DocGo Inc. (DCGO) Earnings Call Transcript & Summary

Good day, and welcome to the iAccess Alpha Virtual Best Ideas Summer Investment Conference 2025. The next presenting company is DocGo Inc. [Operator Instructions] I'd now like to turn the floor over to today's host, Lee Bienstock, CEO at DocGo Inc. Sir, the floor is yours.

Wonderful. Thank you so much. It's great to be with everybody at the Best Ideas Summer Conference 2025. We have a great idea, a big idea. DocGo brings high-quality, highly accessible care to all. It's an old idea. The doctor and care used to come to you, and we do that. We bring care to where patients need it, when they need it. And that big idea, bringing care to patients, meeting the customer, meeting the patient where they are is a big idea. And generally, when you meet the customer where they are, you tend to have a better outcome, and we improve health outcomes. So that's the best idea. That's the big idea I'd love to talk with you all about today and tell you a lot more about it. Before we get started, I would like to remind participants that today's presentation may contain forward-looking statements, which are subject to substantial risks and uncertainties, including those discussed in our 10-K and other filings with the SEC. Actual outcomes may differ material from what is -- materially from what is expressed by these forward-looking statements. And with that, I can really sum up the DocGo thesis with these very key points, and we'll go through all of them today. But DocGo at its core is a leading provider of tech-driven mobile care. As I mentioned, our big idea is bringing care to where patients are when they need it. The only way to do that efficiently, the only way to do that at scale is to leverage technology, much of which we've built ourselves, and I'll walk you through what that looks like. But our platform allows us to manage all of the units we have in the field with the right vehicle, with the right clinician, with the right diagnostic equipment, all for the right patient need, all stacked up together so that we can have each of our clinicians and our units in the field have a full, meaningful quality, impactful day and very efficient. So we leverage our technology to allow us to do that. We have a foundational expanding medical transportation business where we leverage technology to bring patients from care to care across our medical transportation business. We have a rapidly growing care in the home business where we bring care to patients in their home, many of which are patients that are bed bound, have access issues. The traditional health care system has been unable to reach them and we are able to meet them where they are in their home. As I mentioned, we have a proprietary technology backbone. We have a strong balance sheet and the resources to support and fund our growth, and we'll talk about that. The TAM, the addressable market is absolutely massive and expanding. Our country, unfortunately, is getting sicker and sicker. Our health care system is costing more and more money. And our whole goal is to improve outcomes allow -- to allow patients to live healthier, more meaningful lives. And the great thing about that is when patients are healthier, they cost the system less money. So everybody wins, and that's really gets us absolutely fired up and gets us excited about what we're doing in the field day in and day out. And we have a great leadership team. You won't get a chance to meet them or hear from them today, but we have a wonderful dedicated team of people across domains, whether it be medical background. We have great people across all of our teams that are delivering care in the field each and every day. And we have a big vision and big ambition for our company, a 100-year plan for our company. So we'll talk through all of these, but this is the company in summary, this is our thesis. This is everything that we're building towards. So we are on a mission to deliver health care at any address, not just within a hospital, not just within a doctor's office, but at any address. And we believe that when you meet the patient where they are, you improve health outcomes. We have 2 service lines. One is mobile health, where we have an innovative approach, using upskilled clinicians to provide care in the comfort of a patient's home, office or community setting and payers and providers and municipal customers have been leveraging our services to meet patients where they are and serve the underserved and improve health outcomes. We'll talk about that. We have one of the largest medical transportation businesses in the country and across the U.K., where we have a technology-powered state-of-the-art fleet and a wonderful dedicated team of thousands of EMS professionals that are providing medical transportation to large health care systems. We work with hundreds of hospitals today across our footprint, some of the largest hospital systems, which we'll show you in just a moment here. All in, we have over 3,000 clinical staff. We have over 900 mobile health vehicles providing both mobile health and medical transportation services. We provided care across 31 states in the U.K. last year, and we're growing that. Patients love it. When you meet them where they are, our patient Net Promoter Score for our mobile health business is in 87. I think industry average is in the 50s. And because we meet patients where they are, we've been able to save the system a lot of money. We've saved through our ED diversion programs, where we reduce visits to the emergency department. We've saved our