We'll do a quick overview of the business, and then, we'll get into Q&A.
Excellent.
All right, cool. Thank you.
Sure. So, for those that are not too familiar with our company, DocGo, we're one of the largest mobile healthcare companies in the country and the U.K. We operate in 30 states today in the U.S. and all across the U.K. And essentially what we do, our whole mission, is to bring care to those who need it, where they need it, when they need it, outside of the traditional four walls of the healthcare system. So we have three primary types of customers: hospital systems. We work with hundreds of hospital systems throughout the country and the NHS in the U.K. We work with municipalities, and we work with payers. And I can walk through a little bit about what we do with each of them. But with hospital systems, we do emergency, non- emergency, medical transportation.
We also do transitions of care programs. All of our programs are designed to help keep people out of the hospital or transport them out of the hospital. So that essentially the hospital has patients that are focused on people that have acute needs, and anything that can be cared for outside of the four walls of the hospital, that's what we do. And then we work with municipalities on population health programs, all designed to bring care to underserved populations. And then we work with payers ultimately to lower the total cost of care and to improve health outcomes, which is great for the system, and it's great for patients.
Great. So, let us just start with kind of recent events, and then we'll get into more kind of where we are going, you know, going forward. So it's well known that you have a series of contracts with New York City to help care for asylum seekers relocating, you know, to the metro area. And there are two principal contracting agencies, right? New York City Health and Hospitals and the Housing Preservation and Development. And many of these contracts were initially, for those of you on the webcast or in the room that don't know this, awarded under an emergency order, right? You know, after certain border states began busing immigrants up to New York City. And those are difficult circumstances under any terms, right?
Really not surprising that there would be all kinds of controversies, but particularly controversial when you add in the fact that it's an election, close to an election cycle, right, and a lot of political shenanigans going on. So with that as a backdrop, in your most recent earnings call, you took the unusual step, right, of identifying how much revenue is asylee related in this year and what your expectations are for 2025, and I think the 2024 number about, you know, a little over half your revenue, right, was gonna come from those contracts. So implicit in the disclosure is that you'll be pivoting out of some meaningful percentage of these contracts, right?
You didn't really talk about that over the remainder of the year, but maybe you could just, you know, before we get into any kind of numerical conversation, maybe just take a few minutes to talk about why you made that choice, right? And, you know, how would you characterize the status of the contracts with both those agencies? 'Cause I think they're very different, right, you know, in terms of-
Right
What the status is and what your expectations are going forward for those contracts?
Sure.
Yeah.
So I mentioned we have the hospital systems, we have municipal customers, and payer customers. What David was alluding to is, we work with municipalities, specifically, New York City, to help during the migrant crisis, the asylum seeker crisis, that really started about 18 months ago. There was a huge influx of asylum seekers coming to New York City, and we have a long-standing relationship with New York City, working on a range of population health programs that I mentioned earlier. And so one of the things that we did is we helped step in and provide care for the newly arriving New Yorkers as they came to New York City. Things like health screening, infectious disease control, vaccinations, depression screens, and a range of wraparound services.
As part of that, we signed contracts with New York City Health and Hospitals and with the Housing Preservation and Development, part of New York City, to provide these services to the newly arriving New Yorkers. What we did on our last earnings call was, we took the feedback, and we basically broke out how much of the company's revenue was coming from these municipal migrant-related programs, which we shared was $300-$350 million expected for this year. And we gave guidance, updated guidance on our last earnings call. That guidance revenues were gonna be between $600-$650 million. So essentially we broke out, as David was alluding to, the migrant portion of the business, and we did that for a number of reasons.
One is, we really wanted to give our investors and the community, and our stakeholders visibility into how much of the business was coming from the asylum seeker-related contracts, because that has been getting a lot of, attention, and-
Mm
I n some cases, politicized attention. And then we also wanted to show what the base business of the company was doing. The other thing that I really wanted to stress was, I wanted to share essentially how the business has evolved, essentially pre-COVID, pre-migrant. Obviously, we had very large COVID contracts during the COVID crisis, but if you take out all those contracts and the migrant-related contracts, when you compare, let's say, 2019, the year before COVID, and you compare it, we did less than $50 million of revenue that year. And again, we wanted to share that the base business was gonna be between $280 million-$300 million for this year, and $400 million, which I know we'll talk about, $400 million for 2025.
And so really giving more visibility into how that base business has grown over that five-year span-
Mm
G iving visibility into how much of the business is relating to the asylum seeker crisis, and then giving people a real good window and look into what we believe the business is gonna look like next year as well, so people can see that growth.
