Greetings, and welcome to the DocGo second quarter 2022 earnings conference call. At this time, all participants are in a listen-only mode. A question -and -answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star and then zero on your telephone keypad. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Steve Halper. Please go ahead, sir.
Thank you, Irene. Before turning the call over to management, I'd like to make the following remarks concerning forward-looking statements. All statements in this conference call, other than historical facts, are indeed forward-looking statements. The words anticipate, believe, estimate, expect, intend, guidance, confidence, target, project, and other similar expressions are used typically to 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 DocGo's business, financial condition and other operating results. These include, but are not limited to, the risk factors and other qualifications contained in DocGo's annual report on Form 10-K, quarterly reports filed on Forms 10-Q, and other reports and statements filed by DocGo 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 presentation contains references to non-GAAP financial measures. Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are included in our earnings release, as well as in our filings with the Securities and Exchange Commission. The information contained in this call is accurate only as of 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. Stan Vashovsky, CEO and Co-Founder of DocGo. Stan?
Thank you, Steve, and thank you all for joining us today. The second quarter represented another period of strong operational execution. Our revenues increased 76% year-over-year to $109.5 million. Continued sales momentum and acquisition-based contributions have supported an increase in our 2022 revenue guidance to a range of $425 million-$435 million, up from a previous range of $400 million-$420 million. We're also raising our guidance for adjusted EBITDA to a range of $40 million-$45 million, compared to original guidance of $35 million-$41 million. Some of the key factors driving our continued organic growth, including the expansion of our agreements with Carnival Corporation, new municipal programs in New York, new mobile health programs in Los Angeles, and expanded medical transportation business with Northwell Health.
Our mass COVID testing revenues for the quarter were approximately $28 million and are expected to decline significantly in the third quarter. We have already begun offsetting with non-COVID related business in place, and in many cases the customers will remain the same. An example of this in New York is our transition from mass COVID testing with a municipal client directly into providing primary care at homeless shelters or medical imaging services for that same client. In sum, we expect the transition to these new non-COVID projects to be relatively seamless with minimal impact on revenue generation. On the M&A front, we expect to increase our activity with several prospective transactions in the pipeline, about which we are very excited. We continue to pursue synergistic opportunities where prospective targets may be currently outsourcing services which DocGo could directly provide.
This is in addition to those opportunities which open up new markets and drive enhanced profitability. Our goal is to continue utilizing a strong balance sheet and cash flow from operations to expand the breadth, depth, and profitability of the company portfolio of services. We continue to do an excellent job both securing new customers and deepening those relationships considerably over time. Last quarter, we shared a statistic that approximately 90% of DocGo's revenues are generated from customers in the third, fourth, or fifth generation contract, and that trend continues today. This success has occurred across all varieties of customers, from corporations to healthcare systems and municipal accounts. This achievement speaks volumes about our ability to get our foot in the door, provide exceptional value to the customer, and grow that business substantially.
We have also significantly enhanced our RSP capabilities in recent months, allowing us to actively bid on larger contracts across the country. While it is too early to quantify expectations, the pace of activity in this channel has more than tripled recently, and we anticipate a meaningful contribution from these efforts as we enter 2023. It is clear that the municipal customer segment will remain a cornerstone of our business for the foreseeable future, providing us with a stable base of revenue upon which we can build. Our direct to consumer and corporate health beta tests continue to provide very encouraging results. The direct to consumer market represents a tremendous opportunity, and we have partnered with some of the largest payers in the industry, including Aetna, Blue Cross, L.A. Care. We expect coordinated marketing efforts to begin with these partners in late 2022 and early 2023.
One market I would like to take a moment to review in greater detail is the cruise line business. Given that it represents a great business study regarding the value of DocGo's services to the customer. Initially, we entered this market with a relatively small contract to provide COVID related testing services to Carnival staff in early 2021. By the end of 2022, we expect to be facilitating full spectrum of standard healthcare services, from doctors down to lower level clinicians, a majority of Carnival's fleet. In 2022, we began serving two additional major cruise lines that we expect to follow a similar growth trajectory. The pace at which these initial contracts expanded highlights the attractiveness of DocGo's unique model and commitment to customer service. This success is also reflected in our NPS or Net Promoter Score, which is the gold standard of customer experience metrics.
