Executive Summary

Q1 2025 revenue declined to $96.0M, driven by the wind-down of migrant-related programs; GAAP gross margin compressed to 28.2% and adjusted EBITDA was a loss of $3.9M .
Management removed all non‑migrant Government Population Health revenue from FY2025 guidance and cut revenue outlook to $300–$330M from $410–$450M; adjusted EBITDA outlook moved from ~5% margin to a loss of $20–$30M, citing public policy and municipal uncertainty .
Core franchises showed resilience: Transportation Services revenue grew year over year to $50.8M with record trip volume; Payer & Provider assigned lives surpassed 900k, and patient NPS remained strong at 86 .
Cash generation and balance sheet: Operating cash flow was +$9.7M in Q1; cash and restricted cash ended at ~$103.1M; 1.95M shares were repurchased for ~$5.8M .
Key incremental themes: aggressive SG&A cuts, AR collections (migrant-related AR ~$120M at quarter-end) supporting positive cash flow; M&A optionality (PTI Health acquisition) to expand in-home diagnostics .

What Went Well and What Went Wrong

What Went Well

Transportation Services revenue rose to $50.8M YoY with record trip volume; segment adjusted gross margin was 33.3% and improved >300bps sequentially vs Q4 2024, supported by wins in multiple markets .
Payer & Provider momentum: assigned lives exceeded 900k; management highlighted tripled care gap visit volumes vs last year and an NPS of 86, positioning this vertical for higher long‑term margins as clinician utilization improves .
Positive operating cash flow (+$9.7M) despite a net loss, aided by AR collections; cash and restricted cash remained >$100M, enabling buybacks and targeted M&A (PTI Health) .

Quote: “We plan to aggressively cut SG&A over the next several quarters, and anticipate positive cash flow through the balance of the year driven by collections of our outstanding migrant-related receivables.” — CFO Norm Rosenberg .

What Went Wrong

Top‑line miss vs consensus and sharp guidance reset: Q1 revenue of $96.0M vs S&P Global consensus of $104.2M*, EPS of -$0.09 vs -$0.04*; management removed non‑migrant Government Population Health from FY2025 guidance due to policy‑driven uncertainty .
Margin pressure: GAAP gross margin fell to 28.2% and adjusted gross margin to 32.1% vs prior year; early-stage Payer & Provider mix diluted Mobile Health margins during scale‑up .
Elevated SG&A as a percent of revenue (46.7% vs 26.8% YoY) during transition off migrant programs; adjusted EBITDA swung to a -$3.9M loss from +$24.1M YoY .

Financial Results

Quarterly P&L vs Prior Periods and Consensus

Metric	Q3 2024	Q4 2024	Q1 2025	Q1 2025 Consensus
Revenue ($USD Millions)	$138.7	$120.8	$96.0	$104.2*
Diluted EPS ($USD)	$0.05	$(0.09)	$(0.09)	$(0.04)*
GAAP Gross Margin (%)	33.0%	30.8%	28.2%	N/A
Adjusted Gross Margin (%)	36.0%	33.5%	32.1%	N/A
Adjusted EBITDA ($USD Millions)	$17.9	$1.1	$(3.9)	$1.8*
Adjusted EBITDA Margin (%)	12.9%	0.9%	-4.1%	N/A

Note: Values with * retrieved from S&P Global.

Segment Breakdown (Q1 2025)

Segment	Revenue ($USD Millions)	GAAP Gross Margin (%)	Adjusted Gross Margin (%)
Mobile Health Services	$45.2	28.7%	30.8%
Transportation Services	$50.8	29.4%	33.3%

KPIs and Operating Metrics

KPI	Q3 2024	Q4 2024	Q1 2025
Assigned Lives (Care Gap Programs)	>500k	>700k	>900k
Operating Cash Flow ($USD Millions)	$31.0	$12.9	$9.7
Cash + Restricted Cash ($USD Millions)	$108.6	$107.3	$103.1
Share Repurchases (Shares / $USD)	N/A	$(2.68)M bought in Q4 cash; program ongoing	1.95M shares, ~$5.8M

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue ($USD Millions)	FY 2025	$410–$450	$300–$330	Lowered
Adjusted EBITDA	FY 2025	~5% margin	$(20)–$(30) million	Lowered
Transportation Revenue	FY 2025	Not provided	~$225 million	New disclosure
Payer & Provider Revenue	FY 2025	Not provided	~$50 million	New disclosure
Migrant Services Revenue	FY 2025	Not provided	~$50 million	New disclosure
Government Population Health (non‑migrant)	FY 2025	Included in prior range	Removed; any recovery to be incremental upside	Removed
SG&A	FY 2025	N/A	Aggressive cuts planned	New action
Cash Flow	FY 2025	N/A	Expect positive operating cash flow via AR collections	New disclosure

