Here we go. All right. All right, we'll get started. Thanks for joining us. We have DocGo joined here with the CEO, Lee Bienstock. I'm Steve Halper with Healthcare Sales at Cantor. Excited to go through the story. Looking for the update, as everybody else is. I guess maybe to start off, Lee, you've been at DocGo now for the last several years. Just kind of get a sense of what you've seen over the last three years with the company, where you see it going. Just kind of give us an update to start the conversation.
Absolutely. It's great to be here with you and the Cantor team, Steve, the Cantor team. Covers our business really well, and it's great to be at your conference. DocGo, as you mentioned, I've been at the company for three years. I've been at the helm as CEO for the last two years, actually coming up on my two-year anniversary here this month as a CEO. The company's been under a great transformation and really made some incredible progress. For those that don't know the company or are new to the story, we're one of the largest mobile health and medical transportation providers in the country. We also have about 600 team members in the U.K. serving patients across London, Manchester, and Newcastle. We serve patients across 30 states, as I mentioned, and the U.K. All told, we'll provide medical transportation for 750,000 patient transports.
We will provide medical care in the home for 150,000 patients, again, in their living rooms, and we'll monitor remotely 50,000 patients, so all in, just about a million patients will receive services from us this year, and we've really scaled that over the past couple of years, really focusing in on longitudinal care, providing holistic preventative care, as I said, to many, many, many hundreds of thousands of patients. The only way to do that efficiently. This idea is really an old idea, right? The doctor coming to your home is an old idea. It's not a new idea. The only way to do it efficiently and over time profitably is to leverage technology, and we do that in two ways.
One is we've purpose-built our own logistics and dispatch management platform that efficiently deploys our 5,000 heroes in the field, our 5,000 clinicians in the field every day, utilizing 1,000 vehicles across our footprint to deliver care in the home. Our technology platform optimizes the right vehicle with the right clinician, with the right diagnostic equipment, all for the right patient need, all stacked in a most efficient way so that we can see the most number of patients in a shift with the highest quality. So that's what our technology platform does. The other thing that we do, which is very innovative, is we don't actually send the doctor in the car to your home, Steve.
We send a Licensed Practical Nurse, which is the hands, eyes, and presence in the home that's then synchronously, using our technology platform, sending readings back to the remote clinician that's able to see far more patients in every hour. So the LPN, the lower-cost entry labor, is the one driving from home to home, setting up the visits, and the very, very, very specialized resource like MDs, NPs, PAs are the ones sitting centrally seeing patients virtually. So that hybrid model is very unique. It allows us to deploy dozens of services into the home. And that platform, we think, will scale very, very well. And that's what we've been working on over the past number of years.
Great. Yeah. We'll definitely get into the segments you highlighted. I guess maybe start with the biggest, which is the transportation services. Maybe touch on that tech offering, like the interface, how it's utilized, how complex is it, or simplistic is it, and what is it that really is driving your efficiencies there?
Yeah. I think the tech is incredibly complex, but we make it very simple for our hospital system partners. That's the magic, I like to say. I don't know. I haven't gotten a nastygram yet from someone like Uber or Instacart. Delivering your lunch is child's play compared to what we do and manage in the field all day. Really, that complexity of ascertaining when that ambulance is going to arrive is complex, right? Because a patient may be on oxygen. The hospital may have elevators that are slow. Certain discharging nursing stations are slower than others. Certain hospitals have patients ready to be transported faster than others. So we take all those variables and we bake them into the tech platform. And so hospital systems, our customers are hospital systems that leverage our medical transportation platform. And we provide them the software platform.
Their transfer centers that are managing the discharges of patients utilize our software, which is integrated with Epic. That's a very crucial component. We'll talk about it, but we have a joint venture with Jefferson, and Jefferson's one of Epic's largest customers, and they helped us shepherd this integration with Epic. So directly from the patient's chart, a discharging nurse can click a button, just like we've all grown accustomed to in our daily lives, and they can see exactly when that ambulance is going to be arriving to pick up that patient. So very simple for the customer, but in the back end, very complex because we have to optimize, again, the right ambulance for the right patient need, all with the right diagnostic equipment. Some patients are on oxygen. Some patients are on balloon pumps. Some patients don't even need to be transported by ambulance.
