Hello. Welcome, everyone, to the 22nd Annual Needham Healthcare Conference. I'm Ryan MacDonald, and I lead Needham's digital health research efforts. With me in this session, I'm joined, happy to be joined by DocGo and the company's President and Chief Operating Officer, Lee Bienstock. Thanks so much for joining us today, Lee.
Thanks, Ryan. It's great to be with you. I think this is our second fireside chat.
That's great.
Hopefully, we'll have a good time again.
You set a very high bar last time let's see if we can beat it. No.
We'll top it.
Absolutely. For those that are listening in, just a little housekeeping. We've got about 40 minutes for the fireside chat. Lee and I'll go through a number of topics and questions, but if you do have a question for Lee, please put it in the chat box and submit it, and then I'll make sure to get those questions asked and answered before the end of the session. With that, let's dive right in. Lee, for those who are less familiar with DocGo, how about a brief overview of the business?
Yeah. DocGo is one of the nation's largest mobile healthcare company. What we mean by that is we bring care to where it's needed, when it's needed, outside the traditional setting, traditional hospital or doctor's office setting. We have two large components of the business, medical transportation, which makes up about 35% of the business today, and mobile healthcare, again, where we bring care to where it's needed, which is about 65% of the business. We operate in 28 states in the U.S., as well as the U.K., one of the largest providers in the U.K. We have a team about 5,000+ full-time clinicians offering a wide spectrum care, of course, across those markets.
Interesting. Now, as you mentioned, you know, the company started in the transportation business, and you've really used that as an entry point to expand the relationship and to include your mobile care offerings. As you look at the business today, how important is the transportation business for getting DocGo's foot in the door with new government and health system relationships?
Yeah. That's a great point, Ryan. The company started seven years ago it started as a medical transportation company, and really the idea was, let's bring technology to a pretty old and stale space. A lot of it was done on pen and paper. We brought technology, really an Uber-like platform, where hospital systems and our partners can order medical transportation like they can like an Uber or ordering dinner.
Really brought that technology to the space. I would say it's been a great entry point for us as a business. Today we partner with just about 300 healthcare system markets, and really that has given us great relationships with which to grow within these health systems. It's been a great entry point for us. It really is a business today that is a now problem. The industry is going through a bit of a turmoil in the medical transportation space. Reimbursement rates have remained pretty stagnant.
Costs obviously have risen. We take a very different approach to the whole industry, which has been proving very, very successful for us.
I'm sure we'll talk about that.
Really that's allowed us to come in. It's a now problem for these healthcare for these hospital system CEOs. We come in, we provide that service, and then oftentimes we're able to expand into mobile healthcare as well. We have lots of examples of that. Even most of our contracts we're signing today on the medical transportation side already include provisions and components and the options of the mobile health offerings alongside it. It's one contract, and most of what we're signing today includes both of those components.
That's excellent. Yeah. As you mentioned, you know, so 65% of the business is now on that mobile care side. As you think about and look at the pipeline of opportunities and as sort of the spaces continue to evolve and mature, you say obviously that a lot of these opportunities are including both or options, but do you find yourself leading with one versus the other? When you look at the mix of opportunities, do they skew one way or the other?
Well, I think the mix is pretty consistent with the.
[audio distortion] business. We expect mobile health to be about 70% of the business, 30% being medical transportation.
I think that's gonna remain pretty consistent. You know, now any one given large contract can skew that.
We've been fortunate to win some very large contracts, which we announced in our earnings call last month. I think that can move the needle one way or the other, but we're pretty consistent. Our pipeline is fairly consistent, that 70/30 split.
Yeah. Interesting.
Yeah.
Now you mentioned earnings results last month reporting the fourth quarter fiscal 2022 and starting to give an outlook for 2023. You know, one of the most common questions I've received since the earnings report is really on margin trajectory. Can you talk about sort of the progress DocGo's made on margin trajectory? Maybe perhaps why we haven't seen as much leverage as maybe we would've expected thus far as the business continues to scale.
