DocGo Inc. ($DCGO)

Good afternoon. My name is Sarah Conrad, and I'm on the GS Healthcare Services team here. Today, I am joined by DocGo and CEO, Lee Bienstock. We just -- for those who are a little less familiar with the story, can you give a high-level overview of the business today and how we're thinking about the core value proposition?

Absolutely, Sarah. It's great to be here with you. So for those less familiar with DocGo, essentially, we deliver health care literally. We go into patients' homes and deliver health care. We provide virtual care services, remote care services, and we also have a very large medical transportation business where we go and take patients from one care setting to the next. So that's essentially what our company is there to do. We're going to meet patients where they are or bring patients to where they need to get to. And we do that at great scale. Last year, we transported [ to ] 100,000 patients, and we also visited about 150,000 patients in the home and did over 1 million [ telehealth ] visits. So we're really excited. We're meeting patients where they are. And we think when you meet patients where they are, you have better health outcomes, you have better health outcomes. Obviously, it's great for the patient, it's great for the system, and we think we'll do well in that way.

Yes. So the company has gone through a bit of transition over the last couple of years. You've moved away from your COVID and migrant-related work. Can you talk about the main pieces of the business today and how investors should think about like what the normalized business should look like from here?

Absolutely. So you mentioned it. I mean, the company went public in 2021. At that time, we were a medical transportation company. We've been doing medical transportation now for over 10 years. When the company went public, we were doing about $100 million of transportation revenue in that year, this year, we'll do over $200 million. So we've doubled the medical transportation business in that time. And at the time, we were doing a lot of COVID work and over the last number of years doing work relating to the migrant crisis in New York. And so the company was doing a lot of work with emergency response, right, us being an ambulance company at heart, a medical transportation company at heart. We were mobile and dynamic in that way, and that was what was needed to respond to some of these emergencies. But really, the goal of the company has evolved into meeting patients where they are in an evergreen way, tackling their health and their chronic conditions in an evergreen proactive way, and that's where the company has evolved. In Q1 of this year, that was the first quarter in years where the company did not have any COVID revenue or migrant-related revenue, we're providing medical care to the migrants that were being [ busted ] in New York. We didn't have any of that type of revenue. We had about $76 million of revenue in Q1 of this year, all of which was comprised of our medical transportation revenue and the care anywhere portfolio, as I say, bringing care to where it's needed. So that was an exciting moment for us with the sort of first quarter and people got a chance and investors got a chance to see the business for the components that are evergreen and proactive in providing care where it's needed, and that was a big, big model for us.

Yes. So let's move on to medical transportation. This is your largest, most established vertical. Can you talk a little bit about the utilization environment there? What's driving growth today and also just the competitive environment within medical transportation?

Yes. So medical transportation has gotten a lot of excitement recently. And we were talking about one of our peer companies, I'd say, AMR just went public a [ couple ] ago, and we're sharing [ them on ] as well, of course. So I think really, medical transportation is evolving. Patients need to get to the care facilities and care settings that they need to get to receive efficient care. As I mentioned, we've been doing it for over a decade now. And the real genesis for us to bring innovation to the space was really, how can we use technology to become more efficient, how can we use technology to help the system. And that's basically what we set out to build over the last 10, 11 years. We built a platform that's embedded within Epic, where a discharge nurse can literally click a button, and just like Uber, see exactly when the ambulance is going to arrive to pick up the patient. That is a really magical experience for discharge nurse. If you think back, it used to be when you ordered ambulance for medical transportation, call the first company on the list, hey, Can you come pick up my patient now? Great. We'll be there in an hour. You don't really know they're going to be there in an hour. In 20 minutes, are they going to be there in 40 minutes? Maybe they weren't available to pick up the patient. You call the second one on the list. Now with us, we have our platform. It's directly embedded within Epic, and they click a button and they can be exactly when we're arriving. And the other piece is we've approached the market in a very different way. We're not -- we're contracting with major hospital systems to provide medical transportation for their entire population. And this is a big aspect because you can imagine if a hospital calls up an ambulance company and said, hey, can you come pick up a patient? They didn't have such great insurance, maybe they're busy. They didn't have any insurance. Maybe they're not available. But for us, we help the hospital system manage the patient population [ we contract ] in a way that we align incentives so that we can help them manage the patient flow. And that has been a big, big sort of breath of fresh air to the customers we work with. We work with some hospital systems like New York City [ open ] Hospitals, Mount Sinai, Jefferson. We work with mainline health. We work with methodist. We work with a lot of great hospital systems that use our software, Northwell, and we help them manage that patient flow. And that integration between software and services is very unique. I think that's a winning strategy. We can talk more about it, but there's a lot of companies out there that are just doing the software, but they can't provide you with the services or their antiquated companies providing services, but they don't have the technology. And that's kind of our unique value proposition as we bring both to bear, both the platform and the services, all integrated into 1 seamless experience for the facility and the patients.

