Q4 2023 DocGo Inc Earnings Call

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unknown: It's revenue, growth, vision, and migrants. Good day, ladies and gentlemen, and welcome to the Docgo fourth quarter and full year 2023 earnings conference call. At this time, all participants are in a listen-only mode.

Revenue growth Division migrants, let me take it.

Good day, ladies and gentlemen, and welcome to the Doug go forth co chair and two P. F. 'twenty two 'twenty three earnings conference call.

At this time, all participants are in listen only mode.

unknown: The question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press start and zero on your telephone keypad. Please note, this conference is being recorded. I'll now turn the conference over to Mike Cole, Vice President of Investor Relations. Please go ahead, sir.

A question and answer session will follow the formal presentation.

If anyone should require operator assistance during the conference P space.

In DRAM I need help.

And key pad.

This conference is being recorded.

I'll now turn the country said it in my call, but let's face it into all of Investor Relations. Please go ahead Sir.

Mike Cole: Thank you, Operator. Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. All statements made in this conference call, other than statements of historical fact, are forward-looking statements. The words may, will, plan, potential, could, goal, outlook, design, anticipate, aim, believe, estimate, expect, intend, guidance, confidence, target, project, and other similar expressions may be used to identify such forward-looking

Yeah.

Thank you operator before turning the call over to management I would like to make the following remarks concerning forward looking statements. All statements made in this conference call other than statements of historical fact are forward looking statements. The words may will plan potential could goal outlook design anticipate believe estimate expect intend guidance confidence.

Target project and other similar expressions may be used to identify such forward looking statements. These forward looking statements are not guarantees of future performance and we cannot assure you that we will achieve or realize our plans and pension outcomes result, or expectations forward looking statements are inherently subject to substantial risks uncertainties and assumptions many of which are beyond.

Mike Cole: These forward-looking statements are not guarantees of future performance, and we cannot assure you that we will achieve or realize our plans, intentions, outcomes, results, or expectations. Such statements are inherently subject to substantial risks, uncertainties, and assumptions, many of which are beyond our control and which may cause our actual results or outcomes or the timing of results or outcomes to differ materially from those contained in our forward-looking statements. These risks, uncertainties, and assumptions include but are not limited to those discussed in our risk factors and elsewhere in Docgo's annual report on Form 10-K, quarterly reports on Form 10-Q, and other reports and statements filed by Docgo with the SEC to which your attention is directed. Actual outcomes and results or the timing of results or outcomes may differ materially from what is expressed or implied by these forward-looking statements.

Our control and which may cause our actual results or outcomes or the timing of results or outcomes to differ materially from those contained in our forward looking statements. These risks uncertainties assumptions include but are not limited to those discussed in our risk factors and elsewhere in <unk> annual report on Form 10-K quarterly reports on Form 10-Q.

And other reports and statements filed by Doctor with the SEC to which your attention is directed actual outcomes and results or the timing of results or outcomes may differ materially from what is expressed or implied by these forward looking statements.

Mike Cole: In addition, today's call contains references to non-GAAP financial measures. Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are provided directly as part of this call or included in our earnings release, which is posted on our website, docgo.com, as well as filed with the Securities and Exchange Commission. The information contained in this call is accurate as of only the date discussed. Investors should not assume that statements will remain relevant and operative at a later time.

In addition, today's call contains references to non-GAAP financial measures reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are provided directly as part of this call or included in our earnings release, which is posted on our website <unk> dot com as well as filed with the Securities and Exchange Commission.

The information contained in this call is accurate as of only the date discussed investors should not assume that statements will remain relevant and operative at a later time, we undertake no obligation to update any information discussed in this call to reflect events or circumstances. After the date of this call or to reflect new information or the occurrence of unanticipated events.

Lee Bienstock: We undertake no obligation to update any information discussed in this call to reflect events or circumstances after the date of this call or to reflect new information or the occurrence of unanticipated events, except to the extent required by law. At this time, it is now my pleasure to turn the call over to Mr. Lee Bienstock, CEO of Docgo. Lee, please go ahead.

Except to the extent required by law at this time. It is now my pleasure to turn the call over to Mr. Lee Bienstock CEO of Docker Li. Please go ahead.

Yeah.

Lee Bienstock: Thank you, Mike, and thank you all for joining us today. It is certainly fair to say that 2023 was an eventful year, and my first 100 days as CEO were laser focused on setting an ambitious vision for how we will proactively help make patients healthier and help keep them out of the hospital. Our record Q4 and full year results are proof that this vision is taking shape, and I look forward to continuing to build on this momentum in 2024 and beyond. During the quarter, we experienced significant growth and strong operational execution as we made considerable progress with our core strategic objectives in all three key customer verticals, insurance partners, hospital systems, and our government population health program. I'm going to share accomplishments and progress across all three of these verticals, but first, I want to lead off with our financial performance and guidance for 2024. In Q4, we grew revenues and adjusted EBITDA to $199.2 million and $22.6 million, respectively, up 83% and 232% when compared to the fourth quarter of 2022. In the fourth quarter alone, Docgo performed over 72,000 mobile health interactions and 190,000 medical transports globally while leveraging a workforce of now more than 8,000.

Thank you Mike and thank you all for joining today.

It is certainly fair to say that two towards 2023 was an eventful year and my first hundred days as CEO, we're laser focused on setting an ambitious vision for how we will proactively help make patients healthier and help keep them out of the hospital.

Our record Q4 and full year results are proof that this vision is taking shape and I look forward to continuing to build on this momentum in 2024 and beyond.

During the quarter, we experienced significant growth and strong operational execution as we made considerable progress with our core strategic objectives in all three key customer verticals insurance partners Hospital systems, and our government population health programs.

I'm going to share accomplishments and progress across all three of these verticals, but first I want to lead off with our financial performance and guidance for 2024.

In Q4, we grew revenues and adjusted EBITDA to $199 $2 million and $22 $6 million respectively.

Up, 83% and 232% when compared to the fourth quarter of 2022.

In the fourth quarter alone Dacko performed over 72000 mobile health interactions and 190000 medical transports globally, while leveraging a workforce of now more than 8000.

Lee Bienstock: We continue to grow not only in size, but also in scope, as we have more than doubled our service offerings in the last year to include procedures such as bone density scans, depression screenings, and other valuable services we can deliver where convenient outside of the traditional brick and mortar healthcare system. While there is more work to do, we made substantial progress late in the fourth quarter with our cash collections, and that trend has accelerated in 2024. Subsequent to year end, we have collected approximately $120 million in outstanding receivables and are working with our largest customers to maintain a more consistent cadence going forward.

We continue to grow not only in size, but also in scope as we have more than doubled our service offerings in the last year to include procedures, such as such as bone density scans depression screenings and other valuable services, we can deliver where convenient outside of the traditional brick and mortar health care system.

While there is more work to do we made substantial progress late in the fourth quarter with our cash collections and that trend has accelerated in 2024.

Subsequent to year end, we have collected approximately $120 million in outstanding receivables and are working with our largest customers to maintain a more consistent cadence going forward.

Lee Bienstock: We're also moving into a more mature state with some of our recent municipal and population health initiatives and are seeing the associated higher costs that came with those program launches abate. This puts us in a strong position to achieve improved adjusted EBITDA margins and cash flow as we progress through 2024. On that note, today we updated our 2024 revenue guidance to a range of $720 to $750 million. This is consistent with our previously disclosed view that suggested 2024 revenue would exceed $700 million. Our 2024 adjusted EBITDA guidance range is 80 to 85 million. We also recently announced a share repurchase authorization for up to $36 million. Docgo is confident in our cash position, we are confident in our cash collections, we are confident in our access to capital, and we're confident in our strong business fundamentals.

We're also moving into a more mature state with some of our recent municipal and population health initiatives and are seeing the associated higher cost that came with those program launches abate.

This puts us in a strong position to achieve improved adjusted EBITDA margins and cash flow as we progress through 2024.

On that note today, we updated our 2020 for revenue guidance to a range of $720 million to $750 million.

This is consistent with our previously disclosed view that suggested 2024 revenue would exceed $700 million.

Our 2024, adjusted EBITDA guidance range is $80 million to $85 million.

We also recently announced a share repurchase approval for up to $36 million Darko is confidence in our cash position. We are confident in our cash collections. We are confident in our access to capital and we are confident in our strong business fundamentals.

Lee Bienstock: At current valuation levels, we believe that share repurchases represent an efficient and value-enhancing use of capital. Since becoming CEO, I centered our efforts around our core customers, insurance partners, hospital systems, and government population health programs. Now, I would like to share progress and growth on all three. First.

At current valuation levels, we believe that share repurchases represent an efficient and value enhancing use of capital.

Since becoming CEO I centered our efforts around our core customers insurance partners Hospital systems and government population health programs now I would like to share progress in growth on all three.

First.

Lee Bienstock: One area that is relatively small, a relatively small contributor to revenues today, but which we believe offers tremendous growth potential, is our care gap closure programs with major insurance companies. The core initial focus of these programs is on non-compliant patients who have not seen their primary care provider in over a year and have at least one chronic condition. By leveraging our mobile capabilities and meeting patients where they are by bringing care to their homes, we are validating to these customers that we can improve patient compliance rates materially. We are now offering over thirty different Care Gap Closure services, including colon cancer screenings and diabetic retinal examinations. Late in 2023, we launched payer programs in Michigan, Connecticut, and New Jersey, and during the fourth quarter alone, we more than doubled the number of patients seen under these programs when compared to the third quarter, and we expect that trend to continue. The reality is that a certain percentage of the population simply avoids or is unable to go to a traditional brick-and-mortar facility for these services.

One area that is relatively small a relatively small contributor to revenues today, but which we believe offers tremendous growth potential is our care gap closure programs with major insurance companies.

The core initial focus of these programs is on Noncompliant patients, who have not seen their primary care provider in over a year and have at least one chronic condition by leveraging our mobile capabilities and meeting patients where they are by bringing care to their homes. We are validating to these customers that we can improve patient compliance rates materially.

We are now offering over 30 different care gap closure services, including colon cancer cancer screenings and diabetic retinal exams.

Late in 2023, we launched payer programs in Michigan, Connecticut, and New Jersey, and during the fourth quarter alone we more than doubled the number of patients seen under these programs when compared to the third quarter and we expect that trend to continue.