Yeah. I'd say, Ryan, we get a lot of questions on this.
Certainly got a lot of questions on the call and certainly throughout the conference now we're getting questions on that. I would say, one of the things we announced in our earnings call was this rapid normalization project, which is us detailing out the process we're taking on sort of, improving and increasing, and adding to those margins. I mean, one of the big things that is a very key driver for us is when we initially launch a project those projects and new contracts, which is a good thing to have, usually come with associated higher costs, and I'll give some examples of that. Really in Q4 of last year, We had no mass COVID testing revenue.
We meticulously replaced every single one of those contracts, projects and so forth, you know, which we did throughout 2022. As a result, we launched a lot of new projects and new programs, and we saw an increase of those costs when we launch a new project. Really, we have them very clearly defined, which we laid out. We know what the drivers are. It's not like something we're searching for. We know number one, first and foremost, is our labor costs are our biggest bucket of costs.
Usually when we launch and scale a program very, very quickly.
we go out to our agency partners. Now, it's a big, big competitive advantage for us. We have about 30 to 40 core agencies that we're partnered with. They have about 1 million clinicians in their database.
It's a big scale, and it's a big advantage for us when we're able to go and leverage those, but they do come at a higher cost, about 40% higher labor cost there. As we scale a project, we basically transition or convert a lot of that agency staff over to full-time, DocGo clinicians. We transition them on. That's a big component of what we're doing. We meet daily on that. We're even going out and renegotiating some of our partnership agreements with those agencies, as I mentioned, to really make sure that, you know, we're reevaluating the terms that we have with them and making sure that, you know, we're pushing the envelope there.
That's the first bit, and we're making tremendous progress on that, and that's sort of working its way through.
I think you'll start to see that bear fruit, you know, in Q2, you know, and, you know, beyond through the rest of the year. The other two big buckets are overtime.
Again, when you scale a project, when you launch very, very quickly, you tend to see higher overtime percentage. We think there's never zero overtime, right? I mean, there's always gonna be holidays. There's always gonna be people that call out sick on shifts and so forth.
The sweet spot for overtime is around 5%.
That's kind of our process of bringing overtime into that range. The third item is really, in our vehicle space, you know, we like to either purchase or rent. Sorry, we like to purchase or lease our vehicles.
When we scale up rapidly, we sometimes will rent vehicles on a, you know, the next day on an overnight basis. When basically transitioning off of those rental vehicles onto our owned fleet and leased fleet, which is which we are doing, you know, those three areas are kind of gonna be creative to margins as we, as we push through the year here. Those are really the kind of core components that we laid out on our call.
The team is making very strong progress on those you know, you'll start to see accretion to our margin, you know, throughout the year.
No, super helpful.
Yeah.
You know, in addition to that, one of the strategies you had also I think talked about on the call was sort of this shift on the transportation customer side over to the leased hour model. Can you explain, you know, for investors who might not be familiar, what that model is and why that could potentially also result in some margin expansion over time?
Yeah. lease hour, basically our lease hour program is, you know, I was mentioning the kind of industry it was it has been a fee for service, jump ball, they call you, to, you know, take a trip, industry, and we've really moved the industry to, no, dedicated resources that are specific to that hospital. It's not atypical to see the, those resources, as an example, in advanced life support, critical care ambulance, a basic life support ambulance, and the, and associated crew. It's not atypical to see that dedicated resource co-branded as Jefferson Health System, New York City.
Hospitals. We're really transitioning to a dedicated leased hour arrangement where the partner or health system partner will lease out the crew and the unit and all the associated operations that go with that unit, and so that would be a dedicated truck, a dedicated unit to that health system. Essentially, they are paying us the hourly wage or the hourly fee for that unit. Take a BLS unit for the day may come as a $1,500 charge for the 10-hour shift.
