UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
FORM 10-Q
 
(Mark One)
 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31,September 30, 2023

OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from             to             
 
Commission File Number 001-34221
 

ModivCare Inc.
(Exact name of registrant as specified in its charter)

Delaware86-0845127
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
 6900 E Layton Avenue, 12th Floor, Denver, Colorado           80237
(Address of principal executive offices) (Zip Code)  
(303) 728-7030728-7012
(Registrant’s telephone number, including area code)

N/A
(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of exchange on which registered
Common Stock, $0.001 par value per shareMODVThe NASDAQ Global Select Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).   Yes      No
 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
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“smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filer☐  Smaller reporting company
Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 7(a)(2)(B) of the Securities Act.
 
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).      Yes      No

As of April 28,October 27, 2023, there were 14,166,60114,186,655 shares outstanding (excluding treasury shares of 5,432,734)5,428,370) of the registrant’s Common Stock, $0.001 par value per share.

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TABLE OF CONTENTS
 Page
  
 
   
   
 
   
 
  
 
   
Item 2.
   
   
  
 
   
   
Item 1A.
   
   
   
   
   


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PART I—FINANCIAL INFORMATION
Item 1.  Financial Statements.
ModivCare Inc.
Unaudited Condensed Consolidated Balance Sheets
(in thousands, except share and per share data)

March 31, 2023December 31, 2022September 30, 2023December 31, 2022
AssetsAssets  Assets  
Current assets:Current assets:  Current assets:  
Cash and cash equivalentsCash and cash equivalents$12,848 $14,451 Cash and cash equivalents$8,070 $14,451 
Accounts receivable, net of allowance of $2,205 and $2,078, respectively296,745 294,341 
Accounts receivable, net of allowance of $1,396 and $2,078, respectivelyAccounts receivable, net of allowance of $1,396 and $2,078, respectively202,701 223,210 
Contract receivablesContract receivables129,275 71,131 
Other receivablesOther receivables2,246 2,506 Other receivables8,782 2,506 
Prepaid expenses and other current assetsPrepaid expenses and other current assets35,860 34,332 Prepaid expenses and other current assets38,569 34,332 
Restricted cashRestricted cash532 524 Restricted cash544 524 
Total current assetsTotal current assets348,231 346,154 Total current assets387,941 346,154 
Property and equipment, netProperty and equipment, net76,252 69,138 Property and equipment, net81,419 69,138 
GoodwillGoodwill968,654 968,654 Goodwill785,554 968,654 
Payor network, netPayor network, net376,672 391,980 Payor network, net346,109 391,980 
Other intangible assets, netOther intangible assets, net43,250 47,429 Other intangible assets, net34,482 47,429 
Equity investmentEquity investment43,698 41,303 Equity investment45,207 41,303 
Operating lease right-of-use assetsOperating lease right-of-use assets40,311 39,405 Operating lease right-of-use assets39,744 39,405 
Other assetsOther assets44,461 40,209 Other assets42,630 40,209 
Total assetsTotal assets$1,941,529 $1,944,272 Total assets$1,763,086 $1,944,272 
Liabilities and stockholders' equityLiabilities and stockholders' equityLiabilities and stockholders' equity
Current liabilities:Current liabilities:Current liabilities:
Short-term borrowings$15,000 $— 
Accounts payableAccounts payable54,987 54,959 Accounts payable$41,834 $54,959 
Accrued contract payablesAccrued contract payables187,620 194,287 Accrued contract payables133,576 194,287 
Accrued transportation costsAccrued transportation costs93,726 96,851 Accrued transportation costs102,974 96,851 
Accrued expenses and other current liabilitiesAccrued expenses and other current liabilities132,978 135,860 Accrued expenses and other current liabilities146,564 135,860 
Current portion of operating lease liabilitiesCurrent portion of operating lease liabilities9,852 9,640 Current portion of operating lease liabilities8,902 9,640 
Short-term borrowingsShort-term borrowings83,000 — 
Total current liabilitiesTotal current liabilities494,163 491,597 Total current liabilities516,850 491,597 
Long-term debt, net of deferred financing costs of $19,567 and $20,639, respectively980,433 979,361 
Long-term debt, net of deferred financing costs of $17,370 and $20,639, respectivelyLong-term debt, net of deferred financing costs of $17,370 and $20,639, respectively982,630 979,361 
Deferred tax liabilitiesDeferred tax liabilities53,612 57,236 Deferred tax liabilities42,001 57,236 
Operating lease liabilities, less current portionOperating lease liabilities, less current portion32,867 32,088 Operating lease liabilities, less current portion33,397 32,088 
Other long-term liabilitiesOther long-term liabilities29,356 29,434 Other long-term liabilities29,347 29,434 
Total liabilitiesTotal liabilities1,590,431 1,589,716 Total liabilities1,604,225 1,589,716 
Commitments and contingencies (Note 12)
Commitments and contingencies (Note 13)Commitments and contingencies (Note 13)
Stockholders’ equityStockholders’ equityStockholders’ equity
Common stock: Authorized 40,000,000 shares; $0.001 par value; 19,755,832 and 19,729,923, respectively, issued and outstanding (including treasury shares)20 20 
Common stock: Authorized 40,000,000 shares; $0.001 par value; 19,771,636 and 19,729,923, respectively, issued and outstanding (including treasury shares)Common stock: Authorized 40,000,000 shares; $0.001 par value; 19,771,636 and 19,729,923, respectively, issued and outstanding (including treasury shares)20 20 
Additional paid-in capitalAdditional paid-in capital445,379 444,255 Additional paid-in capital448,443 444,255 
Retained earnings176,061 180,023 
Treasury shares, at cost, 5,579,529 and 5,573,529 shares, respectively(270,362)(269,742)
Retained earnings (accumulated deficit)Retained earnings (accumulated deficit)(19,185)180,023 
Treasury shares, at cost, 5,575,275 and 5,573,529 shares, respectivelyTreasury shares, at cost, 5,575,275 and 5,573,529 shares, respectively(270,417)(269,742)
Total stockholders’ equityTotal stockholders’ equity351,098 354,556 Total stockholders’ equity158,861 354,556 
Total liabilities and stockholders’ equityTotal liabilities and stockholders’ equity$1,941,529 $1,944,272 Total liabilities and stockholders’ equity$1,763,086 $1,944,272 

 See accompanying notes to the unaudited condensed consolidated financial statementsstatements.
4



ModivCare Inc.
Unaudited Condensed Consolidated Statements of Operations
(in thousands, except share and per share data)

Three months ended March 31, Three months ended September 30,Nine months ended September 30,
20232022 2023202220232022
Service revenue, netService revenue, net$662,306 $574,475 Service revenue, net$686,925 $647,782 $2,048,338 $1,850,472 
Grant income (Note 2)Grant income (Note 2)1,464 468 Grant income (Note 2)551 789 4,649 4,587 
Operating expenses:Operating expenses:  Operating expenses:  
Service expenseService expense550,266 459,315 Service expense579,214 534,563 1,718,735 1,498,108 
General and administrative expenseGeneral and administrative expense79,713 76,808 General and administrative expense70,142 75,889 229,095 232,108 
Depreciation and amortizationDepreciation and amortization25,693 23,946 Depreciation and amortization26,077 25,672 77,679 74,376 
Impairment of goodwillImpairment of goodwill— — 183,100 — 
Total operating expensesTotal operating expenses655,672 560,069 Total operating expenses675,433 636,124 2,208,609 1,804,592 
Operating income8,098 14,874 
Operating income (loss)Operating income (loss)12,043 12,447 (155,622)50,467 
Interest expense, netInterest expense, net15,958 15,400 Interest expense, net17,844 15,557 50,769 46,429 
Loss before income taxes and equity method investment(7,860)(526)
Provision (benefit) for income taxes(1,873)(361)
Equity in net income of investee, net of tax(2,025)(483)
Net income (loss)$(3,962)$318 
Income (loss) before income taxes and equity method investmentIncome (loss) before income taxes and equity method investment(5,801)(3,110)(206,391)4,038 
Income tax (provision) benefitIncome tax (provision) benefit1,659 1,053 4,362 (877)
Equity in net income (loss) of investee, net of taxEquity in net income (loss) of investee, net of tax(160)(26,448)2,821 (28,020)
Net lossNet loss$(4,302)$(28,505)$(199,208)$(24,859)
Earnings (loss) per common share:  
Loss per common share:Loss per common share:  
BasicBasic$(0.28)$0.02 Basic$(0.30)$(2.03)$(14.06)$(1.77)
DilutedDiluted$(0.28)$0.02 Diluted$(0.30)$(2.03)$(14.06)$(1.77)
Weighted-average number of common shares outstanding:Weighted-average number of common shares outstanding: Weighted-average number of common shares outstanding: 
BasicBasic14,163,511 14,023,585 Basic14,182,839 14,051,794 14,169,537 14,041,224 
DilutedDiluted14,163,511 14,123,825 Diluted14,182,839 14,051,794 14,169,537 14,041,224 

See accompanying notes to the unaudited condensed consolidated financial statementsstatements.
5



ModivCare Inc.
Unaudited Condensed Consolidated Statements of Cash Flows
(in thousands)

Three months ended March 31, Nine months ended September 30,
20232022 20232022
Operating activitiesOperating activities  Operating activities  
Net income (loss)$(3,962)$318 
Adjustments to reconcile net income to net cash provided by (used in) operating activities: 
Net lossNet loss$(199,208)$(24,859)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
DepreciationDepreciation5,792 4,456 Depreciation18,212 14,398 
AmortizationAmortization19,901 19,490 Amortization59,467 59,978 
Stock-based compensationStock-based compensation1,124 2,049 Stock-based compensation4,029 5,152 
Deferred income taxesDeferred income taxes(3,624)(6,587)Deferred income taxes(15,235)(31,232)
Impairment of goodwillImpairment of goodwill183,100 — 
Amortization of deferred financing costs and debt discountAmortization of deferred financing costs and debt discount1,278 1,008 Amortization of deferred financing costs and debt discount3,907 3,878 
Other assetsOther assets(4,253)(3,004)Other assets(2,421)(8,448)
Equity in net income of investee(2,810)(671)
Equity in net (income) loss of investeeEquity in net (income) loss of investee(3,915)38,883 
Reduction of right-of-use assetsReduction of right-of-use assets3,547 2,884 Reduction of right-of-use assets9,875 8,680 
Changes in operating assets and liabilities:Changes in operating assets and liabilities:Changes in operating assets and liabilities:
Accounts receivable and other receivablesAccounts receivable and other receivables(1,730)(42,646)Accounts receivable and other receivables14,242 4,403 
Contract receivablesContract receivables(58,143)(35,580)
Prepaid expenses and other current assetsPrepaid expenses and other current assets(1,734)7,298 Prepaid expenses and other current assets(4,499)4,254 
Accrued contract payablesAccrued contract payables(6,667)34,433 Accrued contract payables(60,710)(37,786)
Accounts payable and accrued expensesAccounts payable and accrued expenses(2,854)49,289 Accounts payable and accrued expenses(2,422)55,887 
Accrued transportation costsAccrued transportation costs(3,125)3,895 Accrued transportation costs6,123 (13,180)
Other long-term liabilitiesOther long-term liabilities(3,538)(727)Other long-term liabilities(9,729)1,098 
Net cash provided by (used in) operating activitiesNet cash provided by (used in) operating activities(2,655)71,485 Net cash provided by (used in) operating activities(57,327)45,526 
Investing activitiesInvesting activities  Investing activities  
Purchase of property and equipmentPurchase of property and equipment(13,320)(8,584)Purchase of property and equipment(31,143)(25,518)
Acquisitions, net of cash acquiredAcquisitions, net of cash acquired— (78,872)
Net cash used in investing activitiesNet cash used in investing activities(13,320)(8,584)Net cash used in investing activities(31,143)(104,390)
Financing activitiesFinancing activities  Financing activities  
Proceeds from short-term borrowings15,000 — 
Net proceeds from short-term borrowingsNet proceeds from short-term borrowings83,000 — 
Payment of debt issuance costsPayment of debt issuance costs— (2,415)Payment of debt issuance costs(376)(2,415)
Proceeds from common stock issued pursuant to stock option exerciseProceeds from common stock issued pursuant to stock option exercise— 1,138 Proceeds from common stock issued pursuant to stock option exercise31 1,237 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment(620)(572)Restricted stock surrendered for employee tax payment(861)(649)
Other financing activitiesOther financing activities315 — 
Net cash provided by (used in) financing activitiesNet cash provided by (used in) financing activities14,380 (1,849)Net cash provided by (used in) financing activities82,109 (1,827)
Net change in cash, cash equivalents and restricted cashNet change in cash, cash equivalents and restricted cash(1,595)61,052 Net change in cash, cash equivalents and restricted cash(6,361)(60,691)
Cash, cash equivalents and restricted cash at beginning of periodCash, cash equivalents and restricted cash at beginning of period14,975 133,422 Cash, cash equivalents and restricted cash at beginning of period14,975 133,422 
Cash, cash equivalents and restricted cash at end of periodCash, cash equivalents and restricted cash at end of period$13,380 $194,474 Cash, cash equivalents and restricted cash at end of period$8,614 $72,731 

See accompanying notes to the unaudited condensed consolidated financial statementsstatements.
6



ModivCare Inc.
Unaudited Supplemental Cash Flow Information
(in thousands)

