March 31, 2025, there was a decrease in employee-related costs of $7.9 million (due to headcount reduction of 34% period over period and reduced stock compensation expense), and due to cost savings measures put into place a decrease in marketing spend of $1.1 million and a decrease in consulting spend of $3.8 million.

General and Administrative Expenses

For the three months ended March 31, 2025, the decrease in general and administrative expense was driven by a decrease in employee-related costs of $6.9 million. The employee related costs were driven primarily by the decrease in stock compensation expense as higher value historic awards had become fully expensed, as well as headcount reductions of 25% period over period. In addition, consulting spend decreased $2.5 million, as a result of cost savings measures put into place.

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Depreciation and Amortization Expense

Depreciation expense remained consistent for the three months ended March 31, 2025. For the three months ended March 31, 2025, amortization expense decreased by $0.4 million due to the sale of intangible assets in connection with the APC sale.

Interest Income and Other (Expense) Income, net

For the three months ended March 31, 2025 and 2024, interest income and other (expense) income, net consist entirely of interest income and gains from our cash equivalents and short-term investments.

Gain on divestiture

The gain of divesture relates to the gain from the sale of the APC Business, and represents the excess cash over the value of the net assets and liabilities sold.

Expense from Income Taxes

Income tax expense was $0.6 million for the three months ended March 31, 2025, compared to income tax expense of $1.3 million for the three months ended March 31, 2024.

Loss from Equity Method Investment

The Company and Cleveland Clinic partnered to form a joint venture, under the name CCAW, JV LLC, to provide broad access to comprehensive and high acuity care services via virtual care. The Company does not have a controlling financial interest in CCAW, JV LLC, but it does have the ability to exercise significant influence over the operating and financial policies of CCAW, JV LLC. Therefore, the Company accounts for its investments in CCAW, JV LLC using the equity method of accounting.

During the three months ended March 31, 2025 and 2024, the Company recognized a loss of $0.8 million and $0.9 million, respectively, as its proportionate share of the joint venture results of operations.

Liquidity and Capital Resources

The following table presents a summary of our cash flow activity for the periods set forth below:

 

 

 

Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Consolidated Statements of Cash Flows Data:

 

 

 

 

 

 

Net cash used in operating activities

 

$

(25,108

)

 

$

(59,756

)

Net cash used in investing activities

 

 

19,391

 

 

 

(4,608

)

Net cash provided by financing activities

 

 

543

 

 

 

956

 

Total

 

$

(5,174

)

 

$

(63,408

)

 

Sources of Financing

Our principal sources of liquidity were cash and cash equivalents totaling $222.4 million and $228.3 million as of March 31, 2025 and December 31, 2024, respectively, which were held for a variety of growth initiatives and investments as well as working capital purposes. Our cash and cash equivalents are comprised of money market funds.

As shown in the accompanying condensed consolidated financial statements, the Company incurred a loss from operations of $30.4 million and a net loss of $18.4 million for the three months ended March 31, 2025 and had an accumulated deficit of $1,984.6 million as of March 31, 2025.

The Company has no debt as of March 31, 2025 or December 31, 2024 and expects to generate operating losses in future periods.

We believe that our existing cash and cash equivalents will be sufficient to meet our working capital and capital expenditure needs for at least the next 12 months from the issuance date of the financial statements. Our future capital requirements will depend on many factors including our growth rate, contract renewal activity, number of consultations on our enterprise platform, the timing and extent of spending to support product development efforts, our expansion of sales and marketing activities, the introduction of new

27


 

and enhanced services offerings, and the continuing market acceptance of digital care services. We may in the future enter into arrangements to acquire or invest in complementary businesses, services and technologies and intellectual property rights. We may be required to seek additional equity or debt financing. In the event that additional financing is required from outside sources, we may not be able to raise it on terms acceptable to us or at all. If we are unable to raise additional capital when desired, our business, financial condition and results of operations would be adversely affected.

Three months ended March 31, 2025, vs. three months ended March 31, 2024

Cash Used in Operating Activities

Cash used in operating activities was $25.1 million for the three months ended March 31, 2025. The primary driver of this use of cash was our net loss of $18.4 million. The net loss was partially offset by non-cash expenses of $6.0 million (primarily stock-based compensation of $7.3 million and depreciation and amortization of $7.8 million, offset by net gain on divestiture of $10.7 million).

