DocGo Inc. ($DCGO)

Good afternoon, ladies and gentlemen, and welcome to the DocGo Fourth Quarter and Full Year 2025 Earnings Call. [Operator Instructions] This call is being recorded on March 16, 2026. I would now like to turn the conference over to Mr. Mike Cole, Vice President, Investor Relations. Please go ahead.

Thank you, operator. Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. All statements made in this conference call other than statements of historical fact, are forward-looking statements. The words may, will, plan, potential, could, goal, outlook, design, anticipate, aim, believe, estimate, expect, intend, guidance, confidence, target, project and other similar expressions may be used to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance, and we cannot assure you that we will achieve or realize our plans, intentions, outcomes, results or expectations. Forward-looking statements are inherently subject to substantial risks, uncertainties and assumptions, many of which are beyond our control, and which may cause our actual results or outcomes or the timing of results or outcomes to differ materially from those contained in our forward-looking statements. These risks, uncertainties and assumptions include, but are not limited to, those discussed in Risk Factors and elsewhere in DocGo's annual report on Form 10-K, quarterly reports on Form 10-Q, our earnings release for this quarter and other reports and statements filed by co with the SEC to which your attention is direct. Actual outcomes and results or timing of results or outcomes may differ materially from what is expressed or implied in these forward-looking statements. In addition, today's call contains references to non-GAAP financial measures. Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are included in the earnings release and the current report on Form 8-K that included in which is posted on our website ao.com as well as filed with the SEC. The information contained in this call is accurate as of only the date discussed. Investors should not assume that statements will remain relevant and operative at a later time. We undertake no obligation to update any information discussed in this call to reflect events or circumstances after the date of this call or to reflect new information or the occurrence of unanticipated events, except as to the extent required by law. At this time, it is now my pleasure to turn the call over to Mr. Lee Bienstock, CEO of DocGo. Lee, please go ahead.

