Q2 2026 GMR Solutions Inc Earnings Call

August 13, 2026

Speaker #1: Hello everyone. Thank you for joining us, and welcome to GMR Solutions Q2, 2026 earnings call. After today's prepared remarks, we will host a question-and-answer session.

Operator: Hello, everyone. Thank you for joining us, and welcome to GMR Solutions Q2 2026 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Christer Sorenson, Vice President of Investor Relations. Christer, please go ahead.

Operator: Hello, everyone. Thank you for joining us, and welcome to GMR Solutions Q2 2026 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Krister Sorensen, Vice President of Investor Relations. Krister, please go ahead.

Speaker #1: If you would like to ask a question, please press star 1 to raise your hand. To withdraw your question, press star 1 again. I will now hand the conference over to Krister Sorensen, Vice President of Investor Relations.

Speaker #1: Krister, please go ahead.

Speaker #2: Joining me today are Nick Lopecaro, our Board Chair. Thank you. Good morning, and welcome to the GMR Solutions Q2 2026 earnings conference call.

Christer Sorenson: Joining me today are Nick Loporcaro, our Board Chair and CEO, Edward Van Horne, our President and COO, and Brian Tierney, our Executive Vice President and CFO. Before we begin, note that during this call, we may make forward-looking statements, and actual results may differ materially from those statements because of various risks and uncertainties, including those described in our most recent earnings report posted on our investor relations website, and in the risk factors section in our IPO prospectus. Today's remarks also include certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in our earnings release and earnings presentation that is available on our website at investors.globalmedicalresponse.com. Unless otherwise noted, references to the quarter will be for the second quarter of 2026. I will now turn the call over to Nick.

Krister Sorensen: Joining me today are Nick Loporcaro, our Board Chair and CEO, Edward Van Horne, our President and COO, and Brian Tierney, our Executive Vice President and CFO. Before we begin, note that during this call, we may make forward-looking statements, and actual results may differ materially from those statements because of various risks and uncertainties, including those described in our most recent earnings report posted on our investor relations website, and in the risk factors section in our IPO prospectus. Today's remarks also include certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in our earnings release and earnings presentation that is available on our website at investors.globalmedicalresponse.com. Unless otherwise noted, references to the quarter will be for the second quarter of 2026. I will now turn the call over to Nick.

Speaker #2: Joining me today are Nick Lopecaro, our Board Chair and CEO; Ted Van Horn, our President and COO; and Brian Tierney, our Executive Vice President and CFO.

Speaker #2: Before we begin, note that during this call we may make forward-looking statements and actual results may differ materially from those statements because of various risks and uncertainties, including those described in our most recent earnings report posted on our Investor Relations website.

Speaker #2: And in the risk factors section in our IPO prospectus. Today's remarks also include certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in our earnings release and earnings presentation that is available on our website at investors.globalmedicalresponse.com.

Speaker #2: Unless otherwise noted, references to the quarter will be for the second quarter of 2026. I will now turn the call over to Nick.

Speaker #3: Thanks, Krister, and thank you all for joining us today. We are excited to report strong financial and operational results for the second quarter of 2026 that are in line with our expectations.

Nick Loporcaro: Thanks, Christer, and thank you all for joining us today. We are excited to report strong financial and operational results in the second quarter of 2026 that are in line with our expectations. To provide a high-level overview of the quarter, GMR completed nearly 1.4 million patient encounters during the second quarter. We provided ground medical services to over 1.3 million patients, which includes more than 1 million transports along with 29,000 calls through our 911 Nurse Navigation offering. The remaining approximately 280,000 ground patient encounters consisted of interventions on scene that did not result in a transport. During the quarter, we provided air medical services to over 36,000 patients. Q2 revenue was $1.49 billion, which represents 3.3% year-over-year growth. Adjusted EBITDA of $285 million decreased 11.8% year-over-year, with an adjusted EBITDA margin of 19.1%.

Nick Loporcaro: Thanks, Krister, and thank you all for joining us today. We are excited to report strong financial and operational results in the second quarter of 2026 that are in line with our expectations. To provide a high-level overview of the quarter, GMR completed nearly 1.4 million patient encounters during the second quarter. We provided ground medical services to over 1.3 million patients, which includes more than 1 million transports along with 29,000 calls through our 911 Nurse Navigation offering. The remaining approximately 280,000 ground patient encounters consisted of interventions on scene that did not result in a transport. During the quarter, we provided air medical services to over 36,000 patients. Q2 revenue was $1.49 billion, which represents 3.3% year-over-year growth. Adjusted EBITDA of $285 million decreased 11.8% year-over-year, with an adjusted EBITDA margin of 19.1%.

Speaker #3: To provide a high level overview of the quarter, GMR completed nearly 1.4 million patient encounters during the second quarter. We provided ground medical services to over 1.3 million patients, which includes more than 1 million transports along with 29,000 calls through our 911 nurse navigation offering.

Speaker #3: And the remaining approximately 280,000 ground patient encounters consisted of interventions on scene that did not result in a transport. During the quarter, we provided air medical services to over 36,000 patients.

Speaker #3: Q2 revenue was 1.49 billion dollars, which represents 3.3% year-over-year growth. Adjusted EBITDA of 285 million decreased 11.8% year-over-year with an adjusted EBITDA margin of 19.1%.

Speaker #3: As mentioned previously, prior year results benefited from favorable revenue estimate adjustments associated with the No Surprises Act, related to collections on claims from earlier dates of service.

Nick Loporcaro: As mentioned previously, prior year results benefited from favorable revenue estimate adjustments associated with the No Surprises Act related collections on claims from earlier dates of service. Aside from this comparability impact, you will see that the business delivered strong underlying revenue and operating performance during the quarter that Brian will expand on later in the call. Our strong performance was driven by continued same-market revenue growth, revenue from cross-selling and new markets, disciplined cost management, continued optimization of our clinical and operational platforms, and an unwavering focus on service to our communities by keeping care at the center of what we do.

Speaker #3: Aside from this comparability, impact you will see that the business delivered strong underlying revenue and operating performance during the quarter that Brian will expand on later in the call.

Speaker #3: Our strong performance was driven by continued same market revenue growth, revenue from cross-selling, and new markets, disciplined cost management, continued optimization of our clinical and operational platforms, and an unwavering focus on service to our communities by keeping care at the center of what we do.

Nick Loporcaro: Today marks our second earnings call since the successful completion of our IPO 3 months ago, which was an incredible accomplishment that could not have been possible without the dedication of our frontline and support staff as we refocused our energy on our core competency of emergency care over the past few years. Before Ted and Brian discuss the quarter in more detail, I want to step back and reiterate why we believe GMR is best positioned as a front-of-the-frontline healthcare provider. As the largest provider of emergency medical services, we serve 5.5 million patients annually, covering markets that represent over 60% of the US population with one or more of our solutions.

Speaker #3: the successful completion of our IPO three months ago. Which was an incredible accomplishment that could not have been possible without the dedication of our frontline and support staff as we refocused our energy on our core competency of emergency care, over the past few years.

Speaker #3: Before Ted and Brian discuss the quarter in more detail, I want to step back and reiterate why we believe GMR is best positioned as the frontline healthcare provider.

Speaker #3: As the largest provider of emergency medical services, we serve 5.5 million patients annually, covering markets that represent over 60% of the U.S. population with one or more of our solutions.

Speaker #3: Our more than 24,000 highly trained clinicians and fleet of ambulances and aircraft are rapidly deployed to navigate and provide essential out-of-hospital care for patients when they need us most.

Nick Loporcaro: Our more than 24,000 highly trained clinicians and fleet of ambulances and aircraft are rapidly deployed to navigate and provide essential out-of-hospital care for patients when they need us most. Our model is differentiated because it is integrated. We bring together clinical capabilities through air, ground, technology, and care navigation assets in a way that allows us to serve communities, health systems, payers, federal and state agencies, and patients across a broad range of settings. In addition to emergent care, we provide non-emergent care, medical response, and disaster response. We have also maintained a longstanding role as a prime EMS contractor for FEMA, supporting national emergency and disaster response needs. The opportunity in front of us is built around four ideas: saving and serving lives through clinical excellence. Second, growth across existing and new markets. Third, differentiation through our integrated platform and innovative solutions.

Speaker #3: Our model is differentiated because it is integrated. We bring together clinical capabilities through air, ground, technology, and care navigation assets in a way that allows us to serve communities, health systems, payers, federal and state agencies, and patients across a broad range of settings.

Speaker #3: In addition to emergent care, we provide non-emergent care, event medical response, and disaster response. We have also maintained a long-standing role as the prime EMS contractor for FEMA, supporting national emergencies and disaster response needs.

Speaker #3: The opportunity in front of us is built around four ideas. Saving and serving lives through clinical excellence, second, growth across existing and new markets, third, differentiation through our integrated platform and innovative solutions, and fourth, maintaining sustainable margins through disciplined operating execution.

Nick Loporcaro: And fourth, maintaining sustainable margins through disciplined operating execution. We operate within a $35 billion total addressable market that includes private providers like us, municipal-run EMS systems, and volunteer programs. The US population is growing as well as aging, and chronic disease prevalence continues to rise. Many rural healthcare facilities face closure or a reduction in service capabilities. All of this drives an increase in demand for EMS. As a primary provider and connection point to healthcare facilities and the only nationally integrated air and ground ambulance provider across 46 states and Washington, DC, we believe GMR is best positioned to capture this demand. This positioning gives us a greater access to growth, to adjacent markets, cross-selling within existing markets, and through disciplined M&A. And we never stop scrutinizing our existing business to ensure we continue to grow and provide sustainable care to our communities.

Speaker #3: We operate within a $35 billion total addressable market that includes private providers like us, municipal-run EMS systems, and volunteer programs. The U.S. population is growing as well as aging, and chronic disease prevalence continues to rise.

Speaker #3: Many rural healthcare facilities face closure or a reduction in service capabilities. All of this drives an increase in demand for EMS. As the primary provider in connection point to healthcare facilities and the only nationally integrated air and ground ambulance provider across 46 states and Washington, D.C., we believe GMR is best positioned to capture this demand.

Speaker #3: This positioning gives us a greater access to growth, to adjacent markets, cross-selling within existing markets, and through disciplined M&A. And we never stop scrutinizing our existing business to ensure we continue to grow and provide sustainable care to our communities.

Speaker #3: As the national leader of EMS, this puts us in an exceptional position to be the innovators of the practice and raise the tide for the entire industry.