The reality is that a certain percentage of the population simply avoid or is unable to go to a traditional brick and mortar facility for these services by making the process extremely convenient and efficient in the comfort of their own home, we can improve health outcomes lower costs help stratify risk.

Lee Bienstock: By making the process extremely convenient and efficient in the comfort of their own home, we can improve health outcomes, lower costs, help stratify risk, and help keep people out of the hospital, which is what our insurance partners want, and it's, of course, what our patients want. Our remote patient monitoring efforts continue to progress as well. We currently monitor approximately 50,000 CIED or cardiac implantable electronic device patients, which is up from 38,000 at the start of 2023. We continue to see a significant opportunity in our monitoring efforts, both on a standalone basis and as part of our HEDIS Quality Score Improvement and Value-Based Service Offer. Second,

And help keep people out of the hospital, which is what our insurance partners want and it's of course, what our patients want.

Our remote patient monitoring efforts continued to progress as well. We currently monitor approximately 50000 and C. I E D or cardiac implantable electronic device patients, which is up from 38000 at the start of 2023.

We continue to see a significant opportunity and are monitoring efforts, both on a standalone basis and as part of our heat is quality score improvement and value based service offerings.

Second.

Lee Bienstock: With our medical transportation segment, which is largely hospital systems, we close out the year with another strong performance. To put the progress in perspective, in the fourth quarter of 2023, this business was at a revenue run rate of $160 million with a gross margin of 28.9%. By closing the year, that run rate was $190 million with a gross margin of 37.5%.

With our medical Transportation segment, which is largely hospital systems, we closed out the year with another strong performance to put the progress in perspective in the fourth quarter of 2023.

This business was at a revenue run rate of $160 million with a gross margin of 28, 9% closing the year that run rate was 190 million with a gross margin of 37, 5% we.

Lee Bienstock: We announced a number of meaningful RFP wins in the second half of 2023, both domestically and in the UK, which we expect will continue to help drive strong growth in 2024. We have also placed a significant emphasis on cross-selling and growing our mobile health presence with our hospital system partners and expect the results of that effort to begin yielding benefits later in the year. In the government RFP channel, we currently operate population health programs in Arizona, California, Michigan, and Tennessee, in addition to New York.

We announced a number of meaningful RFP wins in the second half of 2023, both domestically and in the U K, which we expect will continue to help drive strong growth in 2024.

We have also placed a significant emphasis on cross selling and growing our mobile health presence with our hospital system partners and expect the results of that effort to begin yielding benefits later in the year.

And third in the government RFP channel. We currently operate population health programs in Arizona, California, Michigan and Tennessee. In addition to New York. These represent excellent opportunities to prove our value proposition and grow these geographies over time much like we have done so successfully in the northeast.

Lee Bienstock: These represent excellent opportunities to prove our value proposition and grow these geographies over time, much like we have done so successfully in the Northeast. Our work with asylum seeker populations in New York has enabled us to expand and augment Docgo's offerings, including scaling our behavioral health competency by performing over 50,000 depression screenings, growing our mobile pharmacy to prescribe over 70 different types of medications, and increasing our vaccine administration capacity to over 40 different types of vaccines. We will continue to expand our capabilities and use this institutional knowledge and experience to create valuable new programs for current and prospective customers, a great statistic that highlights the value we are providing. We estimate that in 2023, we prevented over 54,000 unnecessary emergency room visits, and saved our partners and their patients over $167 million in healthcare spending across our various programs, demonstrating just how much of a positive impact Docgo can have for our partners, and perhaps more importantly, for the communities we serve. The impact and reach of our business extends far beyond underserved populations like the homeless and asylum seekers. We provide medical transportation for hundreds of hospitals. We deploy vaccination programs in multiple states.

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Our work with asylum seeker populations in New York has enabled us to expand and augment arcos offerings, including scaling our behavioral health competency by performing over 50000 depression screenings growing our mobile pharmacy to prescribe over 70 different types of medications and increasing our vaccine administration capacity to over 40 different types of vaccine we.

We'll continue to expand our capabilities and use this institutional knowledge and experience to create valuable new programs for current and prospective customers.

A great statistic that highlights the value we are providing we estimate that in 2020 three we prevented over 54000 unnecessary emergency room visits and saved our partners and their patients over $167 million in health care spending across our various programs.

<unk> just how much of a positive impact Taco can have for our partners and perhaps more importantly for the communities we serve.

The impact and reach of our business extends far beyond underserved populations like the homeless and asylum seekers, we provide medical transportation for hundreds of hospitals, we deploy vaccination programs in multiple states, we monitor tens of thousands of cardiac patients, we close care gaps for bed down chronically ill.

Lee Bienstock: We monitor tens of thousands of cardiac patients. We close care gaps for bed-bound, chronically ill patients and so much more. In summary, our mission remains the same.

And so much more.

In summary.

Our mission remains the same to.

Norman Rosenberg: To continue bringing health care to people where and when they need it, which we did for many hundreds of thousands of patients in 2023 from all walks of life, all with the goal of helping keep them out of the hospital. And we're seeing great success with this effort. At this time, I'll turn the call over to Norm, our CFO, to review the financials for both the fourth quarter and the full year 2023. Norm, please go ahead. Thank you, Lee. And good afternoon, everyone.

To continue bringing health care to people, where and when they need it which we did for many hundreds of thousands of patients in 2023 from all walks of life.

All with the goal of helping keep them out of the hospital and we're seeing great success with this effort.

At this time I'll turn the call over to norm, our CFO to review the financials for both the fourth quarter and the full year 2023 norm. Please go ahead.

Julie and good afternoon, everyone total revenue for the fourth quarter of 'twenty 'twenty four was $199 2 million, which was a 7% increase from a quarter ago and an 83% increase from the fourth quarter of 2022 for the full year total revenue was $624 $2 million at the high end of our awkwardly revised guidance range and more than.

Norman Rosenberg: Total revenue for the fourth quarter of 2024 was $199.2 million, which was a 7% increase from a quarter ago and an 83% increase from the fourth quarter of 2022. For the full year, total revenue was $624.2 million, at the high end of our awkwardly revised guidance range and more than 40% higher than full year 2022 revenues of $440.5 million. Mobile health revenue for the fourth quarter of 2023 was $150.4 million, up 8% from the third quarter and more than double the levels of the fourth quarter of 2022.

40% higher than full year 2022 revenues of $440 5 million.

Mobile health revenue for the fourth quarter of 2023 was $154 million up 8% from the third quarter and more than double the levels of fourth quarter 2022, we experienced growth across several projects business lines and geographies medical transportation revenue increase of $48 $8 million in Q4 of 2023.

Norman Rosenberg: We experienced growth across several projects, business lines, and geography. Medical transportation revenue increased to $48.8 million in Q4 of 2023, 32% higher than the transport revenues we recorded in the fourth quarter of 2022. Nearly every transportation market witnessed year-over-year revenue growth, continuing the momentum that began in the second half of last year. Transport revenues have now increased sequentially for six consecutive quarters, more than doubling during that time. In the fourth quarter, mobile health revenues accounted for about 75% of total revenues, and transport for the other 25%.

32% higher than the transport revenues, we recorded in the fourth quarter of 2020 to nearly every transportation market witnessed year over year revenue growth continuing the momentum that began in the second half of last year transport revenues have now increased sequentially for six consecutive quarters more than doubling during that time.

In the fourth quarter mobile health revenues accounted for about 75% of total revenues in transport for the other 25% we expected mobile health will continue to account for about 75% of total revenue in 2024.

Norman Rosenberg: We expect that mobile health will continue to account for about 75% of total revenue in 2024. Net income was $8 million in Q4 2023, compared with net income of $4.6 million in the third quarter, and net income of $7.1 million in the fourth quarter of 2022. As the fourth quarter of 2022 saw a tax benefit of $9.1 million relating to the release of a valuation allowance for net operating losses. For the full year, net income was $10 million compared to $30.7 million in 2022. The year-over-year drop in net income is explained by two line items, non-cash stock compensation expense and income tax expense.

Net income was $8 million in Q4, 2023, compared with net income of $4 $6 million in the third quarter and net income of $7 $1 million in the fourth quarter of 2022.

The fourth quarter of 2022, so our tax benefit of $9 $1 million relating to the release of evaluation allowance for net operating losses for the full year net income was $10 million compared to $37 million in 2022, the year over year drop in net income is explained by two line items noncash stock compensation expense and.

Income tax expense, we have expanded our stock compensation program to include a broader group of managers, so that more of our colleagues who drive strategy and execution are incentivized to maximize shareholder value on the tax front in 2022, we realized a tax benefit of approximately $9 million as we released the valuation allowance on our.

Norman Rosenberg: We have expanded our stock compensation program to include a broader group of managers so that more of our colleagues who drive strategy and execution are incentivized to maximize shareholder value. On the tax front, in 2022, we realized a tax benefit of approximately $9 million as we released the valuation allowance on our Net Operating Loss Carry-Forwards, or NOLs, as we began generating pre-tax income, and those NOLs became realizable. In 2023, we recorded income tax expense as we exhausted those federal Net Operating Loss Carry-Forwards due to the generation of pre-tax income. Our effective tax rate for the fourth quarter was approximately 35%, which we believe is a good assumption for future periods.

Net operating loss carryforwards, or Nols as we began generating pre tax income and those Nols became realizable in 2023, we recorded income tax expense as we exhausted those federal net operating loss carryforwards due to the generation of pretax income.

Our effective tax rate for the fourth quarter was approximately 35%, which we believe is a good assumption for future periods.

Norman Rosenberg: Adjusted EBITDA for the fourth quarter of 2023 was $22.6 million, up 35% from adjusted EBITDA of $16.7 million in the third quarter, and more than tripled to $6.8 million in last year's fourth quarter. For the full year, adjusted EBITDA was $54 million, a 31% increase from $41.3 million in 2022, and more than doubled the adjusted EBITDA recorded back in 2021. The adjusted EBITDA margin was 11.4% in Q4, up from 8.9% in the third quarter and up from 6.3% in the fourth quarter of 2022.

Adjusted EBITDA for the fourth quarter of 2023 was $22 6 million up 35% from adjusted EBITDA of $16 $7 million in the third quarter and more than triple the $6 $8 million in last year's fourth quarter for the full year adjusted EBITDA was $54 million, a 31% increase from 41.3.