And then we certainly don't want to transport those patients by ambulance. We want to send them to our integration that we have with Uber Health as an example. But those patients that need to be transported by advanced life support vehicles with paramedics, our system is optimizing all of that in the back end and giving an ETA to the hospital systems. The hospital system partners love this. Not only do they know when the ambulance is arriving, Steve, the absolute crucial part is now the hospital system, because we're integrated with Epic, knows when to get that bed ready for the next patient and when it's going to be available for the next patient. And that whole optimization is incredibly, incredibly valuable to hospital systems that don't want patients staying an extra night than they don't have to. Because very often that extra night is not reimbursable.
Very often that bed needs to be freed up for the next patient, and that bed management holistic view is what's very valuable to the hospital system partners. Very difficult to do. We've been building this now for 10 years.
Wow.
But very simple for the hospital system partners. And again, integrated with Epic. They love it. I'll just mention one more big thing about this platform. There are other companies out there trying to build a medical transportation platform like ours. The big difference is we actually run the trips. There's a lot of companies out there. That's why I think our strategy is incredibly compelling, because not only do we build the software, we build it for ourselves, and we're the ones using it in the field. We know what it's like to transport a patient from one place to the next. We know what it's like to go from one patient home to the next. We're not just building the software. We're also delivering the services.
I hear from hospital system CEOs, from health plan CEOs, insurers, providers that that vertical integration is very unique, but that's what makes all the difference. They don't want to just buy another software platform. They want to buy an end-to-end solution.
Yeah, that's a great way to put it, because it seems like you're building a boat here, and that's obviously extremely important when we're thinking about technology. Maybe you could touch on your joint venture with Epic. I just want to go over the pipeline. What's the visibility in your pipeline? How should we think about your pipeline? How do you feel about your pipeline? Where are we going with it?
Yeah, so we're very excited. So our integration with Epic specifically is targeted towards the hospital system partners that we have with our integration. I mentioned we have our joint venture with Jefferson, but we work with, and we're sitting here in Midtown Manhattan. Here in New York alone, we have contracts, and they use our software with Northwell, with New York City Health and Hospitals, again, utilizing our software, Mount Sinai. And so we service a big population here in New York. Same thing in Pennsylvania as an example. I mentioned our joint venture with Jefferson. That's been running now since 2017. So again, very sticky customers. They love our service. We work with Main Line Health as well. So we work with the large hospital systems, and those hospital systems are growing. They have more and more demand, and the patient flow is robust.
And in addition, obviously, those logos and that experience helps us win other new contracts in the markets we go. So as an example, just over the last year, we just launched a new market in Texas in the Dallas-Fort Worth area with our tent pole. The way we like to expand is we enter new markets with a marquee customer as our partner. So in that case, we work with Methodist in the Dallas area. And then we'll go and then expand our footprint with that land and expand strategy. And so there's a lot of opportunity in new markets for us, but we also have some density to be gained in the markets we're already in.
How long does it take to win something like that in Texas? What's the sales cycle?
Yeah, I think the sales cycle for medical transportation is anywhere from 6- 18 months. It's actually pretty similar on the mobile health side with the health plans. I think on the fast side, well, every hospital system says they want to move quickly.
Right.
Let's be real. Every hospital system says, "We need it now," and then now ends up being nine months later. But I think that the sales cycle is shortening because a lot of hospital systems really want this holistic strategy. They're tired of the piecemeal that they've had. You have to remember, really, before we innovated in this space, calling an ambulance was like calling a taxi in the '80s and '90s, right? You had a list of taxi providers on the Yellow Pages style. A discharging nurse would have a sheet of paper, call the first one, "Can you come get the patient?" "No, okay," call the next one. And now I think once they see the technology, we demo it for them, and then we also say, "Hey, we'll take over the trips as well, not just sell you the software." I think that the sales cycle shortens.
We also have great proof points of the amount of money we're saving hospital systems, and hospital systems are under a lot of stress right now. There was just a report published that hospital systems have less days cash on hand. Some of them are losing hundreds of millions of dollars, and so we come in and say, "Hey, we can help you monetize the beds you have." Because keep in mind, to bring a new hospital bed online, so to speak, to build one new hospital bed each costs $3 million. So the hospital system is much better off utilizing the beds they have much more efficiently, and that's where we come in, but the sales cycle can be significant because we are partnering with the marquee largest systems out there.
