American Well (AMWL) Q4 2024 earnings summary

Executive summary

• 2024 was a transformative year, marked by a refined strategy, cost reductions, and a focus on core technology-enabled care platform initiatives, including a major rollout with Leidos for the U.S. Military Health System.

• Major progress included the staged launch of the Military Health System (DHA) solution, divestiture of non-core assets, and leadership restructuring.

• Implemented quality of revenue and margin initiatives, resulting in steady, better-than-expected improvements in adjusted EBITDA.

• Partnerships expanded clinical offerings, notably with Vida Health for obesity and diabetes care.

• The company is targeting positive cash flow in 2026, supported by subscription software revenue growth and a robust cash position.

Financial highlights

• Q4 2024 total revenue was $71 million; full-year 2024 revenue reached $254.4 million.

• Subscription revenue in Q4 was $37 million, up 36% year-over-year, driven by DHA deployment; full-year subscription revenue was $115.5 million.

• Q4 gross profit margin was 48%, up 11 percentage points sequentially; full-year gross margin was 39%, up from 37% in 2023.

• Q4 adjusted EBITDA was -$22.8 million, a significant improvement from -$36.9 million in Q4 2023; full-year adjusted EBITDA was -$134.4 million, better than -$165.4 million in 2023.

• Ended Q4 with $228 million in cash and marketable securities, no debt.

Outlook and guidance

• 2025 revenue guidance: $250–$260 million, reflecting the divestiture of Amwell Psychiatric Care.

• Subscription revenue expected to approach 60% of total 2025 revenue.

• 2025 adjusted EBITDA guidance: -$55 to -$45 million, a 60% year-over-year improvement.

• R&D, sales & marketing, and G&A expenses expected to decline by over 10%, 25%, and 20% respectively in 2025.

• Q1 2025 revenue guidance: $59–$61 million; adjusted EBITDA: -$18 to -$20 million.

• Projected to end 2025 with ~$190 million in cash, and >$150 million at end of 2026.