Scores are measured from a range of -100 to +100, with scores over 30 commonly viewed as good, with over 50 being considered excellent. Our Q2 Mobile Health NPS score was an impressive 77, which is a testament to our customers' strong perception regarding the value of DocGo's service. Another example of continued business execution comes from a major hospital system in Southern California. This customer utilizes DocGo's emergency room avoidance program, which attempts to mitigate unnecessary emergency room visits. With our program, we achieved a 35% reduction in ER visits, resulting in a significant financial savings for that institution and earning bonus payments to DocGo for hitting that goal.
At the end of the day, our proprietary technology is the lifeblood that allows us to deliver efficient, cost-effective healthcare in a mobile setting, and we are making further substantial investments to support the next generation of functionality. At this time, I will hand it over to Anthony Capone, our President, to provide us some details on that front. Anthony.
Thanks, Stan. At its heart, DocGo is a technology company. As its former chief technology officer, I've observed our software evolve into a highly sophisticated system. In Q2, we greatly enhanced our dispatching application with the ability to assign Mobile Health and ambulance resources based upon predictive demand analysis. This sophisticated model allows for increased utilization, thus decreasing the idle time of our mobile units, further enabling our ability to deliver cost-effective healthcare. Our team also built a highly intelligent machine learning system to help predict reimbursement and help ensure collectability. At DocGo, we build software that is core to our business model and integrate with systems that support our business. In Q2, we completed our integration with one of the nation's largest EHRs, athenahealth. Additionally, DocGo was accepted into the Epic App Orchard as its first and currently only fully embedded Mobile Health ordering application.
Being in the Epic App Orchard grants the thousands of hospitals using Epic the ability to order DocGo services directly from within their native EHR. DocGo believes in virtual and mobile-first medicine. To support this vision, we've improved HealthPoint, our patient EHR system, by embedding telehealth support, which ensures a seamless in-app patient experience. Software and automation is at the heart of our company, and over the coming years, DocGo will continue investing tens of millions of dollars into our engineering team. Stan, I'll hand it back to you.
Thanks, Anthony. In sum, after an excellent quarter, we continue to see tremendous growth potential coming from a variety of different avenues in the years ahead. At this point, I will hand it over to Andre Oberholzer to address the financial details.
Thank you, Stan, and good morning. Total revenue for the second quarter of 2022 amounted to $109.5 million, representing growth of 76% as compared to the $62.2 million reported for the second quarter of 2021. The year-over-year revenue growth was driven mainly by the contribution of revenue from continued expansion of major corporate accounts, new and expanded municipal Mobile Health contracts, and the expansion of key customer relationships on the medical transportation side, such as Northwell. Mobile Health revenue for the second quarter of 2022 amounted to $87.3 million, as compared to $33.2 million in Q2 of 2021, up approximately 163%.
Excluding mass COVID testing revenues from both quarters, mobile health revenue amounted to $59.3 million, up from $23.2 million last year, an increase of 156%. Total medical transportation revenue amounted to $22.2 million, compared to $28.9 million in Q2 2021. Recurring transportation revenue increased to $20.2 million, as compared to $18.7 million in the prior year quarter, an increase of 8%. It is important to note that last year's second quarter included approximately $10.2 million in project-based standby transportation revenue, comprising emergency deployments on behalf of different municipal agencies to provide standby services at testing and vaccination sites. These emergency deployments gradually wound down by the end of the second quarter of 2021. During Q2 2022, project-based emergency deployment revenues amounted to approximately $2 million.
Mobile Health revenue amounted to 80% of total revenue during Q2 this year. This is 53% in the prior year, with transportation as the remainder. Revenue generated by the UK market grew by 45% to $3.2 million during Q2 of this year, representing approximately 3% of total revenue. Net income amounted to $11.8 million in the second quarter of 2022, which represents a substantial improvement over net income of $100,000 recorded in the second quarter of the prior year. Please note that net income includes a gain of approximately $3 million from the remeasurement of warrant liabilities and $1.4 million in a gain from remeasurement of finance leases. Even after removing these items, net income amounted to more than $7 million for Q3.