Three months ended March 31, Nine months ended September 30,
Supplemental cash flow informationSupplemental cash flow information20232022Supplemental cash flow information20232022
Cash paid for interestCash paid for interest$1,200 $551 Cash paid for interest$32,816 $31,460 
Cash paid for income taxesCash paid for income taxes$429 $892 Cash paid for income taxes$8,348 $4,159 
Assets acquired under operating leasesAssets acquired under operating leases$4,453 $1,314 Assets acquired under operating leases$10,214 $3,298 
Acquisitions:Acquisitions:  
Purchase pricePurchase price$— $79,199 
Less:Less:  
Cash acquiredCash acquired— 327 
Acquisitions, net of cash acquiredAcquisitions, net of cash acquired$— $78,872 

See accompanying notes to the unaudited condensed consolidated financial statementsstatements.
7



ModivCare Inc.
Unaudited Condensed Consolidated Statements of Stockholders’ Equity 
(in thousands, except share and per share data)

Three months ended March 31, 2023Nine months ended September 30, 2023
Common StockAdditionalRetainedTreasury StockCommon StockAdditionalRetained EarningsTreasury Stock
SharesAmountPaid-In CapitalEarningsSharesAmountTotal SharesAmountPaid-In Capital(Accumulated Deficit)SharesAmountTotal
Balance at December 31, 2022Balance at December 31, 202219,729,923 $20 $444,255 $180,023 5,573,529 $(269,742)$354,556 Balance at December 31, 202219,729,923 $20 $444,255 $180,023 5,573,529 $(269,742)$354,556 
Net lossNet loss— — — (3,962)— — (3,962)Net loss— — — (3,962)— — (3,962)
Stock-based compensationStock-based compensation— — 1,039 — — — 1,039 Stock-based compensation— — 1,039 — — — 1,039 
Restricted stock issuedRestricted stock issued24,903 — — — — — — Restricted stock issued24,903 — — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 6,000 (620)(620)Restricted stock surrendered for employee tax payment— — — — 6,000 (620)(620)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends1,006 — 85 — — — 85 Shares issued for bonus settlement and director stipends1,006 — 85 — — — 85 
Balance at March 31, 2023Balance at March 31, 202319,755,832 $20 $445,379 $176,061 5,579,529 $(270,362)$351,098 Balance at March 31, 202319,755,832 $20 $445,379 $176,061 5,579,529 $(270,362)$351,098 
Net lossNet loss— — — (190,944)— — (190,944)
Stock-based compensationStock-based compensation— — 1,021 — — — 1,021 
Exercise of employee stock optionsExercise of employee stock options549 — 31 — — — 31 
Restricted stock issuedRestricted stock issued9,116 — — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 3,138 (221)(221)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends1,871 — 85 — — — 85 
Shares issued for ESPPShares issued for ESPP— — 178 — (7,874)193 371 
Balance at June 30, 2023Balance at June 30, 202319,767,368 $20 $446,694 $(14,883)5,574,793 $(270,390)$161,441 
Net lossNet loss— — — (4,302)— — (4,302)
Stock-based compensationStock-based compensation— — 1,664 — — — 1,664 
Restricted stock issuedRestricted stock issued1,583 — — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 482 (27)(27)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends2,685 — 85 — — — 85 
Balance at September 30, 2023Balance at September 30, 202319,771,636 $20 $448,443 $(19,185)5,575,275 $(270,417)$158,861 

Three months ended March 31, 2022Nine months ended September 30, 2022
Common StockAdditionalRetainedTreasury StockCommon StockAdditionalRetainedTreasury Stock
SharesAmountPaid-In CapitalEarningsSharesAmountTotal SharesAmountPaid-In CapitalEarningsSharesAmountTotal
Balance at December 31, 2021Balance at December 31, 202119,589,422 $20 $430,449 $211,829 5,568,983 $(269,031)$373,267 Balance at December 31, 202119,589,422 $20 $430,449 $211,829 5,568,983 $(269,031)$373,267 
Net incomeNet income— — — 318 — — 318 Net income— — — 318 — — 318 
Stock-based compensationStock-based compensation— — 1,963 — — — 1,963 Stock-based compensation— — 1,963 — — — 1,963 
Exercise of employee stock optionsExercise of employee stock options20,683 — 1,138 — — — 1,138 Exercise of employee stock options20,683 — 1,138 — — — 1,138 
Restricted stock issuedRestricted stock issued16,306 — — — — — — Restricted stock issued16,306 — — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 5,179 (572)(572)Restricted stock surrendered for employee tax payment— — — — 5,179 (572)(572)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends732 — 86 — — — 86 Shares issued for bonus settlement and director stipends732 — 86 — — — 86 
Balance at March 31, 2022Balance at March 31, 202219,627,143 $20 $433,636 $212,147 5,574,162 $(269,603)$376,200 Balance at March 31, 202219,627,143 $20 $433,636 $212,147 5,574,162 $(269,603)$376,200 
Net incomeNet income— — — 3,328 — — 3,328 
Stock-based compensationStock-based compensation— — 2,363 — — — 2,363 
Exercise of employee stock optionsExercise of employee stock options16 — — — — — — 
Restricted stock forfeitedRestricted stock forfeited(551)— — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 322 (36)(36)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends1,000 — 85 — — — 85 
Balance at June 30, 2022Balance at June 30, 202219,627,608 $20 $436,084 $215,475 5,574,484 $(269,639)$381,940 
Net lossNet loss— — — (28,505)— — (28,505)
Stock-based compensationStock-based compensation— — 570 — — — 570 
Exercise of employee stock optionsExercise of employee stock options3,381 — 100 — — — 100 
Restricted stock issuedRestricted stock issued914 — — — — — — 
Restricted stock surrendered for employee tax paymentRestricted stock surrendered for employee tax payment— — — — 421 (42)(42)
Shares issued for bonus settlement and director stipendsShares issued for bonus settlement and director stipends846 — 85 — — — 85 
Balance at September 30, 2022Balance at September 30, 202219,632,749 $20 $436,839 $186,970 5,574,905 $(269,681)$354,148 

See accompanying notes to the unaudited condensed consolidated financial statementsstatements.
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ModivCare Inc.
Notes to the Unaudited Condensed Consolidated Financial Statements
March 31,September 30, 2023
 
1.    Organization and Basis of Presentation

Description of Business

ModivCare Inc. ("ModivCare" or the "Company") is a technology-enabled healthcare services company that provides a suite of integrated supportive care solutions for public and private payors and their members. Its value-based solutions address the social determinants of health or SDoH, connect("SDoH") by connecting members to essential care helpservices. By doing so, ModivCare helps health plans manage risks, reduce costs, and improve overall health outcomes. ModivCare is a provider of non-emergency medical transportation or NEMT,("NEMT"), personal care services ("PCS"), and remote patient monitoring or RPM,("RPM") solutions, which serve similar, highly vulnerable patient populations. The technology-enabled operating model in its NEMT segment includes NEMTthe coordination of non-emergency medical transportation services supported by an infrastructure of core competencies in risk underwriting, contact center management, network credentialing claims management and non-emergency medical transportationclaims management. Additionally, its personal care services include placements of non-medical personal care assistants, home health aides and nurses primarily to Medicaid patient populations in need of care monitoring and assistance performing daily living activities in the home setting. ModivCare’s remote patient monitoring services include personal emergency response systems, vitals monitoring, medication management and data-driven patient engagement solutions. ModivCare is further expanding its offerings to include meal delivery and working with communities to provide meals to food-insecure individuals.

ModivCare also holds a 43.6% minority interest in CCHN Group Holdings, Inc. and its subsidiaries, which operates under the Matrix Medical Network brand (“Matrix”). Matrix, which is included in our Corporate and Other segment, maintains a national network of community-based clinicians who deliver in-home and on-site services, and a fleet of mobile health clinics that provide community-based care with advanced diagnostic capabilities and enhanced care options.services.

Basis of Presentation

The Company follows accounting standards established by the Financial Accounting Standards Board (“FASB”). The FASB establishes accounting principles generally accepted in the United States (“GAAP”). Rules and interpretive releases of the Securities and Exchange Commission (“SEC”) under the authority of federal securities laws are also sources of authoritative GAAP for SEC registrants. References to GAAP issued by the FASB in these notes are to the FASB Accounting Standards Codification (“ASC”), which serves as the single source of authoritative accounting and applicable reporting standards to be applied for non-governmental entities. All amounts are presented in U.S. dollars unless otherwise noted.

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information, and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and disclosures required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for the fair presentation of the results of the interim periods have been included.

The Company has made estimates relating to the reporting of assets and liabilities, revenues and expenses, and certain disclosures in the preparation of these unaudited condensed consolidated financial statements in conformity with GAAP. Actual results could differ from those estimates. Operating results for the three and nine months ended March 31,September 30, 2023 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2023. Management has evaluated events and transactions that occurred after the balance sheet date and through the date these unaudited condensed consolidated financial statements were filed with the SEC and considered the effect of such events in the preparation of these unaudited condensed consolidated financial statements.

The unaudited condensed consolidated balance sheet at December 31, 2022 included in this Form 10-Q has been derived from audited financial statements at that date, but does not include all the information and footnotes required by GAAP for complete financial statements. The unaudited condensed consolidated financial statements contained herein should be read in conjunction with the audited financial statements and notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022.

Reclassifications: Certain prior year amounts have been reclassified to conform to current year presentation.

Impact of the COVID-19 Pandemic

Since March 2020,On May 11, 2023, the Department of Health and Human Services ("HHS") declared the end of the public health emergency ("PHE") for the COVID-19 pandemic. While the Company has continued to experience increased trip volume, service hours, and patient visits each year following the pandemic, andstructural changes in the measures enacted by state and government officials to prevent, prepare for, and respond to COVID-19 or slow its spread have had an ongoing adverse impact onindustry as a result of the Company’s business, aspandemic,
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as well as its patients, communities, and employees. The COVID-19 pandemicongoing constraints on the labor market, specifically related to the strain on healthcare professionals, could continue to have an adverse impact on the Company's financial statements with potential for (i) labor shortages or other disruptions that impact our ability to provide services, (ii) decreased member comfort leaving the house to obtain transportation for non-emergency medical purposes, and (iii) supply chain challenges that may cause an increase in the costs of providing our services; among other things.statements. The Company continues to actively monitor the pandemicstructural changes to the industry and any futurethe impact it maythese have on our business and results of operations with emphasis on protecting the health and safety of its employees, maximizing the availability of its services and products to support the SDoH, and supporting the operational and financial stability of its business.

Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the CARES Act and the American Rescue Plan Act of 2021 ("ARPA"). Through the CARES Act, the federal government has authorized payments to be distributed to healthcare providers through the Public Health and Social Services Emergency Fund ("Provider Relief Fund" or "PRF"). The Government further initiatedThrough ARPA which established the Coronavirus State and Local Fiscal Recovery Fund ("SLFRF") was established to send relief payments to state and local governments impacted by the pandemic to assist with responding to the public health emergency (“PHE”)PHE including the economic hardships that continue to impact communities and to respond to workers performing essential work during the COVID-19 PHE, including providers. These funds are not subject to repayment, provided we are able to attest to and comply with any terms and conditions of such funding, as applicable. See discussion of grant income at Note 2, Significant Accounting Policies and Recent Accounting Pronouncements.

2.    Significant Accounting Policies and Recent Accounting Pronouncements

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Fair Value Measurements

The Company follows FASB ASC Topic 820, Fair Value Measurement (“ASC 820”) which establishes a three-level valuation hierarchy for disclosure of fair value measurements. The valuation hierarchy categorizes assets and liabilities measured at fair value into one of three different levels depending on the observability of the inputs employed in the measurement. The three levels based on the objectivityobservability of inputs are defined as follows:

Level 1: Quoted Prices in Active Markets for Identical Assets – inputs to the valuation methodology are quoted prices in active markets as of the measurement date for identical assets or liabilities.

Level 2: Significant Other Observable Inputs – inputs to the valuation methodology are based upon quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets and liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument.

Level 3: Significant Unobservable Inputs – inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument’s categorization within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. As of March 31,September 30, 2023 and December 31, 2022, the carrying amount for cash and cash equivalents, accounts receivable (net of allowance for credit losses), current assets, and current liabilities was equal to or approximated fair value due to their short-term nature or proximity to current market rates. Fair values for our publicly traded debt securities are based on quoted market prices, when available. See Note 8,9, Debt, for the fair value of our long-term debt.

Goodwill and Intangible Assets

In accordance with ASC 350, Intangibles-Goodwill and Other, the Company reviews goodwill for impairment annually, and more frequently if events and circumstances indicate that an asset may be impaired. Such circumstances could include, but are not limited to: (1) the loss or modification of significant contracts, (2) a significant adverse change in legal factors or in business climate, (3) unanticipated competition, (4) an adverse action or assessment by a regulator, or (5) a significant decline in the Company’s stock price.

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When evaluating goodwill for impairment, the Company first performs qualitative assessments for each reporting unit to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying value. If the qualitative assessment suggests that it is more likely than not that the fair value of a reporting unit is less than its carrying value, then the Company performs a quantitative assessment and compares the fair value of the reporting unit to its carrying value and to the extent the carrying value is greater than the fair value, the difference is recorded as an impairment in the consolidated statements of operations.

As a result of the Company's annual goodwill assessment during the second quarter of 2023, the Company recorded a $183.1 million impairment of goodwill within its Personal Care and Remote Patient Monitoring reporting units. The Company determined that based on its qualitative assessment for each reporting unit, factors existed which required the Company to test its goodwill and indefinite-lived intangible assets for impairment. These factors included a decline in the market price of the Company's common stock, industry specific regulatory pressures such as Medicaid redetermination and the Centers for Medicare and Medicaid Services ("CMS") proposed ruling on Ensuring Access to Medicaid Services, and general economic and market volatility. As a result, the Company performed a quantitative assessment and determined that the goodwill at its PCS and RPM reporting units was impaired. See Note 7, Goodwill and Intangible Assets, for additional details.

