0000950170-25-019024 | 10-K | XBRL Viewer

Subsequent Events	12 Months Ended
Dec. 31, 2024
Subsequent Events [Abstract]
Subsequent Events	20. Subsequent Events On January 8, 2025, Amwell entered into and closed on an asset purchase agreement relating to the sale of all property and assets owned, leased or licensed by Amwell's wholly owned subsidiary, Aligned Telehealth, LLC ("Aligned"), and affiliated clinical partner, Asana Integrated Medical Group ("Asana" and together with Aligned, "APC"), which are primarily used or held for use in connection with the APC Business, subject to certain specified exclusions such as cash. In connection with such purchase and sale, the buyer assumed specified contracts and the related accounts receivable and all accounts payable and accrued expenses of the APC Business. The purchase price is comprised of (i) an upfront cash payment of $20,714, which is equal to 1.1x the APC Business’ trailing twelve-month revenue, excluding on-site revenue attributable to certain of the APC Business’ contracts, subject to customary adjustments and (ii) an additional cash payment (the “Additional Payment”) equal to 0.4x the buyer and its affiliates’ aggregate revenues arising from the provision of the APC Business to current customers and potential customers in the sales pipeline during the twelve-month period immediately following the closing, excluding revenues arising from the provision of on-site psychiatric services to certain of the APC Business’ contracts and other specified revenues, which Additional Payment is payable within ten days following the final determination of the Additional Payment amount. If the buyer experiences certain change-of-control events during the twelve-month period immediately following the closing or if the buyer fails to pay the Additional Payment (“Acceleration Event”), Amwell may elect to receive an amount equal to 0.4x the buyer and its affiliates’ aggregate revenues arising from the provision of the APC Business to current customers and potential customers in the sales pipeline of APC during the twelve-month period ending on the last day of the month immediately preceding the month in which the applicable Acceleration Event occurs.

Subsequent Events

12 Months Ended

Dec. 31, 2024

20. Subsequent Events

On January 8, 2025, Amwell entered into and closed on an asset purchase agreement relating to the sale of all property and assets owned, leased or licensed by Amwell's wholly owned subsidiary, Aligned Telehealth, LLC ("Aligned"), and affiliated clinical partner, Asana Integrated Medical Group ("Asana" and together with Aligned, "APC"), which are primarily used or held for use in connection with the APC Business, subject to certain specified exclusions such as cash.

In connection with such purchase and sale, the buyer assumed specified contracts and the related accounts receivable and all accounts payable and accrued expenses of the APC Business. The purchase price is comprised of (i) an upfront cash payment of $20,714, which is equal to 1.1x the APC Business’ trailing twelve-month revenue, excluding on-site revenue attributable to certain of the APC Business’ contracts, subject to customary adjustments and (ii) an additional cash payment (the “Additional Payment”) equal to 0.4x the buyer and its affiliates’ aggregate revenues arising from the provision of the APC Business to current customers and potential customers in the sales pipeline during the twelve-month period immediately following the closing, excluding revenues arising from the provision of on-site psychiatric services to certain of the APC Business’ contracts and other specified revenues, which Additional Payment is payable within ten days following the final determination of the Additional Payment amount. If the buyer experiences certain change-of-control events during the twelve-month period immediately following the closing or if the buyer fails to pay the Additional Payment (“Acceleration Event”), Amwell may elect to receive an amount equal to 0.4x the buyer and its affiliates’ aggregate revenues arising from the provision of the APC Business to current customers and potential customers in the sales pipeline of APC during the twelve-month period ending on the last day of the month immediately preceding the month in which the applicable Acceleration Event occurs.

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2024

Commitments and Contingencies Disclosure [Abstract]

Summary of Lease Cost


	Years Ended December 31,
	2024		2023		2022
The components of lease cost under ASC 842 were as follows:
Operating lease cost	$	3,390	$	3,495	$	3,694
Short-term lease cost		—		—		—
Variable lease cost		—		—		—
Total lease cost	$	3,390	$	3,495	$	3,694


	Years Ended December 31,
	2024		2023		2022
Supplemental cash flow information:
Cash paid for amounts included in measurement of lease liabilities:
Operating cash flows from operating leases	$	3,690	$	3,527	$	2,672
Non-cash lease activity:
Right-of-use lease assets obtained in exchange for new operating lease liability:
Operating leases	$	—	$	—	$	851


	As of December 31,
	2024			2023
Supplemental balance sheet information related to leases is as follows:
Operating leases
Operating lease right-of-use assets	$	7,203		$	10,453
Total operating right-of-use lease assets	$	7,203		$	10,453
Operating lease liabilities, current		3,690			3,580
Operating lease liabilities, net of current portion		4,511			8,206
Total operating lease liabilities	$	8,201		$	11,786
Weighted-average remaining lease term (in years)	2.2 years			3.2 years
Weighted-average discount rate		1.2	%		1.2	%

Summary of Minimum Future Lease Payments for These Operating Leases

As of December 31, 2024, minimum future lease payments for these operating leases were as follows:


Years ending December 31,
2025	3763
2026	3647
2027	893
2028		—
2029		—
Thereafter		—
Total lease payments	$	8,303
Less imputed interest		(102	)
Total present value of lease liabilities	$	8,201

Segment Information

12 Months Ended

Dec. 31, 2024

Segment Reporting [Abstract]

Segment Information

3. Segment Information

The Company operates and manages its business as one reportable and operating segment. The Company’s enterprise platform and software as a service solutions enable hybrid care delivery for our customers. The measure of segment assets is reported on the balance sheet as total consolidated assets. In addition, the Company derives revenue primarily in the United States and manages the business activities on a consolidated basis.

The Company generates revenues from the use of our enterprise platform and software as a service in the form of recurring subscription fees for use. We also generate revenue from the performance of patient visits and other related professional services and hardware sales. The accounting policies are the same as those described in the summary of significant accounting policies.

The Company’s chief operating decision maker (CODM), its Chief Executive Officer, reviews financial information presented on a consolidated basis and decides how to allocate resources based on net loss. Consolidated net loss is used for evaluating financial performance. The monitoring of budgeted versus actual results are used in assessing performance of the Company and in establishing management’s compensation.

The significant expense categories and amounts align with information that is regularly provided to the CODM. Significant segment expenses, which represent the difference between revenue and net loss, consist of the following:


	Years Ended December 31,
	2024		2023		2022
Employee compensation		192,812		202,380		197,183
Consulting costs		24,267		43,135		68,433
Provider cost		69,538		72,000		73,254
Stock-based compensation expense		47,505		72,040		69,144
Other segment expense items (1)		137,776		561,635		145,029
Total costs and operating expenses		471,898		951,190		553,043

(1) Other segment expense items primarily include hosting, hardware, corporate compliance, severance, strategic transformation costs, amortization, depreciation, bad debt, goodwill impairment and overhead expenses.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2024	Jan. 31, 2025	Jun. 30, 2024
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Trading Symbol	AMWL
Entity Registrant Name	American Well Corporation
Entity Central Index Key	0001393584
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Document Annual Report	true
Document Transition Report	false
ICFR Auditor Attestation Flag	true
Security Exchange Name	NYSE
Title of 12(b) Security	Class A common stock, par value of $0.01 per share
Entity File Number	001-39515
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-5009396
Entity Address, Address Line One	75 State Street
Entity Address, Address Line Two	26th Floor
Entity Address, City or Town	Boston
Document Financial Statement Error Correction [Flag]	false
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02109
City Area Code	617
Local Phone Number	204-3500
Entity Public Float			$ 81
Auditor Firm ID	238
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Boston, Massachusetts, United States
Documents Incorporated by Reference	The Registrant intends to file a definitive proxy statement pursuant to Regulation 14A relating to the 2025 Annual Meeting of Stockholders within 120 days of the end of the Registrant’s fiscal year ended December 31, 2024 ("Definitive Proxy Statement"). Portions of such definitive proxy statement are incorporated by reference into Part III of this Annual Report on Form 10-K to the extent stated herein.
Auditor Opinion	Opinions on the Financial Statements and Internal Control over Financial Reporting We have audited the accompanying consolidated balance sheets of American Well Corporation and its subsidiaries (the “Company”) as of December 31, 2024 and 2023, and the related consolidated statements of operations and comprehensive loss, of stockholders’ equity and of cash flows for each of the three years in the period ended December 31, 2024, including the related notes (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2024 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.
Common Class A [Member]
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		13,962,695
Common Class B [Member]
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		1,369,518
Common Class C [Member]
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		277,777

Commitments and Contingencies - Summary of Lease Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
The components of lease cost under ASC 842 were as follows:
Operating lease cost	$ 3,390	$ 3,495	$ 3,694
Total lease cost	3,390	3,495	3,694
Cash paid for amounts included in measurement of lease liabilities:
Operating cash flows from operating leases	3,690	3,527	2,672
Right-of-use lease assets obtained in exchange for new operating lease liability:
Operating leases		0	851
Operating leases
Operating lease right-of-use assets	7,203	10,453
Operating lease liability, current	3,690	3,580
Operating lease liability, net of current portion	4,511	8,206
Total operating lease liabilities	$ 8,201	$ 11,786	$ 8,201
Weighted-average remaining lease term (in years)	2 years 2 months 12 days	3 years 2 months 12 days
Weighted-average discount rate	1.20%	1.20%

Stockholders' Equity - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Sep. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Preferred stock authorized	100,000,000	100,000,000		100,000,000
Preferred stock per share	$ 0.01	$ 0.01		$ 0.01
Dividends Declared	$ 0
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock authorized	1,300,000,000
Common stock reserve for issuance	4,622,750	3,725,304
Exercise of common stock options		$ 569,000	$ 5,666,000
Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Exercise of common stock options			$ 1,000
Exercise of common stock options, Shares		14,329	134,515
Restricted Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fair value of stock granted	$ 37,010,000	$ 39,419,000	$ 63,987,000
Aggregate intrinsic value of restricted stock units vested	$ 13,744,000	18,773,000	22,218,000
Restricted Stock Units (RSUs) [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Cancelled shares	422,319
Shares issued	595,462
Shares, granted	1,903,463
Performance-based Market Condition Share Awards [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Fair value of stock granted		5,805,000	63,157,000
Shares, granted	0
2020 Equity Incentive Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock option vesting period	4 years
Stock option expiration period	10 years
Shares available for grant	771,730
Aggregate intrinsic value of stock options exercised	$ 0	$ 206,000	$ 5,167,000
Stock options, granted	0	0	0
Exercise of common stock options		$ 569,000	$ 5,740,000
Exercise of common stock options, Shares	0
2020 Employee Stock Purchase Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation arrangement by share-based payment award, discount from market price, purchase date	85.00%
Shares, issued under ESPP	115,527	61,216	35,168
Shares available for issuance	329,741
Equity Award Plan [Member] \| Common Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized stock-based compensation	$ 29,672,000
Weighted-average period	1 year 10 months 24 days
Conversa [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate merger consideration, shares			1,000,000
Common stock fair value per share			$ 4.21
Silver Cloud Health Holdings, Inc. [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate merger consideration, shares			5,000,000
Common stock fair value per share			$ 2.61
Common Class A [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock per share	$ 0.01	$ 0.01		$ 0.01
Common stock authorized	1,000,000,000	1,000,000,000		1,000,000,000
Common stock, voting rights	one
Common stock per share	$ 139
Common Class A [Member] \| SilverCloud Bonus Escrow [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares related to early settlement of bonus escrow			600,000
Common Class C [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock per share	$ 0.01	$ 0.01		$ 0.01
Common stock authorized	200,000,000	200,000,000		200,000,000
Common stock, voting rights	one
Common stock per share	$ 3
Common Class B [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock per share	$ 0.01	$ 0.01		$ 0.01
Common stock authorized	100,000,000	100,000,000		100,000,000
Common stock, voting rights	(x) 1.0408163 and (y) the total number of votes that would be cast at such time by the holders of the Class A and Class C common stock and any other preferred stock entitled to vote under the certificate of incorporation at such time (resulting in the Class B common stock collectively holding 51% of the total outstanding voting power)
Number of shares converted	0
Common stock per share	$ 14

Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue
($3,165, $3,859 and $4,544 from related parties, respectively)	$ 254,364	$ 259,047	$ 277,190
Costs and operating expenses:
Costs of revenue, excluding depreciation and amortization of intangible assets	155,412	164,287	160,422
Research and development	86,065	105,827	138,487
Sales and marketing	76,272	86,460	81,628
General and administrative	121,174	126,645	146,353
Depreciation and amortization expense	32,975	31,492	26,153
Goodwill impairment	0	436,479
Total costs and operating expenses	471,898	951,190	553,043
Loss from operations	(217,534)	(692,143)	(275,853)
Interest income and other income (expense), net	10,757	19,422	6,123
Loss before expense from income taxes and loss from equity method investment	(206,777)	(672,721)	(269,730)
Expense from income taxes	(2,751)	(3,860)	(64)
Loss from equity method investment	(3,110)	(2,590)	(2,278)
Net loss	(212,638)	(679,171)	(272,072)
Net loss attributable to non-controlling interest	(4,495)	(4,007)	(1,643)
Net loss attributable to American Well Corporation	$ (208,143)	$ (675,164)	$ (270,429)
Net loss per share attributable to common stockholders, basic	$ (13.88)	$ (47.5)	$ (19.72)
Net loss per share attributable to common stockholders, diluted	$ (13.88)	$ (47.5)	$ (19.72)
Weighted-average common shares outstanding, basic	14,999,590	14,212,505	13,712,290
Weighted-average common shares outstanding, diluted	14,999,590	14,212,505	13,712,290
Net loss	$ (212,638)	$ (679,171)	$ (272,072)
Other comprehensive income (loss), net of tax:
Foreign currency translation	(190)	1,319	(10,616)
Comprehensive loss	(212,828)	(677,852)	(282,688)
Less: Comprehensive loss attributable to non-controlling interest	(4,495)	(4,007)	(1,643)
Comprehensive loss attributable to American Well Corporation	$ (208,333)	$ (673,845)	$ (281,045)

Goodwill and Intangible Assets - Schedule of finite lived Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 223,367	$ 210,810
Accumulated Amortization	(121,829)	(90,562)
Carrying Value	101,538	120,248
Customer relationships [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	80,437	80,558
Accumulated Amortization	(41,199)	(33,109)
Carrying Value	$ 39,238	$ 47,449
Weighted Average Remaining Life	5 years 8 months 12 days	6 years 6 months
Contractor relationships [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 535	$ 535
Accumulated Amortization	(370)	(329)
Carrying Value	$ 165	$ 206
Weighted Average Remaining Life	4 years	5 years
Trade name [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 13,731	$ 14,303
Accumulated Amortization	(7,404)	(5,389)
Carrying Value	$ 6,327	$ 8,914
Weighted Average Remaining Life	3 years 2 months 12 days	4 years 1 month 6 days
Technology [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 88,350	$ 90,204
Accumulated Amortization	(58,606)	(45,482)
Carrying Value	$ 29,744	$ 44,722
Weighted Average Remaining Life	2 years 4 months 24 days	3 years 3 months 18 days
Internally developed software [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 40,314	$ 25,210
Accumulated Amortization	(14,250)	(6,253)
Carrying Value	$ 26,064	$ 18,957
Weighted Average Remaining Life	3 years 8 months 12 days	2 years 4 months 24 days

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2024 USD ($) Segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2020 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Gain (losses) from foreign currency remeasurement and settlement	$ 0	$ (11,000)	$ (377,000)
Number of reportable segment \| Segment	1
Number of operating segment \| Segment	1
Letter of credit, Total	$ 795,000	795,000
Restricted cash, noncurrent	795,000	795,000
Investments in a continuous unrealized loss position for more than twelve months	0	0
Impairment of intangible assets	0	0	0
Impairment of long-lived assets	0
Impairment charges	0	0	0
Payment to acquire interest in joint venture	3,430,000	3,920,000	1,960,000
Share of loss in operations of joint venture	3,110,000	2,590,000	2,278,000
Advertising expenses	3,935,000	5,508,000	6,607,000
Impairment losses	0
Impairment charges related to capitalized software development costs	$ 0	0	0
Percentage of uncertain income taxes to be realized for recognizing in the income statement	50.00%
Variable Interest Entity, Primary Beneficiary [Member] \| CCACV JV LLC [Member]
Summary Of Significant Accounting Policies [Line Items]
Payment to acquire interest in joint venture				$ 2,940,000
Percentage of ownership interest in joint venture				49.00%
Estimated additional total capital contributions necessary				$ 11,800,000
Additional capital contribution related to portion of phase one capital commitment	$ 3,430,000	3,920,000	1,960,000
Share of loss in operations of joint venture	3,110,000	2,590,000	$ 2,278,000
Equity method investment carrying value	$ 1,500,000	$ 1,180,000
Computer Software [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	3 years
Furniture and Fixtures [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	3 years
Office Equipment [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	3 years
Software Development Costs [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	3 years
Customer Concentration Risk \| Accounts Receivable [Member] \| Related Party Client One [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of net total revenue	47.00%	40.00%
Customer Concentration Risk \| Accounts Receivable [Member] \| Related Party Client Two [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of net total revenue	13.00%
Customer Concentration Risk \| Revenue Benchmark [Member] \| Related Party Client One [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of net total revenue	27.00%	24.00%	23.00%
Minimum [Member] \| Software Development [Member]
Summary Of Significant Accounting Policies [Line Items]
Finite-lived intangible asset, useful life	3 years
Minimum [Member] \| Computer Equipment [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	3 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Percentage of economic or ownership interest in consolidated entities	100.00%
Maximum [Member] \| Software Development [Member]
Summary Of Significant Accounting Policies [Line Items]
Finite-lived intangible asset, useful life	5 years
Maximum [Member] \| Computer Equipment [Member]
Summary Of Significant Accounting Policies [Line Items]
Property and equipment useful life	4 years

Accrued Expenses (Tables)

12 Months Ended

Dec. 31, 2024

Payables and Accruals [Abstract]

Summary of Accrued Expenses

Accrued expenses consist of the following:


	As of December 31,
	2024		2023
Employee compensation and benefits	$	25,988	$	15,573
Professional services		3,791		3,838
Provider services		9,461		7,437
Other		10,086		12,140
Total	$	49,326	$	38,988

Fair Value Measurements - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Transfer from level one to level two fair value assets	$ 0	$ 0
Transfer from level one to level three fair value assets	0	0
Transfer from level two to level one fair value assets	0	0
Transfer from level three to level one fair value assets	0	0
Interest income	$ 11,770,000	$ 9,306,000	$ 4,957,000

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2024

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

Property and equipment, net consisted of the following:


	As of December 31,
	2024			2023
Furniture and fixtures	$	229		$	232
Computer and office equipment		7,440			7,322
Computer software		5,110			5,125
Leasehold improvements		685			692
		13,464			13,371
Less: Accumulated depreciation and amortization		(13,088	)		(12,799	)
Property and equipment, net	$	376		$	572

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2024

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

Goodwill consisted of the following as of:


	December 31,
	2024		2023
Beginning Balance as of January 1	$	—	$	435,279
Purchase accounting adjustment		—		—
Goodwill Impairment		—		(436,479	)
Currency translation adjustments		—		1,200
Ending Balance	$	—	$	—

Schedule of Finite-Lived Intangible Assets

Identified intangible assets consisted of the following as of:


	Gross Amount		Accumulated Amortization			Carrying Value		Weighted Average Remaining Life
December 31, 2024
Customer relationships	$	80,437	$	(41,199	)		39,238		5.7
Contractor relationships		535		(370	)		165		4.0
Trade name		13,731		(7,404	)		6,327		3.2
Technology		88,350		(58,606	)		29,744		2.4
Internally developed software		40,314		(14,250	)		26,064		3.7
	$	223,367	$	(121,829	)	$	101,538

	Gross Amount		Accumulated Amortization			Carrying Value		Weighted Average Remaining Life
December 31, 2023
Customer relationships	$	80,558	$	(33,109	)		47,449		6.5
Contractor relationships		535		(329	)		206		5.0
Trade name		14,303		(5,389	)		8,914		4.1
Technology		90,204		(45,482	)		44,722		3.3
Internally developed software		25,210		(6,253	)		18,957		2.4
	$	210,810	$	(90,562	)	$	120,248

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense

Estimated future amortization expense of the identified intangible assets as of December 31, 2024, is as follows:


2025	$	34,978
2026	$	25,121
2027	$	14,526
2028	$	12,063
2029	$	7,428
Thereafter	$	7,422
		101,538

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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-Paragraph 1
-Subparagraph (h)
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

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-Section 50
-Paragraph 1
-Subparagraph (b)
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

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Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1A

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-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-2

+ Details

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2024

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

11. Goodwill and Intangible Assets

Goodwill consisted of the following as of:


	December 31,
	2024		2023
Beginning Balance as of January 1	$	—	$	435,279
Purchase accounting adjustment		—		—
Goodwill Impairment		—		(436,479	)
Currency translation adjustments		—		1,200
Ending Balance	$	—	$	—

2023 Goodwill Impairment

In the third quarter of 2023, the Company experienced triggering events, due to sustained decreases in the Company's publicly quoted share price and market capitalization, prompting impairment assessments of goodwill and long-lived assets including definite-lived intangibles. As such, the Company assessed the definite-lived intangible assets or other long-lived assets for impairment by performing an undiscounted cash flow analysis to establish fair value. The significant estimates used in fair value methodology, which are based on Level 3 inputs, include the Company's expectations for future operations and projected cash flows, including revenue, gross margin and operating expenses. The assessment did not result in an impairment of definite-lived intangible assets or other long-lived assets, as they passed the recoverability test. No triggering events were identified in the fourth quarter of 2023.

