UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 10-Q

 

(Mark One)

 

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the quarterly period ended June 30, 20212022

 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the transition period from to to

Commission File Number: 001-39515

 

American Well Corporation

(Exact name of registrant as specified in its charter)

 

 

Delaware

20-5009396

(State of incorporation)

(I.R.S. Employer
Identification Number)

 

75 State Street, 26th Floor

Boston, MA02109

(Address of registrant’s principal executive offices)

(617) (617) 204-3500

(Registrant’s telephone number, including area code)

 

Securities registered pursuant to Section 12(b) of the Act:

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Class A common stock,
par value of $0.01 per share

AMWL

The New York Stock Exchange

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definition of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer

 

Accelerated filer

 

 

 

 

 

Non-accelerated filer

 

Smaller reporting company

 

 

 

 

 

 

 

 

Emerging growth company

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No

Securities registered pursuant to Section 12(b) of the Act:

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Class A common stock,
par value of $0.01 per share

AMWL

The New York Stock Exchange

As of July 31, 2021,2022, the number of shares of the registrant’s Class A common stock outstanding was 210,681,731,240,621,761, the number of shares of the registrant’s Class B common stock outstanding was 26,650,76127,390,397 and the number of shares of the registrant’s Class C common stock outstanding was 5,555,555.5,555,555.

 

 


American Well Corporation

QUARTERLY REPORT ON FORM 10-Q

For the period ended June 30, 20212022

TABLE OF CONTENTS

 

 

 

Page

 

PART I

Financial Information

3

Item 1.

Financial Statements

3

 

Condensed Consolidated Balance Sheet as of June 30, 20212022 (unaudited) and December 31, 20202021

3

 

Condensed Consolidated Statement of Operations and Comprehensive Loss (unaudited) for the three and six months ended June 30, 20212022 and 20202021

4

 

Condensed Consolidated Statement of Stockholders’ Equity (Deficit) (unaudited) for the three and six months ended June 30, 20212022 and 20202021

5

 

Condensed Consolidated Statement of Cash Flows (unaudited) for the six months ended June 30, 20212022 and 20202021

7

 

Notes to the Unaudited Condensed Consolidated Financial Statements

8

Item 2

Management’s Discussion and Analysis of Financial Condition and Results of Operations

2322

Item 3.

Quantitative and Qualitative Disclosures About Market Risk

3534

Item 4.

Controls and Procedures

3635

PART II

Other Information

3836

Item 1.

Legal Proceedings

3836

Item 1A.

Risk Factors

3836

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

3836

Item 3.

Defaults Upon Senior Securities

3937

Item 4.

Mine Safety Disclosures

3937

Item 5.

Other Information

3937

Item 6.

Exhibits

4037

 

 

 


 

PART I - FINANCIAL INFORMATION

Item 1. Financial Statements

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED BALANCE SHEETS

(in thousands, except share and per share amounts)

(unaudited)

 

 

June 30, 2022

 

 

December 31, 2021

 

Assets

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

Cash and cash equivalents

 

$

257,189

 

 

$

746,416

 

Investments

 

 

372,880

 

 

 

 

Accounts receivable ($82 and $2,054, from related parties and net of
   allowances of $
1,452 and $1,809, respectively)

 

 

44,675

 

 

 

51,375

 

Inventories

 

 

7,921

 

 

 

7,530

 

Deferred contract acquisition costs

 

 

1,781

 

 

 

1,697

 

Prepaid expenses and other current assets

 

 

22,148

 

 

 

20,278

 

Total current assets

 

 

706,594

 

 

 

827,296

 

Restricted cash

 

 

795

 

 

 

795

 

Property and equipment, net

 

 

1,498

 

 

 

2,235

 

Goodwill

 

 

433,840

 

 

 

442,761

 

Intangible assets, net

 

 

136,434

 

 

 

152,409

 

Operating lease right-of-use asset

 

 

14,511

 

 

 

16,422

 

Deferred contract acquisition costs, net of current portion

 

 

2,202

 

 

 

2,028

 

Other assets

 

 

1,233

 

 

 

1,722

 

Investment in minority owned joint venture

 

 

1,366

 

 

 

168

 

Total assets

 

$

1,298,473

 

 

$

1,445,836

 

Liabilities and Stockholders’ Equity

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

Accounts payable

 

$

5,490

 

 

$

12,156

 

Accrued expenses and other current liabilities

 

 

43,649

 

 

 

58,711

 

Operating lease liability, current

 

 

3,174

 

 

 

1,918

 

Deferred revenue ($867 and $1,860 from related parties, respectively)

 

 

63,971

 

 

 

68,841

 

Total current liabilities

 

 

116,284

 

 

 

141,626

 

Other long-term liabilities

 

 

3,677

 

 

 

5,136

 

Contingent consideration liabilities, net of current portion

 

 

 

 

 

16,450

 

Operating lease liability, net of current portion

 

 

12,842

 

 

 

14,694

 

Deferred revenue, net of current portion ($16 and $22 from related
   parties, respectively)

 

 

4,777

 

 

 

7,055

 

Total liabilities

 

 

137,580

 

 

 

184,961

 

Commitments and contingencies (Note 11)

 

 

 

 

 

 

Stockholders’ equity:

 

 

 

 

 

 

Preferred stock, $0.01 par value; 100,000,000 shares authorized, 0 shares
   issued or outstanding as of June 30, 2022 and as of December 31, 2021

 

 

 

 

 

 

Common stock, $0.01 par value; 1,000,000,000 Class A shares authorized, 240,397,065 and
   
229,402,453 shares issued and outstanding, respectively; 100,000,000 Class B shares authorized,
    
27,390,397 and 26,913,579 shares issued and outstanding, respectively; 200,000,000 Class C
    shares authorized
5,555,555 issued and outstanding as of June 30, 2022 and as of December 31,
    2021

 

 

2,734

 

 

 

2,620

 

Additional paid-in capital

 

 

2,108,576

 

 

 

2,054,275

 

Accumulated other comprehensive income

 

 

(20,845

)

 

 

(6,353

)

Accumulated deficit

 

 

(950,466

)

 

 

(811,284

)

Total American Well Corporation stockholders’ equity

 

 

1,139,999

 

 

 

1,239,258

 

Non-controlling interest

 

 

20,894

 

 

 

21,617

 

Total stockholders’ equity

 

 

1,160,893

 

 

 

1,260,875

 

Total liabilities and stockholders’ equity

 

$

1,298,473

 

 

$

1,445,836

 

 

 

June 30, 2021

 

 

December 31, 2020

 

Assets

 

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

975,187

 

 

$

941,616

 

Investments

 

 

 

 

 

99,963

 

Restricted cash

 

 

795

 

 

 

1,095

 

Accounts receivable ($650 and $12,053, from related parties and net of

   allowances of $1,039 and $1,556, respectively)

 

 

35,544

 

 

 

45,296

 

Inventories

 

 

8,929

 

 

 

9,128

 

Deferred contract acquisition costs

 

 

2,450

 

 

 

2,134

 

Prepaid expenses and other current assets

 

 

13,491

 

 

 

14,055

 

Total current assets

 

 

1,036,396

 

 

 

1,113,287

 

Property and equipment, net

 

 

2,985

 

 

 

3,836

 

Goodwill

 

 

193,877

 

 

 

193,877

 

Intangible assets, net

 

 

51,672

 

 

 

55,528

 

Operating lease right-of-use asset

 

 

3,486

 

 

 

6,609

 

Deferred contract acquisition costs, net of current portion

 

 

898

 

 

 

1,327

 

Other assets

 

 

1,246

 

 

 

1,430

 

Investment in minority owned joint venture

 

 

1,759

 

 

 

752

 

Total assets

 

$

1,292,319

 

 

$

1,376,646

 

Liabilities, Convertible Preferred Stock and Stockholders’ Deficit

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

 

Accounts payable

 

$

5,173

 

 

$

5,797

 

Accrued expenses and other current liabilities

 

 

24,864

 

 

 

42,135

 

Operating lease liability, current

 

 

3,471

 

 

 

6,357

 

Deferred revenue ($2,238 and $14,421 from related parties, respectively)

 

 

57,836

 

 

 

66,693

 

Total current liabilities

 

 

91,344

 

 

 

120,982

 

Other long-term liabilities

 

 

26

 

 

 

64

 

Operating lease liability, net of current portion

 

 

776

 

 

 

1,296

 

Deferred revenue, net of current portion ($29 and $486 from related

   parties, respectively)

 

 

7,530

 

 

 

8,107

 

Total liabilities

 

 

99,676

 

 

 

130,449

 

Commitments and contingencies (Note 11)

 

 

 

 

 

 

 

 

Stockholders’ deficit:

 

 

 

 

 

 

 

 

Preferred stock, $0.01 par value; 100,000,000 shares authorized, 0 shares

   issued or outstanding as of June 30, 2021 and as of December 31, 2020

 

 

 

 

 

 

Common stock, $0.01 par value; 1,000,000,000 Class A shares authorized, 209,875,389 and

   201,488,097 shares issued, and 209,875,389 and 200,751,168 shares outstanding, respectively;

   100,000,000 Class B shares authorized, 26,687,959 and 30,427,128 shares issued, and 26,687,959

   and 29,297,382 shares outstanding, respectively; 200,000,000 Class C shares authorized 5,555,555

   issued and outstanding as of June 30, 2021 and December 31, 2020

 

 

2,422

 

 

 

2,357

 

Treasury stock, 0 shares and 1,866,675 shares as of June 30, 2021

   and December 31, 2020, respectively

 

 

 

 

 

(37,568

)

Additional paid-in capital

 

 

1,877,497

 

 

 

1,841,405

 

Accumulated other comprehensive income

 

 

140

 

 

 

297

 

Accumulated deficit

 

 

(708,587

)

 

 

(582,359

)

Total American Well Corporation stockholders’ equity

 

 

1,171,472

 

 

 

1,224,132

 

Non-controlling interest

 

 

21,171

 

 

 

22,065

 

Total stockholders’ equity

 

 

1,192,643

 

 

 

1,246,197

 

Total liabilities, preferred stock and stockholders’ equity

 

$

1,292,319

 

 

$

1,376,646

 

The accompanying notes are an integral part of these condensed consolidated financial statements.


3


AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

(in thousands, except share and per share amounts)

(unaudited)

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

($1,462, $15,912, $3,089 and $29,160 from related parties, respectively)

 

$

60,217

 

 

$

68,568

 

 

$

117,816

 

 

$

122,282

 

( $1,163, $1,462, $2,377 and $3,089 from related parties, respectively)

 

$

64,516

 

 

$

60,217

 

 

$

128,748

 

 

$

117,816

 

Costs and operating expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Costs of revenue, excluding depreciation and amortization of intangible assets

 

 

33,889

 

 

 

43,826

 

 

 

69,594

 

 

 

76,853

 

 

 

36,497

 

 

 

33,889

 

 

$

73,262

 

 

$

69,594

 

Research and development

 

 

22,378

 

 

 

17,637

 

 

 

45,418

 

 

 

32,573

 

 

 

37,067

 

 

 

22,378

 

 

$

74,548

 

 

$

45,418

 

Sales and marketing

 

 

14,789

 

 

 

12,346

 

 

 

28,521

 

 

 

26,220

 

 

 

18,721

 

 

 

14,789

 

 

$

39,875

 

 

$

28,521

 

General and administrative

 

 

24,212

 

 

 

80,082

 

 

 

45,566

 

 

 

95,424

 

 

 

34,911

 

 

 

24,212

 

 

$

67,627

 

 

$

45,566

 

Depreciation and amortization expense

 

 

2,484

 

 

 

2,509

 

 

 

4,990

 

 

 

4,795

 

 

 

6,724

 

 

 

2,484

 

 

$

13,322

 

 

$

4,990

 

Total costs and operating expenses

 

 

97,752

 

 

 

156,400

 

 

 

194,089

 

 

 

235,865

 

 

 

133,920

 

 

 

97,752

 

 

 

268,634

 

 

 

194,089

 

Loss from operations

 

 

(37,535

)

 

 

(87,832

)

 

 

(76,273

)

 

 

(113,583

)

 

 

(69,404

)

 

 

(37,535

)

 

 

(139,886

)

 

 

(76,273

)

Interest income and other income (expense), net

 

 

224

 

 

 

308

 

 

 

285

 

 

 

1,155

 

Interest income and other (expense) income, net

 

 

764

 

 

 

224

 

 

$

872

 

 

$

285

 

Loss before expense from income taxes and loss from

equity method investment

 

 

(37,311

)

 

 

(87,524

)

 

 

(75,988

)

 

 

(112,428

)

 

 

(68,640

)

 

 

(37,311

)

 

 

(139,014

)

 

 

(75,988

)

Expense from income taxes

 

 

(103

)

 

 

(252

)

 

 

(412

)

 

 

(252

)

Benefit (Expense) from income taxes

 

 

(461

)

 

 

(103

)

 

$

(129

)

 

$

(412

)

Loss from equity method investment

 

 

(722

)

 

 

(444

)

 

 

(1,541

)

 

 

(764

)

 

 

(551

)

 

 

(722

)

 

$

(762

)

 

$

(1,541

)

Net loss

 

 

(38,136

)

 

 

(88,220

)

 

 

(77,941

)

 

 

(113,444

)

 

 

(69,652

)

 

 

(38,136

)

 

 

(139,905

)

 

 

(77,941

)

Net loss attributable to non-controlling interest

 

 

(277

)

 

 

(1,562

)

 

 

(894

)

 

 

(2,405

)

 

 

(507

)

 

 

(277

)

 

$

(723

)

 

$

(894

)

Net loss attributable to American Well Corporation

 

$

(37,859

)

 

$

(86,658

)

 

$

(77,047

)

 

$

(111,039

)

 

$

(69,145

)

 

$

(37,859

)

 

$

(139,182

)

 

$

(77,047

)

Net loss per share attributable to common stockholders,

basic and diluted

 

$

(0.15

)

 

$

(1.99

)

 

$

(0.31

)

 

$

(2.66

)

 

$

(0.25

)

 

$

(0.15

)

 

$

(0.51

)

 

$

(0.31

)

Weighted-average common shares outstanding, basic and diluted

 

 

249,366,652

 

 

 

43,484,313

 

 

 

246,471,733

 

 

 

41,793,108

 

 

 

273,320,740

 

 

 

249,366,652

 

 

 

273,615,031

 

 

 

246,471,733

 

Net loss

 

$

(38,136

)

 

$

(88,220

)

 

$

(77,941

)

 

$

(113,444

)

 

$

(69,652

)

 

$

(38,136

)

 

$

(139,905

)

 

$

(77,941

)

Other comprehensive income (loss), net of tax:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unrealized gain on available-for-sale investments

 

 

(119

)

 

 

(323

)

 

 

(85

)

 

 

(280

)

Unrealized (loss) gain on available-for-sale investments

 

 

(111

)

 

 

(119

)

 

 

(1,362

)

 

 

(85

)

Foreign currency translation

 

 

(20

)

 

 

349

 

 

 

(72

)

 

 

178

 

 

 

(10,179

)

 

 

(20

)

 

 

(13,130

)

 

 

(72

)

Comprehensive loss

 

 

(38,275

)

 

 

(88,194

)

 

 

(78,098

)

 

 

(113,546

)

 

 

(79,942

)

 

 

(38,275

)

 

 

(154,397

)

 

 

(78,098

)

Less: Comprehensive loss attributable to

non-controlling interest

 

 

(277

)

 

 

(1,562

)

 

 

(894

)

 

 

(2,405

)

 

 

(507

)

 

 

(277

)

 

 

(723

)

 

 

(894

)

Comprehensive loss attributable to American Well Corporation

 

$

(37,998

)

 

$

(86,632

)

 

$

(77,204

)

 

$

(111,141

)

 

$

(79,435

)

 

$

(37,998

)

 

$

(153,674

)

 

$

(77,204

)

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

4



 

AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ EQUITY (DEFICIT)

(in thousands, except share amounts)

(unaudited)

 

 

Common Stock

 

 

Treasury

 

 

Additional

Paid-In

 

 

Accumulated

Other

Comprehensive

 

 

Accumulated

 

 

American Well

Corporation

Stockholders’

 

 

Noncontrolling

 

 

Total

Stockholders’

 

 

Shares

 

 

Amount

 

 

Stock

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Equity

 

 

Interest

 

 

Equity

 

 

Common Stock

 

 

Additional
Paid-In

 

Accumulated
Other
Comprehensive

 

Accumulated

 

American Well
Corporation
Stockholders’

 

Noncontrolling

 

Total
Stockholders’

 

Balances as of December 31, 2020

 

 

235,604,105

 

 

$

2,357

 

 

$

(37,568

)

 

$

1,841,405

 

 

$

297

 

 

$

(582,359

)

 

$

1,224,132

 

 

$

22,065

 

 

$

1,246,197

 

 

Shares

 

 

Amount

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Equity

 

 

Interest

 

 

Equity

 

Balances as of January 1, 2022

 

 

261,871,587

 

 

$

2,620

 

 

$

2,054,275

 

 

$

(6,353

)

 

$

(811,284

)

 

$

1,239,258

 

 

$

21,617

 

 

$

1,260,875

 

Exercise of common stock options

 

 

3,474,375

 

 

 

34

 

 

 

 

 

 

10,096

 

 

 

 

 

 

 

 

 

10,130

 

 

 

 

 

 

10,130

 

 

 

976,644

 

 

 

10

 

 

 

2,455

 

 

 

 

 

 

 

 

 

2,465

 

 

 

 

 

 

2,465

 

Vesting of restricted stock units

 

 

853,842

 

 

 

9

 

 

 

 

 

 

(9

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1,398,305

 

 

 

14

 

 

 

(14

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retirement of treasury stock purchased in 2020

 

 

 

 

 

 

 

 

37,568

 

 

 

(15

)

 

 

 

 

 

(37,553

)

 

 

 

 

 

 

 

 

 

Shares withheld related to net share settlement and retired treasury stock in 2021

 

 

(402,060

)

 

 

(4

)

 

 

 

 

 

4

 

 

 

 

 

 

(9,771

)

 

 

(9,771

)

 

 

 

 

 

(9,771

)

Issuance of stock under employee stock purchase plan

 

 

425,114

 

 

 

4

 

 

 

1,497

 

 

 

 

 

 

 

 

 

1,501

 

 

 

 

 

 

1,501

 

Issuance of common stock related to Conversa earn-out settlement

 

 

1,020,964

 

 

 

10

 

 

 

4,288

 

 

 

 

 

 

 

 

 

4,298

 

 

 

 

 

 

4,298

 

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

 

 

8,642

 

 

 

 

 

 

 

 

 

8,642

 

 

 

 

 

 

8,642

 

 

 

 

 

 

 

 

 

12,085

 

 

 

 

 

 

 

 

 

12,085

 

 

 

 

 

 

12,085

 

Capital contributed by selling shareholders of acquired businesses

 

 

 

 

 

 

 

 

2,019

 

 

 

 

 

 

 

 

 

2,019

 

 

 

 

 

 

2,019

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(52

)

 

 

 

 

 

(52

)

 

 

 

 

 

(52

)

 

 

 

 

 

 

 

 

 

 

 

(2,951

)

 

 

 

 

 

(2,951

)

 

 

 

 

 

(2,951

)

Unrealized gains on available-for-sale

securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34

 

 

 

 

 

 

34

 

 

 

 

 

 

34

 

Unrealized losses on available-for-sale
securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

(1,251

)

 

 

 

 

 

(1,251

)

 

 

 

 

 

(1,251

)

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(39,188

)

 

 

(39,188

)

 

 

(617

)

 

 

(39,805

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(70,037

)

 

 

(70,037

)

 

 

(216

)

 

 

(70,253

)

Balances as of March 31, 2021

 

 

239,530,262

 

 

 

2,396

 

 

 

 

 

 

1,860,123

 

 

 

279

 

 

 

(668,871

)

 

 

1,193,927

 

 

 

21,448

 

 

 

1,215,375

 

Balances as of March 31, 2022

 

 

265,692,614

 

 

 

2,658

 

 

 

2,076,605

 

 

 

(10,555

)

 

 

(881,321

)

 

 

1,187,387

 

 

 

21,401

 

 

 

1,208,788

 

Exercise of common stock options

 

 

1,812,491

 

 

 

18

 

 

 

 

 

 

6,656

 

 

 

 

 

 

 

 

 

6,674

 

 

 

 

 

 

6,674

 

 

 

1,083,571

 

 

 

10

 

 

 

1,916

 

 

 

 

 

 

 

 

 

1,926

 

 

 

 

 

 

1,926

 

Vesting of restricted stock units

 

 

844,900

 

 

 

9

 

 

 

 

 

 

(9

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1,606,976

 

 

 

16

 

 

 

(16

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares withheld related to net share settlement and retired treasury stock in 2021

 

 

(68,750

)

 

 

(1

)

 

 

 

 

 

1

 

 

 

 

 

 

(1,857

)

 

 

(1,857

)

 

 

 

 

 

(1,857

)

Issuance of common stock related to SilverCloud earn-out settlement

 

 

4,959,856

 

 

 

50

 

 

 

12,895

 

 

 

 

 

 

 

 

 

12,945

 

 

 

 

 

 

12,945

 

Receipt of Section 16(b) disgorgement

 

 

 

 

 

 

 

 

295

 

 

 

 

 

 

 

 

 

295

 

 

 

 

 

 

295

 

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

 

 

10,726

 

 

 

 

 

 

 

 

 

10,726

 

 

 

 

 

 

10,726

 

 

 

 

 

 

 

 

 

14,907

 

 

 

 

 

 

 

 

 

14,907

 

 

 

 

 

 

14,907

 

Capital contributed by selling shareholders of acquired businesses

 

 

 

 

 

 

 

 

1,974

 

 

 

 

 

 

 

 

 

1,974

 

 

 

 

 

 

1,974

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20

)

 

 

 

 

 

(20

)

 

 

 

 

 

(20

)

 

 

 

 

 

 

 

 

 

 

 

(10,179

)

 

 

 

 

 

(10,179

)

 

 

 

 

 

(10,179

)

Unrealized gains on available-for-sale

securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(119

)

 

 

 

 

 

(119

)

 

 

 

 

 

(119

)

Unrealized losses on available-for-sale
securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

(111

)

 

 

 

 

 

(111

)

 

 

 

 

 

(111

)

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(37,859

)

 

 

(37,859

)

 

 

(277

)

 

 

(38,136

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(69,145

)

 

 

(69,145

)

 

 

(507

)

 

 

(69,652

)

Balances as of June 30, 2021

 

 

242,118,903

 

 

$

2,422

 

 

$

 

 

$

1,877,497

 

 

$

140

 

 

$

(708,587

)

 

$

1,171,472

 

 

$

21,171

 

 

$

1,192,643

 

Balances as of June 30, 2022

 

 

273,343,017

 

 

$

2,734

 

 

$

2,108,576

 

 

$

(20,845

)

 

$

(950,466

)

 

$

1,139,999

 

 

$

20,894

 

 

$

1,160,893

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.


