Conference Transcript - DCGO 2026-06-08

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Good afternoon. My name is Sarah Conrad, and I'm on the GS Healthcare Services team here. Today, I am joined by DocGo and CEO Lee Beamstock. Lee, just for those who are a little less familiar with the story, can you give a high-level overview of the business today and how we're thinking about the core value proposition?

Speaker 2

Absolutely, Sarah. It's great to be here with you. So for those less familiar with DocGo, essentially, we deliver healthcare, literally. We go into patients' homes and deliver healthcare. We provide virtual care services, remote care services, and we also have a very large medical transportation business where we go and take patients from one care setting to the next. So that's essentially what our company is there to do. We're going to meet patients where they are or bring patients to where they need to get to, and we do that at great scale. Last year we transported 700,000 patients, and we also visited about 150,000 patients in the home and did over a million telehealth visits. So we're really excited. we're meeting patients where they are and we think when you meet patients where they are you have better health outcomes you have better health outcomes obviously it's great for the patients it's great for the system and we think we'll do well in that in that way yeah so the company's gone through a bit of transition over the last couple years you've moved away from your covid and migrant related work can you talk about the main pieces of the business today and how investors should think about like what the normalized business should look like from here absolutely So you mentioned it. I mean, the company went public in 2021. At that time, we were a medical transportation company. We've been doing medical transportation now for over 10 years. When the company went public, we were doing about $100 million in medical transportation revenue in that year. This year, we'll do over $200 million. So we've doubled the medical transportation business in that time. And at the time, we were doing a lot of COVID work and over the last number of years doing work relating to the migrant crisis in New York. And so the company was doing a lot of work with emergency response, right? Us being an ambulance company at heart, a medical transportation company at heart, we were mobile and dynamic in that way, and that was what was needed to respond to some of these emergencies. But really, the goal of the company has evolved into meeting patients where they are in an evergreen way, tackling their health and their chronic conditions in an evergreen, proactive way, and that's where the company has evolved. In Q1 of this year, that was the first quarter in years where the company did not have any COVID revenue or migrant-related revenue. We were providing medical care to the migrants that were being bused to New York. We didn't have any of that type of revenue. We had about $76 million of revenue in Q1 of this year, all of which was comprised of our medical transportation revenue and the Care Anywhere portfolio, as I say, bringing care to where it's needed. So that was an exciting moment for us, the sort of first quarter, and people got a chance and investors got a chance to see the business for the components that are evergreen and proactive and providing care where it's needed, and that was a big, big milestone for us.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, so let's move on to medical transportation. So this is your largest, most established vertical. Can you talk a little bit about the utilization environment there, what's driving the growth today, and also just the competitive environment within medical transportation?

Speaker 2

Yes, so medical transportation has gotten a lot of excitement recently. I know we were talking about one of our peer companies, I'd say. AMR just went public a couple months ago, and we're cheering them on as well, of course. So I think really medical transportation is evolving. Patients need to get to the care facilities and care settings that they need to get to to receive efficient care. As I mentioned, we've been doing it for over a decade now. And the real genesis for us to bring innovation to the space was really, how can we use technology to become more efficient? How can we use technology to help the system? And that's basically what we set out to build over the last 10, 11 years. We built a platform that's embedded within Epic where a discharge nurse can literally click a button and, just like Uber, see exactly when the ambulance is going to arrive to pick up the patient. That is a really magical experience for a discharge nurse. If you think back, it used to be when you ordered ambulance or medical transportation, you'd call the first company on the list. Hey, can you come pick up my patient now? Great, we'll be there in an hour. You don't really know, are they going to be there in an hour and 20 minutes? Are they going to be there in 40 minutes? Maybe they weren't available to pick up the patient. You'd call the second one on the list. Now with us, we have our platform. It's directly embedded within Epic, and they click a button, and they can see exactly when we're arriving. And the other piece is we've approached the market in a very different way. We're contracting with major hospital systems to provide medical transportation for their entire population. And this is a big aspect because you can imagine if a hospital called up an ambulance company and said, hey, can you come pick up a patient? If they didn't have such great insurance, maybe they're busy. They didn't have any insurance. But for us, we help the hospital system contract in a way that we align incentives so that we can help them manage the patient flow. and that has been a big, big we work with. We work with some hospital systems like New York City Health and Hospitals, Mount Sinai Jefferson we work with Mainline Health we work with Methodist we work with a lot of great hospital systems that use our software, Northwell and we help them manage that patient flow and that integration between software and services is very unique. I think that's a winning strategy we can talk more about it but there's a lot of companies out there that are just doing the software, but they can't provide you with the services, or there are antiquated companies providing services, but they don't have the technology. And that's kind of our unique value proposition is we bring both to bear, both the platform and the services, all integrated into one seamless experience for the facility and the patient.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, so you mentioned you take all types of payers. We've had a couple of changes in the market recently with the HIC subsidies expiring, Medicaid challenges with SDP payments.

