Q3 2025 DocGo Inc Earnings Call

Speaker #1: I would now like to turn the conference call over to Mr. Mike Cole, Vice President of Best Relations. Please go ahead.

Speaker #2: 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.

Speaker #2: 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 statements.

Speaker #2: 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.

Speaker #2: Forward-looking 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.

Speaker #2: These risks, uncertainties, and assumptions include, but are not limited to, those discussed in risk factors and elsewhere in DocGo's annual report on Form 10-K, quarterly reports on Form 10-Q, our earnings release for this quarter, and other reports and statements filed by DocGo with the SEC to which your attention is directed.

Speaker #2: Actual outcomes and results or timing of results or outcomes may differ materially from what is expressed or implied by these forward-looking statements. In addition, today's call contains references to non-GAAP financial measures.

Speaker #2: Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are included in our earnings release on the current report on Form 8-K that includes our earnings release, which is posted on our website, docgo.com, as well as filed with the SEC.

Speaker #2: 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.

Speaker #2: We undertake no At this time, it is now my pleasure to turn the call over to Mr. Lee Bienstock. CEO of DocGo. Lee, please go ahead.

Speaker #2: 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 as to the extent required by law.

Speaker #3: Thank you, Mike. today. 2025 has been an important year of transition for DocGo, and I would like to start our call by sharing four key headlines from the quarter before sharing more specifics about our performance.

Speaker #3: First, we experienced record volumes across all of our base business offerings in the quarter. Our strategy to build a robust, evergreen healthcare business is coming to fruition.

Speaker #3: Second, we continue to have a strong balance sheet with cash we intend to use to fund our growth and capitalize on the opportunities in front of us.

Speaker #3: Third, we are extremely excited about our acquisition of SteadyMD and how their 50-state virtual care network and over 500 advanced practice providers will allow us to scale more efficiently.

Speaker #3: And fourth, today we announced 2026 guidance of $280 to $300 million in revenue and a full year 2026 adjusted EBITDA loss of $15 to $25 million, with the majority of this adjusted EBITDA loss expected to be realized in the first half of the year.

Speaker #3: Our 2026 revenue guidance represents 12 to 20 percent year-over-year base business growth. Any potential acquisitions or new contract wins would be incremental to that amount, and we would provide updates on 2026 guidance as needed.

Speaker #3: At the top end of our revenue guidance range for 2026, we would expect to exit the year on an adjusted EBITDA positive run rate.

Speaker #3: We have a bold vision of building a company that brings the capabilities of a doctor's office into a patient's living room. I am excited about our investment to build these capabilities, which I believe is a small price to pay for the promise of something that has transformational potential, both for our company and our industry.

Speaker #3: Before I cover the individual business verticals, I want to emphasize that each of our service lines, with the exception of our care gap closure and primary care offerings, is EBITDA is adjusted EBITDA positive on a contribution basis.

Speaker #3: I think it's important to highlight this. Because their value can be masked by the impact of corporate overhead costs at our current scale and the investment we are making in the capabilities I just referenced.

Speaker #3: Now, I'll touch on our medical transportation and payer provider mobile health verticals. Our flagship medical transportation business achieved record volumes in Q3, driven by numerous long-term contracts with strong visibility and an enviable roster of customers, including Jefferson Health, Mount Sinai, New York City Health and Hospitals, HCA TriStar, the NHS, and the UK and others.

Speaker #3: We expect this business will generate more than $200 million in revenue in 2025, making this a strong foundational asset. As we add additional scale and ramp staffing in this segment over the next two to three years, we anticipate that we can further improve the adjusted EBITDA contribution margin to approximately 12 percent.

Speaker #3: We continue to see incredibly strong demand for our services with opportunities to grow revenue within our existing customer base. Several of our large health system customers use our total transportation solution, which includes our proprietary software, dedicated ambulances, EMS crews, and staff to manage their transfer center operations.