What's the length of a typical contract? Once you have that, how do you think about your renewal cycles? Does that change? Are you seeing longer renewal cycle or longer duration with renewals because you've established yourself as being a great provider? Maybe touch on that. It would be helpful.
Yeah. Our contract terms typically on the medical transportation side with the hospital systems tend to be three to five years. So they're very longstanding. They're sticky. We integrate our software into theirs. We run their trips. They have a dedicated fleet-hour model, which we can talk about with them. They tend to run to three to five years. We've been working with Northwell since 2018. We've been working with Jefferson, as I mentioned, since 2017. We just renewed our contract with HCA TriStar in Tennessee. We just renewed our contract. I think we've been operating it for many, many years to provide the 911 service in Atlantic City, New Jersey. So we have a tremendous track record of signing basically three-to-five-year contracts and then, of course, providing great service that they stay with us for almost a decade here now.
Do you have any seasonality in your renewals, or is it pretty consistent throughout the year?
On the medical transportation side, we don't see seasonality. Pretty consistent. Sure, during flu season, we may have more transports. There's a very severe flu season this past flu season. On the health insurer side, which we didn't talk about just yet, but where we go to the home and close care gaps for members of health plans, we tend to see seasonality there where the contracting process heats up, really around this time of the year, maybe a month prior and sort of another month to go here, where the health plans are very focused on trying to get to those members by the end of the year that they haven't reached yet. Because if they leave those open gaps for those health plan members, it ends up degrading their quality scores, which ends up degrading their premiums, which ends up degrading, which we're seeing all over the place.
Just the trickle-down effect.
Trickle-down effect is enormous. So right now, we work on the health insurer side, which we should talk about. We work with two of the top 10 largest national plans. We have two others of the top 10 national plans in contracting right now. And we have another 35 health insurers in the pipeline that we're in the process of engaging to roll out these care gap and primary care service offerings in the home, which is really the future of where healthcare is going, which I'm sure.
We'll get to. Before we get to that, I wanted to ask. You brought up Texas as a win. I know you recently signed New York, so maybe I'm just kind of curious the update there. If you can provide any color with it, it would be great.
Yeah, so in New York, we just onboarded one of the largest hospital systems here in New York. They're leveraging, again, the full vertical integration, our software platform integrated with their Epic instance, which we completed that integration within five weeks, which again is unheard of. Our engineering team is very talented. They got that done within five weeks, and now we're providing dedicated ambulance service and crews to that hospital system. So again, that full integration. That contract, along with some of the other expansions that were underway, we anticipate doing a record number of medical transportation trips for the company this year. As I mentioned in the onset, we should do over 750,000 patient transports, which puts us as one of the largest scale providers, and so that should give us some really great momentum in the back half of this year.
We did 175,000 patient transports in Q2, so we expect to see some uptick in Q3 and Q4.
Right. Yeah, that's actually where I was going to go next. Just the growth around those visits, how should we think about it from not only sequentially, but also kind of on a year-on-year? It seems like you have a lot going in your favor.
Yeah, so we project that our medical transportation business should grow by about 15% year- over- year. Now, some of it is lumpy, as I said, because we bring on hospital systems at a time. We bring on large hospital systems at points in time that step change the growth curve for us. We don't just pick up a few extra trips from some nursing home, or we don't just add a couple of extra trucks, and then we end up taking a few more trips. We end up onboarding, as I mentioned, these large hospital system contracts. And so the growth tends to be more step function versus linear. But we expect to see about 15% growth in the medical transportation space. And then we expect to see on our care in the home business about 50%-100% growth.
And I shared on our last earnings call, so far for the first half of this year, we saw more patients in the home than the entire last year combined, the entire 12 months combined. So that is growing. We think that should grow 100%+ the visits in the home. And the total mobile health segment should grow about 50% year- over- year with the care in the home business.
