GMR Solutions Q2 2026 Earnings Report

GMR Solutions EPS Results

• Actual EPS: -$1.84
• Consensus EPS: $0.38
• Beat/Miss: Missed by -$2.22
• One Year Ago EPS: N/A

GMR Solutions Revenue Results

• Actual Revenue: $1.49 billion
• Expected Revenue: N/A
• Beat/Miss: N/A
• YoY Revenue Growth: +3.30%

GMR Solutions Announcement Details

• Quarter: Q2 2026
• Date: 8/12/2026
• Time: After Market Closes
• Conference Call Date: Thursday, August 13, 2026
• Conference Call Time: 8:30AM ET

GMR Solutions (NYSE:GMRS) is a provider of emergency medical services delivering EMS and other essential out-of-hospital care in rural and urban communities. GMR Solutions Inc. is based in Lewisville, Texas.

GMR Solutions Q2 2026 Earnings Call Transcript

Key Takeaways

• Positive Sentiment: Q2 revenue increased 3.3% year over year to $1.49 billion, supported by 6.9% air-volume growth, 2.4% growth in emergent ground transports, and a favorable shift toward higher-yielding services.
• Positive Sentiment: 911 Nurse Navigation continued to scale, with navigated calls up 50% year over year to nearly 29,000 and coverage expanding to 19.7 million lives across 29 communities; GMR plans four additional implementations this year.
• Positive Sentiment: GMR reiterated full-year guidance of $5.89 billion-$6.18 billion in revenue and $1.135 billion-$1.195 billion in adjusted EBITDA, while net leverage declined to 3.5x from 4.3x a year ago and is expected to fall below 3.3x by year-end.
• Negative Sentiment: Adjusted EBITDA fell 11.8% to $284.5 million and the company posted a $28.3 million net loss, primarily reflecting the absence of roughly $74 million in prior-year favorable No Surprises Act estimate adjustments and $142.3 million of IPO-related expenses.
• Negative Sentiment: Management expects continued pressure from the expiration of ACA exchange subsidies, estimated at a roughly $15 million-$16 million quarterly revenue and EBITDA headwind, as well as higher fuel and related costs tied to the prolonged Iran conflict.

Presentation

[Operator]

Hello, everyone. Thank you for joining us, and welcome to GMR Solutions' Q2 2026 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Krister Sorensen, Vice President of Investor Relations. Krister, please go ahead.

[Krister Sorensen, VP of Investor Relations at GMR Solutions]

Joining me today are Nick Loporcaro, our Board Chair and Thank you. Good morning, and welcome to the GMR Solutions Q2 2026 earnings conference call. Joining me today are Nick Loporcaro, our Board Chair and CEO, Ted Van Horne, our President and COO, and Brian Tierney, our Executive Vice President and CFO. Before we begin, note that during this call, we may make forward-looking statements and actual results may differ materially from those statements because of various risks and uncertainties, including those described in our most recent earnings report posted on our investor relations website, and in the Risk Factors section in our IPO prospectus. Today's remarks also include certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in our earnings release and earnings presentation that is available on our website at investors.globalmedicalresponse.com.

[Krister Sorensen, VP of Investor Relations at GMR Solutions]

Unless otherwise noted, references to the quarter will be for the second quarter of 2026. I will now turn the call over to Nick.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Thanks, Krister, and thank you all for joining us today. We are excited to report strong financial and operational results in the second quarter of 2026 that are in line with our expectations. To provide a high-level overview of the quarter, GMR completed nearly 1.4 million patient encounters during the second quarter. We provided ground medical services to over 1.3 million patients, which includes more than 1 million transports along with 29,000 calls to our 911 Nurse Navigation offering, and the remaining approximately 280,000 ground patient encounters consisted of interventions on scene that did not result in a transport. During the quarter, we provided air medical services to over 36,000 patients. Q2 revenue was $1.49 billion, which represents 3.3% year-over-year growth. Adjusted EBITDA of $285 million decreased 11.8% year-over-year with an adjusted EBITDA margin of 19.1%.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

As mentioned previously, prior year results benefited from favorable revenue estimate adjustments associated with the No Surprises Act-related collections on claims from earlier dates of service. Aside from this comparability impact, you will see that the business delivered strong underlying revenue and operating performance during the quarter that Brian will expand on later in the call. Our strong performance was driven by continued same-market revenue growth, revenue from cross-selling and new markets, disciplined cost management, continued optimization of our clinical and operational platforms, and an unwavering focus on service to our communities by keeping care at the center of what we do.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Today marks our second earnings call since the successful completion of our IPO three months ago, which was an incredible accomplishment that could not have been possible without the dedication of our frontline and support staff as we refocused our energy on our core competency of emergency care over the past few years. Before Ted and Brian discuss the quarter in more detail, I want to step back and reiterate why we believe GMR is best positioned as the front of the frontline healthcare provider. As the largest provider of emergency medical services, we serve 5.5 million patients annually, covering markets that represent over 60% of the U.S. population with one or more of our solutions. Our more than 24,000 highly trained clinicians and fleet of ambulances and aircraft are rapidly deployed to navigate and provide essential out-of-hospital care for patients when they need us most.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Our model is differentiated because it is integrated. We bring together clinical capabilities through air, ground, technology, and care navigation assets in a way that allows us to serve communities, health systems, payers, federal and state agencies, and patients across a broad range of settings. In addition to emergent care, we provide non-emergent care, medical response, and disaster response. We have also maintained a long-standing role as the prime EMS contractor for FEMA, supporting national emergency and disaster response needs. The opportunity in front of us is built around four ideas. Saving and serving lives through clinical excellence. Second, growth across existing and new markets. Third, differentiation through our integrated platform and innovative solutions. And fourth, maintaining sustainable margins through disciplined operating execution. We operate within a $35 billion total addressable market that includes private providers like us, municipal-run EMS systems, and volunteer programs.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