Internal-use Software and Cloud Computing Arrangements

The Company develops and implements software for internal use to enhance the performance and capabilities of the technology infrastructure. The costs incurred for the development of the internal-use software are capitalized when they meet the internal-use software capitalization criteria outlined in ASC 350-40. The capitalized costs are amortized using the straight-line method over the estimated useful lifelives of the software, ranging from 3 to 10 years.

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In addition to acquired software, the Company capitalizes costs associated with cloud computing arrangements (“CCA”) that are service contracts. The CCA includes services which are used to support certain internal corporate functions as well as technology associated with revenue-generating activities. The capitalized costs are amortized using the straight-line method over the term of the related CCA. As of March 31,September 30, 2023 and December 31, 2022, capitalized costs associated with CCA, net of accumulated amortization were $11.8$14.6 million and $11.9 million, respectively. The value of accumulated amortization as of March 31,September 30, 2023 and December 31, 2022 was $2.7$4.1 million and $2.2 million, respectively. Amortization expense during the three months ended March 31,September 30, 2023 and 2022, totaled $0.6 million and $0.5 million, respectively, and $0.2during the nine months ended September 30, 2023 and 2022, totaled $1.8 million and $0.9 million, respectively.

Revenue Recognition

Under ASC 606, the Company recognizes revenue as it transfers promised services directly to its customers and generates all of its revenue from contracts with customers. Theat the amount of revenue recognizedthat reflects the consideration to which the Company expects to be entitled in exchange for providing these services. The Company satisfies substantially all of itsCompany's performance obligations over timeare driven by its different segments of business and recognizes revenue over time insteadprimarily consist of at points in timeintegrated service offerings to provide non-emergency medical transportation, personal care services, or remote monitoring services directly to its customers. The Company receives payment for providing these services from third-party payors that include federal, state, and applies the "as-invoiced" practical expedient which aligns the pattern of transfer of promised services with the value received by the customer for the performance completed to date.local governmental agencies, managed care organizations, and private consumers. In the NEMT segment, the Company's performance obligation is to stand ready to perform transportation-related activities, including the management, fulfillment, and recordkeeping activities associated with such services. In the Personal CarePCS segment, the Company's performance obligation is to deliver patient care services in accordance with the nature and frequency of services and hours worked peroutlined in each contract. In the RPM segment, the Company's performance obligation is to stand ready to perform monitoring services in the form of personal emergency response system (PERS) monitoring, vitals monitoring, and medication management,other monitoring services, as contractually agreed upon. The Company satisfies substantially all of its performance obligations over time and recognizes revenue over time instead of at points in time which aligns the pattern of transfer of promised services with the value received by the customer for the performance completed to date.

The Company holds different contract types under its different segments of business. In the NEMT segment, there are both capitated contracts, under which payors pay a fixed amount monthly per eligible member and revenue is recognized over each distinct service period, and fee-for-service ("FFS") contracts, under which the Company bills and collects a specified amount for each service that is provided. Personal Careprovided and revenue is recognized using the right to invoice practical expedient. In the PCS segment, contracts are also FFS, and service revenue is reported at the estimated net realizable amount from clients, patients and third-party payors for services rendered. RPM servicerendered and revenue consists of revenue from monitoring services providedis recognized using the right to the customer.invoice practical expedient. Under RPM contracts, payors pay per-enrolled-member-per-month, based on enrolled membership.membership, and revenue is recognized ratably over the contract term. For each contract type, the Company determines the transaction price based on the gross charges for services provided, reduced by estimates for contractual adjustments due to settlements of audits and payment reviews from third-party payors. The Company determines the estimated revenue adjustments at each segment based on our historical experience with various third-party payors and previous results from the claims and adjudication process. The Personal CarePCS segment uses the portfolio approach to determine the estimated revenue adjustments. See further information in Note 4, Revenue Recognition.
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Government Grants

The Company has received government grants primarily under the CARES Act PRF and the ARPA SLFRF to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. Under these acts,During the third quarter of 2023, the Company also filed amended payroll tax returns for 2020 and 2021 to claim refunds for Employee Retention Credits ("ERC"). ERC is a U.S. federal tax credit introduced to support businesses and organizations during the COVID-19 pandemic that was initially established under the CARES Act in 2020 and was later expanded and extended by subsequent legislation, including the Consolidated Appropriations Act of 2021 and the American Rescue Plan Act of 2021. The Company received distributions from these government grants of approximately $1.6$6.5 million and $0.5$1.4 million during the three months ended March 31,September 30, 2023 and 2022, respectively, of which $1.5$0.6 million and $0.5$0.8 million waswere recognized as grant income during the three months ended March 31,September 30, 2023 and 2022, respectively, with the remaining balance recorded in accrued expenses and other current liabilities. During the nine months ended September 30, 2023 and 2022, the Company received distributions of approximately $21.0 million and $10.4 million, respectively, of which $4.6 million was recognized as grant income during each of the the nine months ended September 30, 2023 and 2022, respectively, with the remaining balance recorded in accrued expenses and other current liabilities. Distributions received under these acts are targeted to assist with incremental health care related expenses or lost revenue attributable to the COVID-19 pandemic as well as provide stimulus to support long-term growth and recovery.

The payments from these acts are subject to certain restrictions and possible recoupment if not used for designated purposes. As a condition to receiving PRF distributions, providers must agree to certain terms and conditions, including, among other things, that the funds are being used for healthcare related expenses and lost revenues attributable to COVID-19, as defined by the U.S. Department of Health and Human Services ("HHS").HHS. All recipients of PRF payments are required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company has submitted the required documents to meet reporting requirements for the applicable reporting periods. The Company received an audit inquiry letter from HHS related to one of the business units that received PRF payments, to which the Company has responded and submitted all requested information and believes that the payments received are substantiated and within the terms and conditions defined by HHS and continues to include these amounts as grant income. At this time, the Company is unaware of any other pending or upcoming audits or inquiries related to PRF received.amounts received under PRF.

As a condition to receiving SLFRF distributions, providers must agree to use the funds to respond to the PHE or its negative economic impacts, to respond to workers performing essential work by providing premium pay to eligible workers and to offset reduction in revenue due to the COVID-19 PHE as stipulated by the states in which the funds were received. All recipients of SLFRF payments are required to comply with the reporting requirements that the state in which the funds originated has requested in order for the states to meet the requirements as described in the terms and conditions as determined by the Department of the Treasury. The Company has complied with all known reporting requirements to date.
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The Company recognizes distributions from government grants as grant income or accrued expenses and other current liabilities in line with the loss of revenues or expenses for which the grants are intended to compensate when there is reasonable assurance that it has complied with the conditions associated with the grant.

Recent Accounting Pronouncements

In November 2021,The company did not adopt any material new accounting standards during the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance ("ASU 2021-10"). This update requires annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting model by analogy. These disclosures include information about the nature of the transactions and the related accounting policy used to account for the transactions, the line items on the balance sheet and income statement that are affected by the transactions, the amounts applicable to each financial line item, and the significant terms and conditions of the transactions, including commitments and contingencies. ASU 2021-10 is effective for public business entities for fiscal years beginning after December 15, 2021, with early adoption permitted. The Company adopted this accounting standard on January 1, 2022 and will apply it to any government assistance received thereafter.nine months ended September 30, 2023.

3.    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 CODM uses service revenue, net and operating income as the measures of profit or loss to assess segment performance and allocate resources, and uses total assets as the measure of assets attributable to each segment. 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 Company’s reportable segments are strategic units that offer different services under different financial and operating models to the Company’s customers. The Company's CODM manages the Company under four reportable segments.

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;

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Personal CarePCS - The Company's Personal CarePCS 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;

RPM - The Company's RPM segment is a provider of remote patient monitoring solutions, including personal emergency response systems, vitals monitoring 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.operations as well as the results of an investment in innovation related to our data analytics capabilities 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 March 31,September 30, 2023 and 2022 (in thousands):

 Three months ended September 30, 2023
 NEMTPCSRPMCorporate and OtherTotal
 Service revenue, net$485,951 $179,979 $19,779 $1,216 $686,925 
Grant income(1)
— 551 — — 551 
Service expense428,021 143,078 6,934 1,181 579,214 
General and administrative expense25,433 20,252 5,685 18,772 70,142 
Depreciation and amortization6,814 12,850 6,174 239 26,077 
Operating income (loss)$25,683 $4,350 $986 $(18,976)$12,043 
Equity in net income (loss) of investee, net of tax$142 $— $— $(302)$(160)
Equity investment$1,552 $— $— $43,655 $45,207 
Goodwill$135,186 $415,444 $234,894 $30 $785,554 
Total assets$512,032 $774,731 $346,257 $130,066 $1,763,086 
 Nine months ended September 30, 2023
 NEMTPCSRPMCorporate and OtherTotal
 Service revenue, net$1,452,389 $534,435 $57,702 $3,812 $2,048,338 
Grant income(1)
— 4,649 — — 4,649 
Service expense1,277,604 417,636 20,129 3,366 1,718,735 
General and administrative expense87,645 63,480 16,781 61,189 229,095 
Depreciation and amortization20,319 38,590 18,087 683 77,679 
Impairment of goodwill— 137,331 45,769 — 183,100 
Operating income (loss)$66,821 $(117,953)$(43,064)$(61,426)$(155,622)
Equity in net income of investee, net of tax$984 $— $— $1,837 $2,821 
Equity investment$1,552 $— $— $43,655 $45,207 
Goodwill$135,186 $415,444 $234,894 $30 $785,554 
Total assets$512,032 $774,731 $346,257 $130,066 $1,763,086 

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Three months ended March 31, 2023 Three months ended September 30, 2022
NEMTPersonal CareRPMCorporate and OtherTotal NEMTPCSRPMCorporate and OtherTotal
Service revenue, net Service revenue, net$469,463 $174,131 $18,712 $— $662,306 Service revenue, net$459,796 $169,226 $18,760 $— $647,782 
Grant income (1)
Grant income (1)
— 1,464 — — 1,464 
Grant income(1)
— 789 — — 789 
Service expenseService expense407,686 136,090 6,490 — 550,266 Service expense394,981 132,746 6,836 — 534,563 
General and administrative expenseGeneral and administrative expense33,875 22,663 5,769 17,406 79,713 General and administrative expense31,815 22,057 5,816 16,201 75,889 
Depreciation and amortizationDepreciation and amortization6,766 12,868 5,854 205 25,693 Depreciation and amortization7,079 12,919 5,467 207 25,672 
Operating income (loss)Operating income (loss)$21,136 $3,974 $599 $(17,611)$8,098 Operating income (loss)$25,921 $2,293 $641 $(16,408)$12,447 
Equity in net income of investee, net of tax$(653)$— $— $(1,372)$(2,025)
Equity in net income (loss) of investee, net of taxEquity in net income (loss) of investee, net of tax$208 $— $— $(26,656)$(26,448)
Equity investmentEquity investment$1,092 $— $— $42,606 $43,698 Equity investment$208 $— $— $43,269 $43,477 
GoodwillGoodwill$135,186 $552,775 $280,663 $30 $968,654 Goodwill$135,186 $552,775 $280,429 $30 $968,420 
Total assetsTotal assets$505,823 $924,880 $394,076 $116,750 $1,941,529 Total assets$517,930 $962,425 $402,929 $106,561 $1,989,845 
 Three months ended March 31, 2022
 NEMTPersonal CareRPMCorporate and OtherTotal
Service revenue, net$400,920 $159,698 $13,857 $— $574,475 
Grant income (1)
— 468 — — 468 
Service expense332,096 122,232 4,987 — 459,315 
General and administrative expense37,333 23,133 4,962 11,380 76,808 
Depreciation and amortization7,105 12,505 4,128 208 23,946 
Operating income (loss)$24,386 $2,296 $(220)$(11,588)$14,874 
Equity in net loss (income) of investee, net of tax$65 $— $— $(548)$(483)
Equity investment$— $— $— $83,333 $83,333 
Goodwill$135,186 $552,833 $236,738 $30 $924,787 
Total assets$603,875 $1,024,013 $334,071 $151,025 $2,112,984 

 Nine months ended September 30, 2022
 NEMTPCSRPMCorporate and OtherTotal
 Service revenue, net$1,309,449 $491,661 $49,362 $— $1,850,472 
Grant income(1)
— 4,587 — — 4,587 
Service expense1,100,801 379,423 17,884 — 1,498,108 
General and administrative expense102,736 68,536 17,520 43,316 232,108 
Depreciation and amortization21,576 37,976 14,201 623 74,376 
Operating income (loss)$84,336 $10,313 $(243)$(43,939)$50,467 
Equity in net income (loss) of investee, net of tax$143 $— $— $(28,163)$(28,020)
Equity investment$208 $— $— $43,269 $43,477 
Goodwill$135,186 $552,775 $280,429 $30 $968,420 
Total assets$517,930 $962,425 $402,929 $106,561 $1,989,845 

(1)    Grant income for the Personal CarePCS segment includes funding received on a periodic basis from the PRF in relation to relief under the CARES Act and funding received from the SLFRF under ARPA in relation to economic recovery to combat health and economic impacts of the COVID-19 pandemic. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements.

4.    Revenue Recognition

Under ASC 606, the Company recognizes revenue as it transfers promised services to its customers and generates all of its revenue from contracts with customers. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled in exchange for these services. The Company satisfies substantially all of its performance obligations over time and recognizes revenue over time instead of at points in time.