partners over $265 million to date, and we're just getting started. Last year, we traveled over 8.8 million miles to deliver care across 1.5 million patient interactions. I mentioned we provided care across 31 states in the U.K. Our health insurance partners have assigned us over 500,000 patients to close gaps in care for these hard-to-reach patients I was talking and we'll talk more about. We calculated over 15 million ETAs with our tech platform, letting hospital systems and patients know exactly when we'll be arriving to provide them care. We filled over 600,000 shifts with our clinical staff. We coordinated over 100,000 behavioral health screenings and over 58,000 vaccinations for both adults and children. So we are really operating at scale, meeting patients across -- a vast number of patient interactions with unrivaled technology and scale. And again, we're just getting started. Our -- we have a strong balance sheet to fund our growth. You can see here our growth both in revenue, but as well as the assets we have on the balance sheet. We have over $100 million of cash on the balance sheet. We'll talk more about the financial profile of the company. But I'd really like to highlight our core businesses, medical transportation and the care in the home, payer and provider businesses have been growing steadily from 2021 through to today. We guided -- our most recent guidance was $300 million to $330 million of revenue. And you see here how it's broken down between medical transportation and payer. And so we've been funding that growth ourselves. Obviously, by going public, we're able to access the public markets, raise funds, and we have a strong balance sheet with all of the resources we need to fund the growth and all of the ambition that we have to make this company a great company serving a lot of the -- a lot of the ALS of the health care system today. You will see here the gray portion of the graph are some of the large municipal deployments we've done for emergencies that have taken place over the course of these last 4 or 5 years, namely COVID. We were mobilized extensively to help [ before ] the spread of COVID. We're one of the largest providers of testing and vaccinations during that infectious disease outbreak and obviously, in that moment in time. And more recently, we were called up and utilized to help with the migrant crisis and providing care and medical care and screening and behavioral health care for the asylum-seeking migrant population that has come through to the U.S., particularly in New York City. And so we've been providing care and support across those 2 emergencies. And so we have that listed here in terms of where you see with the revenue. Those gray bars represent those projects, particularly. And you see here that we're guiding this year that $300 million to $330 million only includes a small residual portion of the migrant work that's continued into this year, obviously, no COVID anymore, but the growth of those medical transportation and those payer and provider care in the home businesses. And we're excited about the resources we have and the opportunity that we have ahead of us. And we see here really highlighting the growth of those businesses, those base businesses, those core businesses, even without the once-in-a-lifetime sort of infectious disease and other sorts of emergency mobilizations. Hopefully. But we're very proud of the work we've done during those crises. Like I mentioned, our balance sheet is improving. We had a large capital outlay to fund the mobilization to help in those crises and those emergencies. And we outlaid a lot of capital to mobilize and help in those instances and those receivables are coming down. Those are being converted to cash on the balance sheet, those receivables as well as our days sales outstanding for our billing and our collections cycle has been going down again with those resources converting on to the balance sheet. As of our last quarterly call, we had a total of $103 million of cash on the balance sheet, up from about $58.9 million from the year prior. So we continue to convert those receivables and our days sales outstanding continues to go down and convert to more and more resources on our balance sheet. We shared on our last earnings call, our Q1 results, we did $96 million of revenue in the quarter. Our gross margin -- our adjusted gross margin was 32.1%. We continue to invest in the business. Our adjusted EBITDA loss was $3.9 million. As I mentioned, we have the resources to grow and scale the company. And our mobile health segment revenue was $45.2 million, and our medical transportation revenue was $50.8 million. Pretty consistent margins, 31% on the mobile health and about 33% on medical transportation. As I mentioned, we have about over $100 million of cash on the balance sheet. Again, those receivables continue to convert and add to that cash position. And we do have a line of credit that we can leverage that we have leveraged with Citibank, and we have about $30 million -- we have exactly $30 million outstanding on that. We continue to highlight the growth we have. We signed a major contract with a large New York health plan to offer DocGo primary care services to their members in their home. We surpassed now 900,000 patients assigned to the company's payer and provider partners. As I mentioned on previous slide, at the end of last year, in 2024, we have about 500,000. Now at this point this year, we've increased that from 500,000 to over 900,000. We signed a contract that extends the company's California-based cardiology group, with