5


AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ EQUITY (DEFICIT)

(in thousands, except share amounts)

(unaudited)

 

 

Convertible

Preferred Stock

 

 

Common Stock

 

 

Treasury

 

 

Additional

Paid-In

 

 

Accumulated

Other

Comprehensive

 

 

Accumulated

 

 

American

Well

Corporation

Stockholders’

 

 

Noncontrolling

 

 

Total

Stockholders’

 

 

Shares

 

 

Amount

 

 

Shares

 

 

Amount

 

 

Stock

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Deficit

 

 

Interest

 

 

(Deficit)

 

 

Common Stock

 

 

Treasury

 

 

Additional
Paid-In

 

 

Accumulated
Other
Comprehensive

 

 

Accumulated

 

 

American Well
Corporation
Stockholders’

 

 

Noncontrolling

 

 

Total
Stockholders’

 

Balances as of January 1, 2020

 

 

14,012,935

 

 

$

655,799

 

 

 

42,302,845

 

 

 

423

 

 

$

(158

)

 

 

50,289

 

 

$

250

 

 

$

(357,927

)

 

$

(307,123

)

 

$

26,259

 

 

$

(280,864

)

Issuance of Series C convertible preferred stock,

net of issuance costs of $261

 

 

170,000

 

 

 

12,489

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares

 

 

Amount

 

 

Stock

 

 

Capital

 

 

Income (Loss)

 

 

Deficit

 

 

Equity

 

 

Interest

 

 

Equity

 

Balances as of January 1, 2021

 

 

235,604,105

 

 

 

2,357

 

 

$

(37,568

)

 

 

1,841,405

 

 

$

297

 

 

$

(582,359

)

 

$

1,224,132

 

 

$

22,065

 

 

$

1,246,197

 

Exercise of common stock options

 

 

 

 

 

 

 

 

7,392

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

2

 

 

 

3,474,375

 

 

 

34

 

 

 

 

 

 

10,096

 

 

 

 

 

 

 

 

 

10,130

 

 

 

 

 

 

10,130

 

Vesting of restricted stock units

 

 

 

 

 

 

 

 

146,969

 

 

 

1

 

 

 

 

 

 

(1

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

853,842

 

 

 

9

 

 

 

 

 

 

(9

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retirement of treasury stock purchased in 2020

 

 

 

 

 

 

 

 

37,568

 

 

 

(15

)

 

 

 

 

 

(37,553

)

 

 

 

 

 

 

 

 

 

Shares withheld related to net share settlement and retired treasury stock in 2021

 

 

(402,060

)

 

 

(4

)

 

 

 

 

 

4

 

 

 

 

 

 

(9,771

)

 

 

(9,771

)

 

 

 

 

 

(9,771

)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4,458

 

 

 

 

 

 

 

 

 

4,458

 

 

 

 

 

 

4,458

 

 

 

 

 

 

 

 

 

 

 

 

8,642

 

 

 

 

 

 

 

 

 

8,642

 

 

 

 

 

 

8,642

 

Retirement of treasury stock

 

 

 

 

 

 

 

 

 

 

 

 

 

 

158

 

 

 

(158

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(171

)

 

 

 

 

 

(171

)

 

 

 

 

 

(171

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(52

)

 

 

 

 

 

(52

)

 

 

 

 

 

(52

)

Unrealized gains on available-for

-sale securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

43

 

 

 

 

 

 

43

 

 

 

 

 

 

43

 

Unrealized gains on available-for-sale
securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34

 

 

 

 

 

 

34

 

 

 

 

 

 

34

 

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(24,381

)

 

 

(24,381

)

 

 

(843

)

 

 

(25,224

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(39,188

)

 

 

(39,188

)

 

 

(617

)

 

 

(39,805

)

Balances as of March 31, 2020

 

 

14,182,935

 

 

 

668,288

 

 

 

42,457,206

 

 

 

424

 

 

 

 

 

 

54,590

 

 

 

122

 

 

 

(382,308

)

 

 

(327,172

)

 

 

25,416

 

 

 

(301,756

)

Issuance of Series C convertible preferred stock,

net of issuance costs of $750

 

 

1,342,750

 

 

 

133,525

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treasury stock

 

 

 

 

 

 

 

 

(61,600

)

 

 

 

 

 

 

(163

)

 

 

 

 

 

 

 

 

 

 

 

(163

)

 

 

 

 

 

(163

)

Balances as of March 31, 2021

 

 

239,530,262

 

 

 

2,396

 

 

 

 

 

 

1,860,123

 

 

 

279

 

 

 

(668,871

)

 

 

1,193,927

 

 

 

21,448

 

 

 

1,215,375

 

Exercise of common stock options

 

 

 

 

 

 

 

 

768,106

 

 

 

8

 

 

 

 

 

 

2,322

 

 

 

 

 

 

 

 

 

2,330

 

 

 

 

 

 

2,330

 

 

 

1,812,491

 

 

 

18

 

 

 

 

 

 

6,656

 

 

 

 

 

 

 

 

 

6,674

 

 

 

 

 

 

6,674

 

Vesting of restricted stock units

 

 

 

 

 

 

 

 

204,829

 

 

 

2

 

 

 

 

 

 

(2

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

844,900

 

 

 

9

 

 

 

 

 

 

(9

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares withheld related to net share settlement and retired treasury stock in 2021

 

 

(68,750

)

 

 

(1

)

 

 

 

 

 

1

 

 

 

 

 

 

(1,857

)

 

 

(1,857

)

 

 

 

 

 

(1,857

)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

67,638

 

 

 

 

 

 

 

 

 

67,638

 

 

 

 

 

 

67,638

 

 

 

 

 

 

 

 

 

 

 

 

10,726

 

 

 

 

 

 

 

 

 

10,726

 

 

 

 

 

 

10,726

 

Currency translation adjustment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

349

 

 

 

 

 

 

349

 

 

 

 

 

 

349

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20

)

 

 

 

 

 

(20

)

 

 

 

 

 

(20

)

Unrealized gains on available-for

-sale securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(323

)

 

 

 

 

 

(323

)

 

 

 

 

 

(323

)

Unrealized gains on available-for-sale
securities, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(119

)

 

 

 

 

 

(119

)

 

 

 

 

 

(119

)

Net loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(86,658

)

 

 

(86,658

)

 

 

(1,562

)

 

 

(88,220

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(37,859

)

 

 

(37,859

)

 

 

(277

)

 

 

(38,136

)

Balances as of June 30, 2020

 

 

15,525,685

 

 

$

801,813

 

 

 

43,368,541

 

 

$

434

 

 

$

(163

)

 

$

124,548

 

 

$

148

 

 

$

(468,966

)

 

$

(343,999

)

 

$

23,854

 

 

$

(320,145

)

Balances as of June 30, 2021

 

 

242,118,903

 

 

$

2,422

 

 

$

-

 

 

$

1,877,497

 

 

$

140

 

 

$

(708,587

)

 

$

1,171,472

 

 

$

21,171

 

 

$

1,192,643

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

6


 


AMERICAN WELL CORPORATION

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands, except share and per share amounts)

(unaudited)

 

 

Six Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

Cash flows from operating activities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net loss

 

$

(77,941

)

 

$

(113,444

)

 

$

(139,905

)

 

$

(77,941

)

Adjustments to reconcile net loss to net cash used in operating activities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization expense

 

 

4,990

 

 

 

4,795

 

 

 

13,132

 

 

 

4,990

 

Provisions for doubtful accounts

 

 

(57

)

 

 

640

 

Provisions for credit losses

 

 

(308

)

 

 

(57

)

Amortization of deferred contract acquisition costs

 

 

731

 

 

 

730

 

 

 

847

 

 

 

731

 

Amortization of deferred contract fulfillment costs

 

 

351

 

 

 

339

 

 

 

288

 

 

 

351

 

Noncash compensation costs incurred by selling shareholders

 

 

3,993

 

 

 

 

Stock-based compensation expense

 

 

19,368

 

 

 

72,096

 

 

 

27,598

 

 

 

19,368

 

Loss on equity method investment

 

 

1,541

 

 

 

764

 

 

 

762

 

 

 

1,541

 

Deferred income taxes

 

 

(1,164

)

 

 

 

Changes in operating assets and liabilities, net of acquisition:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Accounts receivable

 

 

9,809

 

 

 

(8,708

)

 

 

5,763

 

 

 

9,809

 

Inventories

 

 

199

 

 

 

(2,107

)

 

 

(391

)

 

 

199

 

Deferred contract acquisition costs

 

 

(618

)

 

 

(1,506

)

 

 

(1,135

)

 

 

(618

)

Prepaid expenses and other current assets

 

 

284

 

 

 

(3,004

)

 

 

(1,714

)

 

 

284

 

Other assets

 

 

184

 

 

 

229

 

 

 

489

 

 

 

184

 

Accounts payable

 

 

(624

)

 

 

(2,494

)

 

 

(6,525

)

 

 

(624

)

Accrued expenses and other current liabilities

 

 

(16,063

)

 

 

(687

)

 

 

(490

)

 

 

(16,063

)

Other long-term liabilities

 

 

(38

)

 

 

(195

)

 

 

(15

)

 

 

(38

)

Deferred revenue

 

 

(9,506

)

 

 

(5,270

)

 

 

(6,624

)

 

 

(9,506

)

Net cash used in operating activities

 

 

(67,390

)

 

 

(57,822

)

 

 

(105,399

)

 

 

(67,390

)

Cash flows from investing activities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purchases of property and equipment

 

 

(283

)

 

 

(2,304

)

 

 

(58

)

 

 

(283

)

Investment in less than majority owned joint venture

 

 

(2,548

)

 

 

(2,940

)

 

 

(1,960

)

 

 

(2,548

)

Purchases of investments

 

 

 

 

 

(29,777

)

 

 

(499,223

)

 

 

 

Proceeds from sales and maturities of investments

 

 

100,000

 

 

 

39,355

 

 

 

124,981

 

 

 

100,000

 

Net cash provided by investing activities

 

 

97,169

 

 

 

4,334

 

Net cash used in and provided by investing activities

 

 

(376,260

)

 

 

97,169

 

Cash flows from financing activities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Proceeds from issuance of Series C convertible preferred

stock, net of issuance costs

 

 

 

 

 

146,764

 

Proceeds from exercise of common stock options

 

 

16,733

 

 

 

2,232

 

 

 

4,465

 

 

 

16,733

 

Proceeds from employee stock purchase plan

 

 

1,501

 

 

 

 

Payments for the purchase of treasury stock

 

 

(11,628

)

 

 

(163

)

 

 

 

 

 

(11,628

)

Payment of deferred offering costs

 

 

(1,613

)

 

 

(371

)

 

 

 

 

 

(1,613

)

Net cash provided by financing activities

 

 

3,492

 

 

 

148,462

 

Proceeds from Section 16(b) disgorgement

 

 

295

 

 

 

 

Payment of contingent consideration

 

 

(11,790

)

 

 

 

Net cash used in and provided by financing activities

 

 

(5,529

)

 

 

3,492

 

Effect of exchange rates changes on cash, cash equivalents, and restricted cash

 

 

(2,039

)

 

 

 

Net decrease in cash, cash equivalents, and restricted cash

 

 

33,271

 

 

 

94,974

 

 

 

(489,227

)

 

 

33,271

 

Cash, cash equivalents, and restricted cash at beginning of period

 

 

942,711

 

 

 

138,816

 

 

 

747,211

 

 

 

942,711

 

Cash, cash equivalents, and restricted cash at end of period

 

$

975,982

 

 

$

233,790

 

 

$

257,984

 

 

$

975,982

 

Cash, cash equivalents, and restricted cash at end of period:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cash and cash equivalents

 

 

975,187

 

 

 

232,695

 

 

 

257,189

 

 

 

975,187

 

Restricted cash

 

 

795

 

 

 

1,095

 

 

 

795

 

 

 

795

 

Total cash, cash equivalents, and restricted cash at end of period

 

$

975,982

 

 

$

233,790

 

 

$

257,984

 

 

$

975,982

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cash paid for income taxes

 

$

955

 

 

$

138

 

Cash (refunded) paid for income taxes

 

$

13

 

 

$

955

 

Supplemental disclosure of non-cash investing and financing activities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additions to property and equipment included in accrued expenses and accounts payable

 

$

 

 

$

572

 

Common stock issuance costs

 

$

 

 

$

440

 

Preferred stock issuance costs

 

$

 

 

$

750

 

Issuance of common stock in settlement of earnout

 

$

17,243

 

 

$

 

Receivable related to exercise of common stock options

 

$

71

 

 

$

100

 

 

$

 

 

$

71

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.


7


AMERICAN WELL CORPORATION

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(in thousands, except share and per share amounts)

(unaudited)

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 telehealthenterprise software company that enables theenabling digital distribution and delivery of care for healthcare’s key stakeholders. The Company’s scalableCompany empowers our clients with the core technology is deployed at the enterprise level of clients, embeds into existing offerings and workflows, spans the continuum ofservices necessary to successfully develop and distribute virtual care programs that meet their strategic, operational, financial and enables the delivery of this care across a wide variety of clinical retail, schoolobjectives under their own brands.

Acquisitions

On August 9, 2021 and home settings.

Stock Split

On August 28, 2020,27, 2021, the Company effected an 8.8-for-1.0 stock splitcompleted the acquisitions of its issuedConversa Health Inc. (“Conversa”) and outstanding shares of common stock andSilverCloud Health Holdings, Inc. (“SilverCloud”), respectively (together, the “Acquisitions”). Conversa is a proportional adjustment to the existing conversion ratios for each series of the Company’s then outstanding convertible preferred stock (seeleader in automated virtual healthcare. SilverCloud is a leading digital mental health platform. See Note 10)7 “Business Combinations”. The corresponding number of shares and exercise prices related to stock options and RSUs were also adjusted. The impact of the stock split has been applied retrospectively to all periods presented.

Liquidity and Capital Resources

The accompanying condensed 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. On September 21, 2020, the Company closed on the IPO 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 June 30, 2021, the Company had an accumulated deficit of $708,587. The Company expects to continue to generate operating losses for the foreseeable future.

The Company expects that its cash, cash equivalents and investments balance as of June 30, 20212022 of $975,187$630,069 will be sufficient to fund its operating expenses and capital expenditure requirements for at least the next twelve months.

 


2. Summary of Significant Accounting Policies

There have been no material changes to the significant accounting policies described in the Company’s Form 10-K for the fiscal year ended December 31, 2020,2021, that have had a material impact on the consolidated financial statements and related notes.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) and applicable rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting of normal recurring accruals and adjustments) necessary for the fair statement of the Company’s the financial position, results of operations and cash flows at the dates and for the periods indicated. The interim results for the three and six months ended June 30, 20212022 are not necessarily indicative of results for the full 20212022 calendar year or any other future interim periods. The information included in the interim financial statements should be read in conjunction with the annual consolidated financial statements and accompanying notes included in the Form 10-K.

The unaudited condensed consolidated financial statements 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”), and National Telehealth Network (“NTN”), an entity in which American Well controls fifty percent or more of the voting shares (see Note 4). Intercompany accounts and transactions have been eliminated in consolidation.

For substantially all of theThe Company’s subsidiaries, the functionalreporting 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 condensed consolidated statements of operations and comprehensive loss.

For consolidated entities where American Well owns or is exposed to less than 100%100% of the economics, the net loss attributable to noncontrolling interests is recorded in the condensed 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 condensed consolidated balance sheets.

8


Use of Estimates

The preparation of condensed 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 condensed consolidated financial statements and the reported amounts of revenue and expenses during the reported periods. Significant estimates and assumptions reflected in these condensed 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 and property and equipment and the valuation of common stock. 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.

Due to the COVID-19 global pandemic, the global economy and financial markets have been disrupted and there is a significant amount of uncertainty about the length and severity of the consequences caused by the pandemic. The Company has considered information available to it as of the date of issuance of these financial statements and has not experienced any significant impact to its estimates and assumptions as a result of the COVID-19 pandemic. On an ongoing basis, the Company will continue to closely monitor the COVID-19 impact on its estimates and assumptions.

Segment Information

The Company’s chief operating decision makers (CODMs), its two Chief Executive Officers, review financial information presented on a consolidated basis for purposes of allocating resources and evaluating financial performance. The Company operates and manages its business as 1 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 condensed 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.

The aggregate carrying value of total assets and total liabilities included on the condensed consolidated balance sheets for the PCs after elimination of intercompany transactions were $30,207$26,879 and $1,929,$1,508, respectively, as of June 30, 20212022 and $22,682$29,770 and $1,998,$1,485, respectively as of December 31, 2020.2021.

Total revenue included on the condensed consolidated statements of operations and comprehensive loss for the PCs after elimination of intercompany transactions was $17,585$17,400 and $24,719$17,585 for the three months ended June 30, 20212022 and 2020,2021, respectively. Net loss included on the condensed consolidated statements of operations and comprehensive loss was not material for the three months ended June 30, 20212022 and 2020.2021. Total revenue included on the condensed consolidated statements of operations and comprehensive loss for the PCs after elimination of intercompany transactions was $35,154$35,792 and $43,389$35,154 for the six months ended June 30, 20212022 and 2020,2021, respectively. Net loss included on the condensed consolidated statements of operations and comprehensive loss was not material for the three and six months ended June 30, 20212022 and 2020.2021

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 telehealth.digital care delivery. 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.

9


In 2020 the Company contributed $2,940$2,940 as its initial investment for a 49%49% interest in CCAW, JV LLC. The agreement also requires aggregate total capital contributions by the Company up to an additional $11,800$11,800 in two phases, which is yet to be defined. During the sixthree months ended June 30,March 31, 2021, the Company made a capital contribution of $2,548,$2,548, related to a portion of the phase one capital commitment. In April 2022 the Company made a capital contribution of $1,960 related to a portion of the phase one capital commitment.