Thank you, Mike, and thank you all for joining us. Today, we announced a strong close to the year, reporting $74.9 million in fourth quarter revenue and an adjusted EBITDA loss of $11.6 million. While our revenue exceeded expectations and enabled us to beat the top end of our revenue guidance, our adjusted EBITDA loss was slightly greater than expected largely due to costs associated with the final wind-down of our migrant related programs in the fourth quarter, which we do not expect to recur going forward. Additionally, on the back of new customer expansions and improved hiring rates, we are increasing 2026 revenue guidance to $290 million to $310 million compared to our previous guidance of $280 million to $300 million and when combined with our cost efficiency initiatives, we are now expecting an adjusted EBITDA loss of $5 million to $10 million compared to our previously projected adjusted EBITDA loss of $15 million to $25 million. I'd like to take a few minutes and cover the details driving this improved outlook. First, we are seeing an absolutely stellar performance from our virtual care offering, SteadyMD. During the fourth quarter, StudyMD exceeded $8 million in revenue for the first time in its history, beating the previous quarterly high by approximately $1 million. As we did not acquire SteadyMD until late October, we recorded $6.1 million in DCO's fourth quarter results. At the same time, StudyMD's full year-over-year gross margins improved from approximately 30% to 37% and with the dental gains expected in 2026. Our integration efforts remain on track, and we are aiming to consolidate provider networks so that steady and de clinicians will be able to provide care for patients across Taco's mobile health offerings by the end of the second quarter. For the full year 2025, StudyMD exceeded 4 million patient interactions consisting of approximately 3 million lab orders and 1 million synchronous and asynchronous telehealth visits. That compares to approximately 2.5 million patient interactions in 2024, which consisted of approximately 2 million lab orders and 500,000 synchronous and asynchronous telehealth visits. The fourth quarter performance was exceptional, and we anticipate this strong growth to continue, driven by the recent announcement of major customer expansions to meet the needs of our customers' branded GLP-1 weight loss programs. Second, we are seeing considerable improvement in our hiring rates to support strong demand in our Medical Transportation segment, allowing us to outsource fewer rides and recognize the associated revenue. I want to be clear, we still have considerable work to do, but we have filled 206 ENT and paramedic roles out of the 546 that were opened at the end of last quarter. In Q4, we saw overtime rates in this segment in the teens above our target in the mid-single digits. We are seeing this overtime rate gradually decline as hiring continues to improve, which we expect will provide some additional margin improvement potential as we progress through the year. I am extremely enthusiastic about the progress we are making to bring the doctor's office into the patient's living room and the continued strength in key metrics across our business. For example, when we compare our Q4 2025 metrics to Q4 2024, medical transportation trips increased 11%. Health care and the home visits were up 113%, mobile phlebotomy visits were up 16%, remote patients monitored increased 16%, and telehealth and lab orders were up 50%. We also continued expanding our care gap closure programs with 1 of our top 10 national insurance payer customers to provide annual preventative exams in the state of Kentucky, which is expected to launch later this month. We are working with this payer across California, in New Mexico and now Kentucky. For our care gap closure program as a whole, we saw a 12% sequential gain in the number of assigned lives increasing from 1.3 million last quarter to over 1.45 million currently. As we grow our business with insurance payers, we continue to refine our approach to care delivery in a manner that drives efficiency and maintains our exceptionally high customer satisfaction rate which was measured at an NPS score of 92% as of March 1. To that end, we're planning to leverage SteadyMD's clinical network to provide the virtual portions of our visits starting in Q2 and we continue expanding our use of genic AI and workflow automation for administrative and patient support functions. While we will continue to invest in this business, we expect that level of investment to decline considerably as early markets mature and become more self-sustaining, reducing the cash outlay in 2026. Our goal is to grow this business, which we believe has significant future strategic value in an efficient manner that both minimizes investment and supports our goal of achieving profitability in the second half of 2026. Our remote patient monitoring business was another bright spot during the fourth quarter, generating record revenue of $4 million and $830,000 in adjusted EBITDA for the period. This performance was driven by a 16% increase in the number of patients monitored when compared to the same period in 2024 with strong growth in our virtual care management offering. We are seeing substantial margin gains in this business as greater economies of scale are achieved and we expect continued improvements in profitability over the balance of 2026. Additionally, we launched our efficiency innovation portfolio in Q4. This is a collection of more than a dozen projects designed to increase efficiency and create more operating leverage in our P&L. These projects span our medical transportation, mobile health and corporate segments and are anticipated to deliver approximately $5 million to $6 million of savings in 2026 and approximately $20 million to $24 million of savings in '27 when we experienced the full annual benefit of these projects. Central to this work is our use of technology, which has always been a focus and key differentiator for DocGo. We've already incorporated a genic patient outreach into our proprietary Dara ordering and routing platform, and we introduced automation into our prebilling function to increase efficiency. We're planning to expand these initiatives and bring others online in the coming months. I look forward to sharing more about these efforts on future calls. We shared in our earnings release earlier today that DocGo has initiated a process to explore a range of strategic alternatives designed to maximize shareholder value. We make no assurance that this process will yield positive results or that any transaction may be identified or undertaken. Finally, I'm often asked when DocGo will achieve profitability, and I always say it's a confluence of 3 key components: our top line revenue, our gross margin and our SG&A. With regards to revenue, we continue to see strong demand for our services and top line growth across our volume metrics. Our gross margin is improving due to our progress in hiring and reducing our overtime costs, and we expect our SG&A to improve as our efficiency innovation portfolio projects take shape and make a real impact. At this time, I will now hand it over to Norm to review the financials. Norm, please go ahead.