Right, so if you look at going back to the two different agencies that you're doing business with, HPD and Health and Hospitals, that, you know, H and H has been a client, I think, for quite a while, right? And you do a lot of different things for them. HPD, I believe, was a new client, correct?
That's right.
With the asylum-seeking-
That's right
Y ou know, business. So, how do you think about how those two contracts evolve over the next 18 months? 'Cause or not two contracts, those two relationships, I should say, and the business that you do with each over the next 18 months.
Yeah, so I think we started working with HPD in May of 2023. And that's essentially when we started working to help with the asylum-seeker crisis, and we helped increase enormous capacity and scale for the need, the emergent need that was happening at that time, and has continued and persisted. That contract ran through May of 2024 but then was extended through the rest of this year so that we can transition some of the sites, and depending on the need, the slope of that transition may be steeper or slower. But essentially, what we did was we transitioned out of HPD's Downstate sites in mid-May, so we're not operating the Downstate sites anymore. We also have Upstate New York sites that we're gonna be transitioning over the course of this year.
So I think that relationship will kind of evolve throughout the year. You know, we again, we wanna do it thoughtfully. People sometimes forget there's human beings involved, there's families with children that are being cared for in these programs. We're very proud of the work we've provided to them, and so we wanna make sure that that transition is as smooth as possible, and the slope of that transition will be dictated on what the need is and ultimately making sure that those families are cared for through the transition, but through the end of this year. New York City Health and Hospitals, we've been working with for a number of years, many, many years now, on a range of programs, including providing healthcare access to unsheltered New Yorkers, homeless unsheltered New Yorkers. We run a radiology program.
We provide all of the medical transportation, the non-emergency medical transportation for the hospital system. And so I think that really is the core of what we do, providing healthcare services, using our technology, using our scale, using our resources, using our logistics, using our licensure, to help provide access to care for people who are underserved. And that, you know, is a shared mission with New York City Health and Hospitals, so I think that relationship, we'd be honored and privileged that relationship continues on through this year, through the multitude of services and into next year as well.
Right. So it would... Would it be fair to, you know, characterize it as that the HPD relationship is kind of transitioning to its natural conclusion, maybe the timing's uncertain, whereas Health and Hospitals, that remains, you know, an important client and, and, and customer of yours, which could continue to grow even if you exit out of the, you know, asylum-related projects?
That's right.
Okay, great. Now, you know, one question that often comes back up is, you know, what, what fallout has there been from this really politically charged, you know, kind of contract? Has there been any kind of lasting things, how have you managed that? You know, how should we think about that? Because it's just been so public because of how political it is.
Yeah.
Yeah.
Well, I think the fallout, first off, has been just the story of our company.
Mm-hmm.
You know, I think when you rewind pre-migrant, you know, again, we've been working with hundreds of hospital systems, lots of payers, the national health system. You know, we're the healthcare heroes, and we were there on the front lines through all sorts of public health needs, and we were very, very celebrated for that.
Mm-hmm.
I think also the story of our company is, but again, clouded a bit by this, the story of our company really is this vast mobile healthcare company that has enormous growth over the course of a number of years now, a profitable healthcare delivery services company, technology company. And so I think the story has gotten clouded a bit in terms of all the different range of services we provided. You know, last year, we provided healthcare for 1 million patients-
Mm
J ust about 1 million patients last year. A portion of which are asylum seekers, newly arriving, migrants to the U.S., but many, many, many hundreds of thousands are patients from all walks of life, and I think that had got clouded a bit. And I think the story of our company, I'm excited to share it every time I get the opportunity, really is, you know, we really are innovating on healthcare as delivered. We're using technology to bring care efficiently and profitably and delightfully and effectively to patients where they need it. Many oftentimes, patients that can't travel to seek care, they can't access doctors, and we're bridging that gap, which is incredible. And we built a whole technology suite of services, a whole technology stack that enables us to do it efficiently.
So that is very exciting, and we were very, very excited about that. And so I think that has clouded that, and I think we really need to share all of the opportunities the company has and be very clear. That's again the reason why I wanted to break out that migrant revenue. I think with our customers, the vast majority, you know, all of our customers were very proactive. They work with us on a day-in-day-out basis. They've worked with us for many years now. Lots of our contracts are on its third, fourth, fifth year. Very often, our contracts are in third-generation, fourth-generation contracts. And so the customers that work with us, they know us.