Yes. So you mentioned you take all types of payers. We've had a couple of changes in the market recently with the [ HEC ] subsidies expiring, Medicaid challenges with [ SEP ] payments. Can you talk a little bit about how your payer mix has shifted over the last year or so?

Yes. So for us, really, we contract first and foremost, either with the insurance companies directly or with the hospital systems. I'll tell you that the -- there's a lot of strain on the system right now. Hospital systems are definitely worried about expenses, reimbursement rates that they're going to be getting. Certainly, we believe there's going to be a lot of what makes fewer population on some of the Medicaid plans. And so as a result, what patients are going to end up in the hospital. The question is do they have Medicaid? Or do they not have Medicaid? Do they have insurance or they not have insurance? The hospitals are going to have to grapple with how they're going to provide services for those patients. And so that's really why we exist. We're there to help them either mitigate that. We try to keep patients out of the hospital, right, when they don't need to be there and [ not tell ] a personal story in a second. And of course, if the patient does need to be there and need to be transported out upon discharge, we help them do that efficiently. So I think to [ be more ] and more efficient. One of the [ things ] is really CMS' goal to reward outcomes and the upfront reimbursements are so low, you have no choice but to use technology to drive down the cost. Otherwise, you won't be successful. So it's pretty clear what the industry and what CMS is trying to do. They're trying to incentivize providers like us and hospital systems and insurance companies that we work with to drive the cost down, to improve outcomes and to reward companies and providers for doing that. We've all had experiences where we've gone to the doctor, taking this trial to the hospital, and there's just test after test, providers get rewarded, the sicker and sicker you get, the more and more times they visit hospital, the more and more time they visit a doctor's office. And the system has to change to where actually companies like mine, companies like ours are successful, the healthier the patient is. That's what CMS, I believe, is trying to do. We sit at the intersection of that. And I think you're going to see more and more of that come down, come down the pipe here. I think also in some cases, you're going to see pressure on rates, but in some cases, you're going to see higher incentives. I think CMS is really pushing more preventative care. They're increasing the G-codes on preventative care. They're improving reimbursements on proactive screenings and things of that nature, all with an effort to improve outcomes, which will ultimately drive down the total cost of care. So that's really kind of the piece of the strategy we're focused on.

Yes. So I guess sticking on medical transportation just for a little bit. So what do you think customers are prioritizing when they're selecting their vendors? And then what do you think is [ in ] your ability to continue to take share in this market?