Speaker 2

Can you talk a little bit about how your payer mix has shifted over the last you know year or so yeah so for us really we contract first and foremost either with the insurance companies directly or with the hospital systems I'll tell you that the there's a lot of strain on the system right now hospital systems are definitely worried about expenses and the reimbursement rates that they're going to be getting certainly we believe there's going to be a lot of many fewer population on some of the Medicaid plans and so as a result what patients are going to end up in the hospital the The question is, do they have Medicaid or do they not have Medicaid? Do they have insurance or do they not have insurance? The hospitals are going to have to grapple with how they're going to provide services for those patients. And so that's really why we exist. We're there to help them either mitigate that. We try to get when they don't need to be there, and I'll tell a personal story in a second. And, of course, if the patient does need to be there or needs to be transported out upon discharge, we help them do that efficiently. So I think, you know, reward outcomes and the upfront reimbursements are so low. You have no choice but to use technology to drive down the cost, otherwise you won't be successful. So it's pretty clear what the industry and what CMS is trying to do. They're trying to incentivize providers like us and hospital systems and insurance companies that we work with to drive the cost down, to improve outcomes, and to reward companies and providers for doing that. We've all had experiences where we've gone to the doctor or taken the child to the hospital, and there's just test after test. Providers get rewarded the sicker and sicker you get. The more and more times they visit the hospital, the more and more times they visit a doctor's office, and the system has to change to where actually companies like mine, companies like ours, are successful the healthier the patient is. That's what CMS, I believe, is trying to do. We sit at the intersection of that, and I think you're going to see more and more of that come down the pipe here. I think also in some cases you're going to see pressure on rates, but in some cases you're going to see higher incentives. I think CMS is really pushing more preventative care. They're increasing the G codes on preventative care. They're improving reimbursements on proactive screenings and things of that nature, all with an effort to improve outcomes, which will ultimately drive down the total cost of care. So that's really kind of the piece of the strategy we're focused on.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, so I guess sticking on medical transportation just for a little bit, So what do you think customers are prioritizing when they're selecting their vendors? And then what do you think is driving your ability to continue to take share in this market?