In 2022 and more than double the adjusted EBITDA recorded back in 2021.

The adjusted EBITDA margin was 11, 4% in Q4 up from eight 9% in the third quarter and up from six 3% in the fourth quarter of 2022.

In fact, the fourth quarter's adjusted EBITA margin represents the highest level. We have recorded since the first quarter of 'twenty to 'twenty two when nearly a third of total company revenues came from relatively high margin mass Covid testing services.

Norman Rosenberg: In fact, the fourth quarter's adjusted EBITDA margin represents the highest level we've recorded since the first quarter of 2022, when nearly a third of total company revenues came from relatively high-margin mass COVID testing services. Total gross margin percentage during the fourth quarter of 2023 was 33.5%, up nicely from the 29.5% in the third quarter, but lower than the 39% gross margin recorded in the fourth quarter of 2022. The fourth quarter of 2023 was the highest margin quarter during the year, slightly higher than what we saw in the second quarter. Gross margin in the fourth quarter represented a solid rebound from the subpar levels of the third quarter, which had been negatively impacted by the increased cost that resulted from the recent launch and ramp up of new projects.

Total gross margin percentage during the fourth quarter of 2023 was 33, 5% up nicely from the 29, 5% in the third quarter, but lower than the 39% gross margin recorded in the fourth quarter of 2022.

<unk> fourth quarter of 2023 was the highest margin quarter during the year slightly higher than what we saw in the second quarter.

Gross margin in the fourth quarter represented a solid rebound from the sub par levels of the third quarter, which had been negatively impacted by the increased costs that resulted from the recent launch and ramp up of new projects during.

During the fourth quarter, while we were able to maintain third quarter revenue levels and in fact increase them. Further we were able to improve margins by bringing overtime costs and subcontracted labor expenses closer in line with their projected levels as these projects hit their strides through the first two months of 2024, we have seen further improvements in these areas and believe that we should see some sequential.

Norman Rosenberg: During the fourth quarter, while we were able to maintain third quarter revenue levels, and in fact, increase them further, we were able to improve margins by bringing overtime costs and subcontracted labor expenses closer in line with their projected levels, as these projects hit their stride. Through the first two months of 2024, we have seen further improvements in these areas and believe that we should see some sequential gross margin improvements in Q1 of 2024. During the fourth quarter of 2023, gross margins from the mobile health segment was 32.2%, compared to 28.8% in the third quarter, and 43.9% in the fourth quarter of 22, which had benefited from some one time high margin revenue stream. In the transportation segment, gross margin continued to expand, increasing to 37.4% in Q4 of 2023, up from 31.7% in the third quarter, and 29.4% in Q4 of 2022.

Gross margin improvements in Q1 of 2024.

During the fourth quarter of 2023 gross margins.

The mobile health segment was 32, 2% compared to 28, 8% in the third quarter and 43, 9% in the fourth quarter of 'twenty, two which had benefited from some one time high margin revenue streams.

In the transportation segment gross margin continued to expand increasing to 37, 4% in Q4 of 2023 up from 31, 7% in the third quarter and 29, 4% in Q4 of 2022 transportation gross margin has now expanded for six consecutive quarters alongside the sequential revenue increases.

And earlier as we benefited from scale improve utilization and easing of wage and fuel price pressures and a higher value mix of trips along with a continued shift toward higher margin leased our programs.

Looking at operating costs SG&A as a percentage of total revenues amounted to 27, 6%.

In the fourth quarter of 2023 up from 24, 8% in the third quarter, but much lower than the 38, 1% in the fourth quarter of 2022 as revenues increased over the second half of 2023, we saw SG&A decline as a percentage of total revenues leading to operating margin expansion. We are also regularly reviewing our expense base for <unk>.

Norman Rosenberg: Transportation gross margin has now expanded for six consecutive quarters, alongside the sequential revenue increases I mentioned earlier, as we benefited from scale, improved utilization, an easing of wage and fuel price pressures, and a higher value mix of trips, along with a continued shift toward higher margin lease-to-hour programs. Looking at operating costs, SG&A as a percentage of total revenues amounted to 27.6% in the fourth quarter of 2023, up from 24.8% in the third quarter but much lower than 38.1% in the fourth quarter of 2022.

<unk> gains, particularly our non field head count during Q1 of 2024, we executed a targeted reduction in force, which resulted in some cost savings that will be realized as we move into Q2 and beyond.

Turning to the balance sheet as of December 31, 2023, our total cash and cash equivalents, including restricted cash was $72 $2 million as compared to $67 $3 million as of the end of Q3, our accounts receivable continued to increase reflecting the spike in revenues will be witnessed over the second half of 'twenty.

Norman Rosenberg: As revenues increased over the second half of 2023, we saw SG&A decline as a percentage of total revenues, leading to operating margin expansion. We are also regularly reviewing our expense base for efficiency gains, particularly our non-field headcount. During Q1 of 2024, we executed a targeted reduction in force, which resulted in some cost savings that will be realized as we move into Q2 and beyond. Turning to the balance, as of December 31, 2023, our total cash and cash equivalents, including restricted cash, were $72.2 million, as compared to $67.3 million as of the end of Q3.

23. This increase in accounts receivable is being driven by our government business, which features a very long initial payment cycle as we've discussed.

As Lee mentioned earlier in the fourth quarter, we began to receive payments for this work with an acceleration of these payments taking place since the beginning of the new year, a significant proportion of the year end accounts receivable have now been collected in the recent weeks looking.

Looking at our project with New York City's Department of housing preservation of development or H B D. As of today, we have collected nearly 80% of the year end 2023 accounts receivable for this project and we are very close to being current on this project.

As we further work down this receivable, we expect that near term collections will be enough to drive our total cash balance higher than subsequent periods. Despite our ongoing working capital needs as we grow the.

Norman Rosenberg: Our accounts receivable continue to increase, reflecting the spike in revenues that we witnessed over the second half of 2023. This increase in accounts receivable is being driven by our government business, which features a very long initial payment cycle, as we've discussed. However, as Lee mentioned earlier, in the fourth quarter, we began to receive payments for this work, with an acceleration of these payments taking place since the beginning of the new year. A significant proportion of the year-end accounts receivable have now been collected in recent weeks.

The recent collections have allowed us to pay down the outstanding amounts on our credit line and the present outstanding balance is zero.

Turning to our guidance and outlook for 2024, we anticipate continued strong demand from our customers for both mobile health and transportation services. We are forecasting that revenues for 2024 will be in the range of $720 million to $750 million we.

<unk> quarterly revenues resembling the levels, we saw in Q3 of 2023 throughout the year as any anticipated declines in migrant related revenues in the second half of the year are expected to be offset by new programs and growth in other areas.

Norman Rosenberg: Looking at our project with New York City's Department of Housing Preservation and Development, or HPD, as of today, we have collected nearly 80% of the year-end 2023 accounts receivable for this project, and we are very close to being current on this project. As we further work down this receivable, we expect that near-term collections will be enough to drive our total cash balance higher in subsequent periods, despite our ongoing working capital needs as we grow. The recent collections have allowed us to pay down the outstanding amounts on our credit line. And the present outstanding balance is zero.

We expect gross margins to come in above the levels of the full year 2023, much more in line with what we experienced in Q4, we expect to see adjusted EBITDA in the range of $80 million to $85 million with adjusted EBITDA margin is expected to be solidly in the double digit area. We expect that full year 2024, adjusted EBITDA margins will be 200.

50 to 300 basis points higher than the adjusted EBITA margins, we experienced over the course of the full year 2023.

Finally, we expect to generate cash flow from operations of $65 million to $75 million in 2024.

Norman Rosenberg: Turning to our guidance and outlook for 2024, we anticipate continued strong demand from our customers for both mobile health and transportation services. We are forecasting that revenues for 2024 will be in the range of $720 million to $750 million. We anticipate quarterly revenues resembling the levels we saw in Q3 of 2023 throughout the year, as any anticipated declines in migrant-related revenues in the second half of the year are expected to be offset by new programs and growth in other areas. We expect gross margins to come in above the levels of the full year 2023, much more in line with what we experienced in Q4. We expect to see adjusted EBITDA in the range of 80 to 85 million dollars, with adjusted EBITDA margins expected to be solidly in the double digit area.

At this point I'd like to turn the call back over to the operator for Q&A.

Operator, Please go ahead.

Yeah.

Thank you, ladies and gentlemen, we will now be conducting a question and answer session.

Hey, good luck, all sufficiently spaces, I think TV, one any telephone keypad.

It's a confirmation tone will indicate that your lawn eased in the question queue.

Even so two to leave the question queue.

The Saudi piece limit yourself to one question and one follow up.

For participants, making use of speaking flippant it may be necessary to pick up your handset before pressing the star kids.

Our first question comes from Ryan Macdonald of Needham and company. Please go ahead.

Norman Rosenberg: We expect that full year 2024 adjusted EBITDA margins will be 250 to 300 basis points higher than the adjusted EBITDA margins we experienced over the course of the full year 2023. Finally, we expect to generate cash flow from operations of $65 million to $75 million in 2024. At this point, I'd like to turn the call back over to the operator for Q&A. Operator, please go ahead. Thank you. Ladies and gentlemen, we will now be conducting the question and answer session. If you would like to ask a question, please press star then 1 on your telephone keypad. The confirmation tone will indicate that your line is in the question queue. You may press star 2 to leave the question queue.

Hi, Thanks for taking my questions and congrats on a really strong quarter and strong guide for 'twenty. Four here, we are great to hear the sort of all the success in the update across sort of three sort of end market priorities, but as youre thinking about the and looking at the pipeline for 2024.

Where are you seeing maybe the most optimism you know across payers health systems in a sort of the government channel.

And how do you expect that sort of a that optimism to translate in terms of mix of revenues across those three segments for 'twenty four.

Okay.

Hey, Ryan Thanks, so much for the question great to speak with you.

So I'm optimistic about all three.

