v3.25.4
Segments
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
Segments Segments
The Company’s reportable segments are identified based on a number of factors related to how its Chief Operating Decision Maker ("CODM") determines the allocation of resources and assesses the performance of the Company’s operations.
The Company's CODM is its President and Chief Executive Officer. The Company's reportable segments are strategic business units that offer different healthcare-related services to the Company's members. They are managed separately because each segment has its own distinct revenue generating activities and core business processes, which requires different technology and strategies in order to serve the varying needs of its members. The Company's CODM manages the Company under four reportable segments, the services of each are discussed in detail below.

For each of the segments, the CODM uses operating income or loss as the measure of profit or loss to assess segment performance and allocate resources (including personnel, financial, and capital resources) during periodic budgeting and forecasting processes and budget-to-actual variance reviews. The Company's operating income for the reportable segments includes an allocated portion of corporate expenses to the respective segments and includes revenues and all other costs directly attributable to the specific segment.

The CODM uses total assets as the measure of assets attributable to each segment and reviews this measure in conjunction with segment performance to allocate capital to technology investments and projects in each segment in order to identify the best deployment of resources.

•NEMT - The Company's NEMT segment is the largest manager of non-emergency medical transportation programs for state governments and managed care organizations, or MCOs, in the U.S. This segment also holds the results of the Company's captive insurance program;

•PCS - The Company's PCS segment provides in-home personal care services to State and Managed Medicaid, Medicare, and Private Pay patient populations in need of care monitoring and assistance performing activities of daily living;

•Monitoring - The Company's Monitoring segment provides in-home monitoring solutions, including in-home clinical monitoring and quality improvement services that leverage personal emergency response systems, vitals monitoring devices, relationship-based care and data-driven patient engagement solutions;

•Corporate and Other - The Company's Corporate and Other segment includes the costs associated with the Company's corporate operations as well as the results of an investment in innovation related to expanding our virtual care, digital engagement, monitoring capabilities, and member insights and analytics that the Company made at the end of the first quarter of 2023, which contributes to service revenue and service expense. The operating results of the Corporate and Other segment include activities related to executive, accounting, finance, internal audit, tax, legal and certain strategic and corporate development functions for each segment, the results of this investment in innovation, as well as the results of the Company's Matrix investment.