Revenue Contract Structure

NEMT Capitated Contracts (per-member-per-month)

Under capitated contracts, payors pay a fixed amount per eligible member per month. Capitation rates are generally based on expected costs and volume of services. We assume the responsibility of meeting the covered healthcare related
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transportation requirements based on per-member, per-month fees for the number of eligible members in the payor’s program. Revenue is recognized based on the population served during the period. Certain capitated contracts have provisions for reconciliations, risk corridors or profit rebates. For contracts with reconciliation provisions, capitation payment is received as a prepayment during the month service is provided. These prepayments are reconciled based on actual cost and/or trip volume
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and may result in refunds to the payor, or additional payments due from the payor. Contracts with risk corridor or profit rebate provisions allow for profit within a certain corridor and once we reach profit level maximums, we discontinue recognizing revenue and instead record a liability within the accrued contract payable account. This liability may be reduced through future increases in trip volume or periodic settlements with the payor. While a profit rebate provision could only result in a liability from this profit threshold, a risk corridor provision could potentially result in receivables if the Company does not reach certain profit minimums, which would be recorded in the reconciliation contract receivables account.

NEMT Fee-for-service Contracts

Fee-for-service ("FFS") revenue represents revenue earned under non-capitated contracts in which we bill and collect a specified amount for each service that we provide. FFS revenue is recognized in the period in which the services are rendered and is reduced by the estimated impact of contractual allowances.

Personal CarePCS Fee-for-service Contracts

Personal CarePCS FFS revenue is reported at the estimated net realizable amount from clients, patients and third-party payors for services rendered based on actual personal care hours provided. Payment for services received from third-party payors includes, but is not limited to, insurance companies, hospitals, governmental agencies and other home health care providers who subcontract work to the Company. Certain contracts are subject to retroactive review and possible adjustment by those payors based on the nature of the contract or costs incurred. The Company makes estimates of retroactive adjustments and considers these in the recognition of revenue in the period in which the related services are rendered. The difference between estimated settlement and actual settlement is reported in net service revenues as adjustments become known or as years are no longer subject to such audits, reviews, or investigations.

RPM per-member-per-month Contracts

RPM per-member-per-month ("PMPM") revenue consists of revenue from monitoring services provided to the customer. Under RPM contracts, payors pay per-enrolled-member-per-month based on enrolled membership. Consideration is generally fixed for each type of monitoring service and revenue is recognized ratably over the contracts do not typically contain variable components of consideration. As such, the RPM segment recognizes revenuecontract term based on the monthly fee paid by customers.

Disaggregation of Revenue by Contract Type
The following table summarizes disaggregated revenue from contracts with customers by contract type for the three and nine months ended March 31,September 30, 2023 and March 31,September 30, 2022 (in thousands):

Three months ended March 31,Three months ended September 30,Nine months ended September 30,
202320222023202220232022
NEMT capitated contractsNEMT capitated contracts$404,689 $335,718 NEMT capitated contracts$412,762 $399,859 $1,239,957 $1,145,694 
NEMT FFS contractsNEMT FFS contracts64,774 65,202 NEMT FFS contracts73,189 59,937 212,432 163,755 
Total NEMT service revenue, netTotal NEMT service revenue, net469,463 400,920 Total NEMT service revenue, net485,951 459,796 1,452,389 1,309,449 
Personal Care FFS contracts174,131 159,698 
PCS FFS contractsPCS FFS contracts179,979 169,226 534,435 491,661 
RPM PMPM contractsRPM PMPM contracts18,712 13,857 RPM PMPM contracts19,779 18,760 57,702 49,362 
Other service revenueOther service revenue1,216 — 3,812 — 
Total service revenue, netTotal service revenue, net$662,306 $574,475 Total service revenue, net$686,925 $647,782 $2,048,338 $1,850,472 

Payor Information
Service revenue, net, is derived from state and managed Medicaid contracts, managed Medicare contracts, as well as a small amount from private pay and other contracts. Of the NEMT segment’s revenue, 11.1%11.4% and 10.4% were derived from one payor for the three months ended March 31,September 30, 2023 and 2022, respectively, and 11.2% and 11.0% were derived from one payor for the nine months ended September 30, 2023 and 2022, respectively. Of the Personal CarePCS segment's revenue, 11.3%11.4% and 17.4%12.1% were derived from one payor for the three months ended March 31,September 30, 2023 and 2022, respectively, and 11.3% and 12.0%
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were derived from one payor for the nine months ended September 30, 2023 and 2022, respectively. Of the RPM segment's revenue, 15.2%19.3% and 22.3%18.4% were derived from one payor for the three months ended March 31,September 30, 2023 and 2022, respectively, and 17.4% and 20.4% were derived from one payor for the nine months ended September 30, 2023 and 2022, respectively.


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Revenue Adjustments

During the three months ended March 31,September 30, 2023 and 2022, the Company recognized an increasea reduction of $0.4$0.8 million and an increase of $1.2$1.7 million in service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the payor agreed. During the nine months ended September 30, 2023 and 2022, the Company recognized a reduction of $3.9 million and an increase of $6.5 million in service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the payor agreed.

Related Balance Sheet Accounts
The following table provides information about accounts receivable, net (in thousands):
March 31, 2023December 31, 2022
Accounts receivable$200,926 $225,288 
Reconciliation contract receivables (1)
98,024 71,131 
Allowance for doubtful accounts(2,205)(2,078)
Accounts receivable, net$296,745 $294,341 
(1)     Reconciliation contracts receivable primarily represent underpayments and receivables on certain contracts with reconciliation and risk corridor provisions. See the contract payables and receivables activity below.
September 30, 2023December 31, 2022
Accounts receivable$204,097 $225,288 
Allowance for doubtful accounts(1,396)(2,078)
Accounts receivable, net$202,701 $223,210 
The following table provides information about other revenue related accounts included on the accompanying unaudited condensed consolidated balance sheets (in thousands):
March 31, 2023December 31, 2022
Accrued contract payables (1)
$187,620 $194,287 
Long-term contract receivables (2)
$4,324 $427 
Deferred revenue, current$2,155 $2,202 
September 30, 2023December 31, 2022
Accrued contract payables(1)
$133,576 $194,287 
Contract receivables(2)
$129,275 $71,131 
Long-term contract receivables(3)
$— $427 
Deferred revenue, current$2,008 $2,202 
(1)     Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts. See the contract payables and receivables activity below.

(2)     Contract receivables primarily represent underpayments and receivables on certain risk corridor, profit rebate, and reconciliation contracts. See the contract payables and receivables activity below.
(3)     Long-term contract receivables primarily represent future receivable balances on certain risk corridor, profit rebate and reconciliation contracts that may be received in greater than 12 months.

The following table provides the summary activity of total contract payables and receivables as reported within the unaudited condensed consolidated balance sheets (in thousands):

December 31, 2022Additional Amounts RecordedAmounts Paid or SettledMarch 31, 2023December 31, 2022Additional Amounts RecordedAmounts Paid or SettledMarch 31, 2023
Reconciliation contract payablesReconciliation contract payables$25,853 $1,811 $(18,110)$9,554 Reconciliation contract payables$25,853 $1,811 $(18,110)$9,554 
Profit rebate/corridor contract payablesProfit rebate/corridor contract payables155,161 22,316 (10,873)166,604 Profit rebate/corridor contract payables155,161 22,316 (10,873)166,604 
Overpayments and other cash itemsOverpayments and other cash items13,273 799 (2,610)11,462 Overpayments and other cash items13,273 799 (2,610)11,462 
Total contract payablesTotal contract payables$194,287 $24,926 $(31,593)$187,620 Total contract payables$194,287 $24,926 $(31,593)$187,620 
Reconciliation contract receivablesReconciliation contract receivables$48,153 $22,204 $(5,922)$64,435 Reconciliation contract receivables$48,153 $22,204 $(5,922)$64,435 
Corridor contract receivablesCorridor contract receivables23,405 14,508 — 37,913 Corridor contract receivables23,405 14,508 — 37,913 
Total reconciliation contract receivables$71,558 $36,712 $(5,922)$102,348 
Total contract receivablesTotal contract receivables$71,558 $36,712 $(5,922)$102,348 

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March 31, 2023Additional Amounts RecordedAmounts Paid or SettledJune 30, 2023
Reconciliation contract payables$9,554 $6,687 $(2,749)$13,492 
Profit rebate/corridor contract payables166,604 17,447 (98,683)85,368 
Overpayments and other cash items11,462 2,707 (3,935)10,234 
Total contract payables$187,620 $26,841 $(105,367)$109,094 
Reconciliation contract receivables$64,435 $16,686 $(15,105)$66,016 
Corridor contract receivables37,913 16,290 (456)53,747 
Total contract receivables$102,348 $32,976 $(15,561)$119,763 

June 30, 2023Additional Amounts RecordedAmounts Paid or SettledSeptember 30, 2023
Reconciliation contract payables$13,492 $4,763 $(3,034)$15,221 
Profit rebate/corridor contract payables85,368 10,614 (1,840)94,142 
Overpayments and other cash items10,234 16,313 (2,334)24,213 
Total contract payables$109,094 $31,690 $(7,208)$133,576 
Reconciliation contract receivables$66,016 $14,180 $(19,460)$60,736 
Corridor contract receivables53,747 14,792 — 68,539 
Total contract receivables$119,763 $28,972 $(19,460)$129,275 

5.    Equity Investment

As of March 31,September 30, 2023 and December 31, 2022, the Company owned a 43.6% non-controlling interest in Matrix. Pursuant to a Shareholder’s Agreement, affiliates of Frazier Healthcare Partners hold rights necessary to control the fundamental operations of Matrix. The Company accounts for its investment in Matrix under the equity method of accounting and the Company’s share of Matrix’s income or losses are recorded as “Equity in net (income) lossincome (loss) of investee”investee, net of tax” in the accompanying unaudited condensed consolidated statements of operations. During the year ended December 31, 2022, Matrix recorded asset impairment charges of $82.2 million.million, of which the entire asset impairment charge was recorded during the three and nine months ended September 30, 2022. No asset impairment charges were recorded for the three or nine months ended March 31, 2023 or 2022.
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September 30, 2023.

The Company's gross share of its Matrix's operations for the three months ended March 31,September 30, 2023 and March 31,September 30, 2022 was a loss of $0.4 million and a loss of $36.1 million, respectively, which is presented net of tax on the unaudited condensed consolidated statements of operations for a loss of $0.3 million and a loss of $26.7 million, respectively. The Company's gross share of its Matrix's operations for the nine months ended September 30, 2023 and September 30, 2022 was income of $1.9$2.5 million and incomea loss of $0.8$39.0 million, respectively, which is presented net of tax on the unaudited condensed consolidated statements of operations for income of $1.4$1.8 million and incomea loss of $0.5$28.2 million, respectively.

The carrying amount of the assets included in the Company’s unaudited condensed consolidated balance sheets and the maximum loss exposure related to the Company’s interest in Matrix as of March 31,September 30, 2023 and December 31, 2022 totaled $42.6$45.2 million and $41.3 million, respectively.

Summary financial information for Matrix on a standalone basis is as follows (in thousands):

March 31, 2023December 31, 2022 September 30, 2023December 31, 2022
Current assetsCurrent assets$98,759 $97,750 Current assets$112,994 $97,750 
Long-term assetsLong-term assets$367,752 $373,297 Long-term assets$355,143 $373,297 
Current liabilitiesCurrent liabilities$29,436 $36,913 Current liabilities$34,955 $36,913 
Long-term liabilitiesLong-term liabilities$324,703 $325,613 Long-term liabilities$317,806 $325,613 

Three months ended March 31,
20232022
Revenue$81,316 $85,753 
Operating income$13,407 $2,645 
Net income (loss)$4,570 $(1,317)
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Three months ended September 30,Nine months ended September 30,
2023202220232022
Revenue$84,395 $76,461 $252,973 $235,582 
Operating income (loss)$7,593 $(79,992)$32,196 $(81,604)
Net income (loss)$(239)$(85,081)$6,976 $(93,211)

6.    Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets were comprised of the following (in thousands): 

March 31, 2023December 31, 2022September 30, 2023December 31, 2022
Prepaid insurancePrepaid insurance$8,251 $6,334 
Deferred ERP implementation costsDeferred ERP implementation costs5,070 5,817 
Prepaid income taxesPrepaid income taxes$5,297 $7,186 Prepaid income taxes4,075 7,186 
Deferred ERP implementation costs5,231 5,817 
Prepaid insurance3,513 6,334 
Deferred financing costs on credit facilityDeferred financing costs on credit facility2,919 3,061 Deferred financing costs on credit facility2,864 3,061 
InventoryInventory1,416 2,041 Inventory2,261 2,041 
Prepaid rentPrepaid rent1,290 278 Prepaid rent1,152 278 
Other prepaid expensesOther prepaid expenses16,194 9,615 Other prepaid expenses14,896 9,615 
Total prepaid expenses and other current assetsTotal prepaid expenses and other current assets$35,860 $34,332 Total prepaid expenses and other current assets$38,569 $34,332 

7.    Goodwill and Intangible Assets

The Company tests goodwill for impairment for its reporting units annually as of July 1 or more frequently when events or changes in circumstances indicate that impairment may have occurred. The Company reviews its intangible assets for impairment whenever events or changes in circumstances indicate that the carrying value of an asset group may not be recoverable.

Goodwill

During the second quarter of 2023, the Company recorded a $183.1 million impairment of goodwill within its Personal Care and Remote Patient Monitoring reporting units. This impairment was driven primarily by macroeconomic factors, including a decline in the market value of the Company's common stock. After recording these impairments, the associated reporting units have $650.3 million of goodwill remaining. If, among other factors, (i) the Company's equity values were to decline significantly, (ii) the Company experienced additional adverse impacts associated with macroeconomic factors, including increases in our estimated weighted average cost of capital, or (iii) the adverse impacts stemming from competition, economic, regulatory or other factors were to cause the Company's results of operations or cash flows to be worse than currently anticipated, the Company could conclude in future periods that additional impairment charges of certain reporting units are required in order to reduce the carrying values of goodwill. Any such impairment charges could be significant.

