DocGo Inc. (DCGO)
SIC breadcrumb: Services > SIC Major Group 80 > SIC 8000 Services-Health Services
SEC company page: https://www.sec.gov/edgar/browse/?CIK=1822359. Latest filing source: 0001628280-26-018214.
Informational only - descriptive public-record data, not investment advice.
Business
Read DCGO's verbatim Item 1 Business section from its latest 10-K: Business.
Risk Factors
Read DCGO's verbatim Item 1A Risk Factors from its latest 10-K: Risk Factors.
Selected Fundamentals
| Metric | Value | Unit | FY | Filed |
|---|---|---|---|---|
| Revenue | 322,196,000 | USD | 2025 | 2026-03-16 |
| Net income | -182,399,628 | USD | 2025 | 2026-03-16 |
| Assets | 217,103,012 | USD | 2025 | 2026-03-16 |
Financials
Annual standardized facts from SEC companyfacts as of latest extracted filing date 2026-03-16. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0001822359.json. Derived margins, ratios, and free cash flow are computed from the extracted annual SEC facts.
| Metric | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|
| Revenue | 94,090,658 | 318,718,580 | 440,515,746 | 624,288,642 | 616,555,132 | 322,196,000 |
| Net income | -14,799,212 | 23,743,758 | 34,584,498 | 6,858,455 | 19,992,143 | -182,399,628 |
| Operating income | -14,757,683 | 15,357,298 | 21,831,628 | 15,054,980 | 28,688,726 | -178,033,500 |
| Diluted EPS | -0.25 | 0.25 | 0.34 | 0.06 | 0.18 | -1.84 |
| Operating cash flow | -10,654,692 | -1,947,420 | 28,869,901 | -64,493,170 | 70,115,431 | 34,451,654 |
| Capital expenditures | 4,361,501 | 4,808,409 | 3,198,234 | 7,313,269 | 3,612,507 | 4,544,118 |
| Share buybacks | 0.00 | 3,731,712 | 0.00 | 13,756,271 | 10,828,906 | |
| Assets | 100,172,363 | 309,602,652 | 393,277,628 | 490,451,957 | 455,621,132 | 217,103,012 |
| Liabilities | 33,225,322 | 82,545,628 | 114,350,237 | 185,281,001 | 140,442,002 | 91,231,675 |
| Stockholders' equity | 54,997,841 | 219,582,014 | 273,230,666 | 300,794,867 | 320,917,476 | 144,011,839 |
| Cash and cash equivalents | 32,418,220 | 175,537,221 | 157,335,323 | 59,286,147 | 89,241,695 | 51,018,657 |
| Free cash flow | -15,016,193 | -6,755,829 | 25,671,667 | -71,806,439 | 66,502,924 | 29,907,536 |
Ratios
| Metric | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|
| Net margin | -15.73% | 7.45% | 7.85% | 1.10% | 3.24% | -56.61% |
| Operating margin | -15.68% | 4.82% | 4.96% | 2.41% | 4.65% | -55.26% |
| Return on equity | -26.91% | 10.81% | 12.66% | 2.28% | 6.23% | -126.66% |
| Return on assets | -14.77% | 7.67% | 8.79% | 1.40% | 4.39% | -84.02% |
| Liabilities / equity | 0.60 | 0.38 | 0.42 | 0.62 | 0.44 | 0.63 |
| Current ratio | 2.49 | 4.42 | 2.71 | 1.99 | 2.50 | 2.26 |
Industry Peer Context
Net margin peer context
Operating margin peer context
ROE peer context
ROA peer context
Financial Bridges
Free cash flow = operating cash flow - capital expenditures
Figure provenance: SEC companyfacts FY 2025. Operating cash flow: accession 0001628280-26-018214; concept NetCashProvidedByUsedInOperatingActivities; source concepts us-gaap:NetCashProvidedByUsedInOperatingActivities | Capital expenditures: accession 0001628280-26-018214; concept PaymentsToAcquirePropertyPlantAndEquipment; source concepts us-gaap:PaymentsToAcquirePropertyPlantAndEquipment | Free cash flow: accession 0001628280-26-018214; concept NetCashProvidedByUsedInOperatingActivities - PaymentsToAcquirePropertyPlantAndEquipment; source concepts us-gaap:NetCashProvidedByUsedInOperatingActivities; us-gaap:PaymentsToAcquirePropertyPlantAndEquipment
Financial Charts
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: Revenues. Source concepts: us-gaap:Revenues.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: NetIncomeLoss. Source concepts: us-gaap:NetIncomeLoss.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: OperatingIncomeLoss. Source concepts: us-gaap:OperatingIncomeLoss.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: EarningsPerShareDiluted. Source concepts: us-gaap:EarningsPerShareDiluted.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: NetCashProvidedByUsedInOperatingActivities. Source concepts: us-gaap:NetCashProvidedByUsedInOperatingActivities.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: PaymentsToAcquirePropertyPlantAndEquipment. Source concepts: us-gaap:PaymentsToAcquirePropertyPlantAndEquipment.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: PaymentsForRepurchaseOfCommonStock. Source concepts: us-gaap:PaymentsForRepurchaseOfCommonStock.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: Assets. Source concepts: us-gaap:Assets.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: Liabilities. Source concepts: us-gaap:Liabilities.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: StockholdersEquity. Source concepts: us-gaap:StockholdersEquity.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: CashAndCashEquivalentsAtCarryingValue. Source concepts: us-gaap:CashAndCashEquivalentsAtCarryingValue.
Figure provenance: SEC companyfacts. Latest point: FY 2025 ended 2025-12-31; accession 0001628280-26-018214; filed 2026-03-16. Concept: NetCashProvidedByUsedInOperatingActivities - PaymentsToAcquirePropertyPlantAndEquipment. Source concepts: us-gaap:NetCashProvidedByUsedInOperatingActivities; us-gaap:PaymentsToAcquirePropertyPlantAndEquipment.
Quarterly
Quarterly standardized facts from SEC companyfacts as of latest extracted filing date 2026-05-11. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0001822359.json.
| Quarter | End Date | Revenue | Net Income | Diluted EPS | Method |
|---|---|---|---|---|---|
| 2021-Q2 | 2021-06-30 | -3,042,567 | reported discrete quarter | ||
| 2021-Q3 | 2021-09-30 | 544,487 | reported discrete quarter | ||
| 2021-Q4 | 2021-12-31 | 19,687,700 | derived Q4 = FY annual - nine-month YTD | ||
| 2022-Q1 | 2022-03-31 | 9,372,437 | reported discrete quarter | ||
| 2022-Q2 | 2022-06-30 | 11,755,862 | 0.11 | reported discrete quarter | |
| 2022-Q3 | 2022-09-30 | 2,466,486 | 0.03 | reported discrete quarter | |
| 2022-Q4 | 2022-12-31 | 10,989,712 | derived Q4 = FY annual - nine-month YTD | ||
| 2023-Q1 | 2023-03-31 | -3,465,670 | -0.03 | reported discrete quarter | |
| 2023-Q2 | 2023-06-30 | 125,486,760 | -0.02 | reported discrete quarter | |
| 2023-Q3 | 2023-09-30 | 186,552,910 | 0.05 | reported discrete quarter | |
| 2023-Q4 | 2023-12-31 | 199,246,269 | derived Q4 = FY annual - nine-month YTD | ||
| 2024-Q1 | 2024-03-31 | 192,087,529 | 0.10 | reported discrete quarter | |
| 2024-Q2 | 2024-06-30 | 164,949,716 | 0.06 | reported discrete quarter | |
| 2024-Q3 | 2024-09-30 | 138,684,814 | 0.05 | reported discrete quarter | |
| 2024-Q4 | 2024-12-31 | 120,833,073 | derived Q4 = FY annual - nine-month YTD | ||
| 2025-Q1 | 2025-03-31 | 96,033,055 | -0.09 | reported discrete quarter | |
| 2025-Q2 | 2025-03-31 | -9,405,315 | reported discrete quarter | ||
| 2025-Q2 | 2025-06-30 | 80,417,622 | -0.11 | reported discrete quarter | |
| 2025-Q3 | 2025-06-30 | -11,155,246 | reported discrete quarter | ||
| 2025-Q3 | 2025-09-30 | 70,809,635 | -0.28 | reported discrete quarter | |
| 2025-Q4 | 2025-12-31 | 74,935,688 | -134,070,681 | derived Q4 = FY annual - nine-month YTD | |
| 2026-Q1 | 2026-03-31 | 75,550,484 | -14,763,131 | -0.15 | reported discrete quarter |
Quarterly Charts
Figure provenance: SEC companyfacts. Latest point: FY 2026 ended 2026-03-31; accession 0001628280-26-033563; filed 2026-05-11. Concept: Revenues. Source concepts: us-gaap:Revenues.
Figure provenance: SEC companyfacts. Latest point: FY 2026 ended 2026-03-31; accession 0001628280-26-033563; filed 2026-05-11. Concept: NetIncomeLoss. Source concepts: us-gaap:NetIncomeLoss.
Figure provenance: SEC companyfacts. Latest point: FY 2026 ended 2026-03-31; accession 0001628280-26-033563; filed 2026-05-11. Concept: EarningsPerShareDiluted. Source concepts: us-gaap:EarningsPerShareDiluted.
Macro Cross-References
- CPIAUCSL - Consumer Price Index for All Urban Consumers: All Items in U.S. City Average
- UNRATE - Unemployment Rate
- FEDFUNDS - Federal Funds Effective Rate
- CES0500000003 - Average Hourly Earnings of All Employees, Total Private
- DFEDTARU - Federal Funds Target Range - Upper Limit
- DFEDTARL - Federal Funds Target Range - Lower Limit
- DGS3MO - Market Yield on U.S. Treasury Securities at 3-Month Constant Maturity
- DGS2 - Market Yield on U.S. Treasury Securities at 2-Year Constant Maturity
- DGS10 - Market Yield on U.S. Treasury Securities at 10-Year Constant Maturity
- DGS30 - Market Yield on U.S. Treasury Securities at 30-Year Constant Maturity
- T10Y2Y - 10-Year Treasury Constant Maturity Minus 2-Year Treasury Constant Maturity
- CPILFESL - Consumer Price Index for All Urban Consumers: All Items Less Food and Energy
- CPIUFDSL - Consumer Price Index for All Urban Consumers: Food
- CPIENGSL - Consumer Price Index for All Urban Consumers: Energy
- CUSR0000SAH1 - Consumer Price Index for All Urban Consumers: Shelter
- PCEPI - Personal Consumption Expenditures: Chain-type Price Index
- PCEPILFE - Personal Consumption Expenditures Excluding Food and Energy: Chain-type Price Index
- PPIACO - Producer Price Index by Commodity: All Commodities
- T10YIE - 10-Year Breakeven Inflation Rate
- U6RATE - Total Unemployed, Plus All Marginally Attached Workers Plus Total Employed Part Time for Economic Reasons
- PAYEMS - All Employees, Total Nonfarm
- CIVPART - Labor Force Participation Rate
- EMRATIO - Employment-Population Ratio
- UNEMPLOY - Unemployed
- CE16OV - Employment Level
- ICSA - Initial Claims
- JTSJOL - Job Openings: Total Nonfarm
- JTSQUR - Quits: Total Nonfarm
- GDPC1 - Real Gross Domestic Product
- A191RL1Q225SBEA - Real Gross Domestic Product: Percent Change from Preceding Period
- INDPRO - Industrial Production: Total Index
- TCU - Capacity Utilization: Total Index
- HOUST - New Privately-Owned Housing Units Started: Total Units
- PERMIT - New Privately-Owned Housing Units Authorized in Permit-Issuing Places: Total Units
- RSAFS - Advance Retail Sales: Retail Trade
- PCE - Personal Consumption Expenditures
- DSPIC96 - Real Disposable Personal Income
- PSAVERT - Personal Saving Rate
- M2SL - M2
- BOPGSTB - U.S. International Trade in Goods and Services: Balance
- MSPUS - Median Sales Price of Houses Sold for the United States
- HSN1F - New One Family Houses Sold: United States
- RHORUSQ156N - Homeownership Rate in the United States
- TTLCONS - Total Construction Spending: Total Construction in the United States
- RRVRUSQ156N - Rental Vacancy Rate in the United States
- TOTALSL - Total Consumer Credit Owned and Securitized
- REVOLSL - Revolving Consumer Credit Owned and Securitized
- DRCCLACBS - Delinquency Rate on Credit Card Loans, All Commercial Banks
- GDP - Gross Domestic Product
- GPDI - Gross Private Domestic Investment
- GCE - Government Consumption Expenditures and Gross Investment
- PCEC - Personal Consumption Expenditures
- NETEXP - Net Exports of Goods and Services
- GFDEBTN - Federal Debt: Total Public Debt
- GFDEGDQ188S - Federal Debt: Total Public Debt as Percent of Gross Domestic Product
- FYFSD - Federal Surplus or Deficit
- FGRECPT - Federal Government Current Receipts
- FGEXPND - Federal Government: Current Expenditures
- MANEMP - All Employees, Manufacturing
- USCONS - All Employees, Construction
- USTRADE - All Employees, Retail Trade
- USFIRE - All Employees, Financial Activities
- USGOVT - All Employees, Government
- AWHAETP - Average Weekly Hours of All Employees, Total Private
- DGORDER - Manufacturers' New Orders: Durable Goods
- NEWORDER - Manufacturers' New Orders: Nondefense Capital Goods Excluding Aircraft
- BUSINV - Total Business Inventories
- EXPGS - Exports of Goods and Services
- IMPGS - Imports of Goods and Services
- IR - Import Price Index (End Use): All Commodities
- PPIFIS - Producer Price Index by Commodity: Final Demand
Latest quarter (10-Q)
Latest 10-Q source: 0001628280-26-033563.
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our unaudited Condensed Consolidated Financial Statements and the accompanying notes included elsewhere in this Quarterly Report on Form 10-Q. The discussion and analysis below contain certain forward-looking statements about our business and operations that are subject to the risks, uncertainties and other factors described in the section entitled “Risk Factors” included in Part I, Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2025, and as may be updated in this and other subsequent Quarterly Reports on Form 10-Q. These risks, uncertainties and other factors could cause our actual results or outcomes to differ materially from those expressed in, or implied by, the forward-looking statements. Please refer to the section below entitled “Cautionary Note Regarding Forward-Looking Statements.”
Certain figures included in this section, such as interest rates and other percentages, have been rounded for ease of presentation. Percentage figures included in this section have, in some cases, been calculated on the basis of such rounded figures. For this reason, percentage amounts in this section may vary slightly from those obtained by performing the same calculations using the figures in our unaudited Condensed Consolidated Financial Statements or in the associated text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Cautionary Note Regarding Forward-Looking Statements
This Quarterly Report on Form 10-Q includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities and Exchange Act of 1934, as amended (the “Exchange Act”), regarding, among other things, the plans, strategies, outcomes and prospects, both business and financial, of the Company. These statements are based on the beliefs and assumptions of our management. Although the Company believes that its plans, intentions and expectations reflected in or suggested by these forward-looking statements are reasonable, the Company cannot assure you that it will achieve or realize these plans, intentions, outcomes, results or expectations. Accordingly, you should not place undue reliance on such statements. All statements other than statements of historical fact are forward-looking. Forward-looking statements include, but are not limited to, statements concerning our possible or assumed future actions; business strategies, plans and goals; future events; future results of operations, including revenues, expenses or performance; financing needs; business trends; objectives and intentions with respect to future operations, services and products, including our geographic expansion; the provision of services under existing contracts, including winding down of migrant-related services; M&A activity; impairments; workforce growth; leadership transitions; cash position and liquidity; our share repurchase program; expected impacts of macroeconomic factors, including inflationary pressures and the interest rate environment; our competitive position and opportunities, including our ability to realize the benefits from our operating model and conditions in the healthcare services market; our ability to control costs and maintain or improve gross margins and profitability; cost-containment measures; legislative and regulatory actions; the impact of legal proceedings and compliance risk; the impact on our business and reputation in the event of information technology system failures, network disruptions, cybersecurity incidents or losses or unauthorized access to, or release of, confidential information; the ability of the Company to comply with laws and regulations regarding data privacy and protection; and any statements or assumptions underlying the foregoing. In some cases, these statements may be preceded by, followed by or include the words “believes,” “estimates,” “expects,” “projects,” “forecasts,” “may,” “might,” “will,” “should,” “could,” “can,” “would,” “design,” “potential,” “seeks,” “plans,” “scheduled,” “anticipates,” “intends” or the negative of these terms or similar expressions.
Forward-looking statements are inherently subject to substantial risks, uncertainties and assumptions, many of which are beyond our control, and which may cause our actual results or outcomes, or the timing of our results or outcomes, to differ materially from those contained in our forward-looking statements, including, but not limited to the following: impacts related to the wind down of migrant-related services; our ability to continue as a going concern; our ability to maintain our listing on Nasdaq; our ability to pursue strategic initiatives to deliver on shareholder value; our ability to expand our programs with insurance partners, hospital systems, municipalities and other strategic partners; our ability to successfully implement our business strategy, including delivering value to shareholders via buybacks and funding new strategic relationships; our ability to establish, maintain and grow customer relationships; our ability to execute projects to the satisfaction of our customers; our ability to grow demand for our care gap closure programs; our ability to maintain or grow our cash balances; our reliance on and ability to maintain our contractual relationships with our healthcare provider partners and other strategic partners; our ability to compete effectively in a highly competitive industry, including conditions in the healthcare transportation and mobile health services markets; our ability to maintain existing contracts; our reliance on government contracts, including changes in government spending on healthcare and other social services; recent revenue growth derived from a small number of large customers; our ability to effectively manage our growth; our financial performance and future prospects; our ability to deliver on our business strategies or models, plans and goals; our ability to expand geographically; our M&A activity and success of our acquisition strategy; our ability to retain our
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workforce and management personnel and successfully manage leadership transitions; the availability of healthcare professionals and other personnel; changes in the cost of labor; our ability to collect on customer receivables; risks associated with our share repurchase program; overall macroeconomic and geopolitical conditions, including the interest rate environment, the inflationary environment, the potential recessionary environment, regional conflict and tensions, financial institution instability and the ongoing or any future shutdown of the U.S. federal government; the ability of our suppliers to meet our needs; our ability to obtain or maintain operating licenses; potential changes in federal, state or local government policies or priorities; expected impacts of geopolitical instability; our competitive position and opportunities, including our ability to realize the benefits from our operating model; our ability to improve gross margins; our ability to implement and deliver on cost-containment measures and ongoing cost rationalization initiatives; legislative and regulatory actions; the impact of legal proceedings and compliance risk; volatility of our stock price; the impact on our business and reputation in the event of information technology system failures, network disruptions, cyber incidents or losses or unauthorized access to, or release of, confidential information; our ability to comply with laws and regulations regarding data privacy and protection and other risk factors that are described herein, as well as the risks discussed in Item 1A “Risk Factors” of Part I in our Annual Report on Form 10-K for the fiscal year ended December 31, 2025 and that are otherwise described or updated from time to time in our filings with the SEC.
Moreover, we operate in a very competitive and rapidly changing environment. New risks and uncertainties emerge from time to time, and it is not possible for us to predict all risks and uncertainties that could have an impact on the forward-looking statements contained in this Quarterly Report on Form 10-Q.
In addition, statements that “we believe” and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based on information available to us as of the date of this Quarterly Report on Form 10-Q, and, while we believe that information provides a reasonable basis for these statements, that information may be limited or incomplete. Our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all relevant information. These statements are inherently uncertain, and investors are cautioned not to unduly rely on these statements.
The forward-looking statements made in this Quarterly Report on Form 10-Q are based on events or circumstances as of the date on which the statements are made. We undertake no obligation to update any forward-looking statements made in this Quarterly Report on Form 10-Q to reflect events or circumstances after the date of this Quarterly Report on Form 10-Q or to reflect new information or the occurrence of unanticipated events, except as and to the extent required by law. Our forward-looking statements do not reflect the potential impact of any future acquisitions, mergers, dispositions, joint ventures or investments.
Overview
The Company is a mobile healthcare services company that uses proprietary dispatch and communication technology to help provide quality mobile, in-person medical treatment directly to patients in the comfort of their homes, workplaces and other non-traditional locations, as well as medical transportation in major metropolitan cities in the United States and the United Kingdom.
The Company derives revenue primarily from two operating segments:
•Mobile Health Services: The services offered by this segment include a wide variety of healthcare services performed at homes, offices and other locations and event services such as on-site healthcare support at sporting events and concerts. This segment also provides solutions to large, typically underserved population groups, typically through arrangements with municipalities, which include both physical and mental healthcare services. The services offered by this segment include virtual care and diagnostics, remote patient monitoring, phlebotomy, addressing gaps in care and primary care physician services.
•Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities.
For the three months ended March 31, 2026, the Company recorded a net loss of $16.7 million, compared to net loss of $11.1 million for the three months ended March 31, 2025. See “Results of Operations” for the Company’s evaluation of these results.
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Factors Affecting Our Results of Operations
Our operating results and financial performance are influenced by a variety of factors, including, among others, our ability to establish, maintain and grow customer relationships; our ability to execute projects to the satisfaction of our customers; conditions in the healthcare transportation and mobile health services markets; changes in government spending on healthcare and other social services, including as a result of changes in the U.S. administration and administrative priorities; availability of healthcare p
[Excerpt truncated for page length; source filing is linked above.]
Latest 10-K MD&A
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our Consolidated Financial Statements and the accompanying notes included elsewhere in this Annual Report. The discussion and analysis below contain certain forward-looking statements about our business and operations that are subject to the risks, uncertainties and other factors described in the section entitled “Risk Factors,” included in Part I, Item 1A, and other factors included elsewhere in this Annual Report. These risks, uncertainties and other factors could cause our actual results or outcomes to differ materially from those expressed in, or implied by, the forward-looking statements. Please refer to the section entitled “Cautionary Note Regarding Forward-Looking Statements.”
Certain figures included in this section, such as interest rates and other percentages, have been rounded for ease of presentation. Percentage figures included in this section have, in some cases, been calculated on the basis of such rounded figures. For this reason, percentage amounts in this section may vary slightly from those obtained by performing the same calculations using the figures in our Consolidated Financial Statements or in the associated text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Factors Affecting Our Results of Operations
Our operating results and financial performance are influenced by a variety of factors, including, among others, our ability to establish, maintain and grow customer relationships; our ability to execute projects to the satisfaction of our customers; conditions in the healthcare transportation and mobile health services markets; changes in government spending on healthcare and other social services, including as a result of changes in U.S. administrative priorities; availability of healthcare professionals and other personnel and our ability to attract and retain such personnel; changes in the cost of labor; our competitive environment; overall macroeconomic and geopolitical conditions, including the interest rate environment, the inflationary environment, the potential recessionary environment, regional conflict and tensions, financial institution instability and the prospect of a shutdown of the U.S. federal government; production schedules of our suppliers; our ability to obtain or maintain operating licenses; and the success of our acquisition strategy. Some of these key factors are briefly discussed below. Future revenue growth and improvement in operating results will be largely contingent on our ability to penetrate new markets and further penetrate existing markets, which is subject to a number of uncertainties, many of which are beyond our control.
Healthcare Services Market
The Mobile Health Services market is dependent on several factors, including increased patient acceptance of services that are provided outside of traditional healthcare facilities, such as in homes, businesses or other designated locations; healthcare coverage of the various Mobile Health Services; and, to a lesser extent, continued desire on the part of government and municipal entities to fund programs to assist currently underserved patient segments via “population health” programs.
The Transportation Services market is highly dependent on patients requiring transportation after surgeries and other medical procedures and treatments. The Company primarily focuses on the non-emergency medical transport market, which includes services that are provided to patients who need assistance getting to and from medical appointments. Key drivers of this market are the increase in chronic conditions and the number of elective surgeries as well as the ongoing aging of the population, as the older demographics tend to be much more frequent consumers of medical transportation services. We believe the market will also grow if hospitals and other healthcare facilities continue to outsource more of their transportation needs to independent providers, such as the Company, allowing these facilities to concentrate their efforts on their core competencies.
Overall Economic Conditions in the Markets in Which We Operate
Economic changes, both nationally and locally, in our markets impact our financial performance. Unfavorable changes in demographics, healthcare coverage of Mobile Health Services and Transportation Services, interest rates, inflation rates, the availability of trained and licensed healthcare professionals, or ambulance manufacturing; a weakening
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of the national economy or of any regional or local economy in which we operate; and other factors beyond our control could adversely affect our business.
Our Ability to Control Expenses
We pay close attention to the management of our working capital and operating expenses. Some of our most significant operating expenses are labor costs, medical supplies and vehicle-related costs, such as fuel, maintenance, repair and insurance. Insurance costs include premiums paid for coverage as well as reserves for estimated losses within the Company’s insurance policy deductibles and for the lines of insurance where the Company is self-insured, such as auto and workers’ compensation. We employ our proprietary technology to help drive improvements in productivity per transport and per shift. We regularly analyze our workforce productivity to help achieve the optimum, cost-efficient labor mix for our locations. This involves managing the mix of Company-employed labor and subcontracted labor as well as full-time and part-time employees.
Inflation
The inflation rate in the United States, as measured by the Consumer Price Index, has generally trended down since the middle of 2023. This data is reported monthly, showing year-over-year changes in prices across a basket of goods and services. The inflation rate declined to 2.7% for the full year 2025, down from 2.9% in 2024, 3.4% in 2023 and 6.5% in 2022. In February 2026, the annual inflation rate declined to 2.4%, the lowest since February 2021. An increased inflation rate, such as that witnessed between 2021 and the first half of 2023, could have an impact on DocGo’s expenses in several areas, including wages, fuel and medical and other supplies. This would have the effect of compressing gross profit margins, as DocGo is generally unable to pass these higher costs on to its customers, particularly in the short term. In addition, opportunities to mitigate the impact of inflation are limited, aside from potentially buying more medical supplies than are currently needed in an effort to reduce the volume of future purchases, in instances where supply prices are anticipated to rise. As inflation has moderated, and in an attempt to stimulate economic growth, the U.S. Federal Reserve implemented three interest rate cuts in September, October and December of 2025, lowering its benchmark rate (the “federal funds rate”) to the current level of 3.5-3.8% as of the date of this Annual Report. Looking into 2026, DocGo anticipates that the inflation rate will remain at or near the currently more moderate level, with an annual rate similar to those witnessed in 2024-2025 and the 2010-2020 period, when the annual inflation rate ranged from 0.1% to 3.2%. However, if inflation is above the levels that DocGo anticipates, gross margins could be below plan and as a result, DocGo’s business, operating results and cash flows may be adversely affected.
Trip Volumes and Average Trip Price
A “trip” is defined as an instance where the Company completes the transportation of a patient to a specific destination, for which we are able to charge a fee. This metric does not include instances where a trip is ordered and subsequently either canceled (by the customer) or declined (by the Company). As trip volume represents the most basic unit of transportation service provided by the Company, the Company believes it is a good measure of the level of demand for the Company’s Transportation Services and is used by management to monitor and manage the scale of the business.
The average trip price is calculated by dividing the aggregate revenue from the total number of trips by the total number of trips and is an important indicator of the effective rate at which the Company is being compensated for its provision of Transportation Services.
Revenues generated from programs under which the Company is paid a fixed hourly or daily rate for the use of a fully staffed and equipped ambulance do not factor in the trip counts or average trip prices mentioned above. We expect these fixed rate, “leased hour” programs to continue to account for an increasing proportion of the Transportation Services segment’s revenues in the future.
Acquisitions
Historically, we have pursued an acquisition strategy to obtain enhanced capabilities or licenses to offer Mobile Health Services or Transportation Services. Future acquisitions may also include companies that may help drive revenue, profitability, cash flow and stockholder value.
During the year ended December 31, 2025, the Company completed three acquisitions, for an aggregate purchase price of $21.1 million. During the year ended December 31, 2024, the Company did not complete any acquisitions. During
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the year ended December 31, 2023, the Company completed three acquisitions for an aggregate purchase price of $34.2 million.
Overview
DocGo is a mobile healthcare services company that uses proprietary dispatch and communication technology to help provide quality mobile, in-person medical treatment directly to patients in the comfort of their homes, workplaces and other non-traditional locations, as well as medical transportation in major metropolitan cities in the United States and the United Kingdom.
The Company derives revenue primarily from two operating segments:
•Mobile Health Services: The services offered by this segment include a wide variety of healthcare services performed at homes, offices and other locations and event services such as on-site healthcare support at sporting events and concerts. This segment also provides solutions to large, typically underserved population groups, typically through arrangements with municipalities, which include both physical and mental healthcare services.
•Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities.
See Item 1, “Business” in this Annual Report for additional information regarding DocGo’s business.
For the year ended December 31, 2025 the Company recorded a net loss of $196.4 million, compared to net income of $13.4 million and $10.0 million in the years ended December 31, 2024 and 2023, respectively. See “Results of Operations” for the Company’s evaluation of these results.
Investing in R&D and AI
Our R&D efforts include, among other things, the development of innovative software and services as well as the adoption and responsible integration of AI and ML capabilities across our products and internal operations, including the development, training, validation, deployment, and ongoing monitoring of ML models and related systems. We also intend to develop integrations with third-party products and services, mobile applications, automation tools to improve workforce productivity and operational efficiency, and other new offerings.
These initiatives may require significant capital and operating expenditures, specialized technical expertise, access to high-quality data, robust computing infrastructure, and effective governance and controls. Our ability to realize anticipated benefits from AI adoption, ML training, and workforce automation depends on, among other things, our ability to execute effectively, maintain model performance and reliability over time, manage the risks associated with bias, errors, data quality, and security, comply with evolving legal and regulatory requirements, and achieve adoption by employees, customers, and partners. If we fail to innovate, deploy, and scale these capabilities, or if our investments do not produce the expected returns, our market position, operating results, and revenue may be adversely affected.
Regulatory Environment
The Company is subject to federal, state and local regulations, including healthcare and emergency medical services laws and regulations and tax laws and regulations. The Company’s current business plan assumes no material change in these laws and regulations. In the event that any such change occurs, compliance with new laws and regulations may significantly affect the Company’s operations and cost of doing business.
Government Contracts
In recent years, the Company’s government contract work has represented a substantial portion of its overall revenue. While the Company expects government contract work to decline, both in absolute dollar terms and as a percentage of overall consolidated revenue, due primarily to the ending of large migrant-related projects in New York, the Company continues to bid on government contracts and expects some revenue from this sector in the future. However, government contract work is subject to risks and uncertainties. For example, starting in the second quarter of 2023, the
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Company began providing services to the recent migrant population in New York City and in upstate New York. Some of these services were provided pursuant to a contract with an ending date during the second quarter of 2024. While a portion of that contract was extended through December 31, 2024, other services began to wind down in May 2024. The wind-down of all services under such contract was completed in the fourth quarter of 2024. While the Company continued to provide services under other contracts during 2025, the wind-down of the remaining migrant-related services under other contracts was completed in December, and the Company expects that the revenues from any remaining migrant-related projects will be relatively insignificant in 2026. As such, despite the Company’s expectation for revenue growth in other business lines within the Mobile Health Services segment, we expect that overall Mobile Health Services revenues will be lower in 2026 than they were in 2025, given the absence of migrant-related project revenues.
In addition, government contract work subjects the Company to government audits, investigations and proceedings, which could lead to the Company to being barred from government work or subjected to fines if it is determined that a statute, rule, regulation, policy or contractual provision has been violated. Audits can also lead to adjustments to the amount of contract costs that the Company believes are reimbursable or to the ultimate amount the Company may be paid under the agreement. Furthermore, a shift in government policies or priorities, at either the federal, state or local level, surrounding the allocation of public spending to health care-related projects, could have a large impact on the Company’s revenues in this area. A loss of or a decline in government contract work, if not offset by revenues from new or other existing customers, could have a material adverse effect on the Company’s business, financial condition and results of operations.
Components of Results of Operations
Our business consists of three reportable segments — Mobile Health Services, Transportation Services and Corporate. All revenue and cost of revenues are contained within the Mobile Health Services and Transportation Services segments. Accordingly, revenues and cost of revenues are discussed below on a consolidated level and are also broken down between Mobile Health Services and Transportation Services. Operating expenses are discussed on a consolidated level and broken down among all three segments. The Company evaluates the performance of each of its segments based primarily on its results of operations. Accordingly, other income and expenses not included in results of operations are only included in the discussion of consolidated results of operations. When evaluating results of operations, the Company will typically not take into account certain non-cash elements of results of operations, such as impairments of intangible assets and goodwill. In the Company’s view, these items, while part of results of operations, are not a reflection of the underlying performance of the business during the period being evaluated.
Revenue
The Company’s revenue consists of services provided by its Mobile Health Services segment and its Transportation Services segment.
Cost of Revenues
Cost of revenues consists primarily of revenue generating wages paid to employees, fees paid to subcontractors, medical supplies, vehicle insurance costs (including insurance premiums and costs incurred under the insurance deductibles), maintenance, fuel and facility rent. We expect cost of revenues to continue to rise as we grow our business.
Operating Expenses
General and Administrative Expenses
General and administrative expenses consist primarily of salaries, bad debt expense, impairment expenses, insurance expense, consultant fees and professional fees for accounting and related services. We incur additional general and administrative expenses as a result of operating as a public company, including our compliance with SEC rules and regulations, audit activities, additional insurance expenses, investor relations activities and other administrative and professional services. In dollar terms, our general and administrative expenses have declined in recent quarters, along with the decline in our overall revenues, due to the wind-down of the Company’s migrant-related projects. However, these costs have increased when measured as a percentage of total revenue, as the decline in general and administrative costs has been smaller than has been the decline in total revenue. Looking to 2026, we expect this trend to continue, with general and administrative costs declining sequentially in absolute dollar terms, while also declining as a percentage of revenues, as we see some sequential increases in revenues. Over the longer term, we expect that general and administrative expenses will increase along with headcount as the Company’s overall business activity increases, including higher sales and marketing fees.
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Depreciation and Amortization
The Company depreciates its assets using the straight-line method over the estimated useful lives of the respective assets. Amortization of intangibles consists of amortization of definite-lived intangible assets over their respective useful lives.
Legal and Regulatory Expenses
Legal and regulatory expenses include legal fees, consulting fees related to healthcare compliance and legal settlements.
Technology and Development Expenses
Technology and development expenses consist primarily of costs incurred in the design and development of the Company’s proprietary technology, third-party software and technologies. We expect technology and development expenses to increase in future periods to support our growth, including our intent to continue investing in the optimization, accuracy and reliability of our dispatch and communication platform and driving efficiency in our operations. These expenses may vary from period to period as a percentage of revenue, depending primarily upon when we choose to make more significant investments, particularly when entering new business lines or customer sales channels. Technology and development expenses will also be driven by investments made into new areas, such as artificial intelligence.
Sales, Advertising and Marketing Expenses
Our sales, advertising and marketing expenses consist of costs directly associated with our sales and marketing activities, which primarily include sales commissions, marketing programs, trade shows and promotional materials and general branding. We expect our sales, advertising and marketing expenses to continue to increase over time as we increase our marketing activities, expand into new geographic markets and customer verticals, particularly in the Mobile Health segment, and continue to build brand awareness.
Interest Expense
Interest expense consists primarily of interest on our outstanding borrowings under our outstanding notes payable and financing obligations, including our Prior Revolving Facility. These expenses are determined by the amounts of debt that are outstanding, as well as market interest rates, which form the basis for the interest expenses relating to our Prior Revolving Facility. Interest expense is reported on a net basis, so that interest income earned on the Company’s cash and investment balances serves to offset part or all of our interest expense in a particular period.