Thank you, Lee, and good afternoon. Total revenue for the fourth quarter of 2025 was $74.9 million compared to $120.8 million in the fourth quarter of 2024. The year-over-year revenue decline was entirely due to the wind down of migrant related projects. Removing migrant-related revenues in both periods, we saw a revenue increase of 11% year-over-year in Q4. For the full year, total revenue amounted to $322.2 million in 2025 compared to $616 million in 2024. Medical Transportation services revenue increased to $50.2 million in Q4 of 2025 from $49.1 million in transport revenues that we recorded in the fourth quarter of 2024. Revenues were driven higher by gains in both large and small U.S. markets with some of the strongest growth in markets like New York, Texas and Tennessee. Mobile Health revenue for the fourth quarter of 2025 was $24.8 million, down from $71.8 million in the fourth quarter of last year, driven by the wind-down of migrant revenues. Included in this year's amount was approximately $7.4 million in migrant related revenues. Nonmigrant global health revenues increased by 47%, driven by increases in care gap closures, remote patient monitoring and mobile phlebotomy and by the inclusion of 2 months of revenues from SteadyMD, which we acquired on October 20. Adjusted EBITDA for the fourth quarter of 2025 was a loss of $11.3 million compared to adjusted EBITDA of $1.1 million in the fourth quarter of 2024. For the full year, the adjusted EBITDA loss was $28.6 million in 2025 compared to adjusted EBITDA of $60 million in 2024. The adjusted gross margin, which removes the impact of depreciation and amortization and is the measure of margins that we track most closely was 32.5% in the fourth quarter of 2025 compared to 33.5% in the fourth quarter of 2024. During the fourth quarter of 2025, adjusted gross margins for the medical transportation segment were 32.8% compared to 30.1% in Q4 of 2024, and the highest gross margins that we've seen in that segment since Q1 of 2024. Despite these improvements, medical transportation gross margins are still being restrained by higher-than-planned effective hourly wages for field labor. As we pointed out on the last call, our transportation business has been running at the highest utilization rates that we've seen leading to higher overtime rates. Over time, accounted for about 13% of hourly wages in Q4 and has been running between 11% and 13% for the past several quarters. However, we took solid strides toward increasing our field headcount in the fourth quarter of 2025, and we would expect the overtime rate to trend lower in 2026, closer to the sub 10% overtime rates that we saw in the first half of 2024. This should provide a lift to transportation gross margins in 2026. Mobile Health segment adjusted gross margin was 31.8% versus 35.9% in the fourth quarter of 2024. As we completed the wind down of migrant related programs, we experienced significantly lower gross margins in that area, which were below 20% for the quarter. We expect that Mobile Health segment gross margins will improve in 2026 in the absence of these wind down costs and with greater relative contributions from higher-margin service lines such as remote patient monitoring, mobile phlebotomy and virtual care. There were several nonrecurring noncash items that had a large impact on our GAAP results this quarter, so I'd like to spend some time reviewing them. Within the operating expense category, we incurred noncash charges due to the write-down of intangible assets and goodwill. The write-downs were driven by the persistent gap between the carrying value of our assets and our market cap. We began this process in the third quarter when we wrote down the goodwill and intangible assets relating to our clinical staffing business. Even after these write-downs, entering Q4, there was still a significant amount of goodwill and intangible assets on our balance sheet, primarily due to the acquisitions we have completed over the past 4 years. Throughout the fourth quarter, our market capitalization remained well below our net asset value requiring us to consider adjusting the valuation of all of our intangible assets and goodwill in an attempt to narrow this gap in accordance with ASC 350 and ASC 360. At year-end, we have now written down all the intangible assets and goodwill to 0. This resulted in a total goodwill impairment of $49.5 million and an impairment of intangible assets of an additional $22.6 million in the fourth quarter. Along these lines, within the other expense category, we impaired the entire carrying value of an equity investment into a health care company we made in previous years, which had an impact of $5 million in other expense. It is important to note that these write-downs are all accounting driven and noncash in nature. In no way do they reflect the change in the company's outlook regarding the future prospects or profitability of any of these underlying business lines? At year-end, our total cash and cash equivalents, including restricted cash and investments was $68.3 million, down from $95.2 million at September 30, 2025. The largest factor in the decline in cash was the acquisition of SteadyMD in October. We paid $12.5 million in cash for SteadyMD and incurred additional transaction-related costs of approximately $1.5 million. Our cash balance at year-end was lower than we had expected due to the delay in collecting migrant related accounts receivable owed by New York City's Department of Housing Preservation and development, which we had expected to see during the fourth quarter, coupled with an ongoing operating loss. With further operating losses expected during the first half of 2026 and several growth-related initiatives requiring working capital, we would expect further declines in cash in the near term, creating potential working capital pressure during 2026. To mitigate this, we are highly focused on reducing cash utilization and operating costs, particularly at the corporate level. We're also working with our current credit line provider to remedy issues related to certain financial covenants, which may increase borrowing costs while providing us with greater flexibility. Turning to 2026. As Lee mentioned in his comments earlier, and as we pointed out in our press release, we have updated and increased our guidance for 2026, based upon what we've seen in the first 2-plus months of the year and the positive volume trends across most of our business lines. We now see full year revenues in the range of $290 million to $310 million, up from the range of $280 million to $300 million that we had shared back in November. This does not include any revenues from migrant-related projects and represents a 15% to 23% growth over 2025 space revenues. We anticipate a full year adjusted EBITDA loss in the range of $5 million to $10 million compared to our prior guidance of a loss of $15 million to $25 million. In addition to the increased revenue outlook, we have several cost-cutting initiatives underway that we are addressing with the efficiency innovation portfolio efforts that Lee previously outlined, which we believe can accelerate our pathway to profitability. We continue to expect to achieve profitability on an adjusted EBITDA basis in the back half of this year. At this point, I'd like to turn the call back to the operator for Q&A. Operator, please proceed.

