American Well (AMWL) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue was $54.9 million, down 18% year-over-year, driven by lower subscription revenue but partially offset by higher visit revenue; net loss narrowed to $10.3 million, reflecting cost reductions and strategic transformation actions.

• Adjusted EBITDA improved to $(3.1) million from $(12.2) million in Q1 2025, and operational efficiency increased through headcount reductions and lease abandonment.

• Renewed major contracts (Elevance, DHA), expanded government deployments, and achieved significant pipeline growth, with platform consolidation and AI-powered innovations driving customer renewals.

• Maintained a strong cash position of $179.2 million at quarter end, with no debt and significantly reduced cash burn.

• Positioned for cash flow breakeven in Q4 2026 and confident in multi-year growth.

Financial highlights

• Subscription revenue was $24.9 million, down 23% year-over-year; AMG visit revenue was $28.9 million, up 9% year-over-year; total visits reached 1.1 million.

• Gross profit was $28 million with a gross margin of 51%; operating expenses were $45.4 million, down 31% year-over-year.

• Adjusted EBITDA loss was $3.1 million, improved from $12.2 million loss in Q1 2025; net loss per share was $(0.66), compared to $(1.19) in Q1 2025.

• Cash and cash equivalents at quarter-end were $179.2 million, with cash burn reduced to $1.0 million from $25.1 million in Q1 2025.

Outlook and guidance

• Q2 2026 revenue expected at $48–$52 million; adjusted EBITDA loss projected between $(4) million and $(2) million.

• Full-year 2026 revenue guidance reaffirmed at $195–$205 million; adjusted EBITDA loss expected between $(16) million and $(12) million.

• Targeting positive cash flow from operations in Q4 2026 and meaningful revenue growth in 2027.

• Management expects continued operating losses in the near term but believes existing cash is sufficient for at least the next 12 months.