What we do is we say that unit costs $1,500. We're going to go and bill insurance. We're going to go and collect. If we collect, let's say, $1,200 for the day, the hospital system is on the hook for the $300.
If we're able to bill the full $1,500, the hospital system doesn't owe us anything. Of course, if we're able to bill above the $1,500, then we're able to keep that. We've really transitioned to that. Really what that means for the hospital system, they know they have that dedicated unit. It's branded for them. It's dedicated for them.
They know the crews. The crews know their employees in the hospital. They get to know each other. They form that strong relationship. Those trucks are sitting outside. Those crews are sitting outside. Those teams are sitting outside, ready and optimized to prioritize the trips, as we partner with that health system. We've moved a lot of our contracts to that model. Again, it protects our
protects our margin, protects our downside. We think that model alone, adds potentially about 1,000 basis points to margin.
It's fairly significant. We've already transitioned 60% of those contracts to leased hour, and we're looking to, we're looking to obviously transition more of those.
I wanna give one example which actually ties both of these, two questions, the last two questions, Ryan, together, which is, you know, a new award we just won that is also leased hour.
We announced that we had $180 million backlog of projects and contracts that we were awarded, that we're in the process of either launching or scaling or have launched and are in the process of scaling. We won a large 11-hospital health system contract.
you know, we were replacing an incumbent, and so it's a, and a full leased hour third full leased hour contract, and again, we have dedicated teams at each of the 11 hospitals based on the demand and the need of each of those hospitals. Again, there's a lot of learning that goes into, you know, the demand analysis, and we could talk about that as well. Basically, we were displacing an incumbent provider. That incumbent provider usually in their contracts have a wind down period.
Meaning they receive a notice that we're no longer, they're no longer going to be serving those hospitals.
They're supposed to wind down over six months. Sometimes the incumbent provider doesn't do, you know, the right thing necessarily. that incumbent provider just said, "Okay, well, you're giving us notice, we're just gonna pick up and leave," pretty much overnight we had to step in there and obviously scale very, very quickly right, winning a new contract, 11 hospital system, leased hour, everything we just described is a, is a great thing. It's a great problem to have, I would say, but we came in, and we're scaling that as opposed to over a 6-month timeframe, we're scaling it over 6 weeks.
So that goes back to new contracts. G reat opportunity. That's a five-year contract, and so we scaled it in six weeks. Again, that goes back to all the various costs that come associated with that such a rapid timeframe, but over time, we normalize, those costs, and that's where you get the rapid normalization project.
Yeah, absolutely. I'd maybe just be curious, just given that sort of the processes you're kind of trying to put into place on the Rapid Normalization, are you starting to see some of those incremental improvements with this new win and the rapid sort of timeline that you've got to launch that from?
Yeah, that new contract, obviously the rapid degree to which we need it to scale obviously comes at a higher cost, right?
Yeah, for sure.
All of the other projects we're working on, obviously we're working on all of the measures I mentioned. I would say we've made massive progress on the vehicle front, you know pretty much, reduced all of the rental vehicles down to pretty negligible amount. I would say on the staffing I think we have some continued work to do there, but we've made some very, very solid progress.
On the overtime, I think, you know, we're netting out into a very, very good spot there, so absolutely. With every new contract win comes our benefit, which is our partners look to us. One of the big competitive advantage for us is we scale very quickly.
Usually a now problem they wanna scale yesterday.
It's not atypical for us to ask a customer, "Well, when do you need that by?" They're like, Well, today, tomorrow, yesterday.
Yeah.
Usually a pretty typical answer.
How quick can you do it? Yeah.
Yeah, exactly. It's pretty unique. We were able to deliver on some pretty aggressive timelines.
With every new contract, with every new project, you know, we see that the need to do that. At the same time, our longer full bloom, as I call them, projects, you know.
where we've been operating now for 6+ months that's really where you're seeing the biggest impact because we've been operating those programs for a while.
