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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. 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. 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. 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. 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
  5. 5 · 2024–26Cut back to a smaller software business$249.3M revenue in 2025, about a tenth of Teladoc's; worth about $228M in September 2026.Resource allocation

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

Health plans and their members · 2006 · United States

Regulatory constraints

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.

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.

Founder Domain ExpertiseDistribution Partnerships

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.

Distribution PartnershipsComponent Specialization

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.

M&A StrategyMulti-Product

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.

Resource allocation

Key dates

  1. 2006-06American Well incorporated AWE13
  2. 2009-01HMSA opens Online Care to all of Hawaii AWE5
  3. 2012Online Care Group founded AWE44
  4. 2013-10Consumer app launches at $49 a visit AWE7
  5. 2014-12$80M Series C with Anthem as investor AWE37
  6. 2015-06Sues Teladoc over patents; dismissed 2016 AWE33 AWE31
  7. 2018-04Buys Avizia AWE21
  8. 2019$148.9M revenue Full year; $88.4M net loss AWE13
  9. 2020$245.3M revenue Full year, +65%; 5.9M visits AWL46
  10. 2020-09IPO raises $742M; worth about $5.2B on day one AWL6 AWL7
  11. 2021-04Converge announced AWL28
  12. 2021-07Buys SilverCloud and Conversa for about $320M AWL9
  13. 2022$277.2M revenue Full year, peak; $272.1M net loss AWL19
  14. 2023$679.2M net loss Includes $436.5M of impairments; revenue $259.0M AWL48
  15. 2024-07One-for-20 reverse stock split AWL10
  16. 2025$249.3M revenue Full year; $95.0M net loss AWL1
  17. 2025$2,530.0M revenue Teladoc, full year AWL59
  18. 2025-01Psychiatric care unit sold to Avel eCare AWL24
  19. 2026-09$228M market value September 25 AWL38

Sources

Oldest first.

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  3. AWE28 Hageseth conviction reveals telemedicine practice flaws. BizWest (Northern Colorado Business Report) · 2009-03-26 Trade press
  4. AWE23 Blue Cross and Blue Shield of Minnesota and American Well Join to Bring Online Care to Minnesota. American Well · 2009-04-13 Company release
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