For the three months ended June 30, 20212022 and 2020,2021, the Company recognized a loss of $722$551 and $444$722 as its proportionate share of the joint venture’s results of operations, respectively. For the six months ended June 30, 20212022 and 2020,2021, the Company recognized a loss of $1,541$762 and $764 as its proportionate share of the joint venture’s results of operations,$1,541, respectively. Accordingly, the carrying value of the equity method investment as of June 30, 20212022 and December 31, 20202021 was $1,759$1,366 and $752,$168, respectively.

Concentrations of Credit Risk and Significant Customers

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 that the Company believes are of high credit quality. 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 customers 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 customers. The Company has not experienced significant credit losses from its accounts receivable. As of June 30, 20212022 and December 31, 2020,2021, one customer accounted for 14%15% and 19%19% of outstanding accounts receivable, respectively.


During the three months ended June 30, 20212022 and 2020,2021, sales to one customer (who was a related party during the 2020 period noted) represented 25%24% and 22%25% of the Company’s total revenue, respectively. During the six months ended June 30, 20212022 and 2020,2021, sales to one customer (who was a related party during the periods noted)2021 period) represented 25%25% and 22%25% of the Company’s total revenue, respectively.

Emerging Growth Company Status

The Company is an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until such time as those standards apply to private companies. The Company has elected to use this extended transition period for complying with certain new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it is (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, these financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates.

Recently Adopted Accounting Pronouncements

In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Requirements for Fair Value Measurement (‘‘ASU 2018-13’’), which modifies the existing disclosure requirements for fair value measurements in Topic 820. The new disclosure requirements include disclosure related to changes in unrealized gains or losses included in other comprehensive loss for recurring Level 3 fair value measurements held at the end of each reporting period and the explicit requirement to disclose the range and weighted-average of significant unobservable inputs used for Level 3 fair value measurements. The other provisions of ASU 2018-13 include eliminated and modified disclosure requirements. An entity is permitted to early adopt any removed or modified disclosures upon issuance of ASU 2018-13 and delay adoption of the additional disclosures until their effective date. For all entities, this guidance is required to be adopted for annual periods beginning after December 15, 2019, including interim periods within those fiscal years. Early adoption is permitted. The guidance was adopted effective January 1, 2020 and did not have a material impact on the condensed consolidated financial statements and disclosures.

In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, which aligns the requirements for capitalizing implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use-software. The standard is effective for fiscal years beginning after December 15, 2019 and interim periods within those fiscal years. Early adoption is permitted. The guidance was adopted effective January 1, 2020 and did not have a material impact on the condensed consolidated financial statements and disclosures.

In December 2019, the FASB issued ASU 2019-12, Simplifying the Accounting for Income Taxes (“ASU 2019-12”), which simplifies the accounting for income taxes by removing certain exceptions and clarifying and amending existing guidance. ASU 2019-12 removes certain exceptions for performing intraperiod tax allocations, recognizing deferred taxes for investments, and calculating income taxes in interim periods. The guidance also simplifies the accounting for franchise taxes, transactions that result in a step-up in the tax basis of goodwill, and the effect of enacted changes in tax laws or rates in interim periods. For public entities that are Securities and Exchange Commission filers, excluding entities eligible to be smaller reporting companies, ASU 2019-12 is effective for annual periods beginning after December 15, 2020, including interim periods within those fiscal years. For all other entities, the amendments are effective for fiscal years beginning after December 15, 2021, and interim periods within fiscal years beginning after December 15, 2022. Early adoption is permitted. The guidance was adopted effective January 1, 2021 and did notnot have a material impact on the condensed consolidated financial statements and disclosures.

Recently IssuedIn October 2021, the FASB issued ASU 2021-08, Business Combinations(Topic 805): Accounting Pronouncementsfor Contract Assets and Contract Liabilities from Contracts with Customers (“ASU 2021-08”), which requires that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606. At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it had originated the contracts. To achieve this, an acquirer may assess how the acquiree applied Topic 606 to determine what to record for the acquired revenue contracts. Generally, this should result in an acquirer recognizing and measuring the acquired contract assets and contract liabilities consistent with how they were recognized and measured in the acquiree’s financial statements. The guidance was adopted effective July 1, 2021 and impacted the accounting of acquired deferred revenue for the Conversa and SilverCloud acquisitions that occurred in August 2021.

10


In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (‘‘ASU 2016-13’’), which requires the measurement and recognition of expected credit losses for financial assets held at amortized cost. ASU 2016-13 replaces the existing incurred loss impairment model with an expected loss model. It also eliminates the concept of other-than-temporary impairment and requires credit losses related to available-for-sale debt securities to be recorded through an allowance for credit losses rather than as a reduction in the amortized cost basis of the securities. These changes may result in earlier recognition of credit losses. In November 2018, the FASB issued ASU No. 2018-19, Codification Improvements toTopic 326, Financial Instruments—Credit Losses, which narrowed the scope and changed the effective date for non-public entities for ASU 2016-13. The FASB subsequently issued supplemental guidance within ASU No. 2019-05, Financial Instruments—Credit Losses (Topic 326): Targeted Transition Relief (‘‘ASU 2019-05’’). ASU 2019-05 provides an option to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost basis. For public entities that


The Company are Securities and Exchange Commission filers, excluding entities eligible to be smaller reporting companies,adopted ASU 2016-13 is effective for annual periods beginning after December 15, 2019, including interim periods within those fiscal years. For all other entities, ASU 2016-13 is effective for annual periods beginning after December 15, 2022, including interim periods within those fiscal years. Earlyand the related clarifications in 2021. The adoption is permitted. The guidance will be adopted indid not have a material effect on the 2021 annual condensed consolidated financial statements. The Company is currently evaluating the impact that the adoption of ASU 2016-13 will have on its condensedCompany’s consolidated financial statements.

3. Revenue

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

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Platform subscription

 

$

26,780

 

 

$

24,458

 

 

$

51,376

 

 

$

46,214

 

 

$

29,592

 

 

$

26,780

 

 

$

58,283

 

 

$

51,376

 

Visits

 

 

27,532

 

 

 

36,017

 

 

 

55,353

 

 

 

62,481

 

 

 

29,750

 

 

 

27,532

 

 

 

60,486

 

 

 

55,353

 

Other

 

 

5,905

 

 

 

8,093

 

 

 

11,087

 

 

 

13,587

 

 

 

5,174

 

 

 

5,905

 

 

 

9,979

 

 

 

11,087

 

Total Revenue

 

$

60,217

 

 

$

68,568

 

 

$

117,816

 

 

$

122,282

 

 

$

64,516

 

 

$

60,217

 

 

$

128,748

 

 

$

117,816

 

 

Accounts Receivable, Net

Accounts receivable primarily consist of amounts billed currently due from customers. Accounts receivable are presented net of an allowance for doubtful accounts,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 customer collection matters, including the aging of unpaid accounts receivable and changes in customer 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 doubtful accountscredit losses are recorded as general and administrative expenses in the condensed consolidated statements of operations and comprehensive loss.

Changes in the allowance for doubtful accountscredit losses were as follows:

 

 

Six Months Ended June 30,

 

 

Year Ended

December 31,

2020

 

Allowance for doubtful accounts, beginning of the

period

 

$

1,556

 

 

$

686

 

 

Six Months Ended June 30, 2022

 

 

Year Ended December 31, 2021

 

Allowance for credit losses, beginning of the
period

 

$

1,809

 

 

$

1,556

 

Provisions

 

 

(57

)

 

 

1,646

 

 

 

(308

)

 

 

714

 

Write-offs

 

 

(460

)

 

 

(776

)

 

 

(49

)

 

 

(461

)

Allowance for doubtful accounts, end of the period

 

$

1,039

 

 

$

1,556

 

Allowance for credit losses, end of the period

 

$

1,452

 

 

$

1,809

 

 

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 customer. The amount of unbilled accounts receivable was $3,387 and $3,376 as of June 30, 2021 and December 31, 2020, and has been included within accounts receivable on the condensed consolidated balance sheet.sheet was $4,339 and $5,697 as of June 30, 2022 and December 31, 2021, respectively. The amount of unbilled accounts receivable included within other assets on the consolidated balance sheet was 0 as of June 30, 2022 and $781as of December 31, 2021, respectively.

Deferred Revenue

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 three months ended June 30, 20212022 and 2020,2021, the Company recognized revenue of $21,238$16,845 and $18,985,$21,238, respectively, that was included in the corresponding contract liability balance at the beginning of the periods presented. For the six months ended June 30, 20212022 and 2020,2021, the Company recognized revenue of $39,146$39,992 and $41,731,$39,146, respectively, that was included in the corresponding contract liability balance at the beginning of the periods presented.

11



Significant changesChanges in the Company’s deferred revenue balance for the six months ended June 30, 20212022 and the year ended December 31, 20202021 were as follows:

 

 

Six Months Ended June 30,

 

 

Year Ended

December 31,

2020

 

 

Six Months Ended June 30, 2022

 

 

Year Ended December 31, 2021

 

Total deferred revenue, beginning of the period

 

$

74,800

 

 

$

77,386

 

 

$

75,896

 

 

$

74,800

 

Additions

 

 

45,487

 

 

 

109,542

 

 

 

50,690

 

 

 

123,717

 

Recognized

 

 

(54,921

)

 

 

(112,128

)

 

 

(57,838

)

 

 

(122,621

)

Total deferred revenue, end of the period

 

$

65,366

 

 

$

74,800

 

 

$

68,748

 

 

$

75,896

 

Current deferred revenue

 

 

57,836

 

 

 

66,693

 

 

 

63,971

 

 

 

68,841

 

Non-current deferred revenue

 

 

7,530

 

 

 

8,107

 

 

 

4,777

 

 

 

7,055

 

Total

 

$

65,366

 

 

$

74,800

 

 

$

68,748

 

 

$

75,896

 

 

Transaction Price Allocated to Remaining Performance Obligations

As of June 30, 20212022 and December 31, 2020,2021, the aggregate amount of the transaction price allocated to remaining performance obligations was $190,413$192,836 and $192,238,$219,893, respectively. The substantial majority of the unsatisfied performance obligations will be satisfied over the next three years.years.

As it pertains to the June 30, 20212022 amount, the Company expects to recognize 47%45% of the transaction price in the 12 month period ended June 30, 2022,2023, in its condensed consolidated statement of operations and comprehensive loss with the remainder recognized thereafter.

4. National Telehealth Network

In 2012, the Company and an affiliate of Anthem, 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 significant 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%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 condensed consolidated financial statements. However, because the Company owns less than 100%100% of NTN, the Company recognizes net loss attributable to non-controlling interest in the condensed 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 $277$507 and $1,562$277 for the three months ended June 30, 20212022 and 2020,2021, respectively. The proportionate share of the loss attributed to the non-controlling interest amounted to $894$723 and $2,405$894 for the six months ended June 30, 2022 and 2021, and 2020, respectively.

The carrying value of the non-controlling interest was $21,171$20,894 and $22,065$21,617 as of June 30, 20212022 and December 31, 2020,2021, respectively.

12


5. 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.

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:

 

 

June 30, 2021

 

 

June 30, 2022

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

Money market funds

 

$

814,087

 

 

$

 

 

$

 

 

$

814,087

 

 

$

167,560

 

 

$

 

 

$

 

 

$

167,560

 

Investments

 

 

 

 

 

 

 

 

 

 

$

 

 

$

814,087

 

 

$

 

 

$

 

 

$

814,087

 

U.S government securities

 

 

 

 

 

372,880

 

 

 

 

 

$

372,880

 

Total financial assets:

 

$

167,560

 

 

$

372,880

 

 

$

 

 

$

540,440

 

 

 

December 31, 2021

 

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

Money market funds

 

$

671,107

 

 

$

 

 

$

 

 

$

671,107

 

Total financial assets:

 

$

671,107

 

 

$

 

 

$

 

 

$

671,107

 

Contingent consideration

 

$

 

 

$

 

 

$

16,450

 

 

$

16,450

 

Total financial liabilities:

 

$

 

 

$

 

 

$

16,450

 

 

$

16,450

 

 

 

 

December 31, 2020

 

 

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Total

 

Money market funds

 

$

892,934

 

 

$

 

 

$

 

 

$

892,934

 

Investments

 

 

 

 

 

99,963

 

 

 

 

 

 

99,963

 

 

 

$

892,934

 

 

$

99,963

 

 

$

 

 

$

992,897

 

The Company’s cash equivalents were invested in money market funds and were valued based on Level 1 inputs. The Company’s investments consisted of U.S. government agency bonds and were valued based on Level 2 inputs. In determining the fair value of its U.S. government agency bonds, the Company relied on quoted prices for similar securities in active markets or other inputs that are observable or can be corroborated by observable market data.

The Company has classified its net liability for contingent earnout considerations relating to the Acquisitions within Level 3 of the fair value hierarchy because the fair value is determined using significant unobservable inputs, which included the Monte Carlo method that uses key assumptions to model future revenue and costs of goods sold projections. A description of the Acquisitions is included within Note 7. The contingent earnout payments for each acquisition are based on the achievement of certain revenue thresholds. During the six months ended June 30, 2021,2022 the fair value of the contingent earnout consideration decreased due to the Company signing an amendment to the agreement accelerating the determination of the Conversa revenue earn-out as of March 31, 2022 that resulted in the issuance of 1,020,964 shares of Class A Common Stock, and signing an amendment to the agreement accelerating the determination of the SilverCloud revenue earn-out as of May 11, 2022 that resulted in the issuance of 4,959,856 shares of Class A Common Stock, which resulted in a net accretion to the contingent considerations of $793.

 

 

Six Months Ended June 30, 2022

 

Beginning Balance as of January 1

 

$

16,450

 

Accretion of contingent consideration

 

 

793

 

Fair value adjustment

 

 

 

Earned amount issued to shareholders in Class A Common Stock

 

 

(17,243

)

Ending Balance

 

$

 

During the six months ended June 30, 2022, there were 0 transfers between fair value measurement levels.

13


6. Investments

As of June 30, 20212022 and December 31, 2020,2021, the fair value of the Company’s investments by type of security was as follows:

 

 

 

June 30, 2022

 

 

 

Amortized
Cost

 

 

Gross
Unrealized
Gains

 

 

Gross
Unrealized
Losses

 

 

Fair Value

 

Assets:

 

 

 

 

 

 

 

 

 

 

 

 

U.S government securities

 

$

374,242

 

 

 

 

 

$

(1,362

)

 

$

372,880

 

 

 

$

374,242

 

 

$

 

 

$

(1,362

)

 

$

372,880

 

 

 

June 30,December 31, 2021

 

 

 

Amortized


Cost

 

 

Gross


Unrealized


Gains

 

 

Gross


Unrealized


Losses

 

 

Fair Value

 

Assets:

 

 

 

 

 

 

 

 

 

 

 

 

U.S government securities

 

$

 

 

$

 

 

$

 

 

$

 

 

 

$

 

 

$

 

 

$

 

 

$

 

 

 

 

December 31, 2020

 

 

 

Amortized

Cost

 

 

Gross

Unrealized

Gains

 

 

Gross

Unrealized

Losses

 

 

Fair Value

 

Assets:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

U.S government securities

 

$

99,854

 

 

$

109

 

 

$

 

 

$

99,963

 

 

 

$

99,854

 

 

$

109

 

 

$

 

 

$

99,963

 

7. Business Combinations

On August 27, 2021, the Company completed the acquisition of SilverCloud through a merger in which SilverCloud became a wholly-owned subsidiary of the Company. The cash consideration paid was $105,195 net of cash acquired of $12,239. The stock consideration was comprised of 8.1 million shares of the Company’s Class A common stock valued at $85,571, and escrow share consideration of $6,376. SilverCloud is a leading digital mental health platform. The Company is obligated to pay an earn-out of up to $40,000 contingent upon SilverCloud achieving certain revenue thresholds for the year ending December 31, 2022. The Company estimated the fair value of the contingent consideration as of the acquisition date to be $29,360. The contingent consideration is subject to remeasurement at each reporting date until December 31, 2022, with the remeasurement adjustment reported in the consolidated statement of operations and comprehensive loss. The Company signed an amendment to the agreement accelerating the determination of the SilverCloud revenue earn-out as of May 11, 2022, which resulted in the issuance of 4,959,856 shares of Class A Common Stock. The acquisition was considered a stock acquisition for tax purposes and accordingly, the goodwill resulting from this acquisition is not tax deductible. The total acquisition related costs were $4,854 which included transaction costs from financial and legal advisors and other transaction related fees and were recognized as incurred in the Company’s consolidated statement of operations and comprehensive loss in general and administrative expenses.

On August 9, 2021, the Company completed the acquisition of Conversa through a merger in which Conversa became a wholly-owned subsidiary of the Company. The cash consideration paid was $51,331 net of cash acquired of $9,735. The stock consideration was comprised of 4.7 million shares of the Company’s Class A common stock valued at $52,160. Conversa is a leader in automated virtual healthcare. The Company is obligated to pay an earn-out of up to $30,000 contingent upon Conversa achieving certain integration thresholds in the first quarter of 2022, and certain revenue thresholds for the year ending December 31, 2022. The Company estimated the fair value of the contingent consideration as of the acquisition date to be $15,230. The contingent consideration is subject to remeasurement at each reporting date until December 31, 2022, with the remeasurement adjustment reported in the consolidated statement of operations and comprehensive loss. The integration milestone was achieved in December 2021 and $15,000 was paid in January 2022. The Company signed an amendment to the agreement accelerating the determination of the Conversa revenue earn-out as of March 31, 2022, which resulted in the issuance of 1,020,964 shares of Class A Common Stock. The acquisition was considered a stock acquisition for tax purposes and accordingly, the goodwill resulting from this acquisition is not tax deductible. The total acquisition related costs were $2,435 which included transaction costs from financial and legal advisors and other transaction related fees and were recognized as incurred in the Company’s consolidated statement of operations and comprehensive loss in general and administrative expenses.

The Acquisitions were accounted for using the acquisition method of accounting, which requires, among other things, the assets acquired and the liabilities assumed be recognized at their fair values as of the acquisition date. The results of the Acquisitions were integrated within the consolidated financial statements commencing on the aforementioned acquisition dates. Actual revenue and losses of the Acquisitions since the acquisition date as well as pro forma combined results of operations for the Acquisitions have not been presented because the effect of the Acquisitions was not material to the Company’s consolidated financial results for the periods presented.

14


The following table summarizes the preliminary fair value estimates of the assets acquired and liabilities assumed for the SilverCloud and Conversa acquisitions at the respective acquisition dates. The Company, with the assistance of a third-party valuation expert, estimated the preliminary fair value of the acquired tangible and intangible assets with significant estimates such as revenue projections. The allocation of the consideration transferred to the assets acquired and the liabilities assumed for the Acquisitions remains preliminary, and therefore can be revised as a result of additional information obtained due to completing the assessment of the tax attributes of the business combination. Additional adjustments may be recorded within the measurement period, which will not exceed one year from the acquisition date.

Identifiable assets acquired and liabilities assumed:

 

 

SilverCloud

 

 

Conversa Health

 

Purchase consideration:

 

 

 

 

 

 

Cash consideration, net of cash acquired

 

$

105,195

 

 

$

51,331

 

Stock consideration

 

 

85,571

 

 

 

52,160

 

Contingent consideration

 

 

29,360

 

 

 

15,230

 

Escrow share consideration

 

 

6,376

 

 

 

 

Working capital adjustment

 

 

(300

)

 

 

(127

)

Total consideration transferred

 

$

226,202

 

 

$

118,594

 

 

 

 

 

 

 

 

Allocation of consideration transferred:

 

 

 

 

 

 

Accounts receivable

 

$

2,630

 

 

$

3,651

 

Identifiable intangible assets

 

 

78,146

 

 

 

34,700

 

Other assets

 

 

491

 

 

 

4,604

 

Total assets acquired

 

 

81,267

 

 

 

42,955

 

Current liabilities

 

 

2,155

 

 

 

8,463

 

Deferred revenue

 

 

5,813

 

 

 

4,655

 

Other long-term liabilities

 

 

11,557

 

 

 

115

 

Total liabilities assumed

 

 

19,525

 

 

 

13,233

 

Goodwill

 

$

164,460

 

 

$

88,872

 

 

 

$

226,202

 

 

$

118,594

 

The amount allocated to goodwill reflects the benefits the Company expects to realize from post-acquisition cross selling opportunities from integrating customer relationships and from the growth of the respective acquisitions’ operations.