Earnings Call Themes & Trends

Topic	Previous Mentions (Q3 2024 and Q4 2024)	Current Period (Q1 2025)	Trend
Government Population Health	Pipeline “flurry” and expected 2H revenues	Remove non‑migrant revenue from guidance; significant RFP delays and paused launches	Negative/uncertain
Payer & Provider Growth	West Coast expansion; >500k assigned lives	>900k assigned lives; plan to quadruple visits over 24 months; utilization improving	Strong positive
Medical Transportation	Stable growth; Delaware/TX/UK wins	Record trip volume; sequential margin improvement >300bps; ~$225M FY target	Positive
Margins (Gross/Adj. EBITDA)	Q3 adjusted GM 36.0%; adj. EBITDA $17.9M	Adjusted GM 32.1%; adj. EBITDA -$3.9M; mix shift to early-stage payer programs	Near-term pressure
SG&A and Cost Actions	Investments to support payer growth	SG&A cuts underway; -$3.1M sequential in Q1; further reductions planned	Improving cost discipline
Working Capital/AR	Strong CFO; cash balance growth	~$120M migrant AR; ongoing collections to drive positive OCF	Supportive for liquidity
Technology Enablement	Reduced booking friction; 9% faster	EHR integration (Epic), platform improvements; 40% address search improvement	Continuous enhancement
Capital Allocation/M&A	Buybacks; line of credit flexibility	Buybacks (~$9M YTD Q2) and PTI Health acquisition to expand in-home diagnostics	Active deployment

Management Commentary

“We have decided to remove all non-migrant Government Population Health revenue — and any related projections — from our 2025 guidance… Our Hospital and Payer & Provider verticals continue to perform in line with expectations.” — CEO Lee Bienstock .
“We plan to aggressively cut SG&A over the next several quarters, and anticipate positive cash flow through the balance of the year driven by collections of our outstanding migrant-related receivables.” — CFO Norm Rosenberg .
“Our Medical Transportation business… had record trip volume in the first quarter of 2025 and… we believe we can approach 700,000 transports by the end of 2026.” — CEO Lee Bienstock .

Q&A Highlights

Government vertical outlook: Management will report any material non‑migrant municipal revenues as upside to guidance due to RFP delays and paused launches; quarterly revenue trajectory likely dips through Q3 before a modest Q4 “blip” .
Payer & Provider ramp: Still onboarding new programs; margins sub‑optimal during scale but targeting ~40% gross margin in 2026; clinician utilization running ~30% higher early in Q2 than Q1 .
Guidance prudence: FY2025 “building in” conservatism; line‑item expectations ($225M transport, $50M payer, $50M migrant) sum to ~$325M vs $300–$330M range .
Tariffs/inflation sensitivity: Fleet procurement vs maintenance decisions mitigate risks; fuel prices a potential tailwind; medical equipment tariff risk monitored .

Estimates Context

Q1 2025 actuals vs S&P Global consensus: Revenue $96.0M vs $104.2M* (miss), EPS -$0.09 vs -$0.04* (miss), EBITDA -$10.2M vs $1.8M* (miss), reflecting the sharper‑than‑expected migrant wind-down and early-stage payer mix effects .
Forward quarters (S&P Global): Q3 2025 consensus revenue ~$69.2M* and EPS -$0.13*; Q4 2025 revenue ~$70.2M* and EPS -$0.14* — trajectory consistent with management’s expectation of lower revenue through Q3 before a modest Q4 uptick .
Note: Values marked with * retrieved from S&P Global.

Key Takeaways for Investors

Near-term reset: Guidance removal of non‑migrant government revenue shifts focus to core Transportation and Payer & Provider businesses; expect revenue trough through Q3 with Q4 stabilization per management’s trajectory commentary .
Margin inflection depends on mix and scale: Early-stage payer programs weigh on Mobile Health margins; clinician utilization improvements and program density are the key margin levers over the next 12–18 months .
Liquidity supports execution: Positive operating cash flow and AR collections (~$120M migrant AR) plus >$100M cash provide runway for SG&A rationalization, selective M&A (PTI Health), and buybacks .
Transportation is the earnings anchor: Record volume, sequential margin gains, and ~$225M FY revenue target underscore defensibility while payer ramps .
Watch the government pipeline for optionality: Any municipal work in 2025 would be reported as upside to guidance; monitor RFP progress and contract launch timing .
KPIs to track: Assigned lives and visit volumes in Payer & Provider, clinician utilization, segment adjusted gross margins, SG&A as % of revenue, AR collection cadence .
Risk framework: Policy/macro-driven uncertainty in government vertical, mix-dependent margin pressures, and inflation/tariffs on fleet; partial offsets from fuel, tech-enabled efficiencies, and contract wins .

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