a cardiology group to do cardiac monitoring for those patients, added 1,000 patients to our platform, and we continue to add features to our tech stack, our industry-leading tech stack that helps health plans and health systems manage the flow of patients and the patient visits. So I want to talk a little bit about really the vision for the company and why we think there's such a huge opportunity ahead. It's sad to say, but chronic disease is just a massive issue for the U.S. health care system. The CDC estimates that 90% of the nation's $4.5 trillion in annual health care spending is for people with chronic disease and mental health condition. So if we can really help that portion of the population that's suffering from these chronic conditions, that's suffering from mental health condition, we can do a lot of good and save the system a lot of money. And that cost that's being borne on this percentage of the population, that's the vast majority of the spend creates a substantial challenge for payers, for providers, for our Medicaid and Medicare programs. And it's just that we feel like will drive demand for our services because if we're able to improve outcomes, ultimately, healthier patients lead, of course, to better outcomes for patients, but also those patients then cost the system far less money. And that's the wonderful aspect of our business. If we're able to help patients lead healthier lives, patients are much better off. If the patients are better off, that means the system is less burdened by the cost. It's saving the system money. So the system and our governmental programs, Medicaid to Medicare are better off and then we do well as a company. It's one of those great scenarios where the patients do better, the system does better and our company does better as a result. And we're just so excited about the opportunity to both help patients, help the system and, of course, build a great company. And this is a big opportunity. As I mentioned I want to talk a little bit more about what we do with the partners we work with. We have tailored solutions for crucial, crucial stakeholders in the health care system, payers and providers, they have a percentage of their members of health plans and providers that are in value-based arrangements of patients that have chronic conditions, but for whatever reason, are not getting the care they need. They have gaps in care. They are costing the system a lot of money. And so we provide care in the home programs to reach this hard-to-reach population, and we go to their home and we close care gaps. We provide primary care services. One out of 4 Americans doesn't even have a primary care provider or know who that primary care provider that's assigned to them is. And the first primary care visit saves the system $4,000 just by having that proactive primary care annual wellness visit. We provide virtual care management, population health and medical staffing for payers and providers. And the value proposition is clear. We increase access to care by treating bed bound and unattributed hard-to-reach patients overall lowering the total cost of care. Very powerful, especially in this world of decreasing budgets, higher utilization, being more efficient and being able to reach patients in a more efficient, cost-effective, better outcome way is very, very valuable. And then for health systems, so we work with the payers and the providers. We also work with health systems to provide medical transportation and transitional care management programs. Efficient, reliable medical transportation, I'll talk a lot more about what that looks like. And ultimately, hospital systems don't want patients bouncing back within a 30-day readmit window because they don't get reimbursed for that, and they don't -- and it hurts their quality measures. And so helping transition patients out of the hospital to their next care setting and helping ensure that they don't bounce back to the hospital is obviously great for patients. It's also very much valued by the hospital system partners we work with. So this is who we work with. They assign us the patients. They identify the patients that are in need. They tell us which patients are getting discharged. So it takes a lot of the guesswork or patient acquisition cost out of the process. We contract directly with these, and I'll show some of the logos we work with, we contract directly with these crucial stakeholders in the health care ecosystem, and we bring very clear value to them for the metrics and for the impact that they very clearly are trying to measure and make progress on. And I'll do a deep dive into both. So mobile health, mobile health, these are some of the customers we work with, and they assign us patients that are in need of care gap closure, primary care services, and I'll talk a little bit about what that looks like, but we've been able to sign and we have a very nice robust pipeline of additional customers that we're working with now to get launched. But 30% of the PCP market is expected to shift from -- to nontraditional providers like ourselves according to Bain. And about -- the addressable market of mobile health is about a $265 billion market for care in the home according to McKinsey. So these are not our numbers. This is sort of -- a lot of the care is being transitioned to new settings. The home is probably one of the most crucial settings that's being transitioned to. And because of technology and innovations like some of the models we're bringing to the market, more and more of that is going to be accessible to patients, and it's a gigantic