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spk11: Greetings and welcome to the DocGo fourth quarter and full year 2022 earnings conference call. At this time, all participants are in a listen-only mode. A brief question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Mike Cole, Vice President of Investor Relations. Thank you, Mike. You may begin.
spk10: Thank you, Operator. Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. All statements in this conference call other than historical facts are forward-looking statements. The words anticipate, aim, believe, estimate, expect, intend, guidance, confidence, target, project, and other similar expressions are used to typically identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and may involve and are subject to certain risks and uncertainties and other factors that may affect DOTCO's business, financial condition, and other operating results. These include but are not limited to the risk factors and other qualifications contained in DOTCO's annual report on Form 10-K, quarterly reports filed on Form 10-Q, and other reports and statements filed by DOTCO with the SEC to which your attention is directed. Actual outcomes and results may differ materially from what is expressed or implied by 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 provided directly as part of this call or included in the earnings release, which is posted on our website, stockgo.com, as well as in our filings with the Securities and Exchange Commission. 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 in the future. At this time, it is now my pleasure to turn the call over to Mr. Anthony Capone, CEO of DOTCO. Anthony, please go ahead.
spk07: Thank you, Mike. Looking back on 2022, we did an exceptional job at meticulously replacing substantial mess COVID testing revenue streams with a variety of new programs while laying the foundation for continued profitable growth in 2023 and beyond. In 2022, we generated revenues of $440.5 million, up from $318.7 million in 2021, a growth rate of 38%. Excluding mass COVID testing revenues, we grew 75% year over year. Our initial revenue guidance at the start of last year was for 400 to 420 million with 35 to 40 million in adjusted EBITDA and we are proud to have exceeded both of these measures. Along with our 2022 results today, we are introducing 2023 guidance of 500 to 510 million in revenue and 45 to 50 million in adjusted EBITDA. Our gross margin expectations for the year are 35%. Gross margin is expected to be slightly below that rate in Q1 and Q2, then improving approximately 50 to 75 basis points per quarter over the course of the year. We expect to finish 2023 at an annual rate for gross margin of approximately 37%, and an adjusted EBITDA margin of approximately 13%. Our target consolidated gross margin over the longer term remains at 40%. We are sharing our backlog today for the first time, which we define as projects that have been awarded but not yet started or fully implemented. Our current backlog stands at $180 million over three years. We anticipate this backlog to be fully rolled out by the end of the third quarter this year. This backlog gives us excellent visibility into 2023 revenue and allows us to provide 2023 revenue guidance with a high degree of confidence. At this time, I'm going to hand it over to Lee Beanstock, our President and Chief Operating Officer, to provide an update on some of our key growth initiatives.
spk04: Thanks, Anthony. We were very pleased to recently announce a number of successful contract wins, and we continue to pursue larger opportunities that are working their way through the RFP process. As part of that recent announcement, we secured a $94 million medical transportation contract with a major hospital system, our largest RFP win to date. This is a 100% leased-hour contract, providing DOTCO downside margin protection with significant upside. As we move through 2023, we also expect to see further traction with our population health offerings in new geographies, such as Connecticut and Chicago. We recently won an RFP to provide occupational health services for public health workers in Southern California, and we are in the final stages of a public health RFP for remote patient monitoring and chronic care management in Illinois. Currently, DOTCO has 34 active RFP submissions pending award, totaling over $1 billion in aggregate contract value. None of these RFPs are included in our current guidance, as an award to DOTCO is not guaranteed. We have built one of the nation's largest mobile health workforces on top of a unique clinical delivery model that leverages lower-cost medical professionals. Due to the large pool of these clinicians, we are able to scale quickly while realizing highly profitable unit economics. In addition, our leased-hour reimbursement model provides downside margin protection, mitigating our exposure to demand risk. Our recent success in the RFP channel and growing interest in DACO services across the country highlight the attractiveness of our value proposition to customers. Notably, our pilot program with Dollar General continues to proceed as well. We have seen week-over-week growth in patient volume with this past week being our highest demand week ever. This program's appeal is further validated by an exceptionally strong customer net promoter score. In a recent survey, nearly all patients who have used the service report that they would recommend the service to a friend and plan to use the service again. DOTCO does and will continue to have pilots which are reimbursed on a fee-for-service basis. However, we do not plan to scale any pilot on a fee-for-service basis where we assume demand risk. For any pilot project to expand, including our existing payer pilots, there must be be a reimbursement model which ensures downside margin protection for our company. I will now hand it back to Anthony.