Cash used in operating activities was $59.8 million for the three months ended March 31, 2024. The primary driver of this use of cash was our net loss of $73.4 million. The net loss was partially offset by non-cash expenses of $26.9 million (primarily net gain on divestiture of $10.7 million, stock-based compensation of $16.2 million and depreciation and amortization of $8.2 million).

Cash Provided by Investing Activities

Cash provided by investing activities was $19.4 million for the three months ended March 31, 2025. Cash provided by investing activities consisted of $20.4 million in proceeds from divestiture offset by $1.0 million minority investment in a strategic technology partner.

Cash used in investing activities was $4.6 million for the three months ended March 31, 2024. Cash used in investing activities consisted of $2.8 million in capitalized software development costs and $1.7 million investment in the less than majority owned joint venture.

Cash Provided by Financing Activities

Cash provided by financing activities for the three months ended March 31, 2025, was $0.5 million. Cash provided by financing activities consisted of $0.5 million of proceeds from the employee stock purchase plan.

Cash provided by financing activities for the three months ended March 31, 2024, was $1.0 million. Cash provided by financing activities consisted of $1.0 million of proceeds from the employee stock purchase plan.

Off-Balance Sheet Arrangements

During the periods presented, we did not have, nor do we currently have, any relationships with unconsolidated entities or financial partnerships, such as entities often referred to as structured finance or special purpose entities, which would have been established for the purpose of facilitating off-balance sheet arrangements or other contractually narrow or limited purposes. We are therefore not exposed to the financing, liquidity, market or credit risk that could arise if we had engaged in those types of relationships.

Contractual Obligations and Commitments

As of March 31, 2025, there have been no material changes from the contractual obligations and commitments previously disclosed in our Form 10-K.

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Critical Accounting Policies and Estimates

Our condensed consolidated financial statements and the related notes thereto are prepared in accordance with GAAP. The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business factors, and various other assumptions that the Company believes are necessary to consider to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained, and as the Company’s operating environment evolves. For a discussion of our critical accounting policies and estimates see Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the 2024 Form 10-K.

Recently Issued Accounting Pronouncements Adopted

For more information on recently issued accounting pronouncements, see Note 2 to our condensed consolidated financial statements covered under Part I, Item 1 of this Quarterly Report on Form 10-Q.

New Accounting Pronouncements Not Yet Adopted

For more information on new accounting pronouncements not yet adopted, see Note 2 to our condensed consolidated financial statements covered under Part I, Item 1 in this Quarterly Report on Form 10-Q.

Item 3. Qualitative and Quantitative Disclosure about Market Risk

Interest Rate Risk

We had cash and cash equivalents totaling $222.4 million, and $228.3 million as of March 31, 2025 and December 31, 2024, respectively. These amounts were primarily invested in money markets. The Company held no investments as of March 31, 2025 and December 31, 2024. The cash and cash equivalents are held for a variety of growth and investments as well as working capital purposes.

We do not believe that an increase or decrease of 100 basis points in interest rates would have a material effect on our business, financial condition or results of operations. However, our cash equivalents are subject to market risk due to changes in interest rates. Fixed rate securities may have their market value adversely affected due to a rise in interest rates. Due in part to these factors, our future investment income may fall short of expectation due to changes in interest rates or we may suffer losses in principal if we are forced to sell securities that decline in market value due to changes in interest rates.

Fluctuations in the value of our money market funds caused by a change in interest rates (gains or losses on the carrying value) are recorded in other income and are realized only if we sell the underlying securities.

Foreign Currency Exchange Risk

To date, a substantial majority of our revenue from client arrangements has been denominated in U.S. dollars. We have limited operations outside the United States. As of March 31, 2025 and December 31, 2024, the Company has one foreign subsidiary in Israel, the functional currency of that subsidiary is the New Israeli Shekel. In addition the Company has three foreign subsidiaries from the acquisition of SilverCloud, with functional currencies of the Euro, British pound and Australian dollars. The Company also has a branch with a functional currency of the New Israeli Shekel. The transactional activity for these entities in the three months ended March 31, 2025 and 2024 was not considered significant. Accordingly, we believe we do not have a material exposure to foreign currency risk. We may choose to focus on international expansion, which may increase our exposure to foreign currency exchange risk in the future.

Inflation Risk

We do not believe that inflation had a material effect on our business, financial condition or results of operations in the last two years. If our costs were to become subject to significant inflationary pressures, we may not be able to fully offset such higher costs through price increases. Our inability or failure to do so could harm our business, financial condition or results of operations.

