Liquidity remains a primary concern, with the company reporting a deeply negative free cash flow margin of -31.4% in 2025Q4, further exacerbated by $4.6 million in stock-based compensation.
American Well Corporation (AMWL) cash flow statement — 8-year operating, investing & financing cash flows
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 |
|---|
| Cash from Operations | -26.39M | -65.95M | -127.34M | -148.34M | -192.32M | -141.54M | -112.46M | -81.89M | -74.01M |
| Operating CF Margin % | - | -26.45% | -50.06% | -57.26% | -69.38% | -55.99% | -45.85% | -55.01% | -64.94% |
| Operating CF Growth % | 435.77% | 48.21% | 14.16% | 22.87% | -35.88% | -25.85% | -37.33% | -10.66% | - |
| Net Income | -78.11M | -95.7M | -212.64M | -675.16M | -272.07M | -176.78M | -228.63M | -88.37M | -52.31M |
| Depreciation & Amortization | 32.54M | 33.96M | 32.97M | 31.92M | 26.17M | 16.09M | 10.15M | 7.76M | 5.33M |
| Stock-Based Compensation | 13M | 22.01M | 47.54M | 72.25M | 67.67M | 43.81M | 118.36M | 12.13M | 7.67M |
| Deferred Taxes | -1.11M | -1.11M | -243K | -242K | -2.52M | -6.25M | 3.83M | -1.39M | 884K |
| Other Non-Cash Items | 6.83M | 1.68M | 15.01M | 438.4M | 16.53M | 9.31M | 2.26M | 2.49M | 1.19M |
| Working Capital Changes | -642K | -26.8M | -9.98M | -15.51M | -28.1M | -27.71M | -18.45M | -14.52M | -36.77M |
| Change in Receivables | -4.22M | 12.22M | -25.01M | 3.25M | -8.14M | -512K | -14.21M | 803K | -19.47M |
| Change in Inventory | 1.02M | 1.17M | 1.9M | 2.08M | -1.21M | 1.6M | -6.02M | -592K | 1.57M |
| Change in Payables | -2.02M | -3.42M | 159K | -2.36M | -4.78M | 5.55M | -707K | 1.16M | -787K |
| Cash from Investing | -903K | 17.1M | -18.65M | -19.17M | -11.63M | -59.63M | -66.76M | 120M | -245.93M |
| Capital Expenditures | 2.76M | -21K | -119K | -292K | -10.45M | -559K | -3.32M | -1.34M | -1.91M |
| CapEx % of Revenue | 1.26% | 0.01% | 0.05% | 0.11% | 3.77% | 0.22% | 1.35% | 0.9% | 1.68% |
| Acquisitions | -2.27M | 18.32M | -3.43M | 0 | -1.96M | -159.07M | -2.94M | -45.75M | -64.38M |
| Investments | - | - | - | - | - | - | - | - | - |
| Other Investing | -8.41M | -196K | -15.1M | -18.88M | 0 | -2.55M | 0 | 0 | 0 |
| Cash from Financing | 601K | 840K | 1.38M | 2.15M | -3.61M | 5.75M | 983.12M | 46.64M | 278.18M |
| Debt Issued (Net) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Equity Issued (Net) | 601K | 840K | -3K | -586K | -360K | -15.04M | 980.48M | 45.6M | 277.55M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -2K | -4K | -3K | -586K | -360K | -15.04M | -37.57M | -158K | -2.9M |
| Other Financing | 0 | 0 | 1.38M | 2.73M | -3.25M | 20.79M | 2.64M | 1.04M | 635K |
| Net Change in Cash | -23.13M | -45.99M | -143.72M | -166.51M | -207.87M | -195.5M | 803.89M | 84.75M | -41.76M |
| Free Cash Flow | -23.63M | -65.97M | -142.56M | -163.59M | -202.77M | -142.1M | -115.78M | -83.23M | -75.92M |
| FCF Margin % | -10.81% | -26.46% | -56.05% | -63.15% | -73.15% | -56.21% | -47.21% | -55.91% | -66.62% |
| FCF Growth % | 71.45% | 53.72% | 12.86% | 19.32% | -42.7% | -22.73% | -39.11% | -9.63% | - |
| FCF per Share | -1.41 | -4.11 | -9.50 | -11.51 | -14.79 | -11.19 | -23.38 | -40.46 | -37.41 |
| FCF Conversion (FCF/Net Income) | 0.30x | 0.69x | 0.61x | 0.22x | 0.71x | 0.80x | 0.50x | 0.94x | 1.40x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 362K | 1.97M | 4.11M | 5M | 1.72M | 1.59M | 713K | 193K | 0 |
Quick answers to the most common questions about buying AMWL stock.
American Well Corporation (AMWL) generated $-66.0M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
American Well Corporation (AMWL) reported negative free cash flow of $66.0M in 2025, indicating capital requirements exceeded cash from operations.
American Well Corporation (AMWL) spent $0.0M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, American Well Corporation (AMWL) spent $0.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.
Key Metrics
Top Statement Risk
Persistent Cash Burn Velocity
Metrics are mathematically derived from official filings.
Earnings Quality and Cash Disconnect
According to the provided financial data, AMWL exhibits a persistent disconnect between net losses and operating cash flow, with the OCF/NI ratio fluctuating significantly, reaching 0.70 in 2025Q4, which suggests that non-cash charges and working capital movements are masking the true extent of operational cash consumption.
The reliance on stock-based compensation to bridge the gap between GAAP net income and cash flow warrants caution, as it obscures the underlying cash burn required to sustain the business. Investors should monitor whether the company can achieve a more stable conversion ratio as the Converge platform migration concludes.
Negative Free Cash Flow Trajectory
As reported in recent financial statements, AMWL's free cash flow remains deeply negative, with a 2025Q4 FCF margin of -31.4%, indicating that the company continues to consume significant liquidity to support its operations despite ongoing efforts to streamline the cost structure and transition to the Converge platform.
The consistent negative FCF trajectory suggests that the business model has yet to reach the necessary scale to self-fund its R&D and operational requirements. This trend implies that the company remains highly dependent on external financing or existing cash reserves to maintain its current market footprint.
Working Capital Volatility and Drag
Based on the company's reported figures, working capital changes have been a recurring source of cash volatility, with a notable $9.1 million outflow in 2025Q4, suggesting that the timing of collections and payables management remains a significant challenge for the firm's liquidity position during this transition.
The erratic nature of these working capital swings may indicate friction in the billing cycle or delays in realizing cash from enterprise-level contracts. This volatility complicates cash flow forecasting and highlights the operational risks inherent in managing large-scale, multi-year health system implementations.
Obscured Costs and Cash Realities
As indicated by the provided data, the cash flow statement is heavily impacted by significant stock-based compensation, which totaled $4.6 million in 2025Q4, effectively acting as a non-cash expense that obscures the true economic cost of talent retention required to maintain the company's complex software infrastructure.
The persistent use of equity-based incentives suggests that the company is managing its cash burn by shifting compensation costs off the cash flow statement. Analysts should consider the dilutive impact of these grants, as they represent a real economic cost to shareholders that is not captured in the headline cash flow metrics.