Speaker 2

So I think, first and foremost, the customers we work with are prioritizing the transparency of the service delivery. When are we going to be there? How often do we arrive on time? How quickly can we move the patients and free up the bed for the next patient? That's the key. So, for example, when we're ordered, when medical transportation is ordered through us, alerts go out across the hospital. The housekeeping team is notified now. It's time to go and make up the room for the next patient. The intake team is notified, hey, the bed is freed up for the next patient. The discharge nurse knows exactly when to get the patient ready because they know exactly when we're going to be arriving. So that transparency and understanding each piece of the service delivery is very, very valuable to the hospital system, and that's what the tech platform enables them to do. I also think the quality of the service is very very important and so they choose us based on that they typically don't choose us based on price you know we're not going to be the lowest cost provider we're there to provide medical transportation to the entire patient population that they serve oftentimes that requires the hospital system to invest alongside us right I mean part of the part of the issue has been that all the ambulance companies happen to be busy when a patient that doesn't have insurance or has a low reimbursement insurance needs to be transported we'll be there to take that patient we want to provide great care and great access for all but then the incentives have to be aligned between the facility and the provider so a lot of cases we have a program where we call like a dedicated fleet where our ambulances are dedicated to that facility and we'll transport any of the patients they need to transport and we'll bill insurance if we're able to collect our daily minimum the hospital system doesn't owe us anything if we're able if we're not able to collect and the hospital pitches in the shortfall and that aligns incentives the other way we align incentives is we'll tell the hospital when we're going to arrive to pick up the patient we show up there and the patient's not ready we just have to wait around everybody loses the patient loses the hospital loses and we lose you know we couldn't be the only ones to lose in that scenario where we're just waiting for the patient to be ready so that's the key aligning all the incentives where the hospital system knows they can have reliable great quality transparent you know transportation and patient flow we know that when we show up the patient's going to be ready so we could be really efficient and transport as many patients as we can throughout that shift throughout that day and then of course the patient benefits in a great way when there's great quality predictable transportation to get them where they need to be that's what we've set up that's why we think we're going to be very successful it's great hearing about those partnerships and relationships that you have.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

I want to pivot to the recent acquisition of SteadyMD, which had a really strong first quarter. Can you talk a little bit about how this business is operating post-acquisition and how we should think about the pipeline of new logos and existing logos from here?

Speaker 2

Yes, so we're very excited. We have a very talented team that's joined the company in SteadyMD. They had a record quarter in Q1. They're on a really great trajectory for the rest of this year. They continue to sign incredible customers and partners in the pharmacy space, in the digital wellness space, and I think we're very excited. The other piece that is very foundational, this idea of going to deliver care in the home, we don't send a doctor, we don't send an MD to the home. We don't send a nurse practitioner, a physician's assistant into the home. There's just too much drive time there's too much time in between the patient interactions so what we do which is very unique is we'll send a medical assistant or an LPN into the home they're the hands eyes and ears in the home that's able to vaccinate a patient that's able to take a swab take a lab sample take a screening and remotely virtually is the higher order clinician and that's the steady and D network so we've really through this acquisition we've done two things. A, we've brought a great virtual care practice, 50 states, into the company, and we've created this network where now the study and declinicians are overseeing the DOCO visits in the home. And that 400, 500, 600 clinician network is enabling us to scale the in-the-home visits way faster. So that's why we're so excited about this. And we think, look, you have to be able to provide care in every modality. virtually remotely and in person and there are so many companies that could do it virtually but they can't be in person there are companies that could be in person like the doctor's office but they don't do the digital or remote well we are building the competency to do all of it under one clinical practice and so when the telehealth visit will do we'll do a telehealth visit when we need to be with the patient hands-on we have the ability to do that as well we can't take blood sample through a zoom call through a virtual visit we can't give a patient a vaccination through a screen but we can do a lot of things virtually and so that's the wonderful aspect of what we're building we're building this care anywhere platform where we can be with the patient when it when it's needed we can be virtual when it's efficient we can be remote so we're monitoring the patient throughout their daily lives and we can intervene and be proactive in the moment in real time that is very unique at the scale we're doing it it's a very and it's really frankly what's needed for the health care system because if the health care system keeps going the way it's going where we spend 19% of GDP I'm sure a lot of people are talking about this throughout the conference patients are just getting sicker and sicker and rewarding just keep getting sicker and sicker really frankly makes no sense that's what CMS is really pushing we applaud them for that and rewarding folks like us for the the healthier the patients get, the less they're bouncing back to the hospital is really where the system needs to go to save it.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yes, we talked a little bit about the flywheel of demand with the SteadyMD acquisition. So as we think about the demand trajectory and also the margin profile, how should we think about this integrating into the company and driving additional efficiencies?