We've implemented the rapid normalization process, and you're starting to see that really take hold
We still continue to win and launch new projects. That again comes back with the startup costs of those new projects. Yes, once a project's about six months in, we start to see some pretty, some pretty specific improvements, and we're actually working, the 6-month timeframe we're not happy with. We wanna bring that down to about three months.
Okay.
60-90 days, that's where we wanna bring that rapid normalization expansion, sort of margin accretion. We want that timeframe to be very, very tight. That's really what that whole project's about.
Excellent. Yeah, just maybe last on the, you know, on the leased hour model. You, you mentioned obviously some pretty large potential margin expansion that can help deliver over time. You know, what's, at that $1,500 rate, what kind of gross margin does that kind of lock you in at in terms of on that? Then as you think about the 40% of customers that aren't on leased hour today, how do you start to incentivize those customers to move over to the model?
Yeah. On the gross margin side, I think medical transportation, you're looking at about 35%.
On the mobile health leased hour deals, you're looking at 40%, in that range plus.
I would say, usually, I mean, what the leased hour model does is it basically shifts us from being price takers, right? Whatever the reimbursement rate is, we're taking that.
It moves us from being price takers to price setters for our services, that's really, you know, what it's all about. What it comes down to is we have to sell, and we have to articulate, the value of moving from sort of this fee for service, you have a lots of different operators that you work with, to just a single source award. DocGo is gonna serve your facility, and we have to kind of sell that. I think it's very well-received. I mean, I think there's three very, very large reasons why health systems and why our partners and municipalities have been receptive. I would say number one is the functionality that our platform has.
For the leased hour, meaning they know that crew is going to be there, and then they can prioritize the need for that crew. As an example, discharges and, or, the bed management integration that we have with our health systems allows them to prioritize, "Hey, this patient's getting discharged. We don't want them staying an extra night in the hospital.
They need to leave by this specific time. They can prioritize that, and we work with them. 'Cause if that patient stays the extra night, they don't get reimbursed for that extra night, the hospital.
No.
that's a huge loss for them. It allows them to prioritize, the functionality of basically that coupled with our technology, they could see exactly and prioritize the trips and see exactly when those units are gonna be arriving so that they can get the patient prepped and ready.
That is very, very powerful and very valuable to the health systems. The other piece I would say also is, you know, our data and reporting has been pretty well-received, meaning. We provide our health systems with, and our partners with a tremendous amount of data our municipality partners as well, so they can get up-to-the-minute reporting on exactly all of the various different metrics they care about, and then we even send that report daily and weekly they sort of place tremendous value in that. We're able to say, yes, the leased hour model is a different pricing model, but when you start to factor in the fact that we help with the bed management.
.Y ou start to factor in that we help prioritize and optimize the various, the trips, when they get the data and the reporting to be able to make real-time decisions, all those things obviously drastically reduce the cost of operating and provide them with tremendous value, and we've been seeing them pretty receptive to that to the extent that we've converted 60% of them. I would say, you know, our team is working on converting the rest. I think you'll see us probably through the rest of this year pretty much convert the vast majority of the remainder.
You know, I think we have a plan to convert all of our contracts to leased hour.
Yeah, I mean, it clearly seems like you're, you know, driving a, still driving a pretty material ROI even within that model, you know, compared to what you were on today. Okay. You know, you mentioned obviously within leased hour it's 35% and 40% depending on, you know, on the lock-in rates, you know, obviously some opportunity for upside, other pieces of the business. You know, as you continue to see sort of that evolution in the mix shift of revenues, how should investors think about sort of the longer term margin targets for gross margin and EBITDA margin in the business? Maybe talk about what the primary levers are to sort of hitting those targets.
Yeah. I think we shared for this year you know, we're targeting a blended 35% gross margin.
I think you'll probably see that be, you know, maybe a few points below to start the year, then a few points above as we close out the year and as all these rapid normalization initiatives take hold.
I think that's the way to think about it in 2023.