[Operator Instructions] And your first question comes from the line of Pito Chickering from Deutsche Bank.

I guess just to lead off here. You talked about doing your formal process a lot of strategic alternative. Just can you give us any color on sort of what the process entails, and any color on is going so far?

Peter, absolutely. Thanks for the question. So we've engaged an investment bank to run a formal process with the goal of maximizing shareholder value. We can't share more at this time as we're in the process. But of course, as things progress, if they do progress, we'll share more at that time.

Okay. I figured as much, but if I look ahead to ask here. Can you about the improvement in the 2006 guidance in both revenue and EBITDA from upside from SteadyMD or improvements in mobile health or transportation or SG&A? Just any color because you raised revenues by $10 million and adjusted EBITDA by $10 million to $15 million.

Yes, absolutely. Thanks for that question as well, Pito. So we're seeing increased volumes in -- particularly in our Medical Transportation segment, where we've also made progress on EMS staffing. Those are the 2 key components really for the increased revenue outlook of about $10 million. We are seeing additional upside in SteadyMD and those, I would say, are the primary drivers of our increased guidance. Both volumes in SteadyMD are up significantly as well as our ability to fulfill the volumes that we've seen in the Medical Transportation segment with additional hiring that we've been successful with we still have some additional room to run on the staffing. That's going to be a continued focus for us on the EMS side. But that's really been the driving factor of the revenue guide increase. On the EBITDA side, it really is a factor of, a, the revenue increase provides most -- more gross profit dollars. We're also seeing gross margin improve with reduced overtime that Norm pointed out. And so we see gross margin improving as we start the year here and as we progress because we've been able to staff more efficiently and drive that overtime rate down. And then again, we're also very focused on reducing SG&A by another 10% to 15% from recent levels with some of these efficiency innovation portfolio items that we've already kicked off. These are areas where we're working to automate many of the functions in billing, in dispatch where we can utilize perhaps fewer staff members but leverage automation to make us more efficient. And we've already kicked that off. I mentioned [ 3 ] billing is an area where we've already made that automation process improvement and there's going to be other areas as we progress throughout the year here as we use technology to become more and more efficient and take costs out of the business. That's what's really driving the EBITDA improvement, the EBITDA outlook improvement. Norm, anything to add?

Yes. I mean I would just say that when we look at the gross margin, the exit rate of gross margin, in the fourth quarter. So we showed it was around 32.5%, 33% on a blended adjusted basis. But in reality, 1 of the things -- exactly a couple of things that were holding us back in the fourth quarter that have already improved here in the first 2, 2.5 months of the year. Number 1 is on the transport side. So as Lee mentioned, there's the overtime rate, which is -- it can't be overstated in terms of the impact, that having a higher overtime rate has on your overall gross margins, it raises your effective hourly rate. If we look at the fourth quarter, the effective hourly rate for field labor was probably the highest that we've seen. And it has since moderated along the lines of having our overtime rate come down like 13% closer to the 10% area that we had seen in the first half of 2024. So that's 1 driver. The other part of it is when we look at the mobile health revenue or the Mobile Health gross margins, so on its way out, the migrant revenue came in at a much, much lower gross margin level than it had. It's traditionally been running in the 35% to 38% gross margin range. Then in the third quarter of last year, it ran in maybe the high or mid-20s and then under 20% and it's a little bit of a stranded cost thing, but it's more a matter of just sort of having people on staff until the end of the year. Some of those projects ended midway through the month of December. And you're left with a little bit of cost. Those costs are all gone. There's not going to be any of it in Q1 along with those revenues. So when we think of the exit rate and then we think what we had pegged the gross margin at our original guidance, especially in the first half of the year, we think we're running at a level at somewhat above that.

Okay. Excellent. And then last question here. You talked about sort of free cash flow pros potentially negotiated covenants here. Can you just sort quantify what free cash flow generation or free cash flow declines will be sort of during 2026. And any color on how we start in the year. And just to be very clear, does that include or not include collections in the rest of the migraine business?