Nick Loporcaro: As the national leader of EMS, this puts us in an exceptional position to be the innovators of the practice and raise the tide for the entire industry. At GMR, we have several systems and solutions, including 911 Nurse Navigation, our Concierge platform, and our online ordering system, Transport.Net, that enhance efficiencies across our organization, resulting in the most appropriate care for patients. Our 911 Nurse Navigation connects lower acuity 911 callers with skilled nurses who can guide them to more appropriate sites of care when an ambulance transport is not clinically necessary. Concierge helps health systems better coordinate discharge and non-emergent transport needs, improve hospital throughput, and create a clearer reimbursement framework. Transport.Net reduces the effort in requesting, tracking, and dispatching both air and ground ambulance resources. Together, these solutions strengthen our offering, improve resource utilization, enhance patient outcomes, and create a reinforcing flywheel.

Speaker #3: At GMR, we have several systems and solutions, including 911 nurse navigation, our concierge platform, and our online ordering system transport.net, that enhance efficiencies across our organization resulting in the most appropriate care for patients.

Speaker #3: Our 911 nurse navigation connects lower acuity 911 callers with skilled nurses who can guide them to more appropriate sites of care when an ambulance transport is not clinically necessary.

Speaker #3: Concierge helps health systems better coordinate discharge and non-emergent transport needs, improve hospital throughput, and create a clearer reimbursement framework. Transport.net reduces the effort in requesting tracking and dispatching both air and ground ambulance resources.

Speaker #3: Together, these solutions strengthen our offering, improve resource utilization, enhance patient outcomes, and create a reinforcing flywheel. Our national scale creates clinical data; that data informs innovation, our tools support contract wins, and those wins further reinforce our national scale.

Nick Loporcaro: Our national scale creates clinical data. That data informs innovation. Our tools support contract wins, and those wins further reinforce our national scale. Each of these innovations help take the friction out of a traditionally run EMS system and ultimately provide better patient care, more efficient operations, and better hospital throughput while delivering savings to payers in turn. Our scale also enables a large EMS database, currently over 80 million records, that allows us to pair with hospital outcome data to drive system improvements and protocols. This data-driven effort resulted in GMR receiving ESO Solutions' Best Use of EMS Data to Improve Outcomes award at ESO's Wave conference in April this year, which is a national gathering for fire, EMS, and hospital professionals. Our performance continues to be driven by the same key ideas. First, saving and serving lives through clinical excellence.

Speaker #3: Each of these innovations help take the friction out of a traditionally run EMS system and ultimately provide better patient care, more efficient operations, and better hospital throughput while delivering savings to payers in turn.

Speaker #3: Our scale also enables a large EMS database currently over 80 million records that allows us to pair with hospital outcome data to drive system improvements and protocols.

Speaker #3: This data-driven effort resulted in GMR receiving ESO Solutions' Best Use of EMS Data to Improve Outcomes Award at ESO's WAVE conference in April this year, which is a national gathering for fire, EMS, and hospital professionals.

Speaker #3: Our performance continues to be driven by the same key ideas. First, saving and serving lives through clinical excellence. Our advanced clinical protocols and rigorous training standards remain the foundation of everything we do, ensuring the highest quality of care in every patient encounter.

Nick Loporcaro: Our advanced clinical protocols and rigorous training standards remain the foundation of everything we do, ensuring the highest quality of care in every patient encounter. Second, on growth, we continue to expand in existing markets, enter adjacent and new markets, cross-sell our solutions, and evaluate disciplined M&A opportunities. Third, on differentiation, our integrated air and ground model, supported by innovative technology, allows us to reduce friction in traditional EMS systems and deliver care more efficiently. Fourth, on margins, we continue to scrutinize the market and contracts in which we operate, emphasizing work that is strategically aligned and economically sustainable. On the reimbursement front, we applaud the recent introduction of the Reimbursing Emergency Services for Critical Urgent Encounters Act of 2026 in the US House of Representatives.

Speaker #3: Second, on growth, we continue to expand an existing market, enter adjacent and new markets, cross-sell our solutions, and evaluate disciplined M&A opportunities. Third, on differentiation, our integrated air and ground model, supported by innovative technology, allows us to reduce friction in traditional EMS systems and deliver care more efficiently.

Speaker #3: Fourth, on margins, we continue to scrutinize the market and contracts in which we operate, emphasizing work that is strategically aligned and economically sustainable. On the reimbursement front, we applaud the recent introduction of the reimbursing emergency services for critical urgent events or rescue act of 2026 in the U.S.

Speaker #3: House of Representatives. This bipartisan legislation provides a necessary solution to modernize the Medicare payment structure so emergency medical services are treated similarly to other healthcare providers, with payments based on real cost data.

Nick Loporcaro: This bipartisan legislation provides a necessary solution to modernize the Medicare payment structure so emergency medical services are treated similarly to other healthcare providers with payments based on real cost data. Under this approach, Medicare's payment rates will be more transparent, financially responsible, and cost-based, helping to close the financial gap between reimbursement and the cost of services for EMS providers. Achieving this milestone is another example of the recognition we are garnering with lawmakers and the payer community with respect to the necessary services we provide. Ted will now provide more detail on how our initiatives are unfolding operationally.

Speaker #3: Under this approach, Medicare's payment rates will be more transparent, financially responsible, and cost-based, helping to close the financial gap between reimbursement and the cost of services for EMS providers.

Speaker #3: Achieving this milestone is another example of the recognition we are garnering with lawmakers and the payer community, with respect to the necessary services we provide.

Speaker #3: Ted will now provide more detail on how our initiatives are unfolding operationally.

Speaker #1: Thanks, Nick. GMR's operational focus remains clear, grow our core emergent services participate in non-emergent services where they make fiscal and strategic sense, and realize efficiency through innovative offerings such as 911 nurse navigation, concierge, and transport.net.

Edward Van Horne: Thanks, Nick. GMR's operational focus remains clear. Grow our core emergent services, participate in non-emergent services where they make fiscal and strategic sense and realize efficiency through innovative offerings such as 911 Nurse Navigation, Concierge, and Transport.Net. These capabilities give us ways to pair clinical care with better operational decision-making and stronger partnerships across communities and health systems. These reflect the broader principle behind our model. We coordinate care across modalities and geographies as an integrated service rather than providing services on a standalone basis, given patients rarely fit neatly into a single mode of care. Care coordination allows us to better match resources to acuity, improve visibility for our partners, and support more efficient operations. In weather-constrained air markets, for example, the ability to deploy clinical resources across the ground platform reflects the practical value of integration.

Speaker #1: These capabilities give us ways to pair clinical care with better operational decision-making and stronger partnerships across communities and health systems. These reflect a broader principle behind our model, we coordinate care across modalities and geographies as an integrated service, rather than providing services on a standalone basis given patients rarely fit neatly into a single mode of care.

Speaker #1: Care coordination allows us to better match resources to acuity, improve visibility for our partners, and support more efficient operations, and weather-constrained air markets, for example, the ability to deploy clinical resources across the ground platform reflects the practical value of integration.

Speaker #1: 911 Nurse Navigation continues to be one of our most important examples of innovation in the EMS model. The program connects lower acuity 911 callers with skilled nurses who can assess the patient's needs and guide them to the appropriate care setting or transport modality.

Edward Van Horne: 911 Nurse Navigation continues to be one of our most important examples of innovation in the EMS model. The program connects lower acuity 911 callers with skilled nurses who can assess the patient's needs and guide them to appropriate care setting or transport modality. This is better for patients, better for crews, better for hospital systems facing emergency department overcrowding, a lower cost option for payers, and better for communities seeking a more sustainable EMS model. In Q2, we navigated nearly 29,000 calls through this program, up 50% year over year. In the quarter, we started servicing three new communities, representing 1.3 million covered lives, bringing our total to 29 communities, representing 19.7 million covered lives, and we plan to implement four more communities over the remainder of the year.

Speaker #1: This is better for patients, better for crews, better for hospital systems facing emergency department overcrowding, a lower cost option for payers, and better for communities seeking a more sustainable EMS model.

Speaker #1: In the second quarter, we navigated nearly 29,000 calls through this program, up 50% year over year. In the quarter, we started servicing three new communities representing 1.3 million covered lives, bringing our total to 29 communities representing 19.7 million covered lives.

Speaker #1: We plan to implement four more communities over the remainder of the year. We've seen up to 20% of 911 medical calls diverted to nurse navigation, with qualitative benefits including better alignment of resources to acuity, improved resource utilization, client stickiness, and higher satisfaction for both patients and crews.

Edward Van Horne: We've seen up to 20% of 911 medical calls diverted to Nurse Navigation, with qualitative benefits including better alignment of resources to acuity, improved resource utilization, client stickiness, and higher satisfaction for both patients and crews. For example, during the Spokane wildfires, GMR's 911 Nurse Navigation program quickly partnered with local emergency response and healthcare teams to connect displaced residents with appropriate care. Within hours, nurse navigators were helping patients access urgent care, telehealth, and community resources, reducing unnecessary emergency department visits while ensuring timely support. This effort demonstrates how 911 Nurse Navigation can rapidly adapt during crisis to improve patient access and support healthcare system capacity. We expect to continue expanding 911 Nurse Navigation in existing 911 markets and using the system as a differentiator in new municipal and health system partnerships.

Speaker #1: For example, during the Spokane wildfires, GMR's 911 nurse navigation program quickly partnered with local emergency response and healthcare teams to connect displaced residents with appropriate care.

Speaker #1: Within hours, nurse navigators were helping patients access urgent care, telehealth, and community resources, reducing unnecessary emergency department visits while ensuring timely support. This effort demonstrates how 911 nurse navigation can rapidly adapt during crisis to improve patient access and support healthcare system capacity.

Speaker #1: We expect to continue expanding 911 nurse navigation in existing 911 markets and using the system as a differentiator in new municipal and health system partnerships.

Speaker #1: Concierge, supports the non-emergent side of the model by partnering with health systems to coordinate appropriate transports under a clearer reimbursement structure. This creates a more predictable framework for service that can otherwise be low reimbursing or operationally inefficient.

Edward Van Horne: Concierge supports the non-emergency side of the model by partnering with health systems to coordinate appropriate transports under a clear reimbursement structure. This creates a more predictable framework for service that can otherwise be low reimbursing or operationally inefficient. It also supports hospital throughput by helping discharge processes move more efficiently and by reducing friction in scheduled transport workflows. Transport.net reduces friction in the process of requesting, tracking, and dispatching air and ground ambulance resources. By increasing visibility and simplifying handoffs among access points, health systems, and dispatch teams, the platform enhances the value of our integrated network. We are installed in nearly 3,000 public safety answering points, or PSAPs, across the country, representing over 65% of all PSAPs nationwide. This software reduces dispatch friction, improves visibility, and strengthens partner relationships. For example, in Fredericksburg, Texas, Gillespie County Dispatch serves both the police department and sheriff's office.

Speaker #1: It also supports hospital throughput by helping discharge processes move more efficiently, and by reducing friction in scheduled transport workflows. Transport.net reduces friction in the process of requesting, tracking, and dispatching air and ground ambulance resources.