Speaker #3: Our epic integrated technology platform creates efficiency, transparency, and provides a single source of truth for transportation management across vendors. In this capacity, we often have the ability to select whether to assign a trip to one of our ambulances or select a different transportation vendor if we don't have an available unit staffed to run the trip.

Speaker #3: We estimate that over the last 12 months, we have assigned over 26,000 trips to other companies, many of which could have been run by our fleet if we had available service-level capacity.

Speaker #3: We have accelerated our talent acquisition efforts and are looking to hire hundreds of additional EMS staff as soon as it is practical to create the capacity and better capitalize on this embedded demand from our current customers.

Speaker #3: We expect that these targeted additional hires will enable us to capture millions of dollars of additional top-line revenue on our existing contracts in 2026.

Speaker #3: In summary, our transportation business serves a vital market need, is profitable on a standalone basis, and is a valuable foundational asset. Moving on, I would like to cover our payer and provider vertical, which is expected to generate approximately $50 million in revenue in 2025, including a contribution of approximately $5 million from the SteadyMD acquisition in mid-October.

Speaker #3: And it's expected to grow to $85 million next year. This vertical includes services such as care gap closure, primary and preventative care, telehealth, remote patient monitoring, mobile phlebotomy, and other payer and provider services.

Speaker #3: One of our core offerings in this vertical is our remote patient monitoring business, which has made considerable progress over the last year. Remote patient monitoring is operating at an annual run rate of approximately $15 million with a greater than 10 percent adjusted EBITDA contribution margin, which is expected to continue trending higher in 2026.

Speaker #3: We've signed 13 new contracts or expansions this year on the back of strong demand, and have eight additional proposals submitted or in contracting. We are excited to keep developing this capability in a space that typically commands high multiples.

Speaker #3: An area of our payer and provider vertical that is taking longer than anticipated to ramp, but still holds great promise for us, is our primary care services.

Speaker #3: We had originally budgeted approximately $5 to $10 million of revenue from primary care in 2025. We are seeing progress here and just received a substantial list from a major health plan to offer these services to 10,000 members, which will launch in Q4 and ramp in early 2026.

Speaker #3: Also, within our payer and provider vertical, our care gap closure and transitions of care business more than quadrupled when we compare Q3 2025 to Q3 2024.

Speaker #3: While our investment in product development, training, and technology to build our capabilities was substantial in 2025, we expect that rate of investment to decline considerably in 2026.

Speaker #3: Which will help contribute to our goal of achieving profitability. As we work to drive our care gap and primary care business to profitability as soon as possible, I want to underscore why we are making this strategic investment to build these capabilities.

Speaker #3: DocGo's ability to leverage a tech-enabled clinical workforce to reach difficult populations with chronic conditions delivers meaningful value to our payer and provider customers. Our solutions help keep people healthier and in their homes and have the potential to significantly lower health systems costs.

Speaker #3: Considering the convergence of increasing costs, flat reimbursement levels, facility overcrowding, and ongoing operational challenges facing healthcare today, we believe DocGo's offering is positioned to drive substantial value and represents a significant opportunity for our company.

Speaker #3: While this payer and provider business takes considerable time to develop, we have made significant inroads over the last two years, and we believe it has high growth potential.

Speaker #3: As I shared on our last earnings call, we are already working with two of the top 10 national payers and are in active discussions with both of these customers to expand those contracts.

Speaker #3: Additionally, we are in the process of contracting with two more of the top 10 national payers and have an additional 10 pending proposals in our business development pipeline.

Speaker #3: I wanted to illustrate the potential of these relationships by highlighting the growth trajectory of one of our major payer customers over time. In 2023, our first year working with a major California health plan, we performed 789 total patient visits.

Speaker #3: In 2024, that number grew by nearly 65 percent to 1,293. In 2025, it is expected to grow another 250 percent and reach 4,500. And in 2026, it's expected to grow another 280 percent and reach over 17,000 visits based on existing plans.