The U.S. population is growing as well as aging, and chronic disease prevalence continues to rise. Many rural healthcare facilities face closure or a reduction in service capabilities. All of this drives an increase in demand for EMS. As the primary provider and connection point to healthcare facilities and the only nationally integrated air and ground ambulance provider across 46 states and Washington, D.C., we believe GMR is best positioned to capture this demand. This positioning gives us a greater access to growth through adjacent markets, cross-selling within existing markets, and through disciplined M&A. And we never stop scrutinizing our existing business to ensure we continue to grow and provide sustainable care to our communities. As the national leader of EMS, this puts us in an exceptional position to be the innovators of the practice and raise the tide for the entire industry.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

At GMR, we have several systems and solutions, including 911 Nurse Navigation, our Concierge platform, and our online ordering system, Transport.net, that enhance efficiencies across our organization, resulting in the most appropriate care for patients. Our 911 Nurse Navigation connects lower acuity 911 callers with skilled nurses who can guide them to more appropriate sites of care when an ambulance transport is not clinically necessary. Concierge helps health systems better coordinate discharge and non-emergent transport needs, improve hospital throughput, and create a clearer reimbursement framework. Transport.net reduces the effort in requesting, tracking, and dispatching both air and ground ambulance resources. Together, these solutions strengthen our offering, improve resource utilization, enhance patient outcomes, and create a reinforcing flywheel. Our national scale creates clinical data. That data informs innovation. Our tools support contract wins, and those wins further reinforce our national scale.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Each of these innovations help take the friction out of a traditionally run EMS system and ultimately provide better patient care, more efficient operations, and better hospital throughput while delivering savings to payers in turn. Our scale also enables a large EMS database, currently over 80 million records, that allows us to pair with hospital outcome data to drive system improvements and protocols. This data-driven effort resulted in GMR receiving ESO Solutions' Best Use of EMS Data to Improve Outcomes award at ESO's WAVE Conference in April this year, which is a national gathering for fire, EMS, and hospital professionals. Our performance continues to be driven by the same key ideas. First, saving and serving lives through clinical excellence. Our advanced clinical protocols and rigorous training standards remain the foundation of everything we do, ensuring the highest quality of care in every patient encounter.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Second, on growth, we continue to expand in existing markets, enter adjacent and new markets, cross-sell our solutions, and evaluate discipline M&A opportunities. Third, on differentiation, our integrated air and ground model, supported by innovative technology, allows us to reduce friction in traditional EMS systems and deliver care more efficiently. Fourth, on margins, we continue to scrutinize the market and contracts in which we operate, emphasizing work that is strategically aligned and economically sustainable. On the reimbursement front, we applaud the recent introduction of the Reimbursing Emergency Services for Critical Urgent Encounters, or RESCUE Act of 2026 in the U.S. House of Representatives. This bipartisan legislation provides a necessary solution to modernize the Medicare payment structure so emergency medical services are treated similarly to other healthcare providers with payments based on real cost data.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Under this approach, Medicare's payment rates will be more transparent, financially responsible, and cost-based, helping to close the financial gap between reimbursement and the cost of services for EMS providers. Achieving this milestone is another example of the recognition we are garnering with lawmakers and the payer community with respect to the necessary services we provide. Ted will now provide more detail on how our initiatives are unfolding operationally.

[Ted Van Horne, President and COO at GMR Solutions]

Thanks, Nick. GMR's operational focus remains clear: grow our core emergent services, participate in non-emergent services where they make fiscal and strategic sense, and realize efficiency through innovative offerings such as 911 Nurse Navigation, Concierge, and Transport.net. These capabilities give us ways to pair clinical care with better operational decision-making and stronger partnerships across communities and health systems. These reflect a broader principle behind our model. We coordinate care across modalities and geographies as an integrated service rather than providing services on a standalone basis, given patients rarely fit neatly into a single mode of care. Care coordination allows us to better match resources to acuity, improve visibility for our partners, and support more efficient operations. In weather-constrained air markets, for example, the ability to deploy clinical resources across the ground platform reflects the practical value of integration.

[Ted Van Horne, President and COO at GMR Solutions]

911 Nurse Navigation continues to be one of our most important examples of innovation in the EMS model. The program connects lower acuity 911 callers with skilled nurses who can assess the patient's needs and guide them to appropriate care setting or transport modality. This is better for patients, better for crews, better for hospital systems facing emergency department overcrowding, a lower cost option for payers, and better for communities seeking a more sustainable EMS model. In the second quarter, we navigated nearly 29,000 calls through this program, up 50% year-over-year.

[Ted Van Horne, President and COO at GMR Solutions]

In the quarter, we started servicing three new communities, representing 1.3 million covered lives, bringing our total to 29 communities, representing 19.7 million covered lives, and we plan to implement four more communities over the remainder of the year. We've seen up to 20% of 911 medical calls diverted to nurse navigation with qualitative benefits, including better alignment of resources to acuity, improved resource utilization, client stickiness, and higher satisfaction for both patients and crews. For example, during the Spokane wildfires, GMR's 911 Nurse Navigation program quickly partnered with local emergency response and healthcare teams to connect displaced residents with appropriate care. Within hours, nurse navigators were helping patients access urgent care, telehealth, and community resources, reducing unnecessary emergency department visits while ensuring timely support. This effort demonstrates how 911 Nurse Navigation can rapidly adapt during crisis to improve patient access and support healthcare system capacity.