The Company also identified indicators of goodwill impairment for the single reporting unit which required an interim goodwill impairment assessment in each of the three quarters. In performing the quantitative assessment of goodwill, our reporting unit’s carrying amount exceeded its fair value. The Company estimated the reporting unit's fair value based on the market capitalization and a related control premium of 30% (amount paid by a new controlling shareholder for the benefits resulting from synergies and other potential benefits derived from controlling the acquired company). The Company evaluates the implied control premium or discount by comparing it to control premiums or discounts of recent comparable market transactions, as applicable. As a result of the interim quantitative impairment assessments, the Company recorded $436,479 non-deductible, of non-cash goodwill impairment charges for the year ended December 31, 2023. The goodwill balance as of December 31, 2023 is $0.

Identified intangible assets consisted of the following as of:


	Gross Amount		Accumulated Amortization			Carrying Value		Weighted Average Remaining Life
December 31, 2024
Customer relationships	$	80,437	$	(41,199	)		39,238		5.7
Contractor relationships		535		(370	)		165		4.0
Trade name		13,731		(7,404	)		6,327		3.2
Technology		88,350		(58,606	)		29,744		2.4
Internally developed software		40,314		(14,250	)		26,064		3.7
	$	223,367	$	(121,829	)	$	101,538

	Gross Amount		Accumulated Amortization			Carrying Value		Weighted Average Remaining Life
December 31, 2023
Customer relationships	$	80,558	$	(33,109	)		47,449		6.5
Contractor relationships		535		(329	)		206		5.0
Trade name		14,303		(5,389	)		8,914		4.1
Technology		90,204		(45,482	)		44,722		3.3
Internally developed software		25,210		(6,253	)		18,957		2.4
	$	210,810	$	(90,562	)	$	120,248

The Company capitalized $15,103 and $15,056 of costs during the year ended December 31, 2024 and December 31, 2023, respectively, related to internally developed software to be sold as a service incurred during the application development stage and is amortizing these costs over the expected lives of the related technology. Amortization expense related to intangible assets for the years ended December 31, 2024, 2023 and 2022 was $32,660, $30,861 and $24,638, respectively.

Estimated future amortization expense of the identified intangible assets as of December 31, 2024, is as follows:


2025	$	34,978
2026	$	25,121
2027	$	14,526
2028	$	12,063
2029	$	7,428
Thereafter	$	7,422
		101,538

Segment Information - Additional Information (Detail)	12 Months Ended
Segment Information - Additional Information (Detail)	Dec. 31, 2024 Segment
Segment Reporting [Abstract]
Number of operating segment	1
Number of reportable segment	1
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	srt:ChiefExecutiveOfficerMember
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	Consolidated net loss is used for evaluating financial performance. The monitoring of budgeted versus actual results are used in assessing performance of the Company and in establishing management’s compensation.
Segment Reporting, Expense Information Used by CODM, Type [Extensible Enumeration]	Net loss

Fair Value Measurements

12 Months Ended

Dec. 31, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurements

7. Fair Value Measurements

Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable:

•

Level 1—Quoted prices in active markets for identical assets or liabilities.

•

Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data.

•

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques.

The following tables presents the Company’s fair value hierarchy for its assets and liabilities that are measured at fair value on a recurring basis and indicate the level within the fair value hierarchy of the valuation techniques the Company utilized to determine such fair value:


	December 31, 2024
	Level 1		Level 2		Level 3		Total
Money market funds	$	140,639	$	—	$	—	$	140,639
Total financial assets:	$	140,639	$	—	$	—	$	140,639


	December 31, 2023
	Level 1		Level 2		Level 3		Total
Money market funds	$	299,300	$	—	$	—	$	299,300
Total financial assets:	$	299,300	$	—	$	—	$	299,300

As of December 31, 2024 and 2023, the Company’s cash equivalents were invested in money market funds and were valued based on Level 1 inputs. During the years ended December 31, 2024 and 2023, there were no transfers between Level 1, Level 2 and Level 3. Interest income for the years ended December 31, 2024, 2023 and 2022 was $11,770, $9,306 and $4,957, respectively.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 107
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
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-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2E

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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

National Telehealth Network

12 Months Ended

Dec. 31, 2024

Equity Method Investments and Joint Ventures [Abstract]

National Telehealth Network

6. National Telehealth Network

In 2012, the Company and an affiliate of Elevance Health, Inc. formed NTN to expand the availability and adoption of telemedicine. The Company did not have a controlling financial interest in NTN, but it had the ability to exercise significance influence over the operating and financial policies of NTN. Therefore, the Company accounted for its investment in NTN using the equity method of accounting through December 31, 2015.

On January 1, 2016, the Company made an additional investment in NTN, which increased its ownership percentage above 50%. The Company also obtained the right to elect the Chairman of NTN who has the ability to cast the tie-breaking vote in all decisions. Therefore, on January 1, 2016, the Company obtained control over NTN and has the power to direct the activities that most significantly impact NTN’s economic performance. This step-acquisition was accounted for as a business combination and the results of the operations of NTN from January 1, 2016, have been included in the Company’s consolidated financial statements. However, because the Company owns less than 100% of NTN, the Company recognizes net income (loss) attributable to non-controlling interest in the consolidated statements of operations and comprehensive loss equal to the percentage of the ownership interest retained in NTN by the respective non-controlling party.

The proportionate share of the loss attributed to the non-controlling interest amounted to $4,495, $4,007 and $1,643 for the years ended December 31, 2024, 2023 and 2022, respectively. The carrying value of the non-controlling interest was $11,472 and $15,967 as of December 31, 2024 and 2023.

Revenue and Deferred Revenue - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue From Contract With Customer Line Items [Line Items]
Contract liability revenue recognized	$ 36,430	$ 40,595	$ 56,595
Transaction price allocated to remaining performance obligations	$ 143,529	217,736
Performance obligation percentage of transaction price to recognized in the next twelve months	74.00%
Accounts Receivable [Member]
Revenue From Contract With Customer Line Items [Line Items]
Unbilled accounts receivable	$ 13,628	$ 5,500

Commitments and Contingencies - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Lessee Lease Description [Line Items]
Operating Leases, Rent Expense	$ 3,746	$ 4,292	$ 4,967
Pending Litigation [Member]
Lessee Lease Description [Line Items]
Pending Claims Number	0	0
Indemnification Agreement [Member]
Lessee Lease Description [Line Items]
New Claims Filed, Number	0

Stockholders' Equity - Summary of Performance-based Market Condition Share Awards (Detail) - Performance-based Market Condition Share Awards [Member]	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Class of Stock [Line Items]
Unvested as of January 1, 2024	1,335,803
Shares, Granted	0
Shares, Cancelled/Forfeited	(559,923)
Unvested as of December 31, 2024	775,880
Weighted Average Grant Date Fair Value, Unvested as of January 1, 2024 \| $ / shares	$ 45.82
Weighted Average Grant Date Fair Value, Cancelled/Forfeited \| $ / shares	54.56
Weighted Average Grant Date Fair Value, Unvested as of December 31, 2024 \| $ / shares	$ 39.51

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 505
-SubTopic 10
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-Section 50
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

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-Topic 505
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-Section 50
-Paragraph 13
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
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-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

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-Topic 505
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Topic 505
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-Topic 505
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-Topic 210
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-Name Accounting Standards Codification
-Section S99
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-Topic 210
-SubTopic 10
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-Section S99
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 210
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-Name Accounting Standards Codification
-Section S99
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Section S99
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-03(i)(1))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479886/946-10-S99-3

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 10
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-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-03(i)(2)(i))
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-03(i)(2)(ii))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479886/946-10-S99-3

+ Details

Accrued Expenses - Summary of Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Employee compensation and benefits	$ 25,988	$ 15,573
Professional services	3,791	3,838
Provider services	9,461	7,437
Other	10,086	12,140
Total	$ 49,326	$ 38,988

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2024

Stockholders' Equity Note [Abstract]

Schedule of Common Stock

In the year ended December 31, 2024 no shares of Class B common stock were converted to Class A common stock. As of December 31, 2024 the par value of the Class A, Class B and Class C shares was $139, $14 and $3, respectively.


	Shares Authorized		Shares Issued		Shares Outstanding
Class A		1,000,000,000		13,922,877		13,922,877
Class B		100,000,000		1,369,518		1,369,518
Class C		200,000,000		277,777		277,777
		1,300,000,000		15,570,172		15,570,172

Activity under Plans

Activity under the Plans is as follows:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (Years)		Aggregate Intrinsic Value
Outstanding as of January 1, 2024		499,442		$	101.82		4.6	$	—
Forfeited		(66,892	)	$	95.91
Expired		(4,840	)	$	36.00
Outstanding as of December 31, 2024		427,710		$	103.49		3.7	$	—
Vested and expected to vest as of December 31, 2024		427,351		$	103.48		3.7	$	—
Options exercisable as of December 31, 2024		427,490		$	103.49		3.7	$	—

Summary of Unvested Restricted Stock Unit Activity

The following table summarizes the unvested restricted stock unit activity for the year ended December 31, 2024:


	Shares			Weighted Average Grant Date Fair Value
Unvested as of January 1, 2024		1,119,107		$	74.39
Granted		1,903,463			19.44
Vested		(1,031,080	)		46.04
Forfeited		(637,450	)		50.44
Unvested as of December 31, 2024		1,354,040		$	30.01

Summary of Performance-based Market Condition Share Awards


	Shares			Weighted Average Grant Date Fair Value
Unvested as of January 1, 2024		1,335,803		$	45.82
Granted		—			—
Vested		—			—
Cancelled/Forfeited		(559,923	)		54.56
Unvested as of December 31, 2024		775,880		$	39.51

Schedule of Weighted Average Assumptions used to Determine Estimated Fair Value of Performance-based Market Condition Share Awards Granted

The weighted average estimated fair value of the performance-based market condition share awards granted during the year ended December 31, 2024 and December 31, 2023 was determined using a Monte-Carlo valuation simulation, with the following most significant weighted-average assumptions:


	Years Ended December 31,
	2024	2023			2022
Risk-free rate	N/A		4.61	%		2.34	%
Term to end of performance period (yrs)	N/A	3 years			3 years
Weighted average valuation date stock price	N/A	$	2.76		$	3.50
Expected volatility	N/A		70	%		75	%
Expected dividend yield	N/A		0	%		0	%

Stock-Based Compensation Expense

Stock-based compensation expense was classified in the consolidated statements of operations and comprehensive loss as follows:


	Years Ended December 31,
	2024		2023		2022
Cost of revenues	$	1,470	$	1,681	$	1,605
Research and development		7,160		10,348		10,236
Selling and marketing		4,954		8,613		7,182
General and administrative		33,921		51,398		50,121
Total	$	47,505	$	72,040	$	69,144

- Definition

Tabular disclosure of an entity's stock, including par or stated value per share, number and dollar amount of share subscriptions, shares authorized, shares issued, shares outstanding, number and dollar amount of shares held in an employee trust, dividend per share, total dividends, share conversion features, par value plus additional paid in capital, the value of treasury stock and other information necessary to a fair presentation, and EPS information. Stock by class includes common, convertible, and preferred stocks which are not redeemable or redeemable solely at the option of the issuer. Includes preferred stock with redemption features that are solely within the control of the issuer and mandatorily redeemable stock if redemption is required to occur only upon liquidation or termination of the reporting entity. If more than one issue is outstanding, state the title of each issue and the corresponding dollar amount; dollar amount of any shares subscribed but unissued and the deduction of subscriptions receivable there from; number of shares authorized, issued, and outstanding.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(27))
-SubTopic 10
-Topic 210
-Publisher FASB
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-Subparagraph (SX 210.3-04)
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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
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-Name Accounting Standards Codification
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-SubTopic 10
-Section 45
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481142/505-10-45-2

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 10
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-10

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-Section S99
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-Topic 505
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-Topic 505
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-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-7

+ Details

Accrued Expenses

12 Months Ended

Dec. 31, 2024

Payables and Accruals [Abstract]

Accrued Expenses

12. Accrued Expenses

Accrued expenses consist of the following:


	As of December 31,
	2024		2023
Employee compensation and benefits	$	25,988	$	15,573
Professional services		3,791		3,838
Provider services		9,461		7,437
Other		10,086		12,140
Total	$	49,326	$	38,988

Fair Value Measurements - Fair Value of Assets and Liabilities Measured on Recurring Basis (Detail) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial assets	$ 140,639	$ 299,300
Money Market Funds [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial assets	140,639	299,300
Fair Value, Inputs, Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial assets	140,639	299,300
Fair Value, Inputs, Level 1 [Member] \| Money Market Funds [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial assets	$ 140,639	$ 299,300

Income Taxes - Summary of Components of Current and Deferred Portions of Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current income tax (provision) benefit:
Federal	$ (40)	$ (237)
State	(115)	(167)	$ (22)
Foreign	(2,847)	(3,614)	(3,256)
Total Current	(3,002)	(4,018)	(3,278)
Deferred income tax (provision) benefit:
Foreign	251	158	3,214
Total Deferred	251	158	3,214
Total provision for income taxes	$ (2,751)	$ (3,860)	$ (64)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 270
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (i)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Subparagraph (ee)
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

Reference 4: http://www.xbrl.org/2003/role/exampleRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 231
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482663/740-10-55-231

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-9

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-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.7)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479360/740-10-S99-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-8

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-10

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(9))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477250/944-220-S99-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Subparagraph (a)
-SubTopic 20
-Topic 740
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482659/740-20-45-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h))
-SubTopic 10
-Topic 235
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

+ Details

Allowance for Credit Losses (Tables)

12 Months Ended

Dec. 31, 2024

Receivables [Abstract]

Summary of Changes in the Allowance for Credit Losses

Changes in the allowance for credit losses were as follows:


	Years Ended December 31,
	2024			2023			2022
Allowance for credit losses, beginning of the period	$	2,291		$	1,884		$	1,809
Provisions		7,093			1,034			803
Write-offs		(2,148	)		(627	)		(728	)
Allowance for credit losses, end of the period	$	7,236		$	2,291		$	1,884

Net Loss per Share - Schedule of Antidilutive Securities Excluded From Computation of Earning Per Share (Detail) - shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	2,557,630	2,954,352	2,716,462
Unvested restricted stock units [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	1,354,040	1,119,107	884,350
Unvested Performance Market-based Stock Units [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	775,880	1,335,803	1,280,114
Employee Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	427,710	499,442	551,998

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (208,143)	$ (675,164)	$ (270,429)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-6

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-Publisher FASB
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478666/740-323-65-2

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(20))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483621/220-10-S99-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
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-Subparagraph (c)
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-Topic 825
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-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-28

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
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-Paragraph 6
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-URI https://asc.fasb.org/1943274/2147482765/220-10-50-6

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-Topic 815
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-Name Accounting Standards Codification
-Section 65
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+ Details

Income Taxes - Summary of Reconciliation of Federal Statutory Rate and Provision for Income Taxes (Detail)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Federal statutory income tax rate	21.00%	21.00%	21.00%
State taxes, net of federal benefit	0.00%	1.10%	3.70%
Valuation allowance	(20.40%)	(7.10%)	(18.50%)
Stock-based compensation	(2.30%)	(1.30%)	(5.10%)
Permanent differences	(2.00%)	(14.00%)	(0.70%)
Research and development credit	5.30%	0.00%	0.00%
Other	(2.90%)	(0.30%)	(0.40%)
Effective income tax rate	(1.30%)	(0.60%)

Organization and Description of Business

12 Months Ended

Dec. 31, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Description of Business

1. Organization and Description of Business

Description of Business

American Well Corporation (the “Company”) was incorporated under the laws of the State of Delaware in June 2006. The Company is headquartered in Boston, Massachusetts. The Company is a leading enterprise platform and software company that enables the digital distribution and delivery of care for healthcare’s key stakeholders. The Company’s scalable technology is deployed at the enterprise level of clients, embeds into existing offerings and workflows, spans the continuum of care and enables the delivery of this care across a wide variety of clinical, retail, school and home settings.

Reverse Stock Split

On June 18, 2024, the Company’s stockholders approved a reverse stock split of its Class A common stock, Class B common stock and Class C common stock (collectively, the "common stock") at a ratio ranging from 1-for-10 to 1-for-20, with the exact ratio determined by the Company’s Board of Directors. On June 28, 2024, the Company's Board of Directors approved a 1-for-20 reverse stock split (Reverse Split) of its common stock that became effective on July 10, 2024. The Reverse Stock Split did not change the Company's authorized number of shares of common stock. The Reverse Stock Split did not change the par value of the common stock and, therefore the Company reclassified an amount equal to the reduction in the number of shares of common stock at par value to additional paid-in capital. No fractional shares were issued in connection with the Reverse Split, and stockholders who would otherwise have been entitled to receive a fractional share instead received a cash payment equal to the fraction of a share of common stock in lieu of such fractional share. Proportionate adjustments were made to the number of shares authorized under the Company’s equity incentive plans, the number of shares subject to any award or purchase right under the Company’s equity incentive plans, and the exercise price or purchase price with respect to any stock option award or purchase right under the Company’s equity incentive plans, see Note 8. All shares of the Company’s common stock, stock-based instruments and per-share data included in these consolidated financial statements have been retroactively adjusted as though the Reverse Stock Split has been effected prior to all periods presented.