spk07: Thanks, Lee. While we are extremely excited about our growth prospects for 2023, we are also laser focused on maximizing profitability and reducing costs where prudent. A good example of these efforts is our rapid normalization initiative, which began in early February. As we have mentioned frequently in the past, the first 90 to 120 days of a new program launch have higher associated costs than our mature programs that have been running longer than six months. Typically, the greatest driver of this increased cost is our usage of staffing agency labor to help ramp programs quickly. This ability is a distinct competitive advantage for .go, but it becomes at an immediate term cost. Typically, when utilizing staffing agency clinicians, we are paying a rate that is about 40% higher as compared to a traditional W-2 employee. After 90 days, we can hire that clinician with no additional fee to the staffing agency. Our goal is to reduce that to 60 days over the course of 2023, which is not only expected to increase profitability, but also allows us to potentially grow faster as we can better absorb the upfront costs associated with the rapid growth that we are experiencing. This, as well as other initiatives, such as reducing our usage of rental vehicles while procuring long-term vehicle leases and our efforts to reduce overtime during project launches, are also expected to positively impact margins over the course of the year. Collectively, in 2022, we estimated the combination of all these factors to press margins by approximately 600 basis points. Fortunately, all of these costs are a byproduct of our substantial growth. We will continue to mitigate these costs over time. We also expect to drive greater profitability in our medical transportation business in 2023. Specifically, we continue to work to transition existing medical transportation business to a leased-hour model by the end of the year. Half of our current medical transportation business is fee-for-service, a legacy model that is vulnerable to swings in demand. Our increasingly popular leased-hour model provides much greater visibility to revenues and margins. Given the incredibly strong demand for this service by healthcare institutions, it offers an exceptional opportunity to get our foot in the door and expand that relationship into mobile healthcare services such as our RPM and our ER readmission avoidance programs. During 2023, we will be repositioning medical transportation assets to service these more lucrative leased-hour contracts while discontinuing service in select markets with lower profitability. We have already begun discontinuing service in markets which are not achieving our target margins. We expect these collective changes to have a material positive impact on medical transportation margins over the course of the year with minimal impact on revenue. Additionally, It's worth noting that on May 11th of this year, the federal public health emergency is set to expire. We have been preparing for this, and it is fully considered in our 2023 revenue and EBITDA guidance. At this time, I will hand it over to our CFO, Norm Rosenberg, to review the financials.
spk01: Thank you, Anthony, and good afternoon. I'll begin my comments by looking at full year results and then turn to discuss the fourth quarter. Total revenue for the 12 months ended December 31, 2022 amounted to $440.5 million, representing growth of 38% over total revenue of $318.7 billion for the year ended December 31, 2021. Mass COVID testing revenues in 2022 were estimated at about $75 million compared to $110 million in 2021, removing these revenues from both periods and revenues increased by 75%. This year-over-year revenue growth was driven by a combination of expanded relationships with existing customers, new customer additions, and inorganic growth through the acquisition of licenses and capabilities in various markets. Mobile health revenue amounted to $325.8 million in 2022, up 39% from $234.4 million in 2021. Once again, by removing mass COVID testing revenues from both periods, mobile health revenues doubled in 2022. While our mass COVID testing contracts concluded in September of last year, we do still have standby surge contracts, which will occasionally generate relatively minor amounts of revenue, like we saw in Q4. Medical transportation revenue was 114.7 million in 2022, up 36% from 2021. This growth was fueled by both organic and inorganic sources. We witnessed higher trip counts, average price per trip, or what we call APC, and continued adoption of our leased hour model, where we supply an ambulance and related personnel and equipment for a fixed daily or hourly fee. Gross margins improved to 35.1% in 2022 compared to 34.4% in 2021. Mobile health gross margins were 38.9% compared to 38.1%, while transportation gross margins were 24.5%, virtually unchanged from the 24.7% in 2021. Adjusted EBITDA for 2022 amounted to 41.3 million, up more than 60% from the adjusted EBITDA of 25.1 million for 2021. Net income for 2022 amounted to 30.7 million, up nearly 60% from 19.2 million in 2021. EPS was $0.34 on both a basic and fully diluted basis in 2022, up from $0.30 on a basic basis and $0.25 on a fully diluted basis in 2021. Now turning to the fourth quarter. Total revenue for the fourth quarter of 2022 amounted to $108.8 million compared to $121.3 million in the fourth quarter of 2021, which included an estimated $49 million in mass COVID testing revenues. By