[Ted Van Horne, President and COO at GMR Solutions]

We expect to continue expanding 911 Nurse Navigation in existing 911 markets and using the system as a differentiator in new municipal and health system partnerships. Concierge supports the non-emergent side of the model by partnering with health systems to coordinate appropriate transports under a clear reimbursement structure. This creates a more predictable framework for service that could otherwise be low reimbursing or operationally inefficient. It also supports hospital throughput by helping discharge processes move more efficiently and by reducing friction in scheduled transport workflows. Transport.net reduces friction in the process of requesting, tracking, and dispatching air and ground ambulance resources. By increasing visibility and simplifying handoffs among access points, health systems, and dispatch teams, the platform enhances the value of our integrated network. We are installed in nearly 3,000 Public Safety Answering Points, or PSAPs, across the country, representing over 65% of all PSAPs nationwide.

[Ted Van Horne, President and COO at GMR Solutions]

This software reduces dispatch friction, improves visibility, and strengthens partner relationships. For example, in Fredericksburg, Texas, Gillespie County Communications Center serves both the police department and sheriff's office. This is a very busy system. They were an early adopter of the Transport.net ordering technology and now process 100% of their air transport requests through the platform. Thanks to its ease of use, reliability, and aircraft tracking capabilities, they save valuable minutes on every request, allowing them to focus on other emergencies instead of spending significant time on the phone. Turning to growth, we remain positive about our ability to win new business opportunities in core emergent services and expanded municipal ambulance contracting through 911 Nurse Navigation. Our growth strategy is multi-pronged, grow same market revenue, expand in existing markets, and enter new markets, cross-sell our integrated offering, and evaluate disciplined acquisitions where they are financially accretive and strategically aligned.

[Ted Van Horne, President and COO at GMR Solutions]

Same market revenue increased $53.1 million, or 3.8% year-over-year. New market revenue in the quarter was $21.3 million. For new market starts in the quarter, we opened two new 911 systems in markets where we already had air operations, advancing our integrated market strategy. We also opened three new air bases, two adjacent to existing operations, expanding our footprint, and one in a new region with future growth potential. Also in the quarter, we executed new agreements totaling over $43 million in incremental annualized revenue. We continue engaging with states and other stakeholders on rural healthcare access and EMS models, including opportunities tied to state-led rural health transformation initiatives under the Rural Health Transformation Program with our 911 REACT platform. 911 REACT provides rural areas with the connection point to care that is desperately needed in these healthcare deserts.

[Ted Van Horne, President and COO at GMR Solutions]

While we believe we are the best positioned to help solve rural health issues, we also believe we are the best to provide urban system rescue. Over the 4th of July weekend, as part of our response capabilities, the State of New York requested 50 ambulances and 110 personnel for the City of New York to supplement the FDNY during what is typically the busiest weekend of the year for local EMS. GMR teams responded to over 2,200 emergency calls throughout all five boroughs. This short deployment is just another example of GMR's ability to be the safety net for EMS across the country. Under our event medical operations, we covered seven of the 11 stadiums hosting FIFA World Cup games, as well as provided coverage for several of the teams' practice facilities.

[Ted Van Horne, President and COO at GMR Solutions]

We treated over 3,000 patients across the U.S., including about 300 transports and one full cardiac arrest resuscitation. I will now turn it over to Brian, who will provide more detail on the financials.

[Brian Tierney, EVP and CFO at GMR Solutions]

Thanks, Ted. In the second quarter of 2026, GMR reported net revenue of $1.49 billion, a 3.3% increase year-over-year. Compared to the same quarter in 2025, Q2 air volumes were up 6.9% due to strong request demand coupled with improved capture rate. Emergent ground transports increased 2.4%, driven by strong same-store demand, while non-emergent ground transports decreased 3.0%, reflecting our deliberate strategy of redirecting our resources towards higher acuity responses. As a result, during the quarter, total patient encounters associated with our focus areas of emergent transports and Nurse Navigation grew 3.7%, while lower reimbursement patient encounters associated with non-emergent wheelchair and non-transports decreased. On margin, our operating discipline remains centered on contract profitability, labor productivity, resource utilization, rate adequacy, and operational efficiency.

[Brian Tierney, EVP and CFO at GMR Solutions]

Following the strategic review process that began in 2022, we have continued to focus the portfolio on core operations and better performing services, including reviewing, renegotiating, and, where appropriate, exiting contracts that did not meet the return thresholds or strategic requirements. We also continue to benefit from efficiency initiatives in billing, collections, staffing, fleet utilization, and shared services. Long term, we believe margin sustainability will be supported by integrated operations, payer relationships, disciplined contract structures, and continued refinement of the independent dispute resolution and other reimbursement processes. Net transport revenue per ambulance transport, or NRT, increased 1.4% compared to the prior year quarter. Revenue performance was driven by a positive mix shift from non-emergent to emergent transports and strong underlying NRT improvement on a like-for-like basis.

[Brian Tierney, EVP and CFO at GMR Solutions]

This was partially offset by an approximate $16 million payer mix shift impact from the expiration of the Affordable Care Act exchange subsidies as patients shifted out of commercial insurance and into self-pay, which was in line with our expectations and was included in our prior guidance. Additionally, the current quarter did not benefit from the same level of favorable changes in revenue estimates recognized in the prior year period, which were largely associated with collections on No Surprises Act claims from earlier dates of service. During the second quarter, changes in estimates predominantly related to No Surprises Act claims were approximately $74 million lower than the prior year period. This creates a meaningful variance in the year-over-year comparison in net revenue per transport, total revenue, and adjusted EBITDA, which was $284.5 million, down 11.8% from the prior year.

