Amwell, the telemedicine platform formerly known as American Well, posted first-quarter revenue of $54.9 million, down about 18% from a year earlier, as management discussed artificial intelligence and key contract renewals with investors on Tuesday.
The company has been shifting toward subscription revenue, with subscription software revenue of $24.9 million in the first quarter, accounting for 53% of total revenue, which was down “approximately 23%” year-over-year, Chief Financial Officer Mark Hirshhorn said on a May 5 conference call to discuss first-quarter results.
“Encouragingly, renewal and retention rates were above budget in the first quarter, giving us great confidence in the stability of our subscription base going forward,” Hirschhorn said.
Amwell’s visitor numbers are down about 19% from a year ago, with 1.1 million visitors in the first quarter, Hirschhorn said. Hirschhorn said the numbers are “consistent with the portfolio changes” the company previously disclosed.
The company also reported negative adjusted EBITDA of $3.1 million in the first quarter, compared to negative adjusted EBITDA of $12.2 million in the first quarter of 2025. In the latest quarter, Amwell reported a net loss of $10.3 million, compared to a net loss of $25.2 million in the fourth quarter of 2025.
The company has set a goal of becoming operating cash flow positive in the fourth quarter of 2026.
“We have sufficient cash, no debt, a clear path to cash flow breakeven in the fourth quarter, and have real confidence in our growth in the years to come,” Amwell Chairman and CEO Ido Schoenberg, M.D., told investors.
The company sold assets last year to focus on its core business. In January 2025, the Amwell Psychiatric Care business was sold to Abel Ecare.
Entering 2026, Amwell’s primary focus was to integrate its platforms to meet the unmet needs of payer and provider customers, Schoenberg said. “The technology-enabled care infrastructure we have developed to fill a gap in the market continues to gain momentum as customers realize the clear benefits of lower costs, improved outcomes, increased market share, and increased levels of control and agility,” he said.
“The first quarter was a great start to the year,” Hirshhorn said. “Visitor momentum, stable subscription revenue, and a lean cost structure give us confidence that we are on the right path.”
Schoenberg told investors that technology-enabled care and AI-driven clinical programs are “one of the most important levers a company has,” adding that such tools can help control costs and improve outcomes.
“This is no longer speculative,” Schoenberg said. “It is a necessity for survival, but adoption remains difficult.”
Solera Health’s April survey found that managing digital health vendors generates administrative costs that are matched by potential savings, with 90% of respondents saying they spend more than $1 million in costs and 42% managing eight or more vendors. When it comes to AI implementation, an April report from Qventus found that 74% of health system leaders cited reliance on electronic health record (EHR) vendors as a barrier to implementing AI.
Schoenberg said Amwell provides customers with an “unified engagement and navigation platform” that can reduce acquisition and retention costs. As customers prepare for the transition to more agent-based AI solutions in healthcare, Schoenberg said Amwell’s platform is “positioned as a controlled environment in which these agents can operate safely, effectively and at scale.”
“We’re not positioning Amwell as an AI capability,” he said. “We are the infrastructure layer where AI-powered care becomes operationalized and measurable.”
Schoenberg also told investors that Elevance Health has signed a three-year contract renewal. “This is a strong vote of confidence in our platform and the value we deliver in one of the most sophisticated operating environments on the market,” said Schoenberg.
The Defense Health Agency (DHA), which oversees military health system services, also renewed its contract with the telemedicine platform in August. Schoenberg said the company is “fully committed” to renewing the contract within its current scope. “We expect that to happen,” he said, adding that the platform also plans to expand into behavioral health.
DHA stopped paying for behavioral health and automated care services with Amwell last year. Schoenberg said during a second-quarter 2025 earnings call that the repeal was due to the Pentagon’s cost-cutting measures directed by President Donald Trump, not because the Pentagon was satisfied with the service.
Hirschhorn said the update is expected to be completed by the end of the second quarter or early third quarter, adding: “It will probably be July.”
“We also believe that after the initial renewal there will be opportunities to expand it,” Hirschhorn said.
The company reaffirmed its 2026 revenue and Amwell Medical Group visitor guidance, with full-year revenue in the range of $195 million to $205 million and AMG visitor numbers in the range of 1.32 million to 1.37 million. Amwell also updated its adjusted EBITDA guidance, expecting a loss of $16 million to $12 million.
Amwell expects second-quarter sales to be in the range of $48 million to $52 million and adjusted EBITDA to be a loss of $4 million to $2 million.