Speaker 2

Yes, so that is the big aspect, that integration where the SteadyMD clinical practice group. So before we acquired SteadyMD, we had our own clinical practice group. And then, of course, SteadyMD came with the clinical practice group. So now we've integrated the clinical practice group into one clinical practice group, serving all the patients we see, whether they be the SteadyMD patients, DOCO patients, or any of the patients that we see. And, again, marrying the SteadyMD network to the clinician in the home, when DOCO sends a clinician in the home. That's what's going to be driving the efficiency. So we think that's going to improve the margins. A big aspect of the company is we've been investing into the ability to bring a doctor's office into a patient's living room. That's what we've been investing into. It's cost us money. Obviously, it's contributing to the EBITDA loss. But we think that opportunity is just such a big opportunity. But we also realize that we have to improve the margins as we go. We want to be effective and viable. And so SteadyMD allows us to improve the margins as we go, allows us to see the patients in the home, but also to serve other customers with virtual visits. And that integration, integrating the clinical practice groups and then integrating the competencies, DocGo's ability to go in the home, SteadyMD's ability to be virtual. Now it's all under one roof, and we can be very, very efficient going forward.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, and just double-clicking one more time into SteadyMD. So there's been a little bit of focus on, like, some of the current logos, like the online pharmacies for wait-lifes, but can you talk about, are there any other types of customers that you want to call out or, like, additional logos that you would want to expand into that you think are a big opportunity?

Speaker 2

Yeah, so you mentioned the online pharmacies. That's obviously a big, with the GLP-1, you know, adoption, That's been a big growth driver for the company, and we've been at the forefront of that. I also think something that has not been talked about a lot is, well, everyone's talking about AI, but everyone's talking about AI as sort of like a replacement or maybe to be more efficient. We actually think the clinician with AI is going to be very, very powerful. So I'll give you an example. We work with a customer today, a dermatology AI-focused company, where you can upload a picture of, let's say, a skin condition, or you can engage with AI in a chat. But ultimately, if there's some diagnosis that's needed or there's some higher-level interaction that's needed where a patient actually wants to speak to a clinician, we can unlock that. So I think it's going to be our clinicians that are making sure that the AI is making the right diagnosis. Our clinicians are going to be sort of an off-ramp for when a patient actually does want to speak to a human clinician. And I think you're going to see a lot of marrying between the two. So today, a clinician still has to review that dermatology assessment. And so we're working with a lot of AI companies to bring the clinical practice to whatever tools they're trying to build to make the health care.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Okay, so now that we've walked through a lot of the pieces of the business, I want to ask about the underlying demand trends that you're seeing across the portfolio in the second quarter. We've heard from some of our hospital companies one last week who said surgical volumes were down and potentially flagged a weaker demand environment. So I guess is there any color that you can give us on demand trends throughout the second quarter so far?