The Company performed a quantitative test comparing the carrying value of the Company's reporting units with their respective fair value. The fair value of the Company's reporting units was estimated using both the income approach and the market valuation approach. The income approach produces an estimated fair value of a reporting unit based on the present value of the cash flows the Company expects the reporting unit to generate in the future. Estimates included in the discounted cash flow model are primarily Level 3 inputs and include the discount rate, which the Company determines based on adjusting an industry-wide weighted-average cost of capital for size, geography, and company specific risk factors, long-term rates of growth and profitability of the Company’s business, working capital effects and planned capital expenditures. The market approach produces an estimated fair value of a reporting unit based on a comparison of the reporting unit to comparable publicly traded entities in similar lines of business. The Company’s significant estimates in the market approach include the selected similar companies with comparable business factors such as size, growth, profitability, risk and return on investment and the multiples the Company applies to earnings before interest, taxes, depreciation and amortization (“EBITDA”) to estimate the fair value of the reporting unit.

Changes in key assumptions from the prior year annual goodwill assessment and the resulting reduction in projected future cash flows included in the current year goodwill test resulted in a decrease in the fair values of the Company's PCS and RPM reporting units such that the fair value of each respective reporting unit was less than its respective carrying value. As a
16
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7.result, during the second quarter of 2023, the Company recorded a non-cash goodwill impairment charge of $137.3 million in the PCS reporting unit and $45.8 million in the RPM reporting unit, which is recorded in “Impairment of goodwill” on the Company’s unaudited condensed consolidated statement of operations. No further impairment was taken during the three months ended September 30, 2023. There was no such goodwill impairment charge in the three and nine months ended September 30, 2022.
Changes in the carrying value of goodwill by reportable segment are presented in the following table (in thousands):
NEMTPCSRPMCorporate and OtherTotal
Balance at December 31, 2022$135,186 $552,775 $280,663 $30 $968,654 
Impairment of goodwill— (137,331)(45,769)— (183,100)
Balance at September 30, 2023$135,186 $415,444 $234,894 $30 $785,554 

The accumulated impairment losses on goodwill totaled $279.1 million as of September 30, 2023 and $96.0 million as of December 31, 2022.

Intangible Assets

Intangible assets are comprised of acquired payor networks, trademarks and trade names, developed technology, non-compete agreements, licenses, and an assembled workforce. Finite-lived intangible assets are amortized using the straight-line method over the estimated economic lives of the assets. These finite-lived intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying value of such assets may not be recoverable. Indefinite-lived intangible assets are not amortized, but are tested for impairment annually and more frequently if events occur or circumstances change that indicate an asset may be impaired. Based on the continued value of the definite-lived and indefinite-lived intangible assets acquired, the Company did not identify any circumstances during the three and nine months ended September 30, 2023 that would require an impairment test for our intangible assets.

8.    Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities were comprised of the following (in thousands):

March 31, 2023December 31, 2022September 30, 2023December 31, 2022
Accrued compensation and related liabilitiesAccrued compensation and related liabilities$49,466 $47,947 Accrued compensation and related liabilities$47,183 $47,947 
Accrued interestAccrued interest24,177 10,643 Accrued interest24,855 10,643 
Insurance reservesInsurance reserves19,577 17,836 Insurance reserves19,439 17,836 
Accrued operating expensesAccrued operating expenses11,229 18,432 Accrued operating expenses13,788 18,432 
Accrued legal feesAccrued legal fees9,143 15,574 Accrued legal fees12,002 15,574 
Accrued government grants(1)
Accrued government grants(1)
10,970 7,367 
Union pension obligationUnion pension obligation3,548 3,665 Union pension obligation2,970 3,665 
Accrued government grants (1)
3,464 7,367 
Deferred revenueDeferred revenue2,155 2,202 Deferred revenue2,008 2,202 
OtherOther10,219 12,194 Other13,349 12,194 
Total accrued expenses and other current liabilitiesTotal accrued expenses and other current liabilities$132,978 $135,860 Total accrued expenses and other current liabilities$146,564 $135,860 

(1)     Accrued government grants include payments received from government entities, primarily in relation to the PRF and SLFRF, to offset lost revenue or increased expenditures for which the related expenditure has not yet been incurred and thus the related payments are deferred as of March 31,September 30, 2023 and December 31, 2022.

8.
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9.    Debt

Senior Unsecured Notes

Senior unsecured notes as of March 31,September 30, 2023 and December 31, 2022 consisted of the following (in thousands):

Senior Unsecured NoteSenior Unsecured NoteDate of IssuanceMarch 31, 2023December 31, 2022Senior Unsecured NoteDate of IssuanceSeptember 30, 2023December 31, 2022
$500.0 million 5.875% due November 15, 2025
(effective interest rate 6.485%)
11/4/2020$491,809 $491,098 
$500.0 million 5.000% due October 1, 2029
(effective interest rate 5.395%)
8/24/2021488,624 488,263 
$500.0 million 5.875% due November 15, 2025
(effective interest rate 6.467%)
$500.0 million 5.875% due November 15, 2025
(effective interest rate 6.467%)
11/4/2020$493,265 $491,098 
$500.0 million 5.000% due October 1, 2029
(effective interest rate 5.392%)
$500.0 million 5.000% due October 1, 2029
(effective interest rate 5.392%)
8/24/2021489,365 488,263 
TotalTotal$980,433 $979,361 Total$982,630 $979,361 

The Company pays interest on the Senior Unsecured Notes semi-annually in arrears. Principal payments are not required until the maturity date. Debt issuance costs of $14.5 million in relation to the issuance of the Senior Notes due 2025 were incurred and these costs were deferred and are amortized to interest cost over the term of the Notes. Debt issuance costs of $13.5 million were incurred in relation to the issuance of the Senior Notes due 2029 and these costs were deferred and are amortized to interest cost over the term of the Notes. As of March 31,September 30, 2023, $19.6$17.4 million of unamortized deferred issuance costs was netted against the long-term debt balance on the unaudited condensed consolidated balance sheets. The fair value of the Notes as of March 31,September 30, 2023 and December 31, 2022 was $915.6$836.3 million and $896.6 million, respectively, which was determined based on quoted prices in active markets, and therefore designated as Level 1 within the fair value hierarchy. The Company was in compliance with all covenants as of March 31,September 30, 2023.

Credit Facility

OnThe Company is a party to the amended and restated credit agreement, dated as of February 3, 2022, (as amended, the Company entered into a credit agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent, swing line lender and an issuing bank, Wells Fargo Bank, National Association, as an issuing bank, Truist Bank and Wells Fargo Bank, National Association, as co-syndication agents, Deutsche Bank AG New York Branch, Bank of America, N.A., Regions Bank, Bank of Montreal and Capital One, National Association, as co-documentation agents, and JPMorgan Chase Bank, N.A., Truist Securities, Inc. and Wells Fargo Securities, LLC, as joint bookrunners and joint lead arrangers, and the other lenders party thereto. The Credit Agreement provides the Company with a senior secured revolving credit facility (the “Credit Facility”) in an aggregate principal amount of $325.0 million and sublimits for swingline loans, letters of credit and alternative currency loans in amounts of up to $25.0 million, $60.0 million and $75.0 million, respectively. The Credit Facility matures on February 3, 2027 and the proceeds may be used (i) to finance working capital needs of the Company and its subsidiaries and (ii) for general corporate purposes of the Company and its subsidiaries (including to finance capital expenditures, permitted acquisitions and investments). As of March 31, 2023, the
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On June 26, 2023, the Company entered into an Amendment No. 1 (the "First Amendment") to the Credit Agreement which amended and restated the maximum permitted Total Net Leverage Ratio under the Credit Agreement as follows: for the fiscal quarters ending June 30, 2023 through September 30, 2023, 5.25:1.00; for the fiscal quarters ending December 31, 2023 through March 31, 2024, 5.00:1.00; for the fiscal quarter ending June 30, 2024, 4.75:1.00; and for the fiscal quarters ending September 30, 2024 and for the fiscal quarters ending thereafter, 4.50:1.00.

As of September 30, 2023, the Company had $15.0$83.0 million of short-term borrowings outstanding on the Credit Facility and had $32.8$39.1 million of outstanding letters of credit under the Credit Facility. The interest rate for borrowings outstanding as of March 31,September 30, 2023 was 10.5%9.8% per annum. As of December 31, 2022, the Company did not have any balancesborrowings outstanding on the Credit Facility and had $38.1 million of outstanding letters of credit under the Credit Facility.

Under the Credit Facility, the Company has an option to request an increase in the amount of the Credit Facility or obtain incremental term loans from time to time (on substantially the same terms as apply to the existing facilities) by an aggregate amount of up to $175.0 million, so long as, after giving effect to the relevant incremental facility, the pro forma secured net leverage ratio does not exceed 3.50:1.00.1.00, provided that the lenders agree to increase their existing commitments or to participate in such incremental term loans. The Company may prepay the Credit Facility in whole or in part, at any time without premium or penalty, subject to reimbursement of the lenders’ breakage and redeployment costs in connection with prepayments of Term Benchmark loans or RFR loans, each as defined in the Credit Agreement. The unutilized portion of the commitments under the Credit Facility may be irrevocably reduced or terminated by the Company at any time without penalty.

Interest on the outstanding principal amount of the loans accrues at a per annum rate equal to the Alternate Base Rate, the Adjusted Term SOFR Rate, the Adjusted Daily Simple SOFR Rate, the Adjusted EURIBOR Rate or the Adjusted Daily
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Simple SONIA Rate, as applicable and each as defined in the Credit Agreement, in each case, plus an applicable margin. The applicable margin ranges from 1.75% to 3.50% in the case of Term Benchmark loans or RFR loans, each as defined in the Credit Agreement, and 0.75% to 2.50% in the case of the Alternate Base Rate loans, as defined in the Credit Agreement, in each case, based on the Company’s total net leverage ratio as defined in the Credit Agreement. Interest on the loans is payable quarterly in arrears in the case of Alternate Base Rate loans, on the last day of the relevant interest period in the case of Term Benchmark loans, and monthly in arrears in the case of RFR loans. In addition, the Company is obligated to pay a quarterly commitment fee based on a percentage of the unused portion of the revolving credit facility and quarterly letter of credit fees based on a percentage of the maximum amount available to be drawn under each outstanding letter of credit. The commitment fee and letter of credit fee range from 0.30% to 0.50% and 1.75% to 3.50%, respectively, in each case, based on the Company’s total net leverage ratio.

The Credit Agreement contains customary representations and warranties, affirmative and negative covenants and events of default. The negative covenants include restrictions on the Company’s ability to, among other things, incur additional indebtedness, create liens, make investments, give guarantees, pay dividends, sell assets and merge and consolidate. The Company's borrowing capacity under the Credit Facility is currently limited by, among other covenants, compliance with the total net leverage ratio covenant of 5.00:1.00, which steps downfor each fiscal period as amended in the First Amendment to 4.50:1.00 beginning September 30, 2023.the Credit Agreement.

The Company’s obligations under the Credit Facility are guaranteed by all of the Company’s present and future material domestic subsidiaries, excluding certain material domestic subsidiaries that are excluded from being guarantors pursuant to the terms of the Credit Agreement. The Company’s obligations under, and each guarantor’s obligations under its guaranty of, the Credit Facility are secured by a first priority lien on substantially all of the Company’s or such guarantor’s respective assets. If an event of default occurs, the required lenders may cause the administrative agent to declare all unpaid principal and any accrued and unpaid interest and all fees and expenses under the Credit Facility to be immediately due and payable. All amounts outstanding under the Credit Facility will automatically become due and payable upon the commencement of any bankruptcy, insolvency or similar proceedings. The Credit Agreement also contains a cross default to any of the Company’s indebtedness having a principal amount in excess of $40.0 million. The Company was in compliance with all covenants under the Credit Agreement as of March 31,September 30, 2023.

9.10.    Stock-Based Compensation and Similar Arrangements

The Company provides stock-based compensation to employees, non-employee directors, consultants and advisors under the Company’s 2006 Long-Term Incentive Plan (“2006 Plan”). The 2006 Plan allows the flexibility to grant or award stock options, stock appreciation rights, restricted stock, unrestricted stock, stock units including restricted stock units and performance awards to eligible persons.

Stock options. The Company recognized stock-based compensation expense for non-qualified stock options (“NQs”) of $0.2 million and $0.6 million for the three months ended March 31,September 30, 2023, and recognized a reversal of previously recognized stock-based compensation expense for NQs of $0.3 million during the three months ended September 30, 2022 due to forfeitures that occurred during the period. For the nine months ended September 30, 2023 and 2022, the Company recognized stock-based compensation expense for NQs of $0.6 million and $1.0 million, respectively, in general and administrative expense. At March 31,September 30, 2023, the Company had 108,28087,388 stock options outstanding with a weighted-average exercise price of $115.55.$106.51.

