In 2006 an insured American with a minor illness had to see a doctor in person, at an office, an urgent-care center or an emergency room. A video visit from home was not a covered benefit. Medicare paid for telehealth only when the patient sat in a clinic or hospital in a rural shortage area, and its beneficiaries made about 38,000 such visits in 2009 AWE29. State rules made remote treatment risky for doctors. Colorado's board had treated care without a prior history and physical examination as unprofessional since 2000, licensure followed the patient's state, and in 2007 a California court let prosecutors pursue a Colorado psychiatrist who had prescribed online to a California patient AWE28 AWE27. The online tools health plans gave their members were portals with encyclopedias and risk assessments, which offered information but no doctor AWE15.
Amwell
Amwell sold health plans and hospitals software to run online visits under their own brands, then spent its $742 million IPO on a slow rebuild and acquisitions it wrote down, and by 2025 had about a tenth of Teladoc's revenue.
Why Amwell lost to Teladoc
- 1 · 2006–09Software for health plans to run with their own doctorsFounders who had sold insurer portals sold plans the tools; HMSA opened it to all of Hawaii in 2009 with 140+ of its own physicians.Founder Domain Expertise
- 2 · 2009–21A per-member fee for software, not for doctorsAbout $1.20 of subscription revenue per covered life (2020), against Teladoc's $12.60 per paid member (2019).
- 3 · 2015–20The software inside hospitals' and plans' brandsHealth-system clients grew from 35 (2015) to 158 (2020); 77% of Q2 2020 visits were by the systems' own clinicians.Distribution Partnerships
- 4 · 2020–23IPO cash spent rebuilding the platform and buying programs$742M raised; about $320M for two programs with $15M of revenue; $436.5M written down in 2023.M&A Strategy
Versus Teladoc: Teladoc sold employers and health plans its own doctors for a monthly fee on every covered member, so a client had nothing to build AWE48 AWE16. Amwell sold plans and hospitals the software to run visits under their own brands, priced by members with access or forecast consultations, and billed its own doctors by the visit AWL54 AWE13. Teladoc had about 3.4 times Amwell's revenue in the first half of 2020 and about ten times in 2025 AWL25 AWL59 AWL1.
Arena: Market Conditions Before Amwell
How each step happened
Step 1 of 5 · 2006–09
Software for health plans to run with their own doctors
Founders who knew the insurers
Ido and Roy Schoenberg started American Well in 2006 as they sold CareKey, which built health portals for insurers, to TriZetto for $60 million AWE1 AWE3. Roy had trained in internal medicine and Ido had founded iMDsoft, which made software for intensive care units AWE3. Roy said the portals had offered encyclopedias and risk assessments but 'there were never any long-term relationships'; what people wanted from health care was to talk to a doctor AWE15.
They sold that to the customers they knew. Roy said the company's 'early bet and first strategic choice was to work with payers', aligned with them 'as the primary aggregator of patients and providers', and built enabling technology rather than a product of its own AWE18 AWE41. Ido was blunter: 'The last thing in the world we want to do is compete with the existing delivery network' AWE39. In January 2009 the Hawaii Medical Service Association, Hawaii's Blue Cross plan, opened Online Care to every resident of the state, with ten-minute sessions for $10 to $45 and more than 140 of the plan's own network physicians AWE5. Blue Cross of Minnesota, OptumHealth and TriWest followed that year AWE23 AWE1.
The choice gave American Well its first reach, because each plan offered the service to its members under the plan's own name AWE5 AWE40. It also left the doctors, the brand and the decision to promote the service with the plan. By 2019 Roy counted about 150 million covered lives and warned that this was not reach: most employees still did not 'benefit from the benefit' AWE18.
Rivals Teladoc, founded in 2002, sold the finished service: its own contracted physicians on call, which a plan or employer could buy without supplying doctors of its own AWE48 AWE35.
Step 2 of 5 · 2009–21
A per-member fee for software, not for doctors
American Well's clients paid for the platform. Health plans paid a recurring fee based on the number of members with access, plus fees for added programs; health systems paid fees set by their forecast number of consultations AWL54. The doctors were a separate business. In 2012 Peter Antall founded the Online Care Group, American Well's own physician group, and in October 2013 the company launched a consumer app at $49 a visit served by that group AWE44 AWE7.