The net income improvement resulted from a strong increase in revenues during the quarter, coupled with improved total gross margin, while certain overhead costs related to infrastructure provided leverage as it did not increase in the same proportion as the revenue growth. Adjusted EBITDA grew to $12.3 million during the second quarter of 2022, up from $3.4 million in the prior year period. Even with additional investments we made in regional expansion, product offerings and infrastructure. As a reminder, adjusted EBITDA is a non-GAAP measure representing earnings before interest, tax, depreciation, amortization, stock-based compensation, warrant and finance lease liability revaluation, and other non-recurring expenses. Please refer to our earnings release for a reconciliation of adjusted EBITDA to net income. Total gross margin percentage during Q2 2022 amounted to 35.9% as compared to 34% in the same period of 2021.
It is important to note that on a consolidated basis, DocGo was able to drive year-over-year gross margin improvement despite the negative impact of inflation on the cost of labor and other cost of sales items. The 1.9% increase in the total gross margin percentage was driven by the Mobile Health segment, where gross margins increased from 28% during Q2 last year to 39.9% during our second quarter this year. This Mobile Health gross margin improvement was driven by a combination of factors, including lower lab fees and a continued shift away from higher price subcontractor labor, which represented a much lower percentage of Mobile Health revenues this quarter versus last year's second quarter. Positive improvements were reduced somewhat by higher costs of certain medical supplies.
Margins from the transportation segment were 20% during Q2 this year, compared to 22.7% during Q1. Our transportation gross margin this year continues to be suppressed by the impact of higher hourly wages over time and a significant increased cost of fuel. Transportation gross margins last year benefited from the inclusion of over $10 million in high-margin emergency deployment standby revenues. As of June 30, 2022, our total cash and cash equivalents totaled $208 million as compared to $199 million and $179 million as of the end of Q1 this year and the end of fiscal 2021, respectively. During the first half of 2022, positive net cash provided by operational activities amounted to $30 million, versus $1.1 million cash used in operations during the prior year period.
Excluding vehicle leases, outstanding debt amounted to $2.6 million at the end of Q2 versus $1.9 million at the end of last year. In May of this year, DocGo announced a share repurchase program of up to $40 million of common stock. Under this program, we repurchased 70,000 shares at an average cost of $7.10 during the quarter. In terms of the impact of inflation, as previously discussed, we have two major expense categories where inflation may significantly impact our results. Our 2022 guidance provided at the beginning of this year assumed that the average cost per hour of labor would increase by approximately 7% versus the already inflated 2021 labor rates, and that the average cost of gas would be $4.30 per gallon.
During the second quarter of 2022, the actual increase in the average hourly labor rate was higher than last year's actual rate, but lower than our assumptions. While the average fuel cost per gallon was significantly higher versus both the prior year and our forecasted rates. During Q2 of this year, the negative impact of the increased gas costs was approximately 73 basis points on gross margin compared to the second quarter of 2021, with a negative impact of 55 basis points against our assumptions for 2022. As for the cost of labor, year-over-year increase in the average hourly rate was a negative impact of 129 basis points on margins during Q2 of this year. However, the actual average hourly rate was lower versus our 2022 assumptions, which resulted in a positive impact against forecasted gross margins of approximately 94 basis points.
COVID-related testing revenue declined to $28 million during the second quarter of 2022, as compared to $38 million in the first quarter. Excluding COVID testing revenue from both Q1 and Q2 of this year, Mobile Health revenue increased by 13% to $59.3 million in the second quarter of 2022, up from approximately $52 million in the first quarter. As we have indicated before, going forward, we will no longer break out COVID-related testing revenue from total revenue. Adjusted EBITDA amounted to $12.3 million in the second quarter of 2022, approximately 11.2% of revenue, basically in line with the first quarter's EBITDA margin of 11.5% and above the annual guidance of 9.3% given at the beginning of the year.
For the six months ended June 30, 2022, total revenue amounted to $227 million, representing growth of 104% over total revenue of $112 million last year. Adjusted EBITDA for the six months ended June 30, 2022 amounted to $25.9 million, representing a substantial improvement versus the adjusted EBITDA of $3.8 million last year. Now turning to our 2022 outlook. We anticipate strong demand from our customers for both Mobile Health and transportation services. Given our strong year-to-date performance, as Stan mentioned earlier, we are increasing our revenue guidance to $425 million-$435 million, up from our prior guidance of $400 million-$420 million. We are increasing our adjusted EBITDA guidance to $40 million-$45 million, up from $35 million-$41 million.