Speaker 2

Yeah, so we actually don't play with those higher order surgical procedures. Actually, if we're doing our job well, surgical procedures will go down and sort of higher, more acute interventions will go down, and that's really, frankly, what the health care system needs. Now, of course, hospitals play a vital role. If a patient truly needs that more acute surgical procedure, then we want to be there to be able to maybe coordinate the transportation or to provide the follow-up care in the home to make sure that it's healing properly and so forth. We do all of that. So I think the demand trends we're seeing is really around the consumerization of health care. I think a lot of the wearable companies are going to get more and more into health care. I think they are doing a wonderful job with some of the diagnostics they're able to do with the wearables. But then if they truly want to take the next leap into sort of a medical device, they're going to need a clinical practice. And setting up a clinical practice is not so easy to do. Certainly to do it in all 50 states is not so easy to do. And so we're finding a lot of demand there where you have the consumerization of health care. And those digital health companies that want to offer actual medical advice, medical services to subscribers, we unlock that for them. So we're seeing a lot of growth there. I think we're also seeing a lot of growth, again, from the payer side, where they're trying to improve their MLR. They're trying to drive down costs. They're trying to reduce hospital readmissions. They're trying to improve their HEDIS quality score ratings. And the only way to really do that, well, there's lots of ways to do that, but the big way to do that is that they're going without the care to address that. So we're seeing a big tailwind there for sure. And so, you know, we're continuing to widen the scope that we're providing in the home. We're trying to meet patients before they end up in a hospitalization. We're trying to meet patients within that 30-day re-admit window so that we can see them in the home, maybe redress that incision site, maybe make sure that they don't bounce back to the hospital. We work with a very large payer in California where they've been giving us the LACE score patients, the length of stay, acuity, chronic condition patients on a scale of 1 to 10. They've been giving us, I think, on average, 9.2 out of 10. So these are the highest acuity patients. Our patient population they've been giving us has been bouncing back to the emergency department 60% less. Because, again, we're following up with their care plans in the home. So I think this idea of meeting patients where they are is playing out, and the payers, the majority of the customers we have on the payer side want to expand with us this year.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Okay, so maybe all the demand's just shifting out of those acute settings. So you've outlined a path to profitability this year. So how should we think about the key drivers and what the puts and takes are going to be?

Speaker 2

Yeah, so this is a big, big aspect for the company. You know, we shared on our last earnings call that we plan to break even in the back half of the year. And it's really a factor of three, obviously, key components. The first is on a quarterly revenue basis, we want to achieve the $80 to $85 million. We feel like that's the critical need, the sort of watermark that we need to get to on a revenue side. And so in Q1, I mentioned we did about $76 million of revenue. So we feel like we're quite close to that. And, of course, I mentioned a lot of the growth that we're seeing throughout the company. And so that is sort of, if you will, so that revenue base, that's one component of it, about $80 million to $85 million of quarterly revenue. Then on the gross margin side, we feel like we need to be in the 34% to 35%. In Q1, we are at 31.6 adjusted gross margin. So we feel like, again, we have about 200 to 400 basis points to go there. That's going to be driven by being more and more efficient in our delivery, reducing overtime hours for our staff, reducing shift bonuses, being much more efficient, again, in the field with the medical assistants and the licensed practical nurses alongside the study and declination and driving that gross margin up. And as the mobile health portfolio takes more and more of the revenue component, that will drive margins up with it. So as an example, our mobile phlebotomy offering has about 55% gross margins. Our remote patient monitoring practice has about 60% gross margin. So as those continue to grow and become a bigger component of the revenue base, it will also take gross margins with it. And then we need to cut about $4 to $5 million of SG&A spend per quarter. We did a very large reduction in force recently, so we took some costs out of the business, and we're continuing to work with the vendors that we work with to sort of pare back some of the spending there, and we think that we can get that done.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Okay, so that was some really good detail there on mix versus scale versus operating efficiency. As we think about 27 and beyond, once we're past that break-even point, what do you think are the biggest levers going forward?