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Results of Operations
Comparison of Fiscal 2025 with Fiscal 2024
| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2025 | 2024 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 322.2 | 100.0 | % | $ | 616.6 | 100.0 | % | $ | (294.4) | (47.7) | % | ||||||||
| Expenses: | ||||||||||||||||||||
| Cost of revenues (exclusive of depreciation and amortization, which is shown separately below) | 223.5 | 69.4 | % | 403.0 | 65.3 | % | (179.5) | (44.5) | % | |||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 133.4 | 41.4 | % | 138.8 | 22.5 | % | (5.4) | (3.9) | % | |||||||||||
| Depreciation and amortization | 15.7 | 4.9 | % | 15.9 | 2.6 | % | (0.2) | (1.3) | % | |||||||||||
| Legal and regulatory | 23.8 | 7.4 | % | 17.1 | 2.8 | % | 6.7 | 39.2 | % | |||||||||||
| Technology and development | 13.6 | 4.2 | % | 11.6 | 1.9 | % | 2.0 | 17.2 | % | |||||||||||
| Sales, advertising and marketing | 1.4 | 0.4 | % | 1.5 | 0.2 | % | (0.1) | (6.7) | % | |||||||||||
| Intangible asset impairment | 30.6 | 9.5 | % | — | — | % | 30.6 | 100.0 | % | |||||||||||
| Goodwill impairment | 58.2 | 18.1 | % | — | — | % | 58.2 | 100.0 | % | |||||||||||
| Total expenses | 500.2 | 155.3 | % | 587.9 | 95.3 | % | (87.7) | (14.9) | % | |||||||||||
| (Loss) income from operations | (178.0) | (55.3) | % | 28.7 | 4.7 | % | (206.7) | (720.2) | % | |||||||||||
| Other expense: | ||||||||||||||||||||
| Interest expense, net | (1.3) | (0.4) | % | (1.9) | (0.3) | % | 0.6 | 31.6 | % | |||||||||||
| (Loss) gain on change in fair value of contingent consideration | (2.1) | (0.6) | % | 9.4 | 1.5 | % | (11.5) | (122.3) | % | |||||||||||
| Finite-lived intangible asset impairment | — | — | % | (8.3) | (1.3) | % | 8.3 | 100.0 | % | |||||||||||
| Loss on equity method investments | (0.6) | (0.2) | % | (0.3) | (0.1) | % | (0.3) | (100.0) | % | |||||||||||
| Equity investment impairment | (5.0) | (1.5) | % | — | — | % | (5.0) | (100.0) | % | |||||||||||
| Other (expense) income | (0.5) | (0.2) | % | 0.2 | — | % | (0.7) | (350.0) | % | |||||||||||
| Total other expense | (9.5) | (2.9) | % | (0.9) | (0.2) | % | (8.6) | (955.6) | % | |||||||||||
| Net (loss) income before income tax expense | (187.5) | (58.2) | % | 27.8 | 4.5 | % | (215.3) | (774.5) | % | |||||||||||
| Provision for income taxes | (8.9) | (2.7) | % | (14.4) | (2.3) | % | 5.5 | 38.2 | % | |||||||||||
| Net (loss) income | (196.4) | (60.9) | % | 13.4 | 2.2 | % | (209.8) | (1565.7) | % | |||||||||||
| Net loss attributable to noncontrolling interests | (14.0) | (4.3) | % | (6.6) | (1.0) | % | (7.4) | (112.1) | % | |||||||||||
| Net (loss) income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | (182.4) | (56.6) | % | $ | 20.0 | 3.2 | % | $ | (202.4) | (1012.0) | % |
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Revenues
Consolidated
For the year ended December 31, 2025, total revenues were $322.2 million, a decrease of $294.4 million, or 47.7%, from the total revenues recorded for the year ended December 31, 2024.
Mobile Health Services
For the year ended December 31, 2025, Mobile Health Services revenues were $121.4 million, a decrease of $301.7 million, or 71.3%, as compared with the year ended December 31, 2024. The decline in revenues was primarily due to the wind-down of migrant-related services. Starting in the second quarter of 2023, the Company began providing services to the recently arrived migrant population in New York City and in upstate New York. These projects, which included both medical and non-medical services, such as shelter and security, expanded throughout the third and fourth quarters of 2023 and into the first quarter of 2024. However, some of these services were provided pursuant to a contract with an ending date during the second quarter of 2024. A portion of that contract was extended through December 31, 2024, while other services began to wind down in May 2024. The wind-down of all services under such contract was completed in the fourth quarter of 2024. While DocGo continued to provide migrant-related services under other contracts during 2025, the wind-down of such services was completed in the fourth quarter of 2025, and DocGo expects that the revenues from any migrant-related projects will be relatively insignificant in 2026.
Transportation Services
For the year ended December 31, 2025, Transportation Services revenues were $200.8 million, an increase of $7.3 million, or 3.8%, as compared with the year ended December 31, 2024. This increase was due to a 4.4% increase in trip volumes, from 283,570 trips for the year ended December 31, 2024 to 296,014 trips for the year ended December 31, 2025. The increase in trip volumes, which accelerated in the fourth quarter of 2025, was due to a combination of the expansion in the Company’s customer base in certain core markets, as well as an increase in volumes from existing customers. Our average trip price decreased slightly from $402 in the year ended December 31, 2024 to $401 in the year ended December 31, 2025. In recent years, the average trip price has increased above the levels of 2022 and prior years, reflecting a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports that earn higher prices per trip.
Cost of revenues
For the year ended December 31, 2025, total cost of revenues (exclusive of depreciation and amortization) decreased by 44.5% compared to the year ended December 31, 2024, while revenues decreased by approximately 47.7%. The declines in both revenues and cost of revenues were driven by the wind-down in migrant-related services described above. Cost of revenues as a percentage of revenues increased to 69.4% in the year ended December 31, 2025 from 65.3% in the year ended December 31, 2024.
Total cost of revenues in the year ended December 31, 2025 decreased by $179.5 million compared to the year ended December 31, 2024. This decrease was primarily attributable to a $28.5 million decrease in total compensation, a $101.2 million decrease in subcontracted labor costs, a $30.9 million decrease in medical and related supplies, a $6.5 million decline in vehicle costs, a $1.9 million decline in travel-related costs and a net decrease of $10.5 million across several other cost of revenues categories, all driven by the wind-down of migrant-related projects that began in the second quarter of 2024.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2025 amounted to $86.1 million, down 68.0% from $269.3 million in the year ended December 31, 2024. Cost of revenues as a percentage of revenues increased to 70.9% from 63.6% in the prior year period, despite a decline in compensation expenses, significantly lower subcontracted labor costs and decreased costs for medical supplies, due to the large year-over-year decline in revenues, all reflecting the wind-down in migrant-related projects that began in the second quarter of 2024.
For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2025 amounted to $137.4 million, up 2.8% from $133.7 million in the year ended December 31, 2024. Cost of revenues as a percentage of revenues decreased to 68.4% from 69.1% in the prior year, despite increased labor costs, due to the continued growth of the business.
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Operating expenses
For the year ended December 31, 2025, operating expenses were $276.7 million compared to $184.9 million for the year ended December 31, 2024, an increase of $91.8 million, or 49.6%. As a percentage of revenues, operating expenses increased from 30.0% in 2024 to 85.9% in 2025. The increase of $91.8 million related primarily to impairments of intangible assets and goodwill in the amounts of $30.6 million and $58.2 million, respectively. There were no impairments of intangible assets or goodwill included in operating expenses for the year ended December 31, 2024. (See Note 5, “Goodwill” and Note 6, “Intangibles” in the Notes to Consolidated Financial Statements). In addition, the increase in operating expenses reflected a $7.7 million increase in total compensation, a $6.8 million increase in subcontracted labor costs, a $5.4 million increase in bad debt as the Company increased its allowance for doubtful accounts for aged receivables in both the Transportation Services and Mobile Health Services segments, a $6.8 million increase in professional fees, due primarily to increased legal fees, and a $2.8 million increase in IT infrastructure, driven by the Company’s business expansion. These were partially offset by a $17.4 million decline in travel and lodging fees relating to migrant-related Mobile Health projects that were wound down by the end of 2024 and a $9.1 million net decrease across a variety of expense categories.
For the Mobile Health Services segment, operating expenses in the year ended December 31, 2025 were $89.7 million, up 50.0% from $59.8 million in the year ended December 31, 2024. Operating expenses as a percentage of revenues increased to 73.9% from 14.1% in 2024, due to writedowns of intangible assets and goodwill, as well as an increase in the allowance for doubtful accounts for one particular municipal customer to whom the Company provided COVID-related testing and vaccination services prior to 2024. These were partially offset by reduced travel costs relating to migrant-related projects that were wound down by the end of 2024. Also included in operating expenses for the Mobile Health segment were expenses relating to SteadyMD, which the Company acquired during the fourth quarter of 2025.
For the Transportation Services segment, operating expenses in the year ended December 31, 2025 were $105.7 million, up 71.0% from $61.8 million in the year ended December 31, 2024. The increase in operating expenses for this segment was driven primarily by writedowns of intangible assets and goodwill and, to a lesser extent, by increased bad debt expense. Operating expenses as a percentage of revenues increased to 52.6% for the year ended December 31, 2025 from 31.9% in the year ended December 31, 2024.
For the Corporate segment, which represents primarily shared services that are not contained within the entities included in either the Mobile Health Services or Transportation Services segments, operating expenses in the year ended December 31, 2025 were $81.3 million, up 28.4% from $63.3 million in the year ended December 31, 2024. The increase in operating expenses for this segment was driven by an impairment of goodwill and an increase in professional fees, particularly for legal matters. Corporate expenses amounted to approximately 25.2% of total consolidated revenues in 2025, compared to 10.3% in 2024.
Interest expense, net
For the year ended December 31, 2025, the Company recorded approximately $1.3 million of interest expense, net compared to $1.9 million of interest expense, net in the year ended December 31, 2024. Interest expenses on borrowings under the Prior Revolving Facility outweighed interest earned on balances in the Company’s interest-bearing accounts in both the year ended December 31, 2025 and 2024. The decline in interest expense in 2025 compared to 2024 reflects the pay down of outstanding amounts under the Prior Revolving Facility in August 2025.
(Loss) gain on change in fair value of contingent consideration
During the year ended December 31, 2025, the Company recorded a loss on change in fair value of contingent consideration of approximately $2.1 million, reflecting an increase in the anticipated payments to be made for an acquisition, based upon performance compared to certain targets. During the year ended December 31, 2024, the Company recorded a gain on change in fair value of contingent consideration of approximately $9.4 million, reflecting a reduction in the anticipated payments to be made for a recent acquisition, based upon performance compared to certain targets.
Finite-lived intangible asset impairment
During the year ended December 31, 2024, the Company recorded finite-lived intangible asset impairment of approximately $8.3 million, relating to the projected value of the customer relationships for Cardiac RMS, LLC, arising from a revised long-term forecast for the business that impacted the estimated fair value of contingent consideration. The
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Company did not record a finite-lived intangible asset impairment within other expense that resulted from an updated contingent consideration estimate for the year ended December 31, 2025.
Loss on equity method investments
During the year ended December 31, 2025, the Company recorded a loss on equity method investments of approximately $0.6 million representing an impairment and its share of the losses incurred by an entity in which the Company has a minority interest. During the year ended December 31, 2024, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest.
Equity investment impairment
During the year ended December 31, 2025, the Company recorded an equity investment impairment of $5.0 million based on the latest available financial information and the estimated recoverable value of its investment in Firefly Health, Inc. The Company did not record an equity investment impairment for the year ended December 31, 2024.
Other (expense) income
During the year ended December 31, 2025, the Company recorded other expense of $0.5 million, compared to other income of $0.2 million during the year ended December 31, 2024.
Provision for income taxes
During the year ended December 31, 2025, the Company recorded a provision for income taxes of $8.9 million compared to an income tax provision of $14.4 million in the year ended December 31, 2024. The decreased tax expense in 2025 was primarily due to the recording of a pretax loss in the current period, as compared to pretax income in 2024, offset by the increase in the valuation allowance in 2025.
Net loss attributable to noncontrolling interests
For the year ended December 31, 2025, the Company had net loss attributable to noncontrolling interests of approximately $14.0 million compared to net loss attributable to noncontrolling interests of $6.6 million for the year ended December 31, 2024.
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Comparison of Fiscal 2024 with Fiscal 2023
| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2024 | 2023 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 616.6 | 100.0 | % | $ | 624.3 | 100.0 | % | $ | (7.7) | (1.2) | % | ||||||||
| Expenses: | ||||||||||||||||||||
| Cost of revenues (exclusive of depreciation and amortization, which is shown separately below) | 403.0 | 65.3 | % | 428.9 | 68.7 | % | (25.9) | (6.0) | % | |||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 138.8 | 22.5 | % | 137.1 | 22.1 | % | 1.7 | 1.2 | % | |||||||||||
| Depreciation and amortization | 15.9 | 2.6 | % | 16.4 | 2.6 | % | (0.5) | (3.0) | % | |||||||||||
| Legal and regulatory | 17.1 | 2.8 | % | 13.1 | 2.1 | % | 4.0 | 30.5 | % | |||||||||||
| Technology and development | 11.6 | 1.9 | % | 10.9 | 1.7 | % | 0.7 | 6.4 | % | |||||||||||
| Sales, advertising and marketing | 1.5 | 0.2 | % | 2.8 | 0.4 | % | (1.3) | (46.4) | % | |||||||||||
| Total expenses | 587.9 | 95.3 | % | 609.2 | 97.6 | % | (21.3) | (3.5) | % | |||||||||||
| Income from operations | 28.7 | 4.7 | % | 15.1 | 2.4 | % | 13.6 | 90.1 | % | |||||||||||
| Other (expense) income: | ||||||||||||||||||||
| Interest (expense) income, net | (1.9) | (0.3) | % | 1.7 | 0.3 | % | (3.6) | (211.8) | % | |||||||||||
| Gain on change in fair value of contingent consideration | 9.4 | 1.5 | % | 1.4 | 0.2 | % | 8.0 | 571.4 | % | |||||||||||
| Finite-lived intangible asset impairment | (8.3) | (1.3) | % | — | — | % | (8.3) | (100.0) | % | |||||||||||
| Loss on equity method investments | (0.3) | (0.1) | % | (0.3) | (0.1) | % | — | — | % | |||||||||||
| Loss on disposal of assets | — | — | % | (0.9) | (0.1) | % | 0.9 | 100.0 | % | |||||||||||
| Other income (expense) | 0.2 | — | % | (0.7) | (0.1) | % | 0.9 | 128.6 | % | |||||||||||
| Total other (expense) income | (0.9) | (0.2) | % | 1.2 | 0.2 | % | (2.1) | (175.0) | % | |||||||||||
| Net income before income tax expense | 27.8 | 4.5 | % | 16.3 | 2.6 | % | 11.5 | 70.6 | % | |||||||||||
| Provision for income taxes | (14.4) | (2.3) | % | (6.2) | (1.0) | % | (8.2) | (132.3) | % | |||||||||||
| Net income | 13.4 | 2.2 | % | 10.1 | 1.6 | % | 3.3 | 32.7 | % | |||||||||||
| Net (loss) income attributable to noncontrolling interests | (6.6) | (1.0) | % | 3.2 | 0.5 | % | (9.8) | (306.3) | % | |||||||||||
| Net income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | 20.0 | 3.2 | % | $ | 6.9 | 1.1 | % | $ | 13.1 | 189.9 | % |
Revenues
Consolidated
For the year ended December 31, 2024, total revenues were $616.6 million, a decrease of $7.7 million, or 1.2%, from the total revenues recorded for the year ended December 31, 2023.
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Mobile Health Services
For the year ended December 31, 2024, Mobile Health Services revenues were $423.1 million, a decrease of $19.7 million, or 4.4%, as compared with the year ended December 31, 2023. The decline in revenues was primarily due to the ongoing wind-down of migrant-related services, which had ramped up sharply in the third quarter of 2023 and peaked in the first quarter of 2024. Starting in the second quarter of 2023, the Company began providing services to the recently arrived migrant population in New York City and in upstate New York. These projects, which included both medical and non-medical services, such as shelter and security, expanded throughout the third and fourth quarters of 2023 and into the first quarter of 2024. However, some of these services were provided pursuant to a contract with an ending date during the second quarter of 2024. A portion of that contract was extended through December 31, 2024, while other services began to wind down in May 2024. The wind-down of all services under such contract was completed in the fourth quarter of 2024.
Transportation Services
For the year ended December 31, 2024, Transportation Services revenues were $193.5 million, an increase of $12.0 million, or 6.6%, as compared with the year ended December 31, 2023. This increase was due to a 13.4% increase in trip volumes, from 250,114 trips for the year ended December 31, 2023 to 283,570 trips for the year ended December 31, 2024. The increase in trip volumes was due to a combination of the expansion in the Company’s customer base in certain core markets, as well as an increase in volumes from existing customers. Our average trip price decreased slightly from $407 in the year ended December 31, 2023 to $402 in the year ended December 31, 2024. The decline in the average trip price in the 2024 period reflected a small shift in mix toward markets that have somewhat lower-priced transports when compared to 2023. However, the average trip price remains well above the levels of 2022 and prior years, reflecting a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports that earn higher prices per trip.
Cost of revenues
For the year ended December 31, 2024, total cost of revenues (exclusive of depreciation and amortization) decreased by 6.0% compared to the year ended December 31, 2023, while revenues decreased by approximately 1.2%. Cost of revenues as a percentage of revenues decreased to 65.3% in the year ended December 31, 2024 from 68.7% in the year ended December 31, 2023.
Total cost of revenues in the year ended December 31, 2024 decreased by $25.9 million compared to the same period in 2023. This decrease was primarily attributable to a $4.7 million decrease in total compensation, a $24.0 million decrease in subcontracted labor costs, and a $6.9 million decrease in medical and related supplies, all driven by the wind-down of migrant-related projects that began in the second quarter of 2024. These declines were partially offset by an increase of $3.8 million in vehicle costs, due to the increase in the size of the Company’s fleet and a net increase of $5.9 million across several other cost of revenues categories.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2024 amounted to $269.3 million, down 12.1% from $306.2 million in the year ended December 31, 2023. Cost of revenues as a percentage of revenues decreased to 63.6% from 69.1% in the prior year period, despite a decline in revenues, reflecting lower compensation expenses, significantly lower subcontracted labor costs and decreased costs for medical supplies, all reflecting the wind-down in migrant-related projects that began in the second quarter of 2024.
For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2024 amounted to $133.7 million, up 9.0% from $122.7 million in the year ended December 31, 2023. Cost of revenues as a percentage of revenues increased to 69.1% from 67.6% in the prior year, reflecting increased labor costs, subcontractor costs and vehicle costs, due to the continued growth of the business.
Operating expenses
For the year ended December 31, 2024, operating expenses were $184.9 million compared to $180.3 million for the year ended December 31, 2023, an increase of $4.6 million, or 2.6%. As a percentage of revenues, operating expenses increased from 28.9% in 2023 to 30.0% in 2024. The increase of $4.6 million related primarily to a $3.7 million increase in professional fees, due to increased legal, accounting and other fees, and a $1.0 million increase in IT infrastructure, driven by the Company’s business expansion, partially offset by a $0.1 million net decrease across a variety of expense categories.
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For the Mobile Health Services segment, operating expenses in the year ended December 31, 2024 were $59.8 million, up 6.2% from $56.3 million in the year ended December 31, 2023. Operating expenses as a percentage of revenues increased to 14.1% from 12.7% in 2023, due to the decrease in Mobile Health Services revenues, and reflecting significant expenditures that were made during 2024 related to the expansion of services and geographic areas of operation, as well as the costs of developing the Company’s programs to provide care-gap closure and other services to members of new insurance provider partners.
For the Transportation Services segment, operating expenses in the year ended December 31, 2024 were $61.8 million, up 12.0% from $55.2 million in the year ended December 31, 2023. The increase in operating expenses for this segment was driven primarily by higher insurance expense and office expenses, reflecting the expansion of the business. Operating expenses as a percentage of revenues increased to 31.9% for the year ended December 31, 2024 from 30.4% in the year ended December 31, 2023.
For the Corporate segment, which represents primarily shared services that are not contained within the entities included in either the Mobile Health Services or Transportation Services segments, operating expenses in the year ended December 31, 2024 were $63.3 million, down 8.0% from $68.8 million in the year ended December 31, 2023. The decrease in operating expenses for this segment was driven by lower compensation costs, due to targeted headcount reductions during the year, partially offset by an increase in professional fees. Corporate expenses amounted to approximately 10.3% of total consolidated revenues in 2024, compared to 11.0% in 2023.
Interest (expense) income, net
For the year ended December 31, 2024, the Company recorded approximately $1.9 million of interest expense, net compared to $1.7 million of interest income, net in the year ended December 31, 2023. Interest expenses on borrowings under the Prior Revolving Facility outweighed interest earned on balances in the Company’s interest-bearing accounts in the years ended December 31, 2024. Prior to October 2023, there were no amounts outstanding under the Company’s line of credit.
Gain on change in fair value of contingent consideration
During the year ended December 31, 2024, the Company recorded a gain on change in fair value of contingent consideration of approximately $9.4 million, reflecting a reduction in the anticipated payments to be made for an acquisition, based upon performance compared to certain targets. During the year ended December 31, 2023, the Company recorded a gain on change in fair value of contingent consideration of approximately $1.4 million, reflecting a reduction in the anticipated payments to be made for a recent acquisition, based upon performance compared to certain targets.
Finite-lived intangible asset impairment
During the year ended December 31, 2024, the Company recorded finite-lived intangible asset impairment of approximately $8.3 million, relating to the projected value of the customer relationships for Cardiac RMS, LLC, arising from a revised long-term forecast for the business that impacted the estimated fair value of contingent consideration. The Company did not record a finite-lived intangible asset impairment within other expense that resulted from an updated contingent consideration estimate for the year ended December 31, 2023.
Loss on equity method investments
During the year ended December 31, 2024, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest. During the year ended December 31, 2023, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest.
Loss on disposal of assets
During the year ended December 31, 2024, the Company recorded a gain on disposal of fixed assets of $23,682, compared to a loss on disposal of fixed assets of $0.9 million during the year ended December 31, 2023.
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Other income (expense)
During the year ended December 31, 2024, the Company recorded other income of $0.2 million, compared to other expense of $0.7 million during the year ended December 31, 2023.
Provision for income taxes
During the year ended December 31, 2024, the Company recorded a provision for income taxes of $14.4 million compared to an income tax provision of $6.2 million in the year ended December 31, 2023. The increased tax expense in 2024 was primarily due to the recording of significantly higher pretax income in the 2024 period, as compared to the 2023 period.
Net (loss) income attributable to noncontrolling interests
For the year ended December 31, 2024, the Company had net loss attributable to noncontrolling interests of approximately $6.6 million compared to net income attributable to noncontrolling interests of $3.2 million for the year ended December 31, 2023.
Liquidity and Capital Resources
Between the inception of DocGo’s wholly owned subsidiary Ambulnz and the Business Combination, Ambulnz completed three equity financing transactions as its principal source of liquidity. In November 2021, upon the completion of the Business Combination and the private placement of Common Stock that closed concurrently with the Business Combination, the Company received proceeds of approximately $158.1 million, net of transaction expenses. Generally, the Company has utilized proceeds from the equity financing transactions and the Business Combination to finance operations, invest in assets, make acquisitions and fund accounts receivable. The Company has also funded these activities through operating cash flows. Despite the fact that the Company generated operating cash flow for the year ended December 31, 2025, operating cash flows are not always sufficient to meet immediate obligations arising from current operations. For example, as the business has grown, the Company’s expenditures for human capital and supplies have expanded accordingly, and the timing of the payments for payroll and to associated vendors, compared to the timing of receipts of cash from customers, frequently results in the need to use existing cash balances to fund working capital needs. During the year ended December 31, 2025, as the Company collected older invoices from municipal customers for services provided in 2024 and early 2025, operating cash flows were sufficient to outweigh the Company’s operating losses. However, as most of these older invoices had been collected by the end of 2025, operating cash flows in 2026 might not be sufficient to cover operating losses and working capital demands.
The Company’s future working capital needs depend on many factors, including the overall growth of the Company and the various payment terms that are negotiated with customers and vendors. The Company’s future capital requirements depend on many factors, including potential acquisitions, the Company’s level of investment in technology and ongoing technology development, and rate of growth in existing markets and into new markets. Capital requirements might also be affected by factors outside of the Company’s control, such as interest rates, rising inflation and other monetary and fiscal policy changes to the manner in which the Company currently operates. If the Company’s growth rate is higher than is currently anticipated, resulting in greater-than-anticipated capital requirements, the Company might need to, or choose to, raise additional capital through debt or equity financings, or through a draw down in the Company’s credit line.
On November 1, 2022, the Company entered into the Prior Credit Agreement, which provided for the Prior Revolving Facility in the initial aggregate principal amount of $90.0 million. The Prior Revolving Facility included the ability for the Company to request an increase to the commitment by an additional amount of up to $50.0 million, though no lender (nor the lenders collectively) was obligated to increase its respective commitments. The Prior Revolving Facility was subject to certain financial covenants, such as a net leverage ratio and interest coverage ratio, as defined in the Prior Credit Agreement. On August 1, 2025, the Company repaid the outstanding balances under the Prior Revolving Facility, and there were no amounts outstanding related to the Prior Revolving Facility as of the date of this Annual Report.
On August 7, 2025, the Company amended and restated the Prior Credit Agreement. The Credit Agreement provides for the Revolving Facility of up to an aggregate principal amount of $55.0 million, and borrowings thereunder are subject to a borrowing base formula based on eligible receivables as described therein. The Revolving Facility includes the
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ability for the Company to request an increase to the commitment by an additional amount of up to $20.0 million, though neither Lender nor any other lender is obligated to provide any such additional commitment. Borrowings under the Revolving Facility bear interest at a per annum rate equal to: (i) at the Company’s option, (x) the base rate or (y) the adjusted term SOFR rate, plus (ii) the applicable margin. The applicable margin for an adjusted term SOFR loan is 2.00% and the applicable margin for a base rate loan is 1.00%. The Revolving Facility matures on November 1, 2027, the five-year anniversary of the original closing date of the Prior Credit Agreement. The Credit Agreement is secured by a first-priority lien on substantially all of the Company’s present and future personal assets and intangible assets. The Credit Agreement is subject to a certain minimum liquidity financial covenant based on the prior twelve months’ cash burn and the Company’s available cash balances and borrowing ability under the Credit Agreement. As of December 31, 2025, the Company was no longer in compliance with such covenant under the Credit Agreement. The Company is currently in active discussions with its lender to reach a resolution regarding the covenant non-compliance and to preserve its ability to draw from the Revolving Facility as needed. There can be no assurance that the Company will be successful in reaching a resolution or that the Revolving Facility will remain available; however, the Company’s management believes these discussions are progressing and expects a positive resolution.
Considering the foregoing, including historical operating losses, the projected liquidity deficit, and the covenant non-compliance under the Credit Agreement, the Company, together with its Board of Directors, has reviewed and extensively discussed certain plans intended to reduce cash utilization and operating costs, including transitioning a larger portion of bonus compensation from cash to Company stock, intensified collection efforts focused on closing out open municipal receivables from ended contracts, reducing headcount, and delayed spending on certain business growth strategies, as well as utilizing the Revolving Facility, subject to obtaining the necessary waiver from its lender. While these plans carry meaningful inherent risk to operations, the Company’s management and the Board of Directors have evaluated these conditions in totality and conclude it is probable that, when implemented, the plans will be sufficient to alleviate substantial doubt about the Company’s ability to continue as a going concern for the next 12 months. See Note 2, “Summary of Significant Accounting Policies - Liquidity and Going Concern” for further information.
Capital Resources
Working capital as of December 31, 2025 and 2024 was as follows:
| December 31, | Change $ | Change % | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2025 | 2024 | |||||||||||||
| Working capital | |||||||||||||||
| Current assets | $ | 152.4 | $ | 304.5 | $ | (152.1) | (50.0) | % | |||||||
| Current liabilities | 67.5 | 121.8 | (54.3) | (44.6) | % | ||||||||||
| Total working capital | $ | 84.9 | $ | 182.7 | $ | (97.8) | (53.5) | % |
As of December 31, 2025, available cash totaled $51.0 million, which represented a decrease of $38.2 million compared to December 31, 2024, reflecting cash spent on acquisitions and the repayment of amounts outstanding under the Company’s credit line, which outweighed the effect of a decline in accounts receivable during the year ended December 31, 2025, as the Company collected some of its larger invoices. As of December 31, 2025, working capital amounted to $84.9 million, which represented a decrease of $97.8 million compared to December 31, 2024, as the decrease in cash and accounts receivable described above outweighed a decline in accounts payable and accrued liabilities. Current assets declined by $152.1 million, due to the drop in cash and accounts receivable. This outweighed the $54.3 million decline in current liabilities in the year ended December 31, 2025, due to lower accounts payable and accrued liabilities, reflecting lower invoices and accrued liabilities in the current period for certain expenses, such as subcontracted labor, and as the Company paid down a significant amount of its accounts payable during the year-to-date period. Current liabilities also declined due to the repayment of amounts outstanding under the Company’s line of credit.
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Cash Flows
Cash flows as of the years ended December 31, 2025 and 2024 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2025 | 2024 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash provided by operating activities | $ | 34.5 | $ | 70.1 | $ | (35.6) | (50.8) | % | ||||||
| Net cash used in investing activities | (39.1) | (10.6) | (28.5) | (268.9) | % | |||||||||
| Net cash used in financing activities | (50.8) | (24.2) | (26.6) | (109.9) | % | |||||||||
| Effect of exchange rate changes | 0.6 | (0.2) | 0.8 | 400.0 | % | |||||||||
| Net (decrease) increase in cash | $ | (54.8) | $ | 35.1 | $ | (89.9) | (256.1) | % |
Cash flows as of the years ended December 31, 2024 and 2023 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2024 | 2023 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash provided by (used in) operating activities | $ | 70.1 | $ | (64.5) | $ | 134.6 | 208.7 | % | ||||||
| Net cash used in investing activities | (10.6) | (29.6) | 19.0 | 64.2 | % | |||||||||
| Net cash (used in) provided by financing activities | (24.2) | 1.1 | (25.3) | (2300.0) | % | |||||||||
| Effect of exchange rate changes | (0.2) | 1.1 | (1.3) | (118.2) | % | |||||||||
| Net increase (decrease) in cash | $ | 35.1 | $ | (91.9) | $ | 127.0 | 138.2 | % |
Operating Activities
During the year ended December 31, 2025, cash provided by operating activities was $34.5 million, despite a net loss of $196.4 million. Non-cash charges amounted to $149.2 million, which primarily consisted of $58.2 million impairment of goodwill, $17.4 million of stock compensation expense, $12.0 million in bad debt expense, $10.1 million in depreciation of property and equipment and right-of-use assets, a $30.7 million impairment of intangible assets, a $5.0 million equity investment impairment, $7.8 million in deferred taxes, $5.6 million from amortization of intangible assets, $2.1 million loss resulting from a reduction in the fair value of contingent consideration and a loss of $0.6 million from an investment that is accounted for under the equity method. These were partially offset by a $0.3 million accretion of discount related to restricted investments. Changes in assets and liabilities resulted in approximately $81.7 million in positive operating cash flow, as a $112.5 million decrease in accounts receivable, reflecting collections of invoices from large municipal customers, a $0.4 million decrease in other assets and a $0.2 million decrease from operating lease liabilities and right-of-use assets were partially offset by a $17.6 million decrease in accounts payable, a $10.4 million decrease in accrued liabilities and a $3.4 million increase in prepaid expenses and other current assets.
During the year ended December 31, 2024, cash provided by operating activities was $70.1 million, aided by net income of $13.4 million. Non-cash charges amounted to $37.4 million, which primarily consisted of $13.6 million of stock compensation expense, $10.2 million in depreciation of property and equipment and right-of-use assets, an $8.3 million impairment of a finite-lived intangible asset, $5.7 million from amortization of intangible assets, $5.2 million in bad debt expense, $3.5 million in deferred taxes and a loss of $0.3 million from an investment that is accounted for under the equity method. These were partially offset by a non-cash gain of $9.4 million resulting from a reduction in the fair value of contingent consideration. Changes in assets and liabilities resulted in approximately $19.3 million in positive operating cash flow, as a $41.3 million decrease in accounts receivable, reflecting collections of invoices from large municipal customers, a $13.0 million decrease in prepaid expenses and an $8.3 million increase in accounts payable were partially offset by a $41.9 million decrease in accrued liabilities and a $1.4 million increase in other assets.
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During the year ended December 31, 2023, cash used by operating activities was $64.5 million, despite net income of $10.0 million. Non-cash charges amounted to $38.9 million, which primarily consisted of $21.0 million of stock compensation expense, $11.2 million in depreciation of property and equipment and right-of-use assets, $5.2 million from amortization of intangible assets, $3.6 million in bad debt expense, a $0.9 million loss on the disposal of assets, a loss of $0.3 million from an investment that is accounted for under the equity method and a $0.1 million loss on liquidation of business. These were partially offset by $2.0 million in deferred taxes and a non-cash gain of $1.4 million resulting from a reduction in the fair value of contingent consideration. Changes in assets and liabilities resulted in approximately $113.4 million in negative operating cash flow, as a $160.5 million increase in accounts receivable, reflecting the growth of the business and primarily driven by an increased amount of business with municipalities, which tend to have longer payment cycles; a $10.8 million increase in prepaid expenses and other current assets, and $2.1 million decrease in accounts payable were partially offset by a $59.0 million increase in accrued liabilities and a $1.0 million decline in other assets.
Investing Activities
During the year ended December 31, 2025, investing activities used $39.1 million of cash and consisted of the purchase of restricted investments in the amount of $28.6 million, the acquisition of businesses in the amount of $16.4 million, the purchase of property and equipment totaling approximately $4.5 million, and the purchase of intangibles in the amount of $2.9 million, partially offset by $13.1 million in proceeds from the sale and maturity of restricted investments and a $0.2 million in cash proceeds from the disposal of property and equipment.
During the year ended December 31, 2024, investing activities used $10.6 million of cash and consisted of an investment in equity securities in the amount of $5.0 million, the purchase of property and equipment totaling approximately $3.6 million, the purchase of intangibles in the amount of $2.0 million, and an equity method investment in the amount of $0.3 million, partially offset by $0.3 million in cash proceeds from the disposal of property and equipment.
During the year ended December 31, 2023, investing activities used $29.6 million of cash and consisted of the acquisition of businesses in the amount of $20.2 million, the purchase of property and equipment totaling approximately $7.3 million, the purchase of intangibles in the amount of $2.5 million, and an equity method investment in the amount of $0.3 million, partially offset by $0.7 million in cash proceeds from the disposal of property and equipment.
Financing Activities
During the year ended December 31, 2025, cash used by financing activities was $50.8 million, as the Company spent $30.0 million on the repayment of the Prior Revolving Facility, spent approximately $10.8 million on its share repurchase program, made $5.4 million in payments under the terms of a finance lease, made $2.0 million in earnout payments on contingent liabilities, paid $1.8 million in taxes related to shares withheld for employee taxes, made $0.9 million in payments due to seller, and made $0.2 million in distributions to noncontrolling interests, partially offset by $0.3 million in proceeds from notes payable.
During the year ended December 31, 2024, cash used by financing activities was $24.2 million, as $45.0 million in proceeds from the Company’s Prior Revolving Facility were outweighed by $40.0 million of repayments of amounts outstanding under the Company’s Prior Revolving Facility, $13.8 million in stock repurchases, $4.3 million in payments under the terms of a finance lease, $3.6 million in earnout payments on contingent liabilities, a $3.1 million decrease in amounts due to seller, $1.8 million paid for the acquisition of a non-controlling interest, $1.3 million in payments of distributions to non-controlling interests, $1.2 million in payments for taxes related to shares withheld for employee taxes and $0.1 million in repayments of notes payable.
During the year ended December 31, 2023, cash provided by financing activities was $1.1 million, including $25.0 million in proceeds from the Company’s Prior Revolving Facility and $1.6 million in proceeds from the exercise of stock options, mostly offset by a $13.6 million decrease in amounts due to seller, $5.3 million in earnout payments on contingent liabilities, $4.3 million in payments under the terms of a finance lease, and $2.3 million in payments for taxes related to shares withheld for employee taxes.
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Future minimum annual maturities of notes payable as of December 31, 2025 are as follows (in thousands):
| Notes Payable | ||
|---|---|---|
| 2026 | $ | 51.7 |
| 2027 | 50.0 | |
| 2028 | 54.3 | |
| 2029 | 58.9 | |
| 2030 | 20.7 | |
| Total maturities | 235.6 | |
| Current portion of notes payable | (51.8) | |
| Long-term portion of notes payable | $ | 183.8 |
Future minimum lease payments under finance leases as of December 31, 2025 are as follows (in millions):
| Finance Leases | ||
|---|---|---|
| 2026 | $ | 6.4 |
| 2027 | 5.2 | |
| 2028 | 3.9 | |
| 2029 | 2.3 | |
| 2030 | 0.7 | |
| Thereafter | — | |
| Total future minimum lease payments | 18.5 | |
| Less effects of discounting | (1.8) | |
| Present value of future minimum lease payments | $ | 16.7 |
Future minimum lease payments under operating leases as of December 31, 2025 are as follows (in millions):
| Operating Leases | ||
|---|---|---|
| 2026 | $ | 5.3 |
| 2027 | 3.7 | |
| 2028 | 2.7 | |
| 2029 | 1.4 | |
| 2030 | 0.1 | |
| Thereafter | 0.2 | |
| Total future minimum lease payments | 13.4 | |
| Less effects of discounting | (1.2) | |
| Present value of future minimum lease payments | $ | 12.2 |
Critical Accounting Policies
Basis of Presentation
The Company’s Consolidated Financial Statements are presented in conformity with accounting principles generally accepted in the U.S. (“U.S. GAAP”) and pursuant to the rules and regulations of the SEC. The Consolidated Financial Statements include the accounts and operations of the Company and its subsidiaries. All intercompany accounts and transactions are eliminated upon consolidation. Noncontrolling interests on the Consolidated Balance Sheets represents the portion of consolidated joint ventures and a variable interest entity (“VIE”) in which the Company does not have direct equity ownership.