Speaker #1: By increasing visibility and simplifying handoffs among access points, health systems, and dispatch teams, the platform enhances the value of our integrated network. We are installed in nearly 3,000 public safety answering points, or PSAPs, across the country, representing over 65% of all PSAPs nationwide.

Speaker #1: This software reduces dispatch friction, improves visibility, and strengthens partner relationships. For example, in Fredericksburg, Texas, Gillespie County Dispatch serves both the Police Department and Sheriff's Office.

Speaker #1: This is a very busy system. They were an early adopter of the Transport.net ordering technology and now process 100% of their air transport requests through the platform.

Edward Van Horne: This is a very busy system. They were an early adopter of the Transport.net ordering technology and now process 100% of their air transport requests through the platform. Thanks to its ease of use, reliability, and aircraft tracking capabilities, they save valuable minutes on every request, allowing them to focus on other emergencies instead of spending significant time on the phone. Turning to growth, we remain positive about our ability to win new business opportunities in core emergency medical services and expanded municipal ambulance contracting through 911 Nurse Navigation. Our growth strategy is multi-pronged, grow same market revenue, expand in existing markets, and enter new markets, cross-sell our integrated offering, and evaluate disciplined acquisitions where they are financially accretive and strategically aligned. Same market revenue increased $53.1 million, or 3.8% year over year. New market revenue in the quarter was $21.3 million.

Speaker #1: Thanks to its ease of use, reliability, and aircraft tracking capabilities, they've saved valuable minutes on every request, allowing them to focus on other emergencies instead of spending significant time on the phone.

Speaker #1: Turning to growth, we remain positive about our ability to win new business opportunities in core emergency medical services and expanded municipal ambulance contracting through 911 nurse navigation.

Speaker #1: Our growth strategy is multi-pronged: grow same-market revenue, expand in existing markets and enter new markets, cross-sell our integrated offering, and evaluate disciplined acquisitions where they are financially accretive and strategically aligned.

Speaker #1: Same market revenue increased $53.1 million, or 3.8% year over year. New market revenue in the quarter was $21.3 million. For new market starts in the quarter, we opened two new 911 systems in markets where we already had air operations, advancing our integrated market strategy.

Edward Van Horne: For new market starts in the quarter, we opened two new 911 systems in markets where we already had air operations, advancing our integrated market strategy. We also opened three new air bases, two adjacent to existing operations, expanding our footprint, and one in a new region with future growth potential. Also in the quarter, we executed new agreements totaling over $43 million in incremental annualized revenue. We continue engaging with states and other stakeholders on rural healthcare access and EMS models, including opportunities tied to state-led rural health transformation initiatives under the Rural Health Transformation Program with our 911 REACT platform. 911 REACT provides rural areas with the connection point to care that is desperately needed in these healthcare deserts. While we believe we are the best positioned to help solve rural health issues, we also believe we are the best to provide urban system rescue.

Speaker #1: We also opened three new air bases—two adjacent to existing operations, expanding our footprint, and one in a new region with future growth potential.

Speaker #1: Also in the quarter, we executed new agreements totaling over 43 million in incremental annualized revenue. We continue engaging with states and other stakeholders on rural healthcare access and EMS models, including opportunities tied to state-led rural health transformation initiatives under the Rural Healthcare Transformation Fund with our 911 REACT platform.

Speaker #1: 911 REACT provides rural areas with the connection point to care that is desperately needed in these healthcare deserts. While we believe we are the best positioned to help solve rural health issues, we also believe we are the best to provide urban system rescue.

Speaker #1: Over the 4th of July weekend, as part of our response capabilities, the state of New York requested 50 ambulances and 110 personnel for the city of New York to supplement the FDNY during what is typically the busiest weekend of the year for local EMS.

Edward Van Horne: Over the 4th of July weekend, as part of our response capabilities, the state of New York requested 50 ambulances and 110 personnel for the city of New York to supplement the FDNY during what is typically the busiest weekend of the year for local EMS. GMR teams responded to over 2,200 emergency calls throughout all five boroughs. This short deployment is just another example of GMR's ability to be the safety net for EMS across the country. Under our event medical operations, we covered seven of the 11 stadiums hosting FIFA World Cup games, as well as provided coverage for several of the teams' practice facilities. We treated over 3,000 patients across the US, including about 300 transports and one full cardiac arrest resuscitation. I will now turn it over to Brian, who will provide more detail on the financials.

Speaker #1: GMR teams responded to over 2,200 emergency calls throughout all five boroughs. This short deployment is just another example of GMR's ability to be the safety net for EMS across the country.

Speaker #1: Under our event medical operations, we covered seven of the 11 stadiums hosting FIFA World Cup games, as well as provided coverage for several of the team's practice facilities.

Speaker #1: We treated over 3,000 patients across the US. Including about 300 transports and one full cardiac arrest resuscitation. I will now turn it over to Brian, who will provide more detail on the financials.

Speaker #2: Thanks, Ted. In the second quarter of 2026, GMR reported net revenue of 1.49 billion dollars, a 3.3% increase year over year. Compared to the same quarter in 2025, Q2 air volumes were up 6.9% due to strong request demand coupled with improved capture rate.

Brian Tierney: Thanks, Ted. In the Q2 2026, GMR reported net revenue of $1.49 billion, a 3.3% increase year over year. Compared to the same quarter in 2025, Q2 air volumes were up 6.9% due to strong request demand coupled with improved capture rate. Emergent ground transports increased 2.4%, driven by strong same-store demand, while non-emergent ground transports decreased 3.0%, reflecting our deliberate strategy of redirecting our resources towards higher acuity responses. As a result, during the quarter, total patient encounters associated with our focus areas of emergent transports and nurse navigation grew 3.7%, while lower reimbursement patient encounters associated with non-emergent wheelchair and non-transports decreased. On margin, our operating discipline remains centered on contract profitability, labor productivity, resource utilization, rate adequacy, and operational efficiency.

Speaker #2: Emergent ground transports increased 2.4%, driven by strong same-store demand, while non-emergent ground transports decreased 3.0%, reflecting our deliberate strategy of redirecting our resources towards higher acuity responses.

Speaker #2: As a result, during the quarter, total patient encounters associated with our focus areas of emergent transports and nurse navigation grew 3.7%. While lower reimbursement patient encounters associated with non-emergent wheelchair and non-transports decreased.

Speaker #2: On margin, our operating discipline remains centered on contract profitability, labor productivity, resource utilization, rate adequacy, and operational efficiency. Following the strategic review process that began in 2022, we have continued to focus the portfolio on core operations and better-performing services.

Brian Tierney: Following the strategic review process that began in 2022, we have continued to focus the portfolio on core operations and better performing services, including reviewing, renegotiating and, where appropriate, exiting contracts that did not meet the return thresholds or strategic requirements. We also continue to benefit from efficiency initiatives in billing, collections, staffing, fleet utilization, and shared services. Long term, we believe margin sustainability will be supported by integrated operations, payer relationships, disciplined contract structures, and continued refinement of the independent dispute resolution and other reimbursement processes. Net transport revenue per ambulance transport, or NRT, increased 1.4% compared to the prior year quarter. Revenue performance was driven by a positive mix shift from non-emergent to emergent transports and strong underlying NRT improvement on a like-for-like basis.

Speaker #2: Including reviewing, renegotiating, and, where appropriate, exiting contracts that did not meet the return thresholds or strategic requirements. We also continue to benefit from efficiency initiatives in billing, collections, staffing, fleet utilization, and shared services.

Speaker #2: Long term, we believe margin sustainability will be supported by integrated operations, payer relationships, disciplined contract structures, and continued refinement of the independent dispute resolution and other reimbursement processes.

Speaker #2: Net transport revenue per ambulance transport, or NRT, increased 1.4% compared to the prior-year quarter. Revenue performance was driven by a positive mix shift from non-emergent to emergent transports and strong underlying NRT improvement on a like-for-like basis.

Speaker #2: This was partially offset by an approximate 16 million dollar payer mix shift impact from the expiration of the Affordable Care Act exchange subsidies. As patients shifted out of commercial insurance and into self-pay.

Brian Tierney: This was partially offset by an approximate $16 million payer mix shift impact from the expiration of the Affordable Care Act exchange subsidies as patients shifted out of commercial insurance and into self-pay, which was in line with our expectations and was included in our prior guidance. Additionally, the current quarter did not benefit from the same level of favorable changes in revenue estimates recognized in the prior year period, which were largely associated with collections on No Surprises Act claims from earlier dates of service. During the second quarter, changes in estimates predominantly related to No Surprises Act claims were approximately $74 million lower than the prior year period. This creates a meaningful variance in the year-over-year comparison in NRT, total revenue, and adjusted EBITDA, which was $284.5 million, down 11.8% from the prior year.

Speaker #2: This was in line with our expectations and was included in our prior guidance. Additionally, the current quarter did not benefit from the same level of favorable changes in revenue estimates recognized in the prior-year period.

Speaker #2: Which were largely associated with collections on no surprises act claims from earlier dates of service. During the second quarter, changes in estimates predominantly related to no surprises act claims were approximately 74 million dollars lower than the prior year period.

Speaker #2: This creates a meaningful variance in the year-over-year comparison in net revenue per transport, total revenue, and adjusted EBITDA. Which was 284.5 million dollars down 11.8% from the prior year.

Speaker #2: Aside from this comparability impact, the business continued to demonstrate strong underlying revenue and operating performance during the quarter. Turning to expenses, total operating expense increased 19.4% to 1.43 billion dollars in the quarter compared to 1.20 billion dollars for the same period in 2025.

Brian Tierney: Aside from this comparability impact, the business continued to demonstrate strong underlying revenue and operating performance during the quarter. Turning to expenses. Total operating expense increased 19.4% to $1.43 billion in the quarter, compared to $1.20 billion for the same period in 2025. Employee wages, benefits, and taxes increased by 24.5% to $925 million. The increase year over year was primarily driven by increased stock compensation expense of $129.6 million related to the vesting of stock units associated with the execution of the IPO. The remaining increase was primarily driven by improved staffing and normal wage adjustments to attract and retain talent. The average base unit wage increase during the quarter was 3.3%. Maintenance, fuel, and other direct expenses increased by 21.1% to $136.4 million. The increase was primarily driven by fuel unit costs associated with the Iran conflict and the timing of aircraft maintenance events.

Speaker #2: Employee wages benefits and taxes increased by 24.5% to 925 million dollars. The increased year-over-year was primarily driven by increased stock compensation expense of 129.6 million dollars related to the vesting of stock units associated with the execution of the IPO.

Speaker #2: The remaining increase was primarily driven by improved staffing and normal wage adjustments to attract and retain talent. The average base unit wage increase during the quarter was 3.3%.