Right. Yeah, it makes sense. And that's where I wanted to go to next, mobile health, which is basically 30% of revenue. And it sounds like based on those growth rates, it's going to be a bigger percent of that pie. So yeah, I guess it would be helpful to kind of expand a little bit further on where you see that going. What is it about mobile health that you find is generating that? It's just doubling every year.
Yeah, again, an old idea. It's insane that healthcare really hasn't embraced this earlier, but I think the pandemic pushed it, and we're absolutely at the vanguard of this. An old idea, meet your customers, in our case, our patients, meet them where they are. Pretty simple idea. And we think it's going to have a profound impact, and we're seeing it have a profound impact. And so we go and meet patients where they are. These are the patients that are not seeing their doctor. Only one in four Americans doesn't have a primary care provider, and patients haven't seen their doctor in over a year. These are the patients that the health plans are focused on because, unfortunately, they have chronic conditions. They're not going to get the care they need. And yes, when you don't get the care you need, you get sicker.
When you get sicker, you're more expensive to the health plan, more expensive to the system. You're more expensive to Medicare and Medicaid. We go and meet those drifting, unattached, open care gap patients in their home. We started doing this about 18 months ago. One payer gave us a list of 2,000 patients that fit this description, right? Mobile, not getting the care they need, have open care gaps. Today, we're working with over a half a dozen payers, particularly in New York and California, and they've given us close to a million patients that need care in the home. We're building out all the infrastructure to be able to go and provide that care in the home that they need. We close over 40 different care gaps, things like diabetic retinal exams, bone density scans, colon cancer screenings, vaccinations, annual wellness visits.
We do that for children. We do that for adults. And so we're doing that at more and more scale as we go through the year here.
And I should know this, but the government portion of that business, I know you took it out of the guidance recently, but how should we think about that? Because it's obviously been very complicated. There's definitely a lot of moving parts and moving reimbursement rates. So if you could touch on that, it would be really helpful.
So on the government side on the mobile health, if you know our story well, and certainly over the last two years, we were awarded and enlisted to help with various different crises here and emergencies over the past four or five years, particularly starting with COVID, where we rushed to help with testing, vaccinations. We ended up testing and vaccinating over 2 million patients through that pandemic, and we were one of the largest people helping that. And then most recently, again, if you know our story well, providing medical care and wraparound services for newly arriving migrants and asylum seekers became a polarizing contract, became politicized. We did amazing work there. And so over time, we're also finding that these government contracts, we're being a lot more selective with the ones we take, right? We're looking to do less episodic emergency care.
Of course, as a healthcare company, we have an obligation and duty to help. But when we do help in the case of an emergency, we're going to break that revenue out. We're going to report on it separately. And the contracts we're really focused on right now are helping municipalities care for unattached and unaddressed populations on a population health perspective. So bringing vaccinations into communities that don't have good access to vaccination, bringing mobile units into communities that don't have good access to primary care, medical care. Those are the types of contracts we're focused on the government population outside, which is a big evolution, which I know that was your first question.
Which it sounds like you learned a lot from the experiences, and I guess where I wanted to go next was how it changed your conversations with these government agencies and the way you think about it being more selective, as you put it.
Yeah, so first off, we're just responding to fewer of those emergencies. We're actually funneling those opportunities out of our sales pipeline, right? So most of the government procurement process happens through RFPs, and so submitting RFPs, we are still submitting a large number of RFPs, but as I mentioned, they're for these evergreen population health style programs and less for emergency response. Now, again, I do view we have a responsibility as a healthcare organization, as an emergency medical service provider, as a company that has 1,000 vehicles and 5,000 heroes that work for the company. I do view that every healthcare company like ours has an obligation to health in a time of need and will certainly be there to do that, and that's certainly what we've done over the last five years.
But we'll report on that separately and we'll break that revenue out because it tends to be episodic, non-recurring. And we want investors, and again, I've pushed really over the last two years to give investors more and more transparency and clarity around what those contracts look like. So as an example, about a year and a half ago, we started breaking out the revenues from the migrant-related programs and reporting on that and breaking that out of the revenue. And so on the government side, we're going to start to, as we talked about, break out that revenue report on it separately. And about two quarters ago, we removed that from our guidance so investors can see the revenue being generated from the care in the home business, the healthcare to the address business, and the medical transportation health support business.
