GMR Solutions Inc. Class A

Hello, everyone. Thank you for joining us and welcome to GMR Solutions Q1 2026 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Krister Sorensen, Vice President of Investor Relations. Krister, please go ahead.

Thank you, good morning, and welcome to the GMR Solutions Q1 2026 Earnings Conference Call. Joining me today are Nick Lopecaro, our Board Chair and CEO, Ted Van Horn, our President and COO, and Brian Tierney, our Executive Vice President and CFO. Before we begin, note that during this call, we may make forward-looking statements and that actual results may differ materially from those statements because of various risks and uncertainties, including those described in our most recent earnings report posted on our investor relations website and in the risk factors section in our IPO perspectives. Today's remarks also include certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in our earnings release that is available on our website, investors.globalmedicalresponse.com. Unless otherwise noted, references to the quarter will be for the first quarter of 2026. I will now turn the call over to Nick.

Thanks, Krister, and thank you all for joining us today. This is our first earnings call since the successful completion of our IPO a few weeks ago. An incredible accomplishment that could not have been possible but for the dedication of our frontline and support staff as we refocused our energy on our core competency of emergency care over the past few years. With this, we saw profitability grow in our financial profile strengthen, which led us to the IPO. Now we can more publicly, no pun intended, demonstrate and educate the masses on what EMS actually delivers, and that is that we deliver healthcare. We are the frontline of the frontline. We are the tip of the spear. There's no one further upstream than we are in the emergency situation. GMR is the largest provider of emergency medical services, serving 5.5 million patients annually, covering markets that represent over 60% of the U.S. population with one or more of our solutions. Our 24,000 highly trained clinicians and fleet of ambulances and aircraft are rapidly deployed to navigate and provide essential alternate site out of hospital care for patients when they need us most. As a national leader of EMS, this puts us in an exceptional position to be the innovators of the practice and raise the tide for the entire industry. We accomplish this through our 911 nurse navigation offering, our concierge platform, and our online ordering system, transport.net. Each of these innovations help take the friction out of the traditional run EMS systems and ultimately provide better patient care, more efficient operations, and better hospital throughput while delivering savings to the payers in turn. With that, we are pleased to report strong financial and operational results in the first quarter of 2026. Q1 revenues were $1.46 billion, which represents 6.6% year-over-year growth and continues to highlight the strong demand for the mission-critical services that GMR provides and our strong competitive position. Q1 adjusted EBITDA was $305 million, a year-over-year improvement of 9.7%, and EBITDA margin increase at 59 basis points versus the prior year quarter to 20.9%. These results reflect the continued emphasis on improving the efficiency of our integrated operating model and shared services infrastructure designed to effectively support our operators in the markets we serve. I'll note that both revenue and adjusted EBITDA came into the top of the range we provided in the flash of the quarter in the S-1. Q1 cash capex and cash used in aircraft financing combined was 5.4% of total revenue compared to 4.7% in Q1 2025. GMR completed approximately 1.4 million patient encounters during the quarter. We provided ground medical services to over 1.3 million patients, which includes more than 1 million transports, along with over 28,000 colons through our 911 nurse navigation offer. The remaining approximately 270,000 ground patient encounters consists of interventions on scene that did not result in a transport. During the quarter, we provided air medical services to over 34,000 patients. Our strong performance was driven by continued same-market revenue growth, revenue from cross-selling and new markets, disciplined cost management, continued optimization of our clinical and operational platforms, and an unwavering focus on service to our communities by keeping care at the center of what we do. Ted and Brian will elaborate further on the detailed drivers of the performance later in the call. I now want to provide an overview on regulatory matters. We've engaged with Congress to request that it enact new legislation requiring CMS to modernize air and ground ambulance reimbursement based on cost data that CMS is authorized to collect. GMR has highlighted to Congress and the administration the inadequate reimbursement we received from Medicare. I also raised this issue when I met with the CMS administrator, Dr. Mehmet Oz, in February. As a leader in EMS, we feel an obligation to raise our hand and move the whole industry forward. We are optimistic that bipartisan legislation will be introduced in the House soon. Last week, CMS released a proposed rule that would substantially overhaul the use of state-directed payments and supplemental payments, including intergovernmental transfers, or IGT, with respect to Medicaid funding. Under the proposed rule, a state's fee-for-service Medicaid payments would be limited to between 100 and 110 percent of Medicare rates if the state's total payment is targeted to a subset of providers within a broader provider group. The proposed rule includes ground and air medical groups, both private and municipally run. Notably, if the payment is not targeted to a subset of providers, a type of parity analysis within a broader provider group, then the Medicare rate cap does not apply. State plans that are impacted by the proposed rule will have a transition period until 2029. Albeit not common that ground or hair Medicaid payments exceed Medicare rates, we are evaluating the potential impacts of the proposed rule from all perspectives. Early analysis suggests a less than $5 million negative annual impact to GMR from the proposed rule. We are also evaluating the proposed rule's impact on select municipal run systems and the sustainability of their model versus our private provider model. Overall, we remain encouraged by the progress made in both the federal and state issues, and we'll keep you updated as we learn more. I'll now turn it over to Ted to dive deeper into our performance within the quarter. Thanks, Nick.