Okay. So a little bit to unpack there, so we'll do it in order. I mean the first thing to point out, and we did talk about it here in our prepared comments, our cash balance at year-end was lower than what we had pegged it to be. And that's simply because there's about $20 million of those migrant receivables. The last piece of it, we've collected 97% of everything up until now. That did not come in during the fourth quarter, that still has not come in yet in the first quarter. I believe that a good chunk of that is imminent. By that, I mean I still think that some of it is going to come in during the first quarter, even though it was only about a couple of weeks ago. So it's pretty imminent and the rest will come in in the second quarter, maybe in the third quarter, but we expect to collect all of it. So when I look out a few months, I wouldn't expect there to be any net difference. But yes, that's $20 million of receivables or $20 million of cash that I would have expected when we last spoke in November of last year that I would have expected to have had in the door and in the bank by the end of the year. So that's 1 factor. But again, getting to your other question, very clearly, it doesn't change -- our outlook hasn't changed as to the ultimate collectability of that money. I'm just looking at a cash balance is somewhat lower than it had been before. We do have working capital requirements. As Lee mentioned, we're bringing on a lot of new people on the EMT side. So you bring on EMT, you start to pay them, you get them out in the field, working on the truck, they do more volumes. And then those are typically paid within 80 to 90 days. So you've got a little bit of your typical growth working capital needs there as well. So that's really what we're talking about. As far as the vendor -- the line of credit is concerned. So we have your typical, I'll say, EBITDA covenant or adjusted EBITDA covenant, and it's no secret. We've been running it at an EBITDA negative level for a good few quarters. So that's one of those things that we need to work through with them. We're in the process of working with our credit line provider in terms of how they interpret that and those kinds of adjustments to make sure that, that line of credit remains available to us. We have not tapped down on it since we -- drawn down on it since we paid it back in August of last year. But it would be nice to know it's there. Certainly nice to was there. So that's a big part of it. As far as -- I want to avoid I think I learned my lesson, I want to avoid like looking into the crystal ball and talk about exactly how much cash will be there at what date. But just to give you an idea of the trend, as we mentioned, I think the next couple of quarters where we expect some negative EBITDA, at least in Q1 and Q2 and into Q3, that will probably result in a somewhat lower cash balance. But again, it depends on the timing of that -- of the payment of the remaining migrant receivables. When they come in, that will cover up the loss. And technically, that could keep us at a somewhat flat level. So all of it really depends on the timing of that and the timing of some of the payments that we make. But then as we get towards the back part of the year, and we're looking at relatively small EBITDA losses or even positive EBITDA numbers as we get to the back end of the year, then we should see a sort of a plateauing of that particular cash balance.

And your next question comes from the line of Ryan MacDonald from Needham & Company.

Maybe, Lee, just on the payer business first. Obviously, some great momentum there in terms of covered lives that you continue to grow there, the expansion into Kentucky as well. And I think earlier this year, at our conference, you were talking about sort of a pipeline of 2 to 4 more incremental payers that you could sign on within the first half of this year. Just any update on sort of what that pipeline looks like and if that's being factored into even the increased top line outlook, if at all, that you set today.

Absolutely, Ryan. Thanks for the question. Great to hear from you. So the forecast that we have, the forecast that we shared today is consistent to what we shared in our previous call. We continue to see momentum in this business. The number of visits is up significantly as we mentioned, the number of lives and patients that are being referred to us by the payers is up, and we continue to balance scaling that business with also obviously, the investment we're making in that business. And that's the key factor there. I think the reason why I was excited to share the expansion into a new state by a payer we're already working with in 2 other states is just that is a great harbinger for us that the value we're providing to our partners is there. They're looking to us to expand and provide that value to additional patients in other states. And that is a good indicator to us that, of course, patients and the partners we're working with are deeply valuing the services we're providing. And so that makes us very, very excited. And of course, we see it every day when we go visit patients and see the impact we're making. So that's the momentum we're seeing. We're really focused on making sure that we're growing efficiently, that we're continuing to scale while balancing the investment we're making in this business so that we could achieve really critical mass in the markets -- the markets we're in and be very selective about whatever markets we expand to primarily with existing customers of ours. So that's the focus. I think you'll see us visit in the patient's homes, about 200,000 patients this year across our mobile lab and care in the home business. Care Gap, transitional care management, primary care is another big focus of ours where we're seeing good progress. We always endeavored when we entered this business to not only close care gaps, but provide longitudinal preventative care. That's when you can really impact the cost of care, improve health outcomes, and so we're seeing great progress there as well. So that's what the forecast consists of as, of course, if we sign additional contracts, we'll announce those and then adjust accordingly as we go throughout the year.