So I think, first and foremost, the customers we work with are prioritizing the transparency of the service delivery. When are we going to be there? How often do we arrive on time? How quickly can we move the patients and free up the bed for the next patient. That's the key. So for example, when we're [ ordered ] when medical transportation is ordered through us, alerts go out across the hospital. The housekeeping team is notified. Now it's time to go and make up the room for the next patient. The intake team is notified, hey, the bed is freed up for the next patient. Discharge nurse does exactly when to get the patient ready because they know exactly when we're going to be arriving. So that transparency understanding each piece of the service delivery is very, very valuable to the hospital system, and that's what the tech platform enables them to do. I also think the quality of the service is very, very important. And so they choose us based on that. They typically don't choose us based on price. We're not going to be the lowest cost provider. We're there to provide medical transportation to the entire patient population that they serve often times that requires the hospital system to invest alongside us, right? I mean, part of the issue has been that all the ambulance companies happen to be busy when a patient that doesn't have insurance or has, let's say, low reimbursement insurance, needs to be transported. We'll be there to take that patient. We want to provide great care and great access for all, but then the incentives have to be in line between the facility and the provider. So a lot of cases, we have a program where we call like a dedicated fleet, where our ambulances are dedicated to that facility. And will transport any of the patients they need to transport and we'll bill insurance if we're able to collect our daily minimum, the hospital system doesn't [ know ] us anything, if we're able -- if we're not able to collect, then the hospital pitches in the shortfall. And that aligns incentives. The other way we align incentives is we'll tell the hospital when we're going to arrive to pick up the patient. We show up there and the patient is not ready. We just have to wait around. Everybody loses, the patient loses, the hospital loses and we lose we couldn't be the only ones to lose in that scenario. We're just waiting for the patient to be ready. So that's the key, aligning all the incentives where the hospital system knows they can have reliable, great quality, transparent transportation and patient flow. We know that when we show up, the patient is going to be ready. So we could be really efficient and transport as many patients as we can throughout that shift throughout that day. And then, of course, the patient benefits in a great way when there's great quality, predictable transportation to get them where they need to be. That's what we've set up. That's why we think we're going to be very successful.

Great hearing about those partnerships and relationships that you have. I want to pivot to the recent acquisition of SteadyMD, which had a really strong first quarter. Can you talk a little bit about how this business is operating post acquisition? And how we should think about the pipeline of new logos and existing logos from here?

Yes. So we're very excited. We have a very talented team that's joined the company in SteadyMD. They had a record quarter Q1. They're on a really great trajectory for the rest of this year. They continue to sign incredible customers and partners in the pharmacy space, in the digital wellness space. And I think we're very excited. The piece that is very foundational. This idea of going to deliver care in the home, we don't send a doctor. We [ don't ] send an MD to the home. We don't send a nurse practitioner or physician assistant into the home. There's just too much drive time, there's too much time in between the patient interactions. So what we do, which is very unique, is we'll send the medical assistance or an LPN into the home. They are hands, eyes and ears in the home, that's able to vaccinate a patient, that's able to take a swab, take a lab sample, take a screening and remotely, virtually is the higher order clinician. And that's the SteadyMD network. So we've really -- through this acquisition, we've done 2 things: a, we've brought a great virtual care practice, 50 state into the company. And we've created this network where now SteadyMD clinicians are overseeing the DocGo visits in the home. And that 400, 500, 600 clinician network is enabling us to scale the in-the-home visits way faster. So that's why we're so excited about this. And we think, look, you have to be able to provide care in every modality, virtually, remotely and in-person. And there are so many companies that could do it virtually, but they can't be in-person or companies that could be in person like the doctor's office, but they don't do the digital or remote well. We are building the competency to do all of it, under 1 clinical practice. And so when the telehealth visit will do, we'll do a telehealth visit. When we need to be with the patient hands on, we have the ability to do that as well. We can't take a blood sample through a Zoom call, through a virtual visit. We can't give a patient of vaccination through a screen. But we can do a lot of things virtually. And so that's the wonderful aspect of what we're building. We're building this Care Anywhere platform, where we can be with the patient when it's needed. We can be virtual when it's efficient. We can be remote, so we're monitoring the patient throughout their daily lives, and we can intervene and be proactive in the moment in real time. That is very unique at the scale we're doing it. It's a very big vision. And it's really, frankly, what's needed for the health care system because if -- the health care system keeps going the way it's going, where we spent 19% of GDP. I'm sure a lot of people are talking about this throughout the conference. Patients are just getting sicker and sicker. And rewarding providers like ours for treating patients that just keep getting sicker and sicker, really frankly, makes no sense. That's what CMS is really pushing. We applaud them for that and rewarding folks like us for the healthier the patients get, the less they're bouncing back to the hospital is really where the system needs to go to [ be ] to save the system, frankly, from total collapse.