A plan that bought the software then had to run a program on it: supply or contract the doctors, set the benefit and get members to use it. The fee was priced for software. In mid-2020 Amwell's 55 plan clients covered more than 80 million lives, while its subscription revenue for all of 2020, hospitals included, was $98.4 million, about $1.20 a covered life AWE12 AWL46. Teladoc earned $463.3 million of access fees from 36.7 million paid members in 2019, about $12.60 each AWL58. Members also used the plans' programs little. Among employers that offered telehealth in 2014, only about a quarter saw use above 5% AWE47. Before COVID the software fees were most of American Well's revenue: in the third quarter of 2019 subscriptions brought in $22.0 million and visits $7.2 million AWL55. It delivered about 2,900 visits a day in April 2019, and had $148.9 million of revenue and an $88.4 million net loss that year AWE12 AWE13.
The COVID surge
COVID turned the visit business into half the company. Visits reached about 40,000 a day in April 2020 and brought 51% of revenue in the first half, against 38% from subscriptions AWE12 AWL54. For the year visits brought $117.2 million of $245.3 million AWL46. When the surge eased, volumes fell, from 5.9 million visits in 2020 to 5.8 million in 2021, and revenue grew 3% AWL18.
Rivals Teladoc charged a fee for every covered member each month, 85% of its 2014 revenue and about $5.37 a member a year, for a service its own doctors delivered AWE48 AWE16. The fee bought the doctors as well as the access, so an employer or plan had nothing to build.
Step 3 of 5 · 2015–20
The software inside hospitals' and plans' brands
From 2015 American Well sold more to hospitals. Its health-system clients doubled from 35 in 2015 to 70 at the end of 2016, Cleveland Clinic put its doctors on the platform at CVS MinuteClinic sites in Ohio, and Cerner tied its health record to the software AWE41 AWE26 AWE42. In 2018 it bought Avizia, whose carts ran telestroke and other specialist consults in more than 1,300 hospitals, and raised $365 million AWE21 AWE20.
Roy agreed with an interviewer that American Well was 'like the Intel inside' and said 'We have to let go; we can't be the product' AWE18. The S-1 described white-labeled software that let clients deliver telehealth 'under their own brands and with their own providers' AWE13. In the second quarter of 2020, 77% of visits were delivered by health systems' own clinicians, and Roy put health systems at 'at least half of our business' AWE12 AWL49. By the end of 2020 the company served 158 health systems and 58 health plans, and Anthem alone was 22% of revenue AWE14.
Serving hospitals kept American Well from competing with its clients, but it placed the company where the client owned the patient, the doctors and the brand, and cared most about the health record. A Teladoc executive said in 2018 that 'what hospitals care about is how telehealth integrates with their EHRs' AWE46. In 2023 KLAS found Amwell among the virtual care platforms hospitals most often selected, helped by its Oracle Health integration, but also found seven customers replacing it, citing cost and support AWL39. By its 2025 annual report Amwell described serving around 80 major health systems AWL42.
Rivals Teladoc sold its own service directly to members of the plans and employers that bought it, and grew to more than 7,000 employer and plan clients by 2016 AWE19 AWE38.
Step 4 of 5 · 2020–23
IPO cash spent rebuilding the platform and buying programs
Amwell listed in September 2020, raising $742 million, plus $100 million from Google, and closed its first day worth about $5.2 billion AWL6 AWL4 AWL7. It spent much of the money widening the product. In April 2021 it announced Converge, one platform to replace its separate products, and in July it paid about $320 million for SilverCloud Health, a digital mental health program, and Conversa Health, automated patient check-ins, which together had about $15 million of revenue AWL28 AWL9. It had bought Aligned Telehealth, a telepsychiatry group, in 2019 AWL40.
Ido said the deals showed a 'repeatable design to continually scale digital healthcare services across the different sites of care' AWL8. STAT read them as 'necessary to compete with Teladoc and other rivals who are also trying to deliver more comprehensive services' AWL34. The Defense Health Agency's contract of 2023, worth up to $180 million, put the platform across the military health system AWL35 AWL13; the agency dropped the digital behavioral health and automated care programs in summer 2025 to cut costs AWL3.
A rebuild that ran long
Ido expected Converge to be complete in 2022. About 36% of visits ran on it in the first quarter of 2023 and about 70% by January 2024 AWL47 AWL14 AWL15. Revenue moved from $245.3 million in 2020 to $259.0 million in 2023, when Amwell wrote down $436.5 million of goodwill and lost $679.2 million AWL46 AWL48. Former executives told Axios that 'we were spreading ourselves thin' and that 'Clients felt they were sold vaporware', citing missed rollouts at CVS Health and Memorial Hermann AWL29.