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Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives.

Our management, with the participation of our principal executive officers and principal financial officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the Exchange Act), as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on this evaluation, our principal executive officers and principal financial officer concluded that as of March 31, 2025, our disclosure controls and procedures were effective. Disclosure controls and procedures are our controls and other procedures that are designed to ensure that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms and to provide reasonable assurance that such information is accumulated and communicated to our management, including our principal executive officers and principal financial officer, as appropriate, to allow timely decisions regarding required disclosure.

There have been no changes in our internal control over financial reporting during the quarter ended March 31, 2025, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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PART II – OTHER INFORMATION

From time to time, we may become involved in legal proceedings arising in the ordinary course of our business. We are not presently a party to any legal proceedings that, in the opinion of our management, would individually or taken together have a material adverse effect on our business, financial condition, results of operations or cash flows. Regardless of outcome, litigation can have an adverse impact on us due to defense and settlement costs, diversion of management resources, negative publicity, reputational harm and other factors.

Item 1A. Risk Factors

There have been no material changes to the risk factors previously disclosed in our Form 10-K. For a discussion of potential risks and uncertainties related to our Company see the information in our Form 10-K in the section entitled “Risk Factors.”

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

Recent Sales of Unregistered Securities

There were no sales of unregistered equity securities during the quarter ended March 31, 2025.

Issuer Purchases of Equity Securities

The following table provides information about the Company’s purchases of its common stock for each month during this quarterly period covered by this report:

 

Period

 

(a) Total
number
of shares
(or units)
purchased*

 

 

(b) Average
price paid per
share (or unit)*

 

 

(c) Total number
of shares (or units)
purchased as part
of publicly
announced plans
or programs

 

 

(d) Maximum
number (or
approximate
dollar value)
of shares (or
units) that may
yet be purchased
under the plans
or programs

 

January 1 to January 31

 

 

133

 

 

$

7.25

 

 

 

 

 

 

 

February 1 to February 28

 

 

17

 

 

 

10.78

 

 

 

 

 

 

 

March 1 to March 31

 

 

27

 

 

 

9.96

 

 

 

 

 

 

 

Total

 

 

177

 

 

$

8.00

 

 

 

 

 

 

 

 

* Shares withheld to cover tax withholding obligations under the net settlement provision upon vesting of restricted stock units and exercising of options.

Item 3. Defaults Upon Senior Securities

Not applicable.

Item 4. Mine Safety Disclosures

Not applicable.

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Item 5. Other Information

Insider Trading Arrangements and Policies

During the three months ended March 31, 2025, none of our officers and directors adopted or terminated any Rule 10b5-1 trading arrangement.

 

Item 6. Exhibits

The documents listed below are incorporated by reference or are filed with this Quarterly Report on Form 10-Q, in each case as indicated therein (numbered in accordance with Item 601 of Regulation S-K).

10.1#*

 

Separation Agreement between American Well Corporation and Kurt Knight, dated December 4, 2024

 

 

 

10.2#*

 

Additional Award Agreement between American Well Corporation and Phyllis Gotlib, dated March 3, 2025

 

 

 

10.3#*

 

Additional Award Agreement between American Well Corporation and Mark Hirshhorn, dated November 4, 2024

 

 

 

31.1*

 

Chief Executive Officer Certification

 

 

 

31.2*

 

Chief Financial Officer Certification

 

32.1*

 

CEO Certification of Quarterly Report

 

32.2*

 

CFO Certifications of Quarterly Report

 

 

 

101.INS

 

 

Inline XBRL Instance Document – the instance document does not appear in the Interactive Data File because XBRL tags are embedded within the Inline XBRL document.

 

 

 

101SCH

 

Inline XBRL Taxonomy Extension Schema With Embedded Linkbase Documents

 

 

 

104

 

Cover page formatted as Inline XBRL and contained in Exhibit 101

 

*

Filed herewith

 

#

Indicates a management contract or compensatory plan

 

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SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

 

 

 

 

 

 

AMERICAN WELL CORPORATION

Date:

May 1, 2025

By:

/s/ Ido Schoenberg, MD

Chief Executive Officer

(Principal Executive Officer)

Date:

May 1, 2025

By:

/s/ Mark Hirschhorn

Chief Financial Officer

(Principal Financial Officer)

Date:

May 1, 2025

By:

/s/ Paul McNeice

Chief Accounting Officer

(Principal Accounting Officer)

 

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