Speaker 2

I think it's going to continue to be, from a growth perspective, it's going to continue to be the Care Anywhere platform. I think we're going to continue to have very nice growth in those components. We think the Care Anywhere platform, again, virtual care, the care in the home, in the mobile lab, the remote patient monitoring aspects, will grow about 30% to 40% year-on-year. Again, medical transportation less. And so as that grows, that will be a continuing lever for that. I think we'll also continue to expand with the payers we work with. Right now we work with a number of wonderful, fantastic name-brand payers. I know some of them will be at the conference. And so we work with those payers, and we think over time we're going to be thoughtful about it. there are a lot of markets that those payers want us to go to so I shared and it's always in California we recently expanded with them to Kentucky and New Mexico there's other states we can expand with them and so I think it's but we also want to make be mindful new markets require new investment which require perhaps strain on the EBITDA so we're being very thoughtful about that we're expanding to new states in a very measured way and we think we're expanding to states in a way where we can you know do it profitably quickly we announced a couple weeks ago that we just launched mobile phlebotomy services in southern Florida actually in this neck of the woods and we did that in partnership with one of the major labs and we did it in a way where we were able to scale the staff you know cheaply and quickly and the demand was already there for us we didn't have to generate it so we think we're going to be profitable very quickly in that endeavor here in southern Cal and southern Florida and so that's the way we're kind of you know be scaling the business. Yeah so we touched a little bit on the CMS access model a little earlier I'd love to go more in depth into both CMS access but also are there any other CMS or regulatory proposals that we should be aware of as it relates your business yes so the access model was a big program that CMS launched essentially what that model is trying to incentivize is a much lower upfront basically reimbursement for a preventative you know care and if you're successful in achieving health outcomes which I'll give some examples of then you get sort of and that was a big a big move by CMS they put out an RFP I think a lot of companies responded to it they ultimately ended up choosing 150 to participate we are one of the 150 that was selected and I think time will tell we we will launch in a measured way where patients can be enrolled into our practice as part of the access program and we will provide preventative care exactly like we're doing today and try to drive outcomes. And so I think we will see more programs like that from CMS. I think that's the only real solution. I think part of the aspect that people in healthcare don't talk enough about, in order to improve health outcomes, most of the time you need a long-term view. Patients that have chronic conditions, it takes time to impact their health outcomes. It takes time to improve their condition. The system is set up in a very short-term way. I may have one insurance provider this year, and next year I might change my insurance provider. I might work for a company where I have one insurance, and then I go and work for another company that has a different insurance. So how can an insurance company actually invest to make me healthier, try so hard this year to maybe perhaps help me, you know, if I'm struggling with a chronic condition, only to see me go to another health insurance company if I were to change roles or change jobs or change insurance companies. And so that's the problem the system has. The only one that can solve that is CMS. And so I think that is CMS's responsibility, and I think they're going to continue to look there, all the conversations that we have around this from people that are in that orbit, advising in that space are telling us that CMS is pushing more and more to develop programs that are incentivizing that, because otherwise the health care system is completely doomed. Even for us, we're a self-insured employer on the health side, and we try so hard to help our employees, our team members that perhaps are high utilizers and have chronic conditions. And look, we feel a moral responsibility to try to help them, even if they are to go to move on to another company and have another insurance provider but we see it you know you have to have a long-term view to impact someone's health but the insurance industry and the health care industry is set up for short-term incentives and so that has to be solved everybody's talking about all these things with ai and everything else you can invest in anything you want if it does not improve health outcomes over a period of time where you could actually make a return on that investment which is how we're set up which is the way it should be right i'm going to work so hard to make a patient healthier only to see them go to another provider or go to another insurance company and that insurance company is going to get all the benefit of all the investment I made into that patient then that has to change so I think that's the types of programs you're seeing the heat is quality scale is a big part of that where insurance providers are incentivized to improve outcomes and have higher you know star ratings I think it's about something like 40 percent of the plans you know missing out on that. And 5% is a meaningful premium reimbursement to get from CMS, Uplift. So I think that's where the system's going. It has to go that way. The only one that could actually push incentives like that is CMS. And I know from the Access Program as an example, they're really looking towards that.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Okay, I've got one quick housekeeping modeling question. So fuel costs have been a big area of focus with the conflict in the Middle East. They wait on earnings in the first quarter, but it seems like costs have come down. Is there any updated framing you can give us and how we should be thinking about that into the second quarter and the rest of the year?