Do you have the ability to get a sense of the pipeline on the government side? You said it's episodic, but is there a way to get more durable, longer-term contracts out of a more simplistic offering?
Yeah. So one great example of that is we just launched, and this will give you a really good example of what's happening with government procurement from an example I'll share from our experience. So about at the end of last year, the end of last year, we submitted an RFP to provide community-based vaccination in Southern California. And when we submitted that RFP, they had told us that they wanted to launch the service in February, right? So here I am sitting on our earnings call in March, or at the end of February. We still hadn't heard back, right? What had happened with that RFP? And we had many dozens of RFPs that we had submitted that we had expected to hear back from.
And because of the change of the administration, because of DOGE, because of some of the uncertainties on budgets, a lot of the RFPs were just going unanswered, right? We didn't know whether we lost, whether we won. We were kind of in this middle state, which I say is the worst state to be, which is purgatory, right? We just didn't know where these contracts stood. Fast forward to today, we did hear about that vaccination program. We did win it, and we did launch it. It's a population health program in Southern California to bring mobile vaccinations into communities that don't have great access. That's exactly the type of evergreen long-term program. Now, it's not large in revenue, but it gets us working with a new municipality, helps us provide care to communities that don't have great access.
Those are exactly the types of programs that we want to be deploying. Other programs, for example, as we sign multiple contracts to provide services to the VA, our veterans need good long-term care. Some of our veterans don't have great access. Veterans need to be screened to be fit for duty. Veterans need to be evaluated for when they retire, when they exit the military, and so forth, and so we're going to be providing those services, but we don't know when. They haven't launched yet, so that's the reason why we broke it out. We'll report on it separately. We don't have the same sharp pencil on those municipal programs as we feel like we do on the medical transportation and the mobile care in the home businesses.
I'm curious on the vaccination side. What type of vaccinations are you doing? Because it seems like now we're getting all sorts of mixed messaging out of the administration, and there seem to be cutting back, unfortunately. But what are you providing for vaccination? Is it flu? Is it COVID? What's going on?
Yeah, I think it's your typical vaccines that are recommended to every child and adult. We're actually one of the largest providers of vaccines for children, the Vaccines for Children program, where the government gives providers like us the vaccines for free for us to be able to provide them to populations in need. But we're one of the largest vaccine providers. Again, we are not in the sort of mandate of vaccines business. We're in the providing and making it available and accessible to patients. And so for us, we are there to make it available. I'll give you an example. One of the other works that we do is we provide pediatric vaccines on behalf of health insurance customers.
So as an example, in California, we go into the home and we provide the full pediatric vaccination panel for those children as part of this health plan, which is, again, a very important quality measure for the health plans. And then once we complete the full pediatric vaccination panel, the health insurance company gives us a bonus for doing that as part of a value-based incentive to try and engage the population. So the vaccinations are available. They are accessible through our programs. But again, we're not in the mandating business. We don't participate in any of those politics.
Is a lot of this Medicaid business on that front?
That's right. Managed care. Managed Medicaid, Medicare Advantage patients, exactly right.
I guess thinking about the growth that you've had there, what's the opportunity to do more upselling in mobile health? What's working? What are you getting just quick follow-on sales with?
Yeah. So really our entry into the home is care gap closure. Every health plan is struggling with care gap closure, addressing patients that have open gaps in care, as I mentioned, lots of examples of those. And that is really a great way to help health plans immediately. And of course, by the end of the year, it's a big focus for them. And that's where we start. And we've been proven that we've been able to engage the unengaged. We've been able to visit patients that have not had access to care, patients that have mobility issues, patients that have childcare issues, patients that don't have access to the care they need. We've proven our ability to do that. We're doing thousands and thousands of visits into patients' homes and closing thousands and tens of thousands of care gaps in patients' homes.
Now, many of these patients have not visited their primary care, and we know that good primary care is important for prevention and ultimately to keep patients healthy. And so now we launched our own primary care service, and now we're providing primary care in the home for those patients on a recurring basis, and we're going to be looking to invest and grow that pretty meaningfully over time, and I want to give really one profound example. Over time, not yet. Everything we're doing now is in a fee-for-service arrangement, but over time, I believe we'll be one of the most insightful, best-positioned providers to take on value-based risk care, which is ultimately where everyone agrees the health system needs to go. I'll give you one example. I mentioned a bone density scan that we do, one of the care gaps that we do in the home.