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Principles of Consolidation
In accordance with Accounting Standards Codification (“ASC”) 810, Consolidation (“ASC 810”), the Company assesses whether it has a variable interest in legal entities in which it has a financial relationship and, if so, whether or not those entities are VIEs. For those entities that qualify as VIEs, ASC 810 requires the Company to determine if the Company is the primary beneficiary of the VIE, and if so, to consolidate the VIE.
The Company has entered into management services agreements (“MSAs”) with professional corporations (“PCs”) that employ or contract with physicians and other health professionals in order to provide healthcare services to the public. Each such PC is established and operated pursuant to the requirements of its respective domestic jurisdiction governing the practice of medicine. The Company provides each PC with everything the PC needs to operate except for clinicians, for which the PC is responsible. Without the administrative services, software, intellectual property and administrative personnel (among other things) provided by the Company, the PCs could not carry out their businesses. Moreover, the PCs do not have sufficient equity to finance their activities without additional subordinated financial support. Based on the foregoing, these entities are considered VIEs, and an enterprise having a controlling financial interest in a VIE must consolidate the VIE if it is the primary beneficiary, meaning it has (1) the power to direct the activities of the VIE that most significantly impacts the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). In accordance with corporate practice of medicine restrictions, all clinical treatment decisions are made solely by licensed healthcare professionals engaged by the PCs. Nevertheless, the PCs cannot operate without the Company through the MSAs; therefore, the Company significantly impacts the economic performance of the PCs and funds and absorbs all losses of its PCs. The Company has therefore determined that it is the primary economic beneficiary of the PCs and appropriately consolidates them as VIEs.
Net loss for the Company’s VIEs were $10,063,362, $231,952 and $235,976 for the years ended December 31, 2025, 2024 and 2023, respectively. The total assets, exclusive of intercompany assets, amounted to $7,039,301 and $3,122,209 as of December 31, 2025 and 2024, respectively. Total liabilities, exclusive of intercompany liabilities, were $17,782,198 and $3,801,744 as of December 31, 2025 and 2024, respectively. The Company’s VIEs total stockholders’ deficit were $10,742,897 and $679,535 as of December 31, 2025 and 2024, respectively.
Self-Insurance Reserves
The Company self-insures a number of risks, including, but not limited to, workers’ compensation, auto liability and certain employee-related healthcare benefits. Standard actuarial procedures and data analysis are used to estimate the liabilities associated with these risks on an undiscounted basis. The recorded liabilities reflect the ultimate cost for claims incurred but not paid and any estimable administrative run-out expenses related to the processing of these outstanding claim payments. On a regular basis, the liabilities are evaluated for appropriateness with claims reserve valuations. To limit exposure to some risks, the Company maintains insurance coverage with varying limits and retentions, including stop-loss insurance coverage for workers’ compensation, auto liability and healthcare benefits.
Fair Value of Financial Instruments
ASC 820, Fair Value Measurements, provides guidance on the development and disclosure of fair value measurements. Under this accounting guidance, fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or a liability.
The accounting guidance classifies fair value measurements in one of the following three categories for disclosure purposes:
Level 1: Quoted prices in active markets for identical assets or liabilities.
Level 2: Inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.
Level 3: Unobservable inputs which are supported by little or no market activity and values determined using pricing models, discounted cash flow methodologies, or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.
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Fair value measurements discussed herein are based upon certain market assumptions and pertinent information available to management as of December 31, 2025, 2024 and 2023. For certain financial instruments, including cash, accounts receivable, prepaid expenses, other current assets, restricted cash, accounts payable, accrued expenses and due to seller, the carrying amounts approximate their fair values as it is short term in nature. The notes payable are presented at their carrying value, which, based on borrowing rates currently available to the Company for loans with similar terms, approximates their fair values.
The Company’s cash equivalents, restricted cash equivalents and restricted investments are valued at quoted market prices in active markets for similar assets, which the Company receives from the financial institutions that hold such investments on its behalf. This fair value determination is categorized as Level 1 within the fair value hierarchy.
Level 3 instruments are valued based on unobservable inputs that are supported by little or no market activity and reflect the Company’s own assumptions in measuring fair value. Future changes in fair value of the contingent consideration, as a result of changes in significant inputs such as the discount rate and estimated probabilities of financial milestone achievements, could have a material effect on the Consolidated Statements of Operations and Comprehensive (Loss) Income and Consolidated Balance Sheets in the period of the change.
Accounts Receivable
The Company contracts with hospitals, healthcare facilities, businesses, state and local government entities, and insurance providers to provide Mobile Health Services and Transportation Services at specified rates. These rates are either on a per procedure or per transport basis, or on an hourly or daily basis. Accounts receivable consist of billings for healthcare and transportation services provided to patients. Billings typically are either paid or settled on the patient’s behalf by health insurance providers, managed care organizations, treatment facilities, government sponsored programs or businesses or patients directly. The Company generally does not require collateral for accounts receivable.
Accounts receivable are net of insurance provider contractual allowances, which are estimated at the time of billing based on contractual terms or other arrangements. The Company maintains an allowance for credit losses for accounts receivable, net which is recorded as an offset to accounts receivable, net and changes in this allowance are recorded within general and administrative expenses in the Consolidated Statements of Operations and Comprehensive (Loss) Income. The carrying amount of accounts receivable represents the maximum credit risk exposure of these assets. On a quarterly basis, in accordance with Federal Accounting Standards Board ASC 326, Measurement of Credit Losses on Financial Instruments, the Company evaluates the collectability of outstanding accounts receivable balances to determine an allowance for credit loss that reflects its best estimate of the lifetime expected credit losses. Individual uncollectible accounts are written off against the allowance when collection of the individual account does not appear probable.
Under the current expected credit loss impairment model, the Company develops and documents its allowance for credit losses on its trade receivables based on a single portfolio segment. The Company assesses collectability by aggregating and reviewing accounts receivable on a collective basis for customers that share similar risk characteristics. Additionally, when accounts receivable do not share risk characteristics with other accounts receivable, management will evaluate such accounts receivable for expected credit loss on an individual specific identification basis when the Company identifies specific customers with known disputes or collectability issues. Due to the short-term nature of the Company’s accounts receivable, the estimate of expected credit loss is based on the aging of accounts using an aging schedule as of period ends. In determining the amount of the allowance for credit losses, the Company considers historical collection history based on past due status, the current aging of receivables, customer-specific credit risk factors including their current financial condition, current market conditions, and probable future economic conditions which inform adjustments to historical loss patterns.
As of January 1, 2025, the Company held a beginning balance in its allowance for credit losses on accounts receivable of $5,873,942. The Company recognized an additional provision for credit losses of $9,167,234 and write offs of $(6,742,123) during the year. The Company’s balance in its allowance for credit losses amounted to $8,299,053 as of December 31, 2025.
Business Combinations
The Company accounts for its business combinations under the provisions of ASC 805-10, Business Combinations (“ASC 805-10”), which requires that the acquisition method of accounting be used for all business combinations. Assets acquired and liabilities assumed, including noncontrolling interests, are recorded at the date of
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acquisition at their respective fair values. ASC 805-10 also specifies criteria that intangible assets acquired in a business combination must meet to be recognized and reported apart from goodwill.
Goodwill represents the excess purchase price over the fair value of the tangible net assets and intangible assets acquired in a business combination. If the business combination provides for contingent consideration, the Company records the contingent consideration at fair value at the acquisition date and any changes in fair value after the acquisition date are accounted for as measurement-period adjustments. Changes in fair value of contingent consideration resulting from events after the acquisition date, such as earn-outs, are recognized as follows: 1) if the contingent consideration is classified as equity, the contingent consideration is not re-measured and its subsequent settlement is accounted for within equity, or 2) if the contingent consideration is classified as a liability, the changes in fair value are recognized in earnings. For transactions that are business combinations, the Company evaluates the existence of goodwill or a gain from a bargain purchase. The Company capitalizes acquisition-related costs and fees associated with asset acquisitions and immediately expenses acquisition-related costs and fees associated with business combinations.
The estimated fair value of net assets to be acquired, including the allocation of the fair value to identifiable assets and liabilities, is determined using established valuation techniques. Management uses assumptions on the basis of historical knowledge of the business and projected financial information of the target. These assumptions may vary based on future events, perceptions of different market participants and other factors outside the control of management, and such variations may be significant to estimated values.
Impairment of Long-Lived Assets
The Company evaluates the recoverability of the recorded amount of long-lived assets, primarily property and equipment and finite-lived intangible assets, whenever events or changes in circumstance indicate that the recorded amount of an asset may not be fully recoverable. An impairment is assessed when the undiscounted expected future cash flows derived from an asset are less than its carrying amount. If an asset is determined to be impaired, the impairment to be recognized is measured as the amount by which the carrying amount of the asset exceeds its fair value. Assets targeted for disposal are reported at the lower of the carrying amount or fair value less cost to sell.
Goodwill and Indefinite-Lived Intangible Assets
Goodwill represents the excess of the total purchase consideration over the fair value of the identifiable assets acquired and liabilities assumed in a business combination. Goodwill is not amortized but is tested for impairment at the reporting unit level annually on December 31 or more frequently if events or changes in circumstances indicate that it is more likely than not to be impaired. These events include: (i) severe adverse industry or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations; (iii) current, historical or projected deterioration of the Company’s financial performance; or (iv) a sustained decrease in the Company’s market capitalization, as indicated by our publicly quoted share price, below its net carrying value.
Revenue Recognition
On January 1, 2019, the Company adopted ASC 606, Revenue from Contracts with Customers (“ASC 606”).
To determine revenue recognition for contractual arrangements that the Company determines are within the scope of ASC 606, the Company performs the following five steps: (1) identify each contract with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate the transaction price to performance obligations in the contract; and (5) recognize revenue when (or as) the relevant performance obligation is satisfied. The Company only applies the five-step model to contracts when it is probable that the Company will collect the consideration it is entitled to in exchange for the goods or services the Company provides to the customer.
The Company generates revenues from the provision of (1) Mobile Health Services and (2) Transportation Services. The customer simultaneously receives and consumes the benefits provided by the Company as the performance obligations are fulfilled. Therefore, the Company satisfies performance obligations immediately. The Company has utilized the “right to invoice” expedient, which allows an entity to recognize revenue in the amount of consideration to which the entity has the right to invoice when the amount that the Company has the right to invoice corresponds directly to the value transferred to the customer.
The transaction price associated with the Company’s contracts with customers is generally determined based on fixed and determinable amounts of consideration as specified in a contract, which includes a fixed base rate and fixed
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mileage rate. For transportation services arrangements with billings to third party payors and healthcare facilities, this may also include variable consideration in instances where it is considered probable that a significant reversal of cumulative revenue recognized will not occur. For these services, revenues are recorded net of estimated contractual allowances for claims subject to contracts with responsible paying entities. The Company estimates contractual allowance at the time of billing based on contractual terms, historical collections or other arrangements. The Company also estimates the amount unbilled at month end and recognizes such amounts as revenue, based on available data and customer history. The Company utilizes the expected value method when estimating its variable consideration. The assumptions utilized in estimating variable consideration include the Company’s previous experience with similar contracts and history of collection rates on prior trips that have been performed. The Company reevaluates its variable consideration at each reporting period.
Income Taxes
Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements or its tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Valuation allowances are provided if based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. The Company recognizes any interest and penalties accrued related to unrecognized tax benefits as income tax expense.
Please see Note 2, “Summary of Significant Accounting Policies” to the Consolidated Financial Statements.
MD&A history
Prior-year 10-K MD&A spans are extracted from SEC filings with the same bounded parser used for the latest filing. The latest 10-K appears above; prior years are below.
FY 2024 10-K MD&A
SEC filing source: 0001822359-25-000018.
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our Consolidated Financial Statements and the accompanying notes included elsewhere in this Annual Report. The discussion and analysis below contain certain forward-looking statements about our business and operations that are subject to the risks, uncertainties and other factors described in the section entitled “Risk Factors,” included in Part I, Item 1A, and other factors included elsewhere in this Annual Report. These risks, uncertainties and other factors could cause our actual results to differ materially from those expressed in, or implied by, the forward-looking statements. Please refer to the section entitled “Cautionary Note Regarding Forward-Looking Statements.”
Certain figures included in this section, such as interest rates and other percentages, have been rounded for ease of presentation. Percentage figures included in this section have, in some cases, been calculated on the basis of such rounded figures. For this reason, percentage amounts in this section may vary slightly from those obtained by performing the same calculations using the figures in our Consolidated Financial Statements or in the associated text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Factors Affecting Our Results of Operations
Our operating results and financial performance are influenced by a variety of factors, including, among others, our ability to establish, maintain and grow customer relationships; our ability to execute projects to the satisfaction of our customers; conditions in the healthcare transportation and mobile health services markets; changes in government spending on healthcare and other social services, including as a result of changes in the U.S. administration and administrative priorities; availability of healthcare professionals and other personnel; changes in the cost of labor; our competitive environment; overall macroeconomic and geopolitical conditions, including the interest rate environment, the inflationary environment, the potential recessionary environment, regional conflict and tensions, financial institution instability and the prospect of a shutdown of the U.S. federal government; production schedules of our suppliers; our ability to obtain or maintain operating licenses; and the success of our acquisition strategy. Some of these key factors are briefly discussed below. Future revenue growth and improvement in operating results will be largely contingent on our ability to penetrate new markets and further penetrate existing markets, which is subject to a number of uncertainties, many of which are beyond our control.
Healthcare Services Market
The Mobile Health Services market is dependent on several factors, including increased patient acceptance of services that are provided outside of traditional healthcare facilities, such as in homes, businesses or other designated locations; healthcare coverage of the various Mobile Health Services; and continued desire on the part of government and municipal entities to fund programs to assist currently underserved patient segments via “population health” programs. These programs increased in number, scale and scope since the beginning of the COVID-19 pandemic. While COVID-19 testing and vaccination programs have been dramatically scaled back from their levels at the pandemic’s peak, there have been expansions of these population health programs into other areas, such as the provision of healthcare and related services to recent migrants and asylum seekers.
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The Transportation Services market is highly dependent on patients requiring transportation after surgeries and other medical procedures and treatments. The Company primarily focuses on the non-emergency medical transport market, which includes services that are provided to patients who need assistance getting to and from medical appointments. Key drivers of this market are the increase in chronic conditions and the number of elective surgeries as well as the ongoing aging of the population, as older demographics tend to be much more frequent consumers of medical transportation services. The market will also grow if hospitals and other healthcare facilities continue to outsource more of their transportation needs to independent providers, such as the Company, allowing these facilities to concentrate their efforts on their core competencies.
Overall Economic Conditions in the Markets in Which We Operate
Economic changes, both nationally and locally, in our markets impact our financial performance. Unfavorable changes in demographics, healthcare coverage of Mobile Health Services and Transportation Services, interest rates, inflation rates, the availability of trained and licensed healthcare professionals, ambulance manufacturing, a weakening of the national economy or of any regional or local economy in which we operate and other factors beyond our control could adversely affect our business.
Our Ability to Control Expenses
We pay close attention to the management of our working capital and operating expenses. Some of our most significant operating expenses are labor costs, medical supplies and vehicle-related costs, such as fuel, maintenance, repair and insurance. Insurance costs include premiums paid for coverage as well as reserves for estimated losses within the Company’s insurance policy deductibles. We employ our proprietary technology to help drive improvements in productivity per transport and per shift. We regularly analyze our workforce productivity to help achieve the optimum, cost-efficient labor mix for our locations. This involves managing the mix of Company-employed labor and subcontracted labor as well as full-time and part-time employees.
Inflation
The inflation rate in the United States, as measured by the Consumer Price Index, has generally trended up since early 2021. This data is reported monthly, showing year-over-year changes in prices across a basket of goods and services. However, the inflation rate declined throughout most of 2024, and the annual inflation rate declined to 2.9% for the full year 2024 from 4.1% in 2023 and 8.0% in 2022. The increased inflation rate witnessed between 2021 and 2024 has had an impact on the Company’s expenses in several areas, including wages, fuel and medical and other supplies. This has had the effect of compressing gross profit margins, as the Company is generally unable to pass these higher costs on to its customers, particularly in the short term. In addition, opportunities to mitigate the impact of inflation are limited, aside from potentially buying more medical supplies than are currently needed in an effort to reduce the volume of future purchases, in instances where supply prices are anticipated to rise. As inflation has moderated, and in an attempt to stimulate economic growth, the U.S. Federal Reserve implemented three interest rate cuts in 2024, lowering its benchmark rate to the current level of 4.25-4.50% as of the date of this Annual Report. Looking into 2025, we anticipate that the inflation rate will remain at or near the currently more moderate level, with an annual rate similar to those witnessed in 2024 and in the 2010-2020 period, when the annual inflation rate ranged from 0.1% to 3.2%. If inflation is above the levels that the Company anticipates, gross margins could be below plan and our business, operating results and cash flows may be adversely affected.
Trip Volumes and Average Trip Price
A “trip” is defined as an instance where the Company completes the transportation of a patient to a specific destination, for which we are able to charge a fee. This metric does not include instances where a trip is ordered and subsequently either canceled (by the customer) or declined (by the Company). As trip volume represents the most basic unit of transportation service provided by the Company, the Company believes it is a good measure of the level of demand for the Company’s Transportation Services and is used by management to monitor and manage the scale of the business.
The average trip price is calculated by dividing the aggregate revenue from the total number of trips by the total number of trips and is an important indicator of the effective rate at which the Company is being compensated for its provision of Transportation Services.
Revenues generated from programs under which the Company is paid a fixed hourly or daily rate for the use of a fully staffed and equipped ambulance do not factor in the trip counts or average trip prices mentioned above. We expect
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these fixed rate, “leased hour” programs to continue to account for an increasing proportion of the Transportation Services segment’s revenues in the future.
Acquisitions
Historically, we have pursued an acquisition strategy to obtain enhanced capabilities or licenses to offer Mobile Health Services or Transportation Services. Future acquisitions may also include companies that may help drive revenue, profitability, cash flow and stockholder value.
During the year ended December 31, 2024, the Company did not complete any acquisitions. During the year ended December 31, 2023, we completed three acquisitions for an aggregate purchase price of $34.2 million. During the year ended December 31, 2022, we completed five acquisitions for an aggregate purchase price of $69.1 million.
Overview
DocGo is a mobile healthcare services company that uses proprietary dispatch and communication technology to help provide quality mobile, in-person medical treatment directly to patients in the comfort of their homes, workplaces and other non-traditional locations, as well as medical transportation in major metropolitan cities in the United States and the United Kingdom.
The Company derives revenue primarily from two operating segments:
•Mobile Health Services: The services offered by this segment include a wide variety of healthcare services performed at homes, offices and other locations and event services such as on-site healthcare support at sporting events and concerts. This segment also provides total care management solutions to large, typically underserved population groups, primarily through arrangements with municipalities, which include healthcare services as well as ancillary services, such as shelter.
•Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities.
See Item 1, “Business” in this Annual Report for additional information regarding DocGo’s business.
For the year ended December 31, 2024 the Company recorded net income of $13.4 million, compared to net income of $10.0 million and $30.7 million in the years ended December 31, 2023 and 2022, respectively.
Investing in R&D and Enhancing our Customer Experience
Our performance is dependent on the investments we make in research and development (“R&D”), including our ability to attract and retain highly skilled R&D personnel. We intend to develop and introduce innovative new software services, integrations with third-party products and services, mobile applications and other new offerings. If we fail to innovate and enhance our brand and our products, our market position and revenue may be adversely affected.
Regulatory Environment
The Company is subject to federal, state and local regulations, including healthcare and emergency medical services laws and regulations and tax laws and regulations. The Company’s current business plan assumes no material change in these laws and regulations. In the event that any such change occurs, compliance with new laws and regulations may significantly affect the Company’s operations and cost of doing business.
Government Contracts
In recent years, the Company’s government contract work has represented a substantial portion of its overall revenue, and maintaining and continuing to grow this revenues stream is an important part of the Company’s growth strategy. However, government contract work is subject to risks and uncertainties. For example, in the second quarter of 2023, the Company began providing services to the recent migrant population in New York City and in upstate New York. Some of these services were provided pursuant to a contract with an ending date during the second quarter of 2024. While
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a portion of that contract was extended through December 31, 2024, other services began to wind down in May 2024. The wind-down of all services under such contract was completed in the fourth quarter of 2024. While the exact timing of the wind-down of the remaining services under other contracts is still unknown, the wind-down of services is underway and the Company expects that the revenues from these migrant-related projects will be significantly lower in 2025 than they were in 2024 and in the second half of 2023.
In addition, government contract work subjects the Company to government audits, investigations and proceedings, which could lead to the Company to being barred from government work or subjected to fines if it is determined that a statute, rule, regulation, policy or contractual provision has been violated. Audits can also lead to adjustments to the amount of contract costs that the Company believes are reimbursable or to the ultimate amount the Company may be paid under the agreement. Furthermore, a loss of government contract work, if not offset by revenues from new or other existing customers, could have a material adverse effect on the Company’s business, financial condition and results of operations.
Components of Results of Operations
Our business consists of three reportable segments — Mobile Health Services, Transportation Services and Corporate. All revenue and cost of goods sold are contained within the Mobile Health Services and Transportation Services segments. Accordingly, revenues and cost of goods sold are discussed below on a consolidated level and are also broken down between Mobile Health Services and Transportation Services. Operating expenses are discussed on a consolidated level and broken down among all three segments. The Company evaluates the performance of each of its segments based primarily on its results of operations. Accordingly, other income and expenses not included in results of operations are only included in the discussion of consolidated results of operations.
Revenue
The Company’s revenue consists of services provided by its Mobile Health Services segment and its Transportation Services segment.
Cost of Revenues
Cost of revenues consists primarily of revenue generating wages paid to employees, fees paid to subcontractors, medical supplies, vehicle insurance costs (including insurance premiums and costs incurred under the insurance deductibles), maintenance, fuel and facility rent. We expect cost of revenues to continue to rise as we grow our business.
Operating Expenses
General and Administrative Expenses
General and administrative expenses consist primarily of salaries, bad debt expense, insurance expense, consultant fees and professional fees for accounting services. We expect our general and administrative expenses to increase as we continue to scale our business and grow headcount and as a result of operating as a public company, including our compliance with SEC rules and regulations, audit activities, additional insurance expenses, investor relations activities and other administrative and professional services.
Depreciation and Amortization
The Company depreciates its assets using the straight-line method over the estimated useful lives of the respective assets. Amortization of intangibles consists of amortization of definite-lived intangible assets over their respective useful lives.
Legal and Regulatory Expenses
Legal and regulatory expenses include legal fees, consulting fees related to healthcare compliance and legal settlements.
Technology and Development Expenses
Technology and development expenses consists primarily of costs incurred in the design and development of the Company’s proprietary technology, third-party software and technologies. We expect technology and development expenses to increase in future periods to support our growth, including our intent to continue investing in the optimization,
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accuracy and reliability of our dispatch and communication platform and drive efficiency in our operations. These expenses may vary from period to period as a percentage of revenues, depending primarily upon when we choose to make more significant investments, particularly when entering new business lines or customer sales channels.
Sales, Advertising and Marketing Expenses
Our sales, advertising and marketing expenses consist of costs directly associated with our sales and marketing activities, which primarily include sales commissions, marketing programs, trade shows, promotional materials and general branding. We expect our sales, advertising and marketing expenses to continue to increase over time as we increase our marketing activities, grow our domestic and international operations and continue to build brand awareness.
Interest Expense
Interest expense consists primarily of interest on our outstanding borrowings under our outstanding notes payable and financing obligations, including our Revolving Facility.
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Results of Operations
Comparison of Fiscal 2024 with Fiscal 2023
| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2024 | 2023 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 616.6 | 100.0 | % | $ | 624.3 | 100.0 | % | $ | (7.7) | (1.2) | % | ||||||||
| Expenses: | ||||||||||||||||||||
| Cost of revenues | 403.0 | 65.4 | % | 428.9 | 68.7 | % | (25.9) | (6.0) | % | |||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 138.8 | 22.5 | % | 137.2 | 22.0 | % | 1.6 | 1.2 | % | |||||||||||
| Depreciation and amortization | 15.9 | 2.6 | % | 16.4 | 2.6 | % | (0.5) | (3.0) | % | |||||||||||
| Legal and regulatory | 17.1 | 2.8 | % | 13.1 | 2.1 | % | 4.0 | 30.5 | % | |||||||||||
| Technology and development | 11.6 | 1.9 | % | 10.9 | 1.7 | % | 0.7 | 6.4 | % | |||||||||||
| Sales, advertising and marketing | 1.5 | 0.2 | % | 2.8 | 0.4 | % | (1.3) | (46.4) | % | |||||||||||
| Total expenses | 587.9 | 95.3 | % | 609.2 | 97.6 | % | (21.3) | (3.5) | % | |||||||||||
| Income from operations | 28.7 | 4.7 | % | 15.1 | 2.4 | % | 13.6 | 90.1 | % | |||||||||||
| Other (expense) income: | ||||||||||||||||||||
| Interest (expense) income, net | (1.9) | (0.3) | % | 1.7 | 0.3 | % | (3.6) | (211.8) | % | |||||||||||
| Change in fair value of contingent liability | 9.4 | 1.5 | % | 1.4 | 0.2 | % | 8.0 | 571.4 | % | |||||||||||
| Finite-lived intangible asset impairment | (8.3) | (1.3) | % | — | — | % | (8.3) | (100.0) | % | |||||||||||
| Loss on equity method investments | (0.3) | (0.1) | % | (0.3) | (0.1) | % | — | — | % | |||||||||||
| Loss on remeasurement of operating and finance leases | — | — | % | — | — | % | — | — | % | |||||||||||
| Gain (loss) on disposal of fixed assets | — | — | % | (0.9) | (0.1) | % | 0.9 | 100.0 | % | |||||||||||
| Other income (expense) | 0.2 | — | % | (0.7) | (0.1) | % | 0.9 | 128.6 | % | |||||||||||
| Total other (expense) income | (0.9) | (0.2) | % | 1.2 | 0.2 | % | (2.1) | (175.0) | % | |||||||||||
| Net income before income tax expense | 27.8 | 4.5 | % | 16.3 | 2.6 | % | 11.5 | 70.6 | % | |||||||||||
| (Provision for) benefit from income taxes | (14.4) | (2.3) | % | (6.2) | (1.0) | % | (8.2) | (132.3) | % | |||||||||||
| Net income | 13.4 | 2.2 | % | 10.0 | 1.6 | % | 3.4 | 34.0 | % | |||||||||||
| Net (loss) income attributable to noncontrolling interests | (6.6) | (1.1) | % | 3.2 | 0.5 | % | (9.8) | (306.3) | % | |||||||||||
| Net income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | 20.0 | 3.2 | % | $ | 6.9 | 1.1 | % | $ | 13.1 | 189.9 | % |
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Revenues
Consolidated
For the year ended December 31, 2024, total revenues were $616.6 million, a decrease of $7.7 million, or 1.2%, from the total revenues recorded for the year ended December 31, 2023.
Mobile Health Services
For the year ended December 31, 2024, Mobile Health Services revenues were $423.1 million, a decrease of $19.7 million, or 4.4%, as compared with the year ended December 31, 2023. The decline in revenues was primarily due to the ongoing wind-down of migrant-related services, which had ramped up sharply in the third quarter of 2023 and peaked in the first quarter of 2024. Starting in the second quarter of 2023, the Company began providing services to the recently arrived migrant population in New York City and in upstate New York. These projects, which included both medical and non-medical services, such as shelter and security, expanded throughout the third and fourth quarters of 2023 and into the first quarter of 2024. However, some of these services were provided pursuant to a contract with an ending date during the second quarter of 2024. A portion of that contract was extended through December 31, 2024, while other services began to wind down in May 2024. The wind-down of all services under such contract was completed in the fourth quarter of 2024. While the exact timing of the wind-down of the remaining migrant-related services under other contracts is still unknown, the wind-down of those services is underway and the Company expects that the revenues from any remaining migrant-related projects will be significantly lower in 2025 than they were in 2024. While we expect to launch new Mobile Health Services projects in 2025 and to expand existing projects, we expect that the Mobile Health Services segment’s revenues will be lower in 2025 than they were in 2024.
Transportation Services
For the year ended December 31, 2024, Transportation Services revenues were $193.5 million, an increase of $12.0 million, or 6.6%, as compared with the year ended December 31, 2023. This increase was due to a 13.7% increase in trip volumes, from 250,114 trips for the year ended December 31, 2023 to 284,498 trips for the year ended December 31, 2024. The increase in trip volumes was due to a combination of the expansion in the Company’s customer base in certain core markets, as well as an increase in volumes from existing customers. Our average trip price decreased slightly from $407 in the year ended December 31, 2023 to $401 in the year ended December 31, 2024. The decline in the average trip price in the 2024 period reflected a small shift in mix toward markets that have somewhat lower-priced transports when compared to 2023. However, the average trip price remains well above the levels of 2022 and prior years, reflecting a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports that earn higher prices per trip.
Cost of revenues
For the year ended December 31, 2024, total cost of revenues (exclusive of depreciation and amortization) decreased by 6.0% compared to the year ended December 31, 2023, while revenues decreased by approximately 1.2%. Cost of revenues as a percentage of revenues decreased to 65.4% in the year ended December 31, 2024 from 68.7% in the year ended December 31, 2023.
Total cost of revenues in the year ended December 31, 2024 decreased by $25.9 million compared to the year ended December 31, 2023. This decrease was primarily attributable to a $4.7 million decrease in total compensation, a $24.0 million decrease in subcontracted labor costs, and a $6.9 million decrease in medical and related supplies, all driven by the wind-down of migrant-related projects that began in the second quarter of 2024. These declines were partially offset by an increase of $3.8 million in vehicle costs, due to the increase in the size of the Company’s fleet and a net increase of $5.9 million across several other cost of revenues categories.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2024 amounted to $269.3 million, down 12.1% from $306.2 million in the year ended December 31, 2023. Cost of revenues as a percentage of revenues decreased to 63.6% from 69.1% in the prior year period, despite a decline in revenues, reflecting lower compensation expenses, significantly lower subcontracted labor costs and decreased costs for medical supplies, all reflecting the wind-down in migrant-related projects that began in the second quarter of 2024.
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For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2024 amounted to $133.7 million, up 9.0% from $122.7 million in the year ended December 31, 2023. Cost of revenues as a percentage of revenues increased to 69.1% from 67.6% in the prior year, reflecting increased labor costs, subcontractor costs and vehicle costs, due to the continued growth of the business.
Operating expenses
For the year ended December 31, 2024, operating expenses were $184.9 million compared to $180.3 million for the year ended December 31, 2023, an increase of $4.6 million, or 2.6%. As a percentage of revenues, operating expenses increased from 28.9% in 2023 to 30.0% in 2024. The increase of $4.6 million related primarily to a $3.7 million increase in professional fees, due to increased legal, accounting and other fees, and a $1.0 million increase in IT infrastructure, driven by the Company’s business expansion, partially offset by a $0.1 million net decrease across a variety of expense categories.
For the Mobile Health Services segment, operating expenses in the year ended December 31, 2024 were $59.8 million, up 6.2% from $56.3 million in the year ended December 31, 2023. Operating expenses as a percentage of revenues increased to 14.1% from 12.7% in 2023, due to the decrease in Mobile Health Services revenues, and reflecting significant expenditures that were made during 2024 related to the expansion of services and geographic areas of operation, as well as the costs of developing the Company’s programs to provide care-gap closure and other services to members of new insurance provider partners.
For the Transportation Services segment, operating expenses in the year ended December 31, 2024 were $61.8 million, up 12.0% from $55.2 million in the year ended December 31, 2023. The increase in operating expenses for this segment was driven primarily by higher insurance expense and office expenses, reflecting the expansion of the business. Operating expenses as a percentage of revenues increased to 31.9% for the year ended December 31, 2024 from 30.4% in the year ended December 31, 2023.
For the Corporate segment, which represents primarily shared services that are not contained within the entities included in either the Mobile Health Services or Transportation Services segments, operating expenses in the year ended December 31, 2024 were $63.3 million, down 8.0% from $68.8 million in the year ended December 31, 2023. The decrease in operating expenses for this segment was driven by lower compensation costs, due to targeted headcount reductions during the year, partially offset by an increase in professional fees. Corporate expenses amounted to approximately 10.3% of total consolidated revenues in 2024, compared to 11.0% in 2023.
Interest (expense) income, net
For the year ended December 31, 2024, the Company recorded approximately $1.9 million of interest expense, net compared to $1.7 million of interest income, net in the year ended December 31, 2023. Interest expenses on borrowings under the Revolving Facility outweighed interest earned on balances in the Company’s interest-bearing accounts in the year ended December 31, 2024. Prior to October 2023, there were no amounts outstanding under the Company’s line of credit.
Change in fair value of contingent liability
During the year ended December 31, 2024, the Company recorded a change in fair value of contingent liability of approximately $9.4 million, reflecting a reduction in the anticipated payments to be made for an acquisition, based upon performance compared to certain targets. During the year ended December 31, 2023, the Company recorded a change in fair value of contingent liability of approximately $1.4 million, reflecting a reduction in the anticipated payments to be made for a recent acquisition, based upon performance compared to certain targets.
Finite-lived intangible asset impairment
During the year ended December 31, 2024, the Company recorded finite-lived intangible asset impairment of approximately $8.3 million, relating to the projected value of the customer relationships for Cardiac RMS, LLC, arising from a revised long-term forecast for the business. During the year ended December 31, 2023, the Company did not record any finite-lived intangible asset impairment.
Loss on equity method investments
During the year ended December 31, 2024, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest. During the year ended December 31, 2023, the Company recorded a loss on equity method investments of
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approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest.
Gain (loss) on disposal of fixed assets
During the year ended December 31, 2024, the Company recorded a gain on disposal of fixed assets of $23,682, compared to a loss on disposal of fixed assets of $0.9 million during the year ended December 31, 2023.
Other income (expense)
During the year ended December 31, 2024, the Company recorded other income of $0.2 million, compared to other expense of $0.7 million during the year ended December 31, 2023.
(Provision for) benefit from income taxes
During the year ended December 31, 2024, the Company recorded a provision for income taxes of $14.4 million compared to an income tax provision of $6.2 million in the year ended December 31, 2023. The increased tax expense in 2024 was primarily due to the recording of significantly higher pretax income in the 2024 period, as compared to the 2023 period.
Net (loss) income attributable to noncontrolling interests
For the year ended December 31, 2024, the Company had net loss attributable to noncontrolling interests of approximately $6.6 million compared to net income attributable to noncontrolling interests of $3.2 million for the year ended December 31, 2023.