Liquidity and Capital Resources

The accompanying consolidated financial statements have been prepared on the basis of continuity of operations, realization of assets, and the satisfaction of liabilities and commitments in the ordinary course of business. Through December 31, 2024, the Company has primarily funded its operations with proceeds from the initial public offering, the sales of convertible preferred stock and revenue from clients who purchase access to the enterprise platform and software as a service. On September 21, 2020 the Company closed on the initial public offering raising $822,267 in gross proceeds. On September 21, 2020 the Company closed on a private placement with Google raising $100,000 in gross proceeds. Since inception, the Company has incurred recurring losses. As of December 31, 2024, the Company had an accumulated deficit of $1,965,924. The Company expects to continue to generate operating losses for the near future.

The Company expects that its cash, cash equivalents and investments will be sufficient to fund its operating expenses and capital expenditure requirements for at least the next twelve months.

Revenue and Deferred Revenue - Additional Information (Detail1)	Dec. 31, 2024	Dec. 31, 2023
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2023-01-01
Revenue From Contract With Customer Line Items [Line Items]
Revenue remaining performance obligation expected timing of satisfaction		3 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2024-01-01
Revenue From Contract With Customer Line Items [Line Items]
Revenue remaining performance obligation expected timing of satisfaction	3 years

Allowance for Credit Losses

12 Months Ended

Dec. 31, 2024

Receivables [Abstract]

Allowance for Credit Losses

8. Allowance for Credit Losses

Changes in the allowance for credit losses were as follows:


	Years Ended December 31,
	2024			2023			2022
Allowance for credit losses, beginning of the period	$	2,291		$	1,884		$	1,809
Provisions		7,093			1,034			803
Write-offs		(2,148	)		(627	)		(728	)
Allowance for credit losses, end of the period	$	7,236		$	2,291		$	1,884

Segment Information - Schedule of significant segment expenses (Details) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2024

Dec. 31, 2023

Dec. 31, 2022

Segment Reporting Information [Line Items]

Costs and operating expenses

$ 471,898

$ 951,190

$ 553,043

Employee Compensation [Member]

Segment Reporting Information [Line Items]

Costs and operating expenses

192,812

202,380

197,183

Consulting Costs [Member]

Segment Reporting Information [Line Items]

Costs and operating expenses

24,267

43,135

68,433

Provider Cost [Member]

Segment Reporting Information [Line Items]

Costs and operating expenses

69,538

72,000

73,254

Stock-based Compensation Expense [Member]

Segment Reporting Information [Line Items]

Costs and operating expenses

47,505

72,040

69,144

Other Segment Expense Items [Member]

Segment Reporting Information [Line Items]

Costs and operating expenses

^[1]

$ 137,776

$ 561,635

$ 145,029

[1]	Other segment expense items primarily include hosting, hardware, corporate compliance, severance, strategic transformation costs, amortization, depreciation, bad debt, goodwill impairment and overhead expenses.

Stockholders' Equity - Schedule of Common Stock (Detail) - shares	Dec. 31, 2024	Dec. 31, 2023	Sep. 30, 2020
Class of Stock [Line Items]
Shares Authorized	1,300,000,000
Shares Issued	15,570,172
Shares Outstanding	15,570,172
Class A [Member]
Class of Stock [Line Items]
Shares Authorized	1,000,000,000	1,000,000,000	1,000,000,000
Shares Issued	13,922,877	12,776,608
Shares Outstanding	13,922,877	12,776,608
Class B [Member]
Class of Stock [Line Items]
Shares Authorized	100,000,000	100,000,000	100,000,000
Shares Issued	1,369,518	1,369,518
Shares Outstanding	1,369,518	1,369,518
Class C [Member]
Class of Stock [Line Items]
Shares Authorized	200,000,000	200,000,000	200,000,000
Shares Issued	277,777	277,777
Shares Outstanding	277,777	277,777

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Subsequent Events - Additional Information (Detail) $ in Thousands	Jan. 08, 2025 USD ($)
Subsequent event [Member] \| Asset purchase agreement [Member] \| Aligned Tele-health Inc. [Member] \| APC Business [Member]
Subsequent Event [Line Items]
Upfront Cash Payment	$ 20,714

Stockholders' Equity - Activity under Plans (Detail) - 2020 Equity Incentive Plan [Member] - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares, Outstanding, beginning of period	499,442
Number of Shares, Forfeited	(66,892)
Number of Shares, Expired	(4,840)
Number of Shares, Outstanding, end of period	427,710	499,442
Number of Shares, Vested and expected to vest	427,351
Number of Shares, Options exercisable	427,490
Number of Shares, Outstanding, Weighted Average Exercise Price, beginning of period	$ 101.82
Number of Shares, Forfeited, Weighted Average Exercise Price	95.91
Number of Shares, Expired, Weighted Average Exercise Price	36
Number of Shares, Outstanding, Weighted Average Exercise Price, end of period	103.49	$ 101.82
Number of Shares,Vested and expected to vest, Weighted Average Exercise Price, end of period	103.48
Number of Shares, Options exercisable, Weighted Average Exercise Price, end of period	$ 103.49
Number of Shares, Outstanding, Weighted Average Remaining Contractual Term (years)	3 years 8 months 12 days	4 years 7 months 6 days
Number of Shares, Vested and expected to vest, Weighted Average Remaining Contractual Term (years)	3 years 8 months 12 days
Number of Shares, Options exercisable, Weighted Average Remaining Contractual Term (years)	3 years 8 months 12 days

Stockholders' Equity - Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expenses	$ 47,505	$ 72,040	$ 69,144
Cost of revenues [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expenses	1,470	1,681	1,605
Research and development [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expenses	7,160	10,348	10,236
Selling and marketing [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expenses	4,954	8,613	7,182
General and administrative [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expenses	$ 33,921	$ 51,398	$ 50,121

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Line Items]
Income tax (expense) benefit	$ (2,751,000)	$ (3,860,000)	$ (64,000)
Percentage of change in ownership	50.00%
Unrecognized tax benefits related to uncertain tax positions	$ 0	$ 0
Federal Income Tax Authority [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 985,956,000			$ 1,680,000
Operating loss carryforwards, expiration year	2026
Operating loss carryforwards indefinitely	$ 757,416,000
Federal Income Tax Authority [Member] \| Research and Development [Member]
Income Tax Disclosure [Line Items]
Tax credit carryforwards, amount	$ 12,853,000
Tax credit carryforwards, expiration year	2027
State and Local Jurisdiction [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 45,747,000			$ 6,391,000
Operating loss carryforwards, expiration year	2024
State and Local Jurisdiction [Member] \| Research and Development [Member]
Income Tax Disclosure [Line Items]
Tax credit carryforwards, amount	$ 3,014,000
Tax credit carryforwards, expiration year	2035

Consolidated Statements of Operations And Comprehensive Loss (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Related Party [Member]
Revenue from Related Parties	$ 3,165	$ 3,859	$ 4,544

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

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Variable Interest Entity [Line Items]
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Total liabilities	119,724	109,519
Variable Interest Entity, Primary Beneficiary [Member]
Variable Interest Entity [Line Items]
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Total liabilities	2,053	1,803
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+ Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Depreciation and amortization expense	$ 32,973	$ 31,512	$ 26,167
Property, Plant and Equipment [Member]
Property, Plant and Equipment [Line Items]
Depreciation and amortization expense	$ 315	$ 631	1,515
Disposition of depreciated assets gross value			$ 1,139

Stockholders' Equity - Schedule of Weighted Average Assumptions used to Determine Estimated Fair Value of Performance-based Market Condition Share Awards Granted (Details) - Performance-based Market Condition Share Awards [Member] - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Risk-free rate	4.61%	2.34%
Term to end of performance period (yrs)	3 years	3 years
Weighted average valuation date stock price	$ 2.76	$ 3.5
Expected volatility	70.00%	75.00%
Expected dividend yield	0.00%	0.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Income Taxes

12 Months Ended

Dec. 31, 2024

Income Tax Disclosure [Abstract]

Income Taxes

15. Income Taxes

During the years ended December 31, 2024, 2023 and 2022 the Company recorded an income tax (expense) benefit of $(2,751), $(3,860) and $(64), respectively. The December 31, 2024 and December 31, 2023 income tax provision is primarily due to foreign income taxes in Israel. The December 31, 2022 income tax provision is primarily due to foreign income taxes in Israel partially offset by losses in Ireland. For the years ended December 31, 2024, 2023 and 2022, the Company’s loss before income taxes is primarily generated in the United States as the pre-tax loss from the Company’s foreign subsidiaries is not significant.

The components of our current and deferred portions of the provision for income taxes are presented in the table below:


	Years Ended December 31,
	2024			2023			2022
Current income tax (provision) benefit:
Federal	$	(40	)	$	(237	)	$	—
State		(115	)		(167	)		(22	)
Foreign		(2,847	)		(3,614	)		(3,256	)
Total Current	$	(3,002	)	$	(4,018	)	$	(3,278	)
Deferred income tax (provision) benefit:
Federal	$	—		$	—		$	—
State		—			—			—
Foreign		251			158			3,214
Total Deferred	$	251		$	158		$	3,214
Total provision for income taxes	$	(2,751	)	$	(3,860	)	$	(64	)

The following reconciles the differences between income taxes computed at the federal statutory rate and the provision for income taxes:


	Years Ended December 31,
	2024			2023			2022
Federal statutory income tax rate		21.0	%		21.0	%		21.0	%
State taxes, net of federal benefit		0.0			1.1			3.7
Valuation allowance		(20.4	)		(7.1	)		(18.5	)
Stock-based compensation		(2.3	)		(1.3	)		(5.1	)
Permanent differences		(2.0	)		(14.0	)		(0.7	)
Research and development credit		5.3			0.0			0.0
Other		(2.9	)		(0.3	)		(0.4	)
Effective income tax rate		(1.3	)%		(0.6	)%		—	%

Deferred tax assets and liabilities reflect the net tax effects of net operating loss and tax credit carryforwards and temporary differences between the carrying amount of assets and liabilities for financial reporting and the amounts used for tax purposes. Significant components of the Company's deferred tax assets and liabilities were as follows:


	As of December 31,
	2024			2023
Deferred tax assets:
Net operating loss carryforwards	$	258,002		$	229,264
Research and development credit carryforwards		15,234			1,660
Deferred revenue		298			2,687
Deferred compensation		7,571			5,687
Leasing obligation		2,138			3,087
Capitalized research expense		45,670			43,476
Other		3,736			2,415
Total deferred tax assets		332,648			288,276
Total valuation allowance		313,147			263,001
Total net deferred tax assets		19,501			25,275
Joint venture investment basis difference		(841	)		(1,054	)
Intangibles		(15,800	)		(20,879	)
Right-of-use assets		(1,878	)		(2,738	)
Other		(2,006	)		(1,902	)
Total deferred tax assets (liabilities)		(20,525	)		(26,573	)
Net deferred tax liabilities	$	(1,024	)	$	(1,298	)

The Company has evaluated the positive and negative evidence bearing upon its ability to realize the deferred tax assets. Management has considered the Company's history of cumulative net losses incurred in the U.S. since inception and has concluded that it is more likely than not that the Company will not realize the benefits of the deferred tax assets. Accordingly, a full valuation allowance has been established against the net domestic deferred tax assets as of December 31, 2024, 2023 and 2022. Management reevaluates the positive and negative evidence at each reporting period.

Changes in the valuation allowance for deferred tax assets during the years ended December 31, 2024, 2023 and 2022 related primarily to the increase in net operating loss carryforwards in 2024, 2023 and 2022 and were as follows:


	Years Ended December 31,
	2024		2023		2022
Valuation allowance as of beginning of the year	$	263,001	$	214,776	$	164,391
Increases recorded to income tax provision		50,146		48,225		50,403
Decreases recorded as a benefit to income tax provision		—		—		(18	)
Valuation allowance as of end of year	$	313,147	$	263,001	$	214,776

As of December 31, 2024, the Company has federal net operating loss carryforwards of approximately $985,956, which begin to expire in 2026. The Company’s federal net operating losses generated for the years ended after December 31, 2017, which amounted to a total of $757,416, can be carried forward indefinitely. The Company has tax effected state net operating losses of approximately $45,747, which began to expire in 2024. In addition, the Company has federal and state research and development tax credit carryforwards of $12,853 and $3,014, which begin to expire in 2027 and 2035, respectively.

Utilization of the Company's net operating loss ("NOL") carryforwards and research and development ("R&D") credit carryforwards may be subject to a substantial annual limitation due to ownership change limitations that have occurred previously or that could occur in the future in accordance with Section 382 of the Internal Revenue Code of 1986 ("Section 382") as well as similar state provisions. These ownership changes may limit the amount of NOL and R&D credit carryforwards that can be utilized annually to offset future taxable income and taxes, respectively. In general, an ownership change as defined by Section 382 results from transactions increasing the ownership of certain shareholders or public groups in the stock of a corporation by more than 50% over a three-year period. Since its formation, the Company has raised capital through the issuance of capital stock on several occasions. These financings, combined with the purchasing shareholders' subsequent disposition of those shares, could result in a change of control as defined by Section 382. The Company conducted an analysis under Section 382 to determine if historical changes in ownership through December 31, 2021 would limit or otherwise restrict its ability to utilize its NOL and R&D credit carryforwards. As a result of this analysis, it was determined that $1,680 federal and $6,391 state net operating loss carryforwards generated through December 31, 2021 will expire unused. The Company also conducted an updated analysis under Section 382 to determine if historical changes in ownership through December 31, 2023 would limit or otherwise restrict its ability to utilize its NOL and R&D credit carryforwards. No changes were identified other than those noted in the prior Section 382 study completed as of December 31, 2021. Changes in ownership occurring after December 31, 2023, could affect the limitation in future years, and any limitation may result in expiration of a portion of the NOL or R&D credit carryforwards before utilization.

The Company does not have unrecognized tax benefits related to uncertain tax positions. The Company recognizes both accrued interest and penalties related to unrecognized tax benefits in income tax expense. The Company has not recorded any interest and penalties on any unrecognized tax benefits since its inception. The tax years 2006 through 2024 remain open to examination by major taxing jurisdictions to which the Company is subject, which is primarily in the United States (U.S.), as carryforward attributes generated in prior years may still be adjusted upon examination by the Internal Revenue Service (IRS) or state tax authorities if they have or will be used in a future period. The Company files income tax returns in the U.S. federal and various state jurisdictions. There are currently no federal or state audits in progress by the IRS or any other jurisdiction other than Israel for any tax years.

- Definition

The entire disclosure for income tax.

+ References

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-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

Deferred Contract Acquisition and Contract Fulfillment Costs - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Contract Acquisition Cost [Member]
Capitalized Contract Cost [Line Items]
Amortization expense related to deferred costs	$ 2,450	$ 2,266	$ 1,683
Contract Fulfillment Cost [Member]
Capitalized Contract Cost [Line Items]
Amortization expense related to deferred costs	$ 459	$ 432	$ 620

Severance and Strategic Transformation Costs

12 Months Ended

Dec. 31, 2024

Restructuring and Related Activities [Abstract]

Severance and Strategic Transformation Costs

19. Severance and strategic transformation costs

In 2024 the Company has executed a series of individual actions, referred to as strategic transformation actions. Strategic transformation costs include one time employee termination benefits, strategic transformation consulting expenses, as well as other incremental costs resulting from these actions. Employee termination benefits are recorded in accordance with standard Company policy. Strategic transformation costs are recognized in the Company's consolidated financial statements in accordance with GAAP. Charges are recorded when such actions are approved, communicated, and/or implemented. Amounts remaining to be paid for any strategic transformation costs are $3,631 and included in accrued expenses on the consolidated balance sheet.

In the twelve months ended December 31, 2024, the Company recorded charges of $20,892, in connection with individual strategic transformation actions. For the twelve months ended December 31, 2024, these charges consist of $462 recorded as cost of sales, $2,399 recorded as research and development expense, $6,842 as sales and marketing expense, and $11,189 as general and administrative expenses.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2024

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

14. Commitments and Contingencies

Leases

The Company’s primary lease represents the lease for its corporate headquarters in Boston, Massachusetts. The Company modified the corporate headquarter lease during the third quarter of 2021. Rent expense for the years ended December 31, 2024, 2023 and 2022 was $3,746, $4,292 and $4,967. The carrying value of the Company’s right-of-use assets are substantially concentrated in real estate as the Company primarily leases office space. The Company’s policy is not to record leases with an original lease term of one year or less on the consolidated balance sheets. The Company recognizes lease expense for these short-term leases on a straight-line basis over the lease term. The Company does not have any lease contracts with the option to purchase as of December 31, 2024.


	Years Ended December 31,
	2024		2023		2022
The components of lease cost under ASC 842 were as follows:
Operating lease cost	$	3,390	$	3,495	$	3,694
Short-term lease cost		—		—		—
Variable lease cost		—		—		—
Total lease cost	$	3,390	$	3,495	$	3,694


	Years Ended December 31,
	2024		2023		2022
Supplemental cash flow information:
Cash paid for amounts included in measurement of lease liabilities:
Operating cash flows from operating leases	$	3,690	$	3,527	$	2,672
Non-cash lease activity:
Right-of-use lease assets obtained in exchange for new operating lease liability:
Operating leases	$	—	$	—	$	851


	As of December 31,
	2024			2023
Supplemental balance sheet information related to leases is as follows:
Operating leases
Operating lease right-of-use assets	$	7,203		$	10,453
Total operating right-of-use lease assets	$	7,203		$	10,453
Operating lease liabilities, current		3,690			3,580
Operating lease liabilities, net of current portion		4,511			8,206
Total operating lease liabilities	$	8,201		$	11,786
Weighted-average remaining lease term (in years)	2.2 years			3.2 years
Weighted-average discount rate		1.2	%		1.2	%

As of December 31, 2024, minimum future lease payments for these operating leases were as follows:


Years ending December 31,
2025	3763
2026	3647
2027	893
2028		—
2029		—
Thereafter		—
Total lease payments	$	8,303
Less imputed interest		(102	)
Total present value of lease liabilities	$	8,201

Indemnification

The Company’s arrangements generally include certain provisions for indemnifying clients against third-party claims asserting infringement of certain intellectual property rights in the ordinary course of business. The Company also regularly indemnifies clients against third-party claims that the company’s products or services breach applicable law or regulation or from claims resulting from a breach of the business associate agreement in place with the client. In addition, the Company indemnifies its officers, directors and certain key employees while they are serving in good faith in their capacities. Through December 31, 2024, there have been no claims under any indemnification provisions.