I think obviously thinking beyond, if you continue that trend line, we think there's more headroom there for us to grow margins and grow into. I would say that's pretty much the way to think about it as we go through the year here.
All right. That's super helpful.
Yep.
You know, another common topic of discussion we've gotten is around the robust pipeline that DocGo has in terms of active RFPs out there. You know, I think it's about 34 active RFPs representing about $1 billion of total contract value. Can you sort of talk about the steps you've taken to refine the RFP response process since you've joined? Sort of what sort of changes or improvements have you seen in win rates?
Yeah. The RFP process is very central to what we do particularly on the government municipality side of the business. That's how they make purchasing decisions. In fact, they're required to issue RFPs to make sure that their constituents and their municipalities are getting the best offering and the best deal.
We pretty quickly identified that the RFP channel is a pretty important one for the government municipal side of the business. We've invested pretty heavily there. I would say, and we've announced this, I would say we've probably at this point more than tripled our RFP output.
You know, we were probably submitting about, let's say, 10 a quarter.
Now I think we're submitting well above 40 a quarter.
Maybe $35-$40 a quarter submissions. That's at the start, right? At the top, we're evaluating far more.
We probably evaluate about 250 RFPs a week. We pick which ones we wanna submit.
Obviously we craft a great response. That's sort of the funnel that we look at there. Not only in terms of the number of RFPs submitting, we're actually going after larger and larger opportunities. We were going after opportunity size, or, you know, the opportunities of the RFPs we were going after probably in the $2 million-$5 million range, now we're doing, you know, $10 million-$25+ million . The number of submissions is growing, the size of the submissions is growing, and so we're pretty excited about that. You know. some we'll win, some we won't. I'm very, very, very, very pleased with the process and with the progress we've made on the, on the RFP side.
A lot You know, I get a lot of questions around about like, "Well, what about the win rate?" Right?
Everybody wants to know more win rate.
Yeah.
They can really fill out the calculation.
That's right.
It's funny because everybody wants to see that win rate grow up. win rate grow, right? They say, "Oh, is the win rate growing up?" I always say, you know, it's very important to note that if your win rate is growing up very, very fast, well, maybe you're not going after the most ambitious opportunities, right?
If you hit all the shots you take well, maybe you should expand your range a little bit, right?
You know, that is, that is a balance I have the team focusing on, right? Which is we wanna go after bigger, more aggressive, broader opportunities.
With that huge expansion, right, you're not gonna see the win rate, right? The win rate is one of those things that I like to have a good balance on, right?
I wanna go after things I know we can win.
I wanna go after things that are stretching the company and growing the company significantly. That's something we look at. That is a balance, right? I wanna make sure that we're doing both, that's something we look at. One other thing I like to always share, which to me is the most important, right, which is you win you lose, or there's a third one to me, which is you win or you lose and you learn
Every single submission that we don't get, you know, 'cause our, you know, no one's win rate's gonna be 100% every submission we don't get, the team, we do a debrief. With the municipality. We do a debrief with the issuing body of the RFP, and we basically learn from that process. The quality of our responses has gotten tremendously better.
I would say, over the last year, where we continually are taking the feedback from every single one of the submissions we submit. If we win, okay, we know why. Let's make sure we continue to press on that. For whatever reason, if we don't, okay, what can we have done better? We take those learnings, and we put them in every following submission we do.
That, really, that whole holistic process is something we're very, very proud of. It's something we're investing deeply into. I think you'll see us you know, exceed our goals for the RFP process.
in terms of the number and the size will continue to grow that we're submitting and the size that we're continuing to submit, I think you're gonna see continued growth there.
We got a question in from the audience as you were answering there. As you've kind of continued to refine the process, in deals that you don't win, is there a common thread or a common theme that you see that where area you've, you kind of had to work on or that you work on to try to refine that process?