Comparison of Fiscal 2023 with Fiscal 2022
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| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2023 | 2022 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 624.3 | 100.0 | % | $ | 440.5 | 100.0 | % | $ | 183.8 | 41.7 | % | ||||||||
| Cost of revenues | 428.9 | 68.7 | % | 285.8 | 64.9 | % | 143.1 | 50.1 | % | |||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 137.2 | 22.0 | % | 103.4 | 23.5 | % | 33.8 | 32.7 | % | |||||||||||
| Depreciation and amortization | 16.4 | 2.6 | % | 10.6 | 2.4 | % | 5.8 | 54.7 | % | |||||||||||
| Legal and regulatory | 13.1 | 2.1 | % | 8.8 | 2.0 | % | 4.3 | 48.9 | % | |||||||||||
| Technology and development | 10.9 | 1.7 | % | 5.4 | 1.2 | % | 5.5 | 101.9 | % | |||||||||||
| Sales, advertising and marketing | 2.8 | 0.4 | % | 4.7 | 1.1 | % | (1.9) | (40.4) | % | |||||||||||
| Total expenses | 609.2 | 97.6 | % | 418.7 | 95.1 | % | 190.5 | 45.5 | % | |||||||||||
| Income from operations | 15.1 | 2.4 | % | 21.8 | 4.9 | % | (6.7) | (30.7) | % | |||||||||||
| Other income: | ||||||||||||||||||||
| Interest income, net | 1.7 | 0.3 | % | 0.8 | 0.2 | % | 0.9 | 112.5 | % | |||||||||||
| Gain on remeasurement of warrant liabilities | — | — | % | 1.1 | 0.3 | % | (1.1) | (100.0) | % | |||||||||||
| Change in fair value of contingent liability | 1.4 | 0.2 | % | — | — | % | 1.4 | 100.0 | % | |||||||||||
| (Loss) gain on equity method investments | (0.3) | (0.1) | % | — | — | % | (0.3) | (100.0) | % | |||||||||||
| Gain on remeasurement of finance leases | — | — | % | 1.4 | 0.3 | % | (1.4) | (100.0) | % | |||||||||||
| Gain on bargain purchase | — | — | % | 1.6 | 0.4 | % | (1.6) | (100.0) | % | |||||||||||
| Loss on disposal of fixed assets | (0.9) | (0.1) | % | — | — | % | (0.9) | (100.0) | % | |||||||||||
| Goodwill impairment | — | — | % | (2.9) | (0.7) | % | 2.9 | 100.0 | % | |||||||||||
| Other expense | (0.7) | (0.1) | % | (1.0) | (0.2) | % | 0.3 | 30.0 | % | |||||||||||
| Total other income | 1.2 | 0.2 | % | 1.0 | 0.2 | % | 0.2 | 20.0 | % | |||||||||||
| Net income before (provision for) benefit from income tax | 16.3 | 2.6 | % | 22.8 | 5.2 | % | $ | (6.5) | (28.5) | % | ||||||||||
| (Provision for) benefit from income taxes | (6.2) | (1.0) | % | 7.9 | 1.8 | % | $ | (14.1) | (178.5) | % | ||||||||||
| Net income | 10.0 | 1.6 | % | 30.7 | 7.0 | % | $ | (20.7) | (67.4) | % | ||||||||||
| Net income (loss) attributable to noncontrolling interests | 3.2 | 0.5 | % | (3.9) | (0.9) | % | $ | 7.1 | 182.1 | % | ||||||||||
| Net income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | 6.9 | 1.1 | % | $ | 34.6 | 7.9 | % | $ | (27.7) | (80.1) | % |
Revenues
Consolidated
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For the year ended December 31, 2023, total revenues were $624.3 million, an increase of $183.8 million, or 41.7%, from the total revenues recorded for the year ended December 31, 2022.
Mobile Health Services
For the year ended December 31, 2023, Mobile Health Services revenues were $442.8 million, an increase of $116.9 million, or 35.9%, as compared with the year ended December 31, 2022. The increase in revenues was primarily due to an expansion in services offered by the Mobile Health Services segment, particularly in the government customer sector. This expansion accelerated during the year ended December 31, 2023 as the Company extended several large customer contracts and introduced a broader range of services.
Transportation Services
For the year ended December 31, 2023, Transportation Services revenues were $181.5 million, an increase of $66.9 million, or 58.3%, as compared with the year ended December 31, 2022. This increase was due to a 15.8% increase in trip volumes, from 216,009 trips for the year ended December 31, 2022 to 250,114 trips for the year ended December 31, 2023. The increase in trip volumes was due to a combination of growth in the Company’s customer base in certain core markets and acquisitions made during the second half of 2022. Our average trip price increased from $380 in the year ended December 31, 2022 to $407 in the year ended December 31, 2023. The increase in the average trip price in 2023 reflected a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports resulting in higher prices per trip. The average trip price also benefited from an 8.7% increase in the average Medicare reimbursement rate for ambulance transports. The Medicare ambulance fee schedule has increased by a further 2.4%, effective January 1, 2024.
Cost of revenues
For the year ended December 31, 2023, total cost of revenues (exclusive of depreciation and amortization) increased by 50.1% compared to the year ended December 31, 2022, while revenues increased by approximately 41.7%. Cost of revenues as a percentage of revenues increased to 68.7% in the year ended December 31, 2023 from 64.9% in the year ended December 31, 2022.
Total cost of revenues in the year ended December 31, 2023 increased by $143.1 million compared to the same period in 2022. This increase was primarily attributable to a $44.0 million increase in total compensation, due to higher headcount for both the Transportation Services and Mobile Health Services segments; an $80.2 million increase in subcontracted labor costs, primarily driven by new projects in the Mobile Health Services segment that required a greater number of personnel and certain more highly specialized personnel than the Company was able to initially provide through its existing staff; a $19.6 million increase in medical and related supplies; a $2.1 million increase in travel costs for field personnel and other clinicians who traveled out of their home regions to provide Mobile Health Services; and a $1.6 million net increase in other cost of revenues categories. These items were partially offset by a $2.3 million decline in vehicle costs, as the Company exited certain rental agreements, and a $2.1 million reduction in lab fees, as COVID testing services declined to an immaterial amount in 2023.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2023 amounted to $306.2 million, up 53.7% from $199.2 million in the year ended December 31, 2022. Cost of revenues as a percentage of revenues increased to 69.1% from 61.1% in the prior year period, despite a significant increase in revenues, reflecting higher compensation expenses as a result of headcount growth, significantly higher subcontracted labor costs and increased costs for medical supplies.
For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2023 amounted to $122.7 million, up 41.8% from $86.5 million in the year ended December 31, 2022. Cost of revenues as a percentage of revenues decreased to 67.6% from 75.5% in the prior year, reflecting the impact of higher per-trip prices, increased revenues from standby contracts (for which we are paid a daily or hourly rate) and the overall increase in revenues, as well as a decline in the average fuel price.
Operating expenses
For the year ended December 31, 2023, operating expenses were $180.3 million compared to $132.9 million for the year ended December 31, 2022, an increase of $47.4 million, or 35.7%. As a percentage of revenues, operating expenses decreased from 30.2% in 2022 to 28.9% in 2023, even as the Company added to its management infrastructure
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and total compensation increased, due to the significant increase in overall revenues described above. The increase of $47.4 million related primarily to a $27.1 million increase in total compensation, which included costs for both directly employed and subcontracted staff due to investments in and expansion of corporate infrastructure to support the revenue growth, as well as an increase in stock-based compensation expense; a $5.7 million increase in depreciation and amortization due to an increase in assets to support revenue growth and capitalized software amortization, as well as recently acquired companies; a $4.9 million increase in IT infrastructure, driven by the Company’s business and headcount expansion; a $2.5 million increase in insurance costs, reflecting higher headcount, a larger vehicle fleet and expanded operations; a $1.3 million increase in rent and utilities relating to the Company’s ongoing geographic expansion; and a $5.9 million net increase across a variety of expense categories.
For the Mobile Health Services segment, operating expenses in the year ended December 31, 2023 were $56.3 million, up from $33.9 million in the year ended December 31, 2022. Operating expenses as a percentage of revenues increased to 12.7% from 10.4% in 2022, despite the increase in Mobile Health Services revenues, reflecting significant expenditures that were made in 2023 related to the expansion of services and geographic areas of operation, as well as the continued buildout of the Mobile Health Services management infrastructure and the costs of developing the Company’s “on-demand” direct-to-consumer offering.
For the Transportation Services segment, operating expenses in the year ended December 31, 2023 were $55.2 million, compared to $43.0 million in the year ended December 31, 2022. The increase in operating expenses for this segment, in absolute dollar terms, was driven primarily by higher compensation expense and depreciation charges, reflecting the expansion of the business, including recent acquisitions. Operating expenses as a percentage of revenues decreased to 30.4% for the year ended December 31, 2023 from 37.5% in the year ended December 31, 2022.
For the Corporate segment, which represents primarily shared services that are not contained within the entities included in either the Mobile Health Services or Transportation Services segments, operating expenses in the year ended December 31, 2023 were $68.8 million, compared to $55.1 million in the year ended December 31, 2022. The increase in operating expenses for this segment, in absolute dollar terms, was primarily driven by higher compensation expenses, reflecting the ongoing build-out of the Company’s corporate human resources infrastructure. Corporate expenses amounted to approximately 11.0% of total consolidated revenues in 2023, compared to 12.5% in 2022, reflecting the significant increase in total consolidated revenues.
Interest income, net
For the year ended December 31, 2023, the Company recorded approximately $1.7 million of interest income, net compared to $0.8 million of interest income, net in the year ended December 31, 2022. This increase was primarily due to higher rates of interest earned on balances in the Company's interest-bearing accounts in the year ended December 31, 2023, which reflected significantly higher market interest rates. The higher rates of interest earned outweighed the impact of the lower average cash balances in 2023.
Gain on remeasurement of warrant liabilities
During the year ended December 31, 2023, there were no gains or losses recorded relating to remeasurement of warrant liabilities, as all warrants were redeemed during the third quarter of 2022. During the year ended December 31, 2022, the Company recorded a gain of approximately $1.1 million from the remeasurement of warrant liabilities. The warrants were marked-to-market in each reporting period, and this gain reflected the decline in the Company’s stock price relative to the beginning of the period.
Change in fair value of contingent liability
During the year ended December 31, 2023, the Company recorded a change in fair value of contingent liability of approximately $1.4 million, reflecting a decline in the anticipated payments to be made for a recent acquisition, based upon performance compared to certain targets. There was no related change in fair value recorded in the year ended December 31, 2022.
(Loss) gain on equity method investments
During the year ended December 31, 2023, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest. During the year ended December 31, 2022, the Company recorded a gain on equity method investments of $8,919.
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Gain on remeasurement of finance leases
During the year ended December 31, 2023, there were no gains or losses recorded relating to remeasurement of finance leases. During the year ended December 31, 2022, the Company recorded a gain on remeasurement of finance leases of $1.4 million.
Gain on bargain purchase
During the year ended December 31, 2023, the Company recorded no gain or loss on bargain purchase. During the year ended December 31, 2022, the Company recorded a gain on bargain purchase of $1.6 million.
Loss on disposal of fixed assets
During the year ended December 31, 2023, the Company recorded a loss on disposal of fixed assets of $0.9 million, compared to a loss on disposal of fixed assets of $21,000 during the year ended December 31, 2022.
Goodwill impairment
During the year ended December 31, 2023, the Company did not record any impairment to goodwill. During the year ended December 31, 2022, the Company recorded a goodwill impairment of $2.9 million, relating to the Company’s exit from the medical transportation market in California.
Other expense
During the year ended December 31, 2023, the Company recorded other expense of $0.7 million, compared to other expense of $1.0 million during the year ended December 31, 2022.
(Provision for) benefit from income taxes
During the year ended December 31, 2023, the Company recorded a provision for income taxes of $6.2 million compared to an income tax benefit of $7.9 million in the year ended December 31, 2022. The tax benefit in 2022 was due to the release of the valuation allowance recorded in previous years for net operating losses, as the Company determined that it was more likely than not that it would be able to realize its net operating loss carryforwards in the future.
Net income (loss) attributable to noncontrolling interests
For the year ended December 31, 2023, the Company had net income attributable to noncontrolling interests of approximately $3.2 million compared to a net loss attributable to noncontrolling interests of $3.9 million for the year ended December 31, 2022. The income compared to the prior year period loss reflected improved performance in the Company’s joint venture markets in the year ended December 31, 2023.
Liquidity and Capital Resources
Between the inception of DocGo’s wholly owned subsidiary Ambulnz and the Business Combination, Ambulnz completed three equity financing transactions as its principal source of liquidity. In November 2021, upon the completion of the Business Combination and the private placement of Common Stock that closed concurrently with the Business Combination, the Company received proceeds of approximately $158.1 million, net of transaction expenses. Generally, the Company has utilized proceeds from the equity financing transactions and the Business Combination to finance operations, invest in assets, make acquisitions and fund accounts receivable. The Company has also funded these activities through operating cash flows. Despite the fact that the Company generated positive net income for the year ended December 31, 2024, operating cash flows are not always sufficient to meet immediate obligations arising from current operations. For example, as the business has grown, the Company’s expenditures for human capital and supplies has expanded accordingly, and the timing of the payments for payroll and to associated vendors, compared to the timing of receipts of cash from customers, frequently results in the need to use existing cash balances to fund working capital needs. During the year ended December 31, 2024, as a greater proportion of the Company’s overall revenues were generated through services provided to municipal customers with long payment cycles, and expenditures made by the Company to allow for the provision of these services were substantial, operating cash flows were not sufficient to meet these demands for working
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capital, leading to a marked decline in the Company’s cash balances. As these invoices are collected, the Company expects cash flows to be sufficient for near term working capital needs.
The Company’s future working capital needs depend on many factors, including the overall growth of the Company and the various payment terms that are negotiated with customers and vendors. The Company’s future capital requirements depend on many factors, including potential acquisitions, the Company’s level of investment in technology and ongoing technology development, and rate of growth in existing markets and into new markets. Capital requirements might also be affected by factors outside of the Company’s control, such as interest rates, rising inflation and other monetary and fiscal policy changes to the manner in which the Company currently operates. If the Company’s growth rate is higher than is currently anticipated, resulting in greater-than-anticipated capital requirements, the Company might need to, or choose to, raise additional capital through debt or equity financings. This last factor has been evident at different times during the second half of 2023 and during the first quarter of 2024, leading to a draw down in the Company’s credit line during the fourth quarter of 2023 and during the first quarter of 2024, as described below.
On November 1, 2022, the Company entered into the Credit Agreement, which provides for the Revolving Facility in the initial aggregate principal amount of $90 million. The Revolving Facility includes the ability for the Company to request an increase to the commitment by an additional amount of up to $50 million, though no lender (nor the lenders collectively) is obligated to increase its respective commitments. Borrowings under the Revolving Facility bear interest at a per annum rate equal to (i) at the Company’s option, (x) the base rate or (y) the adjusted term SOFR rate, plus (ii) the applicable margin. The applicable margins are based on the Company’s consolidated net leverage ratio, adjusted on a quarterly basis. The initial applicable margins were 1.25% for an adjusted term SOFR loan and 0.25% for a base rate loan and are updated based on the Company’s consolidated net leverage ratio. The Revolving Facility matures on November 1, 2027 and is secured by a first-priority lien on substantially all of the Company’s present and future personal assets and intangible assets. The Revolving Facility is subject to certain financial covenants, such as a net leverage ratio and interest coverage ratio, as defined in the Credit Agreement. On October 19, 2023, the Company drew down $25 million under the Revolving Facility. On February 8, 2024, the Company drew down an additional $15.0 million. On February 27, 2024, the Company repaid all amounts then outstanding under the Revolving Facility. However, in March 2024, the Company once again drew down under the Revolving Facility, and there was a total of $30.0 million outstanding under the Revolving Facility as of the date of this Annual Report.
Considering the foregoing, DocGo anticipates that its existing balances of cash and cash equivalents, future expected cash flows generated from its operations and its available line of credit under the Revolving Facility will be sufficient to satisfy operating requirements for at least the next twelve months. Looking beyond the next twelve months, DocGo anticipates that expected future cash flows, its available line of credit and proceeds from potential additional financings will be sufficient to satisfy any operating and potential investing requirements.
Capital Resources
Working capital as of December 31, 2024 and 2023 was as follows:
| December 31, | Change $ | Change % | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2024 | 2023 | |||||||||||||
| Working capital | |||||||||||||||
| Current assets | $ | 304.5 | $ | 338.9 | $ | (34.4) | (10.2) | % | |||||||
| Current liabilities | 121.8 | 170.1 | (48.3) | (28.4) | % | ||||||||||
| Total working capital | $ | 182.7 | $ | 168.8 | $ | 13.9 | 8.2 | % |
As of December 31, 2024, available cash totaled $89.2 million, which represented an increase of $30.0 million compared to December 31, 2023, reflecting a decline in accounts receivable during the year ended December 31, 2024, as the Company collected some of its larger invoices. As of December 31, 2024, working capital amounted to $182.7 million, which represented an increase of $13.9 million compared to December 31, 2023, as an increase in cash and a decline in accrued liabilities outweighed a decline in accounts receivable. Despite the increase in cash, current assets declined by $34.4 million, due to a drop in accounts receivable and in prepaid expenses. However, this was outweighed by the decline in current liabilities in the year ended December 31, 2024, due to lower accrued liabilities, reflecting lower invoices and accrued liabilities in the current period for certain expenses, such as subcontracted labor, and as the Company paid down a significant amount of its accrued liabilities during the year-to-date period. Current liabilities also declined due a decrease in
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contingent consideration, reflecting a reduction in anticipated payments to be made for a recent acquisition, which is based upon performance compared to certain targets.
Cash Flows
Cash flows as of the years ended December 31, 2024 and 2023 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2024 | 2023 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash provided by (used in) operating activities | $ | 70.3 | $ | (64.2) | $ | 134.5 | 209.5 | % | ||||||
| Net cash used in investing activities | (10.9) | (29.9) | 19.0 | 63.5 | % | |||||||||
| Net cash (used in) provided by financing activities | (24.1) | 1.1 | (25.2) | (2290.9) | % | |||||||||
| Effect of exchange rate changes | (0.2) | 1.1 | (1.3) | (118.2) | % | |||||||||
| Net increase in cash | $ | 35.1 | $ | (91.9) | $ | 127.0 | 138.2 | % |
Cash flows as of the years ended December 31, 2023 and 2022 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2023 | 2022 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash (used in) provided by operating activities | $ | (64.2) | $ | 28.9 | $ | (93.1) | (322.1) | % | ||||||
| Net cash used in investing activities | (29.9) | (38.4) | 8.5 | 22.1 | % | |||||||||
| Net cash provided by (used in) financing activities | 1.1 | (6.2) | 7.3 | 117.7 | % | |||||||||
| Effect of exchange rate changes | 1.1 | 0.7 | 0.4 | 57.1 | % | |||||||||
| Net decrease in cash | $ | (91.9) | $ | (15.0) | $ | (76.9) | (512.7) | % |
Operating Activities
During the year ended December 31, 2024, cash provided by operating activities was $70.3 million, aided by net income of $13.4 million. Non-cash charges amounted to $37.4 million, which primarily consisted of $10.2 million in depreciation of property and equipment and right-of-use assets, $5.7 million from amortization of intangible assets, $13.6 million of stock compensation expense, $5.2 million in bad debt expense, an $8.3 million impairment of a finite-lived intangible asset, $3.5 million in deferred taxes and a loss of $0.3 million from an investment that is accounted for under the equity method. These were partially offset by a non-cash gain of $9.4 million resulting from a reduction in the fair value of contingent consideration. Changes in assets and liabilities resulted in approximately $19.5 million in positive operating cash flow, as a $41.3 million decrease in accounts receivable, reflecting collections of invoices from large municipal customers, an $8.5 million increase in accounts payable and a $13.0 million decrease in prepaid expenses were partially offset by a $41.9 million decrease in accrued liabilities and a $1.4 million increase in other assets.
During the year ended December 31, 2023, cash used by operating activities was $64.2 million, despite net income of $10.0 million. Non-cash charges amounted to $38.9 million, which primarily consisted of $11.2 million in depreciation of property and equipment and right-of-use assets, $5.2 million from amortization of intangible assets, $21.0 million of stock compensation expense, a $0.9 million loss on the disposal of assets and a loss of $0.3 million from an investment that is accounted for under the equity method and $3.6 million in bad debt expense. These were partially offset by $2.0 million in deferred taxes and a non-cash gain of $1.4 million resulting from a reduction in the fair value of contingent consideration. Changes in assets and liabilities resulted in approximately $113.1 million in negative operating cash flow, as a $160.5 million increase in accounts receivable, reflecting the growth of the business and primarily driven by an increased amount of business with municipalities, which tend to have longer payment cycles; a $1.8 million decrease in accounts payable; and a $10.8 million increase in prepaid expenses and other current assets were partially offset by a $59.0 million increase in accrued liabilities and a $1.0 million decline in other assets.
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During the year ended December 31, 2022, cash provided by operating activities was $28.9 million, aided by net income of $30.7 million. Non-cash charges were $11.3 million and included $7.3 million in depreciation of property and equipment and right-of-use assets, $3.2 million from amortization of intangible assets, $3.8 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable, $8.1 million of stock compensation expense and a non-cash loss of $2.9 million related to the impairment of a business unit that was discontinued at the end of the year. These charges were partially offset by non-cash gains of $1.4 million relating to the remeasurement of finance lease liabilities, $1.1 million from the remeasurement of warrant liabilities, $1.6 million in a gain on a bargain purchase and $9.9 million in the realization of a deferred tax asset. Changes in assets and liabilities resulted in an approximately $13.2 million decrease to operating cash flow, as an $8.4 million increase in accounts receivable, a $4.2 million increase in prepaid expenses and a $6.0 million decrease in accrued liabilities outweighed the effect of a $1.7 million decrease in other assets and a $3.6 million increase in accounts payable.
Investing Activities
During the year ended December 31, 2024, investing activities used $10.9 million of cash and consisted of the acquisition of property and equipment totaling approximately $3.8 million, the acquisition of intangibles in the amount of $2.0 million, an investment in equity securities in the amount of $5.0 million and an equity method investment in the amount of $0.3 million, partially offset by $0.2 million in cash proceeds from the disposal of property and equipment.
During the year ended December 31, 2023, investing activities used $29.9 million of cash and consisted of the acquisition of property and equipment totaling approximately $7.6 million, the acquisition of intangibles in the amount of $2.5 million, the acquisition of businesses in the amount of $20.2 million and an equity method investment in the amount of $0.3 million, partially offset by $0.7 million in cash proceeds from the disposal of property and equipment.
During the year ended December 31, 2022, cash used in investing activities was $38.4 million and consisted of the acquisition of property and equipment totaling approximately $3.2 million, the acquisition of intangibles in the amount of $2.3 million and the acquisition of businesses in the amount of $33.0 million, primarily relating to acquisitions the Company completed in the third and fourth quarters of 2022.
Financing Activities
During the year ended December 31, 2024, cash used by financing activities was $24.1 million, as $45.0 million in proceeds from the Company’s Revolving Facility were outweighed by $40.0 million of repayments of amounts outstanding under the Company’s Revolving Facility, $13.8 million in stock repurchases, $4.3 million in payments under the terms of a finance lease, $3.6 million in earnout payments on contingent liabilities, a $3.1 million decrease in amounts due to seller, $1.8 million paid for the acquisition of a non-controlling interest, $1.3 million in payments of dividends to non-controlling interests and $1.2 million in payments for taxes related to shares withheld for employee taxes.
During the year ended December 31, 2023, cash provided by financing activities was $1.1 million, including $25.0 million in proceeds from the Company’s Revolving Facility and $1.6 million in proceeds from the exercise of stock options, mostly offset by $4.3 million in payments under the terms of a finance lease, a $13.6 million decrease in amounts due to seller, $5.3 million in earnout payments on contingent liabilities and $2.3 million in payments for taxes related to shares withheld for employee taxes.
During the year ended December 31, 2022, cash used in financing activities was $6.2 million, including $3.7 million in the repurchase of Common Stock, $3.0 million in payments under the terms of a finance lease, a $2.5 million decrease in amounts due to seller and $0.9 million in repayments of notes payable, which were partially offset by $2.1 million in non-controlling interest contributions and $2.0 million in proceeds from the exercise of stock options.
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Future minimum annual maturities of notes payable as of December 31, 2024 are as follows (in thousands):
| Notes Payable | ||
|---|---|---|
| 2025 | $ | 12.5 |
| 2026 | 5.2 | |
| Total maturities | 17.7 | |
| Current portion of notes payable | (12.5) | |
| Long-term portion of notes payable | $ | 5.2 |
Future minimum lease payments under finance leases as of the year ended December 31, 2024 are as follows (in millions):
| Finance Leases | ||
|---|---|---|
| 2025 | $ | 5.4 |
| 2026 | 4.6 | |
| 2027 | 3.4 | |
| 2028 | 2.2 | |
| 2029 | 0.7 | |
| Thereafter | — | |
| Total future minimum lease payments | 16.3 | |
| Less effects of discounting | (1.6) | |
| Present value of future minimum lease payments | $ | 14.7 |
Future minimum lease payments under operating leases as of the year ended December 31, 2024 are as follows (in millions):
| Operating Leases | ||
|---|---|---|
| 2025 | $ | 4.5 |
| 2026 | 3.8 | |
| 2027 | 2.6 | |
| 2028 | 1.8 | |
| 2029 | 0.9 | |
| Thereafter | 0.3 | |
| Total future minimum lease payments | 13.9 | |
| Less effects of discounting | (1.5) | |
| Present value of future minimum lease payments | $ | 12.4 |
Critical Accounting Policies
Basis of Presentation
The Company’s Consolidated Financial Statements are presented in conformity with accounting principles generally accepted in the U.S. (“U.S. GAAP”) and pursuant to the rules and regulations of the SEC. The Consolidated Financial Statements include the accounts and operations of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions are eliminated upon consolidation. Noncontrolling interests on the Consolidated Balance Sheets represents the portion of consolidated joint ventures and a variable interest entity (“VIE”) in which the Company does not have direct equity ownership.
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Principles of Consolidation
In accordance with Accounting Standards Codification (“ASC”) 810, Consolidation (“ASC 810”), the Company assesses whether it has a variable interest in legal entities in which it has a financial relationship and, if so, whether or not those entities are VIEs. For those entities that qualify as VIEs, ASC 810 requires the Company to determine if the Company is the primary beneficiary of the VIE, and if so, to consolidate the VIE.
The Company has entered into management services agreements (“MSAs”) with professional corporations (“PCs”) that employ or contract with physicians and other health professionals in order to provide healthcare services to the public. Each such PC is established and operated pursuant to the requirements of its respective domestic jurisdiction governing the practice of medicine. The Company provides each PC with everything the PC needs to operate except for clinicians, which the PC is responsible for. Without the administrative services, software, intellectual property and administrative personnel (among other things) provided by the Company, the PCs could not carry out their businesses. Moreover, the PCs do not have sufficient equity to finance their activities without additional subordinated financial support. Based on the foregoing, these entities are considered VIEs, and an enterprise having a controlling financial interest in a VIE must consolidate the VIE if it is the primary beneficiary, meaning it has (1) the power to direct the activities of the VIE that most significantly impacts the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). In accordance with corporate practice of medicine restrictions, all clinical treatment decisions are made solely by licensed healthcare professionals engaged by the PCs. Nevertheless, the PCs cannot operate without the Company through the MSAs; therefore, the Company significantly impacts the economic performance of the PCs and funds and absorbs all losses of its PCs. The Company has therefore determined that it is the primary economic beneficiary of the PCs and appropriately consolidates them as VIEs.
Net loss for the Company’s VIEs were $231,952, $235,976 and $373,456 for the years ended December 31, 2024, 2023 and 2022, respectively. The total assets amounted to $20,837,325 and $4,364,274 on December 31, 2024 and 2023, respectively. Total liabilities were $21,516,860 and $4,811,857 on December 31, 2024 and 2023, respectively. The Company’s VIEs total stockholders’ deficit were $679,535 and $447,583 on December 31, 2024 and 2023, respectively.
Self-Insurance Reserves
The Company self-insures a number of risks, including, but not limited to, workers’ compensation, general liability, auto liability and certain employee-related healthcare benefits. Standard actuarial procedures and data analysis are used to estimate the liabilities associated with these risks on an undiscounted basis. The recorded liabilities reflect the ultimate cost for claims incurred but not paid and any estimable administrative run-out expenses related to the processing of these outstanding claim payments. On a regular basis, the liabilities are evaluated for appropriateness with claims reserve valuations. To limit exposure to some risks, the Company maintains insurance coverage with varying limits and retentions, including stop-loss insurance coverage for workers’ compensation, general liability and auto liability.
Fair Value of Financial Instruments
ASC 820, Fair Value Measurements, provides guidance on the development and disclosure of fair value measurements. Under this accounting guidance, fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or a liability.
The accounting guidance classifies fair value measurements in one of the following three categories for disclosure purposes:
Level 1: Quoted prices in active markets for identical assets or liabilities.
Level 2: Inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.
Level 3: Unobservable inputs which are supported by little or no market activity and values determined using pricing models, discounted cash flow methodologies, or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.
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Fair value measurements discussed herein are based upon certain market assumptions and pertinent information available to management as of December 31, 2024, 2023 and 2022. For certain financial instruments, including cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, restricted cash, accounts payable and accrued expenses, and due to seller, the carrying amounts approximate their fair values as it is short term in nature. The notes payable are presented at their carrying value, which, based on borrowing rates currently available to the Company for loans with similar terms, approximates its fair values.
Level 3 instruments are valued based on unobservable inputs that are supported by little or no market activity and reflect the Company’s own assumptions in measuring fair value. Future changes in fair value of the contingent consideration, as a result of changes in significant inputs such as the discount rate and estimated probabilities of financial milestone achievements, could have a material effect on the Consolidated Statements of Operations and Comprehensive Income and Consolidated Balance Sheets in the period of the change.
Accounts Receivable
The Company contracts with hospitals, healthcare facilities, businesses, state and local government entities, and insurance providers to provide Mobile Health Services and Transportation Services at specified rates. These rates are either on a per procedure or per transport basis, or on an hourly or daily basis. Accounts receivable consist of billings for healthcare and transportation services provided to patients. Billings typically are either paid or settled on the patient’s behalf by health insurance providers, managed care organizations, treatment facilities, government sponsored programs or businesses or patients directly. The Company generally does not require collateral for accounts receivable.
Accounts receivable are net of insurance provider contractual allowances, which are estimated at the time of billing based on contractual terms or other arrangements. The Company maintains an allowance for credit losses for accounts receivable, net which is recorded as an offset to accounts receivable, net and changes in this allowance are recorded within general and administrative expenses in the Consolidated Statements of Operations and Comprehensive Income (Loss). The carrying amount of accounts receivable represents the maximum credit risk exposure of these assets. On a quarterly basis, in accordance with Federal Accounting Standards Board ASC 326, Measurement of Credit Losses on Financial Instruments, the Company evaluates the collectability of outstanding accounts receivable balances to determine an allowance for credit loss that reflects its best estimate of the lifetime expected credit losses. Individual uncollectible accounts are written off against the allowance when collection of the individual account does not appear probable.
Under the current expected credit loss impairment model, the Company develops and documents its allowance for credit losses on its trade receivables based on a single portfolio segment. The Company assesses collectability by aggregating and reviewing accounts receivable on a collective basis for customers that share similar risk characteristics. Additionally, when accounts receivable do not share risk characteristics with other accounts receivables, management will evaluate such accounts receivable for expected credit loss on an individual specific identification basis when the Company identifies specific customers with known disputes or collectability issues. Due to the short-term nature of the Company’s accounts receivables, the estimate of expected credit loss is based on the aging of accounts using an aging schedule as of period ends. In determining the amount of the allowance for credit losses, the Company considers historical collection history based on past due status, the current aging of receivables, customer-specific credit risk factors including their current financial condition, current market conditions, and probable future economic conditions which inform adjustments to historical loss patterns.
As of January 1, 2024, the Company held a beginning balance in its allowance for credit losses on accounts receivable of $6,276,454. The Company recognized an additional provision for credit losses of $4,384,866 and write offs of $(4,787,379) during the year. The Company’s balance in its allowance for credit losses amounted to $5,873,942 as of December 31, 2024.
Business Combinations
The Company accounts for its business combinations under the provisions of ASC 805-10, Business Combinations (“ASC 805-10”), which requires that the acquisition method of accounting be used for all business combinations. Assets acquired and liabilities assumed, including noncontrolling interests, are recorded at the date of acquisition at their respective fair values. ASC 805-10 also specifies criteria that intangible assets acquired in a business combination must meet to be recognized and reported apart from goodwill.
Goodwill represents the excess purchase price over the fair value of the tangible net assets and intangible assets acquired in a business combination. If the business combination provides for contingent consideration, the Company
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records the contingent consideration at fair value at the acquisition date and any changes in fair value after the acquisition date are accounted for as measurement-period adjustments. Changes in fair value of contingent consideration resulting from events after the acquisition date, such as earn-outs, are recognized as follows: 1) if the contingent consideration is classified as equity, the contingent consideration is not re-measured and its subsequent settlement is accounted for within equity, or 2) if the contingent consideration is classified as a liability, the changes in fair value are recognized in earnings. For transactions that are business combinations, the Company evaluates the existence of goodwill or a gain from a bargain purchase. The Company capitalizes acquisition-related costs and fees associated with asset acquisitions and immediately expenses acquisition-related costs and fees associated with business combinations.
The estimated fair value of net assets to be acquired, including the allocation of the fair value to identifiable assets and liabilities, is determined using established valuation techniques. Management uses assumptions on the basis of historical knowledge of the business and projected financial information of the target. These assumptions may vary based on future events, perceptions of different market participants and other factors outside the control of management, and such variations may be significant to estimated values.
Impairment of Long-Lived Assets
The Company evaluates the recoverability of the recorded amount of long-lived assets, primarily property and equipment and finite-lived intangible assets, whenever events or changes in circumstance indicate that the recorded amount of an asset may not be fully recoverable. An impairment is assessed when the undiscounted expected future cash flows derived from an asset are less than its carrying amount. If an asset is determined to be impaired, the impairment to be recognized is measured as the amount by which the carrying amount of the asset exceeds its fair value. Assets targeted for disposal are reported at the lower of the carrying amount or fair value less cost to sell.
Goodwill and Indefinite-Lived Intangible Assets
Goodwill represents the excess of the total purchase consideration over the fair value of the identifiable assets acquired and liabilities assumed in a business combination. Goodwill is not amortized but is tested for impairment at the reporting unit level annually on December 31 or more frequently if events or changes in circumstances indicate that it is more likely than not to be impaired. These events include: (i) severe adverse industry or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations; (iii) current, historical or projected deterioration of our financial performance; or (iv) a sustained decrease in our market capitalization, as indicated by our publicly quoted share price, below our net book value.
On February 3, 2023, Ambulnz Health, LLC (“Health”), commenced an assignment for the benefit of creditors (“ABC”) pursuant to California law. An ABC is a liquidation process governed by state law (California law in this instance) that is an alternative to a bankruptcy case under federal law. Prior to commencing the ABC, Health ceased business operations and all of its employees were terminated and treated in accordance with California law. In the ABC, all of Health’s assets were transferred to an assignee (the “Assignee”) who acts as a fiduciary for creditors and in a capacity equivalent to that of a bankruptcy trustee. The Assignee is responsible for liquidating the assets. Similar to a bankruptcy case, there is a claims process. Creditors of Health received notice of the ABC and a proof of claim form and were required to submit a proof of claim in order to participate in distribution of net liquidation proceeds by the Assignee.
Based on such filing for Health, the Company impaired the goodwill assigned to that reporting unit as of December 31, 2022 by approximately $5.1 million.
Revenue Recognition
On January 1, 2019, the Company adopted ASC 606, Revenue from Contracts with Customers (“ASC 606”).
To determine revenue recognition for contractual arrangements that the Company determines are within the scope of ASC 606, the Company performs the following five steps: (1) identify each contract with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate the transaction price to performance obligations in the contract; and (5) recognize revenue when (or as) the relevant performance obligation is satisfied. The Company only applies the five-step model to contracts when it is probable that the Company will collect the consideration it is entitled to in exchange for the goods or services the Company provides to the customer.
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The Company generates revenues from the provision of (1) Mobile Health Services and (2) Transportation Services. The customer simultaneously receives and consumes the benefits provided by the Company as the performance obligations are fulfilled; therefore the Company satisfies performance obligations immediately. The Company has utilized the “right to invoice” expedient, which allows an entity to recognize revenue in the amount of consideration to which the entity has the right to invoice when the amount that the Company has the right to invoice corresponds directly to the value transferred to the customer. Revenues are recorded net of an estimated contractual allowances for claims subject to contracts with responsible paying entities. The Company estimates contractual allowances at the time of billing based on contractual terms, historical collections or other arrangements. All transaction prices are fixed and determinable, which includes a fixed base rate, fixed mileage rate and an evaluation of historical collections by each payor.
Income Taxes
Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements or its tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Valuation allowances are provided if based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. The Company recognizes any interest and penalties accrued related to unrecognized tax benefits as income tax expense.
Please see Note 2, “Summary of Significant Accounting Policies” to the Consolidated Financial Statements.
FY 2023 10-K MD&A
SEC filing source: 0001822359-24-000016.