Rivals Teladoc had about 3.4 times Amwell's revenue in the first half of 2020, before its $18.5 billion Livongo merger closed AWL25 AWL4. In the second quarter of 2021 Teladoc's revenue rose 109%, 41% of it organic, while Amwell's fell 12% AWL57. Teladoc sold the added care lines to members whose plans and employers already paid it a monthly fee AWL59.
Step 5 of 5 · 2024–26
Cut back to a smaller software business
From late 2023 Amwell cut about 10% of its staff, and in July 2024 it carried out a one-for-20 reverse split after its shares fell below $1 AWL15 AWL10. Roy Schoenberg stepped back to executive vice chairman, and Teladoc's former finance chief Mark Hirschhorn became chief financial officer AWL12 AWL32. In January 2025 Amwell sold its psychiatric care unit to Avel eCare for about $21 million plus an earn-out, and by early 2026 it had also divested its inpatient tools and hardware AWL24 AWL2.
The cuts moved the company back toward the customers it started with. Ido said it would spend 'significantly less' on hospital products AWL41. Elevance, its largest client, renewed for three years, Florida Blue launched in January 2026, and the Defense Health Agency named Amwell in June 2026 as one of five vendors it intended to award sole-source contracts AWL3 AWL42 AWL51. Losses fell from $679.2 million in 2023 to $95.0 million in 2025 AWL48 AWL1.
The business that came out was smaller than the one that went public. Revenue was $249.3 million in 2025 and was guided to $200 million to $205 million for 2026, below 2020 AWL1 AWL22. On September 25, 2026 Amwell was worth about $228 million AWL38. Ido described it as 'the infrastructure for AI-powered care programs' AWL23.
Rivals Teladoc had $2.53 billion of revenue in 2025, $1.58 billion of it from Integrated Care sold to employers, plans and health systems and the rest from BetterHelp's consumer therapy AWL59.
Key dates
- 2006-06American Well incorporated AWE13
- 2009-01HMSA opens Online Care to all of Hawaii AWE5
- 2012Online Care Group founded AWE44
- 2013-10Consumer app launches at $49 a visit AWE7
- 2014-12$80M Series C with Anthem as investor AWE37
- 2015-06Sues Teladoc over patents; dismissed 2016 AWE33 AWE31
- 2018-04Buys Avizia AWE21
- 2019$148.9M revenue Full year; $88.4M net loss AWE13
- 2020$245.3M revenue Full year, +65%; 5.9M visits AWL46
- 2020-09IPO raises $742M; worth about $5.2B on day one AWL6 AWL7
- 2021-04Converge announced AWL28
- 2021-07Buys SilverCloud and Conversa for about $320M AWL9
- 2022$277.2M revenue Full year, peak; $272.1M net loss AWL19
- 2023$679.2M net loss Includes $436.5M of impairments; revenue $259.0M AWL48
- 2024-07One-for-20 reverse stock split AWL10
- 2025$249.3M revenue Full year; $95.0M net loss AWL1
- 2025$2,530.0M revenue Teladoc, full year AWL59
- 2025-01Psychiatric care unit sold to Avel eCare AWL24
- 2026-09$228M market value September 25 AWL38
Sources
Oldest first.