Speaker #2: Maintenance, fuel, and other direct expenses increased by 21.1% to 136.4 million dollars. The increase was primarily driven by fuel unit costs associated with the Iran conflict and the timing of aircraft maintenance events.

Speaker #2: We also saw higher than normal inflationary costs impact lines that have a direct correlation with the supplier's underlying fuel costs. Including travel and shipping costs.

Brian Tierney: We also saw higher than normal inflationary costs impact lines that have a direct correlation with the suppliers' underlying fuel costs, including travel and shipping costs. Other operating expenses were generally in line with expectations. As reported, we recognized a net loss of $28.3 million in the quarter compared to net income of $80.8 million in the prior year period. The year-over-year change was primarily driven by $142.3 million of expenses associated with our IPO, as well as the lower changes in estimates already mentioned related to No Surprises Act claims on older dates of service. Shifting to CapEx, cash flows, and liquidity. Cash fees for CapEx and aircraft financing was 6.3% of revenue for the second quarter of 2026, compared to 4.5% of revenue for the second quarter of 2025.

Speaker #2: Other operating expenses were generally in line with expectations. As reported, we recognized a net loss of $28.3 million in the quarter, compared to net income of $80.8 million in the prior year period.

Speaker #2: The year-over-year change was primarily driven by 142.3 million dollars of expenses associated with our IPO, as well as the lower changes in estimates already mentioned related to no surprises act claims on older dates of service.

Speaker #2: Shifting to CapEx, cash flows, and liquidity—cash used for CapEx and aircraft financing was 6.3% of revenue for the second quarter of 2026, compared to 4.5% of revenue for the second quarter of 2025.

Speaker #2: The increase was primarily due to the timing of CapEx purchases in both years, as well as our decision to pull forward certain purchases that were planned for later in the year to capture available price discounts.

Brian Tierney: The increase was primarily due to the timing of CapEx purchases in both years, as well as our decision to pull forward certain purchases that were planned for later in the year to capture available price discounts. GMR finished the second quarter with $420.0 million in cash and cash equivalents, and undrawn ABL with $696 million of cash borrowing capacity after letters of credit. Our free cash flow was approximately $15 million. Net leverage finished the quarter at 3.5x, down from 4.3x at the end of Q2 last year. We expect strong cash flows to drive this below 3.3x by year-end, and have line of sight to 3.0x before the end of 2027. Shortly after the IPO, Moody's and S&P upgraded our credit ratings from B2/B to B1/B+, respectively, triggering a 25-basis point interest rate step down on our term loan facility.

Speaker #2: GMR finished the second quarter with 420.0 million dollars in cash and cash equivalents and undrawn AVL with 696 million dollars of cash borrowing capacity after letters of credit.

Speaker #2: Our free cash flow was approximately 15 million dollars. Net leverage finished the quarter at 3.5 times down from 4.3 times at the end of Q2 last year.

Speaker #2: We expect strong cash flows to drive this below 3.3 times by year-end and have line of sight to 3.0 times before the end of 2027.

Speaker #2: Shortly after the IPO, Moody's and S&P upgraded our credit ratings from B2B to B1B+ respectively. Triggering a 25 basis point interest rate step down on our term loan facility.

Speaker #2: Moving on to guidance, we are reiterating our full year earnings guidance. We continue to expect revenue in the range of 5.89 billion to 6.18 billion dollars.

Brian Tierney: Moving on to guidance, we are reiterating our full-year earnings guidance. We continue to expect revenue in the range of $5.89 billion to $6.18 billion, our adjusted EBITDA in the range of $1.135 billion to $1.195 billion, and total cash used for CapEx and aircraft financing between 5.1% and 5.3% of total revenue. Our guidance assumes continued momentum in transport rates and volumes, a stable payer mix that already reflects the elimination of the ACA exchange subsidies, and the ongoing impact of the prolonged Iran conflict. In summary, it was a strong quarter. We had strong demand for and grew our core merchant services. We collected more for those services. Base unit wage costs were moderate. We have ample liquidity enabling further deleveraging. I will now turn it over to the operator to open for any questions. Thank you.

Speaker #2: Our adjusted EBITDA is in the range of $1.135 billion to $1.195 billion, and total cash used for CapEx and aircraft financing is between 5.1% and 5.3% of total revenue.

Speaker #2: Our guidance assumes continued momentum in transport rates and volumes, a stable payer mix that already reflects the elimination of the ACA exchange subsidies and the ongoing impact of the prolonged Iran conflict.

Speaker #2: In summary, it was a strong quarter. We had strong demand for, and grew, our core emergent services. We collected more for those services. Base unit wage costs were moderate.

Speaker #2: We have ample liquidity, enabling further deleveraging. And now, I will turn it over to the operator to open for any questions. Thank you.

Speaker #1: We will now begin the question-and-answer session. Please limit yourself to one question and one follow-up. If you would like to ask a question, please press star one to raise your hand.

Operator: We will now begin the question and answer session. Please limit yourself to one question and one follow-up. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. We ask that you pick up your handset when asking a question to allow for optimum sound quality. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Your first question comes from the line of Scott Fidel with Goldman Sachs. Your line is open. Please go ahead.

Speaker #1: To withdraw your question, press star one again. We ask that you pick up your handset when asking a question quality and if you are muted locally, please remember to unmute your device.

Speaker #1: Please stand by while we compile the Q&A roster. Your first question comes from the line of Scott Fadell with Goldman Sachs. Your line is open.

Speaker #1: Please go ahead.

Speaker #3: Hi, thanks. And good morning. First question, just was hoping to get maybe a little bit more context to the extent you can provide it.

Scott Fidel: Hi. Thanks, and good morning. First question, I was hoping to get maybe a little bit more context, to the extent you can provide it, just around the IDR dynamics and appreciate the flagging the year-over-year change. Maybe if you could just sort of put that maybe in the context of more of like year to date and in the Q1, did you have. I do not recall similar dynamics, but it seems like that was more of a meaningful number in the Q2 of last year. I think you mentioned having maybe some sort of prior year sweeps and collecting some of those funds. Just maybe more broadly, just talk about the trends with IDR in terms of how basically the revenues that you are generating from that, to the extent you can, have been on trend year to date.

Speaker #3: Just around the IDR dynamics and appreciate the flagging the year-over-year change maybe if you could just sort of put that maybe in the context of sort of more of like year to date and the first quarter, did you have I don't recall similar dynamics but it seems like that was more of a meaningful number in the second quarter of last year.

Speaker #3: And I think you mentioned having maybe some sort of prior year sort of sweeps and collecting some of those funds. And just maybe more broadly just talk about the trends with IDR in terms of how those how basically the revenues that you're generating from that to the extent you can have been trending year to date.

Speaker #2: Hey Scott, thank you. This is Brian. Yeah, last year in the second quarter we had about 79 million dollars worth of change in estimate related to the no surprises act.

Brian Tierney: Hey, Scott. Thank you. This is Brian. Last year in the Q2, we had about $79 million worth of change in estimate related to the No Surprises Act stuff. This year was about five, so that drives that $74 million delta. What that really says is we have been able to really dial in the estimates. This is all related, the stuff in 2025 is really related to stuff much earlier. I feel really good about where our ability to predict the revenue here. There is still some older stuff hanging out there. We will continue to try to go get that really old stuff, but feel that we are going to be more in this zero plus or minus five range here as we go forward.

Speaker #2: Stuff this year was about five. So that drives that 74 million dollar delta. What that really says is we've been able to really dial in the estimates.

Speaker #2: This is all related—the stuff in '25 was really related to stuff much earlier. And so I feel really good about where our ability to predict the revenue here.

Speaker #2: Now there's still some older stuff hanging out there. We will continue to try to go get that really old stuff. But feel that we're going to be more in this zero plus or minus five range here as we go forward.

Speaker #3: Okay, got it. And then just for my follow-up question, maybe if you could walk us through just the payer mix dynamics in terms of sort of fully bridging to sort of the year-over-year changes and certainly heard the call out around the impact on the exchanges and would imagine that that certainly had a meaningful amount of it.

Scott Fidel: Okay, got it. Just for my follow-up question, maybe if you could walk us through the payer mix dynamics in terms of fully bridging to the year-over-year changes. Certainly, heard the call out around the impact on the exchanges and would imagine that that certainly had to be an equal amount of it. So should we think about the lower commercial payer mix year-over-year being largely a function of both the impact from the lower exchange revenues and then combined with the lower IDR revenues that you already recognized. Would that largely comprise it. Just curious if there is anything else that we should be aware of, and then how you are thinking about payer mix trends within your guidance into the back half of the year. Thanks.

Speaker #3: So is it should we think about the sort of the lower commercial payer mix year-over-year being largely a function of both the impact from the lower exchange revenues and then combined with the IDR lower IDR revenues that you already recognize?

Speaker #3: Would that largely comprise it, or—just curious if there's anything else that we should be aware of? And then, how are you thinking about payer mix trends within your guidance into the back half of the year?

Speaker #3: Thanks.

Speaker #2: Hey Scott, it's Nick. Let me tackle the higher level, and then Brian can get a little more granular. So, when we had our last call, we said we saw little, if any, impact in the first quarter.

Nick Loporcaro: Hey, Scott, it's Nick. Let me tackle a higher level and then Brian can get in a little more granular. When we had our last call, we had said we saw little, if any, impact Q1. We started seeing some impact in Q2 in the ACA, and I recall mentioning we had seen it in our own benefits. We had more employees taking on our employer benefit plan. We suspect that these were folks that were on the exchanges looking for other alternatives. I also mentioned whether you are on the gold plan or the bronze plan does not make a difference for our types of interventions we get paid. So we did see some impact in Q2 that Brian can expand on and mentioned obviously in our call here. So thinking we still need to better understand it. Where are these folks?

Speaker #2: We started seeing some impact in the second quarter in the ACA. And I recall mentioning we'd seen it in our own benefits. We had more employees taking on our employer benefit plan.

Speaker #2: We suspect that they're that these were folks that were on the exchanges. Looking for other alternatives. I also mentioned whether you're on the gold plan or the bronze plan doesn't make a difference for our types of interventions.

Speaker #2: We get paid. So we did see some impact in second quarter that Brian can expand on and mentioned obviously in our call here. So thinking we still need to better understand it.

Speaker #2: Where are these folks? Are they all going to self-pay? Are they all going to different commercial? And we're seeing evidence of that. The other key thing we're learning—and I think it showed up, at least in what I've read on some of the hospital readouts recently—geographically it's different as well.

Nick Loporcaro: Are they all going to self-pay? Are they all going to different commercial? We are seeing evidence of that. The other key thing we are learning, and I think it showed up, at least in what I have read on some of the hospital readouts recently, geographically, it is different as well. We have parts of the country where, yes, we will see more go to self-pay, other parts of the country that we are finding them now in commercial plans, which is actually an upside for us. Still, thinking about all of this, studying it, learning more, and anticipate we will learn more even this quarter. I will hand it over to Brian to get a little more granular to tackle some of the numbers around your question.