[Brian Tierney, EVP and CFO at GMR Solutions]

Aside from this comparability impact, the business continued to demonstrate strong underlying revenue and operating performance during the quarter. Turning to expenses, total operating expense increased 19.4% to $1.43 billion in the quarter, compared to $1.20 billion for the same period in 2025. Employee wages, benefits, and taxes increased by 24.5% to $925 million. The increase year-over-year was primarily driven by increased stock compensation expense of $129.6 million related to the vesting of stock units associated with the execution of the IPO. The remaining increase was primarily driven by improved staffing and normal wage adjustments to attract and retain talent. The average base unit wage increase during the quarter was 3.3%. Maintenance, fuel, and other direct expenses increased by 21.1% to $136.4 million. The increase was primarily driven by fuel unit costs associated with the Iran conflict and the timing of aircraft maintenance events.

[Brian Tierney, EVP and CFO at GMR Solutions]

We also saw higher than normal inflationary costs impact lines that have a direct correlation with the suppliers' underlying fuel costs, including travel and shipping costs. Other operating expenses were generally in line with expectations. As reported, we recognized a net loss of $28.3 million in the quarter compared to net income of $80.8 million in the prior year period. The year-over-year change was primarily driven by $142.3 million of expenses associated with our IPO, as well as the lower changes in estimates already mentioned related to No Surprises Act claims on older dates of service. Shifting to CapEx, cash flows, and liquidity. Cash used for CapEx and aircraft financing was 6.3% of revenue for the second quarter of 2026, compared to 4.5% of revenue for the second quarter of 2025.

[Brian Tierney, EVP and CFO at GMR Solutions]

The increase was primarily due to the timing of CapEx purchases in both years, as well as our decision to pull forward certain purchases that were planned for later in the year to capture available price discounts. GMR finished the second quarter with $420.0 million in cash and cash equivalents and undrawn ABL with $696 million of cash borrowing capacity after letters of credit. Our free cash flow was approximately $15 million. Net leverage finished the quarter at 3.5 times, down from 4.3 times at the end of 2Q last year. We expect strong cash flows to drive this below 3.3 times by year end and have line of sight to 3.0 times before the end of 2027.

[Brian Tierney, EVP and CFO at GMR Solutions]

Shortly after the IPO, Moody's and S&P upgraded our credit ratings from B2/B to B1/B+, respectively, triggering a 25 basis point interest rate step down on our term loan facility. Moving on to guidance. We are reiterating our full year earnings guidance. We continue to expect revenue in the range of $5.89 billion-$6.18 billion, our adjusted EBITDA in the range of $1.135 billion-$1.195 billion and total cash used for CapEx and aircraft financing between 5.1% and 5.3% of total revenue. Our guidance assumes continued momentum in transport rates and volumes, a stable payer mix that already reflects the elimination of the ACA exchange subsidies, and the ongoing impact of the prolonged Iran conflict. In summary, it was a strong quarter. We had strong demand for and grew our core emergent services. We collected more for those services. Base unit wage costs were moderate.

[Brian Tierney, EVP and CFO at GMR Solutions]

We have ample liquidity enabling further de-leveraging. Now I will turn it over to the operator to open for any questions. Thank you.

[Operator]

We will now begin the question and answer session. Please limit yourself to one question and one follow-up. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. We ask that you pick up your handset when asking a question to allow for optimum sound quality. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Your first question comes from the line of Scott Fidel with Goldman Sachs. Your line is open. Please go ahead.

[Scott Fidel, Analyst at Goldman Sachs]

Hi. Thanks, and good morning. First question, just was hoping to get maybe a little bit more context to the extent you can provide it, just around the IDR dynamics and appreciate the flagging the year-over-year change. Maybe if you could just sort of put that maybe in the context of more of year to date and the first quarter. Did you have, I don't recall, similar dynamics, but it seems like that was more of a meaningful number in the second quarter of last year. I think you mentioned having maybe some sort of prior year sweeps and collecting some of those funds. Just maybe more broadly, just talk about the trends with IDR in terms of how basically the revenues that you're generating from that, to the extent you can, have been on trend year to date.

[Brian Tierney, EVP and CFO at GMR Solutions]

Hey, Scott. Thank you. This is Brian. Last year in the second quarter, we had about $79 million worth of change in estimate related to the No Surprises Act stuff. This year was about $5 million. So that drives that $74 million delta. What that really says is we've been able to really dial in the estimates. This is all related, the stuff in 2025 is really related to stuff much earlier. So feel really good about our ability to predict the revenue here. There's still some older stuff hanging out there. We will continue to try to go get that really old stuff, but feel that we're going to be more in this 0+ or -5 range here as we go forward.

[Scott Fidel, Analyst at Goldman Sachs]

Okay. Got it. For my follow-up question, maybe if you could walk us through just the payer mix dynamics in terms of fully bridging to the year-over-year changes. Certainly, heard the call out around the impact on the exchanges and would imagine that that certainly had a meaningful amount of it. Should we think about the lower commercial payer mix year-over-year being largely a function of both the impact from the lower exchange revenues and then combined with the lower IDR revenues that you already recognized? Would that largely comprise it, or just curious if there's anything else that we should be aware of. How you're thinking about payer mix trends within your guidance into the back half of the year. Thanks.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Hey, Scott, it's Nick. Let me tackle a higher level, and then Brian can get in a little more granular. When we had our last call, we had said we saw little, if any, impact first quarter. We started seeing some impact in the second quarter in the ACA, and I recall mentioning we'd seen that in our own benefits. We had more employees taking on our employer benefit plan. We suspect that these were folks that were on the exchanges looking for other alternatives. I also mentioned whether you're on the gold plan or the bronze plan doesn't make a difference for our types of interventions. We get paid. We did see some impact in second quarter that Brian can expand on and mentioned, obviously, in our call here. Thinking we still need to better understand it. Where are these folks?