We are enthusiastic about this acquisition for numerous reasons first it provides us with a 50 state virtual care footprint, which significantly expands our clinical capacity and positions us to extend our offering to both payers and providers.

We have long believed that pairing our last mile clinical delivery capabilities with virtual care has the potential to unlock the power and potential of telehealth and creates an optimal end to end solution.

We look forward to the potential synergies this creates and will look to both amplify our existing offerings and potentially launch new services next year.

Lastly, we see strong opportunities for cross pollination between the two exceptional customer basis that both Darko and studying D have built and we look forward to exploring those as well.

We continue to believe that <unk> has a unique ability to acquire traditional health care assets, where we can overlay our technology mobile health capabilities and extensive customer base to drive additional value.

There are a wide variety of health care companies out there that see dot goes last mile health care delivery capabilities as a missing piece.

Making us a very attractive partner and we plan to remain active on the M&A front.

In sum <unk>.

2025 has been a transitional year as we move beyond emergency response contracts and increasingly focused on executing dot goes evolution to a provider of long term integrated technology, driven health care solutions that meet the needs of our customers today and tomorrow.

I couldn't be more proud of the progress we are making.

As we are positioned for strong growth in each of our key verticals. We expect the investments in our early stage business lines to gradually abate over the course of 2026 we.

We have made a strategic acquisition and steady and D that expands our footprint adds accretive capabilities and a roster of blue chip customers that we can continue building. Upon Additionally, we continue to grow our pipeline of new business and look for potential acquisition opportunities both of which can help us gain critical mass achieved profitability and create additional share.

[noise] holder value in the coming years.

Our future is bright and valuable we have the right products and services to address critical needs in our health care industry have built differentiated technology and capabilities and have business lines, such as medical transportation and remote patient monitoring that are already firmly EBITDA positive and we have the balance sheet to see our vision of bringing the doctors.

Office to the living room a reality.

At this time I will hand, it over to norm to cover the financials norm. Please go ahead. Thank you Lee and good afternoon total revenue for the third quarter of 2025 was $78 million compared to $138 $7 million in the third quarter of 2024.

The year over year revenue decline was entirely due to the sunset of migrant related projects, excluding revenue from migraine related programs revenue increased by 8% to $62 $4 million in Q3 of 2025 from $58 million in Q3 of 2020 for medical Transportation services revenue increased to $51 million in Q.

Three of 2025 from $48 million and transport revenues that we recorded in the third quarter of 2024 revenues were driven higher by gains in nearly all of our U S markets with some of the strongest growth in Texas and Tennessee.

Mobile health revenue for the third quarter of 2025 was $27 million down from $97 million in the third quarter of last year driven by the wind down of migraine services included in this year's amount was approximately $8 million in marketing related revenues non migrant mobile health revenues increased by more than 20% year over year driven by.

Research and care gap closures remote patient monitoring and mobile phlebotomy.

Adjusted EBITDA for the third quarter of 2025 was a loss of $7 $1 million compared to adjusted EBITDA of $17 $9 million in the third quarter of 2024.

The adjusted gross margin, which removes the impact of depreciation and amortization and several one off items and as the measure of margins are we track. Most closely was 33% in the third quarter of 2025 compared to 36% in the third quarter of 2024.

During the third quarter of 2025, adjusted gross margins for the medical Transportation segment was 31, 7% compared to 37% in Q3 of 2024 and our highest gross margins. We've seen in this segment since Q1 of 2024.

During the third quarter, our transportation business ran at the highest utilization rates that we've seen given these utilization rates it will be critical for us to expand our field labor team, which we would expect to lead to higher revenues and improved gross margins for transport in 2026.

Mobile Health segment adjusted gross margin was 36, 2% versus 38, 8% in the third quarter of 2024, but up from adjusted gross margins of 32, 5% in the second quarter of 2025.