Speaker #2: We have parts of the country where, yes, we'll see more go to self-pay. In other parts of the country, we're finding them now in commercial plans, which is actually an upside for us.

Speaker #2: So, still thinking about all of this, studying it, learning more, and anticipate we'll learn more even this quarter. But I'll hand it over to Brian to get a little more granular, tackle some of the numbers around your question.

Speaker #4: Yeah, the short answer to your question is yes. It's the exchange impact and the No Surprises Act year-over-year comp that really drive the payer mix shift.

[Company Representative] (GMR Solutions): Yep. The short answer to your question is yes, it is the exchange impact and the No Surprises Act year-over-year comp that really drives the payer mix shift. To expand a little bit more on what Nick said, yeah, we are seeing it exactly where we thought we would see it. It is the big exchange providers, the Molinas, the Centenes, a few of the bigger blues that are in the exchange program. We have seen the decrease in their volumes, in the states that they were heavy in. It is really since April, we have seen a very consistent mix shift relative to what we had expected. We have got that in our guidance as we go forward. We had it in our guidance before. It is still in our guidance. We will keep watching this, as Nick said. Got to make sure we understand where everybody ultimately lands.

Brian Tierney: Yep. The short answer to your question is yes, it is the exchange impact and the No Surprises Act year-over-year comp that really drives the payer mix shift. To expand a little bit more on what Nick said, yeah, we are seeing it exactly where we thought we would see it. It is the big exchange providers, the Molinas, the Centenes, a few of the bigger blues that are in the exchange program. We have seen the decrease in their volumes, in the states that they were heavy in. It is really since April, we have seen a very consistent mix shift relative to what we had expected. We have got that in our guidance as we go forward. We had it in our guidance before. It is still in our guidance. We will keep watching this, as Nick said. Got to make sure we understand where everybody ultimately lands.

Speaker #4: To expand a little bit more on what Nick said yeah, we're seeing it exactly where we thought we would see it. It's the big exchange providers, the Molinas, the Santins, a few of the bigger blues that are in the exchange program.

Speaker #4: We've seen the decrease in their volumes in the states that they were heavy in. And so, really since April, we've seen a very consistent mix shift relative to what we had expected.

Speaker #4: And so that we've got that in our guidance as we go forward. We had it in our guidance before. It's still in our guidance.

Speaker #4: For we'll keep watching this as Nick said. We're going to make sure we understand where everybody ultimately lands. But it's been really consistent here across the quarter.

[Company Representative] (GMR Solutions): But it has been really consistent here across the quarter.

Brian Tierney: But it has been really consistent here across the quarter.

Speaker #2: Yeah, and a closing comment I'd make here: Ted and his teams, as we figure out those geographies, remember we do have some levers to pull.

Nick Loporcaro: And closing comment I would make here, Ted and his teams, as we figure out those geographies, remember, we do have some levers to pull. We can go back to the counties. We do have subsidy programs. We can reopen up some of those contracts on pricing. So there are some levers. We have not flipped them yet because we want to better understand where the impact is.

Speaker #2: We can go back to the counties where we do have subsidy programs. We can reopen some of those contracts on pricing. So there are some levers.

Speaker #2: We haven't flipped them yet because we want to better understand where the impact is.

Speaker #3: Okay, helpful details. Thank you.

Scott Fidel: Okay. Helpful details. Thank you.

Speaker #1: Your next question comes from the line of Elizabeth Anderson with Evercore ISI. Your line is open. Please go ahead.

Operator: Your next question comes from the line of Elizabeth Anderson with Evercore ISI. Your line is open. Please go ahead.

Speaker #5: Hi guys. Thanks so much for the question. I have lots of conceptual questions and maybe one numbers cleanup question. If you talk about if you talked about the improved capture rate as one of the nice improvements in the quarter.

Elizabeth Anderson: Hi, guys. Thanks so much for the question. I have lots of conceptual questions and maybe one numbers cleanup question. You talked about the improved capture rate as one of the nice improvements in the quarter. Can you talk a little bit more about that? I know obviously the weather is better in Q2 than Q1, but is that sort of what you are referring to or is there something more underlying than that that also helped improve the capture rate? Thank you very much.

Speaker #5: Can you talk a little bit more about that? I know obviously the weather is better in the second quarter than the first quarter, but is that sort of what you're referring to or is there something under more underlying than that that also helped improve the capture rate?

Speaker #5: Thank you very much.

Nick Loporcaro: Elizabeth, and I will have Ted expand on this. This is Nick. There is a lot of levers here that we are looking at. Some of it is technology, some of it is recruiting of pilots and medical staff, making sure we have people in the right places, studying trends. You heard Ted mention Transport.Net and how that drives, one, making sure we understand the demand, where it is, and that we are readily available to capture it. Obviously, weather, and even with weather, we have talked about further investments in IFR, which mitigates some of the weather impacts. I will ask Ted to maybe provide a little bit more color around this and the initiatives we are having on the airside.

Speaker #2: Elizabeth and I'll have Ted expand on this. This is Nick. There's a lot of levers here that we're looking at. Some of it's technology.

Speaker #2: Some of it's recruiting of pilots and medical staff, making sure we have people in the right places. Studying trends. You heard Ted mention transport.net and how that drives one, making sure we understand the demand.

Speaker #2: Where it is and that we're readily available to capture it. Obviously, weather and even with weather, we've talked about further investments in IFR, which mitigates some of the weather impacts, but I'll ask Ted to maybe provide a little bit more color around this and the initiatives we're having on the air side.

Speaker #4: Yeah, and that quarter specific in Q2 with the way the weather was impacting the good parts, different parts of geographies for us too. So what we see higher capture rates and sort of parts of America generally, and that's where we've seen a lot of the weather improvements and we saw the capture rates improve with that also.

Edward Van Horne: Yeah. That quarter specific, in Q2, the way the weather was impacting different parts of geographies for us, too. So where we see higher capture rates in certain parts of America generally, and that is where we have seen a lot of the weather improvements, and we saw the capture rates improve with that also. So that was a big chunk of the reason why. We are going to continue to make all the improvements and investments. This IFR, different types of aircraft. We have been bringing them in from one of the vendors specifically at a pretty good clip right now. So we are excited about that, and we do see the results every time we bring in the IFR aircraft.

Speaker #4: So that was a big chunk of the reason why and we are going to continue to make all the improvements and investments this IFR, different types of aircraft.

Speaker #4: We've been bringing them in from one of the vendors specifically at a pretty good click right now. So we're excited about that. We do see the results every time we bring in the IFR aircraft.

Speaker #5: Great. And my numbers cleanup question, just to make sure that we're modeling your go-forward correctly. One, I heard you say sort of a continuation of high oil pricing expectations.

Elizabeth Anderson: Great. My numbers cleanup question, just to make sure that we are modeling your go forward correctly. One, I heard you say sort of a continuation of high oil pricing expectations. Is it currently sort of that current rates continue for the rest of the year? So that is the first part of it. Secondly, obviously the World Cup does not happen every year. So is it possible to parse out the specific World Cup part of the revenue just to make sure that we are not comping you off of it for next year?

Speaker #5: Is it currently sort of that current rates continue for the rest of the year? So that's the first part of it. And then secondly, obviously the World Cup doesn't happen.

Speaker #5: Every year. So is it possible to parse out the specific World Cup part of the revenue just to make sure that we're not comping you off of it for next year?

Speaker #4: Yeah, I'll take the second part first. The World Cup was a couple of million dollars. It was very low revenue piece. And not all of that flows through to earnings.

Brian Tierney: Yep. I will take the second part first. The World Cup was a couple million dollars, a very low revenue piece.

Elizabeth Anderson: Right.

[Company Representative] (GMR Solutions): Not all of that flows through to earnings, so it is a very small piece. The oil prices on a go-forward basis, we use the forward curve. The average for the rest of the year is about $80 a barrel, a little bit higher in August and September, a little bit lower in November. I think the market is assuming, at least for the rest of the year, there is continued Iran conflict with potential for a little bit relief at the end. We have baked that in going forward. That is $10 plus million a quarter of incremental fuel relative to what we had initially. We would have done if we were setting a budget or something before the year began. All of that is baked in.

Brian Tierney: Not all of that flows through to earnings, so it is a very small piece. The oil prices on a go-forward basis, we use the forward curve. The average for the rest of the year is about $80 a barrel, a little bit higher in August and September, a little bit lower in November. I think the market is assuming, at least for the rest of the year, there is continued Iran conflict with potential for a little bit relief at the end. We have baked that in going forward. That is $10 plus million a quarter of incremental fuel relative to what we had initially. We would have done if we were setting a budget or something before the year began. All of that is baked in.

Speaker #4: So it's a very, very small piece. The oil prices on a go forward basis we use the forward curve. The average for the rest of the year is about $80 a barrel.

Speaker #4: A little bit higher in August and September, a little bit lower in November. I think the market is assuming, at least for the rest of the year, there's continued Iran conflict with potential for a little bit of relief at the end.

Speaker #4: We've baked that in going forward. That's 10 plus million dollars a quarter of incremental fuel relative to what we had initially we would have done if we were setting a budget or something before the year began.

Speaker #4: All of that's baked in.

Speaker #5: Got it. Super helpful. Thank you very much.

Elizabeth Anderson: Got it. Super helpful. Thank you very much.

Speaker #1: Your next question comes from the line of Benjamin Rossy with JP Morgan. Your line is open. Please go ahead.

Operator: Your next question comes from the line of Benjamin Rossi with JP Morgan. Your line is open. Please go ahead.

Operator: Your next question comes from the line of Benjamin Rossi with JPMorgan. Your line is open. Please go ahead.

Speaker #6: Good morning. Thanks for taking my questions here. Just as a follow-up on the IDR comments, by my math, during the first half of the year you've left about 110 million and out of period benefits from IDR last year.

Benjamin Rossi: Good morning, and thanks for taking my questions here. Just as a follow-up on the IDR comments. By my maths, during the H1 of the year, you have lapped about $110 million in out-of-period benefits from IDR last year. When we think about the H2 of the year, if you were to receive no IDR benefits during Q3 and Q4, what would this out-of-period comp dynamic look like? Is it fair to think of the step-down during the H2 of the year being similar in magnitude as the H1? Just curious on what that contribution looked like last year during the H2 compared to the H1.

Speaker #6: When we think about the back half of the year, if you were to receive no IDR benefits during 3Q and 4Q, what would this out of period comp dynamic look like?

Speaker #6: Is it fair to think of this step down in the second half of the year being similar in magnitude to the first half?