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our Consolidated Financial Statements and the accompanying notes included elsewhere in this Annual Report. The discussion and analysis below contain certain forward-looking statements about our business and operations that are subject to the risks, uncertainties and other factors described in the section entitled “Risk Factors,” included in Part I, Item 1A, and other factors included elsewhere in this Annual Report. These risks, uncertainties and other factors could cause our actual results to differ materially from those expressed in, or implied by, the forward-looking statements. Please refer to the section entitled “Cautionary Note Regarding Forward-Looking Statements.”
Certain figures included in this section, such as interest rates and other percentages, have been rounded for ease of presentation. Percentage figures included in this section have, in some cases, been calculated on the basis of such rounded figures. For this reason, percentage amounts in this section may vary slightly from those obtained by performing the same calculations using the figures in our Consolidated Financial Statements or in the associated text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Overview
DocGo is a mobile healthcare services company that uses proprietary dispatch and communication technology to help provide quality mobile, in-person medical treatment directly to patients in the comfort of their homes, workplaces and other non-traditional locations; and medical transportation in major metropolitan cities in the United States and the United Kingdom.
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The Company derives revenue primarily from two operating segments:
•Mobile Health Services: The services offered by this segment include a wide variety of healthcare services performed at homes, offices and other locations and event services such as on-site healthcare support at sporting events and concerts. This segment also provides total care management solutions to large, typically underserved population groups, primarily through arrangements with municipalities, which include healthcare services as well as ancillary services, such as shelter.
•Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities.
See Item 1, “Business” in this Annual Report for additional information regarding DocGo’s business.
For the year ended December 31, 2023 the Company recorded net income of $10.0 million, compared to net income of $30.7 million and $19.2 million in the years ended December 31, 2022 and 2021, respectively.
Factors Affecting Our Results of Operations
Our operating results and financial performance are influenced by a variety of factors, including, among others, our ability to establish, maintain and grow customer relationships; our ability to execute projects to the satisfaction of our customers; conditions in the healthcare transportation and mobile health services markets; changes in government spending on healthcare and other social services; availability of healthcare professionals and other personnel; changes in the cost of labor; our competitive environment; overall macroeconomic and geopolitical conditions, including rising interest rates, the inflationary environment, the potential recessionary environment, regional conflict and tensions, financial institution instability and the prospect of a shutdown of the U.S. federal government; production schedules of our suppliers; our ability to obtain or maintain operating licenses; and the success of our acquisition strategy. Some of these key factors are briefly discussed below. Future revenue growth and improvement in operating results will be largely contingent on our ability to penetrate new markets and further penetrate existing markets, which is subject to a number of uncertainties, many of which are beyond our control.
Healthcare Services Market
The Mobile Health Services market is dependent on several factors, including increased patient acceptance of services that are provided outside of traditional healthcare facilities, such as in homes, businesses or other designated locations; healthcare coverage of the various Mobile Health Services; and continued desire on the part of government and municipal entities to fund programs to assist currently underserved patient segments via “population health” programs. These programs increased in number, scale and scope since the beginning of the COVID-19 pandemic. While COVID-19 testing and vaccination programs have been dramatically scaled back from their levels at the pandemic’s peak, there have been expansions of these population health programs into other areas, such as the provision of healthcare and related services to recent migrants and asylum seekers.
The Transportation Services market is highly dependent on patients requiring transportation after surgeries and other medical procedures and treatments. The Company primarily focuses on the non-emergency medical transport market, which includes services that are provided to patients who need assistance getting to and from medical appointments. Key drivers of this market are the increase in chronic conditions and the number of elective surgeries as well as the ongoing aging of the population, as older demographics tend to be much more frequent consumers of medical transportation services. The market will also grow if hospitals and other healthcare facilities continue to outsource more of their transportation needs to independent providers, such as the Company, allowing these facilities to concentrate their efforts on their core competencies.
Overall Economic Conditions in the Markets in Which We Operate
Economic changes, both nationally and locally, in our markets impact our financial performance. Unfavorable changes in demographics, healthcare coverage of Mobile Health Services and Transportation Services, interest rates, inflation rates, ambulance manufacturing, a weakening of the national economy or of any regional or local economy in which we operate and other factors beyond our control could adversely affect our business.
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Our Ability to Control Expenses
We pay close attention to the management of our working capital and operating expenses. Some of our most significant operating expenses are labor costs, medical supplies and vehicle-related costs, such as fuel, maintenance, repair and insurance. Insurance costs include premiums paid for coverage as well as reserves for estimated losses within the Company’s insurance policy deductibles. We employ our proprietary technology to help drive improvements in productivity per transport and per shift. We regularly analyze our workforce productivity to help achieve the optimum, cost-efficient labor mix for our locations. This involves managing the mix of Company-employed labor and subcontracted labor as well as full-time and part-time employees.
Inflation
The inflation rate in the United States, as measured by the Consumer Price Index, has generally trended up since early 2021. This data is reported monthly, showing year-over-year changes in prices across a basket of goods and services. Though the annual inflation rate declined to 4.1% for the full year 2023 from 8.0% in 2022, it remains above historical averages. The increased inflation rate has had an impact on the Company’s expenses in several areas, including wages, fuel and medical and other supplies. This has had the effect of compressing gross profit margins, as the Company is generally unable to pass these higher costs on to its customers, particularly in the short term. In a continued attempt to dampen inflation, the U.S. Federal Reserve implemented four interest rate hikes in 2023, raising its benchmark rate to the current level of 5.25-5.50% as of the date of this Annual Report. Looking into 2024, we anticipate a continued moderation of the inflation rate as a result of these recent interest rate increases, with an annual rate similar to those witnessed in the 2010-2020 period, when the annual inflation rate ranged from 0.1% to 3.2%. If inflation is above the levels that the Company anticipates, gross margins could be below plan and our business, operating results and cash flows may be adversely affected.
Trip Volumes and Average Trip Price
A “trip” is defined as an instance where the Company completes the transportation of a patient to a specific destination, for which we are able to charge a fee. This metric does not include instances where a trip is ordered and subsequently either canceled (by the customer) or declined (by the Company). As trip volume represents the most basic unit of transportation service provided by the Company, the Company believes it is a good measure of the level of demand for the Company’s Transportation Services and is used by management to monitor and manage the scale of the business.
The average trip price is calculated by dividing the aggregate revenue from the total number of trips by the total number of trips and is an important indicator of the effective rate at which the Company is being compensated for its provision of Transportation Services.
Revenues generated from programs under which the Company is paid a fixed hourly or daily rate for the use of a fully staffed and equipped ambulance do not factor in the trip counts or average trip prices mentioned above. We expect these fixed rate, “leased hour” programs to continue to account for an increasing proportion of the Transportation Services segment’s revenues in the future.
Acquisitions
Historically, we have pursued an acquisition strategy to obtain enhanced capabilities or licenses to offer Mobile Health Services or Transportation Services. Future acquisitions may also include companies that may help drive revenue, profitability, cash flow and stockholder value.
During the year ended December 31, 2023, we completed three acquisitions for an aggregate purchase price of $34.2 million. During the year ended December 31, 2022, we completed five acquisitions for a purchase price of $69.1 million. During the year ended December 31, 2021, we completed one acquisition for a purchase price of $2.3 million.
Investing in R&D and Enhancing our Customer Experience
Our performance is dependent on the investments we make in research and development (“R&D”), including our ability to attract and retain highly skilled R&D personnel. We intend to develop and introduce innovative new software services, integrations with third-party products and services, mobile applications and other new offerings. If we fail to innovate and enhance our brand and our products, our market position and revenue may be adversely affected.
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Regulatory Environment
The Company is subject to federal, state and local regulations, including healthcare and emergency medical services laws and regulations and tax laws and regulations. The Company’s current business plan assumes no material change in these laws and regulations. In the event that any such change occurs, compliance with new laws and regulations may significantly affect the Company’s operations and cost of doing business.
COVID-19
The spread of COVID-19 and the related shutdowns and restrictions had a mixed impact on the Company’s business. In the ambulance transportation business, which predominantly comprises non-emergency medical transportation, the Company initially saw a decline in volumes from historical and expected levels, as elective surgeries and other procedures were postponed. In some of the Company’s larger markets, such as New York and California, there were declines in trip volume. In addition, the Company experienced lost revenues associated with sporting, concerts and other events, as those events were cancelled or significantly restricted (or entirely eliminated) the number of permitted attendees. Ambulance transports and event-related revenues have both since recovered to pre-COVID levels or higher.
There were two areas in which the Company initially experienced positive business impacts from COVID-19. In April and May 2020, the Company participated in an emergency project with FEMA in the New York City area. This engagement resulted in incremental transportation revenue. In addition, in response to the need for widespread COVID-19 testing, EMTs and paramedics, the Company formed a new subsidiary, Rapid Reliable Testing, LLC (“RRT”), with the goal of performing COVID-19 tests at nursing homes, municipal sites, businesses, schools and other venues. RRT is part of the Mobile Health Services segment. As COVID-19 testing activity slowed and accounted for a more minor portion of the Company’s revenues, RRT expanded its services beyond COVID-19 testing to a wide variety of tests, vaccinations and other procedures. The Company estimates that during 2023, its revenue from COVID-19 related services accounted for less than 1% of total revenues, compared to about 17% in 2022 and nearly 35% in 2021.
The Company’s current business plan assumes increased demand for Mobile Health Services, a demand that was accelerated by the pandemic, but which is also being driven by longer-term factors, such as the increasing desire on the part of patients to receive treatments outside of traditional settings, such as doctor’s offices and hospitals.
Components of Results of Operations
Our business consists of three reportable segments — Mobile Health Services, Transportation Services and Corporate. All revenue and cost of goods sold are contained within the Mobile Health Services and Transportation Services segments. Accordingly, revenues and cost of goods sold are discussed below on a consolidated level and are also broken down between Mobile Health Services and Transportation Services. Operating expenses are discussed on a consolidated level and broken down among all three segments. The Company evaluates the performance of each of its segments based primarily on its results of operations. Accordingly, other income and expenses not included in results of operations are only included in the discussion of consolidated results of operations.
Revenue
The Company’s revenue consists of services provided by its Mobile Health Services segment and its Transportation Services segment.
Cost of Revenues
Cost of revenues consists primarily of revenue generating wages paid to employees, fees to paid to subcontractors, medical supplies, vehicle insurance costs (including insurance premiums and costs incurred under the insurance deductibles), maintenance, fuel and facility rent. We expect cost of revenues to continue to rise as we grow our business.
Operating Expenses
General and Administrative Expenses
General and administrative expenses consist primarily of salaries, bad debt expense, insurance expense, consultant fees and professional fees for accounting services. We expect our general and administrative expenses to increase as we continue to scale our business and grow headcount and as a result of operating as a public company, including our
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compliance with SEC rules and regulations, audit activities, additional insurance expenses, investor relations activities and other administrative and professional services.
Depreciation and Amortization
The Company depreciates its assets using the straight-line method over the estimated useful lives of the respective assets. Amortization of intangibles consists of amortization of definite-lived intangible assets over their respective useful lives.
Legal and Regulatory Expenses
Legal and regulatory expenses include legal fees, consulting fees related to healthcare compliance and legal settlements.
Technology and Development Expenses
Technology and development expenses consists primarily of costs incurred in the design and development of the Company’s proprietary technology, third-party software and technologies. We expect technology and development expenses to increase in future periods to support our growth, including our intent to continue investing in the optimization, accuracy and reliability of our dispatch and communication platform and drive efficiency in our operations. These expenses may vary from period to period as a percentage of revenues, depending primarily upon when we choose to make more significant investments, particularly when entering new business lines or customer sales channels.
Sales, Advertising and Marketing Expenses
Our sales, advertising and marketing expenses consist of costs directly associated with our sales and marketing activities, which primarily include sales commissions, marketing programs, trade shows, promotional materials and general branding. We expect our sales, advertising and marketing expenses to continue to increase over time as we increase our marketing activities, grow our domestic and international operations and continue to build brand awareness.
Interest Expense
Interest expense consists primarily of interest on our outstanding borrowings under our outstanding notes payable and financing obligations, including our Revolving Facility.
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Results of Operations
Comparison of Fiscal 2023 with Fiscal 2022
| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2023 | 2022 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 624.3 | 100.0 | % | $ | 440.5 | 100.0 | % | $ | 183.8 | 41.7 | % | ||||||||
| Cost of revenues | 428.9 | 68.7 | % | 285.8 | 64.9 | % | 143.1 | 50.1 | % | |||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 137.2 | 22.0 | % | 103.4 | 23.5 | % | 33.8 | 32.7 | % | |||||||||||
| Depreciation and amortization | 16.4 | 2.6 | % | 10.6 | 2.4 | % | 5.8 | 54.7 | % | |||||||||||
| Legal and regulatory | 13.1 | 2.1 | % | 8.8 | 2.0 | % | 4.3 | 48.9 | % | |||||||||||
| Technology and development | 10.9 | 1.7 | % | 5.4 | 1.2 | % | 5.5 | 101.9 | % | |||||||||||
| Sales, advertising and marketing | 2.8 | 0.4 | % | 4.7 | 1.1 | % | (1.9) | (40.4 | %) | |||||||||||
| Total expenses | 609.2 | 97.6 | % | 418.7 | 95.1 | % | 190.5 | 45.5 | % | |||||||||||
| Income from operations | 15.1 | 2.4 | % | 21.8 | 4.9 | % | (6.7) | |||||||||||||
| Other income: | ||||||||||||||||||||
| Interest income (expense), net | 1.7 | 0.3 | % | 0.8 | 0.2 | % | 0.9 | 112.5 | % | |||||||||||
| Gain on remeasurement of warrant liabilities | — | — | % | 1.1 | 0.3 | % | (1.1) | |||||||||||||
| Change in fair value of contingent liability | 1.4 | 0.2 | % | — | — | % | 1.4 | |||||||||||||
| (Loss) on equity method investments | (0.3) | (0.1) | % | — | — | % | (0.3) | |||||||||||||
| Gain on remeasurement of finance leases | — | — | % | 1.4 | 0.3 | % | (1.4) | |||||||||||||
| Gain on bargain purchase | — | — | % | 1.6 | 0.4 | % | (1.6) | |||||||||||||
| Loss on disposal of fixed assets | (0.9) | (0.1) | % | — | — | % | (0.9) | |||||||||||||
| Goodwill impairment | — | — | % | (2.9) | (0.7) | % | 2.9 | |||||||||||||
| Other expense | (0.7) | (0.1) | % | (1.0) | (0.2) | % | 0.3 | |||||||||||||
| Total other income | 1.2 | 0.2 | % | 1.0 | 0.2 | % | 0.2 | 20.0 | % | |||||||||||
| Net income before (provision for) benefit from income tax | 16.3 | 2.6 | % | 22.8 | 5.2 | % | (6.5) | |||||||||||||
| (Provision for) benefit from income taxes | (6.2) | (1.0) | % | 7.9 | 1.8 | % | (14.1) | |||||||||||||
| Net income | 10.0 | 1.6 | % | 30.7 | 7.0 | % | (20.7) | |||||||||||||
| Net income (loss) attributable to noncontrolling interests | 3.2 | 0.5 | % | (3.9) | (0.9) | % | 7.1 | 182.1 | % | |||||||||||
| Net income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | 6.9 | 1.1 | % | $ | 34.6 | 7.9 | % | $ | (27.7) |
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Revenues
Consolidated
For the year ended December 31, 2023, total revenues were $624.3 million, an increase of $183.8 million, or 41.7%, from the total revenues recorded for the year ended December 31, 2022.
Mobile Health Services
For the year ended December 31, 2023, Mobile Health Services revenues were $442.8 million, an increase of $116.9 million, or 35.9%, as compared with the year ended December 31, 2022. The increase in revenues was primarily due to an expansion in services offered by the Mobile Health Services segment, particularly in the government customer sector. This expansion accelerated during the year ended December 31, 2023 as the Company extended several large customer contracts and introduced a broader range of services.
Transportation Services
For the year ended December 31, 2023, Transportation Services revenues were $181.5 million, an increase of $66.9 million, or 58.3%, as compared with the year ended December 31, 2022. This increase was due to a 15.8% increase in trip volumes, from 216,009 trips for the year ended December 31, 2022 to 250,114 trips for the year ended December 31, 2023. The increase in trip volumes was due to a combination of growth in the Company’s customer base in certain core markets and acquisitions made during the second half of 2022. Our average trip price increased from $380 in the year ended December 31, 2022 to $407 in the year ended December 31, 2023. The increase in the average trip price in 2023 reflected a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports resulting in higher prices per trip. The average trip price also benefited from an 8.7% increase in the average Medicare reimbursement rate for ambulance transports. The Medicare ambulance fee schedule has increased by a further 2.4%, effective January 1, 2024.
Cost of Revenues
For the year ended December 31, 2023, total cost of revenues (exclusive of depreciation and amortization) increased by 50.1% compared to the year ended December 31, 2022, while revenues increased by approximately 41.7%. Cost of revenues as a percentage of revenues increased to 68.7% in the year ended December 31, 2023 from 64.9% in the year ended December 31, 2022.
Total cost of revenues in the year ended December 31, 2023 increased by $143.1 million compared to the same period in 2022. This increase was primarily attributable to a $44.0 million increase in total compensation, due to higher headcount for both the Transportation Services and Mobile Health Services segments; an $80.2 million increase in subcontracted labor costs, primarily driven by new projects in the Mobile Health Services segment that required a greater number of personnel and certain more highly specialized personnel than the Company was able to initially provide through its existing staff; a $19.6 million increase in medical and related supplies; a $2.1 million increase in travel costs for field personnel and other clinicians who traveled out of their home regions to provide Mobile Health Services; and a $1.6 million net increase in other cost of revenues categories. These items were partially offset by a $2.3 million decline in vehicle costs, as the Company exited certain rental agreements, and a $2.1 million reduction in lab fees, as COVID testing services declined to an immaterial amount in 2023.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2023 amounted to $306.2 million, up 53.7% from $199.2 million in the year ended December 31, 2022. Cost of revenues as a percentage of revenues increased to 69.1% from 61.1% in the prior year period, despite a significant increase in revenues, reflecting higher compensation expenses as a result of headcount growth, significantly higher subcontracted labor costs and increased costs for medical supplies.
For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2023 amounted to $122.7 million, up 41.8% from $86.5 million in the year ended December 31, 2022. Cost of revenues as a percentage of revenues decreased to 67.6% from 75.5% in the prior year, reflecting the impact of higher per-trip prices, increased revenues from standby contracts (for which we are paid a daily or hourly rate) and the overall increase in revenues, as well as a decline in the average fuel price.
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Operating Expenses
For the year ended December 31, 2023, operating expenses were $180.3 million compared to $132.9 million for the year ended December 31, 2022, an increase of $47.4 million, or 35.7%. As a percentage of revenues, operating expenses decreased from 30.2% in 2022 to 28.9% in 2023, even as the Company added to its management infrastructure and total compensation increased, due to the significant increase in overall revenues described above. The increase of $47.4 million related primarily to a $27.1 million increase in total compensation, which included costs for both directly employed and subcontracted staff due to investments in and expansion of corporate infrastructure to support the revenue growth, as well as an increase in stock-based compensation expense; a $5.7 million increase in depreciation and amortization due to an increase in assets to support revenue growth and capitalized software amortization, as well as recently acquired companies; a $4.9 million increase in IT infrastructure, driven by the Company’s business and headcount expansion; a $2.5 million increase in insurance costs, reflecting higher headcount, a larger vehicle fleet and expanded operations; a $1.3 million increase in rent and utilities relating to the Company’s ongoing geographic expansion; and a $5.9 million net increase across a variety of expense categories.
For the Mobile Health Services segment, operating expenses in the year ended December 31, 2023 were $56.3 million, up from $33.9 million in the year ended December 31, 2022. Operating expenses as a percentage of revenues increased to 12.7% from 10.4% in 2022, despite the increase in Mobile Health Services revenues, reflecting significant expenditures that were made in 2023 related to the expansion of services and geographic areas of operation, as well as the continued buildout of the Mobile Health Services management infrastructure and the costs of developing the Company’s “on-demand” direct-to-consumer offering.
For the Transportation Services segment, operating expenses in the year ended December 31, 2023 were $55.2 million, compared to $43.0 million in the year ended December 31, 2022. The increase in operating expenses for this segment, in absolute dollar terms, was driven primarily by higher compensation expense and depreciation charges, reflecting the expansion of the business, including recent acquisitions. Operating expenses as a percentage of revenues decreased to 30.4% for the year ended December 31, 2023 from 37.5% in the year ended December 31, 2022.
For the Corporate segment, which represents primarily shared services that are not contained within the entities included in either the Mobile Health Services or Transportation Services segments, operating expenses in the year ended December 31, 2023 were $68.8 million, compared to $55.1 million in the year ended December 31, 2022. The increase in operating expenses for this segment, in absolute dollar terms, was primarily driven by higher compensation expenses, reflecting the ongoing build-out of the Company’s corporate human resources infrastructure. Corporate expenses amounted to approximately 11.0% of total consolidated revenues in 2023, compared to 12.5% in 2022, reflecting the significant increase in total consolidated revenues.
Interest Income, Net
For the year ended December 31, 2023, the Company recorded approximately $1.7 million of interest income, net compared to $0.8 million of interest income, net in the year ended December 31, 2022. This increase was primarily due to higher rates of interest earned on balances in the Company's interest-bearing accounts in the year ended December 31, 2023, which reflected significantly higher market interest rates. The higher rates of interest earned outweighed the impact of the lower average cash balances in 2023.
Gain on Remeasurement of Warrant Liabilities
During the year ended December 31, 2023, there were no gains or losses recorded relating to remeasurement of warrant liabilities, as all warrants were redeemed during the third quarter of 2022. During the year ended December 31, 2022, the Company recorded a gain of approximately $1.1 million from the remeasurement of warrant liabilities. The warrants were marked-to-market in each reporting period, and this gain reflected the decline in the Company’s stock price relative to the beginning of the period.
Change in Fair Value of Contingent Liability
During the year ended December 31, 2023, the Company recorded a change in fair value of contingent liability of approximately $1.4 million, reflecting a decline in the anticipated payments to be made for a recent acquisition, based upon
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performance compared to certain targets. There was no related change in fair value recorded in the year ended December 31, 2022.
(Loss) Gain on Equity Method Investments
During the year ended December 31, 2023, the Company recorded a loss on equity method investments of approximately $0.3 million representing its share of the losses incurred by an entity in which the Company has a minority interest. During the year ended December 31, 2022, the Company recorded a gain on equity method investments of $8,919.
Gain on Remeasurement of Finance Leases
During the year ended December 31, 2023, there were no gains or losses recorded relating to remeasurement of finance leases. During the year ended December 31, 2022, the Company recorded a gain on remeasurement of finance leases of $1.4 million.
Gain on Bargain Purchase
During the year ended December 31, 2023, the Company recorded no gain or loss on bargain purchase. During the year ended December 31, 2022, the Company recorded a gain on bargain purchase of $1.6 million.
Loss on Disposal of Fixed Assets
During the year ended December 31, 2023, the Company recorded a loss on disposal of fixed assets of $0.9 million, compared to a loss on disposal of fixed assets of $21,000 during the year ended December 31, 2022.
Goodwill Impairment
During the year ended December 31, 2023, the Company did not record any impairment to goodwill. During the year ended December 31, 2022, the Company recorded a goodwill impairment of $2.9 million, relating to the Company’s exit from the medical transportation market in California.
(Provision for) Benefit from Income Taxes
During the year ended December 31, 2023, the Company recorded a provision for income taxes of $6.2 million compared to an income tax benefit of $7.9 million in the year ended December 31, 2022. The tax benefit in 2022 was due to the release of the valuation allowance recorded in previous years for net operating losses, as the Company determined that it was more likely than not that it would be able to realize its net operating loss carryforwards in the future.
Net Income (Loss) Attributable to Noncontrolling Interests
For the year ended December 31, 2023, the Company had net income attributable to noncontrolling interests of approximately $3.2 million compared to a net loss attributable to noncontrolling interests of $3.9 million for the year ended December 31, 2022. The income compared to the prior year period loss reflected improved performance in the Company’s joint venture markets in the year ended December 31, 2023.
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Comparison of Fiscal 2022 with Fiscal 2021
| Year Ended December 31, | Change $ | Change % | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2022 | 2021 | ||||||||||||||||||
| Actual Results | % of Total Revenue | Actual Results | % of Total Revenue | |||||||||||||||||
| Revenues, net | $ | 440.5 | 100.0 | % | $ | 318.7 | 100.0 | % | $ | 121.8 | 38.2 | % | ||||||||
| Cost of revenues | 285.8 | 64.9 | % | 209.0 | 65.6 | % | $ | 76.8 | 36.8 | % | ||||||||||
| Operating expenses: | ||||||||||||||||||||
| General and administrative | 103.4 | 23.5 | % | 74.9 | 23.5 | % | $ | 28.5 | 38.1 | % | ||||||||||
| Depreciation and amortization | 10.6 | 2.4 | % | 7.5 | 2.4 | % | $ | 3.1 | 40.7 | % | ||||||||||
| Legal and regulatory | 8.8 | 2.0 | % | 3.9 | 1.2 | % | $ | 4.9 | 125.6 | % | ||||||||||
| Technology and development | 5.4 | 1.2 | % | 3.3 | 1.0 | % | $ | 2.1 | 63.6 | % | ||||||||||
| Sales, advertising and marketing | 4.7 | 1.1 | % | 4.8 | 1.5 | % | $ | (0.1) | (2.4 | %) | ||||||||||
| Total expenses | 418.7 | 95.1 | % | 303.4 | 95.2 | % | $ | 115.3 | 38.0 | % | ||||||||||
| Income from operations | 21.8 | 4.9 | % | 15.4 | 4.8 | % | $ | 6.5 | ||||||||||||
| Other income: | ||||||||||||||||||||
| Interest income (expense), net | 0.8 | 0.2 | % | (0.8) | (0.2) | % | $ | 1.6 | 200.0 | % | ||||||||||
| Gain on remeasurement of warrant liabilities | 1.1 | 0.3 | % | 5.2 | 1.6 | % | $ | (4.1) | ||||||||||||
| Change in fair value of contingent liability | — | — | % | — | — | % | $ | — | ||||||||||||
| (Loss) on equity method investments | — | — | % | (0.1) | — | % | $ | 0.1 | ||||||||||||
| Gain on remeasurement of finance leases | 1.4 | 0.3 | % | — | — | % | $ | 1.4 | ||||||||||||
| Gain on bargain purchase | 1.6 | 0.4 | % | — | — | % | $ | 1.6 | ||||||||||||
| Gain from PPP loan forgiveness | — | — | % | 0.1 | — | % | $ | (0.1) | ||||||||||||
| (Loss) on disposal of fixed assets | — | — | % | — | — | % | $ | — | ||||||||||||
| Goodwill impairment | (2.9) | (0.7) | % | — | — | % | $ | (2.9) | ||||||||||||
| Other expense | (1.0) | (0.2) | % | — | — | % | $ | (1.0) | ||||||||||||
| Total other income | 1.0 | 0.2 | % | 4.4 | 1.4 | % | $ | (3.4) | (77.3 | %) | ||||||||||
| Net income before benefit from (provision for) income tax | 22.8 | 5.2 | % | 19.8 | 6.2 | % | $ | 3.0 | ||||||||||||
| Benefit from (provision for) income tax | 7.9 | 1.8 | % | (0.6) | (0.2) | % | $ | 8.5 | ||||||||||||
| Net income | 30.7 | 7.0 | % | 19.2 | 6.0 | % | $ | 11.5 | ||||||||||||
| Net (loss) attributable to noncontrolling interests | (3.9) | (0.9) | % | (4.5) | (1.4) | % | $ | 0.6 | 13.3 | % | ||||||||||
| Net income attributable to stockholders of DocGo Inc. and Subsidiaries | $ | 34.6 | 7.9 | % | $ | 23.7 | 7.4 | % | $ | 10.9 |
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Revenues
Consolidated
For the year ended December 31, 2022, total revenues were $440.5 million, an increase of $121.8 million, or 38%, from the total revenues recorded in the year ended December 31, 2021.
Mobile Health Services
For the year ended December 31, 2022, Mobile Health Services revenues were $325.9 million, an increase of $91.4 million, or 39%, as compared with the year ended December 31, 2021. This increase was primarily due to the expansion of the services offered by this segment, particularly with respect to testing, vaccination and other healthcare services revenues. This expansion accelerated through 2021 and into 2022 as the Company increased its customer base, primarily in the municipal customer segment, and its geographic reach, while extending the terms of and/or expanding the scope of several large customer contracts and introducing a broader range of services. Compared to the prior year, 2022 featured significantly lower COVID-19 testing revenue, which was outweighed by the substantial increase in other Mobile Health Services, as the Mobile Health Services segment transitioned away from its dependence on COVID-19 related revenue. COVID-19 testing continued to be a significant driver of Mobile Health Services revenues in the first half of 2022, but dropped sharply in the third quarter of the year, and represented an insignificant proportion of total revenues in the fourth quarter.
Transportation Services
For the year ended December 31, 2022, Transportation Services revenues were $114.6 million, an increase of $30.3 million, or 36%, as compared with the year ended December 31, 2021. This increase was due to a 20% increase in trip volumes, from 180,753 trips for the year ended December 31, 2021 to 216,009 trips for the year ended December 31, 2022. The increase in trip volumes was due to a combination of growth in the customer base in certain core markets, entry into new markets in 2021 and early 2022 and acquisitions made during the second half of 2022. Our average trip price increased from $301 in the year ended December 31, 2021 to $380 in the year ended December 31, 2022. The increase in the average trip price in 2022 reflected a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity transports resulting in higher prices per trip. The average trip price also benefited from a 5.1% increase in the average Medicare reimbursement rate for ambulance transports.
Cost of Revenues
For the year ended December 31, 2022, total cost of revenues (exclusive of depreciation and amortization) increased by 37%, as compared to the year ended December 31, 2021, while revenues increased by approximately 38%. Cost of revenues as a percentage of revenues decreased to 64.9% in 2022 from 65.5% in 2021.
In absolute dollar terms, cost of revenues in the year ended December 31, 2022 increased by $76.8 million from the levels of the year ended December 31, 2021. This was primarily attributable to a $64.9 million increase in total compensation, due to higher headcount for both the Transportation Services and Mobile Health Services segments; a $16.0 million increase in subcontracted labor, driven mostly by the Mobile Health Services segment, where the Company did not have sufficient personnel to staff the initial phases of large new projects; $13.6 million increase in vehicle costs, driven by a continued increase in the Company’s vehicle fleet and higher fuel and maintenance costs, as well as costs incurred to rent vehicles to provide Mobile Health Services; a $2.1 million increase in travel costs, due to field personnel and other clinicians who traveled out of their home regions to provide Mobile Health Services; a $0.4 million increase in facilities and related costs; and approximately $2.6 million in increases across a variety of other cost of revenues categories relating to the Company’s increased scale and geographic presence. These items were partially offset by a $21.1 million decrease in lab fees related to COVID-19 testing activity, reflecting sharply lower COVID-19 testing activity in the second half of 2022, lower per-test lab fees and a shift toward rapid tests; and a $1.8 million decline in medical supplies, reflecting a decline in COVID-19 testing activity and improved sourcing of various supplies.
For the Mobile Health Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2022 amounted to $199.2 million, compared to $145.2 million in the year ended December 31, 2021. Cost of revenues as a percentage of revenues decreased slightly to 61.1% from 61.9%, due to the increase in revenues and
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the continued shift away from higher-cost subcontracted labor toward Company personnel during 2022, which was partially offset by higher compensation costs associated with some of the Company’s newer projects.
For the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2022 was $86.5 million, an increase of $23.1 million, or 36%, from the year ended December 31, 2021. Cost of revenues as a percentage of revenues were essentially unchanged, at 75.5% in 2022 compared to 75.3% in 2021. Increased volumes and higher average trip prices, as described above, combined with lower average hourly wages, as recent market wage pressures began to subside and the Company more effectively managed its staff to reduce overtime hours for field employees, to offset the effects of increased fuel costs. Fuel prices moderated somewhat during the third quarter and in the fourth quarters of 2022, but the full-year average fuel price for 2022 was approximately 29% above the full-year average for 2021. We anticipated that fuel prices would remain at elevated levels for 2023, but we expected that the full-year average for 2023 would be lower than it was in 2022.
Operating Expenses
For the year ended December 31, 2022, operating expenses were $132.9 million compared to $94.4 million for the year ended December 31, 2021, an increase of 41%. As a percentage of revenues, operating expenses increased slightly, from 29.6% in 2021 to 30.2% in 2022, despite the significant increase in overall revenues described above, as the Company continued to add to its management infrastructure and incurred a full year’s worth of expenses relating to its status as a public company. The increase of $38.3 million related primarily to a $20.1 million increase in total compensation, which includes salaries, benefits, bonuses and commissions for both direct and subcontracted labor, reflecting higher headcount driven by the Company’s overall growth and expansion; a $7.1 million increase in legal, accounting and other professional fees related to increased revenues and related contract generation and SEC filing-related costs; a $2.8 million increase in insurance costs reflecting the growth and expansion of the Company, as well as the addition of directors and officers (D&O) insurance in 2022; a $3.2 million increase in depreciation and amortization charges due to an increase in assets to support revenue growth and capitalized software amortization, including from recently acquired companies; a $2.3 million increase in rent utility expenses due to the Company’s ongoing growth and geographic expansion; a $2.9 million increase in IT infrastructure, driven by the Company’s business and headcount expansion; and a $0.6 million increase in marketing expenses, driven in part by expenditures made to develop and expand the Company’s direct-to-consumer offering and other Mobile Health Services. These items were partially offset by a $0.7 million decline witnessed across several operating expense categories, such as travel, commissions and general office expenses.
For the Mobile Health Services segment, operating expenses in the year ended December 31, 2022 were $58.0 million, up 25% from operating expenses of $46.3 million in the year ended December 31, 2021. Operating expenses as a percentage of revenues decreased to 17.8% from 19.8% in 2021, due to the increase in Mobile Health Services revenues, which outweighed the effect of the significant expenditures that were made in 2022 in the expansion of services and geographic areas of operation, as well as the continued buildout of the Mobile Health Services management infrastructure and the costs of developing the Company’s “on-demand” direct-to-consumer offering.
For the Transportation Services segment, operating expenses in the year ended December 31, 2022 were $74.0 million, up $26.6 million, or 56%, from the year ended December 31, 2021. Operating expenses as a percentage of revenues increased to 64.6% from 56.3% in 2021, despite the increase in revenues, primarily due to increases in the Company’s corporate overhead expenditures, as described above, as these expenses were allocated to the Transportation Services segment for purposes of segment reporting. Operating expenses for the Transportation Services segment were also driven higher by the inclusion of the acquisitions the Company made in the second half of 2022.
Interest Income (Expense), Net
For the year ended December 31, 2022, the Company recorded $0.8 million of interest income, net compared to $0.8 million of interest expense, net in the year ended December 31, 2021. This was due to a significantly higher amount of interest earned during 2022, resulting from an increase in the Company’s cash balances in income-bearing accounts, coupled with higher rates of interest earned on balances in these accounts, which reflected significantly higher market interest rates.
Gain on Remeasurement of Warrant Liabilities
During the year ended December 31, 2022, the Company recorded a net gain of approximately $1.1 million from the remeasurement of warrant liabilities. The warrants were marked-to-market in each reporting period, and this gain
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reflected the decrease in DocGo’s stock price relative to the beginning of the period. During the year ended December 31, 2021, the Company recorded a net gain of $5.2 million on the remeasurement of warrant liabilities. On August 15, 2022, the Company announced the redemption of all of its outstanding warrants under the Warrant Agreement, dated as of October 14, 2020, by and between the Company and Continental Stock Transfer & Trust Company, as warrant agent, on the redemption date of September 16, 2022 (the “Redemption Date”). Warrants surrendered for exercise on a cashless basis resulted in the issuance of 1,406,371 shares of Common Stock. A total of 68,514 warrants were not surrendered on the Redemption Date and were redeemed for $0.10 per warrant.
Gain on Equity Method Investments
During the year ended December 31, 2022, the Company recorded a gain on equity method investments of $8,919, representing its share of the losses incurred by an entity in which the Company has a minority interest, which is accounted for under the equity method. This investment was made in the fourth quarter of 2021, during which period a loss of $66,818 was recorded in relation to this equity method investment.
Gain on Bargain Purchase
During the year ended December 31, 2022, the Company recorded a gain on bargain purchase of approximately $1.6 million in relation to an acquisition made during the fourth quarter of the year, wherein the tangible net asset value of the acquired entity exceeded the purchase price. No such gain or loss was recorded during the same period in 2021.