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Are they all going to self-pay? Are they all going to different commercial, and we're seeing evidence of that? The other key thing we're learning, and I think it showed up, at least in what I've read on some of the hospital readouts recently, geographically, it's different as well. We have parts of the country where, yes, we'll see more go to self-pay, other parts of the country that we're finding them now in commercial plans, which is actually an upside for us. Still, thinking about all of this, studying it, learning more, and anticipate we'll learn more even this quarter. I'll hand it over to Brian to get a little more granular to tackle some of the numbers around your question.

[Brian Tierney, EVP and CFO at GMR Solutions]

Yep. The short answer to your question is yes, it's the exchange impact and the No Surprises Act year-over-year comp that really drive the payer mix shift. To expand a little bit more on what Nick said, yeah, we're seeing it exactly where we thought we would see it. It's the big exchange providers, the Molinas, the Centenes, a few of the bigger blues that are in the exchange programs. We've seen the decrease in their volumes in the states that they were heavy in. Really since April, we've seen a very consistent mix shift relative to what we had expected, and so that we've got that in our guidance as we go forward. We had it in our guidance before. It's still in our guidance. We'll keep watching this, as Nick said. Got to make sure we understand where everybody ultimately lands.

[Brian Tierney, EVP and CFO at GMR Solutions]

It's been really consistent here across the quarter.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Closing comment I'd make here, Ted and his teams, as we figure out those geographies, remember, we do have some levers to pull. We can go back to the counties. We do have subsidy programs. We can reopen up some of those contracts on pricing. So there are some levers. We haven't flipped them yet because we want to better understand where the impact is.

[Scott Fidel, Analyst at Goldman Sachs]

Okay, helpful details. Thank you.

[Operator]

Your next question comes from the line of Elizabeth Anderson with Evercore ISI. Your line is open. Please go ahead.

[Elizabeth Anderson, Analyst at Evercore ISI]

Hi, guys. Thanks so much for the question. I have lots of conceptual questions and maybe one numbers cleanup question. You talked about the improved capture rate as one of the nice improvements in the quarter. Can you talk a little bit more about that? I know obviously the weather is better in the second quarter than the first quarter, but is that sort of what you're referring to? Or is there something more underlying than that that also helped improve the capture rate? Thank you very much.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Elizabeth, I will have Ted expand on this. This is Nick. There is a lot of levers here that we are looking at. Some of it is technology, some of it is recruiting of pilots and medical staff, making sure we have people in the right places, studying trends. You heard Ted mention Transport.net and how that drives, one, making sure we understand the demand, where it is, and that we are readily available to capture it. Obviously, weather, and even with weather, we have talked about further investments in IFR, which mitigates some of the weather impacts. I will ask Ted to maybe provide a little bit more color around this and the initiatives we are having on the air side.

[Ted Van Horne, President and COO at GMR Solutions]

Yeah, and that quarter specific, in Q2, the way the weather was impacting different parts of geographies for us, too. So we see higher capture rates in certain parts of America generally, and that is where we have seen a lot of the weather improvements, and we saw the capture rates improve with that also. So that was a big chunk of the reason why. We are going to continue to make all the improvements and investments as IFR, different types of aircraft. We have been bringing them in from one of the vendors specifically at a pretty good clip right now. So we are excited about that. We do see the results every time we bring in the IFR aircraft.

[Elizabeth Anderson, Analyst at Evercore ISI]

Great. My numbers cleanup question, just to make sure that we are modeling your go forward correctly. One, I heard you say sort of a continuation of high oil pricing expectations. Is it currently sort of that current rates continue for the rest of the year? So that is the first part of it. Then secondly, obviously the FIFA World Cup doesn't happen every year. So is it possible to parse out the specific FIFA World Cup part of the revenue just to make sure that we are not comping you off of it for next year?

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. I will take the second part first. The FIFA World Cup was a couple million dollars, a very low revenue piece.

[Elizabeth Anderson, Analyst at Evercore ISI]

Right.

[Brian Tierney, EVP and CFO at GMR Solutions]

Not all of that flows through to earnings. It is a very small piece. The oil prices on a go forward basis, we use the forward curve. The average for the rest of the year is about $80 bbl, a little bit higher in August and September, a little bit lower in November. I think the market is assuming, at least for the rest of the year, there is continued Iran conflict with potential for a little bit of relief at the end. We have baked that in going forward. That is $10+ million a quarter of incremental fuel relative to what we had initially, we would have done if we were setting a budget or something before the year began. All of that is baked in.

[Elizabeth Anderson, Analyst at Evercore ISI]

Got it. Super helpful. Thank you very much.

[Operator]

Your next question comes from the line of Benjamin Rossi with JPMorgan. Your line is open. Please go ahead.

[Benjamin Rossi, Analyst at JPMorgan]

Good morning, and thanks for taking my questions here. Just as a follow-up on the IDR comments, by my maths, during the first half of the year, you have lapped about $110 million in out-of-period benefits from IDR last year. When we think about the back half of the year, if you were to receive no IDR benefits during 3Q and 4Q, what would this out-of-period comp dynamic look like? Is it fair to think of the step-down during the second and a half of the year being similar in magnitude as the first half? Just curious on what that contribution looked like last year during the second half compared to the first half.