Yeah, I mean, part of it sometimes is just the level of depth that we provided in the RFP. you know one example I like to give is, you know, we submitted an RFP, and we didn't end up getting it, and I said to the team, "Okay, let's do the debrief and meet with them and find out, get their feedback." One of the things we learned, especially on these very, very large opportunities, like I said, we're expanding the size of the opportunities we're doing. Some of the feedback we got was like, well, when you use partners to help, right, we're the prime on the RFP, but when you use multiple partners to execute, the governing body of the RFP, they wanna know exactly who those partners are.
They wanna know about them. They wanna be familiar with them. We said, "Well, you know, we have 40, you know, agencies that we do. They have 1 million clinicians in the database that we can tap into.
They wanna know, okay, specifically, who are the ones that you're gonna utilize?
Now we're very prescriptive, right? If we're gonna be procuring vehicles, we tell them exactly where we procure our vehicles from.
We tell them exactly what the process is. When we tell them that we're gonna be staffing a project, we tell them exactly who we're gonna be working with, how we're gonna be doing it. Just the level of specificity in certain areas, you know, we make sure that we're continually now putting that into place. I would say another piece that I'm really pushing the team is for expansion of geography.
The geographies we're working in right now were very known entities, right? I mentioned those 28 states. People know us there. One example was we submitted an RFP. We haven't heard about this one, but just yet, but one of the things we said, "Okay, to make it feel more local, we're gonna make sure that we hand deliver the response of this RFP in one of our vehicles.
They could see our vehicles, they could see our equipment, they could see our clinician, they could see our uniforms, they could see us, right?
Whereas we may not be as visible in their specific city as we are in lots of other cities across the country we hand deliver that one to really show them just the level of clinician, what our vehicles look like, what our crews look like, what supplies they have, and we hand submitted that particular one. There's little things like that that now we can key in on and say, "All right, we submitted something," and they said, "Well, we went with the more local person.
I wanna expand our geography. I wanna expand our footprint, right?
Okay, well, to make us feel more local, let's go and actually shake someone's hand. Let's actually go and deliver. Let's actually show them our vehicles and the quality of our service, the quality of our presentation. We've done things like that. Those are two examples. I have lots and lots and lots of other ones.
I would say those are the key points.
when we win, it's usually because, that we score very high on our technology. very high on what's called our confidence to execute.
Those are two very, very big buckets. Confidence to execute usually ranges about 30 or 40 out of 100 points.
Technology now, we've been seeing that creep up into the 30 range. Sometimes it's in the 20 range.
Then, you know, pricing, we're never gonna be the lowest, you know, cost provider.
That's an area where, you know, we usually score very highly on the first two, and then on the which overshadows, you know, perhaps some of the, some of the concern folks have on pricing. Again, they're getting a quality service. We're never gonna sort of be on the race to the bottom in terms of being the lowest price. Those are the things we've been learning. We usually score very high on those components.
When we do get feedback, we're putting that into every subsequent submission, and the, really the goal is to expand the breadth of submissions, the geography, the scope. When you do that, right, that kind of, that gets us very excited about, you know, kind of where we're heading in that channel.
Yeah, makes sense. Maybe just lastly on this, you know, you mentioned geographic expansion and, you know, recently you made an acquisition to sort of make DocGo a prime contractor essentially in the U.K. What sort of expansion of the opportunity in the U.K.? I know it's relatively small as a percentage of total revenue today, but what sort of how leverageable is that or how does that open up more opportunities over there?
Yeah, first off, that particularly allows us to bid on again, larger contracts.
Allows us to bid on a wider breadth of contracts, right? It opens up our universe opens up our top of the funnel and also widens the amount of submissions and amount of opportunities we can go after and also the size of those opportunities. That's the reason why. I mean, that's where you see kind of our strategy there. When we do kind of make an acquisition, it's usually to sort of fast-track a capability such as that exact one. We did that in the U.K.. You know, we now have access to the Federal Supply Schedule again another example where, Yes, we could have gained access to the Federal Supply Schedule. It takes time.