Excellent. Appreciate it. Obviously, there's a lot of moving parts at the gross margin level this year with some of the migrant revenues coming off, a reduction in overtime rates, also sort of shifting SteadyMD to -- or integrating it to the point where you can start doing more of the mobile health visits through that platform in the second quarter. Can you just kind of give us a sense of sort of implied in the forecast, where you're thinking in terms of gross margins at each segment level on the overall level as you're thinking about the 2026 guide?

Sure. So, at the risk of sounding redundant like everybody else in the world, we do expect sequential gross margin gains as we go through the year. That's the first thing I'll point out. But I think that might -- whether that plays out or whether we end up doing better in the first and second quarter and a little bit less in the third and fourth quarter compared to where we are. But on a full year basis, we would expect the blended gross -- the consolidated blended gross margin to come in right about 33%. So that will be a little bit of a pickup. On the transport side, where we're currently running at about last quarter, our adjusted gross margin was, I think it was 32.8%. I would always be clear about it. There's a certain limit to where gross margins go. I think that once we get to a point where we would have gross margins on the transport side of 34.5% to 35%, can probably, probably end up seeing that scale back a little bit. So I would say that on the transport side, that number is going to be hopefully somewhat higher than -- a little bit north of 33%. As we go through the full year, and I can point to certain markets where we're certainly expecting a turnaround and there are 1 or 2 markets that are currently holding us back that we've already seen better improvement or some improvement in Q1. So that's the transport side. And then Mobile Health, a lot of it is going to come down to mix. We have a group of -- obviously, the health plan provider, the care in the home business is a much relatively lower margin than what we see otherwise. But then the mobile phlebotomy business comes in at a high-margin SteadyMD comes in at a pretty high margin, but we've talked about how they've had to rapidly expand. So you might even see a period of time where SteadyMD margins are taking a little bit of a step back, along with some growth that's above plan. But then you have your relocation monitoring business, which is chugging along, which is increasing both on a year-over-year and sequential basis and the margin is hanging in there and it's north of 50%. So we would like to see mobile health margins get back to, let's say, a 35% blended basis blended level for the year, and that would sort of get you that 33% for the full year.

And your next question comes from the line of David Larsen from BTIG.

Can you talk about for the 2026 guide, the different sort of revenue components in the past, you've kind of disclosed it like by division, transport, municipalities, health systems, payers or also by like RPM, virtual primary care -- any of those sort of sort of details by division would be very helpful. Absolutely, Dave. Thanks for the question.

So I think if we take the midpoint of our updated guidance, call it, $300 million as the midpoint, we're expecting now that transport is going to come in somewhere around $215 million. We think there's some additional upside there if we continue to make progress on the staffing. And on the Mobile Health side continues to be in that $85 million to $88 million of projected revenue. In the Mobile Health side, if you remember, it consists of no population health, municipal revenue doesn't include any micro revenue, of course, for 2026? And also we continue to point out that if we'll do municipal or population health revenue, we're going to report on that as sort of separate item. So it really does consist on the mobile health side of our study and, of course, acquisition, which is a virtual care side, the care and the home portfolio that I was describing, the mobile labs, the Care gap, the primary care and the patient monitoring, along with some of the staff clinics that we do. That's really the component pieces. I would say that we've shared in previous calls that SteadyMD is sort of in the $25 million to $30 million range. As Norm pointed out, we think there's upside to that plan, given the progress that we're making now that we've spent more time with that business having acquired in October, and we're continuing to integrate and infuse them into the company and all the opportunities that the company is seeing and so I would say that's sort of the mix. You have that SteadyMD and acquisition that is coming really into full bloom as we integrate it and that Mobile Health collection of businesses is in the $85 million to $88 million of revenue, of which -- none of that is migrant or municipal or population health in nature?

That's very helpful. And then can you talk about the cross-selling effort? Like I would imagine from a health plan perspective, cargo closures, that's enormously helpful. How frequently would you be able to add in like promote patient monitoring? And then, okay, you assign a primary care doctor or you have a mobile lab service. Like can you talk about the cross-sell and upsell growth potential?