Speaker #6: Just curious on what that contribution looked like last year during the second half compared to the first half.

Speaker #4: Yeah, thanks, Ben. Yeah, the numbers about the same. It's just under 100 million dollars was in that second half of the year last year.

Brian Tierney: Yeah. Thanks, Ben. Yeah, the number is about the same. It is just under $100 million was in that H2 of the year last year.

Speaker #6: Got it. Okay. I guess just as a follow-up question, the press release you mentioned some new business wins. Can you just elaborate on those opportunities and how you think about potential contributions from these wins in the back half of the year?

Benjamin Rossi: Got it. Okay. As a follow-up question, the press release, you mentioned some new business wins. Can you just elaborate on those opportunities and how you are thinking about potential contributions from these wins in the H2 of the year? Thanks.

Speaker #6: Thanks.

Speaker #4: You know, kind of the specific per contract, but overall there are 901 wins both on the ground and air. Air were adjacent markets, I think, as I mentioned, where we had opportunities in airbases and expanding footprint for us when we can operationalize the next town over, the next county over.

Edward Van Horne: We do not get into specific per contract, but overall, there are 911 wins both on the ground and air. Air were adjacent markets, I think, as I mentioned, where we had opportunities and air base is an expanding footprint for us. When we can operationalize the next town over, the next county over, we get such great operational synergies with it. Then when we link in our Transport.Net, we are actually building in more aircraft into that web for the 911 centers as they are using it. So that has been a big piece of the Q2 on the air side. The ground side was two new 911 wins in new communities that we already had the air. So it was great that we were able to bring in the ground operations, create that integrated market.

Speaker #4: We get such great operational synergies with it. And then when we link in our transport.net, we're actually building in more aircraft into that web for the 901 centers as they're using it.

Speaker #4: So that's been a big piece of the Q2 on the air side. The ground side was two new 911 wins and new communities that we already had the air.

Speaker #4: So it was great that we were able to bring in the ground operations, create that integrated market. So those were in the southeast and they're excited because we see a lot of that opportunity continue for the rest of the year, these small, mid-sized communities across the US.

Edward Van Horne: Those were in the Southeast, and they are excited because we see a lot of that opportunity continue for the rest of the year, these small mid-size communities across the US.

Speaker #6: Great. Thanks for the additional details.

Benjamin Rossi: Great. Thanks for the additional details.

Speaker #1: Your next question comes from the line of AJ Rice with UBS. Your line is open. Please go ahead.

Operator: Your next question comes from the line of A.J. Rice with UBS. Your line is open. Please go ahead.

Speaker #6: Hi, everybody. First, maybe just to pursue a little more on your rollout of your 911 nurse navigation. How much of your footprint does that address today?

A.J. Rice: Hi, everybody. First, maybe just to pursue a little more on your rollout of your 911 Nurse Navigation. How much of your footprint does that address today? Is there an ultimate target of how much of your footprint you can get to and what the pacing or limiting factor on rolling that out is?

Speaker #6: And is there an ultimate target of how much of your footprint you can get to and what the pacing or limiting factor on rolling that out is?

Nick Loporcaro: A.J., it's Nick again. I will start at a high level and ask Ted to offer up some more details if I miss anything here. We are probably 29 communities today of coverage, representing just shy of 20 million covered lives. I think you will recall, and we have talked about in our presentations, we have approximately 200 million lives in the geographies that we serve. That is the potential. Do I think, as the CEO and pushing the team as you look at our sort of a five-year plan, could we potentially get to 100 million covered lives? I think that is realistic. I think we have plans in place. What does that mean for the impact of the business? You have all challenged us before on what is Nurse Nav in itself worth. It allows us to run our business better.

Speaker #2: AJ, it's Nick. Again, I'll start at a high level and ask Ted to offer up some more details if I miss anything here. So we're probably 29 communities today.

Speaker #2: Of coverage representing just shy of 20 million covered lives. And I think you'll recall in we talked about in our presentations we have approximately 200 million lives in the geographies that we serve.

Speaker #2: So that's the potential. Do I think, as the CEO and pushing the team, as you look at our sort of a five-year plan, could we potentially get to 100 million covered lives?

Speaker #2: I think that's realistic. I think we have plans in place. Now, what does that mean for the impact of the business? You've all challenged us before on what is nurse nav in and its worth.

Speaker #2: It allows us to run our business better. It allows us to win more business because of the value. And just real interesting, actually—in a session we had yesterday—we have evidence of where we put in Nurse Nav, and Brian can speak to the numbers here, on a 150 basis point lift on just margin improvement in the markets we put it in.

Nick Loporcaro: It allows us to win more business because of the value. Just real interesting, actually, in a session we had yesterday. We have evidence of where we put in Nurse Nav, and Brian can speak to the numbers here on 150 basis points lift on just margin improvement in the markets we put it in. What is even more interesting, what we are learning, when we have Nurse Navigation combined with like a treat no transport, we are actually making better reimbursement on that versus a basic life support transport. That is the dynamic that is important and the reason you will see us continue to talk about Nurse Nav, the push of it, and the proliferation, and how it positions us in the markets where we are deploying. Ted, I do not know if you would offer up any other detail on that. Yeah. For us, the Nurse Nav really is three distinct growth channels.

Nick Loporcaro: It allows us to win more business because of the value. Just real interesting, actually, in a session we had yesterday. We have evidence of where we put in Nurse Nav, and Brian can speak to the numbers here on 150 basis points lift on just margin improvement in the markets we put it in. What is even more interesting, what we are learning, when we have Nurse Navigation combined with like a treat no transport, we are actually making better reimbursement on that versus a basic life support transport. That is the dynamic that is important and the reason you will see us continue to talk about Nurse Nav, the push of it, and the proliferation, and how it positions us in the markets where we are deploying. Van, I do not know if you would offer up any other detail on that.

Speaker #2: But what's even more interesting, what we're learning when we have nurse navigation combined with a treat, no transport, we're actually making better reimbursement on that versus a basic life support transport.

Speaker #2: And that's the dynamic that's important and the reason you'll see us continue to talk about nurse nav, the push of it, and the proliferation and how it positions us in the markets where we're deploying.

Speaker #2: Ted, I don't know if you'd offer up any other detail on that.

Speaker #4: Yeah. For us, the nurse nav really is three distinct growth channels. One is our existing footprint, which you mentioned, and we can continue to spread that out in multiple over the course of each year.

Nick Loporcaro: Yeah. For us, the Nurse Nav really is three distinct growth channels.

Edward Van Horne: One is our existing footprint, which you mentioned, and we can continue to spread that out in multiple over the course of each year. We are going to keep growing those out. The second channel is the Rural Health Transformation Fund and the new bids there as we are proposing that across the US. The third channel is the big metro models, right? Where we are working the Nurse Navigation in with the very large municipal city bids. Those take a little bit longer on the sales cycle, obviously, because they are very big municipalities. We have a great sales team that is working very closely with each one of those cities as they walk through those proposals. That is how we see those three distinct cycles. Each one has got a lot of room in it, and we are excited because we have just opened up the second center in Phoenix.

Speaker #4: We're going to keep growing those out. The second channel is the rural health transformation fund and the new bids there. As we're proposing that across the US.

Speaker #4: And the third channel is the big metro models, right? We're working the nurse navigation in with the very large municipal city bids. Those take a little bit longer on the sales cycle, obviously, because they're very big municipalities.

Speaker #4: But when we have a great sales team that's working very closely with each one of those cities as they walk through those proposals.

Speaker #4: So that's how we see those three distinct cycles. Each one has got a lot of room in it and we're excited because we've just opened up the second center in Phoenix.

Speaker #4: So we've got a lot of capacity and room to grow. We've thought Phoenix, both Phoenix and here in the Dallas area, being able to get the nurses and so we continue to grow that.

Edward Van Horne: We have got a lot of capacity and room to grow. We have got both Phoenix and here in the Dallas area being able to get the nurses, and so we continue to grow that, the actual nurses taking the call. We are ready for it on the technology side, space side, and continue to grow it.

Speaker #4: The actual nurses taking a call. So we're ready for it on the technology side space side and continue to grow it.

Speaker #6: Okay. Thanks. Maybe the follow-up. You mentioned on the prepared remarks, you'll be at 3.3 times leverage by the end of the year, three times by the end of next year.

A.J. Rice: Okay. Thanks. Maybe the follow-up, you mentioned on the prepared remarks, you would be at 3.3 times leverage by the end of the year, 3 times by the end of next year. Is 3 times a steady state that you are comfortable with? If it is, it sounds like there are some potential deals out there. Can you categorize what you are seeing, what kind of things you might be interested in doing, and what kind of valuations are they going to be potentially immediately accretive to you if you can do some things?

Speaker #6: Is sort of 3 times a steady state that you're comfortable with? And then if it is, it sounds like there are some potential deals out there.

Speaker #6: Can you categorize what you're seeing? What kinds of things might you be interested in doing, and what kind of valuations are they? Are they going to be potentially immediately accretive to you if you can do some things?

Speaker #2: So AJ, that's I'm going to start backwards with your question. We had hoped we had hoped and anticipated both the IPO we would have some arbitrage opportunities.

Nick Loporcaro: AJ, I am going to start backwards with your question. We had hoped and anticipated post the IPO, we would have some arbitrage opportunities. Admittedly, with where we are trading and where the market is evaluating things, I think that is created a bit of conservatism around the pipeline. We do have a healthy pipeline. We have probably got about 15 targets.

Speaker #2: Admittedly, with where we're trading and where the market is evaluating things, I think that's created a bit of conservatism around the pipeline. We do have a healthy pipeline.

Speaker #2: We've probably got about 15 targets, from some small, mid-sized to some larger. And ultimately, I lean on Brian and the team here on how do we best leverage our capital.

Nick Loporcaro: From some small midsize to some largers. Ultimately, I lean on Brian and the team here on how do we best leverage our capital? To go now to the front end of your question, are we better focusing on delevering for the time being? We are going to scrutinize the M&A opportunities. There is a couple of opportunities in adjacent markets where we have to ask ourselves the question: Can we just win the business? Is it quicker to buy it? We have mentioned to you guys in the past, we are going to look at a market that has strong ground presence. Do we buy an air asset there? That is how we are looking at it. I think as you said in the prepared remarks, this is a conversation Brian and I and the teams have often is, where are the opportunities now? We constantly look at our current rates.

Speaker #2: To go now to the front end of your question, are we better focusing on delevering for the time being? We're going to be we're going to scrutinize the M&A opportunities.

Speaker #2: There are a couple of opportunities in adjacent markets where we have to ask ourselves the question: Can we just win the business, or is it quicker to buy it?

Speaker #2: We've mentioned to you guys in the past, we're going to look at a market that has strong ground presence. Do we buy an air asset there?