We have really strong pipeline with our hospital systems, both in medical transportation and other mobile health opportunities and I think those are will continue to drive growth for US with hospital systems. I'm also are always optimistic about our work in the municipal space.

unknown: We ask that you please limit yourselves to one question and one follow-up. For participants making use of speaker equipment, it may be necessary to pick up your handset before pressing the star key. Our first question comes from Ryan MacDonald of Needham & Company. Please go ahead. Thanks for taking my questions and congrats on a really strong quarter and strong guide for 24 here. Lee, great to hear the sort of all the success in the update across sort of three sort of end market priorities. But as you're thinking about the and looking at the pipeline for 2024, you know, where are you seeing maybe the most optimism, you know, across payers, health systems and sort of the government channel, you know, and how do you expect that sort of that optimism to translate in terms of mix of revenues across those three segments for 24? Hey Ryan, thanks so much for the question. Great to speak with you.

I mentioned lots of the new geographies, we really focused on in 2023, we're going to continue to submit.

100, Rfps this year and I think our win rate is going to stay consistent throughout this year as we seek opportunities.

Those first to the hospital systems and our municipal work will continue to drive a lot of the growth. This year and then I'm also very optimistic and very excited about our work with our insurance partners I think that will continue to be the smaller piece of the business, but perhaps be the fastest growing and I think it will bear fruit in the.

Later months and into 2025 and beyond but we're really laying a really great foundation with our insurance partners, where we're able to drive results for our patients with them to help close care gaps to really bring care to patients that haven't seen a doctor in over a year and we're really seeing great early success with that.

Lee Bienstock: So I'm optimistic about all three. We have a really strong pipeline with our hospital systems, both in medical transportation and with other mobile health opportunities. And I think those will continue to drive growth for us with hospital systems. I'm also always optimistic about our work in the municipal space.

<unk>.

And so I think you'll see us expand and I think you'll also see us evolve those relationships, we signed our first our partnership and we have others, where we are going to be able to share in the risk alongside our insurance partners as we drive down total cost and as we participate in helping improve health outcomes. Then we're rewarded for that.

Lee Bienstock: I mentioned lots of the new geographies we really focused on in 2023. We're gonna continue to submit one hundred RFPs this year, and I think our win rate is going to stay consistent throughout this year as we seek opportunities.

Which we're also very excited because we think we have a really strong opportunity to do that so we're really optimistic about all three to answer your question directly I think the first two will be continue to be the primary drivers of growth in 2024, but we're really laying a really great foundation and you'll see the growth play out in 2024 and beyond with our insurance partners.

Lee Bienstock: I think those first two, the hospital systems, and our municipal work, will continue to drive a lot of growth this year. And then I'm also very optimistic and very excited about our work with our insurance partners. I think that will continue to be the smaller piece of the business but perhaps be the fastest growing, and I think it'll bear fruit in the latter months and into sort of 2025 and beyond. But we're really laying a really great foundation with our insurance partners, where we're able to drive results for our patients with them to help close care gaps and really bring care to patients that haven't seen a doctor in over a year. And we're really seeing great early success with that.

No I really helpful color, there or at least thinks a lot maybe for my follow up for norm.

Impressed by the sort of the magnitude of margin expansion, that's being built into the initial guide for fiscal 'twenty four and it sounds like there's some some nice sustainable gross margin expansion, but maybe just to double click on as you think about that I think imply 250 basis points at the midpoint of expansion on an adjusted EBITDA margin in 2000.

Four how are you thinking about the balance of mix of sort of gross margin expansion versus sort of continued opex efficiency.

Lee Bienstock: And so I think you'll see us expand, and I think you'll also see us evolve those relationships. We signed our first partnership, and we have others where we are gonna be able to share in the risk alongside our insurance partners. So as we drive down total costs and as we participate in helping improve health outcomes, then we're rewarded for that, which we're also very excited about because we think we have a really strong opportunity to do that. So we're really optimistic about all three to answer your question directly. I think the first two will continue to be the primary drivers of growth in 2024, but we're really laying a really great foundation, and you'll see the growth play out in 2024 and beyond with our insurance partners. A really helpful caller there, Lee. Thanks a lot.

So Ryan I mean, there's a mathematical aspect to it as well because our exit rate EBITDA margin was about 11, 5% and that compares to a full year, which was about eight 5%, 9%. So what we're really saying is that we expect that that operating leverage that we gained in the back part of the year will be sustained we think that the.

<unk> gains in gross margin that we saw in Q4 compared to Q3 will be gate will be sustained so if we simply were too.

If we would experience the same type of EBITDA margins that we did in Q4 across a year. That's your extra 250 to 300 basis point improvement.

Here and there there are some areas, where we think there are some incremental improvement as we go we just want to get too far ahead of ourselves in terms of our assumption on the on the <unk>.

Margin.

I appreciate the color.

We exited the year at a good rate I mean that was a big part of it.

Okay.

Norman Rosenberg: Perhaps for my follow-up to Norm, I'm really impressed by the magnitude of margin expansion that's being built into the initial guide for fiscal 24. And it sounds like there's some nice sustainable gross margin expansion. But maybe just to double-click on it, as you think about that, I think, implied 250 basis points at the midpoint of expansion on adjusted EBITDA margin in 24, how are you thinking about the balance of mix of sort of gross margin expansion versus sort of continued OPEX efficiency? So Ryan, I mean, there's a mathematical aspect to it as well, because our exit rate EBITDA margin was about 11.5%. And that compares to the full year, which was about 8.5% to 9%.

Thank you. Our next question comes from David Larsen of P. P. I G. Please go ahead.

Hi, Congrats on the quarter can you maybe talk about these value based care higher. So you mentioned in the press report it.

It seems to me like the managed care plans.

<unk> is very well suited to serve them in my view, it's great to have data systems like a lot of health Tech companies have but it's another thing to actually do something with them.

It seems like you're on the right path, but I could tell us a little more color there would be great. Thanks very much.

Sure Hi, David I really appreciate the question. So we continue to add top talent, we really made some incredible hires.

Back half of 2023.

Norman Rosenberg: So what we're really saying is that we expect that the operating leverage that we gained in the back part of the year will be sustained. We think that the gains in gross margin that we saw in Q4 compared to Q3 will be sustained. So if we simply were to, you know, if we were to experience the same type of EBITDA margins that we did in Q4 throughout the year, that's your 250, 300 basis point improvement. So, you know, here and there, there are some areas where we think there's some incremental improvement as we go. We just don't want to get too far ahead of ourselves in terms of our assumption on the gross margin. We exited the year at a good rate. I mean, that was a big part of it.

You alluded to a young who joined as our V. P of our payer programs are really leading that business segment with our chief product officer and others in the space in our.

All of our clinical practice group, Dr Powell really bill.

Building, a wonderful team there with with rich experience deep experience and young joins us directly from Cvs.

So cvs that now so really great experience and.

And he's going to help really build that business with US. We also added to our government a program business with a great hire Jan who joins US a formerly as our chief operating officer of Citi Harvest and so we continue to add to our team. We have a wonderful wonderful team of hardworking team really smart team people with different points of experience.

unknown: Thank you. Our next question comes from David Larsen of BTIG. Please go ahead.

And really helping us build out the programs and as he mentioned are our value based arrangements with something we're particularly very excited about because we really feel like our tech platform that helps us optimize the right clinician in the REIT vehicle with the right tools with the right Tech in the home of a patient.

Lee Bienstock: Hi, congrats on the quarter. Can you maybe talk about these value-based care hires that you mentioned in the press report? It seems to me like the managed care plans; Docgo is very, sort of well suited to serve them, in my view. It's great to have data systems like a lot of health tech companies have, but it's another thing to actually do something with them. It seems like you're on the right path from what I can tell. A little more quality would be great.

And making the care way more accessible.

I, we think will really drive improved health outcomes, and we're seeing that play out and obviously as patients health improves then the cost for the overall system and the cost for our insurance partners goes down and so it's just a wonderful experience for the patient where we bring care to them. We also help them become much healthier and then.

unknown: Thanks very much. Sure. Hi, David.

Lee Bienstock: I really appreciate the question. So we continue to add to our talent. We really made some incredible hires at the back half of 2023. You alluded to Yang, who joined as our VP of our payer program. So really leading that business segment with our chief product officer and others in the space and our, CEO of our Clinical Practice Group, Dr. Powell, really building a wonderful team there with rich experience, deep experience, and Yang joins us directly from CVS. So, CVS, I know, it's a really great experience.

He wins in that scenario and so we're very very excited about it it really allows us to leverage our mobile capabilities that we built out now over eight years. It allows us to leverage our tech platform that has helped us optimize the routing of the almost 1000 vehicles. We have operating on every single day throughout the U S and the U K and then allows us to bring care.

In innovative ways with with our with our wonderful clinicians and our clinical practice group to really bring them back.

Our health outcomes to communities and we're seeing that play out in multiple states now. So we're excited to continue to invest there. We're excited to continue to focus and we think as we enter into more and more value based arrangements. We think that there's a lot of opportunity for us there.

Lee Bienstock: And he's going to help really build that business with us. We also added to our government program business with a great hire, Jen, who joins us formally as a Chief Operating Officer of City Harvest. And so we continue to add to our team. We have a wonderful, wonderful team, hardworking team, really smart team, people with different points of experience and really helping us build out the programs. And as you mentioned, our value-based arrangements is something we're particularly very excited about because we really feel like our tech platform that helps us optimize the right clinician in the right vehicle with the right tools with the right tech in the home of a patient and making the care way more accessible, we think will really drive improved health outcomes. And we're seeing that play out.

Great. Thanks, Thanks, very much and then for the city of New York to you on the migrant services piece, if that's trending at $300 million annually at its peak what are your expectations for say the back half of 'twenty for any of the 2025 will not turn into like $115 million.

And in my view, it's like that would be fine, it's kind of been a little bit of a.

Resource drag if you will just any more thoughts there would be very helpful. Thank you.

Of course, so we we've modeled in a moderating our amount of revenue from the asylum seeker work as the year progresses. So as as the quarters go through 2024, the asylum seeker revenue will will moderate and decline as the year progresses, AR and then Av.

Lee Bienstock: And obviously, as patients' health improves, then the cost for the overall system and the cost for our insurance partners go down. And so it's this wonderful experience for the patient where we bring care to them, and we also help them become much healthier. And then everybody wins in that scenario.

Of course, that's going to be replaced by other programs and other investments, we're making and and other customers that we're growing with and so that's.