contrast, mass COVID testing revenues represented a relatively insignificant portion of total revenues in 2022's fourth quarter. Removing these testing revenues from both periods and recurring underlying revenues increased by approximately 49% year-over-year in the fourth quarter. Mobile health revenue for the fourth quarter of 2022 amounted to $71.8 million as compared to $102.6 million in the fourth quarter of 2021. Once again, looking at recurring mobile health revenues by removing mass COVID testing revenues from both periods and mobile health revenues increased by 32%. Medical transportation revenue increased significantly to 37 million in Q4 of 2022, nearly doubling from the levels that we saw in the fourth quarter of 2021. Nearly every core transportation market witnessed year-over-year growth in the fourth quarter, and we finished the year with significant momentum. We recorded net income of about 7.1 million in Q4, compared with net income of 20.3 million in the fourth quarter of 2021. There were several significant non-recurring items in the other income and expense categories that had an impact on the net income in the fourth quarter of 2022. Please refer to the financial statements attached to the earnings release for more detail on these items. Net income in last year's fourth quarter, of course, included a $5.2 million gain on the re-measurement of warrant liabilities. As you will recall, those warrants were redeemed in Q3 of last year. Adjusted EBITDA for the fourth quarter of 2022 amounted to $6.8 million, as compared to adjusted EBITDA of $17.3 million in last year's fourth quarter. The total gross margin percentage during the fourth quarter of 2022 amounted to 39%, as compared to 40.7% for the same period in 2021. Now, gross margins in both periods benefited from items beyond their regular run rate levels. The fourth quarter of 2021 benefited from a surge in COVID testing revenue. In the fourth quarter of 2022, we recognized significant savings across multiple insurance expense categories, and a reduction of certain revenue reserves due to cash collections, which drove margins higher. During the fourth quarter of 2022, gross margins for the mobile health segment were 43.9% compared to 44.7% for the fourth quarter of 2021, and in the transportation segment, gross margins increased to 29.4% in Q4 of 22, up from 20.7% in Q4 of 2021. We recently made the decision to exit the transportation business in California which we estimate was costing us about $1 million in EBITDA per year. We will continue to operate the mobile health business throughout California. We are at a stage as a company where we have a significant set of opportunities to pursue, and we intend to focus on those markets and business lines that offer us the highest expected returns on investment. Turning to the balance sheet, as of December 31st, 2022, our total cash and cash equivalents, including restricted cash, was $164.1 million as compared to $179.1 million as of the end of fiscal 21 and $179.4 million as of the end of Q3. The reduction in cash during the fourth quarter was due to several factors, including the timing of payments from high-quality credit customers, which resulted in an increase of approximately $8 million in accounts receivable, $3 million in acquisition payments and capital expenditures, and approximately $3.2 million spent on stock buybacks. These factors outweighed the cash that we generated from our regular operations. For the full year, operating cash flow was about $29 million. We used $41 million for acquisitions and capital expenditures, and we also used, for the year, a total of $3.7 million on share repurchases during the year. During the fourth quarter, we bought back approximately 465,000 shares at an average price of $7. We plan to continue to use our balance sheet to support our ongoing stock buyback program, where we have approximately $36 million left in our approved program. Combined with our $90 million line of credit, which could potentially be expanded by an additional $50 million, we have the financial wherewithal to execute buybacks, acquisitions, and to invest in new business lines and projects without the need to raise any new capital. We continue to focus on our capital light model while pursuing selective acquisitions funded by cash flow from operations. With the price of capital increasing in the market, this provides us with a distinct competitive advantage. Now turning to our 2023 outlook, we anticipate continued strong demand from our customers for both mobile health and transportation services. As Anthony mentioned, our revenue guidance for the year is in the $500 million to $510 million range. While this range would represent year-over-year top-line growth of about 14% to 16%, when removing the $75 million of mass COVID testing from our 2022 revenue baseline and considering that we're not expecting any mass COVID testing revenues in 2023, then we're looking at top-line growth of approximately 36% to 40%. Growth in 2023 is expected to be driven primarily by organic means and same-store sales. We expect that adjusted EBITDA will be in the range of $45 million to $50 million. We expect to finish 2023 at an annual rate for gross margin of approximately 37%, which would be our high water quarter for the year, and an adjusted EBITDA margin of approximately 13%. That concludes my financial comments, and at this time, I'd like to hand it back to the operator to open the call up for Q&A.