That just fast-tracked our ability now to, again, apply and submit to way more opportunities, much larger ones, much wider geographic footprint, larger opportunities. That's kinda where you see us making those moves is the ability to kinda play into those, you know, bigger opportunities, more wider opportunities, and that's exactly what we did in the case that you just mentioned.
Excellent. Let's move over to remote patient monitoring, which is obviously a big popular topic. It's obviously been a growing focus for DocGo over the past year, and, you know, now there are reimbursement codes for both RPM and chronic care management to support sort of adoption in the home and of home health. Can you walk us through sort of the RPM strategy for DocGo in 2023 and sort of maybe give an update on the progress you're making there?
Yeah. I mean, you touched on it, right? Preventative care. P reventative care, well documented, you know payers, commercial partners, at-risk providers, hospital systems. That's obviously a big trend. Obviously the more preventative care and the more accessible we can make that preventative care, the better outcomes you're gonna get. The better outcomes, just the lower costs go, right?
That is a huge trend. We're seeing it across all of our different initiatives, RPM the same. For those that don't know, the objective of RPM is remote patient monitoring, right? Usually, we're partnering with health systems, physicians practices, and we're identifying chronically ill patients that are managing a chronic disease, and we provide them with the diagnostic tools, with the remote diagnostic tools to be able to track and monitor and manage that condition. As an example, we can provide somebody with a weight scale, a pulse oximeter, we check a blood pressure cuff, and they send us readings from those devices each and every day.
CMS requires one of the CPT codes that you mentioned that we, that we bill, requires 16 readings a month. We try to collect readings every single day, 30 times a month, but the minimum threshold is 16. They send those readings and diagnostics to DocGo, and we monitor and track their condition. When we see that there is an escalation or decomposition of some sort, obviously we intervene and we get in touch with that patient. Getting in touch with that patient can mean picking up the phone.
It could be sending a text message. We layer on chronic care management on top of that. Via our physicians practice, we're able to marry RPM with CCM. Not only are we monitoring the patients, but we're also providing chronic care management to them. We're able to then intervene. Now, intervening again can mean picking up the phone and calling with our mobile health fleet, it could also mean going into the home.
Maybe taking more in-depth vitals, maybe taking blood, might be titrating meds, right? It may be obviously doing an urgent care visit in the home. That's where we see tremendous synergies there not only with our remote monitoring and all of the technology platform we have, but then the ability to go into the home...
and then obviously provide services there. It's a big focus of us. I would say, CMS has eight codes that we bill. It adds up to about $300 per patient per month. I'd say about $250 per patient per month, about $3,000 for the year.
You know, we're really focused on rolling that out. We're making the investments in the technology. We're making the investments in the care management team. We're making investments, you know, in that platform to roll that out and kind of then and kind of scale that in a meaningful way. We're very, very excited about that because again, it has tremendous application to lots of areas of our business, right? It's utilizing a lot of the assets we already have.
It just makes sense for us to stitch that all together.
That makes sense. I mean, obviously you're very much in the sort of the data collection phase and sort of proving out the outcomes, the efficacy, et cetera. Where do you see that, this opportunity really resonating within the customer base? Is it more on the payer channel? Is it with the health systems? How do you, how do you think about that?
Yeah. I think, yes, all the above.
All of those.
I certainly think, you know, first and foremost, we're partnering with other specialists and physicians practices. As an example you can imagine we're partnering with cardiology practices, nephrology practices, and so forth. We're really investing in widening the partner set that we have.
A, we already have a lot of those customers, a lot of those partners that we're already working with. We basically partner with them. They help identify the patients that are really good. We work with them obviously. We enable them to identify the patients that are good candidates for this type of service. Then obviously anybody that is incentivized to bring down the cost of care and anybody that's incentivized to increase the access of preventative, proactive healthcare.