That's a great question. I'm so glad you asked it because that's often something that I think is really an untapped opportunity for us. I think we've done some of it, and I can give some examples in a minute. But I think that, that remains a very big opportunity for the company, 1 that we've made some progress on, but there's clearly more opportunity that we can leverage as we really refine our portfolio of services. I think 2025 was a year where we've established a great portfolio of services on the mobile health and medical transportation side. It's very clear what our value is. Patients love it and now we can start to think about how do we cross-sell and provide those services to patients on a broader basis, particularly because our 2 main customer segments are really the 2 customer segments you want to have in health care. We work directly with large health systems and hospitals and then the payers. And so we're excited about being at the center of that between the payers and the hospitals, which is really where the vast majority of touch points and really cost is coming from in the system that we're contracting with and partnered with in that space. So I'll give you a few examples. I mean, one area that we're really enthused about is our ability to take a care gap patient and turn them into a preventative primary longitudinal care patient. So we go and we may close a care gap for a diabetes patient or do a screening of some sort. And we find that many of those patients do not have a primary care provider or know who that primary care provider is and over 70% of the time would opt for us to be that primary care provider. So we're starting to add that aspect of our services as we go into care gap and then primary care. The other piece I'll just flag also you mentioned the mobile labs. We're working with some of the hottest consumer health care companies in the space, the wearable space, where they're now offering lab orders and they're integrating your lab results into their consumer apps, for their wearables. And right now, they're driving patients to patient service centers, but we have partnerships with a lot of the labs, perhaps we can go to the homes of those patients as an upsell as a more convenience than driving them to the patient center. So going into the home and providing mobile ads as an example. And we continue to think that the opportunity that we have where we're bedside at discharge is a very key moment in a patient's journey. When the patient is being discharged by the hospital on our EMS teams are there transporting the patients, and we're bedside at discharge. We continue to think that, that is a crucial moment in the health care journey. And so what can we do to bridge the discharge from the hospital to the home. We think we have a big role to play in that as we continue to build out the capabilities and continue to work with our amazing partners. So those are some of the areas that we are absolutely excited about it, and that's why I'm giving such a long detailed answer about it because I think it's an additional area of opportunity that is in front of the company as we go forward here.

And your last question comes from the line of Sarah James from Cantor Fitzgerald.

I appreciate the commentary that you've made so far on some of the moving pieces in '26 with migrant costs being concluded in '25 and the improvement you've already seen year-to-date in EMS labor. But wondering if you could put that all together with what you're planning on the SG&A efficiency side and give us a view of how we should think about EBITDA cadence throughout the year. So I guess based on what you're doing on the G&A side, is it like a ratable improvement for the year? Should the year be really back-end loaded? Or how should we think about that?

Yes. Thanks, Norman, for the question. I think as Norm mentioned, I think we see most of the EBITDA -- the adjusted EBITDA projection, the loss focused on the first half of the year. And as we turn the corner into the second half of the year, we turn to profitability. I think the big components really are in reducing corporate expenses both on the headcount side as well as some of the vendors that we work with on the corporate side. I mean we've already undertaken a lot of that work. And so that is a factor. And then on the efficiency side, the charge I've really given to the team is to find a way to make us more efficient, use technology, automate, standardize processes at the company where the patient and the customer doesn't feel it. They don't know that we're being more efficient. The service levels that they've come to love, remain as high as ever, the patient's experience that the patients absolutely love. I mentioned the Net Promoter Score of 92 stay as delightful of a patient experience that you can have in a patient's home when they're in need of health care to maintain that high bar, but at the same time, remove cost and the way to do that is to use technology into automate. And so I mentioned an example of the pre-billing process today or in the past, I should say, we had our dispatchers, and we had members of our team doing the pre-billing component to ensure, of course, that the patient had insurance that we were going to be able to collect, as an example, on the medical transportation trip. Now we're working to automate that. And we feel like we have build something that can automate that process and then, of course, free up our people to do other work or perhaps allow us to be just as efficient and productive perhaps with fewer people. And that really is a driving function. And so -- we're really looking at areas where we are using human labor today, but it can be automated, it can be standardized and that are -- those are the areas that we're using technology to build out. Another great example I've been using is when we first started engaging with the patient list that the payers are providing us for care gap services, we were making phone calls for all those patients, myself included. I did a bunch of those calls, and got quite good, I might add, but engaging with the patients. But now we're automating a large portion of it. We're automating a large portion of it with text, we're automating a large portion of it with agentic-AI, and we're doing more with fewer resources. And so those are really the areas we're focused on. We are very enthused by the progress we're seeing. That agentic-AI, patient engagement solution is already live. It's been running for months now. That automation of the pre-billing is set to go live. We've been testing it for months now. And so these are the areas that we're really going to push forward on to drive efficiency and ultimately remove cost from the business that we know is crucial. And so that is really where we set out. We really worked on it towards the end of last year, and we're starting to see it come to fruition as we kicked off 2026.