Litigation

From time to time, and in the ordinary course of business, the Company may be subject to various claims, charges, and litigation. On September 14, 2020, the Company received a letter from Teladoc Health, Inc. alleging that certain of the Company’s cart products and associated peripherals infringe upon their patents. On October 12, 2020, Teladoc Health, Inc filed a claim against the Company related to these allegations. On June 30, 2022, the claim was dismissed pursuant to a confidential settlement between the parties. As of December 31, 2024 and 2023, the Company did not have any pending claims, charges or litigation that it expects would have a material adverse effect on its consolidated financial position, results of operations or cash flows.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net loss	$ (212,638)	$ (679,171)	$ (272,072)
Adjustments to reconcile net loss to net cash used in operating activities:
Goodwill impairment	0	436,479
Depreciation and amortization expense	32,973	31,512	26,167
Provisions for credit losses	7,090	1,057	806
Inventory write-off	1,893
Amortization of deferred contract acquisition costs	2,457	2,261	1,684
Amortization of deferred contract fulfillment costs	459	432	620
Noncash compensation costs incurred by selling shareholders			11,139
Accretion of discounts on debt securities		(10,010)
Interest on debt securities		10,010
Stock-based compensation expense	47,542	72,246	67,675
Loss on equity method investment	3,110	2,590	2,278
Deferred income taxes	(243)	(242)	(2,524)
Changes in operating assets and liabilities, net of acquisition:
Accounts receivable	(25,012)	3,248	(8,140)
Inventories	1,901	2,085	(1,207)
Deferred contract acquisition costs	(3,287)	(4,499)	(2,771)
Prepaid expenses and other current assets	2,601	4,694	(161)
Other assets	(217)	(76)	(235)
Accounts payable	159	(2,361)	(4,780)
Accrued expenses and other current liabilities	10,118	(15,139)	8,962
Other long-term liabilities			(25)
Deferred revenue	3,756	(3,459)	(19,739)
Net cash used in operating activities	(127,338)	(148,343)	(192,323)
Cash flows from investing activities:
Purchases of property and equipment	(119)	(192)	(292)
Capitalized software development costs	(15,103)	(15,056)	(10,155)
Investment in less than majority owned joint venture	(3,430)	(3,920)	(1,960)
Purchases of investments		(389,990)	(499,223)
Proceeds from sales and maturities of investments		389,990	500,000
Net cash used in investing activities	(18,652)	(19,168)	(11,630)
Cash flows from financing activities:
Proceeds from exercise of common stock options		569	5,740
Proceeds from employee stock purchase plan	1,384	2,164	2,503
Payments for the purchase of treasury stock	(3)	(586)	(360)
Proceeds from Section 16(b) disgorgement			295
Payment of contingent consideration			(11,790)
Net cash provided by (used in) financing activities	1,381	2,147	(3,612)
Effect of exchange rates changes on cash, cash equivalents, and restricted cash	887	(1,144)	(305)
Net decrease in cash, cash equivalents, and restricted cash	(143,722)	(166,508)	(207,870)
Cash, cash equivalents, and restricted cash at beginning of period	372,833	539,341	747,211
Cash, cash equivalents, and restricted cash at end of period	229,111	372,833	539,341
Cash, cash equivalents, and restricted cash at end of period:
Cash and cash equivalents	228,316	372,038	538,546
Restricted cash	795	795	795
Total cash, cash equivalents, and restricted cash at end of period	229,111	372,833	539,341
Supplemental disclosure of cash flow information:
Cash paid for income taxes	$ 4,105	$ 5,003	1,723
Supplemental disclosure of non-cash investing and financing activities:
Issuance of common stock in settlement of earnout			$ 17,243

Insider Trading Policies and Procedures	3 Months Ended
Insider Trading Policies and Procedures	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2024

Income Tax Disclosure [Abstract]

Summary of Components of Current and Deferred Portions of Provision for Income Taxes

The components of our current and deferred portions of the provision for income taxes are presented in the table below:


	Years Ended December 31,
	2024			2023			2022
Current income tax (provision) benefit:
Federal	$	(40	)	$	(237	)	$	—
State		(115	)		(167	)		(22	)
Foreign		(2,847	)		(3,614	)		(3,256	)
Total Current	$	(3,002	)	$	(4,018	)	$	(3,278	)
Deferred income tax (provision) benefit:
Federal	$	—		$	—		$	—
State		—			—			—
Foreign		251			158			3,214
Total Deferred	$	251		$	158		$	3,214
Total provision for income taxes	$	(2,751	)	$	(3,860	)	$	(64	)

Summary of Reconciliation of Federal Statutory Rate and Provision for Income Taxes

The following reconciles the differences between income taxes computed at the federal statutory rate and the provision for income taxes:


	Years Ended December 31,
	2024			2023			2022
Federal statutory income tax rate		21.0	%		21.0	%		21.0	%
State taxes, net of federal benefit		0.0			1.1			3.7
Valuation allowance		(20.4	)		(7.1	)		(18.5	)
Stock-based compensation		(2.3	)		(1.3	)		(5.1	)
Permanent differences		(2.0	)		(14.0	)		(0.7	)
Research and development credit		5.3			0.0			0.0
Other		(2.9	)		(0.3	)		(0.4	)
Effective income tax rate		(1.3	)%		(0.6	)%		—	%

Summary of Significant Components of Deferred Tax Assets and Liabilities

Significant components of the Company's deferred tax assets and liabilities were as follows:


	As of December 31,
	2024			2023
Deferred tax assets:
Net operating loss carryforwards	$	258,002		$	229,264
Research and development credit carryforwards		15,234			1,660
Deferred revenue		298			2,687
Deferred compensation		7,571			5,687
Leasing obligation		2,138			3,087
Capitalized research expense		45,670			43,476
Other		3,736			2,415
Total deferred tax assets		332,648			288,276
Total valuation allowance		313,147			263,001
Total net deferred tax assets		19,501			25,275
Joint venture investment basis difference		(841	)		(1,054	)
Intangibles		(15,800	)		(20,879	)
Right-of-use assets		(1,878	)		(2,738	)
Other		(2,006	)		(1,902	)
Total deferred tax assets (liabilities)		(20,525	)		(26,573	)
Net deferred tax liabilities	$	(1,024	)	$	(1,298	)

Summary of Changes in Valuation Allowance for Deferred Tax Assets


	Years Ended December 31,
	2024		2023		2022
Valuation allowance as of beginning of the year	$	263,001	$	214,776	$	164,391
Increases recorded to income tax provision		50,146		48,225		50,403
Decreases recorded as a benefit to income tax provision		—		—		(18	)
Valuation allowance as of end of year	$	313,147	$	263,001	$	214,776

Allowance for Credit Losses - Summary of Changes in the Allowance for Credit Losses (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Allowance for credit losses, beginning of the period	$ 2,291	$ 1,884	$ 1,809
Provisions	7,093	1,034	803
Write-offs	(2,148)	(627)	(728)
Allowance for credit losses, end of the period	$ 7,236	$ 2,291	$ 1,884

National Telehealth Network - Additional Information (Detail) - NTN [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Jan. 01, 2016
Schedule of Equity Method Investments [Line Items]
Loss attributed to non-controlling interest	$ 4,495	$ 4,007	$ 1,643
Noncontrolling Interest [Member]
Schedule of Equity Method Investments [Line Items]
Non controlling interest carrying value	$ 11,472	$ 15,967
Minimum [Member]
Schedule of Equity Method Investments [Line Items]
Equity method investment, ownership percentage				50.00%
Maximum [Member]
Schedule of Equity Method Investments [Line Items]
Equity method investment, ownership percentage				100.00%

Employee Benefit Plan

12 Months Ended

Dec. 31, 2024

Retirement Benefits [Abstract]

Employee Benefit Plan

17. Employee Benefit Plan

The Company has established a defined contribution savings plan under Section 401(k) of the Internal Revenue Code. This plan covers substantially all employees who meet minimum age and service requirements and allows participants to defer a portion of their annual compensation on a pretax basis, subject to legal limitations. Company contributions to the plan may be made at the discretion of the Company’s board of directors. The Company contributed a total of $3,418, $3,639 and $3,363 to the plan for the years ended December 31, 2024, 2023 and 2022, respectively.

Revenue and Deferred Revenue - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Total Revenue	$ 254,364	$ 259,047	$ 277,190
Platform Subscription [Member]
Disaggregation of Revenue [Line Items]
Total Revenue	115,543	112,361	120,919
Visits [Member]
Disaggregation of Revenue [Line Items]
Total Revenue	116,456	119,485	124,350
Other [Member]
Disaggregation of Revenue [Line Items]
Total Revenue	$ 22,365	$ 27,201	$ 31,921

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-41

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 270
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482964/270-10-50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (ee)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 4: http://fasb.org/us-gaap/role/ref/otherTransitionRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 5: http://fasb.org/us-gaap/role/ref/otherTransitionRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-URI https://asc.fasb.org/1943274/2147479806/606-10-50-5

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
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-Section 50
-Paragraph 30
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-30

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-42

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-40

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-4

+ Details

Stockholders' Equity

12 Months Ended

Dec. 31, 2024

Stockholders' Equity Note [Abstract]

Stockholders' Equity

13. Stockholders’ Equity

Undesignated Preferred Stock

In connection with our IPO in September 2020, we filed an Amended and Restated Certificate of Incorporation which authorizes the issuance of 100,000,000 shares of undesignated preferred stock, par value of $0.01 per share, with rights and preferences, including voting rights, designated from time to time by our board of directors. No shares of preferred stock were issued or outstanding as of December 31, 2024 and December 31, 2023.

Common Stock

In connection with the IPO, the Company filed an Amended and Restated Certificate of Incorporation which authorizes capital stock of 1,000,000,000 shares of Class A common stock, par value $0.01 per share, 100,000,000 shares of Class B common stock, par value $0.01 per share, and 200,000,000 shares of Class C common stock, par value $0.01 per share. Except for the rights noted below, each Class A, Class B and Class C common stock have the same rights, are equal in all respects and are treated by us as one class of shares. Each share of Class A and Class C common stock is entitled to one vote per share on all matters presented for a vote, except that Class C common stock does not have the right to vote for elections of directors. Subject to certain conditions, Class B common stock is collectively entitled to a number of votes equal to the product of (x) 1.0408163 and (y) the total number of votes that would be cast at such time by the holders of the Class A and Class C common stock and any other preferred stock entitled to vote under the certificate of incorporation at such time (resulting in the Class B common stock collectively holding 51% of the total outstanding voting power), and each share of Class B common stock will be entitled to a number of votes equal to the total number of votes held by all Class B common stock divided by the total number of then outstanding shares of Class B common stock. Shares of Class B and Class C common stock will be converted into shares of Class A common stock on a one-for-one basis upon the occurrence of certain events. Shares of Class B common stock will automatically convert on the first business day (i) after the date on which the outstanding shares of Class B common stock constitutes less than 5% of the aggregate number of shares of common stock then outstanding, (ii) after the date on which neither founder is serving as an executive officer or (iii) following seven years after the date the amended and restated certificate of incorporation becomes effective, provided that, such period may, to the extent permitted by law and applicable stock exchange rules, be extended for three years upon the affirmative vote of the holders of a majority of the voting power of the then-outstanding shares of Class A common stock entitled to vote thereon, voting separately as a class. Shares of Class C common stock will be convertible at the option of the holder upon determination that a Hart-Scott-Rodino Antitrust Improvements Act (“HSR”) filing is not necessary prior to the holder’s conversion of such shares or, if required, upon expiration or termination of the HSR waiting period.

Common stockholders are entitled to receive dividends, as may be declared by the board of directors, if any, subject to the preferential dividend right of the preferred stockholders. No dividends have been declared through December 31, 2024.

In the year ended December 31, 2022 the Company issued 1.0 million and 5.0 million shares of Class A common stock at a fair value of $4.21 and $2.61 per share in connection with the settlement of the earnouts for Conversa and SilverCloud, respectively. In the year ended December 31, 2022 the Company also issued 0.6 million shares of Class A common stock in relation to the early settlement of the bonus escrow.


	Shares Authorized		Shares Issued		Shares Outstanding
Class A		1,000,000,000		13,922,877		13,922,877
Class B		100,000,000		1,369,518		1,369,518
Class C		200,000,000		277,777		277,777
		1,300,000,000		15,570,172		15,570,172

As of December 31, 2024 and 2023, the Company had reserved 4,622,750 and 3,725,304 shares of common stock for the exercise of outstanding stock options, the vesting of restricted stock units and the number of shares remaining available for future grant, respectively.

Stock Plans and Stock Options

The Company maintains the 2006 Employee, Director and Consultant Stock Plan as amended and restated (the “2006 Plan”), the 2020 Equity Incentive Plan (the “2020 Plan”) and 2024 Inducement Plan (the “2024 Plan” together, the “Plans”) under which it has granted incentive stock options, non-qualified stock options, and restricted stock units to employees, officers, and directors of the Company. In connection with the adoption of the 2020 Plan, the then-remaining shares of common stock reserved for grant or issuance under the 2006 Plan became available for issuance under the 2020 Plan, and no further grants will be made under the 2006 Plan. The Plans are administered by the board of directors with respect to awards to non-employee directors and by the compensation committee, with respect to other participants, are collectively, referred to as the plan administrator. The exercise prices, vesting and other restrictions are determined at the discretion of the plan administrator. Options issued under the Plans are exercisable for periods not to exceed ten years, and vest and contain such other terms and conditions as specified in the applicable award document. Options to buy common stock are issued under the Plans, with exercise prices equal to the closing price of shares of the Company’s common stock on the New York Stock Exchange on the date of award. Stock options granted under the Plans typically vest over four years and expire ten years after the grant date. The Company had 771,730 shares available for grant as of December 31, 2024.

Activity under the Plans is as follows:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (Years)		Aggregate Intrinsic Value
Outstanding as of January 1, 2024		499,442		$	101.82		4.6	$	—
Forfeited		(66,892	)	$	95.91
Expired		(4,840	)	$	36.00
Outstanding as of December 31, 2024		427,710		$	103.49		3.7	$	—
Vested and expected to vest as of December 31, 2024		427,351		$	103.48		3.7	$	—
Options exercisable as of December 31, 2024		427,490		$	103.49		3.7	$	—

The aggregate intrinsic value of stock options exercised during the years ended December 31, 2024, 2023 and 2022, was $0, $206 and $5,167, respectively. The aggregate intrinsic value of common stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s common stock for those stock options that had exercise prices lower than the fair value of the Company’s common stock.

There were no options granted during the years ended December 31, 2024, 2023 and 2022.

The Company received cash proceeds from the exercise of common stock options of $569 and $5,740 during the years ended December 31, 2023 and 2022, respectively. No stock options were exercised in the year ended December 31, 2024.

Restricted Stock Units

The following table summarizes the unvested restricted stock unit activity for the year ended December 31, 2024:


	Shares			Weighted Average Grant Date Fair Value
Unvested as of January 1, 2024		1,119,107		$	74.39
Granted		1,903,463			19.44
Vested		(1,031,080	)		46.04
Forfeited		(637,450	)		50.44
Unvested as of December 31, 2024		1,354,040		$	30.01

The total grant date fair value of RSU’s granted for the years ended December 31, 2024, 2023 and 2022 was $37,010, $39,419 and $63,987, respectively. The aggregate intrinsic value of restricted stock units vested for the years ended December 31, 2024, 2023 and 2022 was $13,744, $18,773 and $22,218, respectively.

Restricted Stock Units with a Market Condition

The total grant-date fair value of performance-based market condition share awards granted during the year ended December 31, 2023 and 2022 was $5,805 and $63,157, respectively. No performance-based market condition share awards were granted during the year ended December 31, 2024. In the year ended December 31, 2024, the Company cancelled 422,319 restricted stock units with a market condition that were not expected to vest. The Company subsequently issued 595,462 restricted stock units to the individuals who had held the canceled awards. The cancelation and subsequent issuance was treated as a modification.


	Shares			Weighted Average Grant Date Fair Value
Unvested as of January 1, 2024		1,335,803		$	45.82
Granted		—			—
Vested		—			—
Cancelled/Forfeited		(559,923	)		54.56
Unvested as of December 31, 2024		775,880		$	39.51


	Years Ended December 31,
	2024	2023			2022
Risk-free rate	N/A		4.61	%		2.34	%
Term to end of performance period (yrs)	N/A	3 years			3 years
Weighted average valuation date stock price	N/A	$	2.76		$	3.50
Expected volatility	N/A		70	%		75	%
Expected dividend yield	N/A		0	%		0	%

2020 Employee Stock Purchase Plan

In July and August 2020, the Company’s board of directors adopted, and the Company’s stockholders approved, the 2020 Employee Stock Purchase Plan (“ESPP”). Rights granted under the ESPP will be issued only with respect to shares of Class A common stock. The purchase price of the shares will not be less than 85% of the fair market value of Class A common stock on the lower of the purchase date, which will be the final trading day of the purchase period, or the enrollment date, which will be the first trading day of the offering period.

During the years ended December 31, 2024, 2023 and 2022 the Company issued 115,527, 61,216 and 35,168 shares under the ESPP. As of December 31, 2024 329,741 shares remained available for issuance.

Stock-Based Compensation

Stock-based compensation expense was classified in the consolidated statements of operations and comprehensive loss as follows:


	Years Ended December 31,
	2024		2023		2022
Cost of revenues	$	1,470	$	1,681	$	1,605
Research and development		7,160		10,348		10,236
Selling and marketing		4,954		8,613		7,182
General and administrative		33,921		51,398		50,121
Total	$	47,505	$	72,040	$	69,144

As of December 31, 2024, total unrecognized compensation cost related to the unvested common stock-based awards was $29,672, which is expected to be recognized over a weighted-average period of 1.9 years.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478448/946-505-50-6

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480237/815-40-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
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-Paragraph 14
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
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-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-16

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

+ Details

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Retirement Benefits [Abstract]
Annual contributions per employee, amount	$ 3,418	$ 3,639	$ 3,363

Deferred Contract Acquisition and Contract Fulfillment Costs

12 Months Ended

Dec. 31, 2024

Contract with Customer, Contract Asset, Contract Liability, and Receivable [Abstract]

Deferred Contract Acquisition and Contract Fulfillment Costs

9. Deferred Contract Acquisition and Contract Fulfillment Costs

The following table represents a rollforward of the Company’s deferred contract acquisition costs:


	December 31,
	2024			2023
Beginning balance as of January 1	$	7,054		$	4,788
Additions to deferred contract acquisition costs		3,214			4,511
Amortization of deferred contract acquisition costs		(2,450	)		(2,266	)
Currency translation adjustments		45			21
Ending balance	$	7,863		$	7,054
Deferred contract acquisition costs, current	$	2,513		$	2,262
Deferred contract acquisition costs, noncurrent		5,350			4,792
Total	$	7,863		$	7,054

Amortization expense related to deferred contract acquisition costs for the years ended December 31, 2024, 2023 and 2022 was $2,450, $2,266 and $1,683, respectively.

The following table represents a rollforward of the Company’s deferred contract fulfillment costs:


	December 31,
	2024			2023
Beginning balance as of January 1	$	901		$	1,281
Additions to deferred contract fulfillment costs		612			52
Amortization of deferred contract fulfillment costs		(459	)		(432	)
Ending balance	$	1,054		$	901
Deferred contract fulfillment costs, current	$	447		$	309
Deferred contract fulfillment costs, noncurrent		607			592
Total	$	1,054		$	901

Amortization expense related to deferred contract fulfillment costs for the years ended December 31, 2024, 2023 and 2022 was $459, $432 and $620, respectively.

Revenue and Deferred Revenue

12 Months Ended

Dec. 31, 2024

Revenue from Contract with Customer [Abstract]

Revenue and Deferred Revenue

4. Revenue and Deferred Revenue

Revenue

The following table presents the Company’s revenues disaggregated by revenue source:


	Years Ended December 31,
	2024		2023		2022
Platform subscription	$	115,543	$	112,361	$	120,919
Visits		116,456		119,485		124,350
Other		22,365		27,201		31,921
Total Revenue	$	254,364	$	259,047	$	277,190

Contract Balances

The Company has rights to consideration for services completed but not billed at the reporting date. Unbilled receivables are classified as receivables when the Company has the right to invoice the client. Unbilled receivables as of December 31, 2024 and December 31, 2023 is $13,628 and $5,500, respectively, and has been included within accounts receivable on the consolidated balance sheet.

Contract liabilities consist of deferred revenue and include billings in advance of performance under the contract. Such amounts are recognized as revenue over the contractual period. For the years ended December 31, 2024, 2023 and 2022, the Company recognized revenue of $36,430, $40,595, and $56,595, respectively, that was included in the corresponding contract liability balance at the beginning of the periods presented.

The Company receives payments from clients based upon contractual billing schedules. The Company typically invoices its clients annually in advance for their annual software access fee. The Company records accounts receivable when the right to consideration becomes unconditional. Payment terms on invoiced amounts are typically net 30 days.

