GMR Solutions Q2 Earnings Call Highlights

Second-quarter revenue rose 3.3% to $1.49 billion, driven by higher air-medical and emergent ground demand, but adjusted EBITDA fell 11.8% to $284.5 million and the company reported a $28.3 million net loss. Results faced significant comparisons and cost pressures, including $74 million less in favorable No Surprises Act estimate changes, a projected $15 million–$16 million quarterly impact from payer-mix shifts, higher fuel costs, and $129.6 million in IPO-related stock compensation. GMR reiterated its full-year outlook of $5.89 billion–$6.18 billion in revenue and $1.135 billion–$1.195 billion in adjusted EBITDA. The company also expanded its Nurse Navigation program, while net leverage improved to 3.5 times and is expected to fall below 3.3 times by year-end.

GMR Solutions reported second-quarter revenue growth and higher demand for its core emergency services, while adjusted EBITDA declined from the prior year as the company lapped favorable revenue estimate adjustments tied to older No Surprises Act claims and recorded IPO-related expenses. The emergency medical services provider reported net revenue of $1.49 billion for the second quarter of 2026, up 3.3% from a year earlier. Adjusted EBITDA was $284.5 million, down 11.8% year over year, with an adjusted EBITDA margin of 19.1%. The company posted a net loss of $28.3 million, compared with net income of $80.8 million in the prior-year quarter.

Chief Executive Officer Nick Loporcaro said the company completed nearly 1.4 million patient encounters in the quarter, including more than 1 million ground transports, roughly 280,000 ground interventions that did not result in transport, nearly 29,000 911 Nurse Navigation calls, and more than 36,000 air-medical patient encounters.

Chief Financial Officer Brian Tierney said air-medical volumes increased 6.9% from the prior-year period, supported by demand for services and an improved capture rate. Emergent ground transports rose 2.4%, driven by same-store demand, while non-emergent ground transports declined 3.0% as GMR shifted resources toward higher-acuity services. Same-market revenue increased $53.1 million, or 3.8%, year over year, while new-market revenue totaled $21.3 million. The company opened two 911 systems in markets where it already operates air services, opened three air bases, and signed agreements representing more than $43 million in incremental annualized revenue. Net transport revenue per ambulance transport increased 1.4% year over year.

Tierney said revenue reflected a favorable mix shift toward emergent transport and underlying rate improvement on a like-for-like basis. However, the company faced an approximately $16 million impact from payer mix changes associated with the expiration of Affordable Care Act exchange subsidies. According to Tierney, some patients shifted from commercial insurance into self-pay, though management said the effect has varied by geography. The company expects an approximately $15 million to $16 million quarterly impact to revenue and EBITDA for the remainder of the year, which is included in its outlook.

The year-over-year EBITDA comparison was also affected by lower favorable changes in revenue estimates related to No Surprises Act claims from earlier service dates. Tierney said such estimate changes were approximately $74 million lower than in the prior-year quarter. GMR recognized about $5 million of No Surprises Act-related estimate changes during the second quarter, compared with approximately $79 million a year earlier. Tierney said the prior-year benefit was t...