7.The following are the identifiable intangible assets acquired in the Acquisitions and their respective weighted average useful lives, as determined based on initial valuations. The estimated fair value of the Technology and Tradename was determined using a relief from royalty method and the estimated fair value of the Customer relationships was determined using the excess earnings method:

 

 

SilverCloud

 

 

Weighted
Average
Life (Years)

 

 

Conversa Health

 

 

Weighted
Average
Life (Years)

 

Technology

 

$

34,996

 

 

 

5.0

 

 

$

20,400

 

 

 

5.0

 

Tradename

 

 

10,800

 

 

 

7.0

 

 

 

4,200

 

 

 

5.0

 

Customer relationships

 

 

32,350

 

 

 

10.0

 

 

 

10,100

 

 

 

10.0

 

Total

 

$

78,146

 

 

 

 

 

$

34,700

 

 

 

 

8. Goodwill and Intangible Assets

Goodwill consisted of the following:

 

 

Six Months Ended June 30,

 

 

Year Ended

December 31,

2020

 

 

Six Months Ended June 30, 2022

 

 

Beginning Balance as of January 1

 

$

193,877

 

 

$

193,877

 

 

$

442,761

 

 

Goodwill acquired

 

 

 

 

 

 

 

 

 

 

Currency translation adjustments

 

 

(8,921

)

 

Ending Balance

 

$

193,877

 

 

$

193,877

 

 

$

433,840

 

 

 

15



Identified intangible assets consisted of the following:

 

 

Gross

Amount

 

 

Accumulated

Amortization

 

 

Carrying

Value

 

 

Weighted

Average

Remaining

Life

 

June 30, 2021

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gross
Amount

 

 

Accumulated
Amortization

 

 

Carrying
Value

 

 

Weighted
Average
Remaining
Life

 

June 30, 2022

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

38,782

 

 

$

(13,363

)

 

$

25,419

 

 

 

6.5

 

 

$

80,201

 

 

$

(20,852

)

 

$

59,349

 

 

 

7.9

 

Contractor relationships

 

 

535

 

 

 

(226

)

 

$

309

 

 

 

7.5

 

 

 

535

 

 

 

(268

)

 

 

267

 

 

 

6.5

 

Tradename

 

 

13,688

 

 

 

(1,781

)

 

 

11,907

 

 

 

5.5

 

Technology

 

 

37,063

 

 

 

(11,119

)

 

$

25,944

 

 

 

7.0

 

 

 

88,575

 

 

 

(23,664

)

 

 

64,911

 

 

 

4.7

 

 

$

76,380

 

 

$

(24,708

)

 

$

51,672

 

 

 

 

 

 

$

182,999

 

 

$

(46,565

)

 

$

136,434

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gross

Amount

 

 

Accumulated

Amortization

 

 

Carrying

Value

 

 

Weighted

Average

Remaining

Life

 

 

Gross
Amount

 

 

Accumulated
Amortization

 

 

Carrying
Value

 

 

Weighted
Average
Remaining
Life

 

December 31, 2020

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

December 31, 2021

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

38,782

 

 

$

(11,380

)

 

$

27,402

 

 

 

7.0

 

 

$

81,053

 

 

$

(16,842

)

 

$

64,211

 

 

 

8.2

 

Contractor relationships

 

 

535

 

 

 

(206

)

 

 

329

 

 

 

8.0

 

 

 

535

 

 

 

(247

)

 

 

288

 

 

 

7.0

 

Trade name

 

 

300

 

 

 

(300

)

 

 

 

 

 

 

 

 

14,435

 

 

 

(706

)

 

 

13,729

 

 

 

5.8

 

Technology

 

 

37,063

 

 

 

(9,266

)

 

 

27,797

 

 

 

7.5

 

 

 

90,464

 

 

 

(16,283

)

 

 

74,181

 

 

 

5.0

 

 

$

76,680

 

 

$

(21,152

)

 

$

55,528

 

 

 

 

 

 

$

186,487

 

 

$

(34,078

)

 

$

152,409

 

 

 

 

 

Amortization expense related to intangible assets for the three months ended June 30, 2022 and 2021 was $6,328and 2020 was $1,928 and $1,938,$1,928, respectively. Amortization expense related to intangible assets for the six months ended June 30, 2022 and 2021 was $12,514and 2020 was $3,856 and $3,877,$3,856, respectively. Estimated future amortization expense of the identified intangible assets as of June 30, 2021,2022, is as follows:

2021

 

$

3,856

 

2022

 

 

7,712

 

2023

 

 

7,712

 

2024

 

 

7,712

 

2025

 

 

7,712

 

Thereafter

 

 

16,968

 

 

 

$

51,672

 

2022

 

$

12,205

 

2023

 

 

24,361

 

2024

 

 

24,377

 

2025

 

 

24,361

 

2026

 

 

20,102

 

Thereafter

 

 

31,028

 

 

 

$

136,434

 

 


8.9. Accrued Expenses and other current liabilities

Accrued expenses and other current liabilities consist of the following:

 

 

Six Months Ended June 30,

 

 

Year Ended

December 31,

2020

 

 

June 30, 2022

 

 

December 31, 2021

 

Employee compensation and benefits

 

$

10,059

 

 

$

20,521

 

 

$

15,876

 

 

$

21,572

 

Professional services

 

 

3,763

 

 

 

6,832

 

 

 

14,983

 

 

 

8,766

 

Earned contingent consideration

 

 

 

 

 

15,000

 

Provider services

 

 

3,937

 

 

 

4,632

 

 

 

4,483

 

 

 

5,473

 

Other

 

 

7,105

 

 

 

10,150

 

 

 

8,307

 

 

 

7,900

 

Total

 

$

24,864

 

 

$

42,135

 

 

$

43,649

 

 

$

58,711

 

 

9. Line of Credit16


In January 2011, the Company entered into a credit agreement (the “Line of Credit”) with a financial institution that provides for maximum borrowings in one or more advances of an amount up to $5,000. Borrowings under the Line of Credit accrue interest at the London Interbank Offered Rate plus 1.25%. Borrowings are repayable immediately upon demand by the financial institution. In November 2017, the Line of Credit was amended to increase the maximum borrowings to $7,000. As of June 30, 2021 and December 31, 2020, the Company had 0 outstanding borrowings under the Line of Credit.

During any period that the Line of Credit is in effect, the Company can request the financial institution issue a letter of credit with a maximum maturity not to exceed twelve months. Any letters of credit issued by the financial institution reduce the maximum borrowings available under the Line of Credit. As of June 30, 2021, the maximum borrowing available to the Company is $6,205 based on the outstanding letters of credit of $795 that have been issued by the financial institution. As of December 31, 2020, the maximum borrowing available to the Company was $5,905 based on the outstanding letters of credit of $1,095 that have been issued by the financial institution.

10. Stockholders’ Equity

ConvertibleUndesignated Preferred Stock

The authorized, issued and outstanding shares, liquidation preference, and carrying value of the Company’s convertible preferred stock as of December 31, 2019 were as follows:

 

 

Shares

Authorized

 

 

Shares

Issued

 

 

Shares

Outstanding

 

 

Liquidation

Preference

 

 

Carrying

Value

 

Series A

 

 

3,200,000

 

 

 

3,178,650

 

 

 

3,130,077

 

 

 

51,741

 

 

 

28,889

 

Series B

 

 

833,334

 

 

 

787,725

 

 

 

787,725

 

 

 

37,060

 

 

 

23,632

 

Series C

 

 

13,711,111

 

 

 

10,095,133

 

 

 

10,095,133

 

 

 

519,648

 

 

 

603,278

 

 

 

 

17,744,445

 

 

 

14,061,508

 

 

 

14,012,935

 

 

 

608,449

 

 

 

655,799

 

In February 2020, the Company issued and sold 170,000 shares of Series C preferred stock at a price of $75 per share for gross proceeds of $12,750. The Company incurred $261 of issuance costs in connection with the issuance of the Series C preferred stock

In May 2020, the Company issued and sold 1,342,750 shares of Series C preferred stock at a price of $100 per share for gross proceeds of $134,275. The Company incurred $750 of issuance costs in connection with the issuance of the Series C preferred stock.

In conjunction with the Company’s IPO in September 2020, all shares of convertible preferred stock then outstanding, totaling 15,525,685 shares (pre-split), were automatically converted into an equivalent number of shares of Class A common stock on an 8.8-to-1.0 basis pursuant to a stock split and their carrying value, totaling $801,813 was reclassified into stockholders’ equity on the condensed consolidated balance sheet.

In connection with the IPO, the Company 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$0.01 per share, with rights and preferences, including voting rights, designated from time to time by the board of directors.NaN shares of preferred stock were issued or outstanding as of June 30, 2022 and December 31, 2021.


Common Stock

In September 2020, upon completion of the IPO, the Company sold 45,681,499 shares of Class A common stock at an offering price of $18.00 per share, including 4,459,277 shares of Class A common stock pursuant to the exercise in full of the underwriters’ option to purchase additional shares. The Company received net proceeds of $767,568, after deducting underwriting discounts and commissions of $49,336 and offering costs of approximately $4,906. In September 2020, the Company sold 5,555,555 shares of Class C common stock in connection with the stock purchase agreement with Google, LLC for net proceeds of $99,100, after deducting offering costs of $900.

Concurrently with the IPO, the Company used $24,157 of the proceeds from the IPO to repurchase 1,340,354 shares of Class A and Class B common stock from certain executive officers and other employees, to permit such executive officers and other employees to pay taxes owed in connection with the vesting of equity awards, including the repayment of third-party loans incurred to finance the payment of such taxes.

In connection with the IPO, the Company filed anCompany’s 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$0.01 per share, 100,000,000 shares of Class B common stock, par value $0.01$0.01 per share, and 200,000,000 shares of Class C common stock, par value $0.01$0.01 per share. Except for the rights noted below, each share of 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.

In the three and six months ended June 30, 2021, 3,351,0352022, 0 shares of Class B common stock were converted to Class A common stock. As of June 30, 2021,2022, the par value of the Class A, Class B and Class C shares was $2,099, $267,$2,403, $275, and $56,$56, respectively.

 

 

Shares

Authorized

 

 

Shares

Issued

 

 

Shares

Outstanding

 

Class A

 

 

1,000,000,000

 

 

 

209,875,389

 

 

 

209,875,389

 

Class B

 

 

100,000,000

 

 

 

26,687,959

 

 

 

26,687,959

 

Class C

 

 

200,000,000

 

 

 

5,555,555

 

 

 

5,555,555

 

 

 

 

1,300,000,000

 

 

 

242,118,903

 

 

 

242,118,903

 

 

 

Shares
Authorized

 

 

Shares
Issued

 

 

Shares
Outstanding

 

Class A

 

 

1,000,000,000

 

 

 

240,397,065

 

 

 

240,397,065

 

Class B

 

 

100,000,000

 

 

 

27,390,397

 

 

 

27,390,397

 

Class C

 

 

200,000,000

 

 

 

5,555,555

 

 

 

5,555,555

 

 

 

 

1,300,000,000

 

 

 

273,343,017

 

 

 

273,343,017

 

As of June 30, 20212022 and December 31, 2020,2021, the Company had reserved 66,187,34674,437,861 and 61,392,74761,989,749 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”) and 2020 Equity Incentive Plan (the “2020 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 2020 Plan is 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.

17


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.

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, 2021

 

 

23,167,514

 

 

$

4.37

 

 

 

6.2

 

 

$

487,758

 

Granted

 

 

 

 

$

 

 

 

 

 

 

 

 

 

Forfeited

 

 

(317,894

)

 

$

5.70

 

 

 

 

 

 

 

 

 

Expired

 

 

 

 

$

 

 

 

 

 

 

 

 

 

Exercised

 

 

(5,286,866

)

 

$

3.25

 

 

 

 

 

 

 

 

 

Outstanding as of June 30, 2021

 

 

17,562,754

 

 

 

4.68

 

 

 

6.2

 

 

$

140,880

 

Vested and expected to vest as of December 31, 2020

 

 

21,744,937

 

 

$

4.14

 

 

 

6.0

 

 

$

460,712

 

Vested and expected to vest as of June 30, 2021

 

 

16,685,854

 

 

$

4.46

 

 

 

6.1

 

 

$

135,479

 

Options exercisable as of December 31, 2020

 

 

17,640,827

 

 

$

3.71

 

 

 

5.5

 

 

$

381,511

 

Options exercisable as of June 30, 2021

 

 

13,809,991

 

 

$

4.13

 

 

 

5.7

 

 

$

116,756

 

 

 

Number of
Shares

 

 

Weighted
Average
Exercise Price

 

 

Weighted Average
Remaining
Contractual
Term (Years)

 

 

Aggregate
Intrinsic Value

 

Outstanding as of January 1, 2022

 

 

15,893,755

 

 

$

4.81

 

 

 

5.9

 

 

$

23,876

 

Granted

 

 

 

 

$

 

 

 

 

 

 

 

Forfeited

 

 

(953,627

)

 

$

6.64

 

 

 

 

 

 

 

Expired

 

 

(49,542

)

 

$

5.63

 

 

 

 

 

 

 

Exercised

 

 

(2,060,215

)

 

$

2.13

 

 

 

 

 

 

 

Outstanding as of June 30, 2022

 

 

12,830,371

 

 

 

4.81

 

 

 

5.8

 

 

$

6,198

 

Vested and expected to vest as of December 31, 2021

 

 

15,395,398

 

 

$

4.61

 

 

 

5.8

 

 

$

23,752

 

Vested and expected to vest as of June 30, 2022

 

 

12,630,154

 

 

$

4.91

 

 

 

5.7

 

 

$

6,194

 

Options exercisable as of December 31, 2021

 

 

13,407,882

 

 

$

4.38

 

 

 

5.5

 

 

$

23,120

 

Options exercisable as of June 30, 2022

 

 

11,634,556

 

 

$

4.82

 

 

 

5.6

 

 

$

6,198

 

 

NaN options were granted in the six months ended June 30, 2022 and 2021. The weighted-average grant date fair value of common stock options granted during the six months ended June 30, 2020 was $3.88.

The weighted-average of assumptions that the Company used to determine the fair value of the common stock options granted to employees and directors were as follows:

 

 

Six Months Ended June 30,

 

 

 

2021

 

2020

 

Risk-free interest rate

 

N/A

 

 

1.32

%

Expected term (in years)

 

N/A

 

 

6.1

 

Expected volatility

 

N/A

 

 

51

%

Expected dividend yield

 

N/A

 

 

0

%

Executive Equity Awards

Each CEO has received restricted stock units, equaling 1.5% of the Company’s fully-diluted outstanding capital stock as a result of the IPO (“IPO RSUs”), 50% of the IPO RSUs (representing 0.75% of the Company’s fully diluted outstanding capital stock immediately prior to the IPO or 3,230,750 shares of Class A common stock) were granted on the closing date of the IPO based on the closing price per share on the IPO closing date, and 50% (representing 0.75% of the Company’s fully diluted outstanding capital stock immediately prior to the IPO or 3,230,750 shares of Class A common stock) was granted on the 180-day anniversary of the IPO, based on a specific range of the price per share of the Company’s publicly traded common stock prior March 16, 2021, and will vest over a three-year period, with one-third vesting on the first anniversary of the IPO’s closing date and the remaining vesting in equal quarterly installments thereafter. As the issuance of the second 50% tranche was based upon events that are probable the expense related to both tranches of the IPO RSUs was recognized in the three months ended September 30, 2020.

The grant-date fair value of each of the awards issued on the IPO closing date and issued on the 180-day anniversary of the IPO was estimated using a binomial lattice approach. The main inputs to valuing the IPO RSUs include the fair value of Class A common stock ($9.96 post-split), expected volatility (60%) and the expected date of the IPO (September 30, 2020). The Company recognized a total of $23,644 in stock-based compensation expense, which included both tranches of the IPO RSUs for each CEO, on the date of the IPO as the requisite future service of the awards is not substantive for accounting purposes.


Restricted Stock Units

During the year ended December 31, 2020, the Company granted 13,816,885 restricted stock units which vest over the service period of one to four years. During the six months ended June 30, 2021, the Company granted 6,409,182 restricted stock units which vest over the service period of one to four years.

Activity for the restricted stock units is as follows:

 

 

Shares

 

 

Weighted Average

Grant Date

Fair Value

 

Unvested as of January 1, 2021

 

 

11,014,450

 

 

$

14.43

 

 

Shares

 

 

Weighted Average
Grant Date
Fair Value

 

Unvested as of January 1, 2022

 

 

11,718,813

 

 

$

19.63

 

Granted

 

 

6,409,182

 

 

 

19.95

 

 

 

10,622,982

 

 

 

4.09

 

Vested

 

 

(1,698,742

)

 

 

9.56

 

 

 

(3,005,281

)

 

 

12.55

 

Forfeited

 

 

(108,946

)

 

 

15.75

 

 

 

(1,787,601

)

 

 

9.04

 

Unvested as of June 30, 2021

 

 

15,615,944

 

 

$

17.22

 

Unvested as of June 30, 2022

 

 

17,548,913

 

 

$

7.75

 

 

The total grant date fair value of RSU’s granted for the six months ended June 30, 20212022 was $127,834. During$43,456. Restricted stock units vest over the six months ended June 30, 2020 the Company granted 2,616,345 restricted stock units.service period of one to four years. The aggregate intrinsic value of restricted stock units vested for the six months ended June 30, 2022 and 2021 was $13,180and 2020 was $35,223$35,223, respectively.

Restricted Stock Units with a Market Condition

In the six months ended June 30, 2022 the Company granted performance-based market condition share awards to certain members of the Company’s management team, which entitle these employees with the right to receive shares of common stock, upon achievement of certain market capitalization milestones measured over a rolling thirty day trading-period, subject to the satisfaction of the applicable service vesting conditions. The performance-based market condition share awards for management (other than the co-CEOs) consist of 6 tranches with six separate specified award values that become payable upon achievement of certain market capitalization milestones, which can result in a vesting range of up to 10,423,674 shares. Also in 2022 the Company granted performance-based market condition share awards to the co-CEOs, which entitle these employees with the right to receive shares of common stock, upon achievement of certain market capitalization milestones measured over a rolling thirty day trading-period, subject to the satisfaction of the applicable service vesting conditions. The performance-based market condition share awards for the co-CEOs consist of 8 tranches with eight separate specified award values that become payable upon achievement of certain market capitalization milestones (subject to specified vesting caps during each of the first two years of the performance period), which can result in a vesting range of up to 7,500,000 shares for each co-CEO. As of June 30, 2022, the performance-based market conditions for the awards to management and $1,693, respectively.the co-CEOs have not been met. These performance-based market condition share awards have a performance period of three years.

 

18


 

 

Shares

 

 

Weighted Average
Grant Date
Fair Value

 

Unvested as of January 1, 2022

 

 

 

 

$

 

Granted

 

 

25,423,674

 

 

 

2.21

 

Vested

 

 

 

 

 

 

Cancelled/Forfeited

 

 

(1,568,889

)

 

 

2.62

 

Unvested as of June 30, 2022

 

 

23,854,785

 

 

$

2.18

 

The total grant-date fair value of performance-based market condition share awards granted during the six months ended June 30, 2022 was $56,109 million and 0 performance-based market condition share awards were granted during the six months ended June 30, 2021.

The weighted average estimated fair value of the performance-based market condition share awards granted during the six months ended June 30, 2022 was determined using a Monte-Carlo valuation simulation, with the following most significant weighted-average assumptions:

 

 

Six Months Ended June 30,

 

 

 

2022

 

Risk-free rate

 

 

2.28

%

Term to end of performance period (yrs)

 

3 years

 

Valuation date stock price

 

$

3.43

 

Expected volatility

 

 

75

%

Expected dividend yield

 

 

0

%

2020 Employee Stock Purchase Plan

In July and August 2020,During the Company’s board of directors adopted, and the Company’s stockholders approved, the 2020 Employee Stock Purchase Plan (“ESPP”). A total of 3,084,218 shares of Class A common stock were reserved for issuance under the ESPP. The ESPP became effective March 1, 2021. 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.

As of June 30, 2021, the Company had 0t issued any shares under the ESPP and the total 3,084,218 shares remained available for issuance.

For the three and six months ended June 30, 2021, the Company recorded stock-based compensation expense related to the ESPP of $281 and $384, respectively, based on elections madehad 0t issued any shares under the plan to-date.  There was 0 expense forESPP. During the three and six months ended June 30, 2020.2022, the Company issued 425,114 shares under the ESPP. As of June 30, 2022 4,779,994 shares remained available for issuance.