Deferred Revenue

Significant changes in the Company’s deferred revenue balance for the years ended December 31, 2024, 2023 and 2022:


	Years Ended December 31,
	2024			2023			2022
Total deferred revenue, beginning of the period	$	52,456		$	55,794		$	75,896
Additions		130,559			124,091			106,330
Recognized		(127,003	)		(127,429	)		(126,432	)
Total deferred revenue, end of the period	$	56,012		$	52,456		$	55,794
Current deferred revenue		53,232			46,365			49,505
Non-current deferred revenue		2,780			6,091			6,289
Total	$	56,012		$	52,456		$	55,794

Transaction Price Allocated to Remaining Performance Obligations

As of December 31, 2024 and 2023, the aggregate amount of the transaction price allocated to remaining performance obligations was $143,529 and $217,736, respectively. The substantial majority of the unsatisfied performance obligations will be satisfied over the next three years. As it pertains to the December 31, 2024 amount, the Company expects to recognize 74% of the transaction price in the year ending December 31, 2025 in its consolidated statement of operations and comprehensive loss with the remainder recognized thereafter.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Revenue and Deferred Revenue (Tables)

12 Months Ended

Dec. 31, 2024

Revenue from Contract with Customer [Abstract]

Summary of Disaggregation of Revenue

The following table presents the Company’s revenues disaggregated by revenue source:


	Years Ended December 31,
	2024		2023		2022
Platform subscription	$	115,543	$	112,361	$	120,919
Visits		116,456		119,485		124,350
Other		22,365		27,201		31,921
Total Revenue	$	254,364	$	259,047	$	277,190

Summary of Significant Changes in the Company's Deferred Revenue

Significant changes in the Company’s deferred revenue balance for the years ended December 31, 2024, 2023 and 2022:


	Years Ended December 31,
	2024			2023			2022
Total deferred revenue, beginning of the period	$	52,456		$	55,794		$	75,896
Additions		130,559			124,091			106,330
Recognized		(127,003	)		(127,429	)		(126,432	)
Total deferred revenue, end of the period	$	56,012		$	52,456		$	55,794
Current deferred revenue		53,232			46,365			49,505
Non-current deferred revenue		2,780			6,091			6,289
Total	$	56,012		$	52,456		$	55,794

Related-Party Transactions

12 Months Ended

Dec. 31, 2024

Related-Party Transactions

16. Related-Party Transactions

Cleveland Clinic

Cleveland Clinic is a related party because a member of the Company’s board of directors is an executive advisor to Cleveland Clinic. As of December 31, 2024 and 2023, the Company held short-term deferred revenue of $153 and $43,

respectively from contracts with this client. As of December 31, 2024 and 2023, amounts due from Cleveland Clinic were $216 and $24.

During the years ended December 31, 2024, 2023 and 2022, the Company recognized revenue of $1,566, $2,283 and $2,803, respectively, from contracts with this client.

CCAW, JV LLC

CCAW, JV LLC is a related party because it is a joint venture formed between the Company and Cleveland Clinic for which the Company has a less than majority owned interest in. During the year ended December 31, 2020 the Company made an initial investment in CCAW, JV LLC of $2,940 for its less than 50% interest in the joint venture. During the years ended December 31, 2024 and 2023 the Company made a capital contributed of $3,430 and $3,920, related to a portion of the phase one capital commitment.

As of December 31, 2024 and 2023, the Company held short and long term deferred revenue of $55 and $1,243 from contracts with this client. As of December 31, 2024 and 2023 amounts due from CCAW, JV LLC were $400 and $1,602, respectively. During the year ended December 31, 2024, 2023 and 2022, the Company recognized revenue of $1,599, $1,576 and $1,741 from contracts with this client.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
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-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
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-URI https://asc.fasb.org/850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

Organization and Description of Business - Additional Information (Detail) $ in Thousands				12 Months Ended
	Jun. 28, 2024	Jun. 18, 2024	Sep. 21, 2020 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Reverse stock split ratio	0.05
Reverse stock-split, description				On June 18, 2024, the Company’s stockholders approved a reverse stock split of its Class A common stock, Class B common stock and Class C common stock (collectively, the "common stock") at a ratio ranging from 1-for-10 to 1-for-20, with the exact ratio determined by the Company’s Board of Directors. On June 28, 2024, the Company's Board of Directors approved a 1-for-20 reverse stock split (Reverse Split) of its common stock that became effective on July 10, 2024.
Proceeds from private placement			$ 100,000
Accumulated deficit				$ 1,965,924	$ 1,757,778
Maximum [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Reverse stock split ratio		0.1
Minimum [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Reverse stock split ratio		0.05
Initial Public Offering [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Proceeds from issuance of common stock			$ 822,267

- Definition

Amount of accumulated undistributed earnings (deficit).

+ References + Details

Commitments and Contingencies - Summary of Minimum Future Lease Payments for These Operating Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Years ending December 31,
2025	$ 3,763
2026	3,647
2027	893
Total lease payments	8,303
Less imputed interest	(102)
Total present value of lease liabilities	$ 8,201	$ 11,786	$ 8,201

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2024

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Basis of Presentation

The consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and include the accounts of American Well Corporation, its wholly-owned subsidiaries, those of professional corporations, which represent variable interest entities in which American Well has an interest and is the primary beneficiary (“PC”) (see Note 4) and National Telehealth Network (“NTN”), an entity in which American Well controls fifty percent or more of the voting shares (see Note 5). Intercompany accounts and transactions have been eliminated in consolidation.

For consolidated entities where American Well owns or is exposed to less than 100% of the economics, the net income (loss) attributable to noncontrolling interests is recorded in the consolidated statements of operations and comprehensive loss

equal to the percentage of the economic or ownership interest retained in each entity by the respective non-controlling party. The noncontrolling interests are presented as a separate component of stockholders’ deficit in the consolidated balance sheets.

Use of Estimates

The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reported periods. Significant estimates and assumptions reflected in these consolidated financial statements include, but are not limited to, revenue recognition, the estimated customer relationship period that is used in the amortization of deferred contract acquisition costs, the valuation of assets and liabilities acquired in business combinations, the useful lives of intangible assets, capitalization of software development costs and the valuation of share awards. The Company bases its estimates on historical experience, known trends, and other market-specific or other relevant factors that it believes to be reasonable under the circumstances. On an ongoing basis, management evaluates its estimates, as there are changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. Actual results may differ from those estimates or assumptions.

Foreign Currency

The Company’s reporting currency is the U.S. dollar. The Company determines the functional currency of each subsidiary based on the currency of the primary economic environment in which each subsidiary operates. Items included in the financial statements of such subsidiaries are measured using that functional currency.

Foreign currency denominated monetary assets and liabilities are remeasured into U.S. dollars at current exchange rates and foreign currency denominated nonmonetary assets and liabilities are remeasured into U.S. dollars at historical exchange rates. Gains or losses from foreign currency remeasurement and settlements are included in interest income and other income (expense), net in the consolidated statements of operations and comprehensive loss. During the years ended December 31, 2024, 2023 and 2022 the Company’s gains (losses) from foreign currency remeasurement and settlement were $0, $(11) and $(377).

Segment Information

The Company’s chief operating decision maker (CODM), its Chief Executive Officer, is provided financial information presented on a consolidated basis for purposes of allocating resources and evaluating financial performance. The Company operates and manages its business as one reportable and operating segment. In addition, substantially all of the Company’s revenue and long-lived assets are attributable to operations in the United States for all periods presented.

Variable Interest Entities

The Company evaluates its ownership, contractual and other interests in entities to determine if it has any variable interest in a variable interest entity (“VIE”). These evaluations are complex and involve judgment. If the Company determines that an entity in which it holds a contractual or ownership interest is a VIE and that the Company is the primary beneficiary, the Company consolidates such entity in its consolidated financial statements. The primary beneficiary of a VIE is the party that meets both of the following criteria: (i) has the power to make decisions that most significantly affect the economic performance of the VIE; and (ii) has the obligation to absorb losses or the right to receive benefits that in either case could potentially be significant to the VIE. Management performs ongoing reassessments of whether changes in the facts and circumstances regarding the Company’s involvement with a VIE will cause the consolidation conclusion to change. Changes in consolidation status are applied prospectively.

Concentrations of Credit Risk and Significant Clients

Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash, cash equivalents, investments and accounts receivable. The Company invests its excess cash with large financial institutions. Cash and cash equivalents are invested in highly rated money market funds. At times the Company’s cash balances with individual banking institutions are in excess of federally insured limits. The Company’s investments are invested in U.S. government agency bonds. The Company has not experienced any losses on its deposits of cash, cash equivalents or investments. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking relationships.

The Company performs ongoing assessments and credit evaluations of its clients to assess the collectability of the accounts based on a number of factors, including past transaction experience, age of the accounts receivable, review of the invoicing terms of the contracts, and recent communication with clients. The Company has not experienced significant credit losses from its accounts receivable.

As of December 31, 2024 two clients accounted for 47% and 13% of outstanding accounts receivable and as of December 31, 2023 one client accounted for 40% of outstanding accounts receivable. For the years ended December 31, 2024, 2023 and 2022, sales to one client represented 27%, 24% and 23% of the Company’s total revenue, respectively.

Cash Equivalents

The Company considers all highly liquid investments purchased with maturities of three months or less at the date of purchase to be cash equivalents.

Restricted Cash

As of December 31, 2024 and 2023, the Company maintained letters of credit totaling $795 and $795, respectively, for the benefit of the landlord of its leased property. The Company has classified $795 and $795 as non-current on its consolidated balance sheet as of December 31, 2024 and 2023, respectively.

Investments

The Company’s investments are classified as available-for-sale and are carried at fair value, with the unrealized gains and losses reported as a component of accumulated other comprehensive income (loss) in total stockholders’ equity (deficit). The Company has classified its available-for-sale investments as current assets on the consolidated balance sheet as these investments generally consist of highly marketable securities that are identified to be available to meet near-term cash requirements.

Realized gains and losses and declines in value determined to be other than temporary are based on the specific identification method and are included as a component of interest income and other income (expense), net in the consolidated statements of operations and comprehensive loss.

The Company periodically evaluates its investments for other-than-temporary impairment. When assessing investments for other-than-temporary declines in value, the Company considers such factors as, among other things, how significant the decline in value is as a percentage of the original cost, how long the market value of the investment has been less than its original cost, the Company’s ability and intent to retain investment for a period of time sufficient to allow for any anticipated recovery in fair value and market conditions in general. If any adjustment to fair value reflects a decline in the value of the investment that the Company considers to be “other than temporary,” the Company reduces the investment through a charge to the consolidated statement of operations and other comprehensive income (loss). No such adjustments were necessary during the periods presented.

As of December 31, 2024 and 2023, there were no investments that had been in a continuous loss position for more than 12 months.

Accounts Receivable, Net

Accounts receivable primarily consist of amounts billed currently due from clients. Accounts receivable are presented net of an allowance for credit losses, which is an estimate of amounts that may not be collectible. In determining the amount of the allowance at each reporting date, the Company makes judgments about general economic conditions, historical write-off experience and any specific risks identified in client collection matters, including the aging of unpaid accounts receivable and changes in client financial conditions. Account balances are written off after all means of collection are exhausted and the potential for non-recovery is determined to be probable. Adjustments to the allowance for credit losses are recorded as general and administrative expenses in the consolidated statements of operations and comprehensive loss.

Inventories

The Company values all of its inventories, which consist primarily of raw material hardware components, at the lower of cost or net realizable value on a first-in, first-out basis (“FIFO”). Write-offs of potentially slow moving or damaged inventory are recorded through specific identification of obsolete or damaged material.

Property and Equipment

Property and equipment are stated at cost, net of accumulated depreciation and amortization. Depreciation and amortization are recognized using the straight-line method over the useful life of the assets. Computer equipment is depreciated over three to four years. Computer software, furniture and fixtures and office equipment are depreciated over three years. Leasehold improvements are amortized over the shorter of the lease term or the estimated useful life of the related asset. Repairs and maintenance costs are expensed as incurred. When assets are sold or retired, the cost and related accumulated depreciation or amortization are removed from the accounts, with any resulting gain or loss recorded in the consolidated statements of operations and comprehensive loss.

Goodwill

The Company recognizes the excess of the purchase price over the fair value of identifiable net assets acquired as goodwill. Goodwill is not amortized but is tested for impairment annually on November 30 or more frequently if events or changes in circumstances indicate that the carrying amount of the goodwill may not be recoverable. These events include: (i) severe adverse industry or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations; (iii) current, historical or projected deterioration of our financial performance; or (iv) a sustained decrease in our market capitalization, as indicated by the Company’s publicly quoted share price, below our net book value. Our goodwill impairment tests are performed at the enterprise level given our single reporting unit.

When testing goodwill for impairment, we have the option of first performing a qualitative assessment to determine whether it is more likely than not that the fair value of our reporting unit is less than its carrying amount. If we elect to bypass the qualitative assessment, or if a qualitative assessment indicates it is more likely than not that carrying value exceeds its fair value, we perform a quantitative goodwill impairment test. Under the quantitative goodwill impairment test, if our reporting unit’s carrying amount exceeds its fair value, we will record an impairment charge based on that difference. A charge is reported as impairment of goodwill in the consolidated statements of operations and comprehensive loss. In the year ended December 31, 2023 there was a full impairment of the goodwill balance. For details associated with the Company's goodwill impairment, see Note 11 - Goodwill and Intangible Assets.

Intangible Assets

Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired and reported net of accumulated amortization, separately from goodwill. Finite-lived intangible assets, which primarily consist of customer relationships, contractor relationships, technology and trade name, are stated at historical cost and amortized over the assets’ estimated useful lives. Intangible assets are re-evaluated whenever events or changes in circumstances indicate that their estimated useful lives may require updates and/or the carrying value of the related asset group may not be recoverable by its projected undiscounted cash flows. If the carrying value of the asset group is determined to be unrecoverable, an impairment charge would be recognized in an amount equal to the amount by which the carrying value of the asset group exceeds its fair value. During the year ended December 31, 2023 the Company concluded there was a triggering event and a recoverability test for intangible assets was performed. No impairment was identified as result of the recoverability test. The Company did not identify a triggering event during the year ended December 31, 2024. No impairments were identified during the year ended December 31, 2024, 2023 and 2022.

Impairment of Long-Lived Assets

Long-lived assets consist primarily of property and equipment and intangible assets. Long-lived assets to be held and used are tested for recoverability whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. Factors that the Company considers in deciding when to perform an impairment review include significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets, among others. When testing for asset impairment, the Company groups assets and liabilities at the lowest level for which cash flows are separately identifiable. If an impairment review is performed to evaluate a long-lived asset group for recoverability, the Company compares forecasts

of undiscounted cash flows expected to result from the use and eventual disposition of the long-lived asset group to its carrying value. An impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of an asset group are less than the asset’s carrying amount. The impairment loss would be based on the excess of the carrying value of the impaired asset group over its fair value. To date, the Company has not recorded any impairment losses on long-lived assets. No impairments were identified during the years ended December 31, 2024, 2023 and 2022.

Investment in Minority Owned Joint Venture

The Company and Cleveland Clinic partnered to form a joint venture, under the name CCAW, JV LLC, to provide broad access to comprehensive and high acuity care services via digital care. The Company does not have a controlling financial interest in CCAW, JV LLC, but it does have the ability to exercise significant influence over the operating and financial policies of CCAW, JV LLC. Therefore, the Company accounts for its investment in CCAW, JV LLC using the equity method of accounting. The joint venture is considered a variable interest entity under ASC 810-10, but the Company is not the primary beneficiary as it does not have the power to direct the activities of the joint venture that most significantly impact its performance. The Company’s evaluation of ability to impact performance is based on Cleveland Clinic’s managing directors and Cleveland Clinic’s ability to appoint and remove the chairperson who has the ability to cast the tie breaking vote on the most significant activities.

During the year ended December 31, 2020, the Company contributed $2,940 as its initial investment for a 49% interest in CCAW, JV LLC. The agreement also requires aggregate total capital contributions by the Company up to an additional $11,800 in two phases, which is yet to be defined. During the years ended December 31, 2024, 2023 and 2022 the Company made a capital contribution of $3,430, $3,920 and $1,960, respectively, related to a portion of the phase one capital commitment. For the years ended December 31, 2024, 2023 and 2022, the Company recognized a loss of $3,110, $2,590 and $2,278 as its proportionate share of the joint ventures results of operations, respectively. Accordingly, the carrying value of the equity method investment as of December 31, 2024 and 2023 was $1,500 and $1,180, respectively.

Advertising Costs

Advertising costs are expensed as incurred and are included in sales and marketing expense in the consolidated statement of operations and comprehensive loss. For the years ended December 31, 2024, 2023 and 2022, the Company’s advertising expenses were $3,935, $5,508 and $6,607, respectively.

Research and Development Costs

Research and development costs are expensed as incurred. Research and development expenses include payroll, employee benefits and other expenses associated with product development.

Internal-Use Software

The Company evaluates development costs incurred to develop functionality in connection with its internal-use software for capitalization. Qualifying costs incurred to develop internal-use software are capitalized when (i) the preliminary project stage is completed, (ii) management has authorized further funding for the completion of the project and (iii) it is probable that the project will be completed and performed as intended. Capitalization of these costs ceases once the project is substantially complete and the software is ready for its intended purpose. Capitalized internal-use software costs are included in intangible assets on the consolidated balance sheet for the years ended December 31, 2024 and 2023. There were no impairment charges related to capitalized software development costs during the years ended December 31, 2024, 2023 and 2022. Capitalized software development costs are amortized using the straight-line method over an estimated useful life of three to five years.

Stock-Based Compensation

The Company measures all stock options and other stock-based awards granted to employees and directors based on the fair value on the date of the grant and recognizes compensation expense of those awards, net of estimated forfeitures, over the requisite service period, which is generally the vesting period of the respective award. Generally, the Company issues stock options, restricted stock units (“RSU’s”) and performance-based market condition share awards ("PSU's") to employees. Stock options and RSUs only have service-based vesting conditions and the Company records the expense for these awards using the straight-line method. PSUs have multiple tranches each with certain market capitalization milestones

and service-based vesting conditions and the Company records the expense for these awards over the estimated life of each tranche.

The Company classifies stock-based compensation expense in its consolidated statements of operations and comprehensive loss in the same manner in which the award’s recipient’s payroll costs are classified.

The Company recognizes compensation expense for only the portion of awards that are expected to vest. In developing a forfeiture rate estimate, the Company has considered its historical experience to estimate pre-vesting forfeitures for service-based awards. The impact of a forfeiture rate adjustment will be recognized in full in the period of adjustment, and if the actual forfeiture rate is materially different from the Company’s estimate, the Company may be required to record adjustments to stock-based compensation expense in future periods.

The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. The Company historically had been a private company and lacks company-specific historical and implied volatility information. Therefore, it estimates its expected stock volatility based on the historical volatility of a publicly traded set of peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. The expected dividend yield is based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.

The fair value of the PSUs is estimated using a Monte-Carlo valuation simulation. Similar to stock options, the Company estimates its expected stock volatility based on the historical volatility of a publicly traded set of peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. The expected dividend yield is based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.

Deferred Contract Acquisition Costs

The Company capitalizes sales commissions and certain parts of the Company bonus that are incremental to the acquisition of client contracts. These costs are recorded as deferred contract acquisition costs on the consolidated balance sheets. The Company determines whether costs should be deferred based on its sales compensation plans if the commissions are in fact incremental and would not have occurred absent the client contract.