Yes. We talked about -- a little bit about the flywheel demand with the SteadyMD acquisition. So as we think about the demand trajectory and also the margin profile, like how should we think about this integrating into the company and driving additional efficiencies.

Yes. So that is the big aspect. That integration, [ we're ] the SteadyMD clinical practice group. So before we acquired SteadyMD, we had our own clinical practice group and then, of course, SteadyMD came with the clinical practice group. So now we've integrated the clinical practice group into 1 clinical practice group serving all the patients we see, whether they be [ setting ] patients, DocGo patients or [ any ] of the patients that we see. And again, marrying the SteadyMD network to the clinician and the home when DocGo sends a clinician at home. That's what's going to be driving the efficiency. So we think that's going to improve the margins, a big aspect of the company is we've been investing into the ability to bring a doctor's office into a patient's living room. That's what we've been investing into. It's cost us money. Obviously, it's contributing to the EBITDA loss, but we think that opportunity is just such a big opportunity, but we also realize that we have to improve the margins as we go, if we want to be effective and viable. And so SteadyMD allows us to improve the margins as we go, allows us to see the patients in the home, but also to serve other customers with virtual visits, and that integration, integrating the clinical practice groups and then integrating the competencies, DocGo's ability to go in the home, SteadyMD's ability to be virtual. Now it's all under 1 roof, and we can be very, very efficient going forward.

Yes. And just double clicking one more time in the SteadyMD. So there's been a little bit of focus on like some of the current logos like the online pharmacies for [ weight ], but can you talk about are there any other types of customers that you want to call out or like additional logos that you would want to expand into that you think are a big opportunity?

Yes. So you mentioned online pharmacy. That's obviously a big with the GLP-1 adoption. That's been a big driver for the company, and we've been at the forefront of that. I also think something that has not been talked about a lot is -- well, everyone is talking about AI, but everyone is talking about AI as sort of like a replacement or maybe to be more efficient. We actually think the clinician with AI is going to be very, very powerful. So I'll give you an example, we work with a customer today. Dermatology AI company where you can upload a picture of, let's say, a skin condition or you can engage with AI in a chat. But ultimately, if there's some diagnosis needed or there's some higher-level interaction that's needed where a patient actually wants to speak to a clinician, we can unlock that. So I think it's going to -- our clinicians that are making sure that the AI is making the right diagnosis. It's our clinicians are going to be sort of an off ramp for when a patient actually does want to speak to a human clinician. And I think you're going to see a lot of marrying between the 2. Today, a clinician still has to review that dermatology assessment. And so we're working with a lot of the AI companies to bring the clinical practice to whatever tools they're trying to build to make the health care system more efficient.

Okay. So now we walked through a lot of the pieces of the business. I want to ask about the underlying demand trends you're seeing across the portfolio in the second quarter. We've heard from some of our hospital companies, one last week who said, surgical volumes were down and potentially [ lagged ] a weaker demand environment. So I guess just is there any color that you can give us on demand trends throughout the second quarter so far?