We expect to continue replacing migrant related revenues with relatively higher margin service lines, such as remote patient monitoring and mobile phlebotomy.

Both the cost of goods sold and an operating cost basis, we continue to make significant investments in our care gap closure business, we estimate that the adjusted gross margin for mobile health would've been about 40% in Q3 of 2025, excluding the care gap closure business.

There were also some nonrecurring items that had a large impact on our GAAP results. This quarter. So I'd like to briefly review them within the cost of goods sold area, we incurred increased insurance costs and the amount of approximately $5 $2 million. These largely consisted of additional premium owed for workers' compensation coverage back in 2022 and 2023.

Given largely by an increase migrant program related employee base and the settlement of a large auto insurance claim for an incident in 2022 and have since discontinued, California transport market.

Also within the operating expense category, we incurred noncash charges due to the write down of various intangible assets and goodwill these charges totaled $16 $7 million in the quarter.

During the third quarter, we made further progress on strengthening our balance sheet by paying off the outstanding amounts under our line of credit removing $30 million in debt from our balance sheet. We continue to collect our older larger invoices, which allowed us to generate approximately $1 $7 million in operating cash flow for the quarter. Despite our operating losses through the first nine months of 2000.

25, we have generated nearly $45 million in cash flow from operations.

As of September 32025, our total cash and cash equivalents, including restricted cash and investments was $95 $2 million down from 170, $107 3 million at the beginning of the year. However, having paid down the entire outstanding balance on our credit line during Q3, our cash position our cash position net of debt.

That is well above our net position as at the beginning of this year our balance sheet is now debt free for the first time since late 2023.

Our accounts receivable continued to decrease particularly for migrant related receivables at quarter end, we had approximately $37 million in accounts receivable from the various migraine programs, which represented a little more than a third of our total company a or this compares to $54 million in Viking program related. They are at the end of Q2 120 million at the end of Q1 and $150 million.

At the end of 2024, which at the time represented approximately 71% of the company total we've now collected about 96% of all of our migrant related receivables from the inception of those programs until today and we remain confident that we will collect all remaining outstanding amounts.

Now that we've improved our cash balance and paid off our credit line that we are well positioned to carry the company through this ongoing transition every period.

These final seven weeks or so of 2025, we will focus intently on collecting the remainder of the migrant related receivables assuming that these amounts are collected during the fourth quarter. We would expect our cash balances at year end to be higher than they were at the end of Q3 after adjusting for the study MD acquisition.

We expect to exit 2026 at about $65 million of cash, which we expect will be the low point subject of course to buybacks or any additional acquisitions.

Finally, as we head here into the home stretch of 2025, we'd like to discuss our outlook for the full year and offer a preliminary view on 2026 for full year 2025, we now expect revenues in the range of 315 million to $329 of that amount about 68 million to $70 million relates to Margaret projects. So the base revenue should come in at about 200.

$50 million for adjusted EBITDA, we see the full year of 2025 loss in the range of 25 million to $28 million for 2026, we see revenues in the range of $280 million to $300 million, which would represent a 12% to 20% growth over 2020 fives based revenues, we anticipate a full year adjusted EBITDA loss of <unk>.

We're between $15 million and 25 million. However at the top end of this revenue guidance range for 2026, we would expect to exit the year on an adjusted EBITDA positive run rate on a sequential basis looking at 2026, we expect revenues to increase and for the EBITA performance to improve over each of the four quarters of the year.

At this point I'd like to turn the call back over to the operator for questions and answers operator. Please proceed.

Thank you ladies and gentlemen, we'll now begin the question and answer session. So do you have a question. Please press the star followed by the one Touchtone phone you won't hear prompts thier hand has been great.

Should you wish to decline from the polling process. Please press the star followed by the Q if.

If you are using a speaker phone please lift the handset before pressing any Keith one moment. Please for your first question.

And your first question comes from Peter Chickering from Scotiabank. Please go ahead.