This represents revenue growth of 33%-36% year-over-year, while Adjusted EBITDA would show improvement as a percentage of revenue to approximately 10% this year versus 7.9% during fiscal 2021. In terms of segment revenues, we expect that the Mobile Health segment will continue to contribute approximately 74%-76% of revenues, with medical transportation as the remainder. That concludes our prepared remarks. At this time, we will ask the operator to open the call to questions. Thank you.
Thank you. At this time, we will be conducting a question-and-answer session. If you would like to ask a question, please press star and then one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star and then two if you would 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. One moment please while we poll for questions. Our first question is from Richard Close of Canaccord Genuity. Please go ahead.
Yes. Thanks for the questions. Congratulations on the continued success. Andre, I was wondering maybe just some housekeeping. Is there any way you could provide us the transport volumes and pricing for the quarter? As we think about the growth rate in transportation on the recurring revenue side, I'm just curious your thoughts on the 8% growth. Should we be looking for something greater than that going forward? Or how should we think about growth on recurring revenue in transportation?
Hi, Richard. In terms of the actual volume and the price per trip, at this time we have not disclosed that. That will be in the 10-Q tonight, when we file with the SEC. When you see the results, you will see both an increase in the trip volume as well as the increase in price per call, which drove the 8% increase year-over-year. That excludes the, you know, the project-based revenue, so just recurring. We still feel, as in the past, that transportation year-over-year will grow around 30%. We do not see that trend changing at this point in time.
Okay.
Let me add to that, Richard Close. Richard Close, it's Stan Vashovsky. Good to hear from you again. Also, you know, as we've discussed earlier, our business model has evolved over the last several years, where the metric of quantity of trips per day is really no longer relevant because of the way we charge our customers, what we refer to as our lease out program. We get paid the exact same dollar amount by the customer. They're paying us, call it a minimum rate per day, which includes vehicle, crew, supplies, everything. If we do one transport or if we do seven transports with that single vehicle for that one customer, our compensation for that day is the same.
This helps mitigate, you know, days that are quieter versus days that are busier, brings some consistency, and allows us to better forecast our business. It also allows the customer to be assured that they have dedicated resources versus on-demand resources that in the past have proven to be somewhat non-reliable.
30% is a good growth rate in transportation?
Yeah.
I just wanna clear. Okay.
Yeah. We
All right.
We're still gonna stick with 30% growth for the year in that range.
Okay. Is there any non-recurring revenue in the third quarter of 2021 that we should be aware of?
Well, Richard, it's kinda hard to project. Right now we're not projecting much. The reality, you know, is that, you know, there could be a hurricane tomorrow, there could be forest fire in California, where we get notified by FEMA, we get notified by state agencies to come in and assist.
Those are project-based one-time type services. They happen several times throughout the course of the year, but projecting them is quite difficult. We're, you know, we're always gonna be super conservative and say that we can accomplish our growth target, with what we can rely on, which is our contracted business. We don't know if Q3 is gonna have that one time, you know, call it project-based, emergency response, that we've had in the past. Odds are we'll probably have a little bit of it there, but no way to gauge on how much of it will be in Q3.
In terms of last year, Q3 did not have any significant project-based revenue. Most of that work wound down by the end of Q2 last year.
Okay. That's very helpful. Thanks, Andre. Stan, on the M&A opportunity, maybe if you could just dive into that a little bit more. Based on your comments, it somewhat sounded like you guys are seeing opportunities on the Mobile Health side, maybe with some additional services. Did I hear that correctly or just any thoughts on M&A?
No, you're absolutely right, Richard. Our focus on M&A is Mobile Health services. You know, we think there will be opportunities. We're starting to see more and more opportunities, you know, approaching us. We hope to execute in the near future on some of these opportunities. We'll always acquire licenses and small little companies on the transportation side because that's just the most effective way to get a license to break into a market. You can file for one, but you can wait six, 12, 24 months if you're working through the municipality for a license, or you can spend a few hundred thousand dollars and acquire a small company and then just use that license as a starting point.
There'll always be some, you know, call it license acquisitions on the transportation side, but we are reserving most of our, call it, capital for a, you know, significant amount of, M&A activity in the future around mobile health. That's the space that we're mostly excited. It's a very fast-growing space. We see, you know, endless amounts of possibilities. We see lots of areas that we're very interested in, that we've proven to be very effective in, and that's how we're gonna put our capital to work.