spk11: Thank you. We'll now be conducting a question and answer session. If you'd like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys.
spk08: One moment, please, while we poll for questions. Thank you. Our first question is from Richard Close with Canaccord Genuity. Please proceed with your question.
spk09: Yes, thank you. Can you hear me okay?
spk07: Yeah, we can hear you, Richard. Great to hear you again.
spk09: Great. Congratulations on the year and the outlook. After those, maybe if we could talk about the startup ramp-up expenses and maybe the buckets, you know, the composition of those expenses, like how much of it's labor-related versus other costs, right? in terms of winning business and starting those contracts. And then with respect to the $180 million in revenue that was won, I guess, since January, beginning of January, how much in startup expenses do you think is associated with those contracts?
spk07: Good questions. Good questions. The composition certainly weighted much heavier towards labor, both labor regarding staffing agencies, as well as labor regarding overtime. When we looked at 2022, just in that timeframe, we had subcontractor costs that were around 12 million and overtime that was around 14 million. where the other large category or significant category was vehicle rentals, which was around 3 million. Those are the three main categories. There are, and those are all in excess. So it's important to understand that's not how much we spent in subcontractors or in overtime. It is relative to what we deem as being in excess. So actually the amount we spent is quite a bit more than that, but compared to what we say is a, you know, standard mature run rate basis, From there, going forward, you know, there was, you know, those excess costs. So those are the three biggest ones, overtime, subcontractor, and then vehicle rental.
spk08: And then going forward on the hundred, oh, sorry, go ahead.
spk07: On the 180 million, on the going forward basis, At the time being, you'll still continue to see similar percentages on those, although they have similar ramps. And just as a reminder, we had disclosed that we plan to have the $180 million fully ramped by the end of Q3. The only significant difference is that we've already begun our rapid normalization project. And so that will also be kind of coming through to fruition in Q3. So I would expect that the upfront costs on that 180 million will be less than what it has been historically.
spk09: Okay. And just as a follow up on the rapid normalization, will that be fully, you know, fully in place and seeing all the benefits? of that with these contracts, or is that a gradual improvement as you move forward?
spk07: I'd say it's gradual from when we started last month through Q3. So, you know, you can think about maybe about half of the projects getting the maximum benefit. Some of them, you know, have already begun rolling out to the $180 million right now. But I would say it's fairly linear in its improvement from February through Q3 as far as the reduction in those kind of 600 basis points, which, you know, we currently are getting hit with for the excess costs.
spk09: Okay, great. Congratulations. I'll jump back in the queue. I'm sure others have a decent number here as well.
spk08: Thank you.
spk11: Our next question is from Ryan McDonald with Needham and Company. Please proceed with your question.
spk05: Hi, thanks for taking my question. Congrats on a nice quarter. Maybe the first question for Lee, as we think about the pipeline you talked about of RFPs, I think 34 sort of up for decision here, how should we think about the expected timelines for those decisions to be rolled out and And when you think about the average size of those RFPs, where does that range come into play? Is it more in the 1 to 10 million range or that, I think you had bucketed like 10 to 200 million range? Thanks.