Lee Bienstock: And so we're very, very excited about it. It really allows us to leverage our mobile capabilities that we've built out now over eight years. It allows us to leverage our tech platform that's helped us optimize the routing of almost 1,000 vehicles we have operating every single day throughout the U.S. and the U.K. and then allows us to bring care in innovative ways with our wonderful clinicians and our clinical practice group to really bring better health outcomes to communities. And we're seeing that play out in multiple states now.

That's how we modeled the year, that's how we arrived at our guidance. It was a very thoughtful about the guidance that we're giving we have line of sight are as you know that's how we set our guidance and and so that's a that is how we factor everything in we think of as norm mentioned quarterly revenues are going to be pretty consistent with what we saw in Q3 of 'twenty.

Three and that will stay relatively consistent throughout this year and then as I mentioned with with migrant related revenues sort of trailing off and other projects take its place.

Lee Bienstock: So we're excited to continue to invest there. We're excited to continue to focus, and we think as we enter into more and more value-based arrangements, we think that there's a lot of opportunity for us. Thanks very much.

For 2025, they thanks for the tip for that we'll give more information on 2025, as we get closer to 2025.

Lee Bienstock: And then for the city of New York deal, the migrant services piece, if that's trending at 300 million annually at its peak, what are your expectations for say, the back half of 24 and into 2025? Will that turn into like 150 million? And in my view, it's like, that would be fine. It's kind of been a little bit of a resource drag, if you will. Just any more thoughts? That would be very helpful.

Yeah.

Great. Thanks, Congrats on a good quarter.

Thanks.

Okay.

Okay.

Our next question comes from Mike Latimore of Northland Capital markets. Please go ahead.

Okay.

Thanks, Yeah, congrats on the quarter I liked the scatter on a number of.

Our visits preventive does right.

So on the just on the guidance a little bit.

Should we assume EBIT margin is similar each quarter or does it grow throughout the year.

And then in terms of the new business that will fill in for the <unk>.

Lee Bienstock: Thank you. Of course. So, we've modeled in a moderating amount of revenue from the asylum seeker work as the year progresses. So, as the quarters go through 2024, the asylum seeker revenue will moderate and decline. And then, of course, that's going to be replaced by other programs and other investments we're making and other customers that we're growing with. And so, that's how we modeled the year. That's how we arrived at our guidance. We were very thoughtful about the guidance that we were giving. We have a line of sight.

Declining monitoring care as that business, you've already won or is there some of that yet.

Out anyway.

Yeah.

Well, Mike its norm I'll take that first one.

What you saw in terms of the EBITDA margin, which we broke out for Q4 is a pretty good proxy to use as we go through the quarters.

Realistically, you're going to have some quarters, a little bit higher a little bit lower and theres going to be a mix of where the gross margin goes versus the SG&A percentage, but but essentially it should be pretty consistent throughout the year.

And then I like regarding the question on the pipeline and the revenues.

All of the revenues that we are looking at right now for this year are all with our current customers or projects that we've already won.

Lee Bienstock: As you know, that's how we set our guidance. And so, that is how we factored everything in. We think, as Norm mentioned, quarterly revenues are going to be pretty consistent with what we saw in Q3 of 23. And that will stay relatively consistent throughout this year. And then, as I mentioned, with migrant-related revenues sort of trailing off, and other projects taking its place, for 2025. Dave, thanks for the TIA for that.

And of course, we submit new Rfps every week, we work on growing our sales pipeline every day and so you know as new things come in that will be additional opportunities for us.

Great and then.

Where do you see the employee counts going this year like about whether you expect it to be maybe by year end.

Yeah. So we have a wonderful team as it grew significantly over the course of 2023 I think our employee count will stay relatively flat for this year I think we built out our team.

Lee Bienstock: We'll give more information on 2025 as we get closer to 2020. Great, thanks. That's a good quarter. Thanks. Our next question comes from Mike Latimore of Northland Capital Markets. Please go ahead.

Our employee count is consistent with our revenues from Q3 Q4, and so we really built out the team so.

So we feel like our our current team size right. Now is is is optimized and it will be consistent throughout this year.

unknown: Thanks. Yeah, congrats on the quarter. I like the stat on the number of ER visits prevented. That was great.

Okay. Thanks, a lot.

Yeah.

Our next question comes from Sarah James That's kind of just puts Gerald you May go ahead.

Lee Bienstock: So on the guidance a little bit, should we assume EBITDA margin is similar each quarter, or does it grow throughout the year? And then, in terms of the new business that will fill in for the declining migrant care, is that business you've already won, or is there some of that you have to kind of go out for? Mike, it's Norm. I'll take that first one.

Sir Your line is an opinion you can ask your question.

Sorry about that.

Wanted to get a little bit more color on the 24 revenue guide what changed since January and to drive the increase and can you unpack the mechanics of what Youre thinking about New York H P D and the trail down so like just mechanically how does that work after may.

Norman Rosenberg: I think that what you saw in terms of the EBITDA margin, which we broke out for Q4, is a pretty good proxy to use as we go through the quarters. You know, realistically, you're going to have some quarters a little bit higher, a little bit lower, and there's going to be a mix of where the gross margin goes versus the SG&A percentage. But, essentially, it should be pretty consistent throughout the year.

Do you guys keep operating or is there an assumption that there is a multi vendor at that point.

Yeah. So in terms of what's changed since the January revenue guide. So so we and eisai are great to hear from you I should say I should start off with thanks. So much for the question on the revenue guide when we initially provided that sort of initial revenue guide in January we said that revenues would be greater than seven.

Lee Bienstock: And then regarding the question about the pipeline and revenues, all of the revenues that we are looking at right now for this year are all with our current customers or projects that we've already won. And, of course, we submit new RFPs every week. We work on growing our sales pipeline every day. And so, you know, as new things come in, that'll be additional opportunities for us. Great. And then, where do you see the employee count? Going this year?

$3 million, we really wanted to share a number that we had good clarity on and that.

We felt very confident then and we thought at the time that that was very much needed all the while we have built a model where we have line of sight to all of our customers all of our projects all of the revenue that that's expected on a monthly basis, we run a very very exhaustive process with all of our market leaders with all of our project leaders to.

Lee Bienstock: Like, well, what do you expect to be maybe by year end? Yeah, so we have a wonderful team. It grew significantly over the course of 2023. I think our employee count will stay relatively flat for this year. I think we built out our team. Our employee count is consistent with our revenues from Q3, Q4. And so we really built out the team. So we feel like our current team size right now is optimized, and it will be consistent throughout this year. All right, great. Thanks a lot.

Our forecast for this year and then we meet with every single one of them and those meetings were going on at that exact time and so as we refine that forecast as we worked with those market leaders, who really have good line of sight into the revenue we're expecting for this year. That's how we've updated guidance are now during the call to share and so revise it upwards.

unknown: Our next question comes from Sarah James of Cantor Fitzgerald. You may go ahead. Hello Sarah, your line is open, you can ask a question. Sorry about that.

We share that it was going to be greater than 700 million hour showing that the range is going to be 720 $750 million and thats. The process, we've always followed.

Lee Bienstock: I wanted to get a little bit more color on the 24 Revenue Guide. What changed since January to drive the increase? And can you unpack the mechanics of what you're thinking about New York HPD and the trail down?

We've always given specific guidance exactly on this first call of the year. So we wanted to follow that cadence.

Great.

Lee Bienstock: So like, just mechanically, how does that work after May? Do you guys keep operating or is there an assumption that there's multi-vendor at that point? Yeah, so in terms of what's changed since the January revenue guide, so we, and hi Sarah, great to hear from you, I should say, I should start off with thanks so much for the question. On the revenue guide, when we initially provided that sort of initial revenue guide in January, we said that revenues would be greater than $700 million.

Oh go ahead, Sir please.

No I was just going to restate. The question. It seems like you got it yes.

Yeah. So in terms of the the H P D you're referring to the migrant related revenues, we we baked in that that will the migrant related revenues will moderate as the year progresses, we have various different models relating to two the migrant revenues.

And we're continuing to help the cities to the humanitarian crisis and so we did forecast in that migrant related revenues would decline in the back half of the year and we'll continue to update on how that progresses throughout the year.

Lee Bienstock: We really wanted to share a number that we had good clarity on and that we felt very confident in, and we felt at the time that that was very much needed. All the while, we have built a model where we have line of sight to all of our customers, all of our projects, all of the revenue that's expected on a monthly basis. We run a very, very exhaustive process with all of our market leaders, with all of our project leaders to forecast for this year, and then we meet with every single one of them. And those meetings were going on at that exact time.

Got it and last question is just going to be on the EBIT margin guidance. So if.

I look at the range it sort of implies at the high end you guys would keep where you are at for Q, but it almost feels a little conservative given that you have a bunch of contracts maturing.

Lee Bienstock: And so as we refined that forecast, as we worked with those market leaders to really have a good line of sight into the revenue we're expecting for this year, that's how we've updated guidance now during the call to share. And so we revised it upwards. We shared that it was going to be greater than $700 million.

So can you talk about some of the moving pieces that you think about them in the margin progression from 23 to 24.

Yeah. So I think on the on the EBITDA Guide you Hugh you mentioned something very important which is we do have projects that as they mature we're able to optimize and expand the margins, but we're also balancing that with some of the new initiatives. We are growing in the new investments, we're making particularly in the insurance payer business launched.

Lee Bienstock: Now we're sharing that the range is going to be $720 to $750 million. And that's the process we've always followed. And we've always given specific guidance exactly on this first call of the year. And so we wanted to follow that cadence. In terms of the question, oh, go ahead, Sarah, go ahead, please.

New markets launching new geographies, adding capabilities.

And making sure that we deliver a fantastic fantastic patient and customer service experience for the insurance partners that we're working with and we're really investing deeply their new vehicles. We're building out new product features we're bringing on wonderful clinicians we're investing deeply in training for them, we're investing in new technology.

Lee Bienstock: No, I was just going to restate the question, but it seems like you got it. Yep. Yep.

Lee Bienstock: So, in terms of the HPD, you're referring to migrant-related revenues. We baked in that those revenues will moderate as the year progresses. We have various different models relating to migrant revenues, and we're continuing to help the city through the humanitarian crisis. And so, we did forecast that migrant-related revenues would decline in the back half of the year. And, you know, we'll continue to update you on how that progresses throughout the year. I got it.

He is in devices and integrating all of them together and so as you mentioned, we continue to scale. The programs. We have but we are going to be continue to be in growth mode, and we're going to continue to be investing.