Speaker #2: So that's how we're looking at it. I think, as you said in the prepared remarks, this was a conversation Brian and I and the teams have often is where are the opportunities now?

Speaker #2: We constantly look at our current rates. Is delevering combined with some of that in our best interest? So there'll be more news coming along those lines probably in pretty short order.

Nick Loporcaro: Is delevering combined with some of that in our best interest? There will be more news coming along those lines, probably in pretty short order.

Speaker #6: Okay. Thanks.

A.J. Rice: Okay, thanks.

Speaker #1: Your next question comes from the line of Joanna Gajic. With Bank of America, your line is open. Please go ahead.

Operator: Your next question comes from the line of Joanna Gajek with Bank of America. Your line is open. Please go ahead.

Speaker #3: Oh, hi. Good morning. Thanks so much for taking the question. So I actually have a two-part question on the IDR process. So first about the final regulation that came out across for lower fee per claim going to an organization, but there's some other changes in there.

Joanna Gajek: Hi, good morning. Thanks so much for taking the question. I actually have a two-part question on the IDR process. First, about the final regulation that came out, a cost for lower fee-per-claim going to an organization, but there are some other changes in there. Just curious, how do you expect this reg, if at all, to impact your IDR process and your experience there? The second part, we heard from the health plan industry lobby groups. They have been very vocal. They call for some changes to the IDR process altogether. They complain about the number of claims, the rates the providers get awarded. What are your thoughts about potential changes to the IDR process? Thank you.

Speaker #3: So, just curious, how do you expect the thread, if at all, to impact your IDR process and your experience there? And the second part, we heard from the health plan industry lobby groups—they’ve been very vocal. They clearly call for some changes to the IDR process altogether.

Speaker #3: They complain about the number of claims. The rates that providers get awarded. So what are your thoughts about potential changes to the IDR process?

Speaker #3: Thank you.

Nick Loporcaro: Joanna, let me hit the second part of your question. I am going to hand it over to Brian. On the second part, we understand the health plans are pushing back on the volume. Our belief is a lot of that has less to do with us on the EMS side of the business and more on what they are getting from other provider groups. That is our assessment of a lot of that. As Brian has mentioned in the past, and he can provide an update, we continue to bring some of the larger plans in-network. We have great collaboration with them, and we see that continuing. Now, honestly, we have our own concerns on how the plans behave on some of them and some pushback, and have been winning some of those arguments as well. I will hand it over to Brian to tackle the first part of your question.

Speaker #6: Joanna, let me hit the second part of your question. I'm going to hand it over to Brian. On the second part, we understand the health plans are pushing back on the volume our belief is a lot of that has less to do with us on the EMS side of the business and more on what they're getting from other provider groups.

Speaker #6: That's our assessment of a lot of that. As Brian has mentioned in the past, and he can provide an update, we continue to bring some of the larger plans and network.

Speaker #6: We have great collaboration with them. And we see that continuing. Now, honestly, we have our own concerns on how the plans behave on some of them and some pushback.

Speaker #6: And I've been winning some of those arguments as well. But I'll hand it over to Brian to tackle the first part of your question.

Speaker #4: Yeah. Let me just hit quickly on the second part as well. We continue to have really good conversations with a number of large payers.

Brian Tierney: Yeah, let me just hit quickly on the second part as well. We continue to have really good conversations with a number of large payers to get them in-network. You've also got some large payers that really have no interest in getting to a reasonable rate term environment. That group we will continue to have to beat them in IDR. I'd rather have them all in-network. It takes two to get to there. On the first part, no, I think we appreciated the ruling or the new rules from the government on how the IDR process will work. I think it really cleaned up a little bit. It did not have really much impact to us from an overall perspective. We do appreciate the lower fees. That's a slight tailwind for us in the very low millions of dollars range of $1 million, $2 million on an annual basis.

Speaker #4: To get them in network. You've also got some large payers that really have no interest in getting to a reasonable rate and term. Environment.

Speaker #4: And so that group, we will continue to have to beat them in IDR. I'd rather have them all in network. But it takes two to get to there.

Speaker #4: On the first part, I think we appreciated the ruling, or the new rules, from the government on how the IDR process will work.

Speaker #4: I think it really cleaned up a little bit. Didn't have really much impact to us from an overall perspective. We do appreciate the lower fees that's a slight tailwind for us.

Speaker #4: In the very, very low millions of dollars. Range of one, two million dollars on an annual basis. So nothing material. But we think the administration coming out and kind of reaffirming the current process was very helpful.

Brian Tierney: Nothing material. We think the administration coming out and kind of reaffirming the current process was very helpful. It would take Congress to reopen the process to do something different. Until that happens, if that happens, we will just continue to work to get everybody in-network, and if not, we will continue to work to beat them in IDR.

Speaker #4: It would take Congress to reopen the process to do something different. So until that happens, if that happens, we'll just continue to work to get everybody in network.

Speaker #4: And if not, we will continue to work to beat them in IDR.

Speaker #1: Thank you. And if I may,

Joanna Gajek: Thank you. If I may, just to follow up on the comment there around the subsidy expiration impact in the quarter. Should we assume a similar amount per quarter going forward? So sort of $16 million? Just to clarify, that was the EBITDA type headwind you referred to?

Speaker #3: Just a follow-up on the commentary around the subsidy expiration impact in the quarter. So, should we assume a similar amount per quarter going forward?

Speaker #3: So sort of $60 million and just to clarify, that was the EBITDA type headwind you referred to?

Speaker #4: Yes. It's both revenue and EBITDA. And yes, that's what's in our guidance going forward is about that 15, 16 million dollars a quarter.

Brian Tierney: Yes. It's both revenue and EBITDA. Yes, that's what's in our guidance going forward is about that $15 million, $16 million a quarter.

Speaker #3: All right. Thank you.

Joanna Gajek: All right. Thank you.

Speaker #1: Your next question comes from the line of Andrew Mock with Barclays. Your line is open. Please go ahead.

Operator: Your next question comes from the line of Andrew Mok with Barclays. Your line is open. Please go ahead.

Speaker #5: Hi. Good morning. I think Airbase has increased pretty meaningfully in the quarter. I think it's up 10 or so. Do I have that right?

Andrew Mok: Hi, good morning. I think Air Base has increased pretty meaningfully in the quarter. I think it is up 10 or so. Do I have that right? What drove that level of accelerated expansion, and was that all planned or is that a result of new or unexpected wins? Just how should we think about the pace of Air Base expansion for the balance of the year?

Speaker #5: So what drove that level of accelerated expansion? And was that all planned or is that a result of newer unexpected wins? And just how should we think about the pace of Airbase expansion for the balance of the year?

Speaker #2: Yeah. No, I think we were up three or four bases in the quarter. And not 10. And as we go forward, we do have a large number of aircraft coming really over the next couple of years.

Brian Tierney: No, I think we were up three or four bases in the quarter, not 10. As we go forward, we do have a large number of aircraft coming really over the next couple of years. We have a number of them. I do not know the exact count. It is in the high single digits for the remainder of the year. It is actually down a little bit from what we would have projected at the beginning of the year. We have one of our aircraft suppliers is just a little bit late with some of their deliveries. So we are seeing a few aircraft push out of 2026 and into 2027 by a couple of months. Not material or meaningful, and it will all catch up in the long term. We are not at 10, but we do have good air volume growth or air base growth going forward.

Speaker #2: We've got a number of them. I don't know the exact count. It's in the high single digits for the remainder of the year. It's actually down a little bit from what we would have projected at the beginning of the year.

Speaker #2: We've got one of our aircraft suppliers is just a little bit late with some of their deliveries. So we're seeing a few aircraft push out of 26 and into 27 by a couple of months.

Speaker #2: Not material or meaningful. And it will all catch up in the long term. But yeah, we're not at 10, but we do have good air volume growth.

Speaker #2: Airbase growth going forward.

Speaker #6: Yeah. To your question about planned, these aircrafts that Brian's mentioning, are all tied to contracts as well. So they are planned. As they come in, they'll be deployed.

Edward Van Horne: Yeah. To your question about plan, these aircrafts that Brian's mentioning are all tied to contracts as well, so they are planned. As they come in, they will be deployed.

Speaker #5: Got it. Okay. And then just a follow-up on the IDR side. Can you share where your in-network rates stand today, and just the progress you've been able to make with this IDR backdrop developing more negatively against the insurers?

Andrew Mok: Got it. Okay. Then just a follow-up on the IDR side. Can you share where your in-network rates stand today and just the progress you have been able to make with this IDR backdrop developing more negatively against the insurers? Thanks.

Speaker #5: Thanks.

Speaker #4: Yeah. So yes, we get higher rates through the IDR process than we are willing to take in-network. I'd rather have them in-network and we'll take a discount.

Brian Tierney: Yeah. Yes, we get higher rates through the IDR process than we are willing to take in-network. I would rather have them in-network, and we will take a discount, because the whole process is easier. The cash is faster. With the right partners, you can get better terms. So you get your claims flow through the process a lot easier. Again, I would rather have them in-network at a little bit of a discount, relative to what we are winning in IDR. The contracts that we are signing, they are just below our IDR rates. So, we have gotten. We continue to make progress with those groups.

Speaker #4: Because the whole process is easier. Cash is faster. With the right partners, you can get better terms. So you've got your claims flow through the process a lot easier.

Speaker #4: Again, I'd rather have them in-network at a little bit of a discount relative to what we're winning in IDR. And the contracts that we're signing, they are in the just below our IDR rates.

Speaker #4: So we've gotten we continue to make progress with those groups.

Speaker #6: Andrew, the other thing we had and there's two reasons the obvious on why we don't want to mention the rate is for competitive reasons.

Nick Loporcaro: Andrew, the other thing to add, and there are two reasons. The obvious on why we do not want to mention the rate is for competitive reasons. The other thing is, I think we have walked through this before as well. What we find is when we are bringing folks in-network, we see a drop in medical necessity denials. We see a drop in the DSO. So there are a lot of other aspects. So the rate difference, I think we more than make up for as we bring them in-network. So we kind of hesitate on putting that out there because honestly, I think it is a much better deal to bring them in-network, even though the sticker price looks a little different, we more than make up for it.

Speaker #6: The other thing is I think we've walked through this before as well. What we find is when we're bringing folks in-network, we see a drop in medical necessity denials.

Speaker #6: We see a drop in the DSO, so there are a lot of other aspects. The rate difference, I think, we more than make up for as we bring them in-network.

Speaker #6: So we kind of hesitate on putting that out there because honestly, I think it's a much better deal to bring them in-network, even though the sticker price looks a little different.

Speaker #6: We more than make up for it.

Speaker #5: Right. And maybe I should phrase it better. I was looking for the rates themselves, just kind of what percentage of your contracts are in-network today?