Your next question comes from the line of David Grossman from Stifel.

Maybe you could help us better understand kind of your expectations for the cadence of mobile growth as 26 progresses. And maybe if you could, in your response, maybe help us better understand what visibility you have today and what the pipeline may look like, including how do you leverage the success you're having with this 1 particular payer and care gap closure into marketing that to some of the other payers?

Absolutely. Thanks, David, for the question. So as we mentioned on our last call, we really -- we're really taking the approach to set guidance based on what we have today, the contracts we have today, the [ sets ] we have today, the volumes we have today, and then of course, if we're able to add to that with new contracts, new expansions, additional staff, then we would update as we went along. And so we're taking that same approach this quarter. This is based on the staff we have today. We mentioned how much progress we're making on the staffing. There's still more progress to be made. This includes the contracts we have today. It doesn't include any sort of wins that are projected to come but rather what we already have in-house today. So that in terms of visibility, in terms of that part of your question, this is the full visibility that we have. It's the contracts that we have with the staff we have today. Of course, things can happen, but this is what we have in the mix of the business right now with the customers we already have. So that's the key component. I think we really project that the mobile health business will grow as we go throughout the year. There is no 1 quarter where we hit some inflection point. It really is going to be a linear build on the mobile health side, because as I mentioned, it's including all the contracts we already have today. I think what you're seeing on the mobile health side is about a 40% year-over-year growth from 2025 to 2026. Now of course, that does include a full year of stead EMV revenues, which we acquired, as we mentioned in October. If you exclude study MD from both periods, we have about 10% to 15% year-over-year growth as well. So what we're going to be focused on this year is integrating study and b, utilizing them across the DocGo platform so that we're utilizing studying these clinician base to oversee the visits that are happening in the patient's homes with our mobile health clinicians in the homes. And then, of course, enabling them to grow as well. But that's basically what we see is a linear growth on mobile health as we go throughout the year. Of course, if we were to win a new contract that would maybe introduce a step function into the growth rate, but it's based on what we have today is sort of the visibility aspect to your question.

Okay. Great. And just a quick one for you, Norm. So I think you said you expect to get another chunk of cash from HPD at some point, perhaps even before the end of the month. Any sense of what the gating items are to getting paid at this point? Or has it just been typical administrative kind of delays in getting the final payments. Any sense for whether or not there's any risk to the $20 million. I think in your press release, you said you expect to get fully paid, but I just thought I'd just ask the question.

Yes. And sure, David. It's a good question. And just to set the table, we're in touch with them on a pretty frequent basis. I have a counterpart there, there's about half a dozen people here who are in touch with their counterparts. I speak to them weekly. So what has been going on is that as the administration has sort of transitioned , first of all, people have been a little bit busy. But beyond that, they're going through an audit, not just for our payable to -- not just the payable to us, but really for everything that HPD has done with all the different vendors that they have and they're going to even they brought in a, I'll say 1 of the big 4 accounting firms that was and consulting firms that was doing an audit for them across the board. And looking at the stuff that they already paid, looking at the stuff that was already opened, kind of routine type of process, but I would say that, that payment was held hostage, if you will, by that particular audit that really dragged on for quite a few months. That audit has been wrapped up. The findings are now being put together on paper. And that's why I think that we should find out really within days of what they are going to pay us in an initial wave of funding. And then, of course, if there's some stuff where they require additional information, all of which we have, we would provide that and continue that process going. So -- and that was the big gating item there really was getting that audit done that took at least, I would say, 2 to 3 months maybe more to get complete.

And there are no further questions at this time. I will now hand the call back to Mr. Lee Bienstock for any closing remarks.

Wonderful. Thank you so much for everyone joining us today, and we're looking forward to speaking with you again soon. Take care.

And this concludes today's call. Thank you for participating. You may all disconnect.