The following table sets forth certain financial information from operations attributable to the Company’s business segments for the three and nine months ended September 30, 2025 and 2024 (in thousands):
 Three months ended September 30, 2025
 NEMTPCS
Monitoring
Corporate and OtherTotal
 Service revenue, net
$491,672 $168,737 $17,046 $2,252 $679,707 
Purchased services
388,401 — — — 388,401 
Payroll and related costs
39,177 132,104 4,251 343 175,875 
Other service expense
13,033 2,158 3,361 1,302 19,854 
Service expense440,611 134,262 7,612 1,645 584,130 
General and administrative expense25,118 21,194 5,299 32,740 84,351 
Depreciation and amortization7,482 9,304 5,748 761 23,295 
Operating income (loss)18,461 3,977 (1,613)(32,894)(12,069)
Interest expense, net
— — — 14,467 14,467 
Reorganization items, net208 — — 53,274 53,482 
Income (loss) before income taxes and equity method investment
18,253 3,977 (1,613)(100,635)(80,018)
Income tax (benefit) provision(867)3,556 983 3,833 7,505 
Equity in net income (loss) of investee, net of tax21 — — (639)(618)
Net income (loss)
$17,407 $7,533 $(630)$(97,441)$(73,131)
Balance Sheet Information
Equity investment$361 $— $— $27,922 $28,283 
Goodwill$135,186 $203,664 $77,978 $30 $416,858 
Total assets$580,132 $479,332 $165,381 $194,720 $1,419,565 
 Nine months ended September 30, 2025
 NEMTPCS
Monitoring
Corporate and OtherTotal
 Service revenue, net
$1,414,014 $517,412 $52,653 $5,835 $1,989,914 
Purchased services
1,109,159 — — — 1,109,159 
Payroll and related costs
117,732 408,868 12,760 791 540,151 
Other service expense
37,303 6,527 10,028 4,597 58,455 
Service expense1,264,194 415,395 22,788 5,388 1,707,765 
General and administrative expense82,119 65,635 16,651 69,116 233,521 
Depreciation and amortization22,617 28,090 17,709 1,812 70,228 
Impairment of goodwill
— 211,780 51,614 — 263,394 
Operating income (loss)45,084 (203,488)(56,109)(70,481)(284,994)
Interest expense, net
— — — 90,413 90,413 
Reorganization items, net208 — — 53,274 53,482 
Income (loss) before income taxes and equity method investment
44,876 (203,488)(56,109)(214,168)(428,889)
Income tax benefit (provision)
239 3,697 897 (951)3,882 
Equity in net loss of investee, net of tax
(1,070)— — (1,120)(2,190)
Net income (loss)
$44,045 $(199,791)$(55,212)$(216,239)$(427,197)
Balance Sheet Information
Equity investment$361 $— $— $27,922 $28,283 
Goodwill$135,186 $203,664 $77,978 $30 $416,858 
Total assets$580,132 $479,332 $165,381 $194,720 $1,419,565 
 Three months ended September 30, 2024
 NEMTPCS
Monitoring
Corporate and OtherTotal
Service revenue, net$492,253 $188,518 $19,448 $1,818 $702,037 
Purchased services
383,769 — — — 383,769 
Payroll and related costs
40,383 150,132 4,281 108 194,904 
Other service expense
12,397 1,613 3,737 1,514 19,261 
Service expense436,549 151,745 8,018 1,622 597,934 
General and administrative expense30,758 23,823 4,332 11,990 70,903 
Depreciation and amortization7,645 12,918 7,073 304 27,940 
Impairment of goodwill
— — — — — 
Operating income (loss)17,301 32 25 (12,098)5,260 
Interest expense, net
— — — 28,493 28,493 
Loss on debt extinguishment— — — 11,797 11,797 
Income (loss) before income taxes and equity method investment
17,301 32 25 (52,388)(35,030)
Income tax benefit (provision)
(4,490)(24)(7)15,591 11,070 
Equity in net income (loss) of investee, net of tax151 — — (2,795)(2,644)
Net income (loss)
$12,962 $8 $18 $(39,592)$(26,604)
Balance Sheet Information
Equity investment$2,026 $— $— $33,809 $35,835 
Goodwill$135,186 $415,444 $129,592 $30 $680,252 
Total assets$525,768 $736,854 $232,633 $156,493 $1,651,748 
 Nine months ended September 30, 2024
 NEMTPCS
Monitoring
Corporate and OtherTotal
Service revenue, net$1,462,236 $558,696 $58,575 $5,280 $2,084,787 
Purchased services
1,119,248 — — — 1,119,248 
Payroll and related costs
131,160 444,923 12,850 440 589,373 
Other service expense
37,754 6,126 11,706 5,393 60,979 
Service expense1,288,162 451,049 24,556 5,833 1,769,600 
General and administrative expense95,701 72,152 15,780 40,512 224,145 
Depreciation and amortization22,602 38,506 20,834 853 82,795 
Impairment of goodwill
— — 105,302 — 105,302 
Operating income (loss)55,771 (3,011)(107,897)(41,918)(97,055)
Interest expense, net
— — — 67,129 67,129 
Loss on debt extinguishment— — — 11,797 11,797 
Income (loss) before income taxes and equity method investment
55,771 (3,011)(107,897)(120,844)(175,981)
Income tax benefit (provision)
(14,512)866 726 14,975 2,055 
Equity in net income (loss) of investee, net of tax269 — — (4,131)(3,862)
Net income (loss)
$41,528 $(2,145)$(107,171)$(110,000)$(177,788)
Balance Sheet Information
Equity investment$2,026 $— $— $33,809 $35,835 
Goodwill$135,186 $415,444 $129,592 $30 $680,252 
Total assets$525,768 $736,854 $232,633 $156,493 $1,651,748