Stock-Based Compensation

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

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Cost of revenues

 

$

521

 

 

$

168

 

 

$

910

 

 

$

359

 

 

$

426

 

 

$

521

 

 

$

761

 

 

$

910

 

Research and development

 

 

2,171

 

 

 

988

 

 

 

3,678

 

 

 

1,436

 

 

 

2,699

 

 

 

2,171

 

 

 

4,881

 

 

 

3,678

 

Selling and marketing

 

 

2,100

 

 

 

756

 

 

 

3,989

 

 

 

1,546

 

 

 

1,304

 

 

 

2,100

 

 

 

3,099

 

 

 

3,989

 

General and administrative

 

 

5,934

 

 

 

65,726

 

 

 

10,791

 

 

 

68,755

 

 

 

10,478

 

 

 

5,934

 

 

 

18,251

 

 

 

10,791

 

Total

 

$

10,726

 

 

$

67,638

 

 

$

19,368

 

 

$

72,096

 

 

$

14,907

 

 

$

10,726

 

 

$

26,992

 

 

$

19,368

 

 

As of June 30, 2021,2022, the unrecognized stock-based compensation expense related to unvested common stock-based awards was $88,396,$116,818, which is expected to be recognized over a weighted-average period of 32.6 years.

11. Commitments and Contingencies

Indemnification

The Company’s arrangements generally include certain provisions for indemnifying customers against third-party claims asserting infringement of certain intellectual property rights in the ordinary course of business. The Company also regularly indemnifies customers 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 customer. In addition, the Company indemnifies its officers, directors and certain key employees while they are serving in good faith in their capacities. Through June 30, 20212022 and December 31, 2020,2021, there have been 0 claims under any indemnification provisions.

19


 

Litigation

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. ("Teladoc") 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. The Company believes that these claims lack merit and intendsOn June 30, 2022, the claim was dismissed pursuant to defend against them vigorously.a confidential settlement between the parties. As of June 30, 20212022 and December 31, 2020,2021, the Company did 0t0t 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.

12. Income Taxes

As a result of the Company’s history of net operating losses (“NOL”), the Company has provided forcontinues to maintain a full valuation allowance against its domestic net deferred tax assets. For the three and six months ended June 30, 2021,2022, the Company recognized an income tax expense of $103$461 and $412,$129, primarily due to estimated state and foreign income taxes.tax. During the three and six months ended June 30, 2020,2021, the Company recorded income tax expense of $252.$103 and $412, primarily due to estimated state and foreign income taxes.

13. Related-Party Transactions

Teva Pharmaceuticals, Industries LtdPhilips Holding USA, Inc.

Teva Pharmaceuticals, Industries LtdPhilips Holding USA, Inc. (“Teva”Philips”) iswas determined to be a related party through June 2021, because a member of the Company’s board of directors was the President and CFOBusiness Leader of Teva Pharmaceuticals’ North America Commercial.Philips Population Health Management. In addition, Teva is a shareholder of the Company. As of June 30, 2021 and December 31, 2020, short-term and long-term deferred revenue from this customer was 0t material. As of June 30, 2021 and December 31, 2020, amounts due from Teva were 0t material.

During the three and six months ended June 30, 2021 and 2020, revenues recognized from this customer were 0t material.

Philips Holding USA, Inc.

Philips Holding USA, Inc. (“Philips”) is a related party because a member of the Company’s board of directors is the Business Leader of Philips Population Health Management. In addition, Philips is a non-significant shareholder of the Company. As of June 30, 2021 and December 31, 2020, the Company held short-term and long-term deferredrecognized revenue of $977$758 and $2,549,1,658, respectively from contracts with this customer. As of June 30, 2021 and December 31, 2020, amounts due from Philips were $547 and $763, respectively.

During the three months ended June 30, 2021 and 2020, the Company recognized revenue of $758 and $368, respectively from contracts with this customer. During the six months ended June 30, 2021 and 2020, the Company recognized revenue of $1,658 and $708, respectively from contracts with this customer.

Anthem Inc.

Anthem Inc. (“Anthem”) was determined to be a related party through February 2021, because a member of the Company’s board of directors served as the Vice President of Anthem through February 2021. In addition, Anthem is a non-significant shareholder of the Company. As of June 30, 2021 it was determined Anthem was no longer a related party. As of December 31, 2020, the Company held short-term and


long-term deferred revenue of $11,347, from contracts with this customer. As of December 31, 2020, amounts due from Anthem were $8,391.

Anthem. Prior to the board member’sthat director's departure from Anthem in February 2021 the Company recognized revenue of $7,218$7,218 from contracts with this customer. During the three and six months ended June 30, 2020 the Company recognized revenue of $14,848 and $27,155, respectively from contracts with this customer.

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 June 30, 20212022 and December 31, 2020,2021, the Company held short-term and long-termtotal deferred revenue of $451$261 and $606,$456, respectively from contracts with this customer. As of June 30, 20212022 and December 31, 2020,2021, amounts due from Cleveland Clinic were $85$82 and $1,020,$441, respectively.

During the three months ended June 30, 20212022 and 2020,2021, the Company recognized revenue of $279$694 and $294,$279, respectively, from contracts with this customer. During the six months ended June 30, 20212022 and 2020,2021, the Company recognized revenue of $530$1,454 and $490,$530, respectively, from contracts with this customer.

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 minority owned interest in. During the year ended December 31, 2020, the Company made an initial investment in CCAW, JV LLC of $2,940$2,940 for its less than 50%50% interest in the joint venture. During the sixthree months ended June 30, 2021, the Company made a capital contributedcontribution of $2,548,$2,548, related to a portion of the phase one capital commitment. During the three months ended June 30, 20212022 the Company made a capital contribution of $1,960 related to a portion of the phase one capital commitment.

During the three months ended June 30, 2022 and 20202021 the Company recognized revenue of $412$469 and $393$412 from contracts with this customer, respectively. During the six months ended June 30, 20212022 and 20202021, the Company recognized revenue of $874$923 and $786$874 from contracts with this customer, respectively, respectively.

As of June 30, 20212022 and December 31, 2020,2021, the Company held short and long termtotal deferred revenue of $840$622 and $1,496,$1,426, respectively, from contracts with this customer. As of June 30, 20212022 and December 31, 2020,2021, amounts due from CCAW, JV LLC were 0t material.

Loans to Officers

During 2020, the Company entered into secured promissory notes with executive officers in the amount of $16,441. These loans were to fund the taxes associated with the restricted stock units0 and were collateralized by all of the capital stock of the Company that the employee owned or would own in the future and the employees’ personal assets. These loans are recorded within prepaids and other current assets in the Company’s condensed consolidated balance sheet. All outstanding loans with officers were repaid in August 2020 prior to the Company’s IPO.$1,613.

20



14. Net Loss per Share

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

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Numerator:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net loss

 

$

(38,136

)

 

$

(88,220

)

 

$

(77,941

)

 

$

(113,444

)

 

$

(69,652

)

 

$

(38,136

)

 

$

(139,905

)

 

$

(77,941

)

Net loss attributable to non-controlling interest

 

 

(277

)

 

 

(1,562

)

 

 

(894

)

 

 

(2,405

)

 

 

(507

)

 

 

(277

)

 

 

(723

)

 

 

(894

)

Net loss attributable to American Well Corporation

 

$

(37,859

)

 

$

(86,658

)

 

$

(77,047

)

 

$

(111,039

)

 

$

(69,145

)

 

$

(37,859

)

 

$

(139,182

)

 

$

(77,047

)

Denominator:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted-average common shares outstanding

—basic and diluted

 

 

249,366,652

 

 

 

43,484,313

 

 

 

246,471,733

 

 

 

41,793,108

 

 

 

273,320,740

 

 

 

249,366,652

 

 

 

273,615,031

 

 

 

246,471,733

 

Net loss per share attributable to common

stockholders—basic and diluted

 

$

(0.15

)

 

$

(1.99

)

 

$

(0.31

)

 

$

(2.66

)

 

$

(0.25

)

 

$

(0.15

)

 

$

(0.51

)

 

$

(0.31

)

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:

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Unvested restricted stock units

 

 

14,856,621

 

 

 

7,724,006

 

 

 

14,856,621

 

 

 

7,724,006

 

Unvested performance market-based stock units

 

 

23,854,785

 

 

 

 

 

 

23,854,785

 

 

 

 

Options to purchase shares of common stock

 

 

12,830,371

 

 

 

17,562,754

 

 

 

12,830,371

 

 

 

17,562,754

 

 

 

 

51,541,777

 

 

 

25,286,760

 

 

 

51,541,777

 

 

 

25,286,760

 

21

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

 

2021

 

 

2020

 

 

2021

 

 

2020

 

Convertible preferred stock (as converted to common stock)

 

 

 

 

 

136,625,900

 

 

 

 

 

 

136,625,900

 

Unvested restricted stock units

 

 

7,724,006

 

 

 

2,028,461

 

 

 

7,724,006

 

 

 

2,028,461

 

Options to purchase shares of common stock

 

 

17,562,754

 

 

 

25,033,565

 

 

 

17,562,754

 

 

 

25,033,565

 

 

 

 

25,286,760

 

 

 

163,687,926

 

 

 

25,286,760

 

 

 

163,687,926

 


15. Subsequent Events

On July 27, 2021 and July 28, 2021 the Company entered into 2 separate purchase agreements to acquire Conversa Health Inc. (“Conversa”) and SilverCloud Health Holdings, Inc. (“SilverCloud”), respectively. Conversa is a leader in automated virtual healthcare. SilverCloud is a leading digital mental health platform.  By adding the technology of these two companies to its virtual care platform, Amwell is enhancing the differentiated value it can bring to current and future clients.  Under the terms of the agreement with Conversa, the aggregate purchase price of approximately $110,000 will consist of approximately $55,000 in cash and $55,000 in Amwell stock (4.7 million shares). Under the terms of the agreement with SilverCloud, the aggregate purchase price of approximately $210,000 will consist of approximately $110,000 in cash and $100,000 in Amwell stock (8.5 million shares). As this transaction has not yet closed, the mix of cash and stock consideration could change. The aggregate consideration for Conversa could increase by $30,000 subject to financial performance over a twelve-month period paid all in stock. The aggregate consideration for SilverCloud could increase by $40,000 subject to financial and operational performance over a twelve-month period paid all in stock. Conversa closed on August 10, 2021 and SilverCloud is expected to close by the end of the third quarter of 2021. The Company expects to determine the preliminary purchase allocation prior to the end of the third quarter of 2021.

On July 19, 2021, the Company entered into an Employment Agreement (the “Employment Agreement”) with Brendan O’Grady to become the Company’s Chief Commercial & Growth Officer, effective August 16, 2021.  Pursuant to the Employment Agreement, Mr. O’Grady will receive an annual base salary of $485 and will be eligible for an annual target bonus of 200% of his annual base salary.  In addition, Mr. O’Grady will receive a grant of restricted stock units with a grant date value of $8,000 that settle in shares of the Company’s Class A common stock, with 25% of the restricted stock units being vested on the grant date, and the remaining vesting ratably every 3 months thereafter over a four-year period (beginning on the first calendar day of the month following the date that is three months following the grant date).  


Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Special Note Regarding Forward-Looking Statements

This Quarterly Report on Form 10-Q contains forward-looking statements. All statements contained in this Quarterly Report on Form 10-Q other than statements of historical fact, including statements regarding our future results of operations, including descriptions of our business plan and strategies, are forward-looking statements. These statements often include words such as “anticipate,” “expect,” “suggests,” “plan,” “believe,” “intend,” “estimates,” “targets,” “projects,” “should,” “could,” “would,” “may,” “will,” “forecast,” or the negative of these terms, and other similar expressions, although not all forward-looking statements contain these words.

The forward-looking statements and projections are subject to and involve risks, uncertainties and assumptions and you should not place undue reliance on these forward-looking statements or projections. Although we believe that these forward-looking statements and projections are based on reasonable assumptions at the time they are made, you should be aware that many factors could affect our actual financial results or results of operations and could cause actual results to differ materially from those expressed in the forward-looking statements and projections.

Important factors that may materially affect such forward-looking statements and projections include the following:

weak growth and increased volatility in the telehealth market;
our history of losses and the risk we may not achieve profitability;
inability to adapt to rapid technological changes;
our ability to successfully launch our new Converge platform without significant cost overruns or disruptions to our business and our customers’ acceptance of this new platform;
our limited number of significant clients and the risk that we may lose their business;
increased competition from existing and potential new participants in the healthcare industry;
changes in healthcare laws, regulations or trends and our ability to operate in the heavily regulated healthcare industry;
compliance with regulations concerning personally identifiable information and personal health industry;
slower than expected growth in patient adoption of telehealth and in platform usage by either clients or patients;
inability to grow our base of affiliated and non-affiliated providers sufficient to serve patient demand;
our ability to comply with federal and state privacy regulations and the significant liability that could result from a cybersecurity breach or our failure to comply with such regulations;
our ability to establish and maintain strategic relationships with third parties;
our ability to complete, integrate and realize the anticipated benefits of strategic acquisitions;
the impact of the COVID-19 pandemic on our business or on our ability to forecast our business’s financial outlook; and
the risk that the insurance we maintain may not fully cover all potential exposures.

weak growth and increased volatility in the telehealth market;

our history of losses and the risk we may not achieve profitability;

inability to adapt to rapid technological changes;

our ability to successfully launch our new Converge telehealth platform without significant cost overruns or disruptions to our business and our customers’ acceptance of this new platform;

our limited number of significant clients and the risk that we may lose their business;

increased competition from existing and potential new participants in the healthcare industry;

changes in healthcare laws, regulations or trends and our ability to operate in the heavily regulated healthcare industry;

compliance with regulations concerning personally identifiable information and personal health industry;

slower than expected growth in patient adoption of telehealth and in platform usage by either clients or patients;

inability to grow our base of affiliated and non-affiliated providers sufficient to serve patient demand;

our ability to comply with federal and state privacy regulations and the significant liability that could result from a cybersecurity breach or our failure to comply with such regulations;

our ability to establish and maintain strategic relationships with third parties;

our ability to complete, integrate and realize the anticipated benefits of strategic acquisitions;

the impact of the COVID-19 pandemic on our business or on our ability to forecast our business’s financial outlook;

the risk that the insurance we maintain may not fully cover all potential exposures; and

inability to remediate material weaknesses or maintain effective internal control over financial reporting.

The foregoing list of factors is not exhaustive and does not necessarily include all of the important factors that could cause actual results to differ materially from those expressed in any of our forward-looking statements. The information in this Quarterly Report should be read carefully in conjunction with other uncertainties and potential events described in our Form 10-K filed with the SEC on March 26, 2021February 28, 2022 (the “Form 10-K”).

The forward-looking statements included in this Quarterly Report on Form 10-Q are made only as of the date of this Quarterly Report. Except as required by law or regulation, we do not undertake any obligation to update any forward-looking statements to reflect subsequent events or circumstances

Overview22


Overview

We are a leading telehealthenterprise software company enabling digital delivery of care for healthcare’s key stakeholders. We empower our clients at the enterprise level with the core technology and services necessary to successfully develop and distribute telehealthvirtual care programs that meet their strategic, operational, financial and socialclinical objectives under their own brands. The Amwell Platform is a complete


digital care delivery solution that equips our health system, health plan, government, and innovator including government, clients with the tools to enable new models of care for their patients and members. Our scalable technology embedsintegrates with our clients’ existing offerings and clinical workflows, spanning the continuum of care and enabling care delivery across a wide variety of clinical, retail, school and home settings. Our client-focused approach drives our success as one of the largest telehealthglobal digital healthcare enterprise software companies. As of June 30,December 31, 2021, we powered the digital care programs of over 55 health plans, which support over 36,000 employers and collectively represent more than 80 million covered lives, as well as overapproximately 150 of the nation’s largest health systems, encompassing more than 2,000 hospitals. Since inception, we have powered over 1117.7 million telehealth visits for our clients, including 2.9more than 3.3 million in the six months ended June 30, 2021.2022.

Healthcare today faces many challenges. Choice and access can be limited, care delivery is fragmented and inefficient, and costs continue to rise and shift to consumers while health outcomes have not improved. The healthcare industry is evolving to meet these challenges with innovative care models and new regulatory frameworks to promote more effective outcomes. As healthcare’s key stakeholders demand innovative technology solutions that streamline care delivery, lower costs, expand access and improve outcomes, we believe there is significant opportunity for transformation.

We believe Amwell makes this digital care transformation possible for the healthcare ecosystem. The Amwell Platformtelehealth platform ("Amwell Platform") enables virtual and automated care delivery across the full healthcare continuum – from primary and urgent care in the home to high acuity specialty consults, such as telestroke and telepsychiatry, in the hospital. We support both on-demand and scheduled consultations and offer 40 pre-packaged care modules and programs that power over 100 unique use cases today. Our platformThe Amwell Platform can be fully embeddedintegrated into our clients’ patient/member portals and provider workflows. Providers can launch telehealth directly from their native EHRs, with seamless integration to their payer eligibility and claims systems. Providers, patients and members can access this care through a full range of Carepoints, including via mobile, web, phone and our proprietary kiosks and carts that support multi-way video, phone or secure messaging interactions. Through our recent acquisitions of Conversa Health, Inc. (“Conversa”) and SilverCloud Health Holdings, Inc (“SilverCloud”) (together, the “August 2021 Acquisitions”), we enable automated care touchpoints, support ongoing treatment and care through digital engagements, and escalate care when needed to a live clinician. As of June 30, 2021, over 70,0002022, approximately 100,000 of our activeclients’ providers use the Amwell Platform to serve their patients and members. When needed, we augment and extend our clients’ clinical capabilities with AMG,Amwell Medical Group (“AMG”), a nationwide clinical network of clinical entities with over 5,0006,500 multi-disciplinary providers covering 50 states with 24/7/365 coverage.

Converge is the latest version of the Amwell existsPlatform and is designed to empower healthcare’s leading players, who have earnedbe reliable, flexible, scalable, secure and fully integrated with other healthcare software systems. Converge offers state-of-the-art data architecture and video capabilities, flexibility and scalability, and a user experience focused on the deep trustneeds of their patients and members over decades,providers. Converge has been designed from the ground up with the holistic understanding that the future care of any one patient will inevitably blend a mix of physical, digital, and does notautomated experiences. The virtual care of today has grown to encompass hybrid care models, asynchronous and automated care, remote patient monitoring, patient and provider engagement — and the flow of data that drives all of the above.

With Converge, the digital care capabilities that health systems and health plans care about — for example virtual primary care, post-discharge follow-up, chronic condition management, remote patient monitoring — are aligned into a single digital care operating system that aggregates all of the data from these care experiences to provide real-time insight. By providing a single platform for the digital distribution of care, Converge will accelerate innovation and interoperability for health system and health plan clients as well as other healthcare innovators, who aim to compete with or replace them. We help our clients white-label and embed telehealth within their existing healthcare offerings for their patients and members. Thus, we enable our provider customers to offer a seamless experience that blends online convenience when needed with in-person care by known, trustedfor providers, as part of a complete care program that offers patients continuity of care. In this way, providers can use our telehealth platform as an effective augmentation and not a replacement of their traditional care delivery.members.

Our Business Model

The Amwell Platform is a complete digital care delivery solution that equips our health system, health plan and innovator partners with the tools to enable new models of care for their patients and members. We sell the Amwell Platform on a subscription basis, which with our modular platform architecture allows our clients to introduce innovative telehealthdigital health use cases over time, expanding our subscription revenue opportunity. To support the Amwell Platform, we offer professional services on a fee-for-service basis and a range of patient and provider access Carepoints that support hospital and home use cases and access to AMG, our affiliated medical group that provides clinical services on a fee-for-service basis. The combination of the platform,Platform, services and Carepoints allows our clients to deploy telehealth solutions across their full enterprise, deepening their relationships with existing and new patients and members through improved care access and coordination, cost, and quality. Our contracts are typically three years in length but may be longer for our largest strategic customer partners.

Total subscription fees received from Health System, Health Plan and Innovator clients were $26.8$29.6 million and $24.5$26.8 million for the three months ended June 30, 20212022 and 2020,2021, respectively, and $51.4$58.3 million and $46.2$51.4 million for the six months ended June 30, 2022 and 2021, and 2020, respectively.