- AWE6 American Well and Microsoft Enter Into a Strategic Collaboration to Bring Healthcare to People's Homes. Company release
- AWE5 Hawaii debuts new Online Care service for all residents. Trade press
- AWE28 Hageseth conviction reveals telemedicine practice flaws. Trade press
- AWE23 Blue Cross and Blue Shield of Minnesota and American Well Join to Bring Online Care to Minnesota. Company release
- AWE24 American Well opens 'virtual clinic' in Minnesota. Trade press
- AWE27 Doctor gets jail time for online, out-of-state prescribing. Trade press
- AWE1 MassDevice Q&A: American Well CEO Roy Schoenberg. Founder interview
- AWE9 American Well: The Doctor Will E-See You Now (HBS 510061) and American Well: The DTC Decision (HBS). Outside analysis
- AWE25 American Well Launches Online Care Team Edition. Company release
- AWE29 Telehealth and Medicare: Payment Policy, Current Use, and Prospects for Growth. Outside analysis
- AWE8 Direct to consumer mobile video visits with physicians now available in 44 states. Trade press
- AWE7 American Well Debuts Consumer-Direct Doctor Visits via Mobile Devices. Company release
- AWE39 Solving Problems in Healthcare IT for Two Decades: Serial Entrepreneur and American Well CEO Ido Schoenberg (Parts 1-7). Founder interview
- AWE2 Telehealth: Roy Schoenberg, CEO of American Well, Speaks with David Harlow. Founder interview
- AWE10 American Well's latest funding caps big year for telehealth startups. Trade press
- AWE37 Leading Financial and Healthcare Institutions Become Equity Partners in American Well. Company release
- AWE36 8 key thoughts about telehealth from American Well CEO Roy Schoenberg. Founder interview
- AWE40 UnitedHealthcare now covers Doctor On Demand, American Well video visits too. Trade press
- AWE3 HIStalk Practice Interviews Roy Schoenberg, MD, CEO, American Well. Founder interview
- AWE34 American Well sues Teladoc over telehealth IP. Trade press
- AWE33 American Well Asserts its Intellectual Property Rights. Company release
- AWE35 Can telehealth be protected by a patent?. Trade press
- AWE48 Teladoc, Inc. Form S-1/A. SEC filing
- AWE16 Deconstructing the Teladoc IPO and S-1. Outside analysis
- AWE44 American Well Appoints Peter Antall, MD as its First Chief Medical Officer. Company release
- AWE45 American Well and Doximity Building Healthcare Workforce of the Future: The Online Doctor. Company release
- AWE26 Cleveland Clinic and CVS strike deal to deploy American Well telemedicine platform. Trade press
- AWE32 American Well CEO: For telehealth, 2016 will be the year we all remember. Founder interview
- AWE15 Connecting patients to 'the essence of healthcare:' 8 questions with American Well CEO Dr. Roy Schoenberg. Founder interview
- AWE38 Most Employers Paying For Doctor Telemedicine Visits. Trade press
- AWE42 Cerner and American Well partner to tie EHR to telehealth tools. Trade press
- AWE47 American Well CEO: Telehealth can bridge gap between supply and demand. Trade press
- AWE31 10 things to know about American Well. Trade press
- AWE41 From EHRecords to EHDelivery: Talking With Dr. Roy Schoenberg of American Well. Founder interview
- AWE17 Telehealth firms set sights on hospital system market. Trade press
- AWE30 American Well Takes Telehealth Global With New Backers Philips And Allianz. Trade press
- AWE46 Telehealth: Clear use, questionable ROI. Trade press
- AWE21 American Well Moves Into Hospital-Based Telehealth With Avizia Deal. Trade press
- AWE11 American Well Raises $290M+ to Go Bigger in Telehealth. Trade press
- AWE20 American Well scores $290M, with possibility of more to come. Trade press
- AWE22 In 2 months, telehealth company American Well raised $365M. Trade press
- AWE18 'Telehealth is a digital distribution channel for health care' - catching up with Roy Schoenberg. Founder interview
- AWE50 Amwell - Healthy Business, Healthy Stock?. Outside analysis
- AWE43 Teladoc Health Acquires InTouch Health, Signify View. Outside analysis
- AWL58 Teladoc Health Reports Fourth-Quarter and Full-Year 2019 Results. Company release
- AWL49 Diving into telehealth: interviews with executives at Teladoc, Amwell and Doctor on Demand. Executive interview
- AWE12 Amwell files to go public with $100M boost from Google. Trade press
- AWE13 American Well Corporation Form S-1. SEC filing
- AWL4 Google to invest $100 million in Amwell at IPO in cloud deal. Trade press
- AWL53 Amwell Form S-1 (Aug 2020). SEC filing
- AWL25 Telehealth Race Kicks Into Gear As Amwell IPO Cashes In On Coronavirus Boom. Executive interview
- AWL26 After expanding its IPO, Amwell is set to start trading. Trade press