And all of the areas of our business and particularly in that insurance payer business, and that's where you see sort of a blending of those EBITDA margins.

Great. Thank you.

Yeah.

Lee Bienstock: And last question is just going to be on the EBITDA margin guidance. So if I look at the range, it sort of implies that at the high end, you guys would keep where you are at 4Q. But it almost feels a little conservative, given that you have a bunch of contracts maturing. So can you talk about some of the moving pieces that you think about in the margin progression from 23 to 24?

Our next question comes from Richard close of Canaccord. Please go ahead.

Great. Thanks, Congratulations on a strong year maybe.

Maybe Lee on the National payer partnership the value based care agreement that you announced.

Announced here. This morning, that's a new any more details you can provide is this just a pilot.

Lee Bienstock: Yeah, so in the EBITDA guide, you mentioned something very important, which is that we do have projects that, as they mature, we're able to optimize and expand the margins. But we're also balancing that with some of the new initiatives we're growing and the new investments we're making, particularly in the insurance payer business, launching new markets, launching new geographies, adding capabilities, and making sure that we deliver a fantastic, fantastic patient and customer service experience for the insurance partners that we're working with. And we're really investing deeply there, new vehicles, we're building out new product features, we're bringing on wonderful clinicians, we're investing deeply in training for them, we're investing in new and new technologies and devices and integrating all of them together.

Or is this like a set number of lives of certain state any kind of economics that you can share with respect to the risk component.

Yeah, So we're gonna be sharing more and more as the year progresses with these contracts, we really want to make sure that we get them off the ground.

We are already operating.

Number of them and really they're there they start with essentially identifying our work with our health plan partners of which we have many you know we've announced elegance and health first and emblem in L. A care and we have others that we'll be announcing so we're already working with many of them were working in different geographies as I mentioned and it really starts with identive.

Finally, the health plan identifying patients that are hard to reach identifying patients that haven't seen their doctor and that have chronic conditions in some cases have more than one chronic condition.

Lee Bienstock: And so, as you mentioned, we continue to scale the programs we have, but we are going to continue to be in growth mode. And we're going to continue to be investing in all the areas of our business, particularly in that insurance payer business. And that's where you see sort of a blending of those EBITDA. Great, thank you. Our next question comes from Richard Close of Canaccord. Please go ahead.

And and in some cases, we go and visit a patient and they we know they have one chronic condition in the health plan those they have one chronic condition, but by going and seeing them because again, they haven't seen a doctor in over here, we're able to identify that they have more than one chronic condition, which obviously helps stratify risk and helps them manage patient population a lot more accurately.

Lee Bienstock: Great, thanks. Congratulations on a strong year. Maybe Lee, on the National Payer Partnership, the value-based care agreement that you announced here this morning that's new, any more details you can provide? Is this just a pilot?

And so it really starts with that we go into the home we engage the patient and we are closed to care gap, that's really where it starts and then it evolved to where we can become the primary care provider for that patient and then as we're becoming the primary care provider and as we're able to perhaps enroll them in RPM and virtue.

Lee Bienstock: Or is this like a set number of lives, a certain state, any kind of economics that you can share with respect to the risk component? Yeah, so we're going to be sharing more and more as the year progresses with these contracts. We really want to make sure that we get them off the ground. We're already operating a number of them. And really, they start with essentially identifying our work with our health plan partners, of which we have many. You know, we've announced Elevents and Health First and Emblem and LA Care, and we have others that we'll be announcing. So we're already working with many of them. We're working in different geographies, as I mentioned. [inaudible] And in some cases, we go and visit a patient and we know they have one chronic condition and the health plan knows they have one chronic condition, but by going and seeing them, because again, they haven't seen their doctor in over a year, we're able to identify that they have more than one chronic condition, which obviously helps stratify risk and helps manage patient population a lot more accurately.

Care management and now we're getting readings from them, we're getting their blood pressure, perhaps every day or every other day were getting their weight, perhaps everyday or every other day, we're able to monitor their health and then we're able to intervene when needed and so now you can see how we can really have a material impact on that patient's health and then.

We want to make sure that we're entering until as value based arrangements in the risk sharing in it.

Really intelligent way and so that's the way, we really approach the market and it's the way, we're really approaching our work with with our payer partners to make sure that you know first and foremost we're helping close care gaps first and foremost, we're bringing care to patients that haven't been receiving it first and foremost we're able to identify the risk level of.

Lee Bienstock: And so it really starts with that. We go into the home, we engage the patient, and we close the care gap. That's really where it starts.

The patient the RAF score and then we're able to perhaps become the primary care provider and then and then really grows from there.

Lee Bienstock: And then it evolves to where we can become the primary care provider for that patient. And then as we're becoming the primary care provider, and as we're able to perhaps enroll them in RPM and virtual care management, now we're getting readings from them, we're getting their blood pressure perhaps every day or every other day, we're getting their weight perhaps every day or every other day, we're able to monitor their health, and then we're able to intervene when needed. And so now you can see how we can really have a material impact on that patient's health, and then we want to make sure that we're entering into those value-based arrangements and the risk sharing in a really intelligent way. And so that's the way we really approach the market, and it's the way we're really approaching our work with our payer partners to make sure that first and foremost, we're helping close care gaps. First and foremost, we're bringing care to patients that haven't been receiving it. First and foremost, we're able to identify the risk level of the patient, the RAF score, and then we're able to perhaps become the primary care provider, and then really grows from there.

Well.

I guess as a follow up whats the revenue model for these arrangements and is the risk component is that like you know at the end of the year you see how you performed and is there one.

Lump sum bonus just trying to get a better feel of what exactly the revenue model is.

For this business, obviously, it's small now.

And if you want to tell us how big the insurance businesses that would be helpful. But I'm just.

Just trying to get a grasp of that as this business grows over time.

Yeah, and so it's great great question, so our our arrangements essentially start as a care gap arrangement. Once we reach a critical mass of patients then we have the ability to sharing upside risk only and obviously the risk quotient is deep.

Lee Bienstock: Well, I guess as a follow up, what's the revenue model like for these arrangements? And is the risk component is that like, you know, at the end of the year, you see how you performed? And is there a, you know, lump sum bonus, just trying to get a better feel of what exactly the revenue model is for this business? Obviously, it's small now.

The value sharing is mitigated in that situation, where we're only have upside a benefit and then we have the opportunity to progress into upside you know full risk upside and downside risk and so there's sort of a gradation there in terms of the economics, we get a care gap closure.

Lee Bienstock: And if you want to tell us how big the insurance business is, that would be helpful. But, you know, just trying to get a grasp of that as this business grows over time. Yeah, and so it's great. Great question.

Right when we go into the home or do a care gap virtually in some cases, we close care gaps we're able to do so virtually when we need to go into the home we get a care GAAP rate and then as we become the primary care provider as we start to share risk, we take a percentage of the medical loss ratio essentially and those are negotiated with the with the payer partners and that's the way that businesses.

Lee Bienstock: So our arrangements essentially start as a care gap arrangement. Once we reach a critical mass of patients, then we have the ability to share an upside risk only. And obviously, the risk quotient of the value sharing is mitigated in that situation where we only have an upside benefit.

Lee Bienstock: And then we have the opportunity to progress into upside, you know, full risk upside and downside. And so there's sort of a gradation there. In terms of the economics, we get a care gap closure rate when we go into the home or do a care gap virtually. In some cases, when we close care gaps, we're able to do so virtually. When we need to go into the home, we get a care gap rate.

Is structured.

Okay and one final question for norm.

With respect to the lease rate model on trends transportation.

Can you give us any update of where lease rates stands in terms of the percentage of.

Lee Bienstock: And then as we become the primary care provider, as we start to share risk, we take a percentage of the medical loss ratio essentially, and those are negotiated with the payer partners. And that's the way that business is structured. Okay, and one final question for Norm. With respect to the lease rate model on trans transportation, can you give us any update of where lease rate stands in terms of the percentage of, You know, maybe the transportation revenue in the fourth quarter. So it's still.

Maybe the transportation revenue in the fourth quarter.

So it's still.

It's still probably about half of what we do maybe even lower in some markets and yeah. I think that's an important it's a good question. It's an important thing to address because we've been talking for quite some time going back probably a year and a half about how we're sort of phasing out.

The fee for service, but how do you think happened sort of on the way to phasing it out which is that we find that our APC, which we measure and we report upon which is our average price per trip.

And some of the other metrics like utilization around the fee for service business have improved the improvement that you've seen the six sequential quarters of margin improvement on the transport side.

Norman Rosenberg: It's still probably about half of what we do, maybe even lower in some markets. And I think it's a good question. It's an important thing to address because we've been talking for quite some time, going back probably a year and a half, about how we're sort of phasing out the fee-for-service. But a funny thing happened sort of on the way to phasing it out, which is that we find that our APCs, which we measure and we report upon, which is our average price per trip, and some of the other The improvement that you've seen, the six sequential quarters of margin improvement on the transport side, has not occurred as much because of the fact that we've done more leased hours than fee-for-service. It happened because the fee-for-service business has become a much more profitable business after a lot of focus, after a lot of things are moving in the right direction.

Have not occurred as much because of the fact that we've done more leased tower than fee for service its happened because of the fee for service has become much more profitable business.

A lot of focus there are a lot of things are moving in the right direction. So I would say again as we as we tried to negotiate new contracts, but we're certainly moving towards a leased our model, but from my perspective, the fee for service part of the business.

It's always going to be somewhat significant.

It's going to be a profitable driver of the business.

Having said that when you look at the margins will be saw its important to point. This out if you look at the margins will be soft for transport in the fourth quarter above 37%.

I would say that represented us doing particularly well in a couple of things happened that that maybe has.

See some outlier margin. So that's why I would say is necessarily the run rate of the margin going forward I think that number is closer to 34%, 35%, but it's still much much higher than it had been a year earlier when it was in <unk>.