23


Health Systems

For our health system customers, the Amwell Platform’s primary function is to facilitate consultations between patients and providers affiliated with the health system. Our typical contracts with health systems are mainly the platform subscription, but also include services delivered by AMG to complement the health system provider resources, services for technology integration, marketing and Carepoints. Subscription fees are recurring and are determined based on the initial forecasted number of overall consultations throughout the entire health system on the Amwell Platform and net patient revenue of the health system. Subscriptions include a maximum number of consultations that can be delivered on the platform and similar to a cellular phone plan, when consultations exceed the contractual maximum, overages result in higher subscription fees in the following annual period. As the


health system expands its use of the Amwell Platform through additional modules, there is a corresponding increase in subscription fees.

To supplement a health system’s own network of healthcare providers, health systems often choose to purchase clinical services from AMG to deliver care for certain specialties such as telepsychiatry, behavioral health therapy and general urgent care, or to simply operate as backup providers on nights and weekends. AMG services are provided on a fee-for-service basis.

Health Plans

For our health plan clients, the Amwell Platform functions to provideprovides better access to care, better coordination of care and the ability to direct care referrals to providers owned or affiliated with the respective health plan. All of these functions lower the overall cost of care for health plan clients: improved population access to needed services reduces unneeded EDEmergency Department usage and better coordination of care can improve outcomes and lower the overall cost of care.

Currently, our typical health plan contract includes a recurring subscription fee based on the number of members who have access to our platformthe Amwell Platform plus additional subscription fees associated with the various programs we offer the health plan.

Our health plan clients mainly purchase clinical services for their members through AMG. They may also maintain relationships with other in network provider organizations to deliver care on the Amwell Platform on their behalf. These visit consultations are charged on a fee-for-service basis and range in price based on the type of consultation and the specialty of the provider.

Innovators

Amwell has a number of unique customers that use our platformPlatform in various ways to support their products. For example, we support: (i) Philips’ sleep apnea products and programs, (ii) a joint-venture with Cleveland Clinic and Amwell, (iii) Meuhedet’s advanced, hybrid-virtual international health plan.plan and (iv) in the future, we plan to deliver virtual care capabilities delivered through Converge to LG devices and peripheral technologies within the walls of hospitals.

Our contracts with our innovator customers vary from simple subscription fee-only contracts, where an innovator customer embeds our technology within their product, to broad subscription fee and services contracts that resemble a blend of our health system and health plan profile contracts.

Visits

Amwell’s clinical affiliate AMG has built a network of over 5,0006,500 providers who are registered and credentialed to deliver care on the Amwell Platform. This clinical network is designed and operated in a way that allows us to meet the aggregate visit demand requirements of our health plan and health system clients, spanning a broad mix of specialties including, for example, internal medicine, Family Medicine, Psychiatry, Gynecology, Anesthesiology, Nutritionist, Sleep Medicine, Pain Management, Psychology, Pulmonology, Urology, Health Coach, Orthopedic Surgery, Case Manager, Emergency Medicine, Gastroenterology, Nephrology, Pediatrician, Lactation Consultant, Social Worker, Vascular Surgery.

AMG earns fee-for-service revenue for each episode of care delivered on the Amwell Platform by its providers with fees varying by physician specialty or clinical program. These clinical fees vary significantly from $59 to more than $800 per consultation or case based on the specialty and may require an additional module subscription, as in the case of telepsychiatry.

Fees received from AMG-related visits were $27.5$29.7 million and $36.0$27.5 million for the three months ended June 30, 2022 and 2021, respectively, and 2020, respectively. Fees received from AMG-related visits were $55.4$60.5 million and $62.5$55.4 million for the six months ended June 30, 2022 and 2021, and 2020, respectively.

24


Services & Carepoints

We offer a full suite of paid, supporting services to our clients to enable their telehealth offerings, including professional services to facilitate telehealth implementation, workflow design, systems integration and service expansion. To help our clients promote adoption and utilization, we offer patient and provider engagement services through our internal digital engagement agency.

Our customers often deploy telemedicine through a variety of our proprietary Carepoints, which are medical carts and kiosks designed for various clinical and community settings. These Carepoints enable providers to deliver digital care into clinical care locations, such as the ED and clinics, as well as into community settings such as retail stores, community centers, employer sites, skilled nursing facilities and schools. Carepoints consist of hardware integrated into our Platform but can also be deployed


independent of our software solution. Our Carepoints are designed by our product development teams and manufactured through partner and contract relationships.

Fees received from the provision of services and Carepoints were $5.9$5.2 million and $8.1$5.9 million for the three months ended June 30, 2022 and 2021, respectively, and 2020, respectively. Fees received from the provision of services and Carepoints were $11.1$10.0 million and $13.6$11.1 million for the six months ended June 30, 2022 and 2021, respectively.

Acquisitions

We have expanded and 2020, respectively.intend to continue to expand our Platform through research and development as well as the pursuit of selective acquisitions. We have completed multiple acquisitions since our inception, which we believe have expanded the channels that we serve and our distribution capabilities as well as broadening our service offering. Our acquisitions of SilverCloud and Conversa add proven longitudinal care and behavioral healthcare capabilities to our digital care enablement platform. SilverCloud is a leading digital mental health platform. Conversa is a leader in automated virtual healthcare. Acquisition costs and integration costs are an additional one time cost incurred as part of the acquisitions and investment in the future growth of the business.

Key Factors Affecting Our Performance

We believe our future growth, success and performance are dependent on many factors, including those set forth below. While these factors present significant opportunities for us, they also represent the challenges that we must successfully address in order to grow our business and improve our results of operations.

Telehealth Utilization

Telehealth utilization is a key driver of our business. A client’s overall utilization of its telehealth platform provides an important measure of the value they derive. Telehealth utilization drives our business in three important ways. First, to the extent a client succeeds with its telehealth program and sees good usage, they are more likely to renew and potentially expand their contract with us. Second, our health systems agreements typically include a certain number of visits conducted by their own providers annually and provide that as certain volume thresholds are exceeded, its annual license fees will rise to reflect this growing value. Third, to the extent that clients utilize provider services from AMG, Amwell derives revenue from clinical fees. We expect that our future revenues will be driven by the growing adoption of telehealth and our ability to maintain and grow market share within that market.

COVID-19 has dramatically accelerated telehealth adoption seen in both overall volumes and embracement of delivering higher acuity care in a virtual medium. Peak COVID-19 pandemic visit growth reflected several factors. Many patients needed assessment for respiratory or other COVID-19-like symptoms and sought to be assessed for possible referral to hospital or testing facilities. In addition, many patients, especially those with health vulnerabilities, sought to avoid going into brick and mortar facilities – and indeed our health systems’ clients preferred wherever possible to treat patients remotely at home for non-COVID-19 related ongoing healthcare needs. Finally, we saw significant expansion of reimbursement for telehealth during the COVID-19 crisis, which made telehealth more affordable for many people.

25


We continue to experience these levels of telehealth adoption and usage of our platformPlatform and products. In both the six months ended June 30, 2021 and 2020,2022, our clients completed 2.9a total of 3.3 million visits on the Amwell Platform. Visits in the six months ended June 30, 2020 were driven by the height of the COVID-19 pandemicPlatform, while visits in the six months ended June 30, 2021 2.9 million visits were driven by expanded utilization of the platform evident by a larger number of clients’ owncompleted. AMG providers using the Amwell Platform.  During the six months ended June 30, 2021 our clients’ own providers performed over 77% of the total visits performed on the Amwell Platform versus 70%accounted for 23% of total visits performed on the Amwell Platform during the six months ended June 30, 2020. Comparatively, throughout 20192022 and 2021, respectively. We demonstrated that virtual care goes beyond urgent care pandemic needs through February 2020, or pre-COVID-19, clients’ own providers delivering care represented 40% whereas AMG providers typically performed more than 60% of the total overallincrease in scheduled visits. Scheduled visits onincreased to 2.4 million from 2.1 million during the Amwell Platform.  six months ended June 30, 2022 and 2021, respectively.

 

Total Overall Quarterly Visits

Total Overall Quarterly Visits

 

Total Overall Quarterly Visits

 

Quarter Ended

 

Overall Visits

 

 

Performed by Customer Providers

 

 

Overall Visits

 

 

Performed by Customer Providers

 

June 30, 2022

 

 

1,525,000

 

 

 

76

%

March 31, 2022

 

 

1,775,000

 

 

 

78

%

December 31, 2021

 

 

1,525,000

 

 

 

75

%

September 30, 2021

 

 

1,425,000

 

 

 

75

%

June 30, 2021

 

 

1,300,000

 

 

 

75

%

 

 

1,300,000

 

 

 

75

%

March 31, 2021

 

 

1,575,000

 

 

 

80

%

 

 

1,575,000

 

 

 

80

%

December 31, 2020

 

 

1,550,000

 

 

 

75

%

September 30, 2020

 

 

1,400,000

 

 

 

75

%

June 30, 2020

 

 

2,200,000

 

 

 

75

%

March 31, 2020

 

 

725,000

 

 

 

50

%

Active Providers

An important indicator of the value of our Amwell Platform to our clients is the number of non-AMG providers that are active on the Amwell Platform. We define “Active Providers” as providers that have delivered a visit on the Amwell Platform at least once in the last 12 months. Active Providers demonstrate the prevalence of telehealth within our clients in both home and hospital


environments. We believe Active Providers is a measure of our success in delivering on our mission of enabling access to care. We expect that the overall number of Active Providers will increase over time as a result of several factors:

the number of modules and use cases deployed within health systems

the adoption of telehealth by providers across the spectrum of care

the number of programs offered through health plans

the continued improvement in the regulatory environment for telehealth, including reimbursement for telehealth services

the ongoing consumerization of healthcare

A significant number of modules and use cases deployed within health systems

the adoption of telehealth by providers were added toacross the platformspectrum of care
the expansion of modules and programs through acquisitions, including Conversa Health and SilverCloud
the number of programs offered through health plans
the continued improvement in Q2 and Q3the regulatory environment for telehealth, including reimbursement for telehealth services
the ongoing consumerization of 2020 by our Health Plan but predominately by our Health System customers to handle the anticipated extraordinary increase in COVID-related consultations.  Amwell also added additional AMG providers for additional capacity to absorb COVID-related spikes in care.  As the 12 month measurement period for “Active Providers” advances beyond the peak COVID periods of Q2 and Q3 of 2020, we expect these extraordinary COVID-related additional AMG and customer providers to cycle out of the Active Provider count.  healthcare

We continuecontinued to experience growth in core active providers but are expecting a reset periodActive Providers in the current quarter, in which approximately 12,000 Active Providers were added to the core base in Q2Amwell Platform all coming from our Health System and Q3 of 2021Health Plan customers.

Total Active Providers

 

Quarter Ended

 

Total Active Providers

 

 

Customer Providers

 

 

AMG

 

June 30, 2021

 

 

71,000

 

 

 

67,000

 

 

 

4,000

 

March 31, 2021

 

 

81,000

 

 

 

76,000

 

 

 

5,000

 

December 31, 2020

 

 

72,000

 

 

 

68,000

 

 

 

4,000

 

September 30, 2020

 

 

62,000

 

 

 

58,000

 

 

 

4,000

 

June 30, 2020

 

 

57,000

 

 

 

53,000

 

 

 

4,000

 

March 31, 2020

 

 

24,000

 

 

 

22,000

 

 

 

2,000

 

Total Active Providers

 

Quarter Ended

 

Total Active Providers

 

 

Customer Providers

 

 

AMG

 

June 30, 2022

 

 

103,500

 

 

 

100,000

 

 

 

3,500

 

March 31, 2022

 

 

102,000

 

 

 

98,500

 

 

 

3,500

 

December 31, 2021

 

 

91,500

 

 

 

88,000

 

 

 

3,500

 

September 30, 2021

 

 

80,000

 

 

 

76,000

 

 

 

4,000

 

June 30, 2021

 

 

71,000

 

 

 

67,000

 

 

 

4,000

 

March 31, 2021

 

 

81,000

 

 

 

76,000

 

 

 

5,000

 

Regulatory Environment

Our operations are subject to comprehensive United States federal, state and local and international regulation in the jurisdictions in which we do business. Our ability to operate profitably will depend in part upon our ability, and that of our affiliated providers, to maintain all necessary licenses and to operate in compliance with applicable laws and rules. The COVID-19 pandemic has resulted in a reduction of regulatory and reimbursement barriers for telehealth, including removing the originating site restrictions for fee for service Medicare; the expansion of Medicare and commercial reimbursement for telehealth and an easing of state licensure policies for providers. However, it is uncertain how long the relaxed policies will remain in effect, and there can be no guarantee that once the COVID-19 pandemic is over that such restrictions will not be reinstated or changed in a way that adversely affects our business. For additional discussion of this factor, see “Item 1A. Risk Factors—Risks Related to Government Regulation.”

Seasonality26


Seasonality

Visit volumes typically follow the annual flu season, rising during quarter four and quarter one and falling in the summer months. COVID-19 has altered these historical trends as the precautions being taken to prevent the spread of COVID-19 have essentially flattened the spike traditionally experienced related to the flu season. The future impact of COVID-19 on seasonality is unknown as there could be additional surges and demand on telehealth visits. While we sell to and implement our solutions to clients year-round, we experience some seasonality in terms of when we enter into agreements with our clients and when we launch our solutions to members.

Non-GAAP Financial Measures

In addition to our financial results determined in accordance with GAAP, we believe adjusted EBITDA, a non-GAAP measure, is useful in evaluating our operating performance. We use adjusted EBITDA to evaluate our ongoing operations and for internal planning and forecasting purposes. We believe that this non-GAAP financial measure, when taken together with the corresponding GAAP financial measures, provides meaningful supplemental information regarding our performance by excluding certain items that may not be indicative of our business, results of operations or outlook. In particular, we believe that the use of adjusted EBITDA is helpful to our investors as it is a metric used by management in assessing the health of our business and our operating performance. However, non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP. In addition, other companies, including companies in our industry, may calculate similarly-titled non-GAAP measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measure as a tool for comparison. A reconciliation is provided below for our non-GAAP financial measure to the most directly comparable financial measure stated in accordance with GAAP. Investors are encouraged to review the related GAAP financial measure and the reconciliation of this non-GAAP financial measure to their most directly comparable GAAP financial measures, and not to rely on any single financial measure to evaluate our business.


Adjusted EBITDA

Adjusted EBITDA is a key performance measure that our management uses to assess our operating performance. Because adjusted EBITDA facilitates internal comparisons of our historical operating performance on a more consistent basis, we use this measure for business planning purposes and in evaluating acquisition opportunities.

We calculate adjusted EBITDA as net loss adjusted to exclude (i) interest income and other income, net, (ii) tax benefit and expense, (iii) depreciation and amortization, (iv) stock-based compensation expense, (v) public offering expenses, (vi) acquisition-related income and expenses, (vii) litigation expenses related to the defense of our patents in the patent infringement claim filed by Teladoc and (viii) other items affecting our results that we do not view as representative of our ongoing operations, including directnoncash compensation costs incurred by selling shareholders and incremental expenses associated withadjustments made to the COVID-19 pandemic. We had no such other items during the three and six months ended June 30, 2021 and 2020.contingent consideration.

27


The following table presents a reconciliation of adjusted EBITDA from the most comparable GAAP measure, net loss, for the three and six months ended June 30, 20212022 and 2020:2021:

 

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

(in thousands)

 

2022

 

 

2021

 

 

2022

 

 

2021

 

Net loss

 

$

(69,652

)

 

$

(38,136

)

 

$

(139,905

)

 

$

(77,941

)

Add:

 

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization

 

 

6,724

 

 

 

2,484

 

 

 

13,322

 

 

 

4,990

 

Interest income and other (expense) income, net

 

 

(764

)

 

 

(224

)

 

 

(872

)

 

 

(285

)

Benefit (Expense) from income taxes

 

 

461

 

 

 

103

 

 

 

129

 

 

 

412

 

Stock-based compensation

 

 

14,907

 

 

 

10,726

 

 

 

26,992

 

 

 

19,368

 

Public offering expenses(1)

 

 

 

 

 

 

 

 

 

 

 

1,223

 

Acquisition-related expenses

 

 

 

 

 

587

 

 

 

 

 

 

587

 

Noncash expenses and contingent consideration adjustments(2)

 

 

1,259

 

 

 

 

 

 

4,996

 

 

 

 

Litigation expense

 

 

4,261

 

 

 

808

 

 

 

5,399

 

 

 

1,547

 

Adjusted EBITDA

 

$

(42,804

)

 

$

(23,652

)

 

$

(89,939

)

 

$

(50,099

)

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

(in thousands)

 

2021

 

 

2020

 

 

2021

 

 

2020

 

Net loss

 

$

(38,136

)

 

$

(88,220

)

 

$

(77,941

)

 

$

(113,444

)

Add:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization

 

 

2,484

 

 

 

2,509

 

 

 

4,990

 

 

 

4,795

 

Interest income and other income (expense), net

 

 

(224

)

 

 

(308

)

 

 

(285

)

 

 

(1,155

)

Expense from income taxes

 

 

103

 

 

 

252

 

 

 

412

 

 

 

252

 

Stock-based compensation

 

 

10,726

 

 

 

67,638

 

 

 

19,368

 

 

 

72,096

 

Public offering expenses

 

 

 

 

 

526

 

 

 

1,223

 

 

 

677

 

Acquisition-related expense (income)

 

 

587

 

 

 

(65

)

 

 

587

 

 

 

(48

)

COVID-19-related expenses(1)

 

 

 

 

 

4,329

 

 

 

 

 

 

5,742

 

Litigation expense

 

 

808

 

 

 

 

 

 

1,547

 

 

 

 

Adjusted EBITDA

 

$

(23,652

)

 

$

(13,339

)

 

$

(50,099

)

 

$

(31,085

)

(1)
Public offering expenses include non-recurring expenses incurred in relation to our secondary offering for the six months ended June 30, 2021.
(2)
Noncash expenses and contingent consideration adjustments include, noncash compensation costs incurred by selling shareholders and adjustments made to the contingent consideration.

(1)

COVID-19-related expenses include non-recurring provider bonus payments, emergency hosting licensing fees and non-medical provider temporary labor costs related to on-boarding non-AMG providers incurred in response to the initial outbreak of the COVID-19 virus as Amwell attempted to scale quickly to meet unusually high patient and non-AMG provider demand.

(2)

Public offering expenses include non-recurring expenses incurred in relation to our initial public offering for the three and six months ended June 30, 2020 and our secondary offering for the six months ended June 30, 2021.

Some of the limitations of adjusted EBITDA include (i) adjusted EBITDA does not properly reflect capital commitments to be paid in the future, and (ii) although depreciation and amortization are non-cash charges, the underlying assets may need to be replaced and adjusted EBITDA does not reflect these capital expenditures. Our public offering and acquisition-related expenses, including legal, accounting and other professional expenses, reflect cash expenditures and we expect such expenditures for acquisitions to recur from time to time. Our adjusted EBITDA may not be comparable to similarly titled measures of other companies because they may not calculate adjusted EBITDA in the same manner as we calculate the measure, limiting its usefulness as a comparative measure. In evaluating adjusted EBITDA, you should be aware that in the future we will incur expenses similar to the adjustments in this presentation. Our presentation of adjusted EBITDA should not be construed as an inference that our future results will be unaffected by these expenses or any unusual or non-recurring items. Adjusted EBITDA should not be considered as an alternative to loss before benefit from income taxes, net loss, earnings per share, or any other performance measures derived in accordance with U.S. GAAP. When evaluating our performance, you should consider adjusted EBITDA alongside other financial performance measures, including our net loss and other GAAP results.

Components of Statement of Operations

Revenue

The Company has demonstrated continued revenue growth as a direct result increasing acceptance of telehealth, our penetration of the market, and the successful launch of new product enablingor expanded products that enable broadened applications of settings for care delivered virtually.


Revenue performance is reflective of the strong foundation that has been built, focused around health plans, health systems, our provider network and a consistently increasing visit base.

We generate revenues from the use of the Amwell Platform in the form of recurring subscription fees for use of our platform,Platform, and related services and Carepoint sales. We also generate revenue from the performance of AMG patient visits.

Cost of Revenues, Excluding Amortization of Intangible Assets

Cost of revenue primarily consists of hosting fees paid to our hosting providers, costs incurred in connection with our professional services, technical and hosting support, and costs for running our affiliated provider network operations team. These costs primarily include employee-related expenses (including salaries, bonuses, benefits, stock-based compensation and travel).