Sales commissions are paid upon the initial acquisition of a contract and are amortized over an estimated period of benefit of five years. Amortization is recognized on a straight-line basis commensurate with the pattern of revenue recognition. The Company determined the period of benefit for commissions paid for the acquisition of initial contracts by taking into consideration the commitment term of the client contract, the nature of the Company’s technology development life cycle, and an estimated client relationship period. Amortization of deferred contract acquisition costs is included in sales and marketing expenses in the accompanying consolidated statements of operations and comprehensive loss.

The Company reviews these deferred costs to determine whether events or changes in circumstances have occurred that could impact the period of benefit of these deferred contract acquisition costs. There were no impairment losses recorded during the periods presented.

Deferred Contract Fulfillment Costs

The Company capitalizes costs to fulfill contracts with clients in “Prepaid expenses and other current assets” and “Other assets” on its consolidated balance sheet. The Company amortizes these costs to cost of revenue in the consolidated statement of operations and comprehensive loss consistent with the revenue recognition of the performance obligations in the associated contracts. The Company assesses these costs for impairment at the end of each reporting period. There were no impairment losses recorded during the periods presented.

Comprehensive Loss

Comprehensive loss includes net loss as well as other changes in stockholders’ equity (deficit) that result from transactions and economic events other than those with stockholders.

Income Taxes

The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company assesses the likelihood that its deferred tax assets will be recovered from future taxable income, and to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. The potential for recovery of deferred tax assets is evaluated by considering taxable income in carryback years, existing taxable temporary differences, prudent and feasible tax planning strategies and estimating the future taxable profits.

The Company accounts for uncertainty in income taxes recognized in the financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties.

Net Loss per Share

Basic net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net loss attributable to common stockholders is computed by adjusting net losses attributable to common stockholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net loss per share attributable to common stockholders is computed by dividing the diluted net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares.

The Company’s convertible preferred stock contractually entitles the holders of such shares to participate in dividends, but contractually does not require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders since dilutive common shares are not assumed to have been issued, as their effect is anti-dilutive. The Company reported a net loss attributable to common stockholders for the years ended December 31, 2024, 2023 and 2022.

Revenue Recognition

Platform subscription

The Company generates revenue primarily from contracts with clients who purchase subscriptions to access the Company’s enterprise platform and software as a service which includes access to the Company’s affiliated medical group.

The Company’s clients do not have the right to take possession of the Company’s software operating its digital care platform at any time. Instead, clients are granted access to the Company’s platform over the contractual period. Access to the platform, including the stand ready obligation to provide access to the affiliated medical group, represents a series of distinct services as the Company continually provides access to and fulfills its obligation to the client over the contract term. The typical contract term is three years. Most of the Company’s contracts are non-cancelable over the contractual term. Clients typically have the right to terminate their contracts for cause if the Company fails to perform in accordance with the contractual terms.

For clients who purchase access to the enterprise platform and software as a service (the “Amwell Platform”), the Company hosts a dedicated instance of the Amwell Platform, brandable by the client, with customized workflows and

operating choices. The implementation services for the Amwell Platform are not distinct within the context of the contract because the Company’s promise to perform the implementation services are not separately identifiable from the access to the Amwell Platform. The implementation services, which customize the client’s Amwell Platform, are integral to the client’s ability to derive its intended benefit from the Amwell Platform. The development and implementation services generally span several months and cannot be performed by another entity. Therefore, access to the Amwell Platform and the implementation services are bundled together and represent a single performance obligation. The fixed consideration related to the single performance obligation is generally recognized on a straight-line basis over the contract term beginning on the date access to the Amwell Platform is provided. The Company uses a time-elapsed method to measure progress because the Company transfers control evenly over the contractual period.

Clients can also purchase access to the Company’s co-branded digital care practice hosted on the Company’s shared services platform (the “Amwell Practice”). The implementation services for the Amwell Practice do not significantly modify or customize the Amwell Practice, typically occur over a few days, and can be performed by other entities. Therefore, access to the Amwell Practice and the implementation services are separate outputs promised by the Company and represent two distinct performance obligations.

Clients may be billed prior to the related goods or services being transferred to the client. In determining the transaction price, the Company adjusts the promised amount of consideration for a significant financing component if the timing of payments agreed to by the parties in the contract provide the client a significant benefit of financing. The Company has applied the practical expedient and recognizes the promised amount of consideration without adjusting for the effects of a significant financing component if the Company expects, at contract inception, that the period between the transfer of goods or services to the client when the client pays for that good or service will be one year or less. As of December 31, 2024, the effect of the financing component is not significant and does not materially change the amount of revenue that would be recognized under a contract.

The total fixed consideration is allocated to each distinct performance obligation based on standalone selling price (“SSP”) which reflects the amount that the Company charges for each performance obligation if it was sold separately in a standalone sale. The fixed consideration to access the Amwell Practice is recognized on a straight-line basis over the contract term beginning on the date access to the Amwell Practice is provided. A time-elapsed method is used to measure progress because the Company transfers control evenly over the contractual period. The fixed consideration related to the implementation services is recognized as the services are performed.

In addition to the fixed consideration received from the Amwell Platform and Amwell Practice, the Company can also receive variable consideration based on the number of members serviced (that is, a stated fee per member per month). The Company allocates the per member per month variable consideration to the month that the fee is earned, correlating with the amount of services it is providing, which is consistent with the allocation objective of the series guidance. Revenue recognized from the per member per month variable consideration does not represent a significant portion of total revenue for the years ended December 31, 2024, 2023 and 2022.

Some contracts with clients contain a renewal option which allows the client to continue access to the Amwell Platform for a stated price after the initial contractual term has ended. These renewal options are evaluated on a case-by-case basis but generally do not provide a material right as they are priced at or above the price for the same service that the Company offers to similar clients and, as such, would not result in a separate performance obligation.

Visits

The Company also generates revenue when either the Amwell Platform or the Amwell Practice is utilized to conduct a medical visit. In the event of a visit, the fee that is earned upon completion of the visit is allocated to the specific day of performance, as the visit fee meets the criteria to allocate variable consideration to a distinct service within a series of distinct services that comprise the single performance obligation. Therefore, visit fees are recognized when the visits are completed, and the Company has delivered on its stand-ready obligation to provide access to the medical professional.

In addition, clients can visit with the Company’s affiliated medical group without purchasing access to an Amwell Platform or Amwell Practice. These direct-to-consumer virtual care visits are available through the Company’s website where clients can conduct a visit with the Company’s affiliated medical group for a fixed fee. The Company’s affiliated medical group is responsible for fulfilling the promise to the client to perform the medical visit. The Company has discretion in establishing the price for the visit, is responsible for the resolution of any client issues, and is exposed to credit risk for the receivable due from the client. Therefore, the Company recognizes the visit fee on a gross basis upon completion of the visit.

Other

Other revenue primarily represents professional services associated with the Amwell Platform. After implementation of the Amwell Platform has been completed, some clients purchase other professional services, which are designed to help clients enhance their ability to use the Amwell Platform. For the majority of arrangements, the Company prices these professional services on a time and material basis, has standalone selling price for these services, and recognizes revenue as services are performed. Other revenue also includes sale of hardware products, such as the Company’s digital care carts and kiosks. Revenue from the sale of hardware products to clients is recognized upon the transfer of control, which occurs upon shipment of the product.

Deferred Revenue

Deferred revenue includes amounts collected or billed in excess of revenue recognized. Deferred revenue is recognized as revenue as the related performance obligations are satisfied. Deferred revenue that will be recognized during the succeeding twelve-month period is recorded as a current liability and the remaining portion is recorded as a noncurrent liability on the consolidated balance sheet.

Leases

The Company determines at the inception of a contract if such arrangement is or contains a lease. A contract is or contains a lease if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. The Company classifies leases at the lease commencement date as operating or finance leases and records a right-of-use asset and a lease liability on the consolidated balance sheet for all leases with an initial lease term of greater than 12 months. Leases with an initial term of 12 months or less are not recorded on the balance sheet, but payments are recognized as expense on a straight-line basis over the lease term.

The Company’s contracts may contain both lease and non-lease components. Non-lease components may include maintenance, utilities, and other operating costs. The Company combines the lease and non-lease components of fixed costs in its lease arrangements as a single lease component. Variable costs, such as utilities or maintenance costs, are not included in the measurement of right-of-use assets and lease liabilities, but rather are expensed when the event determining the amount of variable consideration to be paid occurs.

Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of future lease payments over the expected lease term. The Company determines the present value of future lease payments by using its estimated secured incremental borrowing rate for that lease term as the interest rate implicit in the lease is not readily determinable. The Company estimates its secured incremental borrowing rate for each lease based on the rate of interest that the Company would have to pay to borrow an amount equal to the lease payments on a collateralized basis over a similar term.

Certain of the Company’s leases include options to extend or terminate the lease. The amounts determined for the Company’s right-of-use assets and lease liabilities generally do not assume that renewal options or early-termination provisions, if any, are exercised, unless it is reasonably certain that the Company will exercise such options.

Recently Issued and Adopted Accounting Pronouncements

In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which includes amendments to improve reportable segment disclosures. The guidance was adopted with the fiscal year ended December 31, 2024 and impacted the disclosures related to segments (see Note 3).

In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which includes amendments to improve income tax disclosures primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. Early adoption is permitted. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures.

In March 2024, the U.S. Securities and Exchange Commission ("SEC") adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule would require

registrants to disclose certain climate-related information in registration statements and annual reports. In April 2024, the SEC issued an order staying the final rule. Prior to this stay, the disclosure requirements would have applied to the Company's fiscal year beginning January 1, 2026. The Company is currently evaluating the final rule to determine its impact on the Company's disclosures.

In November 2024, the FASB issued ASU No. 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of income statement expenses (“ASU 2024-03”), which requires disaggregated information about certain income statement expense line items on an annual and interim basis. ASU 2024-03 is effective for annual periods beginning after December 15, 2026 and interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted and can be applied prospectively or retrospectively. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures.

Variable Interest Entities

12 Months Ended

Dec. 31, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities

5. Variable Interest Entities

The Company provides services pursuant to contracts with PCs which in turn contracts with physicians to provide virtual care medical services. The PC’s collectively represent the Company’s affiliated medical group. The PCs were designed and structured to comply with the relevant laws and regulations governing professional medical practice, which generally prohibits the practice of medicine by lay persons or entities. To satisfy these regulatory requirements, all of the issued and outstanding equity interests of the PCs are owned by a licensed medical professional nominated by the Company (the “Nominee Shareholder”). Upon formation of the PCs, and initial issuance of equity interests, the Nominee Shareholder contributes a nominal amount of capital in exchange for their interest in the PC. The Company then executes with each PC a Business Support Agreement (“BSA”), which provide for various administrative and management services to be provided by the Company to the PC, and a Stock Transfer Agreement (“STA”), which provide for transition of ownership of the PCs.

The Company provides all of the necessary capital for the operations of the PCs through loans to the PCs. The Company also has exclusive responsibility for the provision of all nonmedical services including contracting with clients who access the PCs for a medical visit, handling all financial transactions and day-to-day operations of each PC, overseeing the establishment of virtual care policies and protocol, and making recommendations to the PC in establishing the guidelines for the employment and compensation of the physicians and other employees of the PCs. In addition, the STA provides that the Company’s Board of Directors has the power and authority to change the Nominee Shareholder at any time for any reason, and designate a new Nominee Shareholder who will purchase the equity interests from the predecessor Nominee Shareholder

for the same nominal amount, effectively limiting the Nominee Shareholder’s rights to returns of the PC. The Nominee Shareholders, notwithstanding their legal form of ownership of equity interests in the PC, have no substantive profit-sharing rights in the PCs.

Based upon the provisions of these agreements, the Company determined that the PCs are variable interest entities due to its equity holder having insufficient capital at risk, and the Company has a variable interest in the PCs. The Company consolidated the PCs under the VIE model since the Company has the power to direct activities that most significantly impact the PCs economic performance and the right to receive benefits or the obligation to absorb losses that could potentially be significant to the PCs.

Furthermore, as a direct result of nominal initial equity contributions by the Nominee Shareholder, the financial support the Company provides to the PCs (e.g. loans) and the provisions of the STA, the interests held by noncontrolling interest holders lack economic substance and do not provide them with the ability to participate in the residual profits or losses generated by the PCs. Therefore, all income and expenses recognized by the PCs are allocated to the Company’s stockholders.

The aggregate carrying value of total assets and total liabilities included on the consolidated balance sheets for the PCs after elimination of intercompany transactions were $34,050 and $2,053, respectively, as of December 31, 2024 and $33,842 and $1,803, respectively as of December 31, 2023.

Total revenue included on the consolidated statements of operations and comprehensive loss for the PCs after elimination of intercompany transactions was $61,357, $72,349 and $74,389 for the years ended December 31, 2024, 2023 and 2022, respectively. Net loss included on the consolidated statements of operations and comprehensive was not material for the years ended December 31, 2024, 2023 and 2022.

Net Loss per Share

12 Months Ended

Dec. 31, 2024

Earnings Per Share [Abstract]

Net Loss per Share

18. Net Loss per Share

Basic and diluted net loss per share attributable to common stockholders was calculated as follows:


	Years Ended December 31,
	2024			2023			2022
Numerator:
Net loss	$	(212,638	)	$	(679,171	)	$	(272,072	)
Net loss attributable to non-controlling interest		(4,495	)		(4,007	)		(1,643	)
Net loss attributable to American Well Corporation	$	(208,143	)	$	(675,164	)	$	(270,429	)
Denominator:
Weighted-average common shares outstanding, basic and diluted		14,999,590			14,212,505			13,712,290
Net loss per share attributable to common stockholders, basic and diluted	$	(13.88	)	$	(47.50	)	$	(19.72	)

The Company’s potential dilutive securities, which include stock options, convertible preferred stock and unvested restricted stock units, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, the weighted-average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to common stockholders is the same. The Company excluded the following potential common shares equivalents presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect:


	Years Ended December 31,
	2024		2023		2022
Unvested restricted stock units		1,354,040		1,119,107		884,350
Unvested performance market-based stock units		775,880		1,335,803		1,280,114
Options to purchase shares of common stock		427,710		499,442		551,998
		2,557,630		2,954,352		2,716,462

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Finite Lived Intangible Assets [Line Items]
Amortization of intangible assets	$ 32,660	$ 30,861	$ 24,638
Assumption in fair value of calculation percentage	30.00%
Goodwill impairment	$ 0	436,479
Capitalized cost related to internally developed software	15,103	15,056
Goodwill	$ 0	$ 0	$ 435,279

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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-URI https://asc.fasb.org/1943274/2147478546/942-210-S99-1

+ Details

Deferred Contract Acquisition and Contract Fulfillment Costs (Tables)

12 Months Ended

Dec. 31, 2024

Contract Acquisition Cost [Member]

Capitalized Contract Cost [Line Items]

Capitalized Contract Cost

The following table represents a rollforward of the Company’s deferred contract acquisition costs:


	December 31,
	2024			2023
Beginning balance as of January 1	$	7,054		$	4,788
Additions to deferred contract acquisition costs		3,214			4,511
Amortization of deferred contract acquisition costs		(2,450	)		(2,266	)
Currency translation adjustments		45			21
Ending balance	$	7,863		$	7,054
Deferred contract acquisition costs, current	$	2,513		$	2,262
Deferred contract acquisition costs, noncurrent		5,350			4,792
Total	$	7,863		$	7,054

Contract Fulfillment Cost [Member]

Capitalized Contract Cost [Line Items]

Capitalized Contract Cost

The following table represents a rollforward of the Company’s deferred contract fulfillment costs:


	December 31,
	2024			2023
Beginning balance as of January 1	$	901		$	1,281
Additions to deferred contract fulfillment costs		612			52
Amortization of deferred contract fulfillment costs		(459	)		(432	)
Ending balance	$	1,054		$	901
Deferred contract fulfillment costs, current	$	447		$	309
Deferred contract fulfillment costs, noncurrent		607			592
Total	$	1,054		$	901

Goodwill and Intangible Assets - Schedule of Finite Lived Intangible Assets Future Amortization Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
2025	$ 34,978
2026	25,121
2027	14,526
2028	12,063
2029	7,428
Thereafter	7,422
Carrying Value	$ 101,538	$ 120,248

Income Taxes - Summary of Changes in Valuation Allowance for Deferred Tax Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Valuation Allowance [Abstract]
Valuation allowance as of beginning of the year	$ 263,001	$ 214,776	$ 164,391
Increases recorded to income tax provision	50,146	48,225	50,403
Decreases recorded as a benefit to income tax provision	0		(18)
Valuation allowance as of end of year	$ 313,147	$ 263,001	$ 214,776

Net Loss per Share (Tables)

12 Months Ended

Dec. 31, 2024

Earnings Per Share [Abstract]

Summary of Basic and Diluted Net Loss Per Share Attributable To Common Stockholders

Basic and diluted net loss per share attributable to common stockholders was calculated as follows:


	Years Ended December 31,
	2024			2023			2022
Numerator:
Net loss	$	(212,638	)	$	(679,171	)	$	(272,072	)
Net loss attributable to non-controlling interest		(4,495	)		(4,007	)		(1,643	)
Net loss attributable to American Well Corporation	$	(208,143	)	$	(675,164	)	$	(270,429	)
Denominator:
Weighted-average common shares outstanding, basic and diluted		14,999,590			14,212,505			13,712,290
Net loss per share attributable to common stockholders, basic and diluted	$	(13.88	)	$	(47.50	)	$	(19.72	)

Summary of Antidilutive Securities Excluded From Computation of Net Loss Per Share

The Company excluded the following potential common shares equivalents presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect:


	Years Ended December 31,
	2024		2023		2022
Unvested restricted stock units		1,354,040		1,119,107		884,350
Unvested performance market-based stock units		775,880		1,335,803		1,280,114
Options to purchase shares of common stock		427,710		499,442		551,998
		2,557,630		2,954,352		2,716,462

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 228,316	$ 372,038
Accounts receivable ($616 and $1,626, from related parties and net of allowances of $7,236 and $2,291, respectively)	71,885	54,146
Inventories	2,858	6,652
Deferred contract acquisition costs	2,513	2,262
Prepaid expenses and other current assets	11,421	14,484
Total current assets	316,993	449,582
Restricted cash	795	795
Property and equipment, net	376	572
Intangibles assets, net	101,538	120,248
Operating lease right-of-use asset	7,203	10,453
Deferred contract acquisition costs, net of current portion	5,350	4,792
Other assets	2,213	2,083
Investment in minority owned joint venture (Note 2)	1,500	1,180
Total assets	435,968	589,705
Current liabilities:
Accounts payable	5,015	4,864
Accrued expenses and other current liabilities	49,326	38,988
Operating lease liability, current	3,690	3,580
Deferred revenue ($198 and $1,286 from related parties, respectively)	53,232	46,365
Total current liabilities	111,263	93,797
Other long-term liabilities	1,170	1,425
Operating lease liability, net of current portion	4,511	8,206
Deferred revenue, net of current portion ($10 and $0 from related parties, respectively)	2,780	6,091
Total liabilities	119,724	109,519
Commitments and contingencies (Note 14)
Stockholders’ equity:
Preferred stock, $0.01 par value; 100,000,000 shares authorized, no shares issued or outstanding as of December 31, 2024 and as of December 31, 2023
Common stock, $0.01 par value; 1,000,000,000 Class A shares authorized, 13,922,877 and 12,776,608 shares issued and outstanding, respectively; 100,000,000 Class B shares authorized, 1,369,518 shares issued and outstanding; 200,000,000 Class C shares authorized 277,777 issued and outstanding as of December 31, 2024 and as of December 31, 2023	156	145
Additional paid-in capital	2,286,380	2,237,502
Accumulated other comprehensive income (loss)	(15,840)	(15,650)
Accumulated deficit	(1,965,924)	(1,757,778)
Total American Well Corporation stockholders’ equity	304,772	464,219
Non-controlling interest	11,472	15,967
Total stockholders’ equity	316,244	480,186
Total liabilities and stockholders’ equity	$ 435,968	$ 589,705

Property and Equipment, Net

12 Months Ended

Dec. 31, 2024

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

10. Property and Equipment, Net

Property and equipment, net consisted of the following:


	As of December 31,
	2024			2023
Furniture and fixtures	$	229		$	232
Computer and office equipment		7,440			7,322
Computer software		5,110			5,125
Leasehold improvements		685			692
		13,464			13,371
Less: Accumulated depreciation and amortization		(13,088	)		(12,799	)
Property and equipment, net	$	376		$	572

Depreciation and amortization expense related to property and equipment was $315, $631 and $1,515 for the years ended December 31, 2024, 2023 and 2022, respectively. During the year ended December 31, 2022 the Company disposed of fully depreciated assets with a gross value of $1,139.