- AWL7 Amwell's stock pops 28 percent in public market debut. Trade press
- AWL6 Telehealth company Amwell spikes in public debut with outsized $742M IPO. Trade press
- AWL43 Teladoc sues Amwell, alleging patent infringement. Trade press
- AWE19 Amwell, the 'Intel Inside' Telehealth Company. Executive interview
- AWL55 In first report since IPO, Amwell sees revenue up 80% year over year. Trade press
- AWE4 The Past, Present, and Future of Telehealth: A Conversation with Amwell Co-CEO Ido Schoenberg. Founder interview
- AWL54 How does Amwell make money?. Outside analysis
- AWE14 American Well Corporation Form 10-K for 2020. SEC filing
- AWL46 Amwell Announces Results for Fourth Quarter and Full Year 2020. Company release
- AWL30 American Well Corporation (AMWL) Q4 2020 Earnings Call Transcript. Earnings call
- AWL56 Amwell reveals 65% revenue growth in 2020. Trade press
- AWL31 Amwell co-CEO to Amazon on telehealth play: 'Welcome to the swamp'. Trade press
- AWL8 Amwell scoops up 2 digital health companies for $320M as tech M&A heats up. Trade press
- AWL9 Amwell Enhances Virtual Care Platform with Two Acquisitions: SilverCloud Health and Conversa Health. Company release
- AWL34 With Amwell's deal, the acquisition race heats up in telehealth. Trade press
- AWL57 Better Buy: Teladoc vs. Amwell. Outside analysis
- AWL47 Amwell Announces Results for Fourth Quarter 2021 and Full Year 2021. Company release
- AWL18 Amwell posts $177M net loss for 2021. Trade press
- AWL28 Hospital Telehealth Vendor Financials Round-Up: Teladoc Health, Amwell, SOC Telemed. Outside analysis
- AWL44 Teladoc, Amwell settle remote health tech patent suit. Trade press
- AWE52 Episode #141: Completely Rethinking the Way Healthcare Happens (Roy Schoenberg). Founder interview
- AWL19 Amwell Announces Results for Fourth Quarter and Full Year 2022. Company release
- AWL39 KLAS: Amwell, Teladoc Health, Caregility Most Chosen Vendors. Outside analysis
- AWL14 Telehealth company Amwell hit with $330M impairment charge as share price declines. Trade press
- AWL13 Amwell scores major deal with Defense Health Agency, but stock slides as losses grow. Trade press
- AWL15 Amwell cut headcount by 10% since end of 2023. Trade press
- AWL35 Amwell posts $679M loss for the year but plots accelerated growth in 2025, boosted by major defense contract. Trade press
- AWL48 AMWELL ANNOUNCES RESULTS FOR FOURTH QUARTER AND FULL YEAR 2023. Company release
- AWL27 Opinion: Further thoughts on Teladoc, Amwell, and the future of telehealth-what happens next?. Outside analysis
- AWL29 How telehealth giant Amwell went from stock market darling to dud. Outside analysis
- AWL12 Amwell Appoints Roy Schoenberg to Executive Vice Chairman. Trade press
- AWL10 Amwell to implement reverse stock split to avoid delisting. Trade press
- AWL33 Digital healthcare company Amwell cut more than 100 jobs. Trade press
- AWL32 Amwell taps ex-Teladoc exec as CFO. Trade press
- AWE51 Case Analysis - American Well: The Doctor Will E-See You Now. Outside analysis
- AWL24 Amwell divests virtual psychiatric care business to Avel eCare in all-cash transaction. Company release
- AWL36 AMWELL ANNOUNCES RESULTS FOR FOURTH QUARTER AND FULL YEAR 2024. Company release
- AWL21 Amwell touts military contract deployment wins in Q4. Trade press
- AWL20 Amwell adapts to market cost cutting, beats revenue projections in Q2. Trade press
- AWL41 Amwell mulls divestitures. Trade press
- AWL50 Earnings call transcript: AmWell's Q3 2025 sees revenue drop, AI focus. Earnings call
- AWL1 AMWELL ANNOUNCES RESULTS FOR FOURTH QUARTER AND FULL YEAR 2025. Company release
- AWL3 Earnings call transcript: Amwell's Q4 2025 revenue declines, stock rises. Earnings call
- AWL42 American Well Corp SEC 10-K Report (FY2025). SEC filing
- AWL2 Amwell expects lower revenue in 2026. Trade press
- AWL59 Teladoc Health 2025 Form 10-K. SEC filing
- AWL37 Amwell boasts higher than expected renewals, retention despite Q1 revenue decline. Trade press
- AWL11 Amazon taps Amwell co-founder to lead health business. Trade press
- AWL16 American Well (AMWL) Market Cap & Net Worth. Outside analysis
- AWL22 Amwell Announces Results for the Second Quarter 2026. Company release
- AWL23 Earnings call transcript: Amwell beats Q2 2026 estimates, shares rise after hours. Earnings call
- AWL51 Amwell deepens partnership with Defense Health Agency, boosts 2026 revenue outlook. Trade press
- AWL17 American Well (AMWL) - Market capitalization. Outside analysis
- AWL38 American Well (AMWL) Stock Price & Overview. Outside analysis
- AWL40 Amwell (company). Outside analysis
- AWL52 American Well Extends Elevance Health Digital Care Partnership. Trade press