Andrew Mok: Right. Maybe I should phrase it better. I was looking for the rates themselves, just what percentage of your contracts are in-network today. What progress have you made, and where do you see that going?

Speaker #5: What progress have you made? Where do you see that going?

Nick Loporcaro: Yeah.

Speaker #6: Yeah. Hovering around the 70%. I think if we drill down, we're like at 69, but I keep waiting for Brian to tell me the next big one that's just about to be signed.

Nick Loporcaro: Hovering around 70%. I think if we drill down, we are like at 69%.

Brian Tierney: Yep

Nick Loporcaro: I keep waiting for Brian Tierney to tell me the next big one that is just about to be signed.

Speaker #4: But a number in the upper. And remember, this is just an air conversation. Right? All of the ground in-network, out-of-network is not the same concept.

Brian Tierney: We have got a number in the hopper. Remember, this is just an air conversation, right? All of the ground in-network, out-of-network is not the same concept. So that 69% is where we landed the Q2 for in-network and known reimbursement.

Speaker #4: So that 69% is where we landed the second quarter for in-network and known reimbursement.

Speaker #5: Got it. Thank you.

Andrew Mok: Got it. Thank you.

Speaker #1: Your next question comes from the line of Craig Hettenbach with Morgan Stanley. Your line is unmuted. Please go ahead.

Operator: Your next question comes from the line of Craig Hettenbach with Morgan Stanley. Your line is unmuting. Please go ahead.

Speaker #3: Great. Thank you. But the implied second half guidance, can you just touch on kind of volume expectations, ground and air, like any noticeable changes in the market that you're seeing relative to first half?

Craig Hettenbach: Great, thank you. With the implied H2 guidance, can you just touch on kind of volume expectations, ground and air, like any noticeable changes in the market that you're seeing relative to H1?

Speaker #6: Yeah. I mean, for us, how we are expecting to roll out our new base growth for the second half is what we're still projecting and what you kind of see in the guidance.

Edward Van Horne: Well, for us, how we are expecting to roll out our new base growth for H2 is what we're still projecting and what you kind of see in the guidance. We've worked through that. We've got not only air new bases, but then any of the starts. That's all projected. We do still see and always managing what weather impacts are happening. The fire activity that happens across the US, obviously from an air standpoint, sometimes it cause some weather behavior, believe it or not, and ability to fly out west. We're watching all that through the course of the year. But what you see on the forecast and how we plan that out is on the base expectations of aircraft coming in and the base starts that we've got working in.

Speaker #6: So we've worked through that. So we've got not only our new bases, but then any of the starts. So that's all projected. We do still see, and always manage, what weather impacts are happening—some of the fire activity that happens across the US.

Speaker #6: Obviously, from an air standpoint, sometimes it costs some weather behavior, believe it or not, and the ability to fly out west. So, we're watching all that through the course of the year.

Speaker #6: But what you see in the forecast, and how we plan that out, is based on the expectations of aircraft coming in and the base starts that we've got working in.

Speaker #3: Got it. And then just a follow-up, but Brian, you talked about just some operating efficiencies. Can you just touch on some of the key drivers there and maybe expand on ways you're using technology to help expand margins over time?

Craig Hettenbach: Got it. Just a follow-up for Brian. You talked about some operating efficiencies. Can you just touch on some of the key drivers there and maybe expand on ways you are using technology to help expand margins over time?

Speaker #4: Yeah. Well, I think from an operations efficiencies, we continue to match our labor to our volume. And so in markets where we've got stronger volume, right, it's not always a one-for-one that you've got to add incremental labor costs.

Brian Tierney: Well, I think from an operations efficiencies, we continue to match our labor to our volume. In markets where we have stronger volume, it is not always a one-for-one that you have to add incremental labor cost. We can do that. If we have a market where maybe the volume is down a little bit, the operations do a really good job of trying to manage the staff to that level. We are always looking for efficiencies across the back office. We have 40 or 50 different AI-related initiatives, some of them bigger, some of them smaller, that just help drive the efficiencies that we should get out of our system. We should be better today than we were yesterday and a little better tomorrow than we are today. A little bit of incremental improvement all the time ultimately adds up.

Speaker #4: We can do that. But then also as the if we've got a market where maybe the volume is down a little bit, the operations do a really good job of trying to manage the staff to that level.

Speaker #4: We're always looking for efficiencies across the back office. We've got 40 or 50 different AI-related initiatives, some of them bigger and some of them smaller.

Speaker #4: That just helps drive the efficiencies that we should get out of our system. I mean, we should be better today than we were yesterday, and a little better tomorrow than we are today.

Speaker #4: And a little bit of incremental improvement all the time—ultimately, it adds up. We've got folks that are always focused on making sure we're spending the right amounts out of our procurement teams, and so on.

Brian Tierney: We have folks that are always focused on making sure we are spending the right amounts out of our procurement teams and so on. So it is a culture and a focus for us just to make sure that we are being as efficient as we can.

Speaker #4: So it's really a culture and a focus for us just to make sure that we're being as efficient as we can.

Speaker #6: Yeah. And I would add to the two things. One, we often talk about our scale and our size and one of the things that we gotten really good at and still more room to get better at is how do we get better alignment across the whole organization?

Nick Loporcaro: Yeah, I would add two things. One, we often talk about our scale and our size. One of the things that we have gotten really good at, and still more room to get better at, is how do we get better alignment across

Nick Loporcaro: The whole organization. I often quote my friend Pareto, the 80% that is similar across our platform, we are getting really good at leveraging best practices, better alignment, standardization across the platform with leaving that 20% of the local flavor and intervention that we need to. We are seeing a lot of that on the operations side. Just to lean on the AI implementations. One, we have an AI governance committee we are very sensitive to. We are in healthcare. Not to sound too cliché, our North Star remains and our effort remains patient care and how do we continue to optimize the time that our providers spend with hands-on patients. That is always our focus going into any deployment of technology innovation. We really believe if we do that right, we will see the efficiencies as well in the system as we are providing better care.

Speaker #6: I often quote my friend Pareto: "The 80% that's similar across our platform, we're getting really good at leveraging best practices, better alignment, standardization, across the platform, with leaving that 20% of the local flavor and intervention that we need to." So we're seeing a lot of that on the operation side.

Speaker #6: Just to lean on the AI implementations: one, we have an AI governance committee. We're very sensitive to who we are in healthcare, but not to sound too cliché, our North Star remains—and our effort remains—patient care, and how do we continue to optimize the time that our providers spend with hands-on patients?

Speaker #6: That's always our focus. Going into any deployment of technology, innovation, and we really believe if we do that right, we'll see the efficiencies as well in the system as we're providing better care.

Speaker #3: Oh, thank you.

Craig Hettenbach: Oh, thank you.

Speaker #1: Your next question comes from the line of Daniel Grosslight with Citi. Your line is open. Please go ahead.

Operator: Your next question comes from the line of Daniel Grosslight with Citi. Your line is open. Please go ahead.

Speaker #5: Hey, this is Luis for Daniel. Guidance does contemplate a step down to either down margins in the back half of the year relative to Q2.

[Analyst] (Citi): Hey, this is Luis on for Daniel. Guidance does contemplate a step down EBITDA margins in the back half of the year relative to Q2. I know that you are rolling out some ground 911 contracts which should benefit NRT. My question is, what is driving the margin compression in the back half? Thanks.

Speaker #5: And I know that you're rolling out some ground manual on contracts, which should benefit NRC. So my question is, what is driving the margin compression in the back half?

Speaker #5: Thanks.

Speaker #4: Thanks, Daniel. I think a little bit of your comparing first half to second half. I think as we mentioned in the first quarter, we really didn't see the exchange impact that we saw really start in the second half or second quarter.

Brian Tierney: Thanks, Daniel. I think a little bit if you are comparing H1 to H2, I think as we mentioned in Q1, we really did not see the exchange impact that we saw really start in Q2 that will continue through the rest of the year. Probably another driver of that is really just the whole Iran conflict related costs. Fuel really did not spike up until the latter part of March. And we have really seen that $10 million plus a quarter really run through the P&L. And then we have seen, call it Iran conflict related costs pop up across the P&L in small ways. Our airfare for moving crews around is up, shipping costs, fuel costs. All of those just add a little bit more to the back half of the year. I know we had a new one yesterday, fuel surcharges on office supply delivery.

Speaker #4: That will continue through the rest of the year. Probably another driver of that is really just the whole Iran conflict, related costs, fuel really didn't spike up until the latter part of March.

Speaker #4: And we've really seen that 10 million dollars plus a quarter really run through the P&L. And then we've seen call it Iran conflict related costs pop up across the P&L in small ways.

Speaker #4: Our airfare for moving crews around is up, shipping costs, fuel costs. All of those are just add a little bit more to the back half of the year.

Speaker #4: I think we got a new one yesterday, fuel surcharges on office supply delivery. So making sure that we're minimizing the deliveries. It's that kind of thing that I think will impact the back half of the year.

Brian Tierney: Making sure that we are minimizing the deliveries. It is that kind of thing that I think will impact the back half of the year. But feel good about our guidance and the range that we have got out there.

Speaker #4: But feel good about our guidance and the range that we've got out there.

Speaker #5: Got it. Thank you.

[Analyst] (Citi): Got it. Thank you.

Speaker #1: We have reached the end of the Q&A session. I would now like to turn the call back to Nick Lobacarroll for closing remarks. Please go ahead.

Operator: We have reached the end of the Q&A session. I would now like to turn the call back to Nick Loporcaro for closing remarks. Please go ahead.

Speaker #6: Thank you again for joining our call today. The second quarter reinforces our confidence in GMR strategy and execution. Underlying performance was strong. Our mix continues to shift toward higher-yielding services, nurse navigation and scaling, and our liquidity position remains strong.

Nick Loporcaro: Thank you again for joining our call today. The second quarter reinforces our confidence in GMR strategy and execution. Underlying performance was strong. Our mix continues to shift toward higher yielding services. Nurse navigation is scaling, and our liquidity position remains strong. We are proud of the role GMR plays across the EMS system, from major events to disaster response to everyday care in the communities we serve. None of this would be possible without our exceptional frontline clinicians, pilots, mechanics, dispatchers, support personnel, and regional leaders. They keep care at the center every day, and I want to thank them for their commitment to patients, partners, and communities. Thank you for your continued support and have a wonderful day.

Speaker #6: We are proud of the role GMR plays across the MS system from major events to disaster response to everyday care in the communities we serve.

Speaker #6: None of this would be possible without our exceptional frontline clinicians, pilots, mechanics, dispatchers, support personnel, and regional leaders. They keep care at the center every day.

Speaker #6: And I want to thank them for their commitment to patients, partners, and communities. Thank you for your continued support and have a wonderful day.

Operator: This concludes today's call. Thank you for attending. You may now disconnect.