Norman Rosenberg: So I would say, again, as we try to negotiate new contracts, we're certainly moving towards a leased-hour model. But from my perspective, the fee-for-service part of the business is always going to be somewhat significant, and it's going to be a profitable driver of the business. Having said that, when you look at the margins that we saw, it's important to point this out, if you look at the margins that we saw for transport in the fourth quarter, above 37 percent, I would say that that represented us doing particularly well, and a couple of things happened that maybe had us see some outlier margins. I wouldn't say that's necessarily the run rate of the margin going forward. I think that number is closer to 34 or 35 percent, but that's still, you know, much, much higher than it had been a year earlier when it was in the upper 20s. So that's one of those things that's going to sort of moderate itself as we go into 2024. But the story, both on the revenue side and the margin side, for the transport business is exceedingly healthy. Okay, thank you very much. Our next question comes from David Grossman of Stifle. Please go ahead.

After twice so.

That's one of those things thats going to sort of moderate itself as we go into 2024, but the the story both on a revenue side on the margin side for the transport business.

Exceedingly healthy.

Okay. Thank you very much.

Yeah.

Our next question comes from David Grossman Stifel. Please go ahead.

Thank you.

I just wanted to follow up on a couple of questions that have been asked already.

And the first was.

If you think about the mobile health business just back of the envelope it would appear at least that.

If you back out the HPV contract that you're.

I mean, probably north of 30% growth for the residual so first is that math sound right and then secondly.

When you look at that.

Function of 30% growth.

Do you have decent visibility on that today, maybe you could just give us some sense of where the visibility is on that.

David Michael Grossman: Thank you. You know, I just wanted to follow up on a couple of questions that have been asked already. And the first was, you know, as you think about the mobile health business, just back of the envelope, it would appear at least that if you back out the HPD contract that you're assuming probably north of 30% growth for the residual. So first, is that math sound right? And then secondly, When you look at that, that that assumption of 30% growth. Do you have decent visibility on that today? Maybe you could just give us some sense of where the visibility is on that, you know, kind of non-HPD mobile growth outlook for 24. Yes, David Storm, I'll jump in on that.

H P T mobile growth outlook for 'twenty four.

Yes, Hey, David its normal jumping on that I think the.

First thing is that part of our guidance.

I'm not sure we're exactly at the same point in terms of our expectation for how the HDD revenues evolve like we do definitely as we pointed out.

We definitely expect it to back up a little bit but as the year goes on as we are closer to the end of the contract we feel that the the drop off will not be as abrupt as maybe we might have thought in the past. So having said that I don't know what that backs into a 30% growth on the on the on the mobile health side, but its obviously a pretty robust growth number it'll be higher than the growth.

Of the overall revenues that were putting out here, so it's going to become a higher proportion of the total.

Norman Rosenberg: I think the first thing is that part of our guidance, I'm not sure we're exactly at the same point, in terms of our expectation for how the HPD revenues evolve. Like we do definitely, as Lee pointed out, we definitely expect it to back up a little bit. But as as the year goes on, as we get closer to the end of the contract, we you know, we feel that, that the drop off will not be as abrupt as maybe we might have thought in the past. So having said that, I don't know if that backs into a 30 percent growth on the on the on the mobile health side, but it's obviously a pretty robust growth number. It will be higher than the growth rate of the overall revenues that we're putting out here. So it's going to become a higher proportion of the total. We have we have pretty good visibility into it. I mean, there's not a big go get number that's in there.

We have we have pretty good visibility into it I mean, there's not a big go get number that's in there.

Or anything we talk about in our number for 2024 is organic.

So if we do any acquisitions, which you know it's always a possibility, but that's not that's not part of how we get there.

I think we have a reasonable amount of visibility into that.

Im looking at it from a pure numbers perspective, I know Lee if you want to offer anything from what's going on on the ground.

Yeah, I think David your Youre in the ballpark.

In terms of the growth rate for the rest of the business in a different pieces are growing at different rates, but as norm mentioned, we have we have models that they have the migrant revenue declining in the back half of the year and then other projects are coming in and increasing in growth as the year progresses. So the growth rate will continue to I think at the Q3 level we saw.

Norman Rosenberg: Anything we talk about in our number for twenty twenty four is organic. So if we do any acquisitions, which, you know, it's always a possibility, but that's not part of how we get there. I think we have a reasonable amount of visibility into that. I, you know, I'm looking at it from a pure numbers perspective. I know, Lee, if you want to offer anything from what's going on on the ground.

Last year, consistent with that and then as migraine.

Abates other stuff are going to come in and that will obviously boost the growth rates of those other things that are coming in.

Alright.

One way to think about it really is maybe if you can give us a little more color on the nature of the deals maybe that aren't in the bubble pipeline, but not in the guide.

Lee Bienstock: Yeah, I think David, you're in the ballpark in terms of the growth rate for the rest of the business. You know, different pieces are growing at different rates. But as Norm mentioned, we have models that have migrant revenue declining in the back half of the year, and then other projects are coming in, increasing in growth as the year progresses. So the growth rate will continue to, I think, at the Q3 level we saw last year, you know, consistent with that, and then as migrants, Page PAGE of NUMPAGES www.verbalink.com Page PAGE of NUMPAGES, Right. And maybe one way to think about it, Lee, is maybe to give us a little more color on, you know, the nature of the deals that are in the mobile pipeline but not in the guide.

In terms of the nature of the contracts the timing and if you can share magnitude just to give us a sense of what youre seeing in the pipeline.

Some of these newer pieces of business.

Yes. So we have a we have we continue to have very similar.

Deals and projects in the pipeline that we've always had a lot of the medical transportation deals in the pipeline are very similar in nature, they're identical to our leased our arrangements that we have today and then we're just continuing to do more of those more of those deals were continuing to do more of those partnerships with more hospital systems or expanding too.

Additional hospitals that are current hospital systems have additional locations. So those will continue they look the same as they are as they have for US we've seen success with it it's working.

Lee Bienstock: In terms of, you know, the nature of the contracts and timing, and you know, if you can share the magnitude, just to give us a sense of what you're seeing in the pipeline with, you know, some of these newer pieces of business. Yeah, so we continue to have very similar deals and projects in the pipeline that we've always had. A lot of the medical transportation deals in the pipeline are very similar in nature.

And the contracts do really well with our partners as they align incentives really really well and on the municipal side, it's going to continue to be.

Well, we're going to be more and more thoughtful on the municipal side I should share that so are our <unk>.

Lee Bienstock: They're identical to our leased hour arrangements that we have today, and we're just continuing to do more of those deals, we're continuing to do more of those partnerships with more hospital systems, or expanding to additional hospitals that our current hospital systems have, additional locations. So those will continue, they look the same as they have for us, we've seen success with it, it's working, and the contracts do really well with our partners, they align incentives really, really well. And on the municipal side, it's going to continue to be, Well, we're going to be more and more thoughtful on the municipal side. I should share that.

Projects on the municipal side have historically been relating to access to vaccines infectious disease management.

More and more we're responding and having success in health coaching bringing access to underserved populations.

Particularly.

Medicaid populations in other populations that don't have access to care in munis and municipalities. They have health care deserts municipalities have health care deserts, they were helping to bring care too. We've always done really well there are the access that we bring has really helped those underserved communities and we continue to see success with those projects and they will continue we're getting more and more into behave.

Lee Bienstock: So our projects on the municipal side have historically been relating to access to vaccines, infectious disease management, but we're seeing more and more that we are responding to and having success in health coaching, bringing access to underserved populations, particularly Medicaid populations and other populations that don't have access to care in municipalities. They have healthcare deserts. Municipalities have healthcare deserts that we're helping to bring care to. We've always done really well there. The access that we bring has really helped those underserved communities, and we continue to see success with those projects, and they'll continue. We're getting more and more into behavioral healthcare. We've always done that.

A real health care.

We've always done that we've been doing that for years, but we've really expanded our capabilities. There we now have.

Hundreds of social workers in case workers that are providing a wonderful services from depression screenings to other crisis response, and so we're going to continue to scale that we see a lot of RFP opportunities available in the behavioral health space, It's a very growing field and so I think youll see more growth in that area as well.

Yeah.

Lee Bienstock: We've been doing that for years, but we've really expanded our capabilities there. We now have hundreds of social workers and case workers that are providing wonderful services from depression screenings to other crisis response, and so we're going to continue to scale that. We see a lot of RFP opportunities available in the behavioral health space.

Okay, great. Thank you.

And just one other question if I may.

Looking at the cash flow guidance.

And it looks like.

Cash flows from operations guidance, it's like $10 million to $15 million.

Lower than adjusted EBITDA.

Maybe just be a definition, but I I was just trying to understand that dynamic given what appears to be a fairly material working capital tailwind.

Lee Bienstock: That's a very growing field, and so I think you'll see more growth in that area as well. Okay, great. Thank you. And just one other question, if I may, you know, Norm, looking at the cash flow guidance. It looks like the cash flow from operations guidance is like $10 to $15 million, lower than adjusted EBITDA. It may just be a definition. But I was just trying to understand that dynamic given what appears to be a fairly material working capital tailwind that you should get from the HPD contract this year. So let's walk you through that.

You should get from the HPV contracts this year.

Right. So, let's yes, let's walk you through that obviously.

Obviously, there's a big gap there is taxes.

We're a taxpayer now we've exhausted our federal Nols, we have since we have plenty of state Nols as we pointed out in the K that we filed today, but we have to take into account that we're going to be a taxpayer going forward.

So that's the big part of the difference obviously.

You would add back the any non stock non cash stock comp our depreciation to your calculation.

Norman Rosenberg: Obviously, the big gap there is taxes. We're a taxpayer now. We've exhausted our federal NOLs. We have plenty of state NOLs, as we point out in the K, that we filed today.

In terms of that estimate, though that estimate assumes a somewhat neutral working capital environment.

Norman Rosenberg: But we have to take into account that we're going to be a taxpayer going forward. So that's the big part of the difference. Obviously, you would add back any noncash.com or depreciation to your calculation.

And to your point, David maybe there's a little bit of room, there because if we do if we do see a and we have seen it in Q1.

To date, if we if we do see a reversal of some of the working capital movements that we had at the end of last year. The second half of last year. Then in fact, it would be a tailwind, but that assumption of and again I want to make sure that everybody's got different definitions and different types of cash flow I referred to the the cash flow from operations I E. The number that you will see.

Norman Rosenberg: In terms of that estimate, though, that estimate assumes a somewhat neutral working capital environment. And to your point, David, maybe there's... a little bit of room there, because if we do, and we have seen it in Q1 so far, if we do see a reversal of some of the working capital movements that we had at the end of last year, the second half of last year, then, in fact, it would be a tailwind. But that assumption of, and again, I want to make sure that we're everybody's got different definitions and different types of cash flow. I refer to the cash flow from operations, i.e.