spk04: Yeah, absolutely. So first off on the timeline, those really do vary. We can hear back in a matter of weeks on some, and it could be in a matter of let's say a couple months on others. Really the timeline is part of the RFP process from the issuing body of the RFP. So it really does vary there from weeks to just a couple of months. The average size we've increased significantly. We had originally started with the size that you just mentioned around the $10 million mark, but we've increased that substantially to 30 to 50 million is our average submission at this point. So we're going after larger opportunities and we're going after more opportunities.
spk05: Super helpful. Thank you. And then, Anthony, maybe for you, you talked about obviously the $180 million now that will be rolled out by third quarter. How should we start to think about that, I guess, revenue coming into the model? Is this something that you said over three years, like is that recognized ratably where you're about, you know, $60 million annualized per year starting in third quarter? How should we think about that?
spk07: Yes, that's the right way to look at it. Yeah, that's, you know, you know, we have to build up to that. You know, we have to build up to that. So it's obviously, you know, not 60 million immediately, but that 180 is in the current guidance for this year. And what that allows us to do when you look at, you know, when we look at last year's number versus, you know, the guidance that we just gave, that 60 million really allows us to explain our entire guidance for this year as opposed to having to use a plug.
spk05: Helpful. And maybe just last one for me. On the lease hour model, sort of starting that transition, taking 50%, trying to get all the customers on that model, what sort of, I guess, are your expectations for customer retention as you make that transition? And what sort of pushback are you getting on sort of the switch, if any?
spk07: Medical transportation is an Extraordinary demand right now. So for a customer to switch is very very painful It's very rare that we find a customer that is not willing to switch There are extenuating circumstances where one may not But it is it's certainly rare. I don't From a percentage perspective. I don't know which ones will and which ones will not but what I can say is that we've been speaking about this with our customers for over a year and So they're well informed that when the contract comes up for renewal, that the only option is to renew as a leased hour program. So there will be no surprises to either side if they decide not to go through it. But to switch an ambulance provider right now would be very, very painful for any hospital system to do.
spk08: Excellent. Thanks for the call.
spk11: As a reminder, if you would like to ask a question, please press star 1 on your telephone keypad. The confirmation tone will indicate your line is in question queue. Our next question is from David Grossman with Stifel. Please proceed with your question.
spk02: Good afternoon. Thank you. You know, Anthony, I want to just first follow up a question you just answered about the $180 million of backlog coming into revenue. So should we... should we assume that that once fully implemented is a $60 million ARR kind of revenue contribution and that you get a quarter of that in 22 or 23 and you get a full year of it in 23? Is that the way to think of it? In other words, does it all come into revenue pretty much in the fourth quarter and then it stays at that level throughout next year?
spk07: No, I think that for sure you're at a full run rate basis for all of the fourth quarter. But many of those contracts have already begun rolling out now. Like as of today, they've already begun rolling out. So, you know, I would say the scale between now to the end of the fourth quarter is fairly, fairly linear from now until then. But then through the full fourth quarter, you're at that full run, you know, kind of revenue run rate that, you know, on an annualized basis is, is not exactly 60, but close enough.
spk02: Okay, so linear ramp to around 60 million, right, and then you would take the 15 million a quarter into 24, I guess, right?
spk07: Correct, yeah, then it continues on through, you know, for the next three years into 24 and 25.
spk02: Right, got it, got it. And then just on the margins, so should we assume that I thought in your prepared remarks you said you had about a million-dollar headwind, the EBITDA, from exiting the transport business in California, and then an immaterial impact to revenue. Did I catch that right? So that when we look at the 23 guide, that includes a million-dollar headwind, the EBITDA?
spk07: It does. It already includes that. We've already factored that into our guide.