Good afternoon, guys and thanks for taking my question I'm looking at the implied margins for the fourth quarter to be sort of I think it looks like negative 13%.

Can you help bridge us versus margins, we saw in the third quarter of down 10% you know how.

How much came from the <unk> acquisition services Carrabba's, just bridging the <unk> margins.

So there wasn't anything in Q3 and steady M. D Stadium D showed up in October so you're going to get most of the quarter a steady M D.

We think that number should be somewhere around $5 million in a.

Yeah, right, a little bit more than $5 million in revenue for the quarter and I would say slightly EBITDA negative for that period. So it really shouldn't have a material material impact is going to have an impact on the margin percentage.

But otherwise it's not it's not going to have much of an impact we will have lower.

We will have basically no revenue from a very small revenue number from the migrant related revenue. So that's also going to have an impact on the margin a little bit.

Okay, and then for 'twenty six EBITDA guidance.

Yeah.

The implied margins there for next year or negative, 7%, we're exiting fourth quarter. It's a negative 13% margin can you sort of walk us through kind of how that improves throughout the year and what should we be modeling in the first half their EBITA versus the back half of their EBITDA.

Yeah sure so their cup.

All of areas, where we think we'll do a little bit better in terms of our model first of all on the gross margin percentage. So it's interesting to note that the Q3 adjusted gross margin as we walk through worked out to about 33%.

That's higher than what we did in Q1 or Q2 of this year and we think that it's something of a proxy for where we go in the next few quarters going forward. There are some projects that we have especially on the transport side that we think will raise the gross margin a little bit but realistically those will probably have more of an impact in the second third and fourth quarter of next year. Then here in the fourth quarter of 2025 with the first quarter of 2020.

So theres, a little bit of room over there as well.

And then on the operating expense side. So we continue to work hard at trying to reduce our SG&A.

And as a as we were able to take a couple of million dollars out per quarter in SG&A that should also have an impact towards the back half of next year and then and then there's a scale. So our expectation is that whatever we see in terms of revenue in Q1 will be the low point of 2026, it'll go up it'll go up and the way we model it out into Q2 into Q3 into Q4.

And consequently, the EBITDA loss or profitability will improve every quarter as we go Q1, two three and four so we think that that's going to have the impact.

So going to your second question as far as the breakdown I would say the bulk of the expectation for a negative EBITDA number he is going to come in that in the first half of the year.

Clearly going to be skewed towards the first half of the year in terms of those losses, and then you get a much smaller loss in the third quarter and maybe even perhaps we think a positive number in the fourth quarter.

Okay and then last question for me looking at it for 26 revenue guidance, how much do you assume for migrants are for next year and how should we be modeling transport versus mobile health.

Next year. Thanks.

Absolutely Peter this is Lee so in terms of micro related revenues for 2026, we don't expect any legal related revenues for 2026, so that number it will be zero for next year.

The breakdown for the the guide.

It's important to note that the guide really is our current guidance is based on the baseline of the business as we see it today any new contract wins or M&A would be in addition to the number we're sharing tonight. The breakdown is about two thirds transport one thirds mobile health, that's essentially the way to look at it.

Great. Thanks, so much.

Of course.

Thank you.

And your next question comes from Sarah James from Cantor. Please go ahead.

Thank you.

I wanted to dig a little bit more into the payer provider revenue growth. So you guys. Obviously have a very strong pipeline there and it sounds like when he stepped up from 50 million in 'twenty $5 million to $85 million and 26 am I right in in Annualizing, the steady M D impact to be $15 million of that in.

Then you'd have 20 million from organic growth.

And then what kind of deal closure assumptions does that include for the pipeline that you talked about with possibly expanding your existing T national payers or adding in a few hours.

Absolutely Sarah Thanks for the question, so first off the $85 million for payer and provider for next year includes about $25 million from the study in the acquisition. That's the run rate. The business is on of course, we announced that acquisition a few weeks ago. So we're in the process of integrating it. So we have a 25 million dollar of the $85 million as a star.