Speaker 2

Yeah, it's funny, Sarah. So obviously, I should have mentioned at the onset, we deliver healthcare. How do we do it? We have 1,000 vehicles. We have 4,000 clinicians in the field, all meeting patients where they are, taking patients where they need to get to. And last year, we were bragging that we drove like 11.5 million miles. And the team was, you know, we were talking about it, and I said, Hey, guys, actually, we should be bragging about how much fewer miles we can drive. And so that's part of the efficiency. If we didn't have our tech platform, I'm sure we'd be driving a lot more. As part of that, we purchased about 270,000 gallons of gasoline each quarter. It's pretty significant. And so for every dollar increase at the pump, we see about a 35 basis point margin hit. So for every dollar, again, 35 basis point margin hit. Our biggest component in the business is really the vehicles and the labor, not the gas. But we'd love it if the gas prices went lower, but it's about, you know, for every dollar, it's about 35 basis points. Sometimes people think, like, it would end up impacting our business more. It will be a headwind for us in Q2. We're seeing much higher gas prices in Q2. We think that will persist. But then we think, you know, hopefully the bait's in the back half of the year, which will help on the gross margin side. The other piece that we're doing in order to offset things we can't control, like gas prices, is to invest in the things that we can control, like automating a lot of the aspects of the business. So I mentioned on our last earnings call, we have an efficiency portfolio that includes a lot of automating business. So, for example, on our pre-billing function, where we would go in and see pre-authorization to see if the patient has insurance, we're going to be able to collect, notify the hospital system of that. And now we're using AI to do that, as an example. We were using a lot of human capital to coordinate patient schedules, visits, rescheduling, confirming appointments. And now we're using AI more and more to do that. So we are going to do the best we can to procure the gas for the cheapest possible way, understanding we can't control the price. But we are absolutely, like, sleeves rolled up on the aspects of the business that we can control, investing in automation so that we can improve the margins, which is a big facet of what we're doing to get to break even in the back half of the year.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, and so how should we think about cash flow and capital needs over the medium term, and how should we think about capital allocation, given where we Yeah, so first and foremost, I've been resolute.

Speaker 2

In terms of the capital allocation, we're going to continue to fund the growth of the business and fund the capabilities of the business, and we think that there's a lot of opportunity for us in the pipeline that we have in the business and the existing customer base we have. As I mentioned, we have the majority of our health plans are looking to expand with us this year. So that's really first and foremost where the capital allocation priority will sit. And then I think, you know, we have ability to access capital. We have ability, we have a line of credit today that we're looking to slightly modify and have access to capital to help fund the growth of the business going forward.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Okay, and we've got about two minutes left.

Speaker 2

So I just want to go over, what do you think investors are most misunderstanding about the dot go business today well that's a good one sarah thank you for asking that so you again sometimes um people look at our stock chart and say lee what am i missing you have a 300 million dollar you know healthcare services and technology company going and meeting patients where they are which is you know um again one of the other pieces we didn't talk about is the federal government is also earmarking about 50 billion dollars to help improve access to patients you're doing all this you have great scale you have a thousand vehicles 4 000 clinicians you know you're operating across all 50 states you know what are we missing when we look at the stock charts i think i think we over the last couple of years have really been digesting the the comps from the covet and the migrant like i said i think q1 was the first quarter where we didn't have any of that but in q1 of last year we had 30 about 35 million dollars of migrant revenues providing services to the humanitarian crisis in new york relating to the migrants. So when you look year over year, right, was the business growing or is it not? You know, again, when you take out the migrant revenues, it is. But when you see it in sort of, you know, on that screening process, those year over year comps have been tough for us. So that continues. I think, you know, we'll have some of that in Q2, but as we go throughout the year, that will abate. And I also think, again, I think people are looking at really where we're investing. They want to see the progress in the health care at any address, care that with all the volumes being up in Q1. We'll continue to show that as we go throughout the year here. And then as we hit that profitability threshold, I think we're going to be celebrating that.

Sarah Conrad, Analyst — Goldman Sachs Healthcare Services

Yeah, so we're super excited to watch the rest of the story from here and reaching breakeven profitability. Thank you so much for the time and attending our conference today.

Speaker 2

Thank you, Sarah. Appreciate it. Thank you to the Goldman team.