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Accounts receivable	$ 71,885	$ 54,146
Accounts receivable net of allowances	7,236	2,291
Deferred revenue from related parties current	198	1,286
Deferred revenue from related parties non current	$ 10	$ 0
Preferred Stock, Par Value	$ 0.01	$ 0.01
Preferred Stock, Shares Authorized	100,000,000	100,000,000
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0
Common Stock, Shares Authorized	1,300,000,000
Common Stock, Shares, Issued	15,570,172
Common Stock, Shares, Outstanding	15,570,172
Related Party [Member]
Accounts receivable	$ 616	$ 1,626
Common Class A [Member]
Common Stock, Par Value	$ 0.01	$ 0.01
Common Stock, Shares Authorized	1,000,000,000	1,000,000,000
Common Stock, Shares, Issued	13,922,877	12,776,608
Common Stock, Shares, Outstanding	13,922,877	12,776,608
Common Class B [Member]
Common Stock, Par Value	$ 0.01	$ 0.01
Common Stock, Shares Authorized	100,000,000	100,000,000
Common Stock, Shares, Issued	1,369,518	1,369,518
Common Stock, Shares, Outstanding	1,369,518	1,369,518
Common Class C [Member]
Common Stock, Par Value	$ 0.01	$ 0.01
Common Stock, Shares Authorized	200,000,000	200,000,000
Common Stock, Shares, Issued	277,777	277,777
Common Stock, Shares, Outstanding	277,777	277,777

Stockholders' Equity - Summary of Unvested Restricted Stock Unit Activity (Detail) - Restricted Stock Units [Member]	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Class of Stock [Line Items]
Unvested as of January 1, 2024 \| shares	1,119,107
Shares, Granted \| shares	1,903,463
Shares, Vested \| shares	(1,031,080)
Shares, Forfeited \| shares	(637,450)
Unvested as of December 31, 2024 \| shares	1,354,040
Weighted Average Grant Date Fair Value, Unvested as of January 1, 2024 \| $ / shares	$ 74.39
Weighted Average Grant Date Fair Value, Granted \| $ / shares	19.44
Weighted Average Grant Date Fair Value, Vested \| $ / shares	46.04
Weighted Average Grant Date Fair Value, Forfeited \| $ / shares	50.44
Weighted Average Grant Date Fair Value, Unvested as of December 31, 2024 \| $ / shares	$ 30.01

Revenue and Deferred Revenue - Summary of Contract with Customer Asset and Liability (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Total deferred revenue, beginning of the period	$ 52,456	$ 55,794	$ 75,896
Additions	130,559	124,091	106,330
Recognized	(127,003)	(127,429)	(126,432)
Total deferred revenue, end of the period	56,012	52,456	55,794
Current deferred revenue	53,232	46,365	49,505
Non-current deferred revenue	2,780	6,091	6,289
Total	$ 56,012	$ 52,456	$ 55,794

Deferred Contract Acquisition and Contract Fulfillment Costs - Summary of Capitalized Contract Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Contract Acquisition Cost [Member]
Capitalized Contract Cost [Line Items]
Beginning balance	$ 7,054	$ 4,788
Additions to deferred contract acquisition costs	3,214	4,511
Amortization of deferred contract acquisition costs	(2,450)	(2,266)	$ (1,683)
Currency translation adjustments	45	21
Ending balance	7,863	7,054	4,788
Deferred contract acquisition costs, current	2,513	2,262
Deferred contract acquisition costs, noncurrent	5,350	4,792
Deferred contract acquisition and fulfillment costs	7,863	7,054	4,788
Contract Fulfillment Cost [Member]
Capitalized Contract Cost [Line Items]
Beginning balance	901	1,281
Additions to deferred contract acquisition costs	612	52
Amortization of deferred contract acquisition costs	(459)	(432)	(620)
Ending balance	1,054	901	1,281
Deferred contract acquisition costs, current	447	309
Deferred contract acquisition costs, noncurrent	607	592
Deferred contract acquisition and fulfillment costs	$ 1,054	$ 901	$ 1,281

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2024
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	Insider Trading Arrangements During the three months ended December 31, 2024, none of our officers and directors adopted or terminated any Rule 10b5-1 trading arrangement. We have adopted insider trading policies and procedures governing the purchase, sale and other dispositions of our securities by our directors, senior management and employees that are reasonably designed to promote compliance with applicable insider trading laws, rules and regulations and applicable listing standards. Our Insider Trading Policy is filed as Exhibit 19.1 of this Annual Report. In addition, it is our policy to comply with applicable securities laws when we engage in transactions in our securities.
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurements


	December 31, 2024
	Level 1		Level 2		Level 3		Total
Money market funds	$	140,639	$	—	$	—	$	140,639
Total financial assets:	$	140,639	$	—	$	—	$	140,639


	December 31, 2023
	Level 1		Level 2		Level 3		Total
Money market funds	$	299,300	$	—	$	—	$	299,300
Total financial assets:	$	299,300	$	—	$	—	$	299,300

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and include the accounts of American Well Corporation, its wholly-owned subsidiaries, those of professional corporations, which represent variable interest entities in which American Well has an interest and is the primary beneficiary (“PC”) (see Note 4) and National Telehealth Network (“NTN”), an entity in which American Well controls fifty percent or more of the voting shares (see Note 5). Intercompany accounts and transactions have been eliminated in consolidation. For consolidated entities where American Well owns or is exposed to less than 100% of the economics, the net income (loss) attributable to noncontrolling interests is recorded in the consolidated statements of operations and comprehensive loss equal to the percentage of the economic or ownership interest retained in each entity by the respective non-controlling party. The noncontrolling interests are presented as a separate component of stockholders’ deficit in the consolidated balance sheets.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reported periods. Significant estimates and assumptions reflected in these consolidated financial statements include, but are not limited to, revenue recognition, the estimated customer relationship period that is used in the amortization of deferred contract acquisition costs, the valuation of assets and liabilities acquired in business combinations, the useful lives of intangible assets, capitalization of software development costs and the valuation of share awards. The Company bases its estimates on historical experience, known trends, and other market-specific or other relevant factors that it believes to be reasonable under the circumstances. On an ongoing basis, management evaluates its estimates, as there are changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. Actual results may differ from those estimates or assumptions.
Foreign Currency	Foreign Currency The Company’s reporting currency is the U.S. dollar. The Company determines the functional currency of each subsidiary based on the currency of the primary economic environment in which each subsidiary operates. Items included in the financial statements of such subsidiaries are measured using that functional currency. Foreign currency denominated monetary assets and liabilities are remeasured into U.S. dollars at current exchange rates and foreign currency denominated nonmonetary assets and liabilities are remeasured into U.S. dollars at historical exchange rates. Gains or losses from foreign currency remeasurement and settlements are included in interest income and other income (expense), net in the consolidated statements of operations and comprehensive loss. During the years ended December 31, 2024, 2023 and 2022 the Company’s gains (losses) from foreign currency remeasurement and settlement were $0, $(11) and $(377).
Segment Information	Segment Information The Company’s chief operating decision maker (CODM), its Chief Executive Officer, is provided financial information presented on a consolidated basis for purposes of allocating resources and evaluating financial performance. The Company operates and manages its business as one reportable and operating segment. In addition, substantially all of the Company’s revenue and long-lived assets are attributable to operations in the United States for all periods presented.
Variable Interest Entities	Variable Interest Entities The Company evaluates its ownership, contractual and other interests in entities to determine if it has any variable interest in a variable interest entity (“VIE”). These evaluations are complex and involve judgment. If the Company determines that an entity in which it holds a contractual or ownership interest is a VIE and that the Company is the primary beneficiary, the Company consolidates such entity in its consolidated financial statements. The primary beneficiary of a VIE is the party that meets both of the following criteria: (i) has the power to make decisions that most significantly affect the economic performance of the VIE; and (ii) has the obligation to absorb losses or the right to receive benefits that in either case could potentially be significant to the VIE. Management performs ongoing reassessments of whether changes in the facts and circumstances regarding the Company’s involvement with a VIE will cause the consolidation conclusion to change. Changes in consolidation status are applied prospectively.
Concentrations of Credit Risk and Significant Clients	Concentrations of Credit Risk and Significant Clients Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash, cash equivalents, investments and accounts receivable. The Company invests its excess cash with large financial institutions. Cash and cash equivalents are invested in highly rated money market funds. At times the Company’s cash balances with individual banking institutions are in excess of federally insured limits. The Company’s investments are invested in U.S. government agency bonds. The Company has not experienced any losses on its deposits of cash, cash equivalents or investments. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking relationships. The Company performs ongoing assessments and credit evaluations of its clients to assess the collectability of the accounts based on a number of factors, including past transaction experience, age of the accounts receivable, review of the invoicing terms of the contracts, and recent communication with clients. The Company has not experienced significant credit losses from its accounts receivable. As of December 31, 2024 two clients accounted for 47% and 13% of outstanding accounts receivable and as of December 31, 2023 one client accounted for 40% of outstanding accounts receivable. For the years ended December 31, 2024, 2023 and 2022, sales to one client represented 27%, 24% and 23% of the Company’s total revenue, respectively.
Cash Equivalents	Cash Equivalents The Company considers all highly liquid investments purchased with maturities of three months or less at the date of purchase to be cash equivalents.
Restricted Cash	Restricted Cash As of December 31, 2024 and 2023, the Company maintained letters of credit totaling $795 and $795, respectively, for the benefit of the landlord of its leased property. The Company has classified $795 and $795 as non-current on its consolidated balance sheet as of December 31, 2024 and 2023, respectively.
Investments	Investments The Company’s investments are classified as available-for-sale and are carried at fair value, with the unrealized gains and losses reported as a component of accumulated other comprehensive income (loss) in total stockholders’ equity (deficit). The Company has classified its available-for-sale investments as current assets on the consolidated balance sheet as these investments generally consist of highly marketable securities that are identified to be available to meet near-term cash requirements. Realized gains and losses and declines in value determined to be other than temporary are based on the specific identification method and are included as a component of interest income and other income (expense), net in the consolidated statements of operations and comprehensive loss. The Company periodically evaluates its investments for other-than-temporary impairment. When assessing investments for other-than-temporary declines in value, the Company considers such factors as, among other things, how significant the decline in value is as a percentage of the original cost, how long the market value of the investment has been less than its original cost, the Company’s ability and intent to retain investment for a period of time sufficient to allow for any anticipated recovery in fair value and market conditions in general. If any adjustment to fair value reflects a decline in the value of the investment that the Company considers to be “other than temporary,” the Company reduces the investment through a charge to the consolidated statement of operations and other comprehensive income (loss). No such adjustments were necessary during the periods presented. As of December 31, 2024 and 2023, there were no investments that had been in a continuous loss position for more than 12 months.
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable primarily consist of amounts billed currently due from clients. Accounts receivable are presented net of an allowance for credit losses, which is an estimate of amounts that may not be collectible. In determining the amount of the allowance at each reporting date, the Company makes judgments about general economic conditions, historical write-off experience and any specific risks identified in client collection matters, including the aging of unpaid accounts receivable and changes in client financial conditions. Account balances are written off after all means of collection are exhausted and the potential for non-recovery is determined to be probable. Adjustments to the allowance for credit losses are recorded as general and administrative expenses in the consolidated statements of operations and comprehensive loss.
Inventories	Inventories The Company values all of its inventories, which consist primarily of raw material hardware components, at the lower of cost or net realizable value on a first-in, first-out basis (“FIFO”). Write-offs of potentially slow moving or damaged inventory are recorded through specific identification of obsolete or damaged material.
Property and Equipment	Property and Equipment Property and equipment are stated at cost, net of accumulated depreciation and amortization. Depreciation and amortization are recognized using the straight-line method over the useful life of the assets. Computer equipment is depreciated over three to four years. Computer software, furniture and fixtures and office equipment are depreciated over three years. Leasehold improvements are amortized over the shorter of the lease term or the estimated useful life of the related asset. Repairs and maintenance costs are expensed as incurred. When assets are sold or retired, the cost and related accumulated depreciation or amortization are removed from the accounts, with any resulting gain or loss recorded in the consolidated statements of operations and comprehensive loss.
Goodwill	Goodwill The Company recognizes the excess of the purchase price over the fair value of identifiable net assets acquired as goodwill. Goodwill is not amortized but is tested for impairment annually on November 30 or more frequently if events or changes in circumstances indicate that the carrying amount of the goodwill may not be recoverable. These events include: (i) severe adverse industry or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations; (iii) current, historical or projected deterioration of our financial performance; or (iv) a sustained decrease in our market capitalization, as indicated by the Company’s publicly quoted share price, below our net book value. Our goodwill impairment tests are performed at the enterprise level given our single reporting unit. When testing goodwill for impairment, we have the option of first performing a qualitative assessment to determine whether it is more likely than not that the fair value of our reporting unit is less than its carrying amount. If we elect to bypass the qualitative assessment, or if a qualitative assessment indicates it is more likely than not that carrying value exceeds its fair value, we perform a quantitative goodwill impairment test. Under the quantitative goodwill impairment test, if our reporting unit’s carrying amount exceeds its fair value, we will record an impairment charge based on that difference. A charge is reported as impairment of goodwill in the consolidated statements of operations and comprehensive loss. In the year ended December 31, 2023 there was a full impairment of the goodwill balance. For details associated with the Company's goodwill impairment, see Note 11 - Goodwill and Intangible Assets.
Intangible Assets	Intangible Assets Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired and reported net of accumulated amortization, separately from goodwill. Finite-lived intangible assets, which primarily consist of customer relationships, contractor relationships, technology and trade name, are stated at historical cost and amortized over the assets’ estimated useful lives. Intangible assets are re-evaluated whenever events or changes in circumstances indicate that their estimated useful lives may require updates and/or the carrying value of the related asset group may not be recoverable by its projected undiscounted cash flows. If the carrying value of the asset group is determined to be unrecoverable, an impairment charge would be recognized in an amount equal to the amount by which the carrying value of the asset group exceeds its fair value. During the year ended December 31, 2023 the Company concluded there was a triggering event and a recoverability test for intangible assets was performed. No impairment was identified as result of the recoverability test. The Company did not identify a triggering event during the year ended December 31, 2024. No impairments were identified during the year ended December 31, 2024, 2023 and 2022.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets Long-lived assets consist primarily of property and equipment and intangible assets. Long-lived assets to be held and used are tested for recoverability whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. Factors that the Company considers in deciding when to perform an impairment review include significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets, among others. When testing for asset impairment, the Company groups assets and liabilities at the lowest level for which cash flows are separately identifiable. If an impairment review is performed to evaluate a long-lived asset group for recoverability, the Company compares forecasts of undiscounted cash flows expected to result from the use and eventual disposition of the long-lived asset group to its carrying value. An impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of an asset group are less than the asset’s carrying amount. The impairment loss would be based on the excess of the carrying value of the impaired asset group over its fair value. To date, the Company has not recorded any impairment losses on long-lived assets. No impairments were identified during the years ended December 31, 2024, 2023 and 2022.
Investment in Minority Owned Joint Venture	Investment in Minority Owned Joint Venture The Company and Cleveland Clinic partnered to form a joint venture, under the name CCAW, JV LLC, to provide broad access to comprehensive and high acuity care services via digital care. The Company does not have a controlling financial interest in CCAW, JV LLC, but it does have the ability to exercise significant influence over the operating and financial policies of CCAW, JV LLC. Therefore, the Company accounts for its investment in CCAW, JV LLC using the equity method of accounting. The joint venture is considered a variable interest entity under ASC 810-10, but the Company is not the primary beneficiary as it does not have the power to direct the activities of the joint venture that most significantly impact its performance. The Company’s evaluation of ability to impact performance is based on Cleveland Clinic’s managing directors and Cleveland Clinic’s ability to appoint and remove the chairperson who has the ability to cast the tie breaking vote on the most significant activities. During the year ended December 31, 2020, the Company contributed $2,940 as its initial investment for a 49% interest in CCAW, JV LLC. The agreement also requires aggregate total capital contributions by the Company up to an additional $11,800 in two phases, which is yet to be defined. During the years ended December 31, 2024, 2023 and 2022 the Company made a capital contribution of $3,430, $3,920 and $1,960, respectively, related to a portion of the phase one capital commitment. For the years ended December 31, 2024, 2023 and 2022, the Company recognized a loss of $3,110, $2,590 and $2,278 as its proportionate share of the joint ventures results of operations, respectively. Accordingly, the carrying value of the equity method investment as of December 31, 2024 and 2023 was $1,500 and $1,180, respectively.
Advertising Costs	Advertising Costs Advertising costs are expensed as incurred and are included in sales and marketing expense in the consolidated statement of operations and comprehensive loss. For the years ended December 31, 2024, 2023 and 2022, the Company’s advertising expenses were $3,935, $5,508 and $6,607, respectively.
Research and Development Costs	Research and Development Costs Research and development costs are expensed as incurred. Research and development expenses include payroll, employee benefits and other expenses associated with product development.
Internal-Use Software	Internal-Use Software The Company evaluates development costs incurred to develop functionality in connection with its internal-use software for capitalization. Qualifying costs incurred to develop internal-use software are capitalized when (i) the preliminary project stage is completed, (ii) management has authorized further funding for the completion of the project and (iii) it is probable that the project will be completed and performed as intended. Capitalization of these costs ceases once the project is substantially complete and the software is ready for its intended purpose. Capitalized internal-use software costs are included in intangible assets on the consolidated balance sheet for the years ended December 31, 2024 and 2023. There were no impairment charges related to capitalized software development costs during the years ended December 31, 2024, 2023 and 2022. Capitalized software development costs are amortized using the straight-line method over an estimated useful life of three to five years.
Stock-Based Compensation	Stock-Based Compensation The Company measures all stock options and other stock-based awards granted to employees and directors based on the fair value on the date of the grant and recognizes compensation expense of those awards, net of estimated forfeitures, over the requisite service period, which is generally the vesting period of the respective award. Generally, the Company issues stock options, restricted stock units (“RSU’s”) and performance-based market condition share awards ("PSU's") to employees. Stock options and RSUs only have service-based vesting conditions and the Company records the expense for these awards using the straight-line method. PSUs have multiple tranches each with certain market capitalization milestones and service-based vesting conditions and the Company records the expense for these awards over the estimated life of each tranche. The Company classifies stock-based compensation expense in its consolidated statements of operations and comprehensive loss in the same manner in which the award’s recipient’s payroll costs are classified. The Company recognizes compensation expense for only the portion of awards that are expected to vest. In developing a forfeiture rate estimate, the Company has considered its historical experience to estimate pre-vesting forfeitures for service-based awards. The impact of a forfeiture rate adjustment will be recognized in full in the period of adjustment, and if the actual forfeiture rate is materially different from the Company’s estimate, the Company may be required to record adjustments to stock-based compensation expense in future periods. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. The Company historically had been a private company and lacks company-specific historical and implied volatility information. Therefore, it estimates its expected stock volatility based on the historical volatility of a publicly traded set of peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. The expected dividend yield is based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future. The fair value of the PSUs is estimated using a Monte-Carlo valuation simulation. Similar to stock options, the Company estimates its expected stock volatility based on the historical volatility of a publicly traded set of peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. The expected dividend yield is based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.
Deferred Contract Acquisition Costs	Deferred Contract Acquisition Costs The Company capitalizes sales commissions and certain parts of the Company bonus that are incremental to the acquisition of client contracts. These costs are recorded as deferred contract acquisition costs on the consolidated balance sheets. The Company determines whether costs should be deferred based on its sales compensation plans if the commissions are in fact incremental and would not have occurred absent the client contract. Sales commissions are paid upon the initial acquisition of a contract and are amortized over an estimated period of benefit of five years. Amortization is recognized on a straight-line basis commensurate with the pattern of revenue recognition. The Company determined the period of benefit for commissions paid for the acquisition of initial contracts by taking into consideration the commitment term of the client contract, the nature of the Company’s technology development life cycle, and an estimated client relationship period. Amortization of deferred contract acquisition costs is included in sales and marketing expenses in the accompanying consolidated statements of operations and comprehensive loss. The Company reviews these deferred costs to determine whether events or changes in circumstances have occurred that could impact the period of benefit of these deferred contract acquisition costs. There were no impairment losses recorded during the periods presented.
Deferred Contract Fulfillment Costs	Deferred Contract Fulfillment Costs The Company capitalizes costs to fulfill contracts with clients in “Prepaid expenses and other current assets” and “Other assets” on its consolidated balance sheet. The Company amortizes these costs to cost of revenue in the consolidated statement of operations and comprehensive loss consistent with the revenue recognition of the performance obligations in the associated contracts. The Company assesses these costs for impairment at the end of each reporting period. There were no impairment losses recorded during the periods presented.
Comprehensive Loss	Comprehensive Loss Comprehensive loss includes net loss as well as other changes in stockholders’ equity (deficit) that result from transactions and economic events other than those with stockholders.
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company assesses the likelihood that its deferred tax assets will be recovered from future taxable income, and to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. The potential for recovery of deferred tax assets is evaluated by considering taxable income in carryback years, existing taxable temporary differences, prudent and feasible tax planning strategies and estimating the future taxable profits. The Company accounts for uncertainty in income taxes recognized in the financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties.
Net Loss per Share	Net Loss per Share Basic net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net loss attributable to common stockholders is computed by adjusting net losses attributable to common stockholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net loss per share attributable to common stockholders is computed by dividing the diluted net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares. The Company’s convertible preferred stock contractually entitles the holders of such shares to participate in dividends, but contractually does not require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders since dilutive common shares are not assumed to have been issued, as their effect is anti-dilutive. The Company reported a net loss attributable to common stockholders for the years ended December 31, 2024, 2023 and 2022.
Revenue Recognition	Revenue Recognition Platform subscription The Company generates revenue primarily from contracts with clients who purchase subscriptions to access the Company’s enterprise platform and software as a service which includes access to the Company’s affiliated medical group. The Company’s clients do not have the right to take possession of the Company’s software operating its digital care platform at any time. Instead, clients are granted access to the Company’s platform over the contractual period. Access to the platform, including the stand ready obligation to provide access to the affiliated medical group, represents a series of distinct services as the Company continually provides access to and fulfills its obligation to the client over the contract term. The typical contract term is three years. Most of the Company’s contracts are non-cancelable over the contractual term. Clients typically have the right to terminate their contracts for cause if the Company fails to perform in accordance with the contractual terms. For clients who purchase access to the enterprise platform and software as a service (the “Amwell Platform”), the Company hosts a dedicated instance of the Amwell Platform, brandable by the client, with customized workflows and operating choices. The implementation services for the Amwell Platform are not distinct within the context of the contract because the Company’s promise to perform the implementation services are not separately identifiable from the access to the Amwell Platform. The implementation services, which customize the client’s Amwell Platform, are integral to the client’s ability to derive its intended benefit from the Amwell Platform. The development and implementation services generally span several months and cannot be performed by another entity. Therefore, access to the Amwell Platform and the implementation services are bundled together and represent a single performance obligation. The fixed consideration related to the single performance obligation is generally recognized on a straight-line basis over the contract term beginning on the date access to the Amwell Platform is provided. The Company uses a time-elapsed method to measure progress because the Company transfers control evenly over the contractual period. Clients can also purchase access to the Company’s co-branded digital care practice hosted on the Company’s shared services platform (the “Amwell Practice”). The implementation services for the Amwell Practice do not significantly modify or customize the Amwell Practice, typically occur over a few days, and can be performed by other entities. Therefore, access to the Amwell Practice and the implementation services are separate outputs promised by the Company and represent two distinct performance obligations. Clients may be billed prior to the related goods or services being transferred to the client. In determining the transaction price, the Company adjusts the promised amount of consideration for a significant financing component if the timing of payments agreed to by the parties in the contract provide the client a significant benefit of financing. The Company has applied the practical expedient and recognizes the promised amount of consideration without adjusting for the effects of a significant financing component if the Company expects, at contract inception, that the period between the transfer of goods or services to the client when the client pays for that good or service will be one year or less. As of December 31, 2024, the effect of the financing component is not significant and does not materially change the amount of revenue that would be recognized under a contract. The total fixed consideration is allocated to each distinct performance obligation based on standalone selling price (“SSP”) which reflects the amount that the Company charges for each performance obligation if it was sold separately in a standalone sale. The fixed consideration to access the Amwell Practice is recognized on a straight-line basis over the contract term beginning on the date access to the Amwell Practice is provided. A time-elapsed method is used to measure progress because the Company transfers control evenly over the contractual period. The fixed consideration related to the implementation services is recognized as the services are performed. In addition to the fixed consideration received from the Amwell Platform and Amwell Practice, the Company can also receive variable consideration based on the number of members serviced (that is, a stated fee per member per month). The Company allocates the per member per month variable consideration to the month that the fee is earned, correlating with the amount of services it is providing, which is consistent with the allocation objective of the series guidance. Revenue recognized from the per member per month variable consideration does not represent a significant portion of total revenue for the years ended December 31, 2024, 2023 and 2022. Some contracts with clients contain a renewal option which allows the client to continue access to the Amwell Platform for a stated price after the initial contractual term has ended. These renewal options are evaluated on a case-by-case basis but generally do not provide a material right as they are priced at or above the price for the same service that the Company offers to similar clients and, as such, would not result in a separate performance obligation. Visits The Company also generates revenue when either the Amwell Platform or the Amwell Practice is utilized to conduct a medical visit. In the event of a visit, the fee that is earned upon completion of the visit is allocated to the specific day of performance, as the visit fee meets the criteria to allocate variable consideration to a distinct service within a series of distinct services that comprise the single performance obligation. Therefore, visit fees are recognized when the visits are completed, and the Company has delivered on its stand-ready obligation to provide access to the medical professional. In addition, clients can visit with the Company’s affiliated medical group without purchasing access to an Amwell Platform or Amwell Practice. These direct-to-consumer virtual care visits are available through the Company’s website where clients can conduct a visit with the Company’s affiliated medical group for a fixed fee. The Company’s affiliated medical group is responsible for fulfilling the promise to the client to perform the medical visit. The Company has discretion in establishing the price for the visit, is responsible for the resolution of any client issues, and is exposed to credit risk for the receivable due from the client. Therefore, the Company recognizes the visit fee on a gross basis upon completion of the visit. Other Other revenue primarily represents professional services associated with the Amwell Platform. After implementation of the Amwell Platform has been completed, some clients purchase other professional services, which are designed to help clients enhance their ability to use the Amwell Platform. For the majority of arrangements, the Company prices these professional services on a time and material basis, has standalone selling price for these services, and recognizes revenue as services are performed. Other revenue also includes sale of hardware products, such as the Company’s digital care carts and kiosks. Revenue from the sale of hardware products to clients is recognized upon the transfer of control, which occurs upon shipment of the product.
Deferred Revenue	Deferred Revenue Deferred revenue includes amounts collected or billed in excess of revenue recognized. Deferred revenue is recognized as revenue as the related performance obligations are satisfied. Deferred revenue that will be recognized during the succeeding twelve-month period is recorded as a current liability and the remaining portion is recorded as a noncurrent liability on the consolidated balance sheet.
Leases	Leases The Company determines at the inception of a contract if such arrangement is or contains a lease. A contract is or contains a lease if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. The Company classifies leases at the lease commencement date as operating or finance leases and records a right-of-use asset and a lease liability on the consolidated balance sheet for all leases with an initial lease term of greater than 12 months. Leases with an initial term of 12 months or less are not recorded on the balance sheet, but payments are recognized as expense on a straight-line basis over the lease term. The Company’s contracts may contain both lease and non-lease components. Non-lease components may include maintenance, utilities, and other operating costs. The Company combines the lease and non-lease components of fixed costs in its lease arrangements as a single lease component. Variable costs, such as utilities or maintenance costs, are not included in the measurement of right-of-use assets and lease liabilities, but rather are expensed when the event determining the amount of variable consideration to be paid occurs. Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of future lease payments over the expected lease term. The Company determines the present value of future lease payments by using its estimated secured incremental borrowing rate for that lease term as the interest rate implicit in the lease is not readily determinable. The Company estimates its secured incremental borrowing rate for each lease based on the rate of interest that the Company would have to pay to borrow an amount equal to the lease payments on a collateralized basis over a similar term. Certain of the Company’s leases include options to extend or terminate the lease. The amounts determined for the Company’s right-of-use assets and lease liabilities generally do not assume that renewal options or early-termination provisions, if any, are exercised, unless it is reasonably certain that the Company will exercise such options.
Recently Issued and Adopted Accounting Pronouncements	Recently Issued and Adopted Accounting Pronouncements In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which includes amendments to improve reportable segment disclosures. The guidance was adopted with the fiscal year ended December 31, 2024 and impacted the disclosures related to segments (see Note 3). In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which includes amendments to improve income tax disclosures primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. Early adoption is permitted. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures. In March 2024, the U.S. Securities and Exchange Commission ("SEC") adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule would require registrants to disclose certain climate-related information in registration statements and annual reports. In April 2024, the SEC issued an order staying the final rule. Prior to this stay, the disclosure requirements would have applied to the Company's fiscal year beginning January 1, 2026. The Company is currently evaluating the final rule to determine its impact on the Company's disclosures. In November 2024, the FASB issued ASU No. 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of income statement expenses (“ASU 2024-03”), which requires disaggregated information about certain income statement expense line items on an annual and interim basis. ASU 2024-03 is effective for annual periods beginning after December 15, 2026 and interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted and can be applied prospectively or retrospectively. We are evaluating the effect that this guidance will have on our consolidated financial statement disclosures.