Restricted stock awards and restricted stock units. The Company recognized stock-based compensation expense for restricted stock awards ("RSAs") and restricted stock units ("RSUs") of $0.9$1.1 million and $1.1$0.7 million for the three months ended March 31,September 30, 2023 and 2022, respectively, and $2.9 million and $3.5 million for the nine months ended September 30, 2023 and 2022, respectively, in general and administrative expense. The Company had 11,51816,074 unvested RSAs and 66,383285,472 unvested RSUs outstanding at March 31,September 30, 2023 with a weighted-average grant date fair value of $97.61$80.47 and $107.56,$43.86, respectively.
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Performance-based share awards. The Company grants performance-based restricted stock units (PRSUs)("PRSUs") to align management’s compensation with the Company's financial performance and other operational objectives and to retain key employees. Awards granted under this category are based on the achievement of various targeted metrics as definedapproved by the Plan.Compensation Committee and defined in the related PRSU Agreement. Stock-based compensation expense for PRSUs is recognized over the 3-year vesting period under the straight-line attribution method. The Company recorded an immaterial amount of stock-based compensation expense of $0.4 million for the three months ended March 31,September 30, 2023 and recorded $0.3a reversal of $0.2 million of stock-based compensation expense for the three months ended March 31,September 30, 2022 withdue to forfeitures that occurred during the period. For the nine months ended September 30, 2023 and 2022, the Company recognized stock-based compensation expense for PRSUs of $0.5 million and $0.6 million, respectively, in general and administrative expense. The remaining portionexpense is expected to be recognized over the remainder of the 3-year requisite service period. The Company had 36,601213,428 unvested PRSUs outstanding at March 31,September 30, 2023 with a weighted-average grant date fair value of $112.82.$43.74
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Employee Stock Purchase Plan

During the fourth quarter of 2022, the Company began offering an Employee Stock Purchase Plan ("ESPP") with 1,000,000 shares of Common Stock reserved for purchase pursuant to the Plan for eligible employees. The shares of Common Stock may be newly issued shares, treasury shares or shares acquired on the open market. Under the terms of the plan,ESPP, eligible employees may designate a dollar value or percentage of their compensation to be withheld through payroll deductions, up to a maximum of $25,000 in each plan year, for the purchase of common stock at a discounted rate of 85% of the lower of the market price on the first or last trading day of the offering period. For the three and nine months ended September 30, 2023, Company recorded an immaterial amount of stock-based compensation expense. As of March 31,September 30, 2023, 997,060989,186 shares remain available for future issuance under this plan.the ESPP.

10.    Earnings (Loss)11.    Loss Per Share

The following table details the computation of basic and diluted earnings (loss)loss per share (in thousands, except share and per share data):
 
Three months ended March 31, Three months ended September 30,Nine months ended September 30,
20232022 2023202220232022
Numerator:Numerator:  Numerator:    
Net income (loss)$(3,962)$318 
Net lossNet loss$(4,302)$(28,505)$(199,208)$(24,859)
Denominator:Denominator:  Denominator:    
Denominator for basic earnings per share -- weighted-average sharesDenominator for basic earnings per share -- weighted-average shares14,163,511 14,023,585 Denominator for basic earnings per share -- weighted-average shares14,182,839 14,051,794 14,169,537 14,041,224 
Effect of dilutive securities:Effect of dilutive securities:  Effect of dilutive securities:  
Common stock optionsCommon stock options— 74,296 Common stock options— — — — 
Restricted stockRestricted stock— 25,944 Restricted stock— — — — 
Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversionDenominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion14,163,511 14,123,825 Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion14,182,839 14,051,794 14,169,537 14,041,224 
Earnings (loss) per share:  
Basic earnings (loss) per share$(0.28)$0.02 
Diluted earnings (loss) per share$(0.28)$0.02 
Loss per share:Loss per share:    
Basic loss per shareBasic loss per share$(0.30)$(2.03)$(14.06)$(1.77)
Diluted loss per share Diluted loss per share$(0.30)$(2.03)$(14.06)$(1.77)

The following weighted-average shares were not included in the computation of diluted earnings per share as the effect of their inclusion would have been anti-dilutive:

Three months ended March 31, Three months ended September 30,Nine months ended September 30,
20232022 2023202220232022
Stock options to purchase common stockStock options to purchase common stock101,861 109,085 Stock options to purchase common stock90,579 115,686 96,725 123,534 
Restricted stock awards and restricted stock unitsRestricted stock awards and restricted stock units61,875 54,114 Restricted stock awards and restricted stock units141,712 80,332 97,719 82,944 


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11.12.    Income Taxes

The Company’s effective tax rate for the three months ended March 31,September 30, 2023 and 2022 was a tax benefit of 23.8%28.6% and 68.6%33.9%, respectively, and for the nine months ended September 30, 2023 and 2022 was a tax benefit of 2.1% and a tax provision of 21.7%, respectively.

For the three months ended March 31,September 30, 2023 and 2022, the effective tax rates for the benefits were significantly higher than the U.S. federal statutory rate of 21.0% primarily due to state income taxes and nondeductible expenses. For the nine months ended September 30, 2023, the effective tax rate for the benefit was significantly lower than the U.S. federal statutory rate of 21.0% primarily due to the nondeductible goodwill impairment. For the nine months ended September 30,
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2022, the effective tax rate for the provision was higher than the U.S. federal statutory rate of 21.0% primarily due to state income taxes and nondeductible expenses.

12.13.    Commitments and Contingencies

Surveys, audits and governmental investigations

In the ordinary course of business, the Company may from time to time be or become subject to surveys, audits and governmental investigations under or with respect to various governmental programs and state and federal laws. Agencies associated with the programs and other third-party commercial payors periodically conduct extensive pre-payment or post-payment medical reviews or other audits of claims data to identify possible payments made or authorized other than in compliance with the requirements of Medicare or Medicaid. In order to conduct these reviews, documentation is requested from us and then that documentation is reviewed to determine compliance with applicable rules and regulations, including the eligibility of clients to receive benefits, the appropriateness of the care provided to those clients, and the documentation of that care. Similarly, other state and federal governmental agencies conduct reviews and investigations to confirm our compliance with applicable laws where we operate, including regarding employment and wage related regulations and matters. We cannot predict the ultimate outcome of any regulatory reviews or other governmental surveys, audits or investigations, but management does not expect any ongoing surveys, audits or investigations involving the Company to have a material adverse effect on the business, liquidity, financial condition, or results of operations of the Company. Regardless of our expectations, however, surveys, audits or investigations are subject to inherent uncertainties and can have a material adverse impact on our Company due to, among other reasons, potential regulatory orders that inhibit our ability to operate our business, amounts paid as reimbursement or in settlement of any such matter, diversion of management resources and investigative costs.

Legal proceedings

In the ordinary course of business, the Company may from time to time be or become involved in various lawsuits, some of which may seek monetary damages, including claims for punitive damages. Unless otherwise expressly stated, managementManagement does not expect any ongoing lawsuits involving the Company to have a material impact on the business, liquidity, financial condition, or results of operations of the Company. Legal proceedings are subject to inherent uncertainties, however, and unfavorable rulings or other events could occur. Unfavorable resolutions could involve substantial monetary damages. In addition, in matters for which conduct remedies are sought, unfavorable resolutions could include an injunction or other order precluding particular business practices or requiring other remedies. An unfavorable outcome might result in a material adverse impact on our business, liquidity, financial position, or results of operations.

The Company records accruals for loss contingencies related to legal matters when it is probable that a liability will be incurred and the amount of the loss can be reasonably estimated. If the Company determines that a range of reasonably possible losses can be estimated, the Company records an accrual for the most probable amount in the range. Due to the inherent difficulty in predicting the outcome of any legal proceeding, it may not be reasonably possible to estimate a range of potential liability until the matter is closerclose to resolution. Legal fees related to all legal matters are expensed as incurred.

On September 27, 2022, Daniel Greenleaf, the Company’s former Chief Executive Officer, asserted claims in an arbitration against the Company. His claims allege that the Company breached Mr. Greenleaf’s employment agreement and includeincluded a tort claim against the Company. Mr. Greenleaf’s arbitration complaint seekssought contractual, extra-contractual, and statutory damages. In May 2023, Mr. Greenleaf and the Company executed a settlement agreement related to both sides' claims in arbitration and a general release of all claims and the Company agreed to pay Mr. Greenleaf $9.6 million. The Company disputes Mr. Greenleaf’s claimspaid the settlement amount in their entirety and intends to vigorously contest these claims. Based on the statusfull in May of the proceeding and the uncertainty of the outcome, the Company is unable to estimate a range of possible loss for this matter. The Company does not believe, based on currently available information, that the outcome of the arbitration will have a material adverse effect on the Company's business, liquidity, financial condition, or results of operations. An unfavorable outcome could, however, be material to the Company's operating results or cash flows for the period in which it occurs.2023.

On August 6, 2020, the Company’s subsidiary, ModivCare Solutions, LLC (“ModivCare Solutions”), was served with a putative class action lawsuit filed against it by Mohamed Farah, the owner of transportation provider Dalmar Transportation, in the Western District of Missouri, seeking to represent all non-employee transportation providers contracted with ModivCare Solutions. The lawsuit alleges claims under the Fair Labor Standards Act of 1938, as amended (the “FLSA”), and the Missouri Minimum Wage Act, and asserts that all transportation providers to ModivCare Solutions in the putative class should be considered ModivCare Solutions’ employees rather than independent contractors. On June 6, 2021, the Court conditionally certified as the putative class all current and former In Network Transportation Providers who, individually or through their
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companies, were issued 1099 payments from ModivCare Solutions for providing non-emergency medical transportation services for ModivCare Solutions for the previous three years. Notice of the proposed collective class was issued on October 5, 2021, and potential members of the class had until January 3, 2022 to opt-in. Plaintiff moved for class certification on August 15, 2022, and ModivCare Solutions filed an opposition to class certification on September 6, 2022. On January 13, 2023, the matter was transferred with the consent of the parties and the court to binding arbitration. TheAs of September 30, 2023, the parties have agreed on a settlement and are awaiting the arbitrator's approval. ModivCare Solutions believes that it is and has been in compliance in all material respects with the laws and regulations regarding the characterization of the transportation providers
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as independent contractors, and does not believe that the settlement arrangement, if approved by the arbitrator, or the ultimate outcome of this arbitration, if the settlement is not approved (which is not expected), will have a material adverse effect on the Company’s business, liquidity, financial condition or results of operations.

On January 21, 2019, the United States District Court for the Southern District of Ohio unsealed a qui tam complaint, filed in December 2015, against Mobile Care Group, Inc., Mobile Care Group of Ohio, LLC, Mobile Care EMS & Transport, Inc. (collectively, the “Mobile Care Entities”) and ModivCare Solutions by Brandee White, Laura Cunningham, and Jeffery Wisier (the “Relators”) alleging that the Mobile Care Entities and indirectly ModivCare Solutions violated the federal False Claims Act, and seeking to recover damages, fees and costs under the federal False Claims Act, including treble damages, civil penalties and attorneys’ fees. None of the Relators were employed by ModivCare Solutions, and the federal government declined to intervene against ModivCare Solutions. Following motions and appeals made by the parties, the Relators and ModivCare Solutions executed a settlement agreement in March 2023 resolving all claims, including with respect to attorneys' fees. ModivCare Solutions does not believe that the settlement arrangement has had or will have a material adverse effect on the Company's business, liquidity, financial condition, or results of operations.

In 2017, one of our Personal CarePCS segment subsidiaries, All Metro Home Care Services of New York, Inc. d/b/a All Metro Health Care (“All Metro”), received a class action lawsuit in state court claiming that, among other things, it failed to properly pay live-in caregivers who stay in patients’ homes for 24 hours per day (“live-ins”). The Company currently pays live-ins for 13 hours per day as supported through a written opinion letter from the New York State Department of Labor (“NYSDOL”). A similar case involving this issue has been heard by the New York Court of Appeals (New York’s highest court), which on March 26, 2019, issued a ruling reversing earlier lower courts’ decisions that an employer must pay live-ins for 24 hours. The Court of Appeals agreed with the NYSDOL’s interpretation to pay live-ins 13 hours instead of 24 hours if certain conditions were being met. If the class action lawsuit on this matter is allowed to proceed, and is successful, All Metro may be liable for back wages and litigatedliquidated damages going back to November 2011. All Metro filed its motion to oppose class certification of this matter and the matter was heard on June 23, 2022. The state court issued an order certifying the class on December 12, 2022. Mediation is scheduled for lateThe parties attempted to mediate their dispute in June 2023.2023, but were unable to reach agreement on a settlement. All Metro intends to defend itself vigorously with respect to this matter, believes that it is and has been in compliance in all material respects with the laws and regulations covering pay for live-in caregivers, and does not believe in any event that the ultimate outcome of this matter will have a material adverse effect on the Company’s business, liquidity, financial condition or results of operations.

13.    Subsequent Events

The Company has evaluated events and transactions subsequent to the Company's unaudited condensed consolidated balance sheet date and prior to the date of issuance. Based on this evaluation, the Company is not aware of any events or transactions that occurred subsequent to the unaudited condensed consolidated balance sheet date and prior to the date of issuance that would require recognition or disclosure in these financial statements.
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Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations.

The following discussion should be read in conjunction with our unaudited condensed consolidated financial statements and accompanying notes for the three and nine months ended March 31,September 30, 2023 and 2022 included herein, as well as our audited consolidated financial statements and accompanying notes and management’s discussion and analysis of financial condition and results of operations included in our Form 10-K for the year ended December 31, 2022. For purposes of “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” references to "Q1"Q3 2023" and "Q1"Q3 2022" mean the three months ended March 31,September 30, 2023 and the three months ended March 31,September 30, 2022, respectively.

Cautionary Note Regarding Forward-Looking Statements

This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Rule 175 promulgated thereunder, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and Rule 3b-6 promulgated thereunder, including statements related to the Company’s strategies or expectations about revenues, liabilities, results of operations, cash flows, ability to fund operations, profitability, ability to meet financial covenants, contracts or market opportunities. These statements are predictive in nature and are frequently identified by the use of terms such as “may,” “will,” “should,” “expect,” “believe,” “estimate,” “intend,” and similar words indicating possible future expectations, events or actions. In addition, statements that are not historical statements of fact should also be considered forward-looking statements. Such forward-looking statements are based on current expectations, assumptions, estimates and projections about our business and our industry, and are not guarantees of our future performance. These statements are subject to a number of known and unknown risks, uncertainties and other factors, many of which are beyond our ability to control or predict, that may cause actual events to be materially different from those expressed or implied herein. Among such risks, uncertainties and other factors are those summarized under the caption “Summary Risk Factors” in Part I, and described in further detail under the caption “Risk Factors” in Part I, Item 1A, of our Annual Report on Form 10-K filed with the Securities and Exchange Commission, or SEC, for the fiscal year ended December 31, 2022. Hyperlinks to such sections of our Annual Report are contained in the text included within the quotation marks.