Obviously CMS, any of the payers, any at-risk provider groups, all of them are incentivized to bring down the long-term cost of care and obviously increase, and better patient outcomes. All of the partner set, all of that partner set is, you know, interested in the space. You know, you meant we talked a lot about margins. We get a lot of questions about margins. That space, we think RPM, CCM has, you know, 55%-60% gross margins, right again, you start seeing us moving into these higher margin space. Again, just building it out this year, but, you know, as we go throughout 2023 and sort of exit 2023, you know, we think this is a very, very exciting space.
Excellent. No, that's great. speaking of the payers, you know, obviously in 2022 you entered the payer market and I think have, are now live with five payers, across the U.S., or in various regions across the U.S. You know, how have the rollouts of those contracts gone thus far and what are you starting to see in terms of member engagement and usage?
Yeah, they're going well. You know, I could tell you the strategy and the plan is pretty consistent across a lot of these partners, and we're in different stages of it. Really it goes from being an in-network provider, right?
Their members can access our services to a vendor. Now again, usually a vendor has a negative connotation, but in this case, you know, it's a worthy goal what it means is when you're a vendor of these payers, they actually identify the patients and assign you the patients to go and intervene and to go in to provide your service to, because again, they're highly incentivized to lower the cost of care on this set of patients. Really our work is going towards proving that DocGo is successful in increasing access, bettering outcomes, and in turn lowering costs.
As we do that, we move from an in-network provider. Again, those deals are hard enough to come by, right?
Contracting with these very, very large payers is a tasking of itself but then moving and proving that out to moving upstream into that vendor sort of partner arrangement where they're assigning us patients is something we're very, very focused on. You know, we are pleased with the progress. That's something again you're gonna see us invest more into. Again, it just makes sense for our business. I mean, that's what it's about, increasing access for those that are in the greatest need bringing care to them and we've seen some great success there.
Awesome. Well, we're quickly running out of time, but maybe just one quick one on Dollar General. Obviously a very interesting pilot announced last year. Maybe talk about the progress quick on how things are going with Dollar General, what you're doing there.
Yeah, Dollar General, we have a partnership with Dollar General where we're bringing our mobile clinics, our mobile units directly outside of Dollar General stores.
We're operating it today in Tennessee. Dollar General is headquartered in Nashville. We also run a large operation there, and they have about 600 Dollar General stores just in that one market alone. 19,000 stores throughout the country. What we do is we bring our mobile unit directly outside, of the store. Right now it's in pilot phase, as you mentioned, Ryan. We are, in the process of proving out various hypotheses. The whole idea is how do we bring care to where, what we call those healthcare deserts, right? Typically more rural areas, which Dollar General has a huge footprint in.
Yep.
How do we bring care, to bring closer, deeper into communities, particularly those that are underserved or those that have a dearth of care options. That pilot it has been going well. We've been pleased. I think, we announced on our call that week was the largest week, we had ever had. The numbers continue to grow.
I think, just a couple days ago it was our largest single day ever.
Oh, wow!
And we are, you know, we're pleased with the progress. We always get asked, so I'll mention it, Ryan, I know we're short on time, but really the hypotheses that we are proving out with this pilot are really around what's the right marketing mix in raising awareness.
Dollar General is providing a lot of that.
Yeah.
In-store messaging, their app, their website, but then also store selection, right? You know, which is, what's the right confluence of how rural, how dense? You know, what are the demographic factors that make one store a better choice than another to place our clinic
Once we get that right, I think you'll start to see us scale that. Those are the things that we're basically testing with. You know, do we put the clinic outside the store the whole day? Do we have it there a portion of the day and move it around to multiple stores? You know those sorts of things we are testing and getting some very good, you know, initial feedback on.
Awesome. Look, that's all the time we have. We, as always, way too many interesting things that DocGo's doing to cover them all in such a short amount of time. We put our best foot forward, and it was a very interesting conversation as always. Thanks a lot for joining us. Thanks everyone for participating and good luck with the rest of the conference.
Thanks Ryan. Thanks everyone.
Thanks.
Be well.