Our cash flow statements as we go throughout the year.

Our assumption is.

A neutral to slightly positive working capital moves.

Movement as we go through the year.

That's what's built any of that mission.

Apologies Sir.

Oh go ahead.

Okay.

Thank you. Our next question comes from Peter Chickering. After CIT Bank. Please go ahead.

Hey, good afternoon or good evening, thanks for taking taking my questions to ask the last question is there a little bit differently.

Norman Rosenberg: The number that you will see in our cash flow statements as we go throughout the year. Our assumption is a neutral to slightly positive working capital movement as we go through the year. That's what's built into that. Apologies, sir. I'm quite quiet. Thank you. Our next question comes from Peter Chickering of Deutsche Bank. Please go ahead.

So you said they'd be stepped down for H B D, you'll probably be less than feared so from a pipeline perspective do you think you can grow EBITDA in 2025 without H P D.

You think about H P. D should we think about it as like a $250 million of annualized contracted at 30% gross margin as a ballpark.

Philip Chickering: Thanks for taking my questions. To answer the last questions, I do it a little bit differently. They said they'd be stepped down for HPD, probably less than feared. So from a pipeline perspective, do you think you can grow EBITDA in 2025 without HPD? And as you think about HPD, should we think about it as like a $250 million annualized contract at 3% gross margin as a ballpark? Yeah, I mean, you know, I would say it's normal. I would say maybe a little bit lower than that in terms of run rate. But, you know, that's in the general ballpark.

Yeah.

Yeah.

I would say, it's more of a I would say, maybe a little lower than that in terms of run rate, but you know that's in the general ballpark.

The margin is.

Somewhat consistent with our overall with our overall margin on mobile health I mean, a couple of points lower than some of our other projects, but not you know not materially different one way or the other but as far as 2025 is concerned I can tell you that in terms of our internal planning we are planning as though that that contract or that program doesn't exist.

Norman Rosenberg: The margin is somewhat consistent with our overall margin on mobile health, maybe a couple of points lower than some of our other projects, but not materially different one way or the other. But as far as 2025 is concerned, I can tell you that in terms of our internal planning, we are planning as though that contract or that program doesn't exist. So whatever goals we put out there in terms of where we want to be in 2025 or an exit rate for 2025, those remain the internal goals and the mandate that we've given to the folks in the organization here that are going to make that happen is that they have to come up with a model and plan that gets us there without assuming a big chunk of that from HR. Okay, so just to ask it differently, you know, if it's a small market, say $16 million of EBITDA, if we model 25 without that contract, I guess, you know, should we still be using the guidance from today and think about growth on that?

Whenever goals, we put out there in terms of where we want to be in 2025 or an exit rate for 25, you know those remain the internal goals in the mandate that we've given to the defaults in the organization here that are going to make that happen.

They have to come up with a model and plan that gets us there without assuming a big chunk of that from a treaty.

Okay. So just to ask it differently.

Oh, just ballpark I say $60 million of EBITDA.

The model 25 without that contract I guess should we still be using the the guidance from today and think about growth on that or if you think about a step back before it normalizes in 'twenty five.

Yes.

Yeah.

I think I think as we Havent modeled out we think it's going to moderate.

At a at a pretty nothing is ever linear, but we think it's going to moderate and pretty layered cap and the stuff that we have visibility into what would help us sort of filling those gaps as we get to the end of 2024, I don't see I don't really see a big Cliff right I think that's the biggest thing here that as we went into.

Norman Rosenberg: Or should we think about a step back before it normalizes in 25? I think as we have it modeled out, we think it's going to moderate, at a pretty, you know, nothing's ever linear, but we think it's going to moderate in a pretty linear path. And the stuff that we have visibility into would help us sort of fill in those gaps as we get to the end of 2024. I don't see, I don't really see a big cliff, right? I think that's the biggest thing here, that as we went into the year, as we're going into the second half of last year, you know, there's always that potential. I don't think we really see a cliff. I don't think it's going to happen that way.

And for the year as we're going into the second half of last year. As you know there's always a potential I don't think we really see a cliff I don't think its going to happen that way.

So I think it'll be a little more gradual but there does come a point, where we have to make the assumption that it's going to have to be entirely replace.

Yeah, and just to add there I think we're talking a lot about how we have in our models the microwave related revenues abating in the back half of the year and we do we have it there, but as norm mentioned, we don't we don't foresee necessarily a cliff.

Doing our best to help our partners on New York City, which again, we've been working with for a number of years, we've been running lots of different population health programs with them, including today, we operate programs for on shelter at homeless populations and with regards to the migrant service.

Norman Rosenberg: So I think it'll be a little bit more gradual, but there does come a point where we have to make the assumption that it's going to have to be entirely reflective. And just to add, Pierre, I think we talk a lot about how in our models we have migrant-related revenues abating in the back half of the year. And we do. We have it there. But as Norm mentioned, you know, we don't necessarily foresee a cliff.

We we don't have it where it just hits a cliff again, we're modeling that it's abating, because we'd like to take a conservative approach to that but you know I can tell you. We're really proud of the work that we're doing at enormous scale that we are able to provide it at and and we're doing everything we possibly can to help the city manager.

Lee Bienstock: You know, we're doing our best to help, you know, our partners in New York City, which again we've been working with for a number of years. We've been running lots of different population health programs with them, including today we operate programs for unsheltered homeless populations. And with regards to the migrant service, we don't have it where it just hits a cliff.

A crisis and ultimately help asylum seekers as they arise and to the system and then ultimately exit the system and we have programs designed to do that and so we're going to continue to help there. We did take a conservative approach towards the back half of the year and as we've been talking about but there's no indication right now at all that there is a some cliff or theirs.

Lee Bienstock: Again, we are modeling that it's abating because we like to take a conservative approach to that. But, you know, I can tell you, we're really proud of the work that we're doing at the enormous scale that we are able to provide it at. And we're doing everything we possibly can to help the city manage the crisis and ultimately help asylum seekers as they arrive enter the system and then ultimately exit the system. And we have programs designed to do that. And so we're going to continue to help there. But we did take a conservative approach towards the back half of the year, as we've been talking about. But there's no indication right now at all that there's some cliff, or there's a reason to think that everything is abating towards the back half of the year.

Reason to think.

That everything is abating towards towards the back half of the air again, we that's the approach we've taken and that's what you hear is communicating to you on the call, but again, we feel like we've modeled them, we've modeled that out towards the back half of the year, but again no indication that necessarily there's a clip coming here, which I want to make sure that we're communicating.

Perfect.

Like what are your core strength has always been like your ability to pivot and adapt our business model, which has been extraordinary I guess the investor questions I keep getting is around 25 worst case scenario HBV is not there. So I guess, let me ask this one more time differently and then I apologize, but if I think they were 24 guidance. If there's no H P. D. We're still think about.

Lee Bienstock: Again, that's the approach we've taken, and that's what you hear us communicating to you on the call. But again, we feel like, you know, we've modeled that out for the back half of the year. But again, no indication that necessarily there's a cliff coming here, which I want to make sure that we're communicating.

EBITDA growth off of that base in 2025.

Philip Chickering: Perfect. Yeah, you know, one of your course writings has always been, you know, your ability to pivot and adapt your business model, which has been extraordinary. I guess, you know, the investor questions I keep getting are around sort of 25, worst case scenario, HPD is not there. So I guess, you know, let me sort of ask this sort of one more time differently, and then I apologize.

Yes, that's absolutely what modeling right now and again, we'll share a lot more about 2025 as we progress through this year, but I can tell you we are focused on.

On executing operationally, we're always looking for ways to optimize the business from day. One we've operated these projects as profitable projects. We've operated the business. So that we can expand the business and invest in different areas and so I can tell you we're going to continue to be looking for efficiencies and continuing to expand both revenues Todd.

Norman Rosenberg: But if I think about your 24 guidance, if there's no HPD, are we still thinking about EBITDA growth off of that base in 2025? Yeah, that's absolutely, you know, what we're modeling right now. Again, we'll share a lot more about 2025 as we progress through this year, but I can tell you we are focused on execution. Operationally, we're always looking for ways to optimize the business. From day one, you know, we've operated these projects as profitable projects; we've operated the business so that we can expand the business and invest in different areas.

Line and bottom line.

Thank you ladies and gentlemen, we have reached the end of the question answer session I will now hand over to C. N b been stuck for closing comments.

Thank you. Thank you. Thank you everyone for joining us and we experienced another year of strong growth across each of our key customer verticals in 2023 before we close.

Just wanted to take this opportunity to thank our 8000, plus dedicated staff members, who helped us achieve the success.

Lee Bienstock: And so, I can tell you, we're going to continue to look for efficiencies and to continue to expand both revenues, top line and bottom line. Thank you. Ladies and gentlemen, we have reached the end of the question and answer session. I will now hand over to the CEO, Lee Bienstock, for closing comments. Thank you. Thank you, everyone, for joining us. And we experienced another year of strong growth across each of our key customer verticals in 2023.

You continue to embody dot goes total commitment to democratizing health care by delivering high quality highly accessible care to all I'll continue to spend even more time in the field with you. So that I can see you in action and it's inspiring to witness the empathy professionalism and expert care do you provide.

To each of our patients.

Endlessly grateful for your extraordinary efforts and I'm proud I'm proud to be leading a company that is helping transform how health care is being delivered for the good.

Lee Bienstock: Before we close, I just want to take this opportunity to thank our 8,000 plus dedicated staff members who helped us achieve this success. You continue to embody Docgo's total commitment to democratizing healthcare by delivering high quality, highly accessible care to all. I'll continue to spend even more time in the field with you so that I can see you in action, and it's inspiring to witness the empathy, professionalism, and expert care you provide to each of our patients. I'm endlessly grateful for your extraordinary efforts, and I'm proud. I'm proud to be leading a company that's helping transform how healthcare is being delivered for the better. Thank you all for joining us, and I look forward to our next report in early May. Be well. Thank you. Ladies and gentlemen, that concludes today's event. Thank you for attending, and you may now disconnect your lines.

Thank you all for joining us and I look forward to our next report in early may be well.

Thank you ladies and gentlemen that concludes today's event. Thank you for attending and even now disconnect your lines.

Okay.

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