addressable market that we think is good for patients and good for the system. So payers and providers, they're looking for solutions to increase access and improve quality metrics, reduce their overall cost. And we offer a broad range, perhaps the broadest range of services that is available in the home that we can do, including mobile phlebotomy, urgent care, care gap closure, transitional care management, PCP and other services that bring care to patients. The way we do it, we do not send a doctor door-to-door. There's too much drive time. There's too much downtime in that. We send an LPN on-site, a licensed practical nurse. And we use that advanced practice provider in a central location that is overseeing that hands-on clinician in the home via telehealth. So it's the best of both worlds. You have the efficiency of telehealth, and I'll talk more about that model, but you have the efficiency of telehealth and the centralized clinician with the hands-on clinician in the home that's able to take labs, that's able to see inside the ear, nose and throat and send that diagnostic back to that centralized expensive resource. We close over 30 more different care gaps in the home. And the way we manage it all is through our proprietary technology platform that helps us drive that efficiency that's very crucial when you're running a mobile service like ours. So to talk about that efficiency, here's what we do, what we do. I mentioned in the onset, this is the Best Ideas Conference. This idea is an old idea. The doctor used to come to your home, but it was incredibly inefficient, right, to have this very specialized, very skilled resource going from home to home, right? There's just too much commute time. There's too much drive time. And so eventually, the system oriented to the doctor being in a central location and having all the patients come to him or her. And so we put that back a little bit. We basically send a licensed practical nurse equipped with diagnostic technology, with the ability to take blood, the ability to do ultrasound, the ability to take readings, the ability to send back images and real-time synchronous view of the patient's ear, nose and throat, listen to the chest. And they're sending that LPN that's driving door-to-door is sending back that -- those diagnostics to a centralized clinician, the centralized advanced practice providers, such as a physician assistant or a upskilled clinician that is then overseeing those visits. And while the LPN is going home to home, maybe doing 1 patient an hour or so, our remote APPs that are overseeing each and every one of these visits can do multiple patients per hour. And that efficiency is what's driving our model and technology has unlocked our ability to do that. And this platform can be leveraged across a multitude of different use cases. And here's just a continuum. We do mobile phlebotomy, care gap closure, transitional care management. We have staffed clinics, urgent care and PCP services. We can do it in the home. We can do it in telehealth. We can take mobile clinics and park them anywhere, take them deep into communities that are underserved and give access in a way that's innovative and next generation and allowing us to do multiple services leveraging this platform. It all comes down to access and ultimately, access drives better outcomes. That's mobile health. Our other segment of the 2 is medical transportation. That also is a multibillion-dollar addressable market, where we have a full vertical integration, and I'll talk more about that, but we provide nonemergency medical transportation between clinical settings and patients' residences. You see here a picture of our -- one of our great crews and what those ambulances are. You may see those light blue ambulances running around your cities, providing care. We provide a full continuum of medical transportation services. We provide the software that the transfer centers can utilize, and I'll talk more about that in a minute. And that proprietary technology paired with the fleet of ambulances and crews is a tremendous, tremendous value proposition. These are some of the customers we work with. We work with the largest hospital systems in the markets that we serve. We also work with the NHS in the U.K., and we help provide them with seamless medical transportation. Why does that matter? Patients that have to stay an extra night in the hospital because the transportation was not provided to them cost the system a lot of money. That bed needs to be freed up, and I'll talk about how our tech platform helps with that. Such that it could be used for the next patient that desperately needs it. Those hospital beds are scarce resources. It takes the system. It costs on average, $3 million to bring a new hospital bed into the system. And so we could be more efficient and help our hospital partners be more efficient with the hospital beds they have, that's a huge win. And we do that with our technology platform that we've built proprietary, and it's a mobile health and medical transportation management platform. It's integrated with the hospital system's EHR such as Epic. And directly from the patient's chart, a clinician that is discharging -- a discharge nurse that's discharging a patient, click a button, and they can see exactly when we're arriving so that he or she knows when to get the patient ready for discharge when we'll arrive on scene. In addition, intake is going to get notified that when that bed is being freed up for the next patient, housekeeping is going to know when to come and get that bed turned