Our next question is from Mike Latimore of Northland Securities. Please go ahead.
Great. Thanks. Yeah, congratulations. Excellent execution again. So I guess just on the guidance, in the press release, it says guidance increases based on organic growth and M&A activities which occurred subsequent to the quarter. It kinda sounds like you've already made an acquisition, or am I interpreting that incorrectly?
No, your assumption is correct. We've made what we call, you know, we use a term tuck-in acquisitions, you know, small acquisitions that give us licensing capabilities. So we haven't spent any material amount of money. We haven't acquired any material amounts of revenue, but we're always, I mean, historically buy five, six, seven little companies. We use their licenses as launching points. And, you know, we haven't done anything, call it, material, Richard. I mean, Mike.
Oh, I got it.
If historically you look at our patterns, you know, every quarter, we always, you know, buy a small little mom-and-pop out somewhere for their license.
Yeah. Most of the increase relates to organic activities.
Virtually all of it. I mean, very, very small amounts of it.
Yeah.
Yeah. You also have to understand, a lot of times we'll acquire a company that may have a couple of few million dollars a year in revenue, but it's not the kind of business we want to keep anyway. So we'll release that revenue and, you know, focus more on the way we wanna conduct our business.
Okay, great. Obviously, the growth margins are great. Should we view them as, you know, relatively maintainable at these levels or are there room for expansion in the second half of the year?
Well, you know, the reality is, Mike, we're always gonna try to make them better. You know, we still pay premium for staffing. We're, you know, as the market is talking about contracting on staffing, we're doing the opposite. We're hiring full speed ahead. You know, we're paying recruiter fees, we're paying staffing agencies. You know, we're still giving up a lot of margin that over time, I think will stabilize, and that will help drive continued improvement of our gross margins. We've always said Mobile Health ideally should be somewhere about 42%-43% gross margin and transportation, you know, slightly below that. There's you know, still room for growth and improvement.
Okay. Just last on the, I think you said you're hiring or you want to hire 600 people by year-end. How many of those are, you know, sort of net new versus replacing a staffing agency person?
All 100% are incremental to our current headcount. Whatever we have right now, that 600 does not include, you know, replacements from attrition. You know, just based on current workload contracts that we've executed with start dates already agreed to, work that we're anticipating in the second quarter of the year, our need for clinicians and operational staff is quite strong. We have a recruiting group of over 20 people. We have a whole bunch of agencies that help us bring candidates. We're continuing to hire as aggressively as, you know, almost as aggressive as last year.
Mike, I just—this is Andre. I just wanna clarify something Stan said. For Mobile Health, we still price contracts with a desired margin around 50%-53%. Based on the improvement you saw in Q, you know, two using the subcontracted labor, we are, you know, on that path towards those desired margins.
Correct. Thanks for that, Andre.
Our next question is from Sarah James of Barclays. Please go ahead.
Thank you. You guys had a really strong quarter as far as contract signing goes. I think you flagged Carnival, L.A. Care, and Empire BlueCross BlueShield in the release. Can you give us any idea on size of those or how we should think about modeling new contract adds as f ar as transportation revenue growth goes?
You know, that's a great question, Sarah. We don't really provide details down to the customer level. You know, our agreements with our customers prohibit us from sharing that kind of information. You know, in terms of modeling, you know, all I can say is we have a very good, strong track record of meeting and beating our guidance. You know, we feel very comfortable with the municipal contracts, the hospital contracts that we've signed. You know, the percentage of customers that are migrating from COVID-related work to non-COVID-related work is extremely high, well over 80%. You know, I would just say that municipal work will continue to be our biggest contributor throughout the country.
We have some very unique programs, you know, that I think differentiate DocGo from other medical providers, and then followed by hospitals and insurance companies from there.
Great.
Andre, anything else you wanna add to that? Or what do you think, Andre?
No, that sounds good. I mean, year-over-year, you know, we see this year about 33%-36% growth and, you know, that's kind of the, those kind of contracts it seems will stand up the growth.