Yes. So we actually -- we don't play with those higher order surgical procedures. Actually, if we're doing our job well, surgical procedures will go down and sort of higher, more acute interventions will go down. And that's really, frankly, what the health care system needs. Now of course, hospitals play a [ vital ] role. If a patient truly needs that more acute surgical procedure than we want to be there to be able to maybe coordinate the transportation or to provide the follow-up care in the home to make sure that it's healing properly and so forth, we do all of that. So I think the demand trends we're seeing is really around the [ conization ] of health care. I think a lot of the wearable companies are going to get more and more into health care. I think they are doing a wonderful job with some of the diagnostics they're able to do with the wearables, but then if they truly want to take the next leap into sort of a medical device, they're going to need a clinical practice and setting up a clinical practice is not so easy to do, certainly to do it in all 50 states is not so easy to do. And so we're finding a lot of demand there, where you have the consumerization of health care and those digital health companies that want to offer actual medical advice, medical services, to their members, to their subscribers, we unlock that for them. So we're seeing a lot of growth there. I think we're also seeing a lot of growth again from the payer side, where they're trying to improve their [ MR ]. They're trying to drive down cost. They're trying to reduce hospital readmissions. They're trying to improve their HEDIS quality score ratings. And the only way to really do that, there's a lot of ways to do that, but the big way to do that [ is drifting ] that are [ unattached ] that are going without the care [ we're ] helping them address that. So we're seeing a big tailwind there for sure. And so we're continuing to widen the scope that we're providing in the home. We're trying to meet patients before they end up in a hospitalization. We're trying to meet patients within that 30-day readmit window so that we can see them in the home. Maybe readdress that [ incision site ], maybe make sure that they don't bounce back to the hospital. We work with a very large payer in California, where they've been giving us the late score patients, length of stay acuity, chronic condition patients on a scale of 1 to 10. They've been giving us, I think on average 9.2 [ out of ] 10. So these are the highest acuity patients. Our patient population they've been giving us has been bouncing back to the emergency department 60% less. So because, again, we're following up with their care plans in the home. So I think this idea of meeting patients where they are is playing out and the payers that -- the majority of the customers we have on the payers, I want to expand with us this year.

Okay? So maybe all the demand is just shifting out of those acute settings. So you've outlined a path to profitability this year. So how should we think about the key drivers and what the puts and takes are going to be?

Yes. So this is a big, big aspect for the company. We shared on our last earnings call that we plan to breakeven in the back half of the year. And it's really a factor of 3, obviously, key components. The first is on a quarterly revenue basis, we want to achieve the $80 million to $85 million. We feel like that's the critical need, the sort of watermark that we need to get to on the revenue side in order to have the scale that we need. And so in Q1, I mentioned we did about $76 million of revenue. So we feel like we're quite close to that. And of course, I mentioned a lot of the growth that we're seeing throughout the company. And so that is sort of within reach, if you will. So that revenue base, that's one component of it, that $80 million to $85 million of quarterly revenue. Then on the gross margin side, we feel like we need to be in the 34% to 35%. In Q1, we are at 31.6% adjusted gross margin. So we feel like, again, we have about 200 or 300 basis points to -- 200 to 400 basis points to go there. That's going to be driven by being more and more efficient in our delivery, reducing overtime hours for staff, reducing shift bonuses, being much more efficient again in the field, the medical assistance and the licensed practical nurses alongside the SteadyMD clinicians and driving that gross margin up. And as the mobile health portfolio takes more and more of the revenue component that will drive margins up with it. So as an example, our mobile phlebotomy offering has about 55% gross margins, our remote patient monitoring practice has about 60% gross margin. So as those continue to grow and become a bigger component of the revenue base, it will also take gross margins with it. And then we need to cut about $4 million to $5 million of SG&A spend per quarter. We did a very large reduction in force recently, so we took some costs out of the business, and we're continuing to work with the vendors that we work with to sort of [ pare ] back some of the spending there, and we think that we can get that done.

Okay. So that was some really good detail there on mix versus scale versus operating efficiency. As we think about '27 and beyond, once we're past that breakeven point, what do you think are the biggest levers going forward?

Yes. I think it's going to continue to be on -- from a growth perspective, it's going to continue to be the Care Anywhere platform. I think we're going to continue to have very nice growth in those components. We think the Care Anywhere platform, again, the virtual care, the care in the home, the mobile app, the more patient monitoring aspects, will grow about 30% to 40% year-on-year. [ Get ] medical transportation less. And so as that grows, that will be a continuing lever for that. I think we'll also continue to expand with the payers we work with. Right now, we work with a number of wonderful fantastic name brand payers. I know some of them will be at the conference. And so we work with those payers. And we think over time, we're going to be thoughtful about it. There are a lot of markets that those payers want us to go to. So I shared -- and it's always -- I think you said it's a balance there, right? So we have a payer that we work with in California. We recently expanded with them to Kentucky, New Mexico. There's other states we can stand with them. And so I think it's -- but we also want to make -- be mindful of new markets, require new investment, which require perhaps strain on the EBITDA. So we're being very thoughtful about that. We're expanding to new states in a very measured way. And we think we're expanding to states in a way where we can do it profitably quickly. We announced a couple of weeks ago that we just launched mobile phlebotomy services in Southern Florida, actually, that's [ of ] the woods. And we did that in partnership with one of the major labs, and we did it in a way where we were able to scale the staff cheaply and quickly and the demand was already there for us. We didn't have to [ generate ] it. So we think we're going to be profitable very quickly in that [ here ] in Southern Florida. And so that's the way we're kind of be scaling the business.