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. Thanks, Ben. The number's about the same. It's just under $100 million was in that second half of the year last year.

[Benjamin Rossi, Analyst at JPMorgan]

Got it. Okay. As a follow-up question, the press release, you mentioned some new business wins. Can you just elaborate on those opportunities and how you're thinking about potential contributions from these wins in the back half of the year? Thanks.

[Ted Van Horne, President and COO at GMR Solutions]

We don't get into specifics per contract, but overall, there are 911 wins both on the ground and air. Air were adjacent markets, I think, as I mentioned, where we had opportunities in airbases and expanding footprint for us. When we can operationalize the next town over, the next county over, we get such great operational synergies with it. When we link in our Transport.net, we're actually building in more aircraft into that web for the 911 centers as they're using it. That's been a big piece of the Q2 on the air side. The ground side was two new 911 wins in new communities that we already had the air. It was great that we were able to bring in the ground operations, create that integrated market.

[Ted Van Horne, President and COO at GMR Solutions]

Those were in the Southeast, and they're excited because we see a lot of that opportunity continue for the rest of the year, these small, midsize communities across the U.S.

[Benjamin Rossi, Analyst at JPMorgan]

Great. Thanks for the additional details.

[Operator]

Your next question comes from the line of A.J. Rice with UBS. Your line is open. Please go ahead.

[Operator]

Your line is open.

[A.J. Rice, Analyst at UBS]

Hi, everybody. First, maybe just to pursue a little more on your rollout of your 911 Nurse Navigation. How much of your footprint does that address today? Is there an ultimate target of how much of your footprint you can get to and what the pacing or limiting factor on rolling that out is?

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

A.J., it's Nick. Again, I'll start at a high level and ask Ted to offer up some more details if I miss anything here. We're probably 29 communities today of coverage, representing just shy of 20 million covered lives. I think you'll recall, and we've talked about in our presentations, we have approximately 200 million lives in the geographies that we serve. That's the potential. Do I think, as the CEO and pushing the team, as you look at our five-year plan, could we potentially get to 100 million covered lives? I think that's realistic. I think we have plans in place. What does that mean for the impact of the business? You've all challenged us before on what is 911 Nurse Navigation in itself worth. It allows us to run our business better. It allows us to win more business because of the value.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Just real interesting, actually, in a session we had yesterday, we have evidence of where we put in 911 Nurse Navigation, and Brian can speak to the numbers here, on 150 basis points lift on just margin improvement in the markets we put it in. What's even more interesting, what we're learning, when we have nurse navigation combined with a treat no transport, we're actually making better reimbursement on that versus a basic life support transport. That's the dynamic that's important and the reason you'll see us continue to talk about 911 Nurse Navigation, the push of it, and the proliferation, and how it positions us in the markets where we're deploying. Ted, I don't know if you'd offer up any other detail on that.

[Ted Van Horne, President and COO at GMR Solutions]

Yeah. For us, the 911 Nurse Navigation really is three distinct growth channels. One is our existing footprint, which you mentioned, and we can continue to spread that out in multiple over the course of each year. We're going to keep growing those out. The second channel is the Rural Health Transformation Program and the new bids there as we're proposing that across the U.S. And the third channel is the big metro models, right? Where we're working the nurse navigation in with the very large municipal city bids. Those take a little bit longer on the sales cycle, obviously, because they're very big municipalities. But we have a great sales team that's working very closely with each one of those cities as they walk through those proposals. That's how we see those three distinct cycles.

[Ted Van Horne, President and COO at GMR Solutions]

Each one has got a lot of room in it, and we're excited because we've just opened up the second center in Phoenix. We've got a lot of capacity and room to grow. We've thought both Phoenix and here in the Dallas area, being able to get the nurses, and so we continue to grow that, the actual nurses taking the call. We're ready for it on the technology side, space side, and continue to grow it.

[A.J. Rice, Analyst at UBS]

Okay. Thanks. Maybe the follow-up, you mentioned on the prepared remarks, you would be at 3.3 times leverage by the end of the year, 3 times by the end of next year. Is 3 times a steady state that you are comfortable with? If it is, it sounds like there are some potential deals out there. Can you categorize what you are seeing? What kind of things you might be interested in doing, and what kind of valuations are they going to be potentially immediately accretive to you if you can do some things?

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

AJ, I am going to start backwards with your question. We had hoped and anticipated post the IPO we would have some arbitrage opportunities. Admittedly, with where we are trading and where the market is evaluating things, I think that has created a bit of conservatism around the pipeline. We do have a healthy pipeline. We have probably got about 15 targets from some small, mid-size to some largers. Ultimately, I lean on Brian and the team here on how do we best leverage our capital? To go now to the front end of your question, are we better focusing on de-levering for the time being? We are going to scrutinize the M&A opportunities. There is a couple of opportunities in adjacent markets where we have to ask ourselves the question, can we just win the business? Is it quicker to buy it?

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

We have mentioned to you guys in the past, we are going to look at a market that has strong ground presence. Do we buy an air asset there? That is how we are looking at it. I think, as you said in the prepared remarks, this is a conversation Brian and I and the teams have often is, where are the opportunities now? We constantly look at our current rates. Is de-levering combined with some of that in our best interest? There will be more news coming along those lines, probably in pretty short order.

[A.J. Rice, Analyst at UBS]

Okay, thanks.

[Operator]

Your next question comes from the line of Joanna Gajuk with Bank of America. Your line is open. Please go ahead.