You know, let me just add one more thing. We talk about 36% growth, but that's if you take, you know, the number of $319 million from last year compared to the guidance that we provided this year. The realities are that $319 million number from last year has about $40 million-$60 million of COVID testing that's not gonna replicate in this year. So if you take that $319 million number down to, let's say $250 million, you know, that's the real incremental business that we're out there securing. So it's been a wonderful year. We're very excited about the year. The demand for our services continue to be very strong. We provide clinical services in a way that our competition does not, extremely innovative and very tech-enabled.
It's 30%-35% if you look at it from end of last year. In reality, that number is closer to 50%-60% if you remove last year's, you know, you know, second half portion of the COVID testing, which we did not see as a major contributor this year.
Got it. That's very helpful. Could you give us a little color on your pipeline for new clients, either municipal RFP pipeline or conversations with providers?
Yeah.
How does that compare to last year?
Strong, extremely strong. You know, one thing that we've said before, you know, something that we're very happy about is the remainder of the COVID business. There's really only two, call it customers, two major customers left that we do mass COVID testing for. One of those agreements expire early September. The other one, the second one is extremely small. Something that we're just super proud of, and I think, you know, speaks a lot to our company's efforts is that same exact customer is migrating from a COVID program to a pure Mobile Health traditional type program. The personnel and the revenue that they contributed will remain, you know, working. There will be no layoffs.
They'll just simply come in, get some additional training in-house, and then be redeployed, a lot of times working for that exact same customer. We've accounted for all of the revenue that we expect to lose from the mass COVID testing sites for the second half of the year. All of that revenue is gonna be traditional mobile health, nothing to do with COVID testing, COVID vaccinations or anything related to COVID.
Our next question is from Pito Chickering of Deutsche Bank. Please go ahead.
Hi there. This is Kieran Ryan on for Pito. Thanks for taking the question. Just wanted to ask on margins again. I heard your comments on, you know, the strong 2Q gross margin and, you know, you think that can be maintainable going from here. It looks like the guidance, you know, suggests at least some step down in 2H. Just wanted to get a feel for is that just kind of the roll off of the COVID testing revenue or, you know, some conservatism around the labor and fuel costs? Or can you just talk a little bit more about kind of that move in margins going into 2H?
Andre, you wanna take that and I'll add to it?
Sure. I'll give it a go. In terms of the COVID testing reduction, there's no real impact on gross margin because everything we price on mobile health that includes COVID testing and mass testing, not consumer. We price at about the same margin between 50%-53%. As we roll off a COVID program and roll into a mobile health replacement program, there's no real change in the margin shift. For the second half, you know, we continue to look at inflation, gas prices, you know, did surprise us more than we planned on during Q2, so it cost us a couple of basis points. Labor is still holding, but, you know, we always wanna give guidance that includes, you know, some conservatism.
There's no real margin decline that we plan on other than, you know, looking at inflation and thinking about the impact of inflation in the second half.
Got it. Okay.
Yeah. I would just add that, you know, traditionally we've been always very conservative when it comes to revenue and EBITDA guidance. Internally, we always plan for the worst, and those are the numbers that you're seeing. Ideally, we hope for the best. If we see an improvement, we'll go ahead and then raise guidance one more time if that opportunity arises at the end of the next quarter. But in general, you know, our company cultures try to be conservative, you know, expect the worst and hope for the best.
Got it. Thank you. If you could just give us any quick update on is there any seasonality to watch for on the transportation side in 3Q into 4Q? Just kinda how did that business track versus your internal expectations this quarter? I think you took down, you know, that transport mix as a percentage of total by one percentage point. I'm guessing that's just kind of some outperformance on the COVID revenues within mobile health, but did that kinda live up to what you guys wanted to see there in 2Q? Thanks a lot.
Yeah. Look, we see a lot of value in our transportation business. That part of our business is getting smaller a little bit. You know, it may continue, you know, over time. We'll see. We like that business because it's recurring, it's steady, it's almost annuity-like. It also gives us access to a lot of patients that may down the line require our Mobile Health services. You know, naturally we focus our energy, we focus our strength in our higher revenue, higher gross margin, more profitable business, which is Mobile Health. We are still strategically committed to our transportation business. We still see good steady growth in that business. What we're very busy with doing is, you know, we transport tremendous amounts of thousands of people every single day.
What we're very busy doing is saying, "Hey, you know, we've got a person in our vehicle, we're taking them home. We know why they're being released. Well, what other services can we now offer to that patient?" Ultimately take a patient that was purely transport revenue and have that patient contribute in the future to our Mobile Health revenue. That's the kind of stuff that we're always thinking about and innovating.
