American Well (AMWL) Q4 2025 earnings summary

Executive summary

• 2025 marked a pivotal transformation year, focusing on a unified tech platform, divestiture of non-core activities, and improved revenue quality through contract renewals and new client wins.

• Executed over 15 payer contract renewals, including a major 3-year renewal with Elevance, driving commercial momentum.

• Positioned to achieve operational efficiency and cash flow breakeven in Q4 2026, supported by strong cash reserves and no debt.

Financial highlights

• 2025 total revenue was $249.3 million; subscription revenue grew to $132.4 million (53% of total), AMG visit revenue was $94.3 million.

• Q4 2025 revenue was $55.3 million; subscription revenue $28.8 million, AMG visit revenue $23.7 million.

• Q4 gross margin was 51.2%, a 280 basis point decline year-over-year; full year gross margin was 53%.

• Net loss and adjusted EBITDA losses were each reduced by approximately $100 million year-over-year; full year net loss $(95.0)M, improved from $(212.6)M in 2024.

• Ended 2025 with $182.3 million in cash and marketable securities and no debt.

Outlook and guidance

• 2026 revenue guidance is $195–$205 million; AMG visits expected between 1.32–1.37 million.

• Adjusted EBITDA loss for 2026 projected at $24–$18 million; Q1 2026 revenue expected at $48–$53 million.

• Positive cash flow from operations targeted for Q4 2026.

• Guidance assumes continued subscription stability, visit volume trends, cost discipline, and incremental AI-driven efficiencies.