over so that we can be super efficient on the bed management side. So not only transporting the patients, but really integrating with the hospital systems so that the beds are freed up and made ready and utilized for the next patient that needs it. And so the discharging nurse knowing exactly when we're going to arrive, that ETA, that Uber-like experience. And so that is very, very valuable to the health systems, and this is the technology that we've built -- purpose-built. I know we're running short on time. I do want to get some questions in, so I'll wrap up here in a minute or so. But I really wanted to highlight the company -- while we've wound down some of the municipal work that we've been doing on COVID and migrant, the company continues to grow this medical transportation and care gap and care in the home business. You see some of the metrics here. We've never done more medical transportation than we're doing now. We've never done more care in the home than what we're doing now. And we just think there's a massive opportunity in front of us to continue to scale. And you see here some of the growth metrics that we're projecting out. You can spend some time. There's a more background on our team, but we have our Chairman of the Board. You may know Dr. Stephen Klasko, world renowned. He's a former -- he's the former CEO of the Jefferson Health System. He is currently an executive resident at General Catalyst. He's a physician by training and obviously a great, great partner for us as we scale out our health care offering. You've got a chance hopefully to know me a little bit more. My background is in tech and scaling platforms such as this. And we have a great team with Norm and Dr. Powell. We have a tremendous medical advisory board that's weighing in on our programs and our clinical efficacy and design. So I invite you to take a look at all those people that are helping build our great company that's detailed that on our website. We vertically integrated everything. We've talked about it. We have our proprietary tech platform. We have our own staff, our lab license, our clinical practice group, all together so that we can do this care at any address. And that vertical integration is both a competitive moat and allows us to give a great patient experience. We're pretty unique. If you look across what we offer and compare to others out there that are doing this, very few have all of the capabilities that we're able to offer. Okay. I'm going to jump to our key takeaways, and then I see we have a few questions, which I'll do some rapid fire in the Q&A. But again, just the key takeaways, I hope you've taken from our presentation today. We have a strong balance sheet. We have our defensible competitive advantage in our technology and our vertical integration. We have a very unique value proposition that benefits both the patients and the payers and providers in the hospital systems and we're building this recurring revenue base with great -- with a roster of tremendous customers that we're so privileged and honored to be working with. And I think our team is just fired up every day to come in, knowing that we're helping patients live healthier, better lives.

Let me check quickly for some of the questions we have in here today. The HHS Secretary Kennedy says, we're expanding rural health access through innovators in telemedicine and AI-powered diagnostics, bringing cutting-edge care to every corner of the country. Does that DocGo give -- does this give DocGo a tailwind? We think it does. We think our ability to be mobile. We think our ability to be out in the field to bring care deep into communities is absolutely what Secretary Kennedy is talking about. But more broadly, we feel there's been a lot of talk of lowering the total cost of care, being more efficient, dropping budgets, we feel like we fit well into that. Our whole goal is to help the system save money. So why is there going to be this growth now? There's no crisis like COVID to make money. This really needs to have a spike in home care. Why is there going to be a spike now? So we feel like there is a big, big percentage of the population that doesn't have great access to care. And very often, the best site of care is often the patient's home. The last place you want to be perhaps when you're sick is in a waiting room, and there are just patients that are not able to access the system and they are costing the system a lot of money. And so at the end of 2023, we were working with one payer that gave us 2,000 patients that needed -- that had these gaps in care. And today, I shared all the payers we're working with have given us over 900,000. And we think, yes, patients that are being served by the traditional doctor's office, that's great. But there are a lot of patients that are falling through the cracks, that are drifting that are unattributed and unfortunately, are very sick. And we feel like if we can go and meet them in their home, close care gaps and bring them care where they are, there is a tremendous need for that and a very, very large TAM. I see we're at time. Perhaps we'll leave it there. But we are available. You can reach out to our Investor Relations team. I spent a lot of time with investors, getting feedback, getting input into the business and sharing a lot of the great, great opportunities that we're working on. So absolutely go to our website, reach out. But we're excited to be joining you here at this Best Ideas Conference, and we're very excited about the big idea and the big opportunity we have in front of us. Thank you so much for joining us.