Our next question is from Ryan MacDonald of Needham. Please go ahead.
Thanks for taking my questions and congrats on a great quarter. Stan, first one for you. It's great to see all the success you're starting to have in the payer end market. You know, now accessing member populations really starts to flex a new muscle for DocGo in terms of needing to market to members within that population. Would just be curious, you know, how that's going thus far in the beta test and, you know, maybe what your expectations are as this grows of what sort of penetration you think you can get within those member populations. Lastly, are you assuming any revenue or much revenue contribution from these contracts in the back half of this year? Thanks.
Hey, Ryan. Good, good to hear from you again. The reality is we do not assume any revenue or any significant revenue from those payers for all the rest of 2022. We see a little bit of contribution in 2023. We see a lot of potential in that space in our direct to consumer future offering. The results are coming in very strong. Ryan, as you can imagine, we don't do anything traditional. That, you know, we realize that in a traditional direct to consumer offering, the customer acquisition costs can get very high. We know that.
We are working and thinking very creatively, how do we reach out to millions of patients that can benefit from our service, but doing it in a non-traditional way that allows us to have access to high amounts of people at a very low cost. Until we figure that out, you know, we're gonna keep on trying various different things. Right now the pilots are going very well in New York and New Jersey. I would say tracking a little bit ahead of plan where we had expected, but we still have a long way to go to really come up with a direct to consumer plan that we feel super confident about.
Once that happens, and we hope that will happen sometime in 2023, you know, that will open up a tremendous TAM that we're not even tapping into right now.
Really helpful color, Stan. Thanks very much. Maybe just as a follow-up, you know, I thought it was interesting to hear about the updated technical integrations with athenahealth and then being accepted into the Epic App Orchard. I'd be curious, in your conversations with health systems, how much in the past has this been maybe a gating factor that might have prevented opportunities from materializing? How do you think what do you think the impact is to the pipeline, you know, having these natural integrations with two major EHRs now? Thanks.
Ryan, I'm gonna let Anthony Capone, our President, answer that. Go ahead, Anthony.
Thanks. Yeah. Thanks, Stan. One of the biggest, I would say, issues that many companies run into when they work with health systems is they try to convince the health system to use their software. It's a whole new application, and a hospital system may have thousands, tens of thousands of employees, and they're trying to get those tens of thousands of employees to use their new web portal, their new application. When you embed inside of their EHR and you eliminate all of that, it's single sign on, it's a click right from the patient's chart, it's seamless integration of data of all the patient's demographics, payer details, and charting information, HPI, all of that comes straight into your application, the barrier is pretty much nonexistent at that point. That's what the Epic App Orchard allows us to do.
Now, many people go into the Epic App Orchard, it's really just a link that you're inside of Epic, and then it launches your application. That's not the route we took. We took the route where the entire experience, end to end, start to finish, is inside of Epic, and then all of the data goes back into Epic so that the health system can do all of their reporting and KPIs and metrics inside of their application, without having to come to us for any of that. That really, you know, eliminates the barrier. As far as the second part of your question about what it opens up to, well, Epic is, you know, the most widely used and the fastest growing EHR in the hospital health system space.
That is, you know, very encouraging for us because the Epic App Orchard is now available to anyone that's in that space.
Ryan, let me add to that. You know, coming into a hospital system, a major hospital system, and sharing with them an offering that we would like to do with them and telling them they can further leverage their investment that they've already made in Epic, by utilizing our tech, it just makes the sale so much more attractive than anything else a competitor might be able to offer. In terms of barriers of entry, getting that integration completed took years. It took millions of dollars, and most importantly, it took major hospital systems lobbying on our behalf with Epic to get the support we needed to complete this endeavor. This was, you know, very, very complex, expensive, and time-consuming.
The only reason why we were able to achieve it is because large hospital systems that we have working relationships with lobbied on our behalf. Our competitors today don't have that advantage. That's something that we're, you know, very excited about and, you know, something that we think will continue to contribute to our growth in the future because we're telling hospitals, "Hey, just further leverage what you've already spent hundreds of millions of dollars on by using our services.
Our next question is from Craig Jones of Stifel. Please go ahead.