Yes. So we touched a little bit on the CMS access model a little earlier. I'd love to go more in depth into both CMS access, but also are there any other CMS or regulatory proposals that we should be aware of as it relates to your business?

Yes. So the access model was a big program that CMS launched. Essentially, what that model is trying to incentivize is a much lower upfront, basically, reimbursement for a preventative care. And if you're successful in achieving health outcomes, which I'll give me examples of, then you get sort of incentive payments and bonus payments. And that was a big move by CMS. They put out an RFP. I think a lot of companies responded to it. They ultimately ended up choosing 150 to participate. We are one of the [ 100 ] that was selected. And I think time will tell. We will launch in a measured way where patients can be enrolled into our practice as part of the ACCESS program, and we will provide preventative care exactly like we're doing today and try to drive outcomes. And so I think we will see more programs like that from CMS. I think that's the only real solution. I think part of the aspect that people in health care don't talk enough about is in order to improve health outcomes, most of the time, you need a long-term view, right? Patients that have chronic conditions, it takes time to impact their health outcomes. It takes time to improve their condition. And our system is set up in a very short-term way. I may have 1 insurance provider this year. And next year, I might change my insurance provider. I might work for a company where I have 1 insurance and then I go and work for another company, it has a different insurance. So how can a insurance company actually invest to make me healthier, try so hard this year to maybe perhaps help me if I'm struggling with a chronic condition, only to see me go to another health insurance company if I were to change roles or change jobs, change insurance companies? And so that's the problem the system has. The only one that can solve that is CMS. And so I think that is CMS' responsibility, and I think they're going to continue to look there, all the conversations that we have around this from people that are in that orbit, advising in that space are telling us that CMS is pushing more and more to develop programs that are incentivizing that because otherwise, the health care system is completely [ done ]. Even for us, we're a self-insured employer on the health side. And we try so hard to help our employees, our team members that perhaps are high utilizers and have chronic conditions. And look, we feel more responsibility to try to help them, even if they are to go to move on to another company and have another insurance provider, but we see it. You have to have a long-term view to impact someone's health. But the insurance industry and the health care industry is set up for short-term incentives. And so that has to be solved. Everybody is talking about all these things with AI and everything else, you can invest in anything you want. If it does not improve health outcomes over a period of time where you could actually make a return on that investment, which is how we're set up, which is the way it should be, right? I'm going to work so hard to make a patient healthier only to see them go to another provider or go to another insurance company. And that insurance company is going to get all the benefit of all the investment I made into that patient, then that has to change. So I think that's the types of programs you're seeing, the HEDIS quality scale is a big part of that, where insurance providers are incentivized to improve outcomes and have higher star ratings. I think it's about something like 40% of the plans, improvement in their reimbursement rate if they were [ stars ], and they're missing out on that. And 5% is a meaningful premium reimbursement to get from CMS uplift. So I think that's where the system is going. It has to go that way. The only one that could actually push incentives like that is CMS and I know from the ACCESS program as an example, they're really looking towards that.

Okay. I've got 1 quick housekeeping modeling question. So fuel costs have been a big area of focus with the conflict in the Middle East. They weighed on earnings in the first quarter. But it seems like costs have come down. Is there any updated framing you can give us? And how we should be thinking about that into the second quarter and the rest of the year?