spk02: Right. Got it. And then just one last thing I wanted to ask was on the, just how to think about startup expenses. So you've already done a great job of articulating, you know, you're at these elevated levels and you're trying to bring them down. You know, how much, you know, by the time you exit this year, it sounds like you feel that you'll have taken a lot of the costs out of the ramp as a result of some of the staffing, you know, actions that you're taking as well as on the vehicles. You know, how do you think about when you go into 24 then when you wrap? I mean, do you think you'll have the vast majority of that 600 basis points out of the system by the time we exit this year?
spk07: No, I think you'll have about half of it. When you think about it, we're at about 120 days today, and we're trying to go down to 60 days. You're basically cutting the time period for your startup in half. But then there's certainly that 60 days worth of room to grow, and there's additional plans we have to kind of eliminate that 60, the 60-day period of startup costs on the labor side. I won't go into too much detail here because I don't want to spoil all the good stuff for next earnings call, but we have a lot of plans for 2024 to get the additional 60 days so that there's actually virtually no startup costs. And we'll begin those initiatives after we get through this rapid normalization initiative. But the current rapid normalization initiative is to go from 120 to 60. So you can think about it as gaining those kind of 300 basis points of the 600.
spk02: Got it. And just one last thing, just for Norm. What should we use for CapEx for 2023?
spk01: So, I mean, we're typically, and we refer to our capital-like model, of course, where we typically will try to lease instead of buy. But that equation has changed, as you know, David, right? I mean, we're looking at our cost of capital versus what the cost of leasing is and interest rates are going up. I would say in this year, I think we, in 2022, I think we spent about $3 million and change on CapEx. I would expect a somewhat similar number.
spk03: And that includes capitalized software?
spk08: that would include a little bit of capitalized software.
spk03: Great. Great. All right, guys. Thanks.
spk08: Thank you.
spk11: Our next question is from Richard Close with Canaccord Genuity. Please proceed with your question.
spk09: Great. Thanks for the follow-up question. Anthony, when you were talking about Dollar General, you had mentioned something with respect to fee-for-service and you know, going forward in the future, you want to, you know, be fully in the leased rate model. Can you talk a little bit about that in terms of, you know, how you expect that, like a relationship maybe like Dollar General to move to the leased hour model as well?
spk07: Yeah, great question. So there's two approaches. The primary one is to take on similar kind of way that the ambulance 911 system works, which DOTCO is not really involved in the ambulance 911 system in a significant degree, but that works by the county subsidizes the ambulances because the county needs ambulance services. Without ambulance services, people will get far worse healthcare. If you go to a county as well and you say, well, in your county, you have no health care institutions are very, very minimal and primary, but not urgent or vice versa. Are you willing to lease this for us for a very, very small amount? Because keep in mind, they're only paying the difference between what we collect on insurance versus the daily minimum, which sometimes can be nothing. Are you willing to to lease this model so that you do have health care in your county? And when you pair that together with, you know, the prominence and the respect that the dollar general has in the community, you bring the two together and you basically provide a service to the county where the county is willing for relatively low cost to guarantee that their citizens, they have access to high quality healthcare, both in the primary and urgent side. The second approach is you're going to payers and you go to payers and they're the ones that are going to pay for that least hour model, which we have examples of that today as well. Not with Dollar General, but we have examples elsewhere in our organization where the payers pay on a least hour basis. So those are the two approaches as we continue to expand these pilots.
spk09: And with the counties, have you had those conversations already, and is it being well received?
spk07: Yeah, I've had a couple of them in the local areas, and I think they're very well understood. It's also important to understand how small the dollar figure is. So part of the reason why they're well understood or well received is because, you know, an ambulance contract is oftentimes many, many millions of dollars to a local municipality. And that's because the collection rates on these ambulance services are very, very low, which is why .gov stays out of 911. But in this case, the collection rates are actually very high. We already see it right now in our ability to fee for service. We just don't want to take risk on demand. So the actual amount the county has to face is very, very low. So the sell is much, much easier for them to have very high quality service.
spk08: Okay, thank you. Thank you.
spk11: Our next question is from Pito Chickering with Deutsche Bank. Please proceed with your question.