<unk> contribution for next year and the remaining would be the $60 million from our current payer and provider baseline business to answer your question, specifically I'm glad you asked it. It does not include any deal closures or additional M&A or contribution from our pipeline. We're looking at the contracts. We currently have today, we're looking at the geographies.

We currently operate in today the list of patients that have been provided to us so far in our current customer set and basing our guidance for next year off of that both for payer and provider and the transportation portions of the business.

Great and can you help us understand what does it look like when you expand the payer provider contracts going from transition of care to care gap closure to longitude or know what are the orders of magnitude of revenue that that could impact or the way. It could change your margin profile for that segment.

Absolutely so as you mentioned tariffs.

Our payer and provider contracts typically start with either care gap closure services, where they I think the payers provide us with a list of patients that have open care gaps. They havent been seen this can be diabetic retinal exams bone density scans annual wellness visits vaccinations and then we go and engage those patients we meet them, where they are really helped close out those care gaps and these are chronically ill patients. They are typically patients that are.

In closing the health plans a lot of money and so the health plans are heavily incentivized to make sure that they're reaching these patients and if they don't their quality scores for their plan are negatively impacted and then of course patients end up landing in the hospital that caused the payers lots of money. So they are providing us with Elisa patients. These are the patients that have open gaps in care and we're going.

See them, so they either start with care gap closure or transitional care management, and so as a patient is being discharged from the hospital they've already been hospitalized with a visit to the emergency room, they're leaving the hospital, we work with them to make sure that their transition of care to the next setting could be their home could be.

Another facility, we make sure that they're they're.

Their discharge plan is as well as well taken care of and that where <unk>.

Addressing the incision site tight trading meds are making sure we're checking their vital set their transition of care as well well taken care of and they don't end up back in the hospital, that's where our services typically start with the payers, but we're also finding is allowed these patients need primary care services and preventative care and so.

As I mentioned, we're in the process of expanding the relationships, we have into primary care and preventative care more longitudinal care. So instead of going to serve a carryout closure visit or transitional care, we're providing the long term care and the preventative care and the primary care for that patient and that's typically step two in that process.

Yes, and then you can see scenarios.

Scenarios, where we enroll those patients in remote patient monitoring as I mentioned, so really enveloping the patients in and the care they need medium for them, where they are closing care gaps to start and then making sure. They have the proper primary and preventative care. That's how the progression of those contracts typically take and then the list get larger the patient needs get bigger.

And more varied and then we're there to sort of expand into into those payer contracts as they see really the.

The impact of our work and how better off their patients are with our services I know, we shared in and I want to share one more piece here, which is.

With a lot of the health plans, we work with one example, we gave a which I gave in the prepared remarks, we've helped reduce their E D readmission rate by over 50% of the patients in that transitional care management program. So the payers are seeing real benefit and they're continuing to give us more and more work and so that's what we're basing our guidance on is contracts. We currently have and the ability to.

Expand with our current customer set any new additions from the pipeline or M&A or any significant contract wins would be in addition to the guidance, we're giving tonight.

Okay. Thank you very much.

Absolutely.

Thank you.

Next question comes from Ryan Macdonald from Needham. Please go ahead.

Hi, Thanks for taking my questions, maybe just start on the transportation side. So it's great to hear about the heightened levels of utilization and sort of that being a signal for incremental investment to scale. The team, but how do you balance sort of supply demand in terms of what youre seeing so that.

As you continue to scale the team that you.

You have enough demand to sort of.

Utilize those teams in an optimal ways or you know, it's not becoming sort of margin dilutive.

Absolutely Ryan Thanks for the question. So I thought it was important for us to mention how many trips were currently outsourcing or handing off to other vendors and so we looked at that number over the last 12 months. It's added up to about 26000 trips. So that's really the number we're using as sort of the embedded demand we have and the contracts we have and how.