Gain on Remeasurement of Finance Leases
During the year ended December 31, 2022, the Company recorded a gain on remeasurement of finance leases of approximately $1.4 million, resulting from a change in estimated remaining liabilities under the terms of its leases. No such gain or loss was recorded in the same period in 2021.
Gain from PPP Loan Forgiveness
In 2021, the Company recorded a $0.1 million gain due to the forgiveness of a loan that one of its subsidiaries had obtained via the government’s Paycheck Protection Program (“PPP”) in 2020. No gain from loan forgiveness was recorded during the year ended December 31, 2022.
Benefit From (Provision For) Income Taxes
During the year ended December 31, 2022, the Company recorded a benefit from income taxes of $7.9 million compared to a provision for income taxes of $0.6 million in the year ended December 31, 2021. The tax benefit in 2022 was due to the release of the valuation allowance recorded in previous years for net operating losses, as the Company determined that it was more likely than not that it would be able to realize its net operating loss carryforwards in the future.
Net Loss Attributable to Noncontrolling Interests
For the year ended December 31, 2022, the Company had a net loss attributable to noncontrolling interests of approximately $3.8 million compared to a net loss attributable to noncontrolling interests of $4.6 million for the year ended December 31, 2021. For both periods, the loss reflected ongoing investments in new markets that were entered into during 2021 and 2022, partially offset by income generated by those markets.
Liquidity and Capital Resources
Between the inception of DocGo’s wholly owned subsidiary Ambulnz and the Business Combination, Ambulnz completed three equity financing transactions as its principal source of liquidity. In November 2021, upon the completion of the Business Combination and the PIPE Financing, the Company received proceeds of approximately $158.1 million, net of transaction expenses. Generally, the Company has utilized proceeds from the equity financing transactions and the Business Combination to finance operations, invest in assets, make acquisitions and fund accounts receivable. The Company has also funded these activities through operating cash flows. Despite the fact that the Company generated positive net income for the year ended December 31, 2023, operating cash flows are not always sufficient to meet immediate obligations arising from current operations. For example, as the business has grown, the Company’s expenditures for human capital and supplies has expanded accordingly, and the timing of the payments for payroll and to associated vendors, compared to the timing of receipts of cash from customers, frequently results in the need to use existing
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cash balances to fund working capital needs. During the year ended December 31, 2023, as a greater proportion of the Company’s overall revenues were generated through services provided to municipal customers with long payment cycles, and expenditures made by the Company to allow for the provision of these services were substantial, operating cash flows were not sufficient to meet these demands for working capital, leading to a marked decline in the Company’s cash balances. As these invoices are collected, the Company expects cash flows to be sufficient for near term working capital needs.
The Company’s future working capital needs depend on many factors, including the overall growth of the Company and the various payment terms that are negotiated with customers and vendors. The Company’s future capital requirements depend on many factors, including potential acquisitions, the Company’s level of investment in technology and ongoing technology development, and rate of growth in existing markets and into new markets. Capital requirements might also be affected by factors outside of the Company’s control, such as interest rates, rising inflation and other monetary and fiscal policy changes to the manner in which the Company currently operates. If the Company’s growth rate is higher than is currently anticipated, resulting in greater-than-anticipated capital requirements, the Company might need to, or choose to, raise additional capital through debt or equity financings. This last factor was evident during the second half of 2023, leading to a draw down in the Company’s credit line during the fourth quarter of 2023 and the first quarter of 2024, as described below.
On November 1, 2022, the Company entered into the Credit Agreement, which provides for the Revolving Facility in the initial aggregate principal amount of $90 million. The Revolving Facility includes the ability for the Company to request an increase to the commitment by an additional amount of up to $50 million, though no lender (nor the lenders collectively) is obligated to increase its respective commitments. Borrowings under the Revolving Facility bear interest at a per annum rate equal to (i) at the Company’s option, (x) the base rate or (y) the adjusted term SOFR rate, plus (ii) the applicable margin. The applicable margins are based on the Company’s consolidated net leverage ratio, adjusted on a quarterly basis. The initial applicable margins were 1.25% for an adjusted term SOFR loan and 0.25% for a base rate loan and are updated based on the Company’s consolidated net leverage ratio. The Revolving Facility matures on November 1, 2027 and is secured by a first-priority lien on substantially all of the Company’s present and future personal assets and intangible assets. The Revolving Facility is subject to certain financial covenants, such as a net leverage ratio and interest coverage ratio, as defined in the Credit Agreement. On October 19, 2023, the Company drew down $25 million under the Revolving Facility, which amount remained outstanding as of December 31, 2023. In February 2024, the Company repaid all amounts outstanding under the Revolving Facility, and no amounts are outstanding as of the date of this Annual Report.
Considering the foregoing, DocGo anticipates that its existing balances of cash and cash equivalents, future expected cash flows generated from its operations and its available line of credit under the Revolving Facility will be sufficient to satisfy operating requirements for at least the next twelve months. Looking beyond the next twelve months, DocGo anticipates that expected future cash flows, its available line of credit and proceeds from potential additional financings will be sufficient to satisfy any operating and potential investing requirements.
Capital Resources
Working capital as of December 31, 2023 and December 31, 2022 was as follows:
| December 31, | Change $ | Change % | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2023 | 2022 | |||||||||||||
| Working capital | |||||||||||||||
| Current assets | $ | 338.9 | $ | 271.1 | $ | 67.8 | 25.0 | % | |||||||
| Current liabilities | 170.1 | 100.2 | 70.0 | 69.8 | % | ||||||||||
| Total working capital | $ | 168.8 | $ | 170.9 | $ | (2.2) | (1.2 | %) |
As of December 31, 2023, available cash totaled $59.3 million, which represented a decrease of $98.0 million compared to December 31, 2022, reflecting a significant increase in accounts receivable and acquisitions made during the year ended December 31, 2023. As of December 31, 2023, working capital amounted to $168.8 million, which represented a decrease of $2.2 million compared to December 31, 2022, which reflected the decreased cash balance in 2023. Increased accounts receivable, which reflected the growth of the business and a shift towards higher credit quality customers who have longer payment cycles in 2023, were outweighed by the increase in current liabilities, which reflected the growth of
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the business and amounts due to seller and contingent consideration resulting from acquisitions, as well as the draw down of $25 million under the terms of the Revolving Credit Facility.
Cash Flows
Cash flows as of the years ended December 31, 2023 and 2022 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2023 | 2022 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash (used in) provided by operating activities | $ | (64.2) | $ | 28.9 | $ | (93.1) | (322.1 | %) | ||||||
| Net cash used in investing activities | (29.9) | (38.4) | 8.5 | (22.1 | %) | |||||||||
| Net cash provided by (used in) financing activities | 1.1 | (6.2) | 7.3 | (117.7 | %) | |||||||||
| Effect of exchange rate changes | 1.1 | 0.7 | 0.4 | 57.1 | % | |||||||||
| Net decrease in cash | $ | (91.9) | $ | (15.0) | $ | (76.9) | 512.7 | % |
Cash flows as of the years ended December 31, 2022 and 2021 were as follows:
| Year Ended December 31, | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2022 | 2021 | ||||||||||||
| Cash flow summary | ||||||||||||||
| Net cash provided by (used in) operating activities | $ | 28.9 | $ | (1.9) | $ | 30.8 | 1621.1 | % | ||||||
| Net cash used in investing activities | (38.4) | (8.6) | (29.9) | (347.7 | %) | |||||||||
| Net cash (used in) provided by financing activities | (6.2) | 155.2 | (161.4) | (104.0 | %) | |||||||||
| Effect of exchange rate changes | 0.7 | — | 0.7 | 100.0 | % | |||||||||
| Net (decrease) increase in cash | $ | (15.0) | $ | 144.7 | $ | (159.7) | (110.4 | %) |
Operating Activities
During the year ended December 31, 2023, cash used by operating activities was $64.2 million, despite net income of $10.0 million. Non-cash charges amounted to $38.9 million, which primarily consisted of $11.2 million in depreciation of property and equipment and right-of-use assets, $5.2 million from amortization of intangible assets, $21.0 million of stock compensation expense, a $0.9 million loss on the disposal of assets and a loss of $0.3 million from an investment that is accounted for under the equity method and $3.6 million in bad debt expense. These were partially offset by $2.0 million in deferred taxes and a non-cash gain of $1.4 million resulting from a reduction in the fair value of contingent consideration. Changes in assets and liabilities resulted in approximately $113.1 million in negative operating cash flow, as a $160.5 million increase in accounts receivable, reflecting the growth of the business and primarily driven by an increased amount of business with municipalities, which tend to have longer payment cycles; a $1.8 million decrease in accounts payable; and a $10.8 million increase in prepaid expenses and other current assets were partially offset by a $59.0 million increase in accrued liabilities and a $1.0 million decline in other assets.
During the year ended December 31, 2022, cash provided by operating activities was $28.9 million, aided by net income of $30.7 million. Non-cash charges were $11.3 million and included $7.3 million in depreciation of property and equipment and right-of-use assets, $3.2 million from amortization of intangible assets, $3.8 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable, $8.1 million of stock compensation expense and a non-cash loss of $2.9 million related to the impairment of a business unit that was discontinued at the end of the year. These charges were partially offset by non-cash gains of $1.4 million relating to the remeasurement of finance lease liabilities, $1.1 million from the remeasurement of warrant liabilities, $1.6 million in a gain on a bargain purchase and $9.9 million in the realization of a deferred tax asset. Changes in assets and liabilities resulted in an approximately $13.2 million decrease to operating cash flow, as an $8.4 million increase in accounts receivable, a $4.2 million increase in prepaid
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expenses and a $6.0 million decrease in accrued liabilities outweighed the effect of a $1.8 million decrease in other assets and a $3.6 million increase in accounts payable.
During the year ended December 31, 2021, cash used in operating activities was $1.9 million, despite net income of $19.2 million. Non-cash charges amounted to $7.7 million, as $5.2 million in depreciation of property and equipment and right-of-use assets, $1.8 million from amortization of intangible assets, $4.5 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable and $1.4 million of stock compensation expense were partially offset by $5.2 million in a non-cash gain on the remeasurement of warrant liabilities. Changes in assets and liabilities resulted in an approximately $28.8 million decrease in operating cash flow and were primarily driven by a $57.1 million increase in accounts receivable arising from the growth of the business, particularly in the fourth quarter of the year, and the inclusion of larger Mobile Health Services customers with extended credit terms, and a $3.5 million increase in prepaid expenses and other current assets, partially offset by a $32.6 million increase in accounts payable and accrued expenses due primarily to the extension of credit and timing of payments, as DocGo attempted to align the timing of payments to vendors with the timing of payments received from customers, where possible, in an attempt to manage cash balances.
Investing Activities
During the year ended December 31, 2023, investing activities used $29.9 million of cash and consisted of the acquisition of property and equipment totaling approximately $7.6 million, the acquisition of intangibles in the amount of $2.5 million, the acquisition of businesses in the amount of $20.2 million and an equity method investment in the amount of $0.3 million, partially offset by $0.7 million in cash proceeds from the disposal of property and equipment.
During the year ended December 31, 2022, cash used in investing activities was $38.4 million and consisted of the acquisition of property and equipment totaling approximately $3.2 million, the acquisition of intangibles in the amount of $2.3 million and the acquisition of businesses in the amount of $33.0 million, primarily relating to acquisitions the Company completed in the third and fourth quarters of 2022.
During the year ended December 31, 2021, cash used in investing activities was $8.6 million, primarily consisting of the acquisition of property and equipment totaling $4.8 million and the acquisition of businesses and intangibles totaling $3.1 million to support the ongoing growth of the business. In addition, the Company made an equity investment amounting to approximately $0.7 million.
Financing Activities
During the year ended December 31, 2023, cash provided by financing activities was $1.1 million, including $25 million in proceeds from the Company’s Revolving Facility and $1.6 million in proceeds from the exercise of stock options, mostly offset by $4.3 million in payments under the terms of a finance lease, a $13.6 million decrease in amounts due to seller, $5.3 million in earnout payments on contingent liabilities and $2.3 million in payments for taxes related to shares withheld for employee taxes.
During the year ended December 31, 2022, cash used in financing activities was $6.2 million, including $3.7 million in the repurchase of Common Stock, $3.0 million in payments under the terms of a finance lease, a $2.5 million decrease in amounts due to seller and $0.9 million in repayments of notes payable, which were partially offset by $2.1 million in non-controlling interest contributions and $2.0 million in proceeds from the exercise of stock options.
During the year ended December 31, 2021, cash provided by financing activities was $155.2 million, due primarily to $158.1 million in proceeds from the issuance of Common Stock in connection with the Business Combination, which is net of $20.0 million in issuance costs. This was slightly offset by $2.2 million in payments on obligations under the terms of a finance lease and $0.5 million in expenditures to acquire the remaining 20% of the Company’s U.K. subsidiary. During 2021, the Company received $8.0 million in proceeds from a revolving bank loan, which was repaid during the fourth quarter of 2021.
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Future minimum annual maturities of notes payable as of December 31, 2023 are as follows (in thousands):
| Notes Payable | ||
|---|---|---|
| 2024 | $ | 28.8 |
| 2025 | 25.8 | |
| 2026 | 15.1 | |
| Total maturities | 69.7 | |
| Current portion of notes payable | (28.1) | |
| Long-term portion of notes payable | $ | 41.6 |
Future minimum lease payments under finance leases as of the year ended December 31, 2023 are as follows (in millions):
| Finance Leases | ||
|---|---|---|
| 2024 | $ | 4.1 |
| 2025 | 3.7 | |
| 2026 | 2.9 | |
| 2027 | 1.5 | |
| 2028 | 0.3 | |
| Thereafter | — | |
| Total future minimum lease payments | 12.5 | |
| Less effects of discounting | (1.1) | |
| Present value of future minimum lease payments | $ | 11.4 |
Future minimum lease payments under operating leases as of the year ended December 31, 2023 are as follows (in millions):
| Operating Leases | ||
|---|---|---|
| 2024 | $ | 3.3 |
| 2025 | 3.3 | |
| 2026 | 2.4 | |
| 2027 | 1.2 | |
| 2028 | 0.6 | |
| Thereafter | 0.3 | |
| Total future minimum lease payments | 11.1 | |
| Less effects of discounting | (1.1) | |
| Present value of future minimum lease payments | $ | 10.0 |
Critical Accounting Policies
Basis of Presentation
The Company’s Consolidated Financial Statements are presented in conformity with accounting principles generally accepted in the U.S. (“U.S. GAAP”) and pursuant to the rules and regulations of the SEC. The Consolidated Financial Statements include the accounts and operations of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions are eliminated upon consolidation. Noncontrolling interests on the Consolidated Balance Sheets represents the portion of consolidated joint ventures and a variable interest entity (“VIE”) in which the Company does not have direct equity ownership.
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The Business Combination was accounted for as a reverse recapitalization in accordance with U.S. GAAP (the “Reverse Recapitalization”). Under this method of accounting, the Company was treated as the “acquired” company for financial reporting purposes. Accordingly, for accounting purposes, the Reverse Recapitalization was treated as the equivalent of Ambulnz stock for the net assets of the Company, accompanied by a recapitalization. The net assets of the Company are stated at historical cost, with no goodwill or other intangible assets recorded. The consolidated assets, liabilities and results of operations prior to the Reverse Recapitalization are those of Ambulnz. The shares of common stock and corresponding capital amounts and earnings per share available for common stockholders, prior to the Business Combination, have been retroactively restated as shares of the Company, reflecting the exchange ratio (645.1452 to 1) established in the Business Combination. Further, Ambulnz was determined to be the accounting acquirer in the transaction; as such, the acquisition is considered to be a business combination under Accounting Standards Codification (“ASC”) Topic 805, Business Combinations and was accounted for using the acquisition method of accounting.
Principles of Consolidation
In accordance with ASC 810, Consolidation (“ASC 810”), the Company assesses whether it has a variable interest in legal entities in which it has a financial relationship and, if so, whether or not those entities are VIEs. For those entities that qualify as VIEs, ASC 810 requires the Company to determine if the Company is the primary beneficiary of the VIE, and if so, to consolidate the VIE.
The Company holds variable interests in legal entities that contract with physicians and other health professionals in order to provide services to the Company. These entities are considered VIEs since they do not have sufficient equity to finance their activities without additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if it is the primary beneficiary, meaning it has (1) the power to direct the activities of the VIE that most significantly impacts the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has the power and rights to control all activities of its VIEs and funds and absorbs all losses of its VIEs. The Company has determined that it is the primary beneficiary of its VIEs and therefore appropriately consolidates its VIEs.
Net loss for the Company’s VIEs were $235,976, $373,456 and $122,982 for the years ended December 31, 2023, 2022 and 2021, respectively. The total assets amounted to $4,364,274 and $610,553 on December 31, 2023 and 2022, respectively. Total liabilities were $4,811,857 and $320,424 on December 31, 2023 and 2022, respectively. The Company’s VIEs total stockholders’ deficit were $447,583 and $290,130 on December 31, 2023 and 2022, respectively.
Business Combinations
The Company accounts for its business combinations under the provisions of ASC 805-10, Business Combinations (“ASC 805-10”), which requires that the acquisition method of accounting be used for all business combinations. Assets acquired and liabilities assumed, including noncontrolling interests, are recorded at the date of acquisition at their respective fair values. ASC 805-10 also specifies criteria that intangible assets acquired in a business combination must meet to be recognized and reported apart from goodwill.
Goodwill represents the excess purchase price over the fair value of the tangible net assets and intangible assets acquired in a business combination. If the business combination provides for contingent consideration, the Company records the contingent consideration at fair value at the acquisition date and any changes in fair value after the acquisition date are accounted for as measurement-period adjustments. Changes in fair value of contingent consideration resulting from events after the acquisition date, such as earn-outs, are recognized as follows: 1) if the contingent consideration is classified as equity, the contingent consideration is not re-measured and its subsequent settlement is accounted for within equity, or 2) if the contingent consideration is classified as a liability, the changes in fair value are recognized in earnings. For transactions that are business combinations, the Company evaluates the existence of goodwill or a gain from a bargain purchase. The Company capitalizes acquisition-related costs and fees associated with asset acquisitions and immediately expenses acquisition-related costs and fees associated with business combinations.
The estimated fair value of net assets to be acquired, including the allocation of the fair value to identifiable assets and liabilities, is determined using established valuation techniques. Management uses assumptions on the basis of historical knowledge of the business and projected financial information of the target. These assumptions may vary based on future events, perceptions of different market participants and other factors outside the control of management, and such variations may be significant to estimated values.
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Goodwill and Indefinite-Lived Intangible Assets
Goodwill represents the excess of the total purchase consideration over the fair value of the identifiable assets acquired and liabilities assumed in a business combination. Goodwill is not amortized but is tested for impairment at the reporting unit level annually on December 31 or more frequently if events or changes in circumstances indicate that it is more likely than not to be impaired. These events include: (i) severe adverse industry or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations; (iii) current, historical or projected deterioration of our financial performance; or (iv) a sustained decrease in our market capitalization, as indicated by our publicly quoted share price, below our net book value.
On February 3, 2023, Ambulnz Health, LLC (“Health”), commenced an assignment for the benefit of creditors (“ABC”) pursuant to California law. An ABC is a liquidation process governed by state law (California law in this instance) that is an alternative to a bankruptcy case under federal law. Prior to commencing the ABC, Health ceased business operations and all of its employees were terminated and treated in accordance with California law. In the ABC, all of Health’s assets were transferred to an assignee (the “Assignee”) who acts as a fiduciary for creditors and in a capacity equivalent to that of a bankruptcy trustee. The Assignee is responsible for liquidating the assets. Similar to a bankruptcy case, there is a claims process. Creditors of Health received notice of the ABC and a proof of claim form and were required to submit a proof of claim in order to participate in distribution of net liquidation proceeds by the Assignee.
Based on such filing for Health, the Company impaired the goodwill assigned to that reporting unit as of December 31, 2022 by approximately $5.1 million.
Revenue Recognition
On January 1, 2019, the Company adopted ASC 606, Revenue from Contracts with Customers (“ASC 606”).
To determine revenue recognition for contractual arrangements that the Company determines are within the scope of ASC 606, the Company performs the following five steps: (1) identify each contract with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate the transaction price to performance obligations in the contract; and (5) recognize revenue when (or as) the relevant performance obligation is satisfied. The Company only applies the five-step model to contracts when it is probable that the Company will collect the consideration it is entitled to in exchange for the goods or services the Company provides to the customer.
The Company generates revenues from the provision of (1) Mobile Health Services and (2) Transportation Services. The customer simultaneously receives and consumes the benefits provided by the Company as the performance obligations are fulfilled; therefore the Company satisfies performance obligations immediately. The Company has utilized the “right to invoice” expedient, which allows an entity to recognize revenue in the amount of consideration to which the entity has the right to invoice when the amount that the Company has the right to invoice corresponds directly to the value transferred to the customer. Revenues are recorded net of an estimated contractual allowances for claims subject to contracts with responsible paying entities. The Company estimates contractual allowances at the time of billing based on contractual terms, historical collections or other arrangements. All transaction prices are fixed and determinable, which includes a fixed base rate, fixed mileage rate and an evaluation of historical collections by each payor.
Income Taxes
Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements or its tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Valuation allowances are provided if based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. The Company recognizes any interest and penalties accrued related to unrecognized tax benefits as income tax expense.
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Please see Note 2, “Summary of Significant Accounting Policies” to the Consolidated Financial Statements.
FY 2022 10-K MD&A
SEC filing source: 0001213900-23-019936.
Item 7. Management’s Discussion and Analysis
of Financial Condition and Results of Operations.
The following discussion and analysis of our financial condition and
results of operations should be read in conjunction with our Consolidated financial statements and the accompanying notes included elsewhere
in this Annual Report on Form 10-K. The discussion and analysis below contain certain forward-looking statements about our business and
operations that are subject to the risks, uncertainties, and other factors described in the section entitled “Risk Factors,”
included in Part I, Item 1A, and other factors included elsewhere in this Annual Report on Form 10-K. These risks, uncertainties, and
other factors could cause our actual results to differ materially from those expressed in, or implied by, the forward-looking statements.
Please refer to the section entitled “Cautionary Note Regarding Forward-Looking Statements.”
Unless the context requires otherwise, references to “DocGo,”
“we,” “us,” “our” and “the Company” in this section are to the business and operations
of DocGo and its consolidated subsidiaries, including those periods prior to the Business Combination. Certain figures, such as interest
rates and other percentages, included in this section have been rounded for ease of presentation. Percentage figures included in this
section have, in some cases, been calculated on the basis of such rounded figures. For this reason, percentage amounts in this section
may vary slightly from those obtained by performing the same calculations using the figures in DocGo’s Consolidated Financial Statements
or in the associated text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Overview
DocGo,
which was originally formed in 2015, is a healthcare transportation and mobile services company that uses proprietary dispatch and
communication technology to help provide quality healthcare transportation and mobile services in-person medical treatment
directly to patients in the comfort of their homes, workplaces and other non-traditional locations, in major metropolitan
cities in the United States and the United Kingdom.
The
Company derives revenue primarily from its two operating segments: Transportation Services and Mobile Health Services.
| Column 1 | Column 2 | Column 3 |
|---|---|---|
| ● | Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities. |
| Column 1 | Column 2 | Column 3 |
|---|---|---|
| ● | Mobile Health Services: The services offered by this segment include a wide variety of healthcare services performed at home and offices, testing, vaccinations and event services which include on-site healthcare support at sporting events and concerts. |
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See Item 1. “Business” in this Annual Report on Form 10-K
for additional information regarding DocGo’s business.
For
the year ended December 31, 2022 the Company recorded net income of $30.7 million, compared to net income of $19.2 million in
the year ended December 31, 2021.
COVID-19
The spread of COVID-19 and the related shutdowns and restrictions had
a mixed impact on our business. In the Transportation Services segment, which comprises primarily of non-emergency medical transport,
the Company saw a decline in volumes from historical and expected levels, as elective surgeries and other non-emergency surgical procedures
were postponed. In addition, in the Mobile Health segment, the Company experienced lost revenue associated with sporting, concerts and
other events, as those events were cancelled or had a significantly restricted (or entirely eliminated) number of permitted attendees.
Ambulance transports and event-related revenues have both since recovered to pre-COVID levels or higher.
There are two areas where the Company experienced positive business
impacts from COVID-19. In April and May 2020, the Company participated in an emergency project with Federal Emergency Management Agency
in the New York City area. This engagement resulted in incremental transportation revenue that partially offset some of the lost non-emergency
transport revenues. In addition, in response to the need for widespread COVID-19 testing and available EMTs and paramedics, the Company
expanded its operations to include Rapid Reliable Testing (“RRT”), with the goal of performing COVID-19 tests at nursing homes,
municipal sites, businesses, schools and other venues. RRT is part of the Mobile Health business line. Mobile Health generated approximately
$325.9 million in revenue in the year ended December 31, 2022, as compared to $234.4 million in 2021 and $30.9 million in 2020. While
COVID-19 testing has become a minor part of this segment’s business, as of the second half of 2022, the Mobile Health segment has
continued to grow. We have expanded our service offerings in this segment to offer a wider range of testing, vaccination and other services
to a broader customer group.
During 2020 and the early part of 2021, the Company continued to operate
with several back-office employees working remotely. During that time, the Company did not witness any significant reduction in productivity
from these employees, nearly all of whom returned to their respective offices and other locations by early 2021 and our operations have
proceeded without major interruption. DocGo also utilized several government programs in 2020 related to the pandemic, receiving approximately
$1.0 million in payments through the Public Health and Social Services Emergency Fund authorized under the Coronavirus Aid, Relief and
Economic Security Act and related legislation as well as various state and local programs. DocGo also received accelerated Medicare payments
of approximately $2.4 million that were repaid in 2022.
As the COVID-19 pandemic reaches endemic stages, the future impacts
of it or other pandemics on DocGo remain highly uncertain and subject to numerous factors, including the severity of any new outbreaks,
resurgences and variants, actions taken to contain resurgences or variants or to address their impact, and other effects, and its related
impact on medical transportation levels remain uncertain. However, trip volumes in most of our markets returned to more normal historical
levels in 2021, and this trend continued throughout 2022. The Company generated, during 2021, COVID-19 testing revenue, included in its
Mobile Health services segment, above the levels projected, and this persisted through the second quarter of 2022. However, as expected,
COVID-19 testing revenues declined in the third quarter of 2022 and declined further in the fourth quarter, to the point where, as of
the date of the filing of this Annual Report on Form 10-K, they account for an insignificant proportion of total revenues. Given the nature
of the Company’s contracts with most of its customers, which include multiple procedures for which the Company is paid per hours
worked, per vehicles and related equipment utilized and on a per-procedure basis (such procedures including both testing and several other
procedures), it is difficult to determine the revenues that are directly attributable to COVID-19 testing. However, the Company estimates
that COVID-19 testing revenue will continue to account for an insignificant proportion of Mobile Health segment and overall consolidated
revenues in 2023 and beyond, as COVID-19 enters the endemic phase. In a broader, strategic sense, the consumer focus on Mobile Health
services and the formation of RRT, and its emergence as a significant contributor to overall revenues, have accelerated the diversification
in the Company’s business by more rapid expansion of the Mobile Health segment, which has now become our larger operating segment,
both in terms of revenues and personnel.
The Company’s current business plan assumes an increased demand
for Mobile Health services, a demand that was accelerated by the pandemic, but which we believe is also being driven by longer-term secular
factors, such as the increasing desire on the part of patients to receive treatments outside of traditional settings, such as doctor’s
offices and hospitals. In the Transportation segment, volumes are expected to continue to rise, reflecting an aging population in the
U.S. and U.K., which tends to drive demand for the non-emergent medical transportation services provided by the Company.
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Factors Affecting
Our Results of Operations
Our operating results and financial performance are influenced by a
variety of factors, including, among others, our ability to obtain or maintain operating licenses; the success of our acquisition strategy;
conditions in the healthcare transportation and mobile health services markets; our competitive environment; overall macroeconomic and
geopolitical conditions, including rising interest rates, the inflationary environment, the potential recessionary environment, regional
conflict and tensions; availability of healthcare professionals; changes in the cost of labor; and production schedules of our suppliers.
Some of these important factors are briefly discussed below. Future revenue growth and improvement in operating results will be largely
contingent on DocGo’s ability to penetrate new markets and further penetrate existing markets, which is subject to a number of uncertainties,
many of which are beyond DocGo’s control. The COVID-19 pandemic also significantly impacted DocGo’s business, as discussed
above. While the direct impact of the pandemic itself has waned, other impacts, such as supply chain disruptions and the cost and availability
of labor are expected to persist.
Operating Licenses
DocGo
has historically pursued a strategy to apply for ambulance operating licenses in the states, counties and cities, identified for future
new market entry. The approval of a new operating license may take an extended period of time. DocGo reduces this risk through its acquisition
strategy by identifying businesses and/or underlying licenses in these new markets that may be for sale.
Acquisitions
Historically
DocGo pursued an acquisition strategy to obtain ambulance operating licenses from small operators. Future acquisitions may also
include larger companies that may help drive revenue, profitability, cash flow and stockholder value, in both the Mobile Health and
the Transportation segments. During the twelve months ended December 31, 2022, DocGo completed five acquisitions, for a
purchase price of $69.1 million.
On July 6, 2022, the Company acquired Government Medical Services,
LLC (“GMS”) in exchange for $20.3 million in cash and up to a total of $3.0 million in future contingent consideration upon
GMS meeting certain performance conditions. GMS is in the business of providing licensed healthcare clinicians. We believe this
acquisition will allow us to increase our presence in that market, while giving us improved access to municipal contracts.
On July 13, 2022, the Company acquired Exceptional Medical Transportation,
LLC (“Exceptional”) in exchange for $7.7 million in cash (and a total of $6.0 million deferred consideration). The
Company also agreed to pay an estimated $1.1 million contingent consideration upon Exceptional meeting certain performance conditions.
Exceptional is in the business of providing medical transportation services in New Jersey. We believe this acquisition will allow us to
increase our presence in that market.
On August 9, 2022, the Company acquired Ryan Brothers Ambulance Inc.
(“RB”), in exchange for $7.4 million of cash (and a total of $4 million in future contingent consideration). Ryan Brothers
is in the business of providing medical transportation services in Wisconsin. We believe this acquisition will allow us to increase our
presence in that market.
On
October 12, 2022, the Company acquired Community Ambulance Services LTD (“CAS”) in exchange for approximately $5.5
million in cash. CAS is located in the U.K. and is engaged in providing emergency and non-emergency transport
services, including high dependency, urgent care, mental health and blue light transport services and diagnostics testing. We believe
that this acquisition will help allow us to continue to grow our presence in the U.K. market.
On December 9, 2022, Ambulnz
U.K. Ltd., a wholly owned subsidiary of the Company acquired Location Medical Services, LLC (“LMS”) for a total of $11.6 million
in cash (of which $11.3 million is deferred consideration) and $2.5 million in future contingent consideration. LMS, based in Shepperton,
U.K., provides professional medical support services, including staff and equipment, for events (festivals, equestrian, cycling, etc.),
as well as for the film and television production industry. LMS has a staff of over 250 medical professionals. We believe that this acquisition
will allow us to increase our share of the events business in the U.K. market.
During the twelve months ended December 31, 2021, DocGo completed
one acquisition, for a purchase price of $2.3 million.
Healthcare Services Market
The transportation services market is highly dependent on patients
requiring transportation after surgeries and other medical procedures and treatments. During the pandemic, DocGo experienced a decrease
in transportation volumes as a result of fewer elective surgeries. However, since 2021, the Company has seen increased demand and trip
volumes in nearly all of its Transportation services markets, as elective surgeries resumed and as the Company expanded its customer base.
51
Overall Economic Conditions in the Markets in which we Operate
Economic
changes both nationally and locally in our markets impact our financial performance. Unfavorable changes in demographics, health care
coverage of transportation and mobile health services, interest rates, ambulance manufacturing, a weakening of the national economy or
of any regional or local economy in which we operate and other factors beyond our control could adversely affect our business.
Trip Volumes and Average
Trip Price
A
“trip” is defined as an instance where the Company completes the transport of a patient to a specific destination, for which
we are able to charge a fee. This metric does not include instances where a trip is ordered and subsequently either canceled (by the customer)
or declined (by the Company). As trip volume represents the most basic unit of transportation service provided by the Company, it is the
best measure of the level of demand for the Company’s Transportation services, and is used by management to monitor and manage the
scale of the business.
The
average trip price is calculated by dividing the aggregate revenue from completed transports (“trips”) by the total number
of transports, and is an important indicator of the effective rate at which the Company is being compensated for its provision of Transportation
services.
Revenues
generated from programs under which DocGo is paid a fixed rate for the use of a fully staffed and equipped ambulance do not factor in
the trip counts or average trip prices mentioned above. We anticipate that these fixed rate, “leased hour” programs will account
for an increasing proportion of the Transportation segment’s revenues in the future.
Our Ability to Control Expenses
We pay close attention to managing our working capital and operating
expenses. Some of our most significant operating expenses are labor costs, medical supplies and vehicle-related costs, such as fuel,
maintenance, repair and insurance. Insurance costs include premiums paid for coverage as well as reserves for estimated losses within
the Company’s insurance policy deductibles. We aim to employ our proprietary technology to drive improvements in productivity per
transport. We regularly analyze our workforce productivity with a goal of balancing the optimum, cost-efficient labor mix for our
locations.
Inflation
Beginning in March 2021, the inflation rate in the US, as measured
by the Consumer Price Index (CPI) has generally trended higher. This data is reported monthly, showing year-over-year changes in prices
across a basket of goods and services. The monthly 12-month inflation rate was 2.6% in March 2021, and increased steadily over the rest
of 2021 and into 2022, with the inflation rate hitting 9.1% in June 2022. The inflation rate has seemingly moderated since that point,
declining to 6.4% in January 2023, but remains well above historical averages. On an annual basis, in 2019, the inflation rate was approximately
1.8%, while it dropped to approximately 1.2% in 2020, rising to 4.7% in 2021 and 8.0% in 2022. The increased inflation rate has had an
impact on the Company’s expenses in several areas, including wages, fuel and medical and other supplies. This has had the impact
of compressing gross profit margins, as the Company is generally unable to pass these higher costs on to its customers, particularly in
the short term. In an attempt to dampen inflation, the U.S. Federal Reserve implemented seven interest rate hikes in 2022, and another
hike to date in 2023, raising its benchmark rate (the “federal funds rate”) from near 0.00%% at the beginning of 2022 to the
current level of 4.50%-4.75% as of the date of the filing of this Annual Report on Form 10-K. The federal funds rate was raised in March,
May, June, July, September, November and December of 2022 and in February of 2023. The rate of the increase in the federal funds rate
has declined, however, with the December 2022 increase coming in at 0.50% and the February 2023 rate increase of 0.25%, compared with
rate hikes at 0.75% each in June, July, September and November of 2022. Looking to 2023, we anticipate a continued moderation of the inflation
rate when compared to the levels seen in 2022, as a result of these recent rate hikes, but expect that inflation will remain well above
the levels seen in the previous 10 years, when the annual inflation rate ranged from 0.1% to 2.4%. If inflation is above the levels that
the Company anticipates, gross margins could be below plan and our business, operating results and cash flows may be adversely affected.
Investing in R&D and Enhancing our Customer Experience
Our
performance is dependent on the investments we make in research and development, including our ability to attract and retain highly skilled
research and development personnel. We must continually develop and introduce innovative new software services, integrate with third-party products
and services, mobile applications and other new offerings. If we fail to innovate and enhance our brand and our products, our market position
and revenue will likely be adversely affected.
Regulatory Environment
DocGo
is subject to federal, state and local regulations including healthcare and emergency medical services laws and regulations and tax laws
and regulations. The Company’s current business plan assumes no material change in these laws and regulations. In the event any
such change occurs, compliance with new laws and regulations might significantly affect its operations and cost of doing business.
52
Components of Results
of Operations
Our
business consists of two reportable segments — Transportation services and Mobile Health services. The Company evaluates
the performance of both segments based primarily on results of its operations. Accordingly, other income and expenses not included in
results from operations are only included in the discussion of consolidated results of operations.
Revenue
The
Company’s revenue consists of services provided by its Transportation segment and its Mobile Health segment.
Cost of Revenues
Cost
of revenues consists primarily of revenue generating wages paid to employees, vehicle insurance costs (including insurance premiums and
costs incurred under the insurance deductibles), maintenance, fuel, laboratory fees, facility rent, medical supplies and subcontractors.