Yes, it's funny. So obviously, we have -- I should have mentioned at the onset, we deliver health care. How do we do it? We have 1,000 vehicles. We have 4,000 clinicians in the field, all meeting patients where they are, taking patients where they need to get to. And last year, we were bragging that we drove like 11.5 million miles. And the team was -- we were talking about it and I said, hey, guys, actually, we should be bragging about how few -- how much fewer miles we can drive. And so that's part of the efficiency. If we didn't have our tech platform, I'm sure we'd be driving a lot more. But as part of that, we purchased about 270,000 gallons of gasoline each quarter. It's pretty significant. And so about -- for every dollar increase at the pump, we see about a 35% -- 35 basis point margin hit. So for every dollar, again, 35 basis point margin hit. Our biggest component in the business is really the vehicles and labor, not to guess. But we'd love it if the gas prices went lower, but it's about -- for every dollar, it's about 35 basis points. Sometimes people think like it would end up impacting our business more. It will be a headwind for us in Q2, we saw much higher -- we're seeing much higher gas prices in Q2, we think that will persist. But then we think hopefully debates in the back half of the year, which will help on the gross margin side. The other piece that we're doing in order to offset things we can control, like gas prices, is to invest in the things that we can control like automating a lot of the aspects of the business. So we -- I mentioned on our last earnings call, we have an efficiency portfolio that includes a lot of [ automation ] in the business. So for example, on our prebilling [ annual ] prebilling function where we would go in and see a preauthorization to see if the patient has insurance, we're going to be able to collect [ the ] hospital system of that. And now we're using AI to do that as an example. We were using a lot of human capital to coordinate patient schedules, visits, rescheduling, confirming appointments and now we're using AI more and more to do that. So we are going to do the best we can to procure the gas for cheapest possible way, but understanding we can't control the price. But we are absolutely like, we're sleeves rolled up on the aspects of the business that we [ can't ] control, investing in automation so that we can improve the margins, which is a big facet of what we're doing to get to breakeven in the back half of the year.

Yes. And so how should we think about cash flow and capital needs over the medium term? And how should we think about capital allocation given where we are today?

Yes. So first and foremost, I've been [ resoluted ]. In terms of the capital allocation, we're going to continue to fund the growth of the business and fund the capabilities of the business. And we think that there's a lot of opportunity for us in the pipeline that we have in the business and the existing customer base we have. As I mentioned, we have the majority of our health plans are looking to expand with us this year. So that's really, first and foremost, for the capital allocation priority will sit. And then I think we have ability to access capital. We have ability -- we have a line of credit today that we're looking to slightly modify and have access to capital to help fund the growth of the business going forward.

Okay. And we've got about 2 minutes left. So I just want to go over what do you think investors are most misunderstanding about the DocGo business today?

Good ones there, and thank you for asking that. So again, sometimes people look at our stock chart and said, lee, what am I missing? A $300 million health care services and technology company going and meeting patients where they are, again, [ which ] is one of the other pieces we didn't talk about is the federal government is also earmarking about $50 billion to help improve access to patients. You're doing all this. You have great scale. You have 1,000 vehicles, 4,000 clinicians. You're operating across all 50 states. What are we missing when we look at the stock chart? So I think we've -- over the last couple of years have really been digesting the comps from COVID and the migrant. Like I said, I think Q1 was the first quarter where we didn't have any of that. But in Q1 of last year, we had about $35 million of migrant revenues, providing services to the humanitarian crisis in Europe relating to the migrants. So when you look year-over-year, right, the business is growing or is it not? Again, when you take out the migrant revenues, it is, but when you see it in sort of on that screening process, those year-over-year comps have been tough for us. So that continues. I think we'll have some of that in Q2, but as we go throughout the year, that will abate. And I also think, again, I think people are looking at really where we're investing into and seeing -- they want to see the progress in the health care and the address Care Anywhere program. I think we are showing that. We certainly showed that with all the volumes being up in Q1. We'll continue to show that as we go throughout the year here. And then as we hit that profitability threshold, I think we're going to be celebrating that.

Yes. So we're super excited to watch the rest of the story from here and reaching breakeven profitability. Thank you so much for the time and attending our conference today.

Thanks, Sarah. Appreciate it. Thank you to the Goldman team.