Related-Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2020	Dec. 31, 2021
Related Party Transaction [Line Items]
Short-term deferred revenue	$ 53,232	$ 46,365	$ 49,505
Deferred revenue	56,012	52,456	55,794		$ 75,896
Payment to acquire interest in joint venture	3,430	3,920	1,960
CCAW JV LLC [Member]
Related Party Transaction [Line Items]
Deferred revenue	55	1,243
Revenues recognized from related party	1,599	1,576	1,741
Payment to acquire interest in joint venture	3,430	3,920		$ 2,940
Equity method investment, ownership percentage				50.00%
Cleveland Clinic [Member]
Related Party Transaction [Line Items]
Short-term deferred revenue	153	43
Revenues recognized from related party	1,566	2,283	$ 2,803
Related Party [Member] \| CCAW JV LLC [Member]
Related Party Transaction [Line Items]
Due from related parties	400	1,602
Related Party [Member] \| Cleveland Clinic [Member]
Related Party Transaction [Line Items]
Due from related parties	$ 216	$ 24

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Conversa [Member]	SilverCloud earn-out settlement [Member]	Common Stock [Member]	Common Stock [Member] Conversa [Member]	Common Stock [Member] SilverCloud earn-out settlement [Member]	Common Stock [Member] SilverCloud Bonus Escrow [Member]	Additional Paid-in Capital [Member]	Additional Paid-in Capital [Member] Conversa [Member]	Additional Paid-in Capital [Member] SilverCloud earn-out settlement [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Accumulated Deficit [Member]	American Well Corporation Stockholder Equity [Member]	American Well Corporation Stockholder Equity [Member] Conversa [Member]	American Well Corporation Stockholder Equity [Member] SilverCloud earn-out settlement [Member]	Noncontrolling Interest [Member]
Beginning balance at Dec. 31, 2021	$ 1,260,875			$ 132				$ 2,056,763			$ (6,353)	$ (811,284)	$ 1,239,258			$ 21,617
Beginning balance (in shares) at Dec. 31, 2021				13,093,411
Exercise of common stock options	5,666			$ 1				5,665					5,666
Exercise of common stock options, Shares				134,515
Vesting of restricted stock units				$ 3				(3)
Vesting of restricted stock units, Shares				268,577
Shares withheld related to net share settlement and retired treasury stock	(360)							(45)				(315)	(360)
Shares withheld related to net share settlement and retired treasury stock, Shares				(4,250)
Issuance of stock under employee stock purchase plan	2,503							2,503					2,503
Issuance of stock under employee stock purchase plan, Shares				35,168
Issuance of common stock related to Conversa/SilverCloud earn-out settlement		$ 4,298	$ 12,945		$ 1	$ 2			$ 4,297	$ 12,943				$ 4,298	$ 12,945
Issuance of common stock related to Conversa/SilverCloud earn-out settlement, Shares					51,048	247,992	30,330
Receipt of Section 16(b) disgorgement	295							295					295
Stock-based compensation expense	69,144							69,144					69,144
Capital contributed by selling shareholders of acquired businesses	11,173							11,173					11,173
Currency translation adjustment	(10,616)										(10,616)		(10,616)
Net loss	(272,072)											(270,429)	(270,429)			(1,643)
Ending balance at Dec. 31, 2022	1,083,851			$ 139				2,162,735			(16,969)	(1,082,028)	1,063,877			19,974
Ending balance, Shares at Dec. 31, 2022				13,856,791
Exercise of common stock options	569							569					569
Exercise of common stock options, Shares				14,329
Vesting of restricted stock units				$ 5				(5)
Vesting of restricted stock units, Shares				504,815
Shares withheld related to net share settlement and retired treasury stock	(586)											(586)	(586)
Shares withheld related to net share settlement and retired treasury stock, Shares				(13,248)
Issuance of stock under employee stock purchase plan	2,164			$ 1				2,163					2,164
Issuance of stock under employee stock purchase plan, Shares				61,216
Stock-based compensation expense	72,040							72,040					72,040
Currency translation adjustment	1,319										1,319		1,319
Net loss	(679,171)											(675,164)	(675,164)			(4,007)
Ending balance at Dec. 31, 2023	480,186			$ 145				2,237,502			(15,650)	(1,757,778)	464,219			15,967
Ending balance, Shares at Dec. 31, 2023				14,423,903
Vesting of restricted stock units				$ 10				(10)
Vesting of restricted stock units, Shares				1,031,080
Shares repruchased and retired	(3)											(3)	(3)
Shares repruchased and retired, Shares				(338)
Issuance of stock under employee stock purchase plan	1,384			$ 1				1,383					1,384
Issuance of stock under employee stock purchase plan, Shares				115,527
Stock-based compensation expense	47,505							47,505					47,505
Currency translation adjustment	(190)										(190)		(190)
Net loss	(212,638)											(208,143)	(208,143)			(4,495)
Ending balance at Dec. 31, 2024	$ 316,244			$ 156				$ 2,286,380			$ (15,840)	$ (1,965,924)	$ 304,772			$ 11,472
Ending balance, Shares at Dec. 31, 2024				15,570,172

Goodwill and Intangible Assets - Schedule of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning Balance as of January 1	$ 0	$ 435,279
Purchase accounting adjustment	0	0
Goodwill impairment	0	(436,479)
Currency translation adjustments	0	1,200
Ending Balance	$ 0	$ 0

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Property and Equipment, Net - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and Equipment, Gross	$ 13,464	$ 13,371
Less: Accumulated depreciation and amortization	(13,088)	(12,799)
Property and equipment, net	376	572
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property and Equipment, Gross	229	232
Computer and Office Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and Equipment, Gross	7,440	7,322
Computer Software [Member]
Property, Plant and Equipment [Line Items]
Property and Equipment, Gross	5,110	5,125
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and Equipment, Gross	$ 685	$ 692

Net Loss per Share - Schedule of Earnings Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Numerator:
Net loss	$ (212,638)	$ (679,171)	$ (272,072)
Net loss attributable to non-controlling interest	(4,495)	(4,007)	(1,643)
Net loss attributable to American Well Corporation	$ (208,143)	$ (675,164)	$ (270,429)
Denominator:
Weighted-average common shares outstanding, basic	14,999,590	14,212,505	13,712,290
Weighted-average common shares outstanding, diluted	14,999,590	14,212,505	13,712,290
Net loss per share attributable to common stockholders, basic	$ (13.88)	$ (47.5)	$ (19.72)
Net loss per share attributable to common stockholders, diluted	$ (13.88)	$ (47.5)	$ (19.72)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

- Definition

Amount of Net Income (Loss) attributable to noncontrolling interest.

+ References

+ Details

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

+ References

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+ Details

Severance and Strategic Transformation Costs - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
Restructuring Cost and Reserve [Line Items]
Strategic transformation costs, remaining amount to be paid	$ 3,631
Restructuring charges	$ 20,892
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Cost of Goods and Service, Excluding Depreciation, Depletion, and Amortization, General and Administrative Expense, Research and Development Expense, Selling and Marketing Expense
Cost of sales [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 462
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Cost of Goods and Service, Excluding Depreciation, Depletion, and Amortization
Research and development [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 2,399
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Research and Development Expense
Sales and marketing [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 6,842
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Selling and Marketing Expense
General and administrative [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 11,189
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	General and Administrative Expense

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Income Taxes - Summary of Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Deferred tax assets:
Net operating loss carryforwards	$ 258,002	$ 229,264
Research and development credit carryforwards	15,234	1,660
Deferred revenue	298	2,687
Deferred compensation	7,571	5,687
Leasing obligation	2,138	3,087
Capitalized research expense	45,670	43,476
Other	3,736	2,415
Total deferred tax assets	332,648	288,276
Total valuation allowance	313,147	263,001	$ 214,776	$ 164,391
Total net deferred tax assets	19,501	25,275
Deferred tax liabilities:
Joint venture investment basis difference	(841)	(1,054)
Intangibles	(15,800)	(20,879)
Right-of-use assets	(1,878)	(2,738)
Other	(2,006)	(1,902)
Total deferred tax assets (liabilities)	(20,525)	(26,573)
Net deferred tax liabilities	$ (1,024)	$ (1,298)

Segment Information (Tables)

12 Months Ended

Dec. 31, 2024

Segment Reporting [Abstract]

Schedule of Significant Segment Expenses

Significant segment expenses, which represent the difference between revenue and net loss, consist of the following:


	Years Ended December 31,
	2024		2023		2022
Employee compensation		192,812		202,380		197,183
Consulting costs		24,267		43,135		68,433
Provider cost		69,538		72,000		73,254
Stock-based compensation expense		47,505		72,040		69,144
Other segment expense items (1)		137,776		561,635		145,029
Total costs and operating expenses		471,898		951,190		553,043