We expect cost of revenue to continue to rise in proportion to the expected increase in revenue.
Operating expenses
General and Administrative Expenses
General
and administrative expenses consist primarily of salaries, bad debt expense, insurance expense, consultant fees, and professional fees
for accounting services. We expect our general and administrative expense to increase as we scale up headcount with the growth of our
business, and as a result of operating as a public company, including compliance with SEC rules and regulations, audit, additional insurance
expenses, investor relations activities, and other administrative and professional services.
Depreciation and Amortization
DocGo
depreciates its assets using the straight-line method over the estimated useful lives of the respective assets. Amortization of intangibles
consists of amortization of definite-lived intangible assets over their respective useful lives.
Legal and
Regulatory Expenses
Legal
and regulatory expenses include legal fees, consulting fees related to healthcare compliance, claims processing fees and legal settlements.
Technology and
development Expenses
Technology and development expense, net of capitalization, consists
primarily of costs incurred in the design and development of DocGo’s proprietary technology, third-party software and technologies.
We expect technology and development expense to increase in future periods to support our growth, including as we invest in the optimization,
accuracy and reliability of our platform to help drive efficiency in our operations. These expenses may vary from period to period as
a percentage of revenue, depending primarily upon when we choose to make more significant investments, which is in turn, dependent on
numerous factors, including when we plan to enter into new business lines or customer sales channels.
Sales, Advertising and Marketing
Our
sales and marketing expenses consist of costs directly associated with our sales and marketing activities, which primarily include sales
commissions, marketing programs, trade shows, and promotional materials. We expect that our sales and marketing expenses will continue
to increase over time as we increase our marketing activities, grow our domestic and international operations, and continue to build brand
awareness. As the Company expands its sales efforts to include the direct-to-consumer channel, marketing expenses are likely to increase
as a percentage of revenues, given the marketing-intensive nature of that sales channel.
Interest Expense
Interest
expense consists primarily of interest on our outstanding borrowings under our outstanding notes payable, credit line and financing obligations.
53
Results of Operations
Comparison of Fiscal
2022 with Fiscal 2021
| Years Ended December 31, | Change | Change | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2022 | 2021 | $ | % | ||||||||||||
| Revenue, net | $ | 440.5 | $ | 318.7 | $ | 121.8 | 38 | % | ||||||||
| Cost of revenues | 285.8 | 209.0 | 76.8 | 37 | % | |||||||||||
| Operating expenses: | ||||||||||||||||
| General and administrative | 103.4 | 74.9 | 28.5 | 38 | % | |||||||||||
| Depreciation and amortization | 10.6 | 7.5 | 3.1 | 41 | % | |||||||||||
| Legal and regulatory | 8.8 | 3.9 | 4.9 | 126 | % | |||||||||||
| Technology and development | 5.4 | 3.3 | 2.1 | 64 | % | |||||||||||
| Sales, advertising and marketing | 4.7 | 4.8 | (0.1 | ) | (2 | )% | ||||||||||
| Total expenses | 418.7 | 303.4 | 115.3 | 38 | % | |||||||||||
| Income (loss) from operations | 21.8 | 15.4 | 6.5 | |||||||||||||
| Other income (expenses): | ||||||||||||||||
| Interest income (expense), net | 0.8 | (0.8 | ) | 1.6 | 200 | % | ||||||||||
| Gain (loss) from Payroll Protection Program (“PPP”) loan forgiveness | - | 0.1 | (0.1 | ) | ||||||||||||
| Gain on remeasurement of warrant liabilities | 1.1 | 5.2 | (4.1 | ) | ||||||||||||
| Gain (loss) on equity method investment | - | (0.1 | ) | 0.1 | ||||||||||||
| Gain on remeasurement of finance leases | 1.4 | - | 1.4 | |||||||||||||
| Loss on disposal of fixed assets | - | - | - | |||||||||||||
| Gain on bargain purchase | 1.6 | - | 1.6 | |||||||||||||
| Other income (loss) | (3.9 | ) | - | (3.9 | ) | |||||||||||
| Total other income (expense) | 1.0 | 4.4 | (3.4 | ) | (77 | )% | ||||||||||
| Net income (loss) before income tax benefit (expense) | 22.8 | 19.8 | 3.3 | |||||||||||||
| Benefit (provision) for income tax | 7.9 | (0.6 | ) | 8.5 | ||||||||||||
| Net income (loss) | 30.7 | 19.2 | 11.5 | 60 | % | |||||||||||
| Net loss attributable to noncontrolling interests | (3.9 | ) | (4.5 | ) | 0.6 | 13 | % | |||||||||
| and Subsidiaries | $ | 34.6 | $ | 23.7 | 10.9 |
Consolidated
For the year ended December
31, 2022, total revenues were $440.5 million, an increase of $121.8 million, or 38%, from the total revenues recorded in the year ended
December 31, 2021.
Mobile Health
For the year ended December 31, 2022, Mobile Health revenue was $325.9
million, an increase of $91.4 million, or 39%, as compared with the year ended December 31, 2021. This increase was primarily due to the
expansion of the services offered by this segment, particularly with respect to testing, vaccination and other healthcare services revenues.
This expansion accelerated through 2021 and into 2022 as the Company increased its customer base, primarily in the municipal customer
segment, and its geographic reach, while extending the terms of and/or expanding the scope of several large customer contracts and introducing
a broader range of services. Compared to the prior year, 2022 featured significantly lower COVID-19 testing revenue, which was outweighed
by the substantial increase in other Mobile Health services, as the Mobile Health segment transitioned away from its dependence on COVID-19
related revenue. COVID-19 testing continued to be a significant driver of Mobile Health revenues in the first half of 2022, but dropped
sharply in the third quarter of the year, and represented an insignificant proportion of total revenues in the fourth quarter.
54
Transportation Services
For the year ended December 31, 2022, Transportation Services revenue
was $114.6 million an increase of $30.3 million, or 36%, as compared with the year ended December 31, 2021. This increase was due to a
20% increase in transportation trip volumes, from 180,753 trips for the year ended December 31, 2021 to 216,009 trips for the year ended
December 31, 2022. The increase in trip volumes was due to a combination of growth in the customer base in certain core markets, entry
into new markets in 2021 and early 2022 and acquisitions made during the second half of 2022. Our average trip price increased from $301
in the year ended December 31, 2021, to $380 in the year ended December 31, 2022. The increase in the average trip price in 2022 reflected
a shift in mix toward higher-priced transports with existing customers, as well as the acquisition of licenses to provide higher acuity
transports resulting in higher prices per trip. The average trip price also benefited from a 5.1% increase in the average Medicare reimbursement
rate for ambulance transports. In October 2022, the Centers for Medicare and Medicaid Services (CMS) announced that the Medicare ambulance
fee schedule would be increasing by a further 8.7%, effective January 1, 2023.
Cost of Revenue
For the year ended December 31, 2022, total cost of revenue (exclusive
of depreciation and amortization) increased by 37%, as compared to the year ended December 31, 2021, while revenue increased by approximately
38%. Cost of revenue as a percentage of revenue decreased to 64.9% in 2022 from 65.5% in 2021.
In absolute dollar terms,
cost of revenue in the year ended December 31, 2022 increased by $76.8 million from the levels of the year ended December 31, 2021. This
was primarily attributable to a $64.9 million increase in total compensation, due to higher headcount for both the Transportation Services
and Mobile Health segments; a $16.0 million increase in subcontracted labor, driven mostly by the Mobile Health segment, where the Company
did not have sufficient personnel to staff the initial phases of large new projects; $13.6 million increase in vehicle costs, driven by
a continued increase in the Company’s vehicle fleet and higher fuel and maintenance costs, as well as costs incurred to rent vehicles
to provide Mobile Health services; a $2.1 million increase in travel costs, due to field personnel and other clinicians who traveled out
of their home regions to provide Mobile Health services; a $0.4 million increase in facilities and related costs; and approximately $2.6
million in increases across a variety of other cost of revenue categories relating to the Company’s increased scale and geographic
presence. These items were partially offset by a $21.1 million decrease in lab fees related to COVID-19 testing activity, reflecting sharply
lower COVID-19 testing activity in the second half of 2022, lower per-test lab fees and a shift toward rapid tests; and a $1.8 million
decline in medical supplies, reflecting a decline in COVID-19 testing activity and improved sourcing of various supplies.
For the Mobile Health segment,
cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2022 amounted to $199.2 million, compared
to $145.2 million in the year ended December 31, 2021. Cost of revenues as a percentage of revenues decreased slightly to 61.1% from 61.9%,
due to the increase in revenues and the continued shift away from higher-cost subcontracted labor toward Company personnel during 2022,
which was partially offset by higher compensation costs associated with some of the Company’s newer projects.
For the Transportation services
segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2022 was $86.5 million, an increase
of $23.1 million, or 36%, from the year ended December 31, 2021. Cost of revenues as a percentage of revenues were essentially unchanged,
at 75.5% in 2022 compared to 75.3% in 2021. Increased volumes and higher average trip prices, as described above, combined with lower
average hourly wages, as recent market wage pressures began to subside, and as the Company more effectively managed its staff to reduce
overtime hours for field employees, to offset the effects of increased fuel costs. Fuel prices moderated somewhat during the third quarter
and in the fourth quarters of 2022, but the full-year average fuel price for 2022 was approximately 29% above the full-year average for
2021. We anticipate that fuel prices will remain at elevated levels for 2023, but we expect that the full-year average for 2023 will be
lower than it was in 2022.
Operating expenses
For the year ended December 31, 2022, operating expenses were $132.9
million compared to $94.4 million for the year ended December 31, 2021, an increase of 41%. As a percentage of revenue, operating expenses
increased slightly, from 29.6% in 2021 to 30.2% in 2022, despite the significant increase in overall revenues described above, as the
Company continued to add to its management infrastructure and incurred a full year’s worth of expenses relating to its status as
a public company. The increase of $38.3 million related primarily to a $20.1 million increase in total compensation, which includes salaries,
benefits, bonuses and commissions for both direct and subcontracted labor, reflecting higher headcount driven by the Company’s overall
growth and expansion; a $7.1 million increase in legal, accounting and other professional fees related to increased revenue and related
contract generation and SEC filing-related costs; a $2.8 million increase in insurance costs reflecting the growth and expansion of the
Company, as well as the addition of directors and officers (D&O) insurance in 2022; a $3.2 million increase in depreciation and amortization
charges due to an increase in assets to support revenue growth and capitalized software amortization, including from recently acquired
companies; a $2.3 million increase in rent utility expenses, due to the Company’s ongoing growth and geographic expansion; a $2.9
million increase in IT infrastructure, driven by the Company’s business and headcount expansion; and a $0.6 million increase in
marketing expenses, driven in part by expenditures made to develop and expand the Company’s direct-to-consumer (DTC) and other Mobile
Health programs. These items were partially offset by a $0.7 million decline witnessed across several operating expense categories, such
as travel, commissions and general office expenses. The Company anticipates that operating expenses will continue to increase along with
the Company’s revenue growth and remain in the range of 25%-30% of revenue in the coming quarters.
55
For the Mobile Health segment,
operating expenses in the year ended December 31, 2022 were $58.0 million, up 25% from operating expenses of $46.3 million in the year
ended December 31, 2021. Operating expenses as a percentage of revenues decreased to 17.8% from 19.8% in 2021, due to the increase in
Mobile Health revenues, which outweighed the effect of the significant expenditures that were made in 2022 in the expansion of services
and geographic areas of operation, as well as the continued buildout of the Mobile Health management infrastructure and the costs of developing
the Company’s “on-demand” direct-to-consumer offering.
For the Transportation services
segment, operating expenses in the year ended December 31, 2022 were $74.0 million, up $26.6 million, or 56%, from the year ended December
31, 2021. Operating expenses as a percentage of revenues increased to 64.6% from 56.3% in the prior year period, despite the increase
in revenues, primarily due to increases in the Company’s corporate overhead expenditures, as described above, as these expenses
were allocated to the Transportation segment for purposes of segment reporting. Operating expenses for the Transportation segment were
also driven higher by the inclusion of the acquisitions the Company made in the second half of 2022.
Interest Income (Expense), Net
For the year ended December
31, 2022, the Company recorded $0.8 million of net interest income compared to $0.8 million of interest expense in the year ended December
31, 2021. This was due to a significantly higher amount of interest earned during 2022, resulting from an increase in the Company’s
cash balances in income-bearing accounts, coupled with higher rates of interest earned on balances in these accounts, which reflected
significantly higher market interest rates.
Gain/(loss) on Remeasurement of Warrant Liabilities
During the year ended December
31, 2022, the Company recorded a net gain of approximately $1.1 million from the remeasurement of warrant liabilities. The warrants are
marked-to-market in each reporting period, and this gain reflected the decrease in DocGo’s stock price relative to the beginning
of the period. During the year ended December 31, 2021, the Company recorded a net gain of $5.2 million on the remeasurement of warrant
liabilities. On August 15, 2022, the Company announced the redemption of all of its outstanding warrants under the Warrant Agreement,
dated as of October 14, 2020, by and between Motion and Continental Stock Transfer & Trust Company, as warrant agent, on the redemption
date of September 16, 2022 (the “Redemption Date”). Warrants surrendered for exercise on a cashless basis resulted in the
issuance of 1,406,371 shares. A total of 68,514 warrants were not surrendered on the Redemption Date and were redeemed for $0.10 per warrant.
Gain/(Loss) on Equity Method Investment
During the year ended December
31, 2022, the Company recorded a gain on equity method investment of $8,919, representing its share of the losses incurred by an entity
in which the Company has a minority interest, which is accounted for under the equity method. This investment was made in the fourth quarter
of 2021, during which period a loss of $66,818 was recorded in relation to this equity method investment.
Gain on Bargain Purchase
During the year ended December
31, 2022, the Company recorded a gain on bargain purchase of approximately $1.6 million in relation to an acquisition made during the
fourth quarter of the year, wherein the tangible net asset value of the acquired entity exceeded the purchase price. No such gain or loss
was recorded during the same period in 2021.
Gain/(Loss) from Remeasurement of Finance Leases
During the year ended December
31, 2022, the Company recorded a gain from remeasurement of finance leases of approximately $1.4 million, resulting from a change in estimated
remaining liabilities under the terms of its leases. No such gain or loss was recorded in the same period in 2021.
Gain from PPP Loan Forgiveness
In 2021, the Company recorded
a $0.1 million gain due to the forgiveness of a loan that one of its subsidiaries had obtained via the government’s Paycheck Protection
Program (PPP) in 2020. No gain from loan forgiveness was recorded during the year ended December 31, 2022.
Income Tax Benefit (Expense)
During the year ended December
31, 2022, the Company recorded an income tax benefit of $7.9 million compared to an income tax expense of $0.6 million in the year ended
December 31, 2021. The tax benefit in 2022 was due to the release of the valuation allowance recorded in previous years for net operating
losses (NOLs), as the Company determined that it was now more likely than not that it would be able to realize its NOL carryforwards in
the future.
Net Loss Attributable to Noncontrolling Interest
For the year ended December
31, 2022, the Company had a net loss attributable to noncontrolling interest of approximately $3.8 million compared to a net loss attributable
to noncontrolling interest of $4.6 million for the year ended December 31, 2021. For both periods, the loss reflected ongoing investments
in new markets that were entered into during 2021 and 2022, partially offset by income generated by those markets.
56
Liquidity and Capital Resources
Since inception, DocGo has
completed three equity financing transactions as its principal source of liquidity. Generally, the Company has utilized equity raised
to finance operations, investments in assets, ambulance operating licenses and to fund accounts receivable. The Company has also funded
these activities through operating cash flows. In November 2021, upon the completion of the merger between Motion and Ambulnz, the Company
received proceeds of approximately $158.1 million, net of transaction expenses. Despite the fact that the Company generated positive net
income in the year ended December 31, 2022, operating cash flows are not always sufficient to meet immediate obligations arising from
current operations. For example, as the business has grown, the Company’s expenditures for human capital and supplies has expanded
accordingly, and the timing of the payments for payroll and to associated vendors, compared to the timing of receipts of cash from customers,
frequently results in the need to use existing cash balances to fund these working capital needs. The Company’s working capital
needs depend on many factors, including the overall growth of the Company and the various payment terms that are negotiated with customers
and vendors. Future capital requirements depend on many factors, including potential acquisitions, DocGo’s level of investment in
technology and ongoing technology development, and rate of growth in existing markets and into new markets. Capital requirements might
also be affected by factors outside of the Company’s control, such as interest rates, rising inflation and other monetary and fiscal
policy changes to the manner in which the Company currently operates. Additionally, as the impact of the COVID-19 on the economy and on
the Company’s market environment and operations evolves, the Company routinely assesses its liquidity needs. If the Company’s
growth rate is higher than is currently anticipated, resulting in greater-than-anticipated capital requirements, the Company might need
to, or choose to, raise additional capital through debt or equity financings.
On November 1, 2022, the Company
entered into a revolving loan and security agreement with two banks, with one bank acting as the administrative agent (the “Lenders”),
with an initial maximum commitment amount of $90,000,000. The revolving facility includes the ability for the Company to request an increase
to the commitment by an additional amount of up to $50,000,000, though no Lender (nor the Lenders collectively) are obligated to increase
their respective commitments. Borrowings under the revolving facility bear interest at a per annum rate equal to (i) at the Company’s
option, the (x) the base rate or (y) the adjusted term SOFR rate, plus (ii) the applicable margin. The applicable margins are based on
the Company’s consolidated net leverage ratio, adjusted on a quarterly basis. The initial applicable margins are 1.25% for an adjusted
term SOFR loan and 0.25% for a base rate loan and will be updated based on the Company’s consolidated net leverage ratio. The revolving
facility matures on November 1, 2027. The revolving facility is secured by a first-priority lien on substantially all of the Company’s
present and future personal assets and intangible assets. The revolving facility is subject to certain financial covenants, such as a
net leverage ratio and interest coverage ratio, as defined in the agreement. As of the date of the filing of this Annual Report on Form
10-K, the Company has not made any draws under the facility and there are no amounts outstanding.
Considering the foregoing,
DocGo anticipates that its existing balances of cash and cash equivalents, future expected cash flows generated from its operations and
its available line of credit under the revolving facility (as further discussed in Note 9, “Line of Credit” to the Consolidated
Financial Statements) will be sufficient to satisfy operating requirements for at least the next twelve months.
57
Capital Resources
Comparison as of December 31, 2022 and December
31, 2021
| As of December 31, | Change | Change | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2022 | 2021 | $ | % | ||||||||||||
| Working capital | ||||||||||||||||
| Current assets | $ | 271.1 | $ | 256.0 | $ | 15.1 | 6 | % | ||||||||
| Current liabilities | 100.2 | 57.9 | 42.3 | 73 | % | |||||||||||
| Total working capital | $ | 170.9 | $ | 198.1 | $ | (27.2 | ) | (14 | %) |
As of December 31, 2022, available
cash totaled $157.3 million, which represented a decrease of $18.2 million compared to December 31, 2021, as changes to working capital
accounts and cash used for acquisitions in 2022 outweighed the positive cash flow generated by operations. As of December 31, 2022, working
capital amounted to $170.9 million, which represented a decrease of $27.2 million compared to December 31, 2021, which reflected the decreased
cash balance in 2022. Increased accounts receivable, which reflected the growth of the business and a shift towards higher credit quality
customers, who have longer payment terms, in 2022, were outweighed by the increase in current liabilities, which reflected the growth
of the business and amounts due to seller resulting from acquisitions.
Cash Flows
Year ended December 31, 2022 and 2021
| As of December 31, | Change | Change | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2022 | 2021 | $ | % | ||||||||||||
| Cash flow summary | ||||||||||||||||
| Net cash provided by/(used in) operating activities | $ | 28.9 | $ | (1.9 | ) | $ | 30.8 | 1,621 | % | |||||||
| Net cash provided by/(used in) investing activities | (38.4 | ) | $ | (8.6 | ) | (29.8 | ) | (347 | %) | |||||||
| Net cash provided by/(used in) financing activities | (6.2 | ) | $ | 155.2 | (161.4 | ) | (104 | %) | ||||||||
| Effect of exchange rate changes | 0.7 | $ | - | 0.7 | 100 | % | ||||||||||
| Net (decrease) increase in cash | $ | (15.0 | ) | $ | 144.7 | $ | (159.7 | ) | (110 | %) |
58
Operating activities
During the year ended December
31, 2022, cash provided by operating activities was $28.9 million, aided by net income of $30.73 million. Non-cash charges were $11.3
million and included $7.3 million in depreciation of property and equipment and right-of-use assets, $3.2 million from amortization of
intangible assets, $3.8 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable,
$8.1 million of stock compensation expense, and a non-cash loss of $2.9 million related to the impairment of a business unit that was
discontinued at the end of the year. These charges were partially offset by non-cash gains of $1.4 million relating to the remeasurement
of finance lease liabilities $1.1 million from the remeasurement of warrant liabilities, $1.6 million in a gain on a bargain purchase
and $9.9 million in the realization of a deferred tax asset. Changes in assets and liabilities resulted in an approximately $13.2 million
decrease to operating cash flow, as an $8.4 million increase in accounts receivable, a $4.2 million increase in prepaid expenses and a
$6.0 million decrease in accrued liabilities outweighed the effect of a $1.8 million decrease in other assets and a $3.6 million increase
in accounts payable.
During the year ended December
31, 2021, cash used in operating activities was $1.9 million, despite net income of $19.2 million. Non-cash charges amounted to $7.7 million,
as $5.2 million in depreciation of property and equipment and right-of-use assets, $1.8 million from amortization of intangible assets,
$4.5 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable and $1.4 million of
stock compensation expense were partially offset by $5.2 million in a non-cash gain on the remeasurement of warrant liabilities. Changes
in assets and liabilities resulted in an approximately $28.8 million decrease in operating cash flow and were primarily driven by a $57.1
million increase in accounts receivable arising from the growth of the business, particularly in the fourth quarter of the year and the
inclusion of larger Mobile Health customers with extended credit terms; and a $3.5 million increase in prepaid expenses and other current
assets, partially offset by a $32.6 million increase in accounts payable and accrued expenses due primarily to the extension of credit
and timing of payments, as DocGo attempted to align the timing of payments to vendors with the timing of payments received from customers,
where possible, in an attempt to manage cash balances.
Investing activities
During the year ended December
31, 2022, cash used in investing activities was $38.4 million and consisted of the acquisition of property and equipment totaling approximately
$3.2 million, the acquisition of intangibles in the amount of $2.3 million and $33.0 million in the acquisition of businesses, primarily
relating to acquisitions the Company completed in the third and fourth quarters of 2022.
During the year ended December
31, 2021, cash used in investing activities was $8.6 million, primarily consisting of the acquisition of property and equipment totaling
$4.8 million and the acquisition of businesses and intangibles of $3.1 million to support the ongoing growth of the business. In addition,
the Company made an equity investment amounting to approximately $0.7 million.
Financing activities
During the year ended December
31, 2022, cash used in financing activities was $6.2 million, including $3.7 million in the repurchase of Common Stock, $3.0 million in
payments under the terms of a finance lease, $2.5 million decrease in amounts due to seller and $0.9 million in repayments of notes payable,
which were partially offset by $2.1 million in non-controlling interest contributions and $2.0 million in proceeds from the exercise of
stock options.
During the year ended December
31, 2021, cash provided by financing activities was $155.2 million, due primarily to $158.1 million in proceeds from the issuance of common
stock in connection with the Motion merger, which is net of $20.0 million in issuance costs. This was slightly offset by $2.2 million
in payments on obligations under the terms of a finance lease, and $0.5 million in expenditures to acquire the remaining 20% of the Company’s
U.K. subsidiary. During 2021, the Company received $8.0 million in proceeds from a revolving bank loan, which was repaid during the fourth
quarter of 2021.
Future minimum annual maturities
of notes payable as of December 31, 2022 are as follows:
| Amounts in millions | Notes Payable | |||
|---|---|---|---|---|
| 2023 | 0.6 | |||
| 2024 | 0.5 | |||
| 2025 | 0.4 | |||
| 2026 | 0.3 | |||
| Thereafter | 0.1 | |||
| Total maturities | $ | 1.9 | ||
| Current portion of notes payable | (0.7 | ) | ||
| Long-term portion of notes payable | $ | 1.2 |
59
Future
minimum lease payments under finance leases as of the year ended December 31, 2022:
| Amounts in millions | Finance Leases | |||
|---|---|---|---|---|
| 2023 | $ | 3.2 | ||
| 2024 | 2.4 | |||
| 2025 | 2.2 | |||
| 2026 | 1.4 | |||
| 2027 and thereafter | 0.4 | |||
| Total future minimum lease payments | 9.6 | |||
| Less effects of discounting | (1.0 | ) | ||
| Present value of future minimum lease payments | $ | 8.6 |
Future minimum lease payments
under operating leases as of the year ended December 31, 2022:
| Amounts in millions | Operating Leases | ||||
|---|---|---|---|---|---|
| 2023 | $ | 2.8 | |||
| 2024 | 2.3 | ||||
| 2025 | 2.3 | ||||
| 2026 | 1.7 | ||||
| 2027 and thereafter | 1.6 | ||||
| Total future minimum lease payments | 10.7 | ||||
| Less effects of discounting | (1.3 | ) | |||
| Present value of future minimum lease payments | $ | 9.4 |
Critical Accounting
Policies
Basis of Presentation
The Company’s Consolidated
Financial Statements are presented in conformity with accounting principles generally accepted in the U.S. (“U.S. GAAP”) and
pursuant to the rules and regulations of the SEC. The Consolidated Financial Statements include the accounts and operations of the Company
and its wholly-owned subsidiaries. All intercompany accounts and transactions are eliminated upon consolidation. Noncontrolling interests
(“NCI”) on the Consolidated Balance Sheets represents the portion of consolidated joint ventures and a variable interest entity
in which the Company does not have direct equity ownership. Accounts and transactions between consolidated entities have been eliminated.
Pursuant to the Business Combination,
the merger between Motion and Ambulnz was accounted for as a reverse recapitalization in accordance with U.S. GAAP (the “Reverse
Recapitalization”). Under this method of accounting, Motion was treated as the “acquired” company for financial reporting
purposes. Accordingly, for accounting purposes, the Reverse Recapitalization was treated as the equivalent of Ambulnz
stock for the net assets of Motion, accompanied by a recapitalization. The net assets of Motion are stated at historical cost, with no
goodwill or other intangible assets recorded. The consolidated assets, liabilities and results of operations prior to the Reverse Recapitalization
are those of Ambulnz. The shares of common stock and corresponding capital amounts and earnings per share available for common stockholders,
prior to the Business Combination, have been retroactively restated as shares of the Company, reflecting the exchange ratio (645.1452
to 1) established in the Business Combination. Further, Ambulnz was determined to be the accounting acquirer in the transaction, as such,
the acquisition is considered to be a business combination under Accounting Standards Codification (“ASC”), Topic 805, Business
Combinations, (“ASC 805”) and was accounted for using the acquisition method of accounting.
Principles of Consolidation
The Company holds a variable
interest in an entity which contracts with physicians and other health professionals in order to provide services to the Company. MD1
Medical Care P.C. (“MD1”) is considered a variable interest entity (“VIE”) since it does not have sufficient equity
to finance its activities without additional subordinated financial support. An enterprise having a controlling financial interest in
a VIE must consolidate the VIE if it has both power and benefits—that is, it has (1) the power to direct the activities of
a VIE that most significantly impacts the VIE’s economic performance (power) and (2) the obligation to absorb losses of the
VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant
to the VIE (benefits). The Company has the power and rights to control all activities of MD1 and funds and absorbs all losses of the VIE
and appropriately consolidates MD1.
Total revenue for the VIE
amounted to $2,857,463 as of December 31, 2022. Net loss for the VIE was $373,456 as of December 31, 2022. The VIE’s total assets,
all of which were current, amounted to $610,553 as of December 31, 2022. Total liabilities, all of which were current for the VIE, was
$320,424 as of December 31, 2022. The VIE’s total stockholders’ deficit was $290,130 as of December 31, 2022. The Company
made payments of $3,018,119 and $1,746,736 to MD1 and its affiliates during the years ended December 31, 2022 and 2021, respectively.
60
Business Combinations
The Company accounts for its business combinations
under the provisions of ASC 805-10, Business Combinations (“ASC 805-10”), which requires that the acquisition method
of accounting be used for all business combinations. Assets acquired and liabilities assumed, including NCI, are recorded at the date
of acquisition at their respective fair values. ASC 805-10 also specifies criteria that intangible assets acquired in a business combination
must meet to be recognized and reported apart from goodwill.
Goodwill represents the excess purchase price
over the fair value of the tangible net assets and intangible assets acquired in a business combination. If the business combination provides
for contingent consideration, the Company records the contingent consideration at fair value at the acquisition date and any changes in
fair value after the acquisition date are accounted for as measurement-period adjustments. Changes in fair value of contingent consideration
resulting from events after the acquisition date, such as earn-outs, are recognized as follows: 1) if the contingent consideration is
classified as equity, the contingent consideration is not re-measured and its subsequent settlement is accounted for within equity, or
2) if the contingent consideration is classified as a liability, the changes in fair value are recognized in earnings. For transactions
that are business combinations, the Company evaluates the existence of goodwill or a gain from a bargain purchase. The Company capitalizes
acquisition-related costs and fees associated with asset acquisitions and immediately expenses acquisition-related costs and fees associated
with business combinations.
The estimated fair value of net assets to be acquired,
including the allocation of the fair value to identifiable assets and liabilities, is determined using established valuation techniques.
Management uses assumptions on the basis of historical knowledge of the business and projected financial information of the target. These
assumptions may vary based on future events, perceptions of different market participants and other factors outside the control of management,
and such variations may be significant to estimated values.
Goodwill and Indefinite-Lived Intangible
Assets
Goodwill represents the excess
of the total purchase consideration over the fair value of the identifiable assets acquired and liabilities assumed in a business combination.
Goodwill is not amortized but is tested for impairment at the reporting unit level annually on December 31 or more frequently if events
or changes in circumstances indicate that it is more likely than not to be impaired. These events include: (i) severe adverse industry
or economic trends; (ii) significant company-specific actions, including exiting an activity in conjunction with restructuring of operations;
(iii) current, historical or projected deterioration of our financial performance; or (iv) a sustained decrease in our market capitalization,
as indicated by our publicly quoted share price, below our net book value.
On February 3, 2023, Ambulnz
Health, LLC (“Health”), commenced an assignment for the benefit of creditors (“ABC”) pursuant to California law.
An ABC is a liquidation process governed by state law (California law in this instance) that is an alternative to a bankruptcy case under
federal law. Prior to commencing the ABC, Health ceased business operations and all of its employees were terminated and treated in accordance
with California law. In the ABC, all of Health’s assets were transferred to an assignee (the “Assignee”) who acts as
a fiduciary for creditors and in a capacity equivalent to that of a bankruptcy trustee. The Assignee is responsible for liquidating the
assets. Similar to a bankruptcy case, there is a claims process. Creditors of Health will receive notice of the ABC and a proof of claim
form and are required to submit a proof of claim in order to participate in distribution of net liquidation proceeds by the Assignee.
Based on such filing for Health,
the Company impaired the goodwill assigned to that reporting unit as of December 31, 2022 by approximately $5.1 million.
61
Revenue Recognition
On January 1, 2019, the Company adopted ASU 2014-09,
Revenue from Contracts with Customers (“ASC 606”), as amended.
To determine revenue recognition for contractual
arrangements that the Company determines are within the scope of ASC 606, the Company performs the following five steps: (1) identify
each contract with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate
the transaction price to performance obligations in the contract; and (5) recognize revenue when (or as) the relevant performance obligation
is satisfied. The Company only applies the five-step model to contracts when it is probable that the Company will collect the consideration
it is entitled to in exchange for the goods or services the Company provides to the customer.
The Company generates revenues from the provision of (1) ambulance
and medical transportation services (“Transportation Services”) and (2) Mobile Health services. The customer simultaneously
receives and consumes the benefits provided by the Company as the performance obligations are fulfilled, therefore the Company satisfies
performance obligations immediately. The Company has utilized the “right to invoice” expedient which allows an entity to recognize
revenue in the amount of consideration to which the entity has the right to invoice when the amount that the Company has the right to
invoice corresponds directly to the value transferred to the customer. Revenues are recorded net of an estimated contractual allowances
for claims subject to contracts with responsible paying entities. The Company estimates contractual allowances at the time of billing
based on contractual terms, historical collections, or other arrangements. All transaction prices are fixed and determinable which includes
a fixed base rate, fixed mileage rate and an evaluation of historical collections by each payor.
Income Taxes
Income taxes are recorded in accordance with ASC
740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company
recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial
statements or its tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement
and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse.
Valuation allowances are provided, if based upon the weight of available evidence, it is more likely than not that some or all of the
deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740.
When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more
likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely
than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances.
The Company recognizes any interest and penalties accrued related to unrecognized tax benefits as income tax expense.
Please see Note 2, “Summary
of Significant Accounting Policies” to the Consolidated Financial Statements.
FY 2021 10-K MD&A
SEC filing source: 0001213900-22-012545.
Item
7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The
following discussion and analysis of our financial condition and results of operations should be read in conjunction with our consolidated
financial statements and the accompanying notes included elsewhere in this Annual Report on Form 10-K. The discussion and analysis below
contain certain forward-looking statements about our business and operations that are subject to the risks, uncertainties, and other
factors described in the section entitled “Risk Factors,” included in Part I, Item 1A, and elsewhere in this Annual Report
on Form 10-K. These risks, uncertainties, and other factors could cause our actual results to differ materially from those expressed
in, or implied by, the forward-looking statements. Please read the section entitled “Cautionary Note Regarding Forward-Looking
Statements.”
Unless
the context requires otherwise, references to “DocGo,” “we,” “us,” “our” and “the
Company” in this section are to the business and operations of DocGo and its consolidated subsidiaries, including those periods
prior to the Business Combination. Certain figures, such as interest rates and other percentages, included in this section have been
rounded for ease of presentation. Percentage figures included in this section have not in all cases been calculated on the basis of such
rounded figures but on the basis of such amounts prior to rounding. For this reason, percentage amounts in this section may vary slightly
from those obtained by performing the same calculations using the figures in DocGo’s financial statements or in the associated
text. Certain other amounts that appear in this section may similarly not sum due to rounding.
Overview
DocGo,
which was originally formed in 2015, is a healthcare transportation and mobile services company that uses proprietary dispatch and communication
technology to provide quality healthcare transportation and mobile services in-person medical treatment directly to patients in
the comfort of their homes, workplaces and other non-traditional locations, in major metropolitan cities in the United States
and the United Kingdom.
The
Company derives revenue primarily from its two operating segments: Transportation Services and Mobile Health services.
| Column 1 | Column 2 | Column 3 |
|---|---|---|
| ● | Transportation Services: The services offered by this segment encompass both emergency response and non-emergency transport services. Non-emergency transport services include ambulance transports and wheelchair transports. Net revenue from Transportation Services is derived from the transportation of patients based on billings to third party payors and healthcare facilities. |
| Column 1 | Column 2 | Column 3 |
|---|---|---|
| ● | Mobile Health Services: The services offered by this segment include services performed at home and offices, COVID-19 testing, and event services which include on-site healthcare support at sporting events and concerts. |
See
the section of this prospectus titled “Description of DocGo’s Business — Our Segments” and
Note 11 to the notes to the audited consolidated financial statements of Ambulnz included in the prospectus for additional information
regarding DocGo’s segments.
For
the years ended December 31, 2021 the Company recorded net income of $19.2 million, compared to a net loss of $14.8 million
in the year ended December 31, 2020.
COVID-19
On
January 30, 2020, the World Health Organization announced a global health emergency because of COVID-19, a new strain of coronavirus.
In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally.
The
spread of COVID-19 and the related shutdowns and restrictions have had a mixed impact on our business. In the ambulance transportation
business, which comprise predominantly non-emergency medical transport, the Company experienced a decline in transportation volumes
versus historical levels, as elective surgeries and other non-emergency surgical procedures were postponed or cancelled. In addition,
the Company experienced lost revenue associated with sporting, concerts and other events, as those events were either cancelled or have
experienced a significantly restricted number of permitted attendees In most markets, these trip volumes have recovered, and on a consolidated
basis, trip volumes in December 2021 were 27.2% above those of March 2020, when COVID-19 related restrictions were first implemented.