You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date the statement was made and are expressly qualified in their entirety by the cautionary statements set forth herein and in our other filings with the SEC, which you should read in their entirety before making an investment decision with respect to our securities. We undertake no obligation to update or revise any forward-looking statements contained in this release, whether as a result of new information, future events or otherwise, except as required by applicable law.

Overview of Our Business

ModivCare Inc. ("ModivCare" or the "Company") is a technology-enabled healthcare services company that provides a suite of integrated supportive care solutions for public and private payors and their members. Its value-based solutions address the social determinants of health or SDoH, connect("SDoH") by connecting members to essential care helpservices. By doing so, ModivCare helps health plans manage risks, reduce costs, and improve overall health outcomes. ModivCare is a provider of non-emergency medical transportation or NEMT,("NEMT"), personal care services ("PCS"), and remote patient monitoring or RPM,("RPM") solutions, which serve similar, highly vulnerable patient populations. The technology-enabled operating model in its NEMT segment includes NEMTthe coordination of non-emergency medical transportation services supported by an infrastructure of core competencies in risk underwriting, contact center management, network credentialing claims management and non-emergency medical transportationclaims management. Additionally, its personal care services include placements of non-medical personal care assistants, home health aides and nurses primarily to Medicaid patient populations in need of care monitoring and assistance performing daily living activities in the home setting, including senior citizens and disabled adults.setting. ModivCare’s remote patient monitoring services include personal emergency response systems, vitals monitoring and data-driven patient engagement solutions. ModivCare is further expanding its offerings to include meal delivery and working with communities to provide meals to food-insecure individuals.

ModivCare also holds a 43.6% minority interest in CCHN Group Holdings, Inc. and its subsidiaries, which operates under the Matrix Medical Network brand (“Matrix”). Matrix, which is included in our Corporate and Other segment, maintains a national network of community-based clinicians who deliver in-home and on-site services, and a fleet of mobile health clinics that provide community-based care with advanced diagnostic capabilities and enhanced care options.services.


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Business Outlook and Trends
 
Our performance is affected by a number of trends that drive the demand for our services. In particular, the markets in which we operate are exposed to various trends, such as healthcare industry and demographic dynamics. Over the long term, we believe there are numerous factors that could affect growth within the industries in which we operate, including:

an aging population, which is expected to increase demand for healthcare services including required transportation to such healthcare services and in-home personal care and remote patient monitoring services;
increasing prevalence of chronic illnesses that require active and ongoing monitoring of health data which can be accomplished at a lower cost and result in better health outcomes through remote patient monitoring services;
a movement towards value-based care versus fee-for-service and cost plus care and budget pressure on governments, both of which may increase the use of private corporations to provide necessary and innovative services;
increasing demand for in-home care provision, driven by cost pressures on traditional reimbursement models and technological advances enabling remote engagement, including remote monitoring and similar internet-based health related services;
a shift in membership dynamics as a result of Medicaid redetermination efforts, which may decrease membership levels at our NEMT segment;
advancement of regulatory priorities, which include the Centers for Medicare and Medicaid Services ("CMS") proposed rule, Ensuring Access to Medicaid Services, which may lower profit margins at our PCS segment;
technological advancements, which may be utilized by us to improve services and lower costs, but may also be utilized by others, which may increase industry competitiveness; and
MCO, Medicaid and Medicare plans increasingly are covering NEMTincreasing coverage of non-emergency medical transportation services for a variety of reasons, including increased access to care, improved patient compliance with treatment plans, social trends, and to promote SDoH, and this trend may be accelerated or reinforced by The Consolidated Appropriations Act of 2021 ("H.R.133"), a component of which mandates that state Medicaid programs ensure that Medicaid beneficiaries have necessary transportation to and from health care providers.providers; and
uncertain macroeconomic conditions, including rising interest rates, could have an effect on our debt and short-term borrowings, which may have a negative impact on our results.

SinceOn May 11, 2023, the COVID-19 pandemic emerged in March 2020, we observed a material reduction in trip volume in our NEMT segmentDepartment of Health and a material reduction in volumeHuman Services ("HHS") declared the end of hours and visits in our Personal Care segment. Our RPM segment did not experience a direct material impact to operations or financial activity as a result ofthe public health emergency ("PHE") for the COVID-19 pandemic. While this reduction inthe Company has continued to experience increased trip volume, service hours, and patient visits has continued to improve each year following the pandemic, structural changes in the industry as a result of the pandemic, predominantly related to an increase in the utilization of telehealth and virtual care, as well as ongoing constraints on the labor market, specifically related to the strain on healthcare professionals, could continue to have continued toan adverse impact on the volume of services we are able to provide.Company's financial statements. For the NEMT segment, any ongoing impact to trip volume as a result of this structural change in the industry may have a negative financial impact on our transportation providers and may result in lower revenueshigher transportation costs as the Company adapts to this changeincrease in demand for transportation services and adapts to the availability of transportation providers, should any capacity constraints within our network of transportation providers arise. For the Personal CarePCS segment, the shortage of caregivers will continue to impact the volume of service hours that can be provided while also driving increased wage rates, which limits the Company's ability to be profitable in contracts with set rates for various care services. Any depressed volumesAdditionally, changes in membership dynamics at the NEMT segment as a result of Medicaid redetermination and reduction in payor reimbursement rates at the labor shortage andPCS segment in an attempt to contain costs could limit the strain on healthcare professionals could reduceability for the quality with which our caregivers provide services and could result in lower than expected revenue.Company to generate revenue despite the Company's shift toward emphasizing the importance of value-based care. Any of these circumstances and factors could have a material adverse effect on our reputation and business.

Furthermore, the impactbusiness and long-term effects of the COVID-19 pandemic are continuously evolving, and the continuation of the pandemic, any additional resurgence, or any long-term macroeconomic impacts that have arisen as a result of the pandemic could continue to change trends in the market.

Our business environment is competitive, the structural changes in our industry related to the COVID-19 pandemic have been lasting, the labor market for healthcare professionals remains constrained, and the market price for our common stock on the Nasdaq Stock Market continues to be volatile; the continuing effect of all or any of the foregoing could result in, in future periods, in an impairment to the estimated fair value of the goodwill that has been established for our reporting units. As discussed elsewhere herein and under the caption “Risk Factors” in the Company’s annual report on Form 10-K filed with the Securities and Exchange Commission for the year ended December 31, 2022, impairment tests may be required in advance ofaddition to the annual impairment testing as of July 1, 2023, if circumstances change that would, more likely than not, reduce the fair value of goodwill of a reporting unit below such reporting unit’s carrying value. The Company monitors the performance of the business and the value of its stock price and reporting unit estimated fair values of its reporting units, among other relevant considerations, to determine if any impairments to goodwill could exist at any particular time. Furthermore,During our management refines their business strategy throughoutJuly 1, 2023 annual assessment of goodwill, we determined that based on our qualitative assessment for each reporting unit, factors existed which required us to test our goodwill for impairment. As a result of our quantitative assessment, we determined that the year in order to address the competitive business environmentgoodwill at our PCS and other marketRPM reporting units was impaired. See Note 7, Goodwill and industry conditions identified above, but there can be no assurances that such efforts will be successful in avoiding future impairments to estimated goodwill fair values.Intangible Assets, for additional details.


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Critical Accounting Estimates and Policies

ThereOther than our change in accounting policy related to the change in the date of our annual goodwill test from October 1 to July 1, included in Note 2, Significant Accounting Policies and Recent Accounting Pronouncements in our Form 10-Q for the quarter ended June 30, 2023, there have been no significant changes to our critical accounting policies in our unaudited condensed consolidated financial statements from our Form 10-K for the year ended December 31, 2022. For further discussion of our critical accounting policies, see management’s discussion and analysis of financial condition and results of operations contained in our Form 10-K for the year ended December 31, 2022.

Components of Results of Operations

The following results of operations include the accounts of ModivCare Inc. and our subsidiaries for the three months ended March 31, 2023.

Revenues

Service revenue, net. Service revenue for our NEMT segment includes the revenue generated by providing non-emergency transportation services directly to our customers. These services are provided on either a capitated basis, which means we are paid on a per-member, per-month ("PMPM") basis for each eligible member, or on a fee-for-service ("FFS") basis, which means we are paid based on the volume of trips or services performed. We receive payments for our services from third-party payors, predominately made up of state Medicaid agencies and MCOs.

UnderOur capitated contracts operate under either a Full-Risk or a Shared-Risk structure. Under Full-Risk contracts, which represent approximately 20% of our NEMT revenue, payors pay a fixed amount per eligible member per month and we assume the responsibility of meeting the covered healthcare related transportation requirements for the number of eligible members in the payor's program. Revenue is recognized based on the number of members served during the period. For certain capitatedUnder Shared-Risk contracts, which represent approximately 65% of our NEMT revenue, we have provisions for reconciliations, risk corridors, and/or profit rebates. These contracts allow for periodic reconciliations based on actual cost and or/trip volume and may result in refunds to the payor, or additional payments due from the payor. These shared-risk contracts also allow for margin stabilization, as generally the amount received per member per month is adjusted for the costs to provide the transportation.

Under fee-for-service ("FFS") contracts, which represent approximately 15% of our NEMT revenue, payors pay a specified amount for each service that we provide based on costs incurred plus an agreed-upon margin. FFS revenue is recognized in the period in which the services are rendered and is reduced by the estimated impact of contractual allowances.

Service revenue for our Personal CarePCS segment includes the revenue generated based on the hours incurred by our in-home caregivers to provide services to our customers, primarily on a FFS basis in which we earn a specified amount for each service that we provide. Payment for our Personal CarePCS services is billed to third-party payors which include, but are not limited to, MCOs, hospitals, Medicaid agencies and programs and other home health care providers who subcontract the services to our caregivers.caregivers, and individuals.

Service revenue for our RPM segment includes the sale of monitoring equipment to our third-party distributors as well as revenue generated from the hours incurred by our Clinical Team for providing monitoring services to our customers, primarily on a PMPM basis for each eligible member. Payment for our monitoring services is billed to third-party payors which include, but are not limited to, national and regional health plans, government-funded benefit programs, healthcare provider organizations, and individuals.

Grant Income

Grant income. The Company has received distributions under the CARES Act Provider Relief Fund ("PRF") and the ARPA Coronavirus State and Local Fiscal Relief Fund ("SLFRF") targeted to providing economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic.

Operating Expenses

Service expense. Service Expenseexpense for our NEMT segment includes purchased transportation, operational payroll and other operational related costs. Purchased transportation includes the amounts we pay to third-party service providers and is typically dependent upon service volume. Operational payroll predominately includes our contact center operations, customer advocacy and transportation network team. Other operating expenses primarily include operational overhead costs, and operating facilities and related charges. Service expense for our Personal CarePCS segment includes payroll and other operational related costs for our caregivers to provide in-home care. Service expense for our RPM segment primarily consists of salaries of employees in our contact centers, connectivity costs and occupancy costs.

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General and administrative expense. General and administrative expense for all segments consists principally of salaries for administrative employees that support the operations, occupancy costs, marketing expenditures, insurance, and professional fees.
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Impairment of goodwill.
We determined that based on our qualitative assessment for each reporting unit, qualitative factors existed which required us to test our goodwill for impairment. As a result of the impairment evaluation, we determined that the goodwill within our PCS and RPM reporting units was impaired during the second quarter of 2023.

Depreciation and amortization expense. Depreciation within this caption includes infrastructure items such as computer hardware and software, office equipment, monitoring and vitals equipment, buildings, and leasehold improvements. Amortization expense is generated primarily from amortization of our intangible assets, including payor networks, trade names and developed technology, a non-compete agreement, an assembled workforce, and a New York LHCSA permit.technology.

Other Expenses (Income)

Interest expense, net. Interest expense consists principally of interest accrued during the period ended March 31,September 30, 2023 on the Company’s borrowings outstanding under the Credit Facility and Senior Unsecured Notes, and amortization of deferred financing fees. Refer to the “Liquidity and Capital Resources” section below for further discussion of these borrowings.

Equity in net loss (income)income (loss) of investee, net of tax. Equity in earnings of equity method investee consists of our proportionate share of equity earnings or losses from our Matrix equity investment held at our Corporate and Other segment, presented net of related taxes.taxes, as well as the earnings of our insurance captive held at the NEMT segment.

Income tax (benefit) provision(provision) benefit. The Company is subject to federal taxation in the United States and state taxation in the various jurisdictions in which we operate.

Segment Reporting

Our segments reflect the manner in which our operations are organized and reviewed by management. Segment results are based on how our CODM manages our business, makes operating decisions and evaluates operating performance.

We operate four reportable business segments: NEMT, Personal Care,PCS, RPM, and Corporate and Other. The NEMT segment provides non-emergency medical transportation services throughout the country. The Personal CarePCS segment provides non-medical personal care and home health services. The RPM segment provides remote patient monitoring solutions. 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, as well as the results of the Matrix investment. The operating results of the NEMT, Personal CarePCS and RPM segments include revenue and expenses generated and incurred by the segment, and the Corporate and Other segment includes expenses incurred in relation to the Corporate operations of the Company

See Note 3, Segments, in our accompanying unaudited condensed consolidated financial statements for further information on our segments.