spk06: Hi there, guys. You've got Kieran Ryan on for PDO. Thanks for taking the question. First off, I just wanted to confirm this up front. I believe the last time I checked, you weren't including the leased hour contracts in the KPIs for your transportation business. I was just wondering, now that, you know, you're taking, you're kind of putting a bigger focus on the leased hour contracts with the one very large one coming through this year, Are you going to alter that, you know, how you report those KPIs or anything else to allow us to kind of better track the progress there?
spk07: It's an interesting suggestion. I think there's a lot of logic to it. You have to take it back and see what that means. Are we doing least hour on revenue or on number of trips or number of shifts or number of hours? And there's a bunch of different ways that you can look at that. But it's certainly an interesting measurement that we focus on internally. So we'll discuss it and look back, but I think it makes a lot of sense.
spk01: Yeah, hey, this is Karen. This is Norm. I'll just add to that. I think that as long as the fee-for-service remains a somewhat significant piece of the business, we'll probably continue to track our trip count and our APC, and it becomes very important for us also as a way to explain why the transport margins have gone up very, very nicely, both sequentially and year over year, because our APC is higher. right? It's not by accident. We're running higher acuity trips, more advanced life-saving trips or critical care trips. It's made a very, very big difference. And that's definitely one of the things that's driving margin and something that was part of the plan. What you will notice is when you do the math, if you look at the, if you look at over time, if you look at the trip count multiplied by the average price per trip, and then you look at that and compare it to the total amount of transport revenue, you'll see that the fee-per-service piece explains a smaller and smaller proportion of the overall revenue from transport, with the rest being from the leased hour model.
spk04: And if we, I'll just add one more point, which is we've shared every new contract on the transportation side that we sign is a leased hour contract. So we're not adding any fee-for-service contracts going forward. They're all leased hour contracts moving forward.
spk06: That's super helpful. Thank you. And just one quick follow up. You mentioned that you've incorporated the roll off of the PHE in your guidance. Can you just give us a little bit more color on the mechanics on how exactly that impacts the business? Thank you.
spk07: I'm going to show my ignorance here.
spk06: PHE is... Sorry, the public health emergency.
spk07: Oh, thank you. We're all trying to guess here. So, yeah, so that, the public health emergency, you know, we've been planning on for a long time. And so there's many, it's a very, when that was implemented, it impacted many, many things. And so it's not just one silver bullet to mitigate it, but the biggest part of mitigating it is just making sure that we don't work on a fee-for-service basis. So, you know, most companies that are fee-for-service right now the way that the reimbursement from insurance works or from Medicare works really dramatically impacts the level of reimbursement, what that fee-for-service code is. They're going to, day after that's over, potentially get less from Medicare, get less from managed care organizations, whereas because of the fact that we do not take fee-for-service business, we're not subjective to those reductions for Medicare or changes in the Medicare fee schedule versus telehealth or in-person. So we've been planning on this for a long time and structuring contracts in such a way that it doesn't impact us. And again, it's fully baked into the guidance that we gave.
spk08: Thanks. Thank you. There are no further questions at this time.
spk11: I'd like to hand the floor back over to Anthony Capone for any closing comments.
spk07: Thank you, Operator. Before we conclude our call for today, I wanted to add that on June 30th of this year, we will be hosting an in-person investor day at NASDAQ's market site at Times Square from 1.30 to 3 p.m. During this session, we will be presenting in detail DOTCO's vision for the future of healthcare. The session will include tech demos, Q&A, and an opportunity to meet the entire DOTCO executive team. We hope to see many of you there. And lastly, I want to thank our team. Docco's value equation is a combination of our proprietary technology and the hard work of our dedicated 5,000 plus workforce. Our employees are not only the bedrock of our company, but thousands of them are also partners holding Docco shares and options. I am sincerely grateful to each and every Docco employee for their tireless efforts to help make high quality highly accessible healthcare a reality, and look forward to working together to take DocDocGo to greater heights in 2023 and beyond. That concludes our call this evening. Thank you again for joining us, and we look forward to our next quarterly update in May.
spk11: This concludes today's conference. You may disconnect your lines at this time. Thank you for your participation.
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