There
are two areas where the Company experienced positive business impacts from COVID-19. In April and May 2020, the Company participated
in an emergency project with Federal Emergency Management Agency in the New York City area. This engagement resulted in incremental
transportation revenue that partially offset some of the lost non-emergency transport revenues. In addition, in response to the need
for widespread COVID-19 testing and available EMTs and paramedics, the Company expanded its operations to include Rapid Reliable
Testing (“RRT”), with the goal to perform COVID-19 tests at nursing homes, municipal sites, businesses, schools and other
venues. RRT is part of the Mobile Health business line. Mobile Health generated approximately $234.4 million in revenue in the year
ended December 31, 2021, as compared to $30.9 million in 2020 and $1.9 million in 2019.
47
During
2020 and the early part of 2021, the Company continued to operate with several back-office employees working remotely. To date,
the Company has not witnessed any degradation in productivity from these employees, the large majority of whom have now returned to their
respective offices, and our operations have proceeded without major interruption. By early 2021, nearly all remote employees had returned
to work in their respective offices and other locations. DocGo also utilized several government programs in 2020 related to the pandemic,
receiving approximately $1.0 million in payments through the Public Health and Social Services Emergency Fund authorized under the
Coronavirus Aid, Relief and Economic Security Act and related legislation as well as various state and local programs, net of amounts
that will be repaid to HHS. DocGo also received accelerated Medicare payments of approximately $2.4 million that were required
to be repaid beginning in April 2021. Through December 31, 2021, approximately $1.7 million of this advance had been recouped
by Medicare.
While
it is very difficult to accurately predict the future direction of the effects of the COVID-19 pandemic, and the related impact on
medical transportation levels, the revenue from the Transportation Services segment during 2021 exceeded that of 2020 by approximately
33%. Since the beginning of 2021, trip volumes in most of our markets have started to return to more normal historical levels. The Company
generated, during 2021, COVID-19 testing revenue, including its Mobile Health services segment, above the levels projected. In a
broader, strategic sense, the consumer focus on Mobile Health services and the formation of RRT, and its emergence as a significant contributor
to overall revenues have accelerated the diversification in the Company’s business by more rapid expansion of the Mobile Health
segment.
The
Company’s current business plan assumes gradual recovery of industrywide transportation volumes to historical levels, plus an increased
demand for mobile health services, a demand that was accelerated by the pandemic, but which is also being driven by longer-term secular
factors. However, given the unpredictable, unprecedented, and fluid nature of the pandemic and its economic consequences, we are unable
to predict the duration and extent to which the pandemic and its related positive and negative impacts will affect our business, financial
condition, and results of operations in future periods.
Factors
Affecting Our Results of Operations
Our
operating results and financial performance are influenced by a variety of factors, including, among others, obtaining operating licenses,
acquisitions, conditions in the healthcare transportation and mobile health services markets and economic conditions generally, availability
of healthcare professionals, changes in the cost of labor, and production schedules of our suppliers. Some of the more important factors
are briefly discussed below. Future revenue growth and improvement in operating results will be largely contingent on DocGo’s ability
to penetrate new markets and further penetrate existing markets, which is subject to a number of uncertainties, many of which are beyond
DocGo’s control. The COVID-19 pandemic has also significantly impacted DocGo’s business, as discussed above.
Operating
Licenses
DocGo
has historically pursued a strategy to apply for ambulance operating licenses in the states, counties and cities, identified for future
new market entry. The approval of a new operating license may take an extended period of time. DocGo reduces this risk through its acquisition
strategy by identifying businesses and/or underlying licenses in these new markets that may be for sale.
Acquisitions
Historically
DocGo pursued an acquisition strategy to obtain ambulance operating licenses from small operators. Future acquisitions may also include
larger companies that may help drive revenue, profitability, cash flow and stockholder value During the 12 months ended December 31,
2021, DocGo completed one acquisition, for a purchase price of $2.3 million, which contributed approximately $0.3 million to
2021 revenues. During the 12 months ended December 31, 2020, DocGo completed one acquisition, for a purchase price of $0.8 million, which
contributed approximately $0.1m to 2020 revenues. During the 12 months ended December 31, 2019, DocGo completed four acquisitions,
for an aggregate purchase price of approximately $1.1 million. These acquisitions contributed a combined total of approximately
$0.4 million to 2019 revenues.
Healthcare
services market
The
transportation services market is highly dependent on patients requiring transportation after surgeries and other medical procedures
and treatments. During the pandemic, DocGo experienced a decrease in transportation volumes as a result of fewer elective surgeries.
However, the Company was able to reallocate assets to locations where demand increased as a result of the pandemic.
48
Overall
economic conditions in the markets we operate
Economic
changes both nationally and locally in our markets impact our financial performance. Unfavorable changes in demographics, health care
coverage of transportation and mobile health services, interest rates, ambulance manufacturing, a weakening of the national economy or
of any regional or local economy in which we operate and other factors beyond our control could adversely affect our business.
Trip
Volumes and Average Trip Price
A
“trip” is defined as an instance where the Company completes the transport of a patient to a specific destination, for which
we are able to charge a fee. This metric does not include instances where a trip is ordered and subsequently either canceled (by the
customer) or declined (by the Company). As trip volume represents the most basic unit of transportation service provided by the Company,
it is the best measure of the level of demand for the Company’s Transportation Services, and is used by management to monitor and
manage the scale of the business.
The
average trip price is calculated by dividing the aggregate revenue from completed transports (“trips”) by the total number
of transports, and is an important indicator of the effective rate at which the Company is being compensated for its provision of Transportation
Services.
Revenues
generated from programs under which DocGo is paid a fixed rate for the use of a fully staffed and equipped ambulance do not factor in
the trip counts or average trip prices mentioned above.
Our
ability to control expenses
We
pay close attention to managing our working capital and operating expenses. Some of our most significant operating expenses are labor
costs, medical supplies and vehicle-related costs, such as fuel, maintenance, repair and insurance. Insurance costs include premiums
paid for coverage as well as reserves for estimated losses within the Company’s insurance policy deductibles. We employ our proprietary
technology to drive improvements in productivity per transport. We regularly analyze our workforce productivity to achieve the optimum,
cost-efficient labor mix for our locations.
Inflation
Beginning
in April 2021, the inflation rate in the US, as measured by the Consumer Price Index (CPI) has been steadily increasing. In 2019, the
inflation rate was approximately 1.8%, while it dropped to approximately 1.2% in 2020. These data are reported monthly, showing year-over-year
changes in prices across a basket of goods and services. For 2021, inflation increased from the 1.4%-2.6% range in the first quarter,
to 4.2% in April, and was in the 5.0% area through the end of the third quarter of 2021. The inflation rate continued to increase throughout
the fourth quarter, measuring approximately 7.5% in December 2021. The increased inflation rate has had an impact on the Company’s
expenses in several areas, including wages, fuel and medical and other supplies. This has had the impact of compressing gross profit
margins, as the Company is generally unable to pass these higher costs on to its customers, particularly in the short term. Looking to
2022, we anticipate a moderation of the inflation rate when compared to 2021, when the annual inflation rate was 4.7%, but expect that
inflation will remain above the levels seen in the previous 10 years, when the annual inflation rate ranged from 0.1% to 2.4%. If inflation
is above the levels that the Company anticipates in 2022, gross margins could be below plan.
Investing
in R&D and enhancing our customer experience
Our
performance is dependent on the investments we make in research and development, including our ability to attract and retain highly skilled
research and development personnel. We must continually develop and introduce innovative new software services, integrate with third-party products
and services, mobile applications and other new offerings. If we fail to innovate and enhance our brand and our products, our market
position and revenue will likely be adversely affected.
Regulatory
Environment
DocGo
is subject to federal, state and local regulations including healthcare and emergency medical services laws and regulations and tax laws
and regulations. The Company’s current business plan assumes no material change in these laws and regulations. In the event any
such change occurs, compliance with new laws and regulations might significantly affect its operations and cost of doing business.
49
Components
of Results of Operations
Our
business consists of two reportable segments — Transportation services and Mobile Health services. The Company evaluates
the performance of both segments based primarily on results of its operations. Accordingly, other income and expenses not included in
results from operations are only included in the discussion of consolidated results of operations.
Revenue
The
Company’s revenue consists of services provided by its ambulance Transportation segment and its Mobile Health segment.
Cost
of Revenues
Cost
of revenues consists primarily of revenue generating wages paid to employees, vehicle insurance costs (including insurance premiums and
costs incurred under the insurance deductibles), maintenance, and fuel related to Transportation Services, and laboratory fees, facility
rent, medical supplies and subcontractors. We expect cost of revenue to continue to rise in proportion to the expected increase in revenue.
Operating
expenses
General
and administrative expenses
General
and administrative expense consists primarily of salaries, bad debt expense, insurance expense, consultant fees, and professional fees
for accounting services. We expect our general and administrative expense to increase as we scale up headcount with the growth of our
business, and as a result of operating as a public company, including compliance with SEC rules and regulations, audit, additional insurance
expenses, investor relations activities, and other administrative and professional services.
Depreciation
and Amortization
DocGo
depreciates its assets using the straight-line method over the estimated useful lives of the respective assets. Amortization of
intangibles consists of amortization of definite-lived intangible assets over their respective useful lives.
Legal
and Regulatory
Legal
and regulatory expenses include legal fees, consulting fees related to healthcare compliance, claims processing fees and legal settlements.
Technology
and development
Technology
and development expense, net of capitalization, consists primarily of cost incurred in the design and development of DocGo’s proprietary
technology, third-party software and technologies. We expect technology and development expense to increase in future periods to
support our growth, including continuing to invest in the optimization, accuracy and reliability of our platform and drive efficiency
in our operations. These expenses may vary from period to period as a percentage of revenue, depending primarily upon when we choose
to make more significant investments.
Sales,
advertising and marketing
Our
sales and marketing expenses consist of costs directly associated with our sales and marketing activities, which primarily include sales
commissions, marketing programs, trade shows, and promotional materials. We expect that our sales and marketing expenses will continue
to increase over time as we increase our marketing activities, grow our domestic and international operations, and continue to build
brand awareness.
Interest
Expense
Interest
expense consists primarily of interest on our outstanding borrowings under our outstanding notes payable and financing obligations.
50
Results
of Operations
Comparison
of Fiscal 2021 with Fiscal 2020
| For the Years Ended December 31, | Change | Change | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2021 | 2020 | $ | % | ||||||||||||
| Revenues, net | $ | 318.7 | $ | 94.1 | $ | 224.6 | 239 | % | ||||||||
| Cost of revenue | 209.0 | 62.7 | 146.3 | 233 | % | |||||||||||
| Operating expenses | ||||||||||||||||
| General and administrative | 74.9 | 34.9 | 40.0 | 115 | % | |||||||||||
| Depreciation and amortization | 7.5 | 5.5 | 2.0 | 36 | % | |||||||||||
| Legal and regulatory | 3.9 | 3.7 | 0.2 | 4 | % | |||||||||||
| Technology and development | 3.3 | 1.2 | 2.1 | 179 | % | |||||||||||
| Sales, advertising and marketing | 4.8 | 0.7 | 4.0 | 538 | % | |||||||||||
| Total expenses | 303.4 | 108.8 | 194.6 | 179 | % | |||||||||||
| Income/(loss) from operations | 15.4 | (14.8 | ) | 30.2 | ||||||||||||
| Other income (expenses) | ||||||||||||||||
| Interest income (expense), net | (0.8 | ) | (0.2 | ) | (0.6 | ) | 274 | % | ||||||||
| Gain (loss) from PPP loan forgiveness | 0.1 | - | 0.1 | |||||||||||||
| Gain (loss) on disposal of fixed assets | (0.0 | ) | 0.0 | (0.1 | ) | (213 | )% | |||||||||
| Gain (loss) on remeasurement of warrant liabilities | 5.2 | - | 5.2 | |||||||||||||
| Gain (loss) on initial equity method investment | (0.1 | ) | - | (0.1 | ) | |||||||||||
| Other income | (0.0 | ) | 0.3 | (0.3 | ) | (113 | )% | |||||||||
| Total other expense | 4.4 | 0.1 | 4.3 | 3450 | % | |||||||||||
| Net income/(loss) before income tax | 19.8 | (14.6 | ) | 34.5 | ||||||||||||
| Income tax (expense) benefit | (0.6 | ) | (0.2 | ) | (0.4 | ) | 268 | % | ||||||||
| Net income (loss) | 19.2 | (14.8 | ) | 34.0 | ||||||||||||
| Net income (loss) attributable to Non-controlling interests | (4.6 | ) | (0.4 | ) | (4.1 | ) | 940 | % | ||||||||
| Net income (loss) attributable to the shareholders of DocGo Inc and Subsidiaries | $ | 23.8 | $ | (14.4 | ) | $ | 38.2 |
Consolidated
For the year ended December
31, 2021, total revenues were $318.7 million, an increase of $224.6 million, or 239%, from the total revenues recorded in the year ended
December 31, 2020.
Transportation
Services
For
the year ended December 31, 2021, Transportation Services revenue totaled $84.3 million and increased by $21.1 million, or 33%, as compared
with the year ended December 31, 2020. This increase was due to a 12% increase in transportation trip volumes, from 159,908 trips for
the year ended December 31, 2020 to 179,063 trips for the year ended December 31, 2021. The increase in trip volumes is due to a combination
of growth in markets originally entered in 2019 and 2020, expansion of existing markets and entry into new markets in 2021. Our average
trip price increased from $324 in the year ended December 31, 2020, to $342 in the year ended December 31, 2021. The increase in the
average trip price in the 2021 period reflects a shift in mix toward higher-priced transports. We anticipate that average trip price
could increase further in 2022, due to a 5.1% increase in the Medicare reimbursement rate for ambulance transports. Transportation Services
revenues were also driven higher in 2021 by an 135% increase in revenues generated from programs under which DocGo is paid a fixed rate
for the use of a fully staffed and equipped ambulance, driven by new customer acquisition. These services do not factor in the trip counts
or average trip prices mentioned above. This was partially offset by the absence of FEMA transport revenues in the current year period.
FEMA revenues amounted to approximately $4.5 million in the second quarter and full year of 2020.
51
Mobile
Health
For the year ended December
31, 2021, Mobile Health revenue totaled $234.4 million, an increase of $203.5 million, or 659%, as compared with the year ended December
31, 2020. This significant increase was mainly due to the expansion of the services offered by this segment in 2021, particularly with
respect to COVID-19 related testing (which began in May 2020) and vaccination and other healthcare services revenues included in the Mobile
Health segment. This expansion accelerated throughout 2021 as the Company increased its customer base and geographic reach, while extending
several large customer contracts and began providing a broader range of services.
Cost
of Revenue
For the year ended December
31, 2021, total cost of revenue (exclusive of depreciation and amortization) increased by 233%, as compared to the year ended December
31, 2020, while revenue increased by approximately 239%. Cost of revenue as a percentage of revenue decreased to 65.6% in 2021 from 66.6%
in 2020.
In
absolute dollar terms, cost of revenue in the year ended December 31, 2021 increased by $146.3 million from the levels of the year ended
December 31, 2020. This was primarily attributable to a $40.9 million increase in total compensation, reflecting higher headcount for
both the Transportation Services and Mobile Health segments; a $65.5 million increase in subcontracted labor, driven mostly by the Mobile
Health segment, where revenue increases outpaced the Company’s ability to service such revenue solely with internal resources,
temporarily causing the Company to rely increasingly on subcontracted labor; a $12.7 million increase in lab fees related to COVID-19
testing activity, which was launched toward the middle of the prior-year period and continued to increase in volume throughout the year,
particularly in the fourth quarter of 2021; a $20.8 million increase in medical supplies, due to the purchase of COVID-19 test kits and
the need for increased personal protective equipment (PPE) and related supplies, particularly in the fourth quarter of 2021, and the
increased cost thereof as a result of increased demand during the pandemic; and a $4.6 million increase in vehicle costs, driven by a
continued increase in the Company’s vehicle fleet and higher fuel costs; and $1.6 increase in facilities and other costs of sales,
relating to the Company’s increased scale and geographic presence.
For
the Transportation Services segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2021
amounted to $63.4 million, up $19.6 million, or 45%, from the year ended December 31, 2021. Cost of revenues as a percentage of revenues
increased to 75.3% from 69.3%, reflecting higher hourly wages in certain markets and increased overtime for field employees, and increased
fuel costs, as described above.
For
the Mobile Health segment, cost of revenues (exclusive of depreciation and amortization) in the year ended December 31, 2021 amounted
to $145.6 million, compared to $18.9 million in the year ended December 31, 2020. Cost of revenues as a percentage of revenues increased
to 62.3% from 61.2%, despite lower average per-test lab fees and the inclusion of higher-margin, hourly-based programs in the 2021 period,
reflecting the increased use of higher cost subcontracted labor and significant increases in medical supply costs, as described above.
Operating
expenses
For the year ended December
31, 2021, the Company recorded $94.4 million of operating expenses compared to $46.1 million for the year ended December 31, 2020, an
increase of 105%. As a percentage of revenue, operating expenses declined from 49.0% in 2020 to 29.6% in 2021, due primarily to the significant
increase in overall revenues described above, coupled with the semi-fixed nature cost of the corporate infrastructure. The increase of
$48.3 million related primarily to a $25.8 million increase in payroll due to investments in and expansion of corporate infrastructure
to support the revenue growth; a $0.9 million increase in subcontracted labor costs, due to the growth of the Mobile Health segment, which
outpaced the Company’s ability to hire enough internal personnel to service these revenues; a $3.7 million increase in sales and
marketing cost, driven by higher sales commissions and increased marketing activity arising from the expansion of the Mobile Health segment;
a $1.0 million increase in liability insurance expense, reflecting a reserve for estimated losses under the Company’s insurance
policy deductibles; a $4.5 million increase in travel and entertainment expenses, reflecting both the growth of the overall employee base,
as well as increased business development related activities for both the Transportation Services and Mobile Health segments; a $3.4 million
increase in depreciation and amortization due to an increase in assets to support revenue growth and capitalized software amortization;
a $1.9 million increase in legal, accounting and other professional fees related to increased revenue and related contract generation
and financing and capital-raising activities; a $1.8 million increase in office-related expenses, owing to the Company’s ongoing
geographic expansion; a $0.8 million increase in licenses and taxes, due primarily to the geographic expansion of the Mobile Health segment;
a $1.9 million increase in computer IT infrastructure, driven by the Company’s business and headcount expansion; and a $2.6 million
increase in bad debt expense, in line with the increase in overall revenues during the period.
52
For
the Transportation Services segment, operating expenses in the year ended December 31, 2021 were $47.2 million, up $8.5 million, or 22%,
from the year ended December 31, 2020. Operating expenses as a percentage of revenues declined to 56.1% from 61.2% in the prior year
period, reflecting the increase in Transportation Services revenues, compared to the semi-fixed cost nature of the corporate infrastructure.
The increased operating expenses, in dollar terms, in the year ended December 31, 2021 primarily reflected higher costs for payroll,
travel and entertainment, professional fees and depreciation, as described above.
For the Mobile Health segment,
operating expenses in the year ended December 31, 2021 were $47.2 million, compared to operating expenses of $7.5 million in the year
ended December 31, 2020. Operating expenses as a percentage of revenues decreased to 20.1% from 24.2% in 2020, despite significant expenditures
made in the expansion of services and geographic areas of operation, as well as the buildout of the Mobile Health management infrastructure
throughout 2021, due to the faster rate of increase in Mobile Health revenues. The increased operating expenses, in dollar terms, in 2021
were primarily driven by higher costs for payroll, subcontracted labor costs, travel and entertainment, marketing and computer IT infrastructure,
and facilities costs, as described above.
Interest
income (expense, net)
For
the year ended December 31, 2021, the Company recorded $0.8 million of net interest expense compared to $0.2 million of interest expense
in the year ended December 31, 2020. The increase in net interest expense in the current period reflects an increase in payments made
for leased vehicles, as the Company’s fleet expanded.
Other
income
During
the year ended December 31, 2021, the Company recorded a $0.1 million gain from the forgiveness of a PPP loan made to one of the Company’s
subsidiaries. No gain or loss was recorded in relation to the disposition of any loan in the prior year period.
Gain
on remeasurement of warrant liabilities
During
the year ended December 31, 2021, the Company recorded a $5.2 million gain from the remeasurement of warrant liabilities, The warrants
are marked-to-market in each reporting period, and this gain reflects the decline in DCGO’s stock price relative to the beginning
of the period. No gain or loss was recorded in relation to the remeasurement of warrant liabilities in 2020.
Income
tax (expense)/benefit
During the year ended December
31, 2021, the Company recorded income tax expense of $0.6 million, compared to an income tax expense of $0.2 million in the year ended
December 31, 2020. The increase in income tax expense resulted from the higher level of pretax income as well as state income taxes in
jurisdictions the Company entered during the past year.
Noncontrolling
Interest
For
the year ended December 31, 2021, the Company had a net loss attributable to noncontrolling interest of approximately $4.6 million, compared
to a net loss attributable to noncontrolling interest of $0.4 million for the year ended December 31, 2020. The increased loss reflects
ongoing investments made into new markets that were entered into during 2020 and 2021.
53
Liquidity
and Capital Resources
Since
inception, DocGo completed three equity financing transactions as its principal source of liquidity, with minimal debt incurred. Generally,
the Company utilized equity raised to finance operations during its development phase, investments in assets, ambulance operating licenses
and funding accounts receivable. The Company has also funded these activities through operating cashflows. In November 2021, upon the
completion of the merger between Motion Acquisition Corp. and Ambulnz, Inc., the Company received proceeds of approximately $158.1 million,
net of transaction expenses. Despite the fact that the Company generated positive net income in the year ended December 31, 2021, operating
cash flows are not always sufficient to meet immediate obligations arising from current operations. For example, as the business has
grown, the Company’s expenditures for human capital and supplies has expanded accordingly, and the timing of the payments for payroll
and to associated vendors, compared to the timing of receipts of cash from customers frequently results in the requirement for using
existing cash balances to fund these working capital needs. The Company’s working capital needs depend on many factors, including
the overall growth of the company and the various payment terms that are negotiated with customers and vendors. Future capital requirements
depend on many factors, including potential acquisitions, our level of investment in technology, and rate of growth in existing and into
new markets. The cost of ongoing technology development is another factor that is considered. Capital requirements might also be affected
by factors which the Company cannot control, such as interest rates, and other monetary and fiscal policy changes to the manner in which
the Company currently operates. Additionally, as the impact of the COVID-19 on the economy and operations evolves, the Company will continuously
assess its liquidity needs. If the Company’s growth rate is higher than is currently anticipated, resulting in greater-than-anticipated
capital requirements, the Company might need or choose to raise additional capital through debt or equity financings.
Considering
the foregoing, DocGo anticipates that existing balances of cash and cash equivalents, future expected cash flows generated from our operations
and an available line of credit will be sufficient to satisfy operating requirements for at least the next twelve months.
Capital
Resources
Comparison
as of December 31, 2021 and December 31, 2020
| $ in Millions | As of December 31, 2021 | As of December 31, 2020 | Change $ | Change % | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Working capital | ||||||||||||||||
| Current Assets | $ | 256.0 | $ | 58.4 | $ | 197.6 | 338 | % | ||||||||
| Current Liabilities | 57.9 | 23.5 | $ | 34.4 | 146 | % | ||||||||||
| Total working capital | $ | 198.1 | $ | 34.9 | $ | 163.2 | 468 | % |
As of December 31, 2021, available
cash totaled $175.5 million, which represented an increase of $143.1 million compared to December 31, 2020, reflecting the receipt of
the proceeds of the Motion transaction described above. As of December 31, 2021, working capital amounted to $198.1 million, which represents
an increase of $163.2 million compared to December 31, 2020, reflecting the increased cash balance. Increased accounts receivable, reflecting
the growth of the business in 2021, were partially offset by increases in current liabilities reflecting the growth of the business and
resulting from extended payment terms from vendors.
Cash
Flows
Year
ended December 31, 2021 and 2020
| For the Year ended December 31, | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| $ in Millions | 2021 | 2020 | Change | Change | ||||||||||||
| Cash Flow Summary | ||||||||||||||||
| Net cash provided by/(used in) operating activities | $ | (1.9 | ) | $ | (10.7 | ) | 8.8 | -82 | % | |||||||
| Net cash used in investing activities | (8.6 | ) | (6.0 | ) | (3.1 | ) | 43 | % | ||||||||
| Net cash provided by financing activities | 155.2 | (0.8 | ) | 156.5 | ||||||||||||
| Effect of exchange rate changes | 0.0 | 0.2 | (0.2 | ) | -100 | % | ||||||||||
| Net (decrease) increase in cash | $ | 144.7 | $ | (17.3 | ) | 162.0 | % |
54
Operating
activities
During the year ended December
31, 2021, operating activities used $1.9 million of cash, despite net income of $19.2 million. Non-cash charges amounted to $7.7 million,
as $5.2 million in depreciation of property and equipment and right-of-use assets, $1.8 million from amortization of intangible assets,
$4.5 million in bad debt expense primarily related to a provision for potential uncollectible accounts receivable and $1.4 million of
stock compensation expense were partially offset by $5.2 million in a non-cash gain on the remeasurement of warrant liabilities. Changes
in assets and liabilities resulted in approximately $28.8 million in negative operating cash flow and were primarily driven by a $57.1
million increase in accounts receivable arising from the growth of the business, particularly in the fourth quarter of the year and the
inclusion of larger Mobile Health customers with extended credit terms; and a $3.5 million increase in prepaid expenses and other current
assets, partially offset by a $32.6 million increase in accounts payable and accrued expenses due primarily to the extension of credit
and timing of payments, as DocGo attempted to align the timing of payments to vendors with the timing of payments received from customers,
where possible, in an attempt to manage cash balances.
During
the year ended December 31, 2020, operating activities used $10.7 million of cash, primarily resulting from a net loss of $14.8 million,
partially offset by non-cash charges of $7.7 million. The non-cash items included $1.9 million of bad debt expense primarily related
to a provision for potential uncollectible accounts receivable, $4.0 million resulting from the depreciation of property and equipment
and right-of-use assets, $1.4 million from amortization of intangible assets, and $0.7 million of stock compensation expense, partially
offset by a non-cash gain of $0.3 million from a write off of amounts due to a seller. Changes in assets and liabilities resulted in
approximately $3.6 million in negative operating cash flow and were primarily driven by a $16.2 million increase in accounts receivable
and a $0.1 million increase in prepaid expenses and other current assets, which were partially offset by a $12.7 million increase in
combined accounts payable and accrued expenses.
Investing
activities
During the year ended December
31, 2021, investing activities used $8.6 million of cash, primarily consisting of the acquisition of property and equipment totaling $4.8
million and the acquisition of businesses and intangibles in the amount of $3.1 million to support the ongoing growth of the business.
In addition, there was an equity investment amounting to approximately $0.7 million.
During
the year ended December 31, 2020, investing activities used $6.0 million, primarily consisting of the acquisition of intangibles ($1.9
million) and the acquisition of property and equipment ($4.4 million) to support growth of new transportation markets, partially offset
by $0.3 million in proceeds from the disposal of property and equipment.
Financing
activities
During the year ended December
31, 2021, financing activities provided $155.2 million of cash, due primarily to $158.1 million in proceeds from the issuance of common
stock in connection with the Motion merger, which is net of $20.0 million in issuance costs. This was slightly offset by $2.2 million
in payments on obligations under the terms of a finance lease, and $0.5 million in expenditures to acquire the remaining 20% of the Company’s
U.K. subsidiary. During 2021, the Company received $8.0 million in proceeds from a revolving bank loan, which was repaid during the fourth
quarter of 2021.
During
the year ended December 31, 2020, financing activities used $0.8 million of cash, as noncontrolling interest contributions were outweighed
by repayments made on notes payable and finance leases.
Future
minimum annual maturities of notes payable at December 31, 2021 are as follows:
| Notes Payable | |||
|---|---|---|---|
| 2022 | $ | 0.6 | |
| 2023 | $ | 0.5 | |
| 2024 | $ | 0.3 | |
| 2025 | $ | 0.2 | |
| 2026 | $ | 0.2 | |
| 2027 and thereafter | $ | 0.1 | |
| Total maturities | $ | 1.9 | |
| Current portion of notes payable | $ | 0.6 | |
| Long-term portion of notes payable | $ | 1.3 |
55
Future
lease payments included in lease liabilities as of December 31, 2021, and for the following five fiscal years and thereafter were as
follows:
| Operating Leases | ||||
|---|---|---|---|---|
| 2022 | $ | 3.8 | ||
| 2023 | $ | 3.0 | ||
| 2024 | $ | 1.7 | ||
| 2025 | $ | 1.7 | ||
| 2026 | $ | 1.1 | ||
| 2027 and thereafter | $ | 0.0 | ||
| Total future minimum lease payments | 11.3 | |||
| Less effects of discounting | $ | (1.2 | ) | |
| Present value of future minimum lease payments | $ | 10.1 |
Critical
Accounting Policies
Basis of Presentation
The Company’s consolidated financial statements
are presented in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and
pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). The consolidated financial statements
include the accounts and operations of the Company and its wholly owned subsidiaries. All intercompany accounts and transactions are eliminated
upon consolidation. Noncontrolling interests (“NCI”) on the consolidated statements of financial condition represents the
portion of consolidated joint ventures and a variable interest entity in which the Company does not have direct equity ownership. Accounts
and transactions between consolidated entities have been eliminated.
Pursuant to the Business Combination, the merger
between Motion and Ambulnz, Inc. was accounted for as a reverse recapitalization in accordance with U.S. GAAP (the “Reverse Recapitalization”).
Under this method of accounting, Motion was treated as the “acquired” company for financial reporting purposes. Accordingly,
for accounting purposes, the Reverse Recapitalization was treated as the equivalent of Ambulnz, Inc. stock for the net assets of Motion,
accompanied by a recapitalization. The net assets of Motion are stated at historical cost, with no goodwill or other intangible assets
recorded. The consolidated assets, liabilities and results of operations prior to the Reverse Recapitalization are those of Ambulnz, Inc.
The shares and corresponding capital amounts and earnings per share available for common stockholders, prior to the Business Combination,
have been retroactively restated as shares reflecting the exchange ratio (645.1452 to 1) established in the Business Combination. Further,
Ambulnz, Inc. was determined to be the accounting acquirer in the transaction, as such, the acquisition is considered a business combination
under Accounting Standards Codification (“ASC”), Topic 805, Business Combinations, (“ASC 805”) and was accounted
for using the acquisition method of accounting.
Principles of Consolidation
The Company’s Consolidated Financial statements
include the accounts of DocGo Inc and its subsidiaries. All significant intercompany transactions and balances have been eliminated in
these Consolidated Financial statements.
The Company holds a variable interest which contracts
with physicians and other health professionals in order to provide services to the Company. MD1 Medical Care P.C. (“MD1”)
is considered a variable interest entity (“VIE”) since it does not have sufficient equity to finance its activities without
additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if
it has both power and benefits—that is, it has (1) the power to direct the activities of a VIE that most significantly impacts
the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant
to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has
the power and rights to control all activities of MD1 and funds and absorbs all losses of the VIE and appropriately consolidates MD1.
Total revenue for the VIE amounted to $477,654 as of December 31, 2021.
Net loss for the VIE was $122,982 as of December 31, 2021. The VIE’s total assets, all of which were current, amounted to $481,338
on December 31, 2021. Total liabilities, all of which were current for the VIE, was $906,444 on December 31, 2021. The VIE’s total
stockholders’ deficit was $425,106 on December 31, 2021. The Company made payments of $1,746,736 and $298,404 to MD1 and its
affiliates during the years ended December 31, 2021 and 2020, respectively.
56
Business Combinations
The Company accounts for its business combinations
under the provisions of ASC 805-10, Business Combinations (“ASC 805-10”), which requires that the acquisition method of
accounting be used for all business combinations. Assets acquired and liabilities assumed, including NCI, are recorded at the date of
acquisition at their respective fair values. ASC 805-10 also specifies criteria that intangible assets acquired in a business combination
must meet to be recognized and reported apart from goodwill.
Goodwill represents the excess purchase price
over the fair value of the tangible net assets and intangible assets acquired in a business combination. If the business combination provides
for contingent consideration, the Company records the contingent consideration at fair value at the acquisition date and any changes in
fair value after the acquisition date are accounted for as measurement-period adjustments. Changes in fair value of contingent consideration
resulting from events after the acquisition date, such as earn-outs, are recognized as follows: 1) if the contingent consideration is
classified as equity, the contingent consideration is not re-measured and its subsequent settlement is accounted for within equity, or
2) if the contingent consideration is classified as a liability, the changes in fair value are recognized in earnings. For transactions
that are business combinations, the Company evaluates the existence of goodwill or a gain from a bargain purchase. The Company capitalizes
acquisition-related costs and fees associated with asset acquisitions and immediately expenses acquisition-related costs and fees associated
with business combinations.
The estimated fair value of net assets to be acquired,
including the allocation of the fair value to identifiable assets and liabilities, is determined using established valuation techniques.
Management uses assumptions on the basis of historical knowledge of the business and projected financial information of the target. These
assumptions may vary based on future events, perceptions of different market participants and other factors outside the control of management,
and such variations may be significant to estimated values.
Goodwill and Indefinite-Lived Intangible
Assets
Goodwill represents the excess of the purchase
price of an acquired business over the fair value of amounts assigned to assets acquired and liabilities assumed. Goodwill and indefinite-lived
intangible assets, consisting primarily of operating licenses, are not amortized, but are evaluated for impairment on an annual basis,
or on an interim basis when events or changes in circumstances indicate that the carrying value may not be recoverable. In assessing the
recoverability of goodwill and indefinite-lived intangible assets, the Company makes assumptions regarding the estimated future cash flows,
including forecasted revenue growth, projected gross margin and the discount rate to determine the fair value of these assets. If these
estimates or their related assumptions change in the future, the Company may be required to record impairment charges against these assets
in the reporting period in which the impairment is determined.
The Company tests goodwill for impairment at the
reporting unit level, which is one level below the operating segment. The Company has the option of performing a qualitative assessment
to determine whether further impairment testing is necessary before performing the one-step quantitative assessment. If as a result of
the qualitative assessment, it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, a quantitative
impairment test will be required. Otherwise, no further testing will be required. If a quantitative impairment test is performed, the
Company compares the fair values of the applicable reporting units with their aggregate carrying values, including goodwill. Estimating
the fair value of the reporting units requires significant judgment by management. If the carrying amount of a reporting unit exceeds
the fair value of the reporting unit, goodwill impairment is recognized.
Any excess in carrying value over the estimated
fair value is recorded as impairment loss and charged to the results of operations in the period such determination is made. For the periods
ended December 31, 2021 and 2020, management determined that there was no impairment loss required to be recognized in the carrying value
of goodwill or other intangible assets. The Company selected December 31 as its annual testing date.
57
Revenue Recognition
On January 1, 2019, the Company adopted ASU 2014-09,
Revenue from Contracts with Customers (“ASC 606”), as amended.
To determine revenue recognition for contractual
arrangements that the Company determines are within the scope of ASC 606, the Company performs the following five steps: (1) identify
each contract with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate
the transaction price to performance obligations in the contract; and (5) recognize revenue when (or as) the relevant performance obligation
is satisfied. The Company only applies the five-step model to contracts when it is probable that the Company will collect the consideration
it is entitled to in exchange for the goods or services the Company provides to the customer.
The Company generates revenues from the provision
of (1) ambulance and medical transportation services (“Transportation Services”) and (2) Mobile Health services. The customer
simultaneously receives and consumes the benefits provided by the Company as the performance obligations are fulfilled, therefore the
Company satisfies performance obligations immediately. The Company has utilized the “right to invoice” expedient which allows
an entity to recognize revenue in the amount of consideration to which the entity has the right to invoice when the amount that the Company
has the right to invoice corresponds directly to the value transferred to the customer. Revenues are recorded net of an estimated contractual
allowances for claims subject to contracts with responsible paying entities. The Company estimates contractual allowances at the time
of billing based on contractual terms, historical collections, or other arrangements. All transaction prices are fixed and determinable
which includes a fixed base rate, fixed mileage rate and an evaluation of historical collections by each payer.
Income Taxes
Income taxes are recorded in accordance with ASC
740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company
recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial
statements or its tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement
and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse.
Valuation allowances are provided, if based upon the weight of available evidence, it is more likely than not that some or all of the
deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740.
When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more
likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely
than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances.
The Company recognizes any interest and penalties accrued related to unrecognized tax benefits as income tax expense.
Please see Note 2, “Summary
of Significant Accounting Policies” to the Consolidated Financial Statements.