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Q1Results of Operations

Q3 2023 compared to Q1Q3 2022

Consolidated Results.results. The following table sets forth results of operations and the percentage of consolidated total Service revenue, net represented by items in our unaudited condensed consolidated statements of operations for Q1Q3 2023 and Q1Q3 2022 (in thousands):

Three months ended March 31, Three months ended September 30,
20232022 20232022
Amount% of Service RevenueAmount% of Service Revenue Amount% of Service RevenueAmount% of Service Revenue
Service revenue, netService revenue, net$662,306 100.0 %$574,475 100.0 %Service revenue, net$686,925 100.0 %$647,782 100.0 %
Grant incomeGrant income1,464 0.2 %468 0.1 %Grant income551 0.1 %789 0.1 %
Operating expenses:Operating expenses:    Operating expenses:    
Service expenseService expense550,266 83.1 %459,315 80.0 %Service expense579,214 84.3 %534,563 82.5 %
General and administrative expenseGeneral and administrative expense79,713 12.0 %76,808 13.4 %General and administrative expense70,142 10.2 %75,889 11.7 %
Depreciation and amortizationDepreciation and amortization25,693 3.9 %23,946 4.2 %Depreciation and amortization26,077 3.8 %25,672 4.0 %
Total operating expenses Total operating expenses655,672 99.0 %560,069 97.5 % Total operating expenses675,433 98.3 %636,124 98.2 %
Operating incomeOperating income8,098 1.2 %14,874 2.6 %Operating income12,043 1.8 %12,447 1.9 %
Interest expense, netInterest expense, net15,958 2.4 %15,400 2.7 %Interest expense, net17,844 2.6 %15,557 2.4 %
Loss before income taxes and equity method investmentLoss before income taxes and equity method investment(7,860)(1.2)%(526)(0.1)%Loss before income taxes and equity method investment(5,801)(0.8)%(3,110)(0.5)%
Benefit for income taxes(1,873)(0.3)%(361)(0.1)%
Equity in net income of investee, net of tax(2,025)(0.3)%(483)(0.1)%
Net income (loss)$(3,962)(0.6)%$318 0.1 %
Income tax benefitIncome tax benefit1,659 0.2 %1,053 0.2 %
Equity in net loss of investee, net of taxEquity in net loss of investee, net of tax(160)— %(26,448)(4.1)%
Net lossNet loss$(4,302)(0.6)%$(28,505)(4.4)%

Service revenue, net. Consolidated service revenue, net, for Q1Q3 2023 increased $87.8$39.1 million, or 15.3%6.0%, compared to Q1Q3 2022. ServiceThis change is driven primarily by an increase in revenue net, forof $26.2 million at our NEMT segment, increased by $68.5 million, primarily due to higher membershipwith the remainder of the increase at our PCS and trip volume when compared to Q1 2022. Service revenue, net, further increased by $14.4 million for our Personal Care segment, primarily due to higher hours worked by our caregivers in Q1 2023 as compared to Q1 2022. Service revenue, net increased by $4.9 million for our RPM segment, due to an increase in average monthly members as compared to Q1 2022.segments. See our Results of Operations - Segments, for further discussion.

Grant income. The Company recognized income of approximately $1.5$0.6 million during the three months ended March 31,Q3 2023 and $0.5$0.8 million during the three months ended March 31,Q3 2022 related to grants fromgovernment grant distributions received, primarily under the CARES Act PRF and the ARPA SLFRFSLFRF. These government grants are targeted to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. These funds were received by our Personal CarePCS segment and are available to eligible providers who have health care relatedhealthcare-related expenses and lost revenues attributable to COVID-19.

Service expense. Service expense components are shown below (in thousands):

Three months ended March 31, Three months ended September 30,
20232022 20232022
Amount% of Service RevenueAmount% of Service Revenue Amount% of Service RevenueAmount% of Service Revenue
Purchased servicesPurchased services$344,420 52.0 %$277,947 48.4 %Purchased services$363,594 52.9 %$340,138 52.5 %
Payroll and related costsPayroll and related costs189,645 28.6 %167,507 29.2 %Payroll and related costs197,009 28.7 %181,965 28.1 %
Other service expensesOther service expenses16,201 2.4 %13,861 2.4 %Other service expenses18,611 2.7 %12,460 1.9 %
Total service expenseTotal service expense$550,266 83.1 %$459,315 80.0 %Total service expense$579,214 84.3 %$534,563 82.5 %

Service expense for Q1Q3 2023 increased $91.0$44.7 million, or 19.8%8.4%, compared to Q1 2022Q3 2022. This change is primarily due to higher purchased services costs in thefor our NEMT segment of $66.5$23.5 million drivenwhich is caused by higher third-party transportation costs.an increased number of trips serviced when compared to Q3 2022, partially offset by lower cost per trip due to certain volume service commitments with
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Transportationsome of our larger transportation providers and payrollcost savings due to our multi-modal strategy. Payroll and related costs increased by $15.0 million, primarily as a result of higher trip volume across multiple contracts and higher wage rates. This increase was alsorelated to increased labor costs at our PCS segment, driven by higher service expense of $13.9 millionan increase in our Personal Care segment, primarily related tohours worked and higher wage rates paid to our caregivers, further contributed to by higher wage rates paid to our call center employees at our NEMT segment. See our Results of Operations - Segments, for our caregivers.further discussion.

General and administrative expense. General and administrative expense for Q1Q3 2023 increased $2.9decreased $5.7 million, or 3.8%7.6%, compared to Q1Q3 2022. The increase was primarily attributableGeneral and administrative expense, expressed as a percentage of service revenue, net decreased to an increase10.2% for Q3 2023 compared to 11.7% for Q3 2022. See our Results of personnel related expenses and integration activities.Operations - Segments, for further discussion.

Depreciation and amortization. Depreciation and amortization for Q1remained consistent from Q3 2022 to Q3 2023 increased $1.7with an increase of $0.4 million, or 7.3% compared to Q1 2022 primarily as a result of $1.2 million of additional depreciation and amortization expense at the RPM segment related to the assets acquired in May 2022 in the acquisition of GMM.1.6%.

Interest expense, net. Interest expense, net, for Q1Q3 2023 and Q1Q3 2022 was $16.0$17.8 million and $15.4$15.6 million, respectively. During Q1Q3 2023, we incurred $8.1 million and $6.6 million of interest expense related to the Senior Notes due 2025 and $6.6 million related to the Notes due 2029.2029, respectively. The remainder of the interest expense in Q1Q3 2023 is related to interest and fees on the credit facility.facility, which increased during Q3 2023 due to increased borrowing on the credit facility as compared to Q3 2022. Interest expense is recorded at our Corporate and Other segment.

Equity in net income (loss) of investee, net of tax. Our equity in net incomeloss of investee, net of tax, for Q1Q3 2023 of $2.0$0.2 million and our equity in net incomeloss of investee, net of tax, of $0.5$26.4 million for Q1Q3 2022 was a result of our proportional share of the net income or loss of Matrix and our investment in a captive insurance program. The loss in Q3 2022 was the result of an asset impairment that occurred at Matrix during Q3 2022 compared to no asset impairment during Q3 2023.

Benefit for income taxes.Income tax (provision) benefit. Our effective tax rates from operations for Q1Q3 2023 and Q1Q3 2022 were a tax benefitsbenefit of 23.8%28.6% and 68.6%33.9%, respectively. For Q1 2023 and Q1 2022,both periods, the effective tax rates for the benefits were significantly higher than the U.S. federal statutory rate of 21.0% primarily due to state income taxes and nondeductible expenses.

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Nine months ended September 30, 2023 compared to nine months ended September 30, 2022

Consolidated results. The following table sets forth results of operations and the percentage of consolidated total Service revenue, net represented by items in our unaudited condensed consolidated statements of operations for the nine months ended September 30, 2023, which we refer to as “YTD 2023”, and for the nine months ended September 30, 2022, which we refer to as “YTD 2022” (in thousands):

 Nine months ended September 30,
 20232022
 Amount% of Service RevenueAmount% of Service Revenue
Service revenue, net$2,048,338 100.0 %$1,850,472 100.0 %
Grant income4,649 0.2 %4,587 0.2 %
Operating expenses:    
Service expense1,718,735 83.9 %1,498,108 81.0 %
General and administrative expense229,095 11.2 %232,108 12.5 %
Depreciation and amortization77,679 3.8 %74,376 4.0 %
Impairment of goodwill183,100 8.9 %— — %
Total operating expenses2,208,609 107.8 %1,804,592 97.5 %
Operating income (loss)(155,622)(7.6)%50,467 2.7 %
Interest expense, net50,769 2.5 %46,429 2.5 %
Income (loss) before income taxes and equity method investment(206,391)(10.1)%4,038 0.2 %
Income tax (provision) benefit4,362 0.2 %(877)— %
Equity in net income (loss) of investee, net of tax2,821 0.1 %(28,020)(1.5)%
Net loss$(199,208)(9.7)%$(24,859)(1.3)%

Service revenue, net. Consolidated service revenue, net, for YTD 2023 increased $197.9 million, or 10.7%, compared to YTD 2022. This change is driven primarily by an increase in revenue of $142.9 million at our NEMT segment, with the remainder of the increase at our PCS and RPM segments. See our Results of Operations - Segments, for further discussion.

Grant income. The Company recognized income of approximately $4.6 million during both YTD 2023 and YTD 2022 related to government grant distributions received, primarily under the CARES Act PRF and the ARPA SLFRF. These government grants are targeted to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. These funds were received by our PCS segment and are available to eligible providers who have healthcare-related expenses and lost revenues attributable to COVID-19.

Service expense. Service expense components are shown below (in thousands):

 Nine months ended September 30,
 20232022
 Amount% of RevenueAmount% of Revenue
Purchased services$1,085,206 53.0 %$935,298 50.5 %
Payroll and related costs579,571 28.3 %520,556 28.1 %
Other service expenses53,958 2.6 %42,254 2.3 %
Total service expense$1,718,735 83.9 %$1,498,108 81.0 %

Service expense for YTD 2023 increased $220.6 million, or 14.7%, compared to YTD 2022 primarily due to higher purchased services for our NEMT segment of $149.9 million related to an increase in transportation costs. Payroll and related
31



costs across all segments increased by $59.0 million, primarily related to increased labor costs paid to our caregivers and call center employees.

General and administrative expense. General and administrative expense for YTD 2023 remained relatively consistent at a decrease of $3.0 million, or 1.3%, compared to YTD 2022. General and administrative expense, expressed as a percentage of service revenue, net decreased slightly to 11.2% for YTD 2023 compared to 12.5% for YTD 2022. See our Results of Operations - Segments, for further discussion.

Depreciation and amortization. Depreciation and amortization remained consistent from YTD 2022 to YTD 2023 with an increase of $3.3 million, or 4.4%.

Impairment of goodwill. Impairment of goodwill for YTD 2023 was $183.1 million and was driven by goodwill impairments that were recorded at our PCS and RPM reporting units during the second quarter of 2023. See Note 7, Goodwill and Intangible Assets.

Interest expense, net. Interest expense, net for YTD 2023 was $50.8 million and for YTD 2022 was $46.4 million. During YTD 2023, we incurred $24.2 million and $19.9 million of interest expense related to the Senior Notes due 2025 and 2029, respectively. The remainder of the interest expense during YTD 2023 is related to interest and fees on the credit facility, which increased during YTD 2023 due to increased borrowing on the credit facility as compared to YTD 2022. Interest expense is recorded at our Corporate and Other segment.

Equity in net income (loss) of investee, net of tax. Our equity in net income of investee, net of tax for YTD 2023 of $2.8 million and our equity in net loss of investee, net of tax for YTD 2022 of $28.0 million was a result of our proportional share of the net income or loss of Matrix and our investment in a captive insurance program. The loss in YTD 2022 was the result of an asset impairment that occurred at Matrix during Q3 2022 compared to no asset impairment during YTD 2023.

Income tax (provision) benefit. Our effective tax rates from operations for YTD 2023 and YTD 2022 were a tax benefit of 2.1% and a tax provision of 21.7%, respectively. The YTD 2023 effective tax rate for the benefit was significantly lower than the U.S. federal statutory rate of 21.0% primarily due to the nondeductible goodwill impairment. The YTD 2022 effective tax rate for the provision was higher than the U.S. federal statutory rate of 21.0% primarily due to state income taxes and nondeductible expenses.

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Results of Operations - Segments

The following tables set forth certain financial information attributable to the Company’s business segments:segments for the three and nine months ended September 30, 2023 and 2022:

NEMT Segment

(in thousands, except for Revenuerevenue per member per month, Revenuerevenue per trip, and Serviceservice expense per trip)

Three months ended March 31,Three months ended September 30,Nine months ended September 30,
202320222023202220232022
Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Operating ResultsOperating ResultsOperating Results
Service revenue, netService revenue, net$469,463 100.0%$400,920 100.0%Service revenue, net$485,951 100.0%$459,796 100.0%$1,452,389 100.0%$1,309,449 100.0%
Service expenseService expense407,686 86.8%332,096 82.8%Service expense428,021 88.1%394,981 85.9%1,277,604 88.0%1,100,801 84.1%
General and administrative expenseGeneral and administrative expense33,875 7.2%37,333 9.3%General and administrative expense25,433 5.2%31,815 6.9%87,645 6.0%102,736 7.8%
Depreciation and amortizationDepreciation and amortization6,766 1.4%7,105 1.8%Depreciation and amortization6,814 1.4%7,079 1.5%20,319 1.4%21,576 1.6%
Operating incomeOperating income$21,136 4.5%$24,386 6.1%Operating income$25,683 5.3%$25,921 5.6%$66,821 4.