They're not easily swayed by what they might read in the press relating to the unrelated migrant contract to the work we do with them. And so our customers know the value of the service we're providing, the quality. They know our people, their patients. Our collected patients with those customers are very, very happy with the work we're providing, and so we haven't seen any impact with our current roster of customers. We do have one insurance partner. You know, we have
Mm. Mm
I nsurance contracts with eight of some of the largest insurance providers in the country. We do have one of those paused just about the noise surrounding the migrant work, but I would say that would be the one that I would share and call out. But the many, many hundreds of our other customers that we're working with, the hospital systems, all know the value of our work, and so we haven't seen a big impact there.
Good. So let's, let's just kind of, like, kind of go on to the next phase, if you will. Because I think, again, just from an investment perspective, and this relates to the fundamentals of the business, is that, you know, the question comes up: how do you manage that transition when you lose, you know, 55% of your revenue year-over-year? And I know not all of that goes away, but, you know, a big chunk of that does. So if you take, you know, the 2024 revenue ex asylee-related revenue, it's a little under $300 million, I think, right? It's, like, $290 million, and about 190 of that is transportation, right? So you've got about $100 million left, of mobile health.
So if you just take trend line growth in transportation, the mobile health business probably needs to get up to hit your $400 million, needs to do about $80 million plus, right? So it's got to grow 80% year-over-year. So the question comes up: how do you do that, right? So do you wanna just, you know, take some time here maybe to talk about, you know, where is that growth gonna come from? You know, because it is definitely doable 'cause, you know, it's a $100 million base going to $80 million, and you guys have done that in the past, right? So it's not like it hasn't happened.
Yeah.
But why don't you talk a little bit about how you envision... 'Cause you had to come up with the 400, right?
Right.
What, what is the mechanics that get you there, and what, what is the pipeline of what gets you there, things like that?
Yeah, and we are very data-driven around that approach. People that know my background, you know, we take a very data-driven approach. And so what we did was we looked at the current business that we have, that you alluded to, with all the current customers we're already working with, very, very large hospital systems, very, very large name brand payers, very large municipalities, and we said, "What's the work and the projects and the programs that we're gonna continue to develop with them over the course of this year and into next year?" And obviously, that went into the revenue build. Then we looked at all of the pipeline that we have now, and the pipeline is really comprised of multiple items.
So the first is, people that know our business well, is they know that we submit a tremendous amount of RFPs, request for proposals. That's usually how the municipal business is contracted. Even hospital systems issue RFPs, and we respond to those. I would say over the last two years, we've responded to well over 200 proposals. Now, some of those are, some of those we'll win, some of those we won't. Some of those, as an example, we've already received a notice of award, but we haven't contracted. It's in the contracting phases now. So we looked at all of those RFPs that we've submitted, including ones where we've been notified, "Hey, you've been selected as the winner," but we don't announce anything until we've actually contracted.
That's one of the things that's important to me, too, is when we announce things when it gets contracted and launched. You know, since I took over as CEO, that's kind of been the... Essentially what we're doing efficiently and then also delightfully for the patients and for the hospital system, and that it's, I want to share that because that's what makes all the difference. Otherwise, you'd be... You know, you have to go into the patient's home, you have to do it as efficiently as possible. You don't want your clinicians driving around or, you know, not being as efficient as possible.
Sadly, we've already gone over our time limit here.
Oh.
So is there anything in closing you want to say that we didn't get to, just quickly? We're over, but go ahead if you have anything.
Well, I shared that-
Yeah.
T hat technology piece. But, you know, I would say we really are, you know, we are really at the early innings of all of... It feels like we've been at it for a while, and I just mentioned we grew the business from less than $50 million revenue in 2019 to over, let's say, $400 million, is what we shared for next year, non-migrant, non-emergency contract or COVID related. And so we've really grown the business really well. We've proven that we can grow the business and execute on it. But I would say we are just scratching the surface in the markets that we are serving, right?
I mean, when you think about all of the hospital systems that we can help, all the patients that are getting discharged day in, day out, the last thing they want to do is bounce back to the hospital. The last thing the hospital wants is for them to be readmitted or bounce back to the ED. And so that's, you know, McKinsey basically shared that in-home health and the mobile healthcare market is $ hundreds of billions.
When you think about all the good that we can do, bringing care into the home, bringing care to where people are, working with hospital systems, working with huge municipalities, working with huge payers, you know, we have a very, very large, you know, runway and a big opportunity in front of us, and we've built a lot of the capabilities and licensure and technology that's gonna allow us to scale.
Great. Well, again, thank you for coming.
Yeah.
Delightful to have you.