Much staffs and supply we need in order to meet that demand and that's really the number we're working off of of course, new contract wins, we'd have to hire more but that's the number we're working off of them, we've been able to quantify those those trips and all of our markets and then the corresponding level of staff that we would need in order to satisfy those trips and not outsource them.

And so that's what we're basing our entire hiring plan around if you add those up those 26000 trips across all of our markets. It looks like we have to hire about another seven to 800 staff now I'll tell you we've made progress on that over the past number of weeks here, but we're continuing to ramp that up pretty intensively right now we have a big work stream.

Is going within the company to make sure that we're both retaining the great staff, we have and attracting a new new team members to join so that we can scale those efforts, but it's really based off of the number of trips that were already already outsourcing from the embedded demand we have from our contracts.

Helpful color there. Thanks, and then maybe as a follow up you know obviously, great to hear about the continued scaling and growth in the remote patient monitoring business 13 contracts. This year a more proposals could you just talk about what some of the core areas endpoint sort of care areas that you're you're focused in with remote and really.

The Genesis of the question is a bit as you know obviously the recent news about United are Rolling back you know RPM, except for any chronic heart failure and hypertension. During pregnancy, just kind of curious what youre hearing in the market of does that sort of create a knock on effect at.

At all for other payers in the market. Thanks.

Yeah, Ryan I'm. So glad you mentioned that is actually our core offering and remote patient monitoring is really in.

In the cardiology space. So you mentioned chronic heart failure and other insurance companies pulling back coverage too to just cardiology and heart disease, that's actually would bode well for us we have a deep expertise in cardiology and implantable cardiac devices like loop recorders pacemaker.

And so forth so that's really our specialty.

And that's that's the area, where we're investing in so that's that's the focus of our remote patient monitoring efforts as these devices that are transmitting data, particularly for heart.

Heart failure, and other cardiology related chronic conditions.

We have been expanding since from that into other into other specialties like diabetes and others, but the core focus of our group right now is in cardiology.

Awesome I appreciate all the color there.

Of course.

Thank you and your next question comes from David Larsen from <unk>. Please go ahead.

Hi, This is Jenny Chen on for David Thanks for taking my question.

Firstly I just wanted to ask about your current view.

Hospital and hospital spending environment as a whole we've spoken to some hospital executives said awesome and the uncertainty in the market, including around things like M. A C.

D and Medicaid have caused them to be more cautious with their budgets and they are expecting there could be a pressure on volumes and spending have you had or heard any of that sentiment.

Your customers, so far but it looks like volumes are strong just any thoughts on hospital customers tend to mountain spending. Thank you.

Oh, absolutely journey, it's a it's great to hear from you and it's a great question. So yeah look I think it's still early to tell what really the impacts will be from any new legislation, but you can certainly see an area, where perhaps there's more Americans that are underinsured or uninsured and they end up in hospitals emergency rooms.

And really straining capacity and then of course, perhaps those hospitals won't be able to recoup.

<unk> from underinsured or uninsured.

Patients. So it's definitely a concern we spent a lot of time with hospital executives and I speak to hospital system Ceos very regularly and I think our core focus is on how we can save them money and be more efficient that's really always been our focus we feel like we.

We can help them manage their patient flow make sure patients are not staying an extra night in the hospital, they don't need to because they couldn't get the medical transportation coordinated we help with that our platform. Specifically is designed for that and so we feel like we've gotten receptivity from hospital systems are very recently to that and then of course on the payer and provider.

Side, our whole goal again, whether it be with hospital systems or payers is we want to help lower their costs and their utilization and so that transitional care management program. I described when a patient is getting discharged that is a critical moment in patient engagement, they're leaving the hospital and so where their beds.

Side, often scheduling a follow up appointment, making sure that we're gonna go and see them, perhaps in their home to make sure their discharge planning is.