[Joanna Gajuk, Analyst at Bank of America]

Hi. Good morning. Thanks so much for taking the question. Actually, I have a two-part question on the IDR process. First, about the final regulation that came out, a cost for lower fee per claim going to an arbitration, but there's some other changes in there. Just curious, how do you expect this reg, if at all, to impact your IDR process and your experience there? The second part, we heard from the health plan industry lobby groups. They've been very vocal. They call for some changes to the IDR process altogether. They complain about the number of claims, the rates the providers get awarded. What are your thoughts about potential changes to the IDR process? Thank you.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Joanna, let me hit the second part of your question. I'm going to hand it over to Brian. On the second part, we understand the health plans are pushing back on the volume. Our belief is a lot of that has less to do with us on the EMS side of the business, and more on what they're getting from other provider groups. That's our assessment of a lot of that. As Brian has mentioned in the past, and he can provide an update, we continue to bring some of the larger plans in-network. We have great collaboration with them, and we see that continuing. Now, honestly, we have our own concerns on how the plans behave on some of them, and some pushback, and have been winning some of those arguments as well. I'll hand it over to Brian to tackle the first part of your question.

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. Let me just hit quickly on the second part as well. We continue to have really good conversations with a number of large payers, to get them in-network. You've also got some large payers that really have no interest in getting to a reasonable rate and term environment, and so that group we will continue to have to beat them in IDR. I'd rather have them all in-network. But, it takes two to get to there. On the first part, no, I think we appreciated the ruling or the new rules from the government on how the IDR process will work. I think it really cleaned up a little bit. Didn't have really much impact to us from an overall perspective. We do appreciate the lower fees. That's a slight tailwind for us, in the very low millions of dollars range of $1 million-$2 million on an annual basis.

[Brian Tierney, EVP and CFO at GMR Solutions]

Nothing material. But we think the administration coming out and reaffirming the current process was very helpful. It would take Congress to reopen the process to do something different. Until that happens, if that happens, we will just continue to work to get everybody in-network, and if not, we will continue to work to beat them in IDR.

[Joanna Gajuk, Analyst at Bank of America]

Thank you. If I may, just to follow up on the commentary around the subsidy expiration impact in the quarter. Should we assume a similar amount per quarter going forward? So, $16 million? Just to clarify, that was the EBITDA type headwind you referred to?

[Brian Tierney, EVP and CFO at GMR Solutions]

Yes, it is both revenue and EBITDA. Yes, that is what is in our guidance going forward, is about that $15 million, $16 million a quarter.

[Joanna Gajuk, Analyst at Bank of America]

All right. Thank you.

[Operator]

Your next question comes from the line of Andrew Mok with Barclays. Your line is open. Please go ahead.

[Andrew Mok, Analyst at Barclays]

Hi, good morning. I think air bases increased pretty meaningfully in the quarter. I think it is up 10 or so. Do I have that right? What drove that level of accelerated expansion, and was that all planned or is that a result of new or unexpected wins? Just how should we think about the pace of air base expansion for the balance of the year?

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. No, I think we were up three or four bases in the quarter, not 10. As we go forward, we do have a large number of aircraft coming really over the next couple of years. We have a number of them. I do not know the exact count. It is in the high single digits for the remainder of the year. It is actually down a little bit from what we would have projected at the beginning of the year. We have one of our aircraft suppliers is just a little bit late with some of their deliveries. We are seeing a few aircraft push out of 2026 and into 2027, by a couple of months. Not material or meaningful, and it will all catch up in the long term. We are not at 10, but we do have good air volume growth or air base growth going forward.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Yeah. To your question about plan, these aircraft that Brian Tierney is mentioning are all tied to contracts as well. They are planned. As they come in, they will be deployed.

[Andrew Mok, Analyst at Barclays]

Got it. Okay. Just a follow-up on the IDR side. Can you share where your in-network rates stand today and just the progress you've been able to make with this IDR backdrop developing more negatively against the insurers? Thanks.

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. Yes, we get higher rates through the IDR process than we are willing to take in-network. I'd rather have them in-network, and we'll take a discount, because the whole process is easier. The cash is faster. With the right partners, you can get better terms. So you got your claims flow through the process a lot easier. Again, I'd rather have them in-network at a little bit of a discount, relative to what we're winning in IDR. The contracts that we're signing, they are just below our IDR rates. So, we continue to make progress with those groups.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Andrew, the other thing to add, there's two reasons. The obvious on why we don't want to mention the rate is for competitive reasons. The other thing is, I think we've walked through this before as well. What we find is when we're bringing folks in-network, we see a drop in medical necessity denials. We see a drop in the DSO. So there's a lot of other aspects, so.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

The rate difference, I think we more than make up for as we bring them in-network. So we hesitate on putting that out there because honestly, I think it's a much better deal to bring them in-network, even though the sticker price looks a little different, we more than make up for it.

[Andrew Mok, Analyst at Barclays]

Right. Maybe I should phrase it better. I wasn't looking for the rates themselves, just what percentage of your contracts are in-network today? What progress have you made, and where do you see that going?

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Hovering around the 70%. I think if we drill down, we're like at 69%, but

[Brian Tierney, EVP and CFO at GMR Solutions]

Yep.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

I keep waiting for Brian Tierney to tell me the next big one that's just about to be signed.

[Brian Tierney, EVP and CFO at GMR Solutions]

We've got that number in the hopper. Remember, this is just an air conversation, right? All of the ground in-network, out-of-network is not the same concept. So that 69% is where we landed the second quarter for in-network and known reimbursement.

[Andrew Mok, Analyst at Barclays]

Got it. Thank you.

[Operator]

Your next question comes from the line of Craig Hettenbach with Morgan Stanley. Your line is unmuting. Please go ahead.