Now, health plans are trying to funnel that patient into the doctor's office to get the bone density scan that they need, which is great, and it's important that they do that. And a patient will come into the office, get the reading, right? For us, we go into the home. We do the same bone density scan, but while we're there, we notice, "Wait a second, there's loose carpeting all over the patient's home. There's a real trip and fall hazard. Wait a second, the patient's bedroom is upstairs and the stairs are not safe." So now a patient that has osteoporosis, the very reason why you want to get a bone density scan, they're worried about them falling, you're worried about them breaking a bone, you're worried about their health declining once they become immobile or once that happens.
We have a much deeper understanding of the social determinants of health for that patient, of the environmental factors of that patient in a way that you cannot get when that patient just comes in to see you in the office. And ultimately, over time, once we visit patients in their home, A, they love the service. Our Net Promoter Scores are the highest practically in the industry, unheard of. And now we get this holistic view of the patient. We believe that that model is going to be at the vanguard of value-based care and ultimately helping patients in a much, much deeper way.
Wow, that's a great example. I didn't even think about that, just the ability to connect all the dots and file on that. We're running out of time. Still a few things to get to, but I guess because this mobile health is doing well and you have a great handle on it, I guess how should we think about the mix of it? Think about it longer- term, five years from now. How do you see it versus the other parts of the business?
Yeah, so I think medical transportation is the majority of the revenue. That's where we started the company. We've been doing it for 10 years. I'd like to share, I believe about four or five years ago or so, we were doing $50 million of revenue in that business, and now this year we'll do over $200 million of revenue in that business, so it's been growing very nicely, profitable business, and we're going to look to grow margins and scale in that business, and then the mobile health side, all the work I just described with the payers and providers, the patient monitoring that we do, that work is about $50 million of revenue this year, and we believe, again, that we can grow that 50%-100% year- over- year as we go through here into next year.
And so that's the mix that you see the business today. Yes, over many years, as we go through here, over many quarters, the mobile health revenue is obviously growing at a faster pace, and so that will eclipse the medical transportation side. But we have a good competition going between the medical transportation team and the mobile healthcare team, and both of them want to be the majority of the revenue at the company. And I'm very excited to let that competition play out and let those teams climb to greater heights.
All right. Quickly, I know we touched on a bunch of policy items, but I'm curious, the hospital spending cycle, have you noticed any changes recently? It feels like there's been a little uncertainty around spending trends. Your offering has a very robust and very meaningful ROI. So I'm just curious if you had any quick lines on that. And then obviously there's been a lot of issues around Star cut points too. It seems like you can enhance that. Are you getting traction, bringing services on that front?
Yeah, on Stars, exactly right. Quality scores. We're doing care gap closure, one of the marquee focal points of quality scores. I think on the new legislation and some of the changes I think we're seeing, we touched on some of the uncertainty in the government contracting. We already touched on that. We're absolutely seeing that. We're at the forefront of that. I think we're really seeing more focus on primary care. We're seeing the new administration focus on some of the G codes that haven't been utilized for primary care, preventative care. That's why I said we're in a really good position to provide that and then help with the quality scores. I do think there's some uncertainty relating to Medicaid rolls and enrollment. One health plan CEO here in New York was telling me they expect about 600,000 Medicaid members to fall off because of the new legislation.
And so we're monitoring that. But I think the TAM is so large for us. We have lists of patients that need help. Exactly. I think something we're watching. I think health plan CEOs are thinking about it. And that's just going to, once their pool shrinks, they have to be even more efficient with the members they do have, which is where we come in.
Awesome. Lee, this has been great. I don't know if you have any closing remarks you want to make here where you're thinking about the next few years. It seems like you have an awesome TAM, an awesome opportunity. And I really like the value-based care trend that's going to go in your favor, so.
Appreciate it, Steve. We're excited. We're excited. Absolutely.
Thank you very much.
Yep.
Have a great rest of the conference, and we'll move on to the next fireside one.
Thanks, everyone.
Appreciate it.