Being taken care of that is very valuable and that will help patient stay out of the hospital and that helps hospitals because hospitals get penalized if patients bounce back within a 30 day window and so we're helping keep patients from doing that and it helps the payers because again patients are most costly when they're in the hospital. So again, we re.

We are excited by what we're building here. We think it is very timely we think it's incredibly strategic to the health care ecosystem and really it's all designed I'm trying to save the system money, the hospital's money and the payers money and that will we think will be successful with that Gerry what I would add to that is it I can say anecdotally that in the last six months or a year.

We've had conversations with hospital systems that we've been in the ambulance business for quite some time, but there are some big hospital systems. We've spoken to we have not really spoken through prior to lets say last six to 12 months, who are now thinking about precisely that outsourcing the management of the flow of patients into and out of their facilities is something that they had always done on their own.

It's always been a pinpoint to them and how they really have to think about being more efficient and getting it off their plate. So we're having we have opportunities I don't think even existed a couple of years ago.

Okay.

That sounds great and then for a quick follow up have you seen any.

The impact from the government shutdown has that impacted any municipal decision, making at all thank you.

Yeah, absolutely. So we we've shared over the past several earnings calls we've actually emphasize.

Emphasized less our work in the population government space. So we've really been focused on the hospital systems payers or providers. Yes, studying these now customer set it's going to get more and more of our attention time and resources and so that's really where our big focus is and again I think honestly, it's very early to tell.

Any impact from some of this legislation or policy changes, we don't see it yet and frankly, a lot of the policy changes kick in later on down the road next year or the year. After so we're really heads down we think our value prop.

Speaks to whatever environment, the health care system more policy, maybe maybe whatever.

Situation the health care system may be in or whatever policy that there may be a yeah.

In effect because again, we're there to help save the system money save hospital systems money help CMS save money help our insurance partners save money and that's really our goal and we think that'll be germane and relevant.

No matter what going forward here.

That's great. Thank you.

Okay. Thank you and your last question comes from Mike Latimore from Northland Capital. Please go ahead.

Yeah.

Hi, This is on behalf of Mike Latimore could you give some color on how were the bookings in the third quarter, how much did they grow sequentially.

For which for which business.

Like overall.

Well I mean, we saw we saw sequential growth in almost all of our businesses in transport, where you would see let's say in the U S. And you know we look at it in terms of the the number of trips that we carried so we saw like a mid single digit sequential growth in trip and trip count.

Which you know that for quarter over quarter number that's that's very very good.

We're happy with that obviously, our payer and provider business lines, all chosen growth during the quarter I think every one of those business lines showed a higher revenue number for Q3, then for Q4. So in fact, when we look towards 2026, if we would simply take the Q3 results and annualize them that we'd already put us in pretty good shape as far as the guidance that we gave so.

We definitely saw a pickup in volumes I think we mentioned in the release or elsewhere that we did see record volumes that granted it wasn't blowing away our previous records, but we did see higher volumes across all of those business lines in Q3 than we had ever seen.

Got it and how much cash do you expect to have at the end of the year.

So I'm just using the end of Q3 as a baseline we had $95 million and when you take the cash and the restricted cash as well or $73 million. If you just look at the unrestricted cash we would expect that number to go up net by a few million dollars assuming.

As we expect we will collect on the remainder of the large migrant related invoices that are out there that would be enough to cover any kind of operating loss and we should be able to squeeze out some operating cash flow on that on that basis. So we would expect that the number will go up a little bit by the end of Q4.

As we shared we think that that number from there starts to go down at the end of Q1 at the end of Q2 before picking up in the back half of the year.

But we feel that we would exit 2026 at a number that's about $65 million or higher.

Alright got it thank you.

Of course.

Thank you and there are no further questions at this time I will now turn the call back to Mr. <unk>.

Thank you and thank you all for joining us today B well.

Okay.

Okay.

Ladies and gentlemen, this could you conference call for today, we thank you very much for your participation. You may now disconnect have a great day.

Okay.