Hey, thank you. Stan, you mentioned how that your main COVID mass COVID testing partner was rolling into just a Mobile Health contract. Of that $28 million that you did in 2Q of the mass COVID, how much of that are you modeling in for 3Q and 4Q, whether it's mobile or COVID or however you wanna classify it?
Very little. We basically just have, you know, through August, a couple of days in September, and then that entire program goes away. You know, so you're looking at, you know. We don't give segment reporting out on particular projects. But what I would say is, you know, very minimal, mass COVID testing revenue going forward. And that is the reason why, as Andre mentioned, we don't really plan on reporting it as a separate line item going forward. It's way below the level of materiality, and it's just way too much effort and way too much work, to continue doing. You know, something that generates a few million here and there, is not worth separating out for us.
Yeah. Sorry, maybe I didn't ask that well enough. I meant, so your client is transitioning to Mobile Health. Like, how big of a, you know, quarterly revenue contributor will they be from a Mobile Health perspective?
From that aspect, I would say, you know, you can basically model out very similar to, you know, if not maybe a little higher, to what they were contributing in terms of revenue while they were doing COVID testing.
Okay.
We expect.
The majority of the $28 million should keep going just but as under a different contract under mobile?
Under a different contract on the traditional Mobile Health services. Correct.
Okay. Got it. On the Carnival side, you know, I think the Mobile Health grew something like 13%-14% sequentially excluding COVID. Was the majority of this Carnival ramping? You think about sort of the ARR, you know, how close are we to getting, you know, I guess, where is it right now from either monthly or annual perspective, recurring, and then, you know, how high can it get?
You know, Carnival was definitely a contributor. We have other cruise lines that are contributors. We have other hospitals and municipalities that are contributors. Another way that you may wanna consider looking at it is that all of the COVID or the very vast majority of the COVID testing revenue is going to become Mobile Health revenue. Whatever growth you're seeing right now in Mobile Health, that excludes mass COVID testing. In the future, you know, you can basically model out that revenue will become part of Mobile Health, and that percentage of Mobile Health growth will increase nicely going forward in Q3 and Q4.
Got it. Okay. If we look at the guidance, it looks like it's implying, you know, sequentially lower 3Q and 4Q versus the first half for Mobile Health or I guess for, yeah, probably for Mobile Health. If that customer is largely transitioning from, you know, mass COVID to Mobile, what's driving that headwind there? For why that would decline sequentially?
You know, so kind of like we mentioned earlier, we're always taking a very conservative approach. Many things can happen during the transition. We feel very good about the way the second half of the year looks. Naturally, you know, we are taking a conservative approach. At the end of the third quarter, if we're a bit too conservative, we'll once again go ahead and raise guidance.
Okay. Got it. All right. That's good to know. Thank you. That's all for me. Thanks.
Our next question is a follow-up from Richard Close of Canaccord Genuity. Please go ahead.
Yep. Thanks for the follow-up. Stan, I was wondering if you could talk a little bit about the RFP. You made some comments there about activity, growing.
Can you just dive in a little bit more on that? Is anything baked into your guidance, or is that all upside? On those type of contracts, how does a typical contract look like on that side?
Well, in terms of baking anything into our guidance, the answer is no. You know, we base our guidance on contracts and agreements that we feel very confident about. On the RFP side, we have access to lots of municipal and government systems that allow us to see what needs are throughout various municipalities throughout the country. We probably have the most amount of experience in the large medical programs of anyone out there today. We have wonderful clients that are willing to be our references for those types of services. We've seen a 3x growth in our responses in those RFPs.
We win some of them, and they could be small contracts, but we're now really are focusing in for some of the large ones. You know, contracts by the CDC, Department of Homeless Services, and there's municipalities, Border Patrol. There are medical services by very large agencies, dozens of them, that come out every couple of months. More than ever, we're responding to those and, slowly we're starting to win a couple.
Okay. Thank you.
Ladies and gentlemen, we have reached the end of the question -and- answer session. I would like to hand the call back to Stan Vashovsky for closing remarks.
Okay. Well, this concludes our call this morning. We began 2022 with a clear and significant momentum across our businesses. I'm optimistic that we have set the stage for a very successful year. I look forward to our next quarterly update in November. Thank you everybody for joining us.
This concludes today's conference. Thank you for joining us. You may now disconnect your line.