[Craig Hettenbach, Analyst at Morgan Stanley]

Great. Thank you. For the implied second half guidance, can you just touch on volume expectations, ground and air, any noticeable changes in the market that you are seeing relative to first half?

[Ted Van Horne, President and COO at GMR Solutions]

For us, how we are expecting to roll out our new base growth for second half is what we are still projecting and what you see in the guidance. We have worked through that. We have got not only air new bases, but then any of the starts. That is all projected. We do still see and always managing what weather impacts are happening. Some of the fire activity that happens across the U.S., obviously from an air standpoint, sometimes cause some the weather behavior, believe it or not, and ability to fly out west. We are watching all that through the course of the year, but what you see on the forecast and how we plan that out is on the base expectations of aircraft coming in and the base starts that we have got working in.

[Craig Hettenbach, Analyst at Morgan Stanley]

Got it. Then just a follow-up for Brian Tierney. You talked about just some operating efficiencies. Can you just touch on some of the key drivers there and maybe expand on ways you are using technology to help expand margins over time?

[Brian Tierney, EVP and CFO at GMR Solutions]

Yeah. Well, I think from an operations efficiencies, we continue to match our labor to our volume. In markets where we've got stronger volume, it's not always a one-for-one that you've got to add incremental labor costs. We can do that. Then also if we've got a market where maybe the volume's down a little bit, the operations do a really good job of trying to manage the staff to that level. We're always looking for efficiencies across the back office. I think we've got 40 or 50 different AI-related initiatives, some of them bigger, some of them smaller, that just help drive the efficiencies that we should get out of our system. We should be better today than we were yesterday and a little better tomorrow than we are today. A little bit of incremental improvement all the time ultimately adds up.

[Brian Tierney, EVP and CFO at GMR Solutions]

We've got folks that are always focused on making sure we're spending the right amounts out of our procurement teams and so on. So it's a culture and a focus for us just to make sure that we're being as efficient as we can.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Yeah, I would add two things. One, we often talk about our scale and our size. One of the things that we've gotten really good at, and still more room to get better at, is how do we get better alignment across the whole organization? I often quote my friend Pareto. The 80% that's similar across our platform, we're getting really good at leveraging best practices, better alignment, standardization across the platform with leaving that 20% of the local flavor and intervention that we need to. So we're seeing a lot of that on the operations side. Just to lean on the AI implementations. One, we have an AI governance committee we're very sensitive to. We are in healthcare.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

But, not to sound too cliché, our North Star remains and our effort remains patient care and how do we continue to optimize the time that our providers spend with hands-on patient. That's always our focus going into any deployment of technology innovation. We really believe if we do that right, we'll see the efficiencies as well in the system as we're providing better care.

[Craig Hettenbach, Analyst at Morgan Stanley]

Okay. Thank you.

[Operator]

Your next question comes from the line of Daniel Grosslight with Citigroup. Your line is open. Please go ahead.

[Company Representative at Citi]

Hey, this is Luis in for Daniel. Guidance does contemplate a step down in EBITDA margins in the back half of the year relative to 2Q, and I know that you're rolling out some ground 911 contracts, which should benefit NRT. My question is, what is driving the margin compression in the back half? Thanks.

[Brian Tierney, EVP and CFO at GMR Solutions]

Thanks, Daniel. I think a little bit, if you're comparing first half to second half, I think as we mentioned in the first quarter, we really didn't see the exchange impact that we saw really start in the second quarter that will continue through the rest of the year. Probably another driver of that is really just the whole Iran conflict related costs. Fuels really didn't spike up until the latter part of March. We've really seen that $10 million plus a quarter really run through the P&L. Then we've seen, call it Iran conflict-related costs pop up across the P&L in small ways. Our airfare for moving crews around is up. Shipping costs, fuel costs. All of those just add a little bit more to the back half of the year. I know we had a new one yesterday, fuel surcharges on office supply delivery.

[Brian Tierney, EVP and CFO at GMR Solutions]

Making sure that we're minimizing the deliveries. It's that kind of thing that I think will impact the back half of the year. But feel good about our guidance and the range that we've got out there.

[Company Representative at Citi]

Got it. Thank you.

[Operator]

We have reached the end of the Q&A session. I would now like to turn the call back to Nick Loporcaro for closing remarks. Please go ahead.

[Nick Loporcaro, Board Chair and CEO at GMR Solutions]

Thank you again for joining our call today. The second quarter reinforces our confidence in GMR strategy and execution. Underlying performance was strong. Our mix continues to shift toward higher yielding services. Nurse Navigation is scaling, and our liquidity position remains strong. We are proud of the role GMR plays across the EMS system, from major events to disaster response, to everyday care in the communities we serve. None of this would be possible without our exceptional frontline clinicians, pilots, mechanics, dispatchers, support personnel, and regional leaders. They keep care at the center every day, and I want to thank them for their commitment to patients, partners, and communities. Thank you for your continued support, and have a wonderful day.

[Operator]

This concludes today's call. Thank you for attending. You may now disconnect

Participants

Executives

• Krister Sorensen, VP of Investor Relations
• Nick Loporcaro, Board Chair and CEO
• Ted Van Horne, President and COO
• Brian Tierney, EVP and CFO

Analysts

• Scott Fidel, Analyst at Goldman Sachs
• Elizabeth Anderson, Analyst at Evercore ISI
• Benjamin Rossi, Analyst at JPMorgan
• A.J. Rice, Analyst at UBS
• Joanna Gajuk, Analyst at Bank of America
• Andrew Mok, Analyst at Barclays
• Craig Hettenbach, Analyst at Morgan Stanley
• Company Representative at Citi