Cost of revenues are primarily driven by the size of our provider network and the hosting and technical support required to service our platformPlatform customers. Our business models are designed to be scalable and to leverage fixed costs to generate higher revenues. While we currently expect increased investments to support accelerated growth, we also expect increased efficiencies and economies of scale. Our quarterly cost of revenues as a percentage of revenues is expected to fluctuate from period to period depending on the interplay of these aforementioned factors.

28


Operating Expenses

Operating expenses consist of research and development, sales and marketing, and general and administrative expenses.

Research and Development Expenses

Research and development expenses include personnel and related expenses for software and hardware engineering, information technology infrastructure, security and compliance and product development (inclusive of stock-based compensation for our research and development employees). Research and development expenses also include the periodic outsourcing of similar functions to third party specialists. Due to the quarantine and isolation strategies employed by governmental authorities, health systems and health plans to deal with the COVID-19 pandemic, a significant portion of healthcare was forced to be delivered virtually. Our health plan and health system customers believe that overall utilization of telemedicine and care delivered virtually will continue to increase during and after the COVID-19 crisis. By partnering with our customers during the crisis, we understand the increased volume and additional types of care they intend to deliver virtually on our platform.the Amwell Platform. We originally expected this increase in volume, evolution and advancement of telemedicine usage to occur over the next few years but we have now adjusted our research and development strategies to match the views of our customer partners, thus accelerating the expansion of our platformPlatform volume capacity and the development of additional functionality through new programs and modules. We have also expanded the use of offshore resources to provide more efficient rates which are designed to offset the increased research and development spend. While an increase in the research and development expense is expected in the near-term future periods, the corresponding future revenue growth is expected to result in lower expenses as a percentage of revenue. Further, while we expect to see an increase in research and development expense during the next several quarters, this expense represents an investment in a more scalable and economically beneficial solution. We believe the temporary increase will properly position the Company to benefit in the long term.

Our research and development expenses may also fluctuate as a percentage of our total revenue from period to period due to the seasonality of our total revenue and the timing and extent of our research and development expenses. We are accelerating our multiyear technology investment in 2021 to accommodate the anticipated significant growth in market demand for increasingly broad and sophisticated telehealth enablement infrastructure following COVID-19.

Sales and Marketing Expenses

Sales expenses consist primarily of employee-related expenses, including salaries, benefits, commissions, travel and stock-based compensation costs for our employees engaged in sales. We expect our sales expenses to increase as we continue to invest in the expansion of our business. We expect to hire additional sales personnel and related account management and sales support personnel to properly service our growing client base and to identify and capitalize on new strategic market opportunities.

Marketing expenses consist primarily of personnel and related expenses (inclusive of stock-based compensation) for our marketing staff, including costs of communications materials that are produced to generate greater awareness and utilization of our platformthe Amwell Platform among our clients and their users. Marketing costs also include third-party independent research, participation in trade shows, brand messaging, and public relations costs.

Our sales and marketing expenses will fluctuate as a percentage of our total revenue from period to period due to the seasonality of our total revenue and the timing and extent of our advertising and marketing expenses.


General and Administrative Expenses

General and administrative expenses include personnel and related expenses, and professional fees incurred by finance, legal, human resources, information technology, our executives, and executive administration staff. They also include stock-based compensation for employees in these departments and expenses related to auditing, consulting, legal, and corporate insurance.

We expect our general and administrative expenses to increase for the foreseeable future due to costs thatas we incur as a new public company, as well as other costs associated with continuingcontinue to grow our business. However, we expect our general and administrative expenses to decrease as a percentage of our total revenue over the next several years. Our general and administrative expenses may fluctuate as a percentage of our total revenue from period to period due to the seasonality of our total revenue and the timing and extent of our general and administrative expenses.

Depreciation and Amortization Expense

Depreciation and amortization expense includes the amortization of intangible assets and depreciation related to our fixed assets. Amortization of intangible assets consists of the amortization of acquisition-related intangible assets, which are customer relationships, contractor relationships, technology and trade names.

29


Interest Income and Other Income (Expense), Net

The balance of interest income and other income (expense), net, consists predominantly of interest income on our money-market and short-term investments. We did not incur material interest expenses in the period as there were no outstanding debts or notes payables.

Provision for Income Taxes

The income tax provision and benefit were primarily due to state and foreign income tax expense.expense, and benefit related to release of the valuation allowance as a result of our acquisitions.

Deferred tax assets are reduced by a valuation allowance to the extent management believes it is not more likely than not to be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income. Management makes estimates and judgments about future taxable income based on assumptions that are consistent with our plans and estimates.


Consolidated Results of Operations

The following table sets forth our summarized condensed consolidated statement of operations data for the three and six months ended June 30, 2021,2022 and 20202021 and the dollar and percentage change between the respective periods:

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

Three Months Ended June 30,

 

 

Six Months Ended June 30,

 

(in thousands)

 

2021

 

 

2020

 

 

Change

 

 

%

 

 

2021

 

 

2020

 

 

Change

 

 

%

 

 

2022

 

 

2021

 

 

Change

 

 

%

 

 

2022

 

 

2021

 

 

Change

 

 

%

 

Revenue

 

$

60,217

 

 

$

68,568

 

 

$

(8,351

)

 

 

-12

%

 

$

117,816

 

 

$

122,282

 

 

$

(4,466

)

 

 

-4

%

 

$

64,516

 

 

$

60,217

 

 

$

4,299

 

 

 

7

%

 

$

128,748

 

 

$

117,816

 

 

$

10,932

 

 

 

9

%

Costs and operating expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Costs of revenue, excluding depreciation and

amortization of intangible assets

 

 

33,889

 

 

 

43,826

 

 

 

(9,937

)

 

 

(23

)%

 

 

69,594

 

 

 

76,853

 

 

 

(7,259

)

 

 

(9

)%

 

 

36,497

 

 

 

33,889

 

 

 

2,608

 

 

 

8

%

 

 

73,262

 

 

 

69,594

 

 

 

3,668

 

 

 

5

%

Research and development

 

 

22,378

 

 

 

17,637

 

 

 

4,741

 

 

 

27

%

 

 

45,418

 

 

 

32,573

 

 

 

12,845

 

 

 

39

%

 

 

37,067

 

 

 

22,378

 

 

 

14,689

 

 

 

66

%

 

 

74,548

 

 

 

45,418

 

 

 

29,130

 

 

 

64

%

Sales and marketing

 

 

14,789

 

 

 

12,346

 

 

 

2,443

 

 

 

20

%

 

 

28,521

 

 

 

26,220

 

 

 

2,301

 

 

 

9

%

 

 

18,721

 

 

 

14,789

 

 

 

3,932

 

 

 

27

%

 

 

39,875

 

 

 

28,521

 

 

 

11,354

 

 

 

40

%

General and administrative

 

 

24,212

 

 

 

80,082

 

 

 

(55,870

)

 

 

(70

)%

 

 

45,566

 

 

 

95,424

 

 

 

(49,858

)

 

 

(52

)%

 

 

34,911

 

 

 

24,212

 

 

 

10,699

 

 

 

44

%

 

 

67,627

 

 

 

45,566

 

 

 

22,061

 

 

 

48

%

Depreciation and amortization expense

 

 

2,484

 

 

 

2,509

 

 

 

(25

)

 

 

(1

)%

 

 

4,990

 

 

 

4,795

 

 

 

195

 

 

 

4

%

 

 

6,724

 

 

 

2,484

 

 

 

4,240

 

 

 

171

%

 

 

13,322

 

 

 

4,990

 

 

 

8,332

 

 

 

167

%

Total costs and operating expenses

 

 

97,752

 

 

 

156,400

 

 

 

(58,648

)

 

 

(37

)%

 

 

194,089

 

 

 

235,865

 

 

 

(41,776

)

 

 

(18

)%

 

 

133,920

 

 

 

97,752

 

 

 

36,168

 

 

 

37

%

 

 

268,634

 

 

 

194,089

 

 

 

74,545

 

 

 

38

%

Loss from operations

 

 

(37,535

)

 

 

(87,832

)

 

 

50,297

 

 

 

(57

)%

 

 

(76,273

)

 

 

(113,583

)

 

 

37,310

 

 

 

(33

)%

 

 

(69,404

)

 

 

(37,535

)

 

 

(31,869

)

 

 

85

%

 

 

(139,886

)

 

 

(76,273

)

 

 

(63,613

)

 

 

83

%

Interest income and other income (expense), net

 

 

224

 

 

 

308

 

 

 

(84

)

 

 

(27

)%

 

 

285

 

 

 

1,155

 

 

 

(870

)

 

 

(75

)%

Interest income and other (expense) income, net

 

 

764

 

 

 

224

 

 

 

540

 

 

 

241

%

 

 

872

 

 

 

285

 

 

 

587

 

 

 

206

%

Loss before expense from income taxes and loss from

equity method investment

 

 

(37,311

)

 

 

(87,524

)

 

 

50,213

 

 

 

(57

)%

 

 

(75,988

)

 

 

(112,428

)

 

 

36,440

 

 

 

(32

)%

 

 

(68,640

)

 

 

(37,311

)

 

 

(31,329

)

 

 

84

%

 

 

(139,014

)

 

 

(75,988

)

 

 

(63,026

)

 

 

83

%

Expense from income taxes

 

 

(103

)

 

 

(252

)

 

 

149

 

 

(N/A)

 

 

 

(412

)

 

 

(252

)

 

 

(160

)

 

 

63

%

Benefit (Expense) from income taxes

 

 

(461

)

 

 

(103

)

 

 

(358

)

 

 

348

%

 

 

(129

)

 

 

(412

)

 

 

283

 

 

 

(69

)%

Loss from equity method investment

 

 

(722

)

 

 

(444

)

 

 

(278

)

 

 

63

%

 

 

(1,541

)

 

 

(764

)

 

 

(777

)

 

N/A

 

 

 

(551

)

 

 

(722

)

 

 

171

 

 

 

(24

)%

 

 

(762

)

 

 

(1,541

)

 

 

779

 

 

 

(51

)%

Net loss

 

 

(38,136

)

 

 

(88,220

)

 

 

50,084

 

 

 

(57

)%

 

 

(77,941

)

 

 

(113,444

)

 

 

35,503

 

 

 

(31

)%

 

 

(69,652

)

 

 

(38,136

)

 

 

(31,516

)

 

 

83

%

 

 

(139,905

)

 

 

(77,941

)

 

 

(61,964

)

 

 

80

%

Net loss attributable to non-controlling interest

 

 

(277

)

 

 

(1,562

)

 

 

1,285

 

 

 

(82

)%

 

 

(894

)

 

 

(2,405

)

 

 

1,511

 

 

 

(63

)%

 

 

(507

)

 

 

(277

)

 

 

(230

)

 

 

83

%

 

 

(723

)

 

 

(894

)

 

 

171

 

 

 

(19

)%

Net loss attributable to American Well

Corporation

 

$

(37,859

)

 

$

(86,658

)

 

$

48,799

 

 

 

(56

)%

 

$

(77,047

)

 

$

(111,039

)

 

$

33,992

 

 

 

(31

)%

 

$

(69,145

)

 

$

(37,859

)

 

$

(31,286

)

 

 

83

%

 

$

(139,182

)

 

$

(77,047

)

 

$

(62,135

)

 

 

81

%

 

Revenue

For the three months ended June 30, 2021, the decrease in2022, subscription revenue increased by $2.8 million. Subscription revenue increase was substantially driven by a decreasethe expanded use of the Amwell Platform by existing customers. In addition, visit revenue increased by $2.4 million due to increased visit volume in visit revenue. Visit revenue earned from AMG patient visits decreased by $8.5 million, or 24%, from $36.0 million inurgent care, primarily associated with the threeOmicron variant.

For the six months ended June 30, 2020 to $27.5 million in the three months ended June 30, 2021. The decrease was primarily driven by reduced visit volume versus the height of the COVID-19 pandemic experienced in the second quarter of 2020, but was slightly offset by the overall increased utilization of telemedicine as a part of now normal delivery of healthcare. The decrease in visit revenue was offset by an increase in2022, subscription revenue from $24.5 million for the three months ended June 30, 2020 to $26.8 million during the three months ended June 30, 2021, an increase of 2.3 million, or 9%. Subscription revenue grew asincreased by $6.9 million. This was a result of new customers subscribing to the platformAmwell Platform and existing customers expanding their use of the platform through increasing the number of members they provided accessAmwell Platform. In addition, visit revenue increased by $5.1 million due to the platform, increased number of programs, increased modules and increased volume of care delivered on our platform by our customers’ own providers.

For the six months ended June 30, 2021, the decrease in revenue was substantially driven by a decrease in visit revenue. Visit revenue earned from AMG patient visits decreased by $7.1 million, or 11%, from $62.5 million in the six months ended June 30, 2020 to $55.4 million in the six months ended June 30, 2021. As stated above, the decrease was primarily driven by reduced visit volume versusin urgent care, primarily associated with the height of the COVID-19 pandemic experienced in the second quarter of 2020, but was slightly offset by the overall increased utilization of telemedicine as a part of now normal delivery of healthcare. The decrease in visit revenue was offset by an increase in subscription revenue from $46.2 million for the six months ended June 30, 2020 to $51.4 million during the six months ended June 30, 2021, an increase of 5.2 million, or 11%. Subscription revenue grew as a result of new customers subscribing to the platform and existing customers expanding their use of the platform through increasing the number of members they provided access


Omicron variant.to the platform, increased number of programs, increased modules and increased volume of care delivered on our platform by our customers’ own providers.

Costs of Revenue, Excluding Amortization of Acquired Intangible Assets

For the three months ended June 30, 2021,2022, the decreaseincrease in cost of revenue was primarily due to a decreasean increase of $6.5$1.3 million in provider related to employee-related costs due to decreased visit volumes. The decreaseincreased headcount. There was also an increase in visit volume also resulted in the need to utilize a lower level of non-clinical contractor resources to properly service visit demand. The Company also experienced a $1.7 million and $2.0 million decrease in employee costs and hardware costs respectively. of $0.4 million.

For the six months ended June 30, 2021,2022, the decreaseincrease in cost of revenue was primarily due to a decreasean increase of $5.5$2.2 million in provider related costs, with some portion of these providerto employee-related costs due to decreased visit volumes. The decreaseincreased headcount. There was also an increase in visit volume also resulted in the needprovider costs of $0.7 million due to utilize a lower level of non-clinical contractor resources to properly service visit demand. The Company also experienced a $2.2 million decrease in hardware costs.increased visits.

30


Research and Development Expenses

For the three months ended June 30, 2021,2022, the increase in research and development expense was primarily driven by an increase of $3.4$9.9 million in consulting services for Converge and $4.0 million in employee-related costs (inclusive of stock compensation expense). The due to increased headcount.

For the six months ended June 30, 2022, the increase in research and development expense was further driven by a $1.9 million increase in consulting services primarily driven by increased spend related to our new Converge telehealth platform. For the six months ended June 30, 2021, the increase was primarily driven by an increase of $7.8$20.3 million in consulting services for Converge and $7.1 million in employee-related costs (inclusive of stock compensation expense). The increase in research and development expense was further driven by a $5.6 million increase in consulting services primarily driven by due to increased spend related to our new Converge telehealth platform.headcount.

Sales and Marketing Expenses

For the three months ended June 30, 2021,2022, the increase in sales and marketing expense primarily consisted of $1.9$2.0 million in employee-related costs (inclusive of commissions and stock compensation expense). due to increased headcount. There was also an increase of $0.7 million related to company meetings that did not occur in the prior year and consulting expense of $0.8 million mainly related to marketing expenses of $0.4 million. campaigns and services for system integration.

For the six months ended June 30, 2021,2022, the increase in sales and marketing expense primarily consisted of $3.9$5.2 million in employee-related costs (inclusive of commissions and stock compensation expense). The due to increased headcount. There was also an increase was offset by reduced travel expenses of $0.6million and reducedin marketing expenses of $0.4 million.$2.1 million related to conferences and an increase of $1.1 million related to company meetings that did not occur in the prior year. In addition there was an increase in consulting expense of $1.9 million mainly related to marketing campaigns and services for system integration.

General and Administrative Expenses

For the three months ended June 30, 2021,2022, the decreaseincrease in general and administrative expense was driven by a decrease in stock-based compensation expense of $59.8million (predominantlyan increase related to employee-related costs (inclusive of $4.5 million of stock compensation expense) of approximately $7.4million, due to additional equity awards granted in 2022 and headcount increase. There was also a $3.8million increase in legal costs mainly due to the co-CEOs). The decreasefees paid for the Teladoc litigation.

For the six months ended June 30, 2022, the increase in general and administrative expense was offsetdriven by an increase related to employee-related costs (excluding(inclusive of $7.5 million of stock compensation expense) of approximately $0.7$14.4 million. The decreasemillion, due to additional equity awards granted in generalMarch and administrative expensesMay 2022 and headcount increase. There was offset byalso a $1.9$3.5 million increase in insurancelegal costs mainly due to the fees paid for our directors and officers and $0.9the Teladoc litigation. There was an increase of $1.8 million in increased legal costs. The decrease in general and administrative expenses was further offset by a $1.2million increase in system costs to enhance administrative processing. For the six months ended June 30, 2021, the decreaseIn addition, there was driven by a decreasean increase in stock-based compensation expensecontingent consideration adjustments recorded of $58.0$1.0 million (predominantly related to awards granted to the co-CEOs). The decrease was offset by increases related to employee-related costs (excluding stock compensation expense) of approximately $0.9million. The decrease in generalConversa and administrative expenses was further offset by a $3.8SilverCloud revenue earnouts.million increase in insurance costs for our directors and officers and $2.2million in increased legal costs. The decrease in general and administrative expenses was further offset by a $1.6million increase in system costs to enhance administrative processing. General and administrative expenses are expected to continue to increase (in absolute dollars) in future periods as we continue to grow in size and complexity while at the same time recognizing the full year impact of the regulatory and compliance costs associated with being a publicly traded company.

Depreciation and Amortization Expense

Depreciation expense and amortization expense remained consistent for the three months ended June 30, 2021. Depreciation2022. Amortization expense increased by $0.2$4.4 million andfor the three months ended June 30, 2022. The increase in amortization was related to the intangible assets acquired in 2021.

Depreciation expense remained consistent for the six months ended June 30, 2022. Amortization expense increased by $8.7million six months ended June 30, 2022. The increase in amortization was related to the intangible assets acquired in 2021.

Interest Income and Other (Expense) Income, (Expense), net

For the three and six months ended June 30, 20212022 and 2020,2021, interest income and other expenses(expense) income, net consist entirely of interest income and gains from our cash equivalents and short-term investments.


Expense from Income Taxes

Income tax expense was $0.5 million and $0.1 million for the three months ended June 30, 2021, compared to $0.3 million for the three months ended June 30, 2020. Income tax expense was $0.4 million for theand six months ended June 30, 2021,2022, compared to $0.3income tax expense of $0.1 million and $0.4 million for the three and six months ended June 30, 2020.2021.

31


Loss from Equity Method Investment

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 telehealth. 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 investments in CCAW, JV LLC using the equity method of accounting.

During the three months ended June 30, 20212022 and 2020,2021, the Company recognized a loss of $0.7$0.6 million and $0.4$0.7 million, respectively, as its proportionate share of the joint venture results of operations. During the six months ended June 30, 20212022 and 2020,2021, the Company recognized a loss of $1.5$0.8 million and $0.8$1.5 million, respectively, as its proportionate share of the joint venture results of operations.

Liquidity and Capital Resources

The following table presents a summary of our cash flow activity for the periods set forth below:

 

 

Six Months Ended June 30,

 

 

Six Months Ended June 30,

 

 

2021

 

 

2020

 

 

2022

 

 

2021

 

Consolidated Statements of Cash Flows Data:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net cash used in operating activities

 

$

(67,390

)

 

$

(57,822

)

 

$

(105,399

)

 

$

(67,390

)

Net cash provided by investing activities

 

 

97,169

 

 

 

4,334

 

Net cash provided by financing activities

 

 

3,492

 

 

 

148,462

 

Net cash used in and provided by investing activities

 

 

(376,260

)

 

 

97,169

 

Net cash used in and provided by financing activities

 

 

(5,529

)

 

 

3,492

 

Total

 

$

33,271

 

 

$

94,974

 

 

$

(487,188

)

 

$

33,271

 

 

Sources of Financing

Our principal sources of liquidity were cash, cash equivalents and short-term investments totaling $975.2$630.1 million and $1,041.6$746.4 million as of June 30, 20212022 and December 31, 2020,2021, respectively, which were held for a variety of growth initiatives and investments as well as working capital purposes. Our cash, cash equivalents and short-term investments are comprised of money market funds and marketable securities including U.S. Treasury bills.

In September 2020, we received net proceeds of $767.6 million associated with the issuance of 45,681,499 shares of Class A common stock from our IPO, after deducting underwriting discounts and commissions of $49.3 million and offering costs of approximately $4.9 million. In conjunction with the IPO, we closed on the Google LLC private placement and issued 5,555,555 shares of Class C common stock for proceeds of $99.1 million, net of offering costs of $0.9 million.

Prior to our IPO, the Company funded its operations primarily through private placements of its convertible preferred stock as well as through revenues generated through customer contracts.

As shown in the accompanying condensed consolidated financial statements, the Company incurred a loss from operations of $76.3$139.9 million and a net loss of $77.9$139.9 million for the six months ended June 30, 20212022 and had an accumulated deficit of $708.6$950.5 million as of June 30, 2021.2022.

The Company has no debt as of June 30, 20212022 or December 31, 20202021 and expects to generate operating losses in future years.

We believe that our existing cash and cash equivalents will be sufficient to meet our working capital and capital expenditure needs for at least the next 12 months from the issuance date of the financial statements. Our future capital requirements will depend on many factors including our growth rate, contract renewal activity, number of consultations on our platform,Platform, the timing and extent of spending to support product development efforts, our expansion of sales and marketing activities, the introduction of new and enhanced services offerings, and the continuing market acceptance of telehealth services. We may in the future enter into arrangements to acquire or invest in complementary businesses, services and technologies and intellectual property rights. We may be required to seek additional equity or debt financing. In the event that additional financing is required from outside sources, we may not be able to raise it on terms acceptable to us or at all. If we are unable to raise additional capital when desired, our business, financial condition and results of operations would be adversely affected.


Indebtedness & Lines of Credit

In January 2011, the Company entered into a credit agreement (the “Line of Credit”) with a financial institution that provides for maximum borrowings in one or more advances of an amount up to $5.0 million. Borrowings under the Line of Credit accrue interest at the London Interbank Offered Rate plus 1.25%. Borrowings are repayable immediately upon demand by the financial institution. In November 2017, the Line of Credit was amended to increase the maximum borrowings to $7.0 million. As of June 30, 2021 and December 31, 2020, the Company had no outstanding borrowings under the Line of Credit.

During any period that the Line of Credit is in effect, the Company can request the financial institution issue a letter of credit with a maximum maturity not to exceed twelve months. Any letters of credit issued by the financial instrument reduce the maximum borrowings available under the Line of Credit. As of June 30, 2021 and December 31, 2020, the maximum borrowing available to the Company was $6.2 million and $5.9 million based on the outstanding letters of credit of $0.8 million and $1.1 million that have been issued by the financial institution.

Six months ended June 30, 2021,2022, vs. six months ended June 30, 20202021

Cash Used in Operating Activities

For the six months ended June 30, 2022, cash used in operating activities was $105.4 million. The primary driver of this use of cash was our net loss of $139.9 million. The net loss was reflective of the investments made back into the Company (from a technology perspective), partially offset by the overall growth of our business including expansion of business with existing clients. The net loss was partially offset by non-cash expenses of $45.1 million (primarily stock-based compensation of $27.6 million and depreciation and amortization of $13.1 million).

32


For the six months ended June 30, 2021, cash used in operating activities was $67.4 million. The primary driver of this use of cash was our net loss of $77.9 million. The net loss for the year was reflective of the investments made back into the Company (from both a personnel and technology perspective), partially offset by the overall growth of our business including an increase in new clients and expansion of business with existing clients. The net loss was partially offset by non-cash expenses of $26.9 million (primarily stock-based compensation of $19.4 million and depreciation and amortization of $5.0 million).

ForCash Used in and Provided by Investing Activities

Cash used in investing activities was $376.3 million for the six months ended June 30, 2020, cash2022. Cash used in operatinginvesting activities was $57.8 million. The primary driverconsisted of this use$2.0 million investment in the less than majority owned joint venture, $0.1 million in the purchases of cash was our net lossproperty and equipment and purchases of $113.4 million. The net loss for the year was reflectiveshort-term investments of the expenses incurred with our response to COVID-19 and our continued investments made back into the Company’s infrastructure,$499.2 million, partially offset by the revenue growth discussed above. The net loss was partially offset by non-cash expensessales and maturities of $79.4 million (primarily stock-based compensationinvestments of $72.1 million and depreciation and amortization of $4.8 million).$125.0 million.

Cash Provided by Investing Activities

Cash provided by investing activities was $97.2 million for the six months ended June 30, 2021. Cash provided by investing activities consisted of proceeds from maturities of investments of $100.0 million, partially offset by a $2.5 million investment in the CCAW, JV LLC joint venture with Cleveland Clinic and $0.3 million in the purchases of property and equipment.

Cash providedUsed in and Provided by investingFinancing Activities

Cash used in financing activities was $4.3 million for the six months ended June 30, 2020.2022, was $5.5 million. Cash provided by investingused in financing activities consisted of $39.4$11.8 million inrelated to the payment of the Conversa integration earnout, partially offset by $6.0 million of proceeds from the maturitiesexercise of investments, offset by $29.8 million in purchases of investments. Further, cash used in investing activities included a $2.9 million investment in the CCAW, JV LLC joint venture with Cleveland Clinicemployee stock options and $2.3 million in the purchases of property and equipment.employee stock purchase plan.

Cash Provided by Financing Activities

Cash provided by financing activities for the six months ended June 30, 2021, was $3.5 million. Cash provided by financing activities consisted of $16.7 million of proceeds from the exercise of employee stock options. These proceeds were offset by cash payments primarily for the purchase of treasury stock of $11.6 million.

Cash provided by financing activities for the six months ended June 30, 2020, was $148.5 million. Cash provided by financing activities consisted of $146.8 million of cash proceeds from our issuance of Series C Convertible Preferred Stock, net of issuance costs.

Off-Balance Sheet Arrangements

During the periods presented, we did not have, nor do we currently have, any relationships with unconsolidated entities or financial partnerships, such as entities often referred to as structured finance or special purpose entities, which would have been established for the purpose of facilitating off-balance sheet arrangements or other contractually narrow or limited purposes. We are therefore not exposed to the financing, liquidity, market or credit risk that could arise if we had engaged in those types of relationships.


Contractual Obligations and Commitments

As of June 30, 2021,2022, there have been no material changes from the contractual obligations and commitments previously disclosed in our Form 10-K.

Critical Accounting Policies and Estimates

Our condensed consolidated financial statements and the related notes thereto are prepared in accordance with GAAP. The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business factors, and various other assumptions that the Company believes are necessary to consider to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained, and as the Company’s operating environment evolves.

Our significant accounting policies are discussed in Note 2, Summary of Significant Accounting Policies, to our condensed consolidated financial statements in our Form 10-K and Note 2, Summary of Significant Accounting Policies to our condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q. There have been no significant changes to these policies during the six months ended June 30, 2021.2022.

33


Recently Issued Accounting Pronouncements Adopted

For more information on recently issued accounting pronouncements, see Note 2 to our condensed consolidated financial statements covered under Part I, Item 1 of this Quarterly Report on Form 10-Q.

New Accounting Pronouncements Not Yet Adopted

For more information on new accounting pronouncements not yet adopted, see Note 2 to our condensed consolidated financial statements covered under Part I, Item 1 in this Quarterly Report on Form 10-Q.

Emerging Growth Company Status

We are an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until such time as those standards apply to private companies. We have elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it is (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, our financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates.

Item 3. Qualitative and Quantitative Disclosure about Market Risk

Interest Rate Risk

We had cash and cash equivalents totaling $975.2$257.2 million, and $941.6$746.4 million as of June 30, 20212022 and December 31, 2020,2021, respectively. The Company also held investments totaling $0 million and $100.0$372.9 million as of June 30, 2021, and2022 . The Company held no investments as of December 31, 2020, respectively.2021. These amounts were primarily invested in money markets and U.S. Treasury bills. The cash and cash equivalents are held for a variety of growth and investments as well as working capital purposes. Our investments are made for capital preservation purposes. We do not enter into investments for trading or speculative purposes. All our investments are denominated in U.S. dollars.

We do not believe that an increase or decrease of 100 basis points in interest rates would have a material effect on our business, financial condition or results of operations. However, our cash equivalents are subject to market risk due to changes in interest rates. Fixed rate securities may have their market value adversely affected due to a rise in interest rates. Due in part to these factors, our future investment income may fall short of expectation due to changes in interest rates or we may suffer losses in principal if we are forced to sell securities that decline in market value due to changes in interest rates.


Fluctuations in the value of our money market funds caused by a change in interest rates (gains or losses on the carrying value) are recorded in other income and are realized only if we sell the underlying securities.

Foreign Currency Exchange Risk

To date, a substantial majority of our revenue from customer arrangements has been denominated in U.S. dollars. We have limited operations outside the United States. As of June 30, 20212022 and December 31, 2020,2021, we had four foreign subsidiaries with functional currencies of the Euro, British pound, Australian dollars and New Israeli Shekel. As of June 30, 2021 the Company had one foreign subsidiary. Thesubsidiary in Israel, the functional currency of our foreignthat subsidiary is the U.S. dollar. Thedollar, and Company also hashad a branch with a functional currency of the New Israeli Shekel, howeverShekel. The activity for these entities in the New Israeli Shekel issix months ended June 30, 2022 and 2021 was not considered significant. Accordingly, we believe we do not have a material exposure to foreign currency risk. We may choose to focus on international expansion, which may increase our exposure to foreign currency exchange risk in the future.

Inflation Risk

We do not believe that inflation had a material effect on our business, financial condition or results of operations in the last two years. If our costs were to become subject to significant inflationary pressures, we may not be able to fully offset such higher costs through price increases. Our inability or failure to do so could harm our business, financial condition or results of operations.

34


Item 4. Controls and Procedures

EvaluationManagements Report on Internal Control over Financial Reporting

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of Disclosure Controlsachieving the desired control objectives and Proceduresmanagement necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures.

Our management, with the participation of our principal executive officers and principal financial officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the Exchange Act), as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on this evaluation, our principal executive officers and principal financial officer concluded that as of June 30, 2022, our disclosure controls and procedures were effective. Disclosure controls and procedures refer toare our controls and other procedures that are designed to ensurethat information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms and to provide reasonable assurance that such information is accumulated and communicated to our management, including our principal executive officers and principal financial officer, as appropriate, to allow timely decisions regarding required financial disclosure.disclosure.

Based on this evaluation, our principal executive officers and principal financial officer concluded that our disclosure controls and procedures were not effective at the reasonable assurance level due to the material weaknessesThere have been no changes in our internal control over financial reporting, as further described below:

We concluded that certain material weaknesses in our internal control over financial reporting are still present as of June 30, 2021. The material weaknesses present are as follows: We did not maintain an effective control environment as we did not maintain a sufficient complement of accounting and financial reporting resources commensurate with our financial reporting requirements. This material weakness contributed to the following material weaknesses:

We did not have sufficient resources to appropriately record revenue transactions, nor did we did have controls in place to validate that the terms of the revenue transactions were appropriately entered into the revenue sub-ledger based on the terms of the arrangement with the customer.

We did not design or maintain effective controls over the period end financial reporting process and preparation of financial statements. Specifically, we did not design and implement a sufficient level of formal accounting policies and procedures that define how transactions across the business cycles should be initiated, recorded, processed and reported and appropriately authorized and approved.

These control deficiencies did not result in errors that were material to our annual or interim financial statements. However, these control deficiencies could result in a misstatement in our accounts or disclosures that would result in a material misstatement to the financial statements that would not be prevented or detected. Accordingly, we determined that these control deficiencies constitute material weaknesses.

We are in the process of implementing measures designed to improve our internal control over financial reporting and remediate the control deficiencies that led to the material weaknesses. As of June 30, 2021, we have completed the following remedial actions:

hired additional full-time accounting resources with appropriate levels of accounting knowledge and experience, including but not limited to a Chief Financial Officer in the second half of 2018, and the following resources who all have significant public company experience: a Vice President of Accounting, Vice President of FP&A, Senior


Director of Revenue in the first half of 2019, Director of SEC Reporting with Big Four Accounting experience and a Corporate Controller in the second half of 2020, and a Senior Revenue Manager in the first quarter of 2021;

reallocated responsibilities across the accounting organization to ensure that the appropriate level of knowledge and experience is applied based on risk and complexity of transactions and tasks under review;

migrated to a new accounting enterprise resource planning (“ERP”) system that better meets the needs of our business;

designed and implemented controls and continued to refine processes to validate all terms of the revenue transactions were properly considered when determining revenue recognition and that all revenue transactions were subject to thorough review from individuals with the appropriate mix of expertise and oversight to ensure accurate presentation;

increased the number of Board Directors on our Audit Committee to three independent Directors late 2020; and

engaged a Big Four public accounting firm to assist us in the creation of, and ultimately serve as, in an internal audit function, including the establishment of an internal audit charter and assessment, documentation, design and implementation of control activities related to internal controls in the second quarter of 2021.

We have made significant progress towards remediating the material weaknesses and will continue to review, revise, and improve the effectiveness of our internal controls as appropriate Although we have made significant enhancements to our control procedures, these material weaknesses will not be considered remediated until our controls are operational for a sufficient period of time, tested, and management concludes that these controls are operating effectively.

Changes in Internal Control over Financial Reporting

The second quarter remediation activity described above is a change in internal control over financial reporting during the quarter ended June 30, 2021,2022, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

Limitations on Effectiveness of Controls and Procedures35


Our management, including our principal executive officers and principal financial officer, do not expect that our disclosure controls and procedures or our internal control over financial reporting will prevent all errors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, have been detected. These inherent limitations include the realities that judgments in decision-making can be faulty, and that breakdowns can occur because of a simple error or mistake. Additionally, controls can be circumvented by the individual acts of some persons, by collusion of two or more people or by management override of the controls. The design of any system of controls is also based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions; over time, controls may become inadequate because of changes in conditions, or the degree of compliance with policies or procedures may deteriorate. Due to inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be detected.


PART II – OTHER INFORMATION

From time to time, we may become involved in legal proceedings arising in the ordinary course of our business. We are not presently a party to any legal proceedings that, in the opinion of our management, would individually or taken together have a material adverse effect on our business, financial condition, results of operations or cash flows. Regardless of outcome, litigation can have an adverse impact on us due to defense and settlement costs, diversion of management resources, negative publicity, reputational harm and other factors.

On September 14, 2020, we received a letter from Teladoc Health, Inc. ("Teladoc") alleging that certain of our 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. While we can provide no guarantees aboutOn June 30, 2022, the outcome of this dispute, we believe that these claims lack merit and we intendclaim was dismissed pursuant to defend against them vigorously. Moreover, even if we were found to infringe upon any valid claim of these patents, our revenues froma confidential settlement between the Carepoints products approximated 6% of our revenues in 2020. See “Item 1A. Risk Factors—Risks Related to Intellectual Property—parties.Third parties may challenge the validity of our patents and trademarks, or oppose our patent and trademark applications. We may not be able to obtain and enforce additional patents to protect our proprietary rights from use by potential competitors. Companies with other patents could require us to stop using or pay to use required technology” and “Item 1A. Risk Factors—Risks Related to Intellectual Property—We could incur substantial costs as a result of any claim of infringement of another party’s intellectual property rights” in our Form 10-K.

Item 1A. Risk Factors

There have been no material changes to the risk factors previously disclosed in our Form 10-K. For a discussion of potential risks and uncertainties related to our Company see the information in our Form 10-K in the section entitled “Risk Factors.”

In addition to the other information set forth in this Quarterly Report on Form 10-Q, you should carefully consider the factors discussed in the “Special Note Regarding Forward-Looking Statements” section in Part I, Item 2, of this Quarterly Report on Form 10-Q.

ITEM 2. Unregistered Sales of Equity Securities and Use of Proceeds

Recent Sales of Unregistered Securities

There were no sales of unregistered equity securities during the quarter ended June 30, 2021.2022.

Issuer Purchases of Equity Securities

The following table provides information about the Company’s purchases of its common stock for each month during this quarterly period covered by this report:

 

Period

 

(a) Total

number

of shares

(or units)

purchased*

 

 

(b) Average

price paid per

share (or unit)*

 

 

(c) Total number

of shares (or units)

purchased as part

of publicly

announced plans

or programs

 

 

(d) Maximum

number (or

approximate

dollar value)

of shares (or

units) that may

yet be purchased

under the plans

or programs

 

April 1 to April 30

 

 

68,750

 

 

$

27.01

 

 

 

 

 

 

 

May 1 to May 31

 

 

 

 

 

 

 

 

 

 

 

 

June 1 to June 30

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

68,750

 

 

$

27.01

 

 

 

 

 

 

 

Period

(a) Total
number
of shares
(or units)
purchased*

(b) Average
price paid per
share (or unit)
*

Shares withheld to cover tax withholding obligations

(c) Total number
of shares (or units)
purchased as part
of publicly
announced plans
or programs

(d) Maximum
number (or
approximate
dollar value)
of shares (or
units) that may
yet be purchased
under the net settlement provision upon vesting of restricted stock units and exercising of options.plans
or programs

April 1 to April 30

$

May 1 to May 31

June 1 to June 30

Total

$


* Shares withheld to cover tax withholding obligations under the net settlement provision upon vesting of restricted stock units and exercising of options.

36


Item 3. Defaults Upon Senior Securities

Not applicable.

Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

Not applicable.


Item 6. Exhibits

The documents listed below are incorporated by reference or are filed with this Quarterly Report on Form 10-Q, in each case as indicated therein (numbered in accordance with Item 601 of Regulation S-K).

31.14.2*

Amendment No 1 to the Agreement and Plan of Merger by and among Parent, the Company, Shannon Merger Subsidiary, Inc., Shannon merger Sister Subsidiary, LLC, and the Fortis Advisors, LLC, as the Security Representative, dated July 28, 2021.

10.1#

Employment Agreement between American Well Corporation and Phyllis Gotlib, dated April 8, 2022 (incorporated by reference to the Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on April 14, 2022)

10.3#*

Performance Share Unit Agreement between American Well Corporation and Ido Schoenberg, dated May 11, 2022

10.4#*

Performance Share Unit Agreement between American Well Corporation and Roy Schoenberg, dated May 11, 2022

31.1*

 

Chief Executive Officers Certifications

 

 

 

31.231.2*

 

Chief Financial Officer Certification

 

 

 

32.132.1*

 

CEO Certification of Quarterly Report

 

 

 

32.232.2*

 

CFO CertificationCertifications of Quarterly Report

 

 

 

101.INS

 

 

Inline XBRL Instance Document – the instance document does not appear in the Interactive Data File because XBRL tags are embedded within the Inline XBRL document.

 

 

 

 

101.SCH

 

Inline XBRL Taxonomy Extension Schema Document

 

 

 

101.CAL

 

Inline XBRL Taxonomy Extension Calculation Linkbase Document

 

 

 

101.DEF

 

Inline XBRL Taxonomy Extension Definition Linkbase Document

 

 

 

101.LAB

 

Inline XBRL Taxonomy Extension Label Linkbase Document

 

 

 

101.PRE

 

Inline XBRL Taxonomy Extension Presentation Linkbase Document

 

 

 

104

 

Cover Page Interactive Data File (embedded within the Inline XBRL document)

 


*

Filed herewith

#

Indicates a management contract or compensatory plan

 

SIGNATURES

37


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

 

 

 

 

 

 

 

 

 

 

AMERICAN WELL CORPORATION

 

 

 

 

 

Date:

August 12, 2021 5, 2022

 

By:

/s/ Ido Schoenberg, MD

 

 

 

 

Co-Chief Executive Officer

 

 

 

 

(Principal Executive Officer)

 

 

 

 

 

Date:

August 12, 2021 5, 2022

 

By:

/s/ Roy Schoenberg, MD, MPH

 

 

 

 

Co-Chief Executive Officer

 

 

 

 

(Principal Executive Officer)

 

 

 

 

 

Date:

August 12, 2021 5, 2022

 

By:

/s/ Keith Anderson Robert Shepardson

 

 

 

 

Chief Financial Officer

 

 

 

 

(Principal Financial Officer)

 

 

 

 

 

Date:

August 12, 2021 5, 2022

 

By:

/s/ Paul McNeice

 

 

 

 

Vice President of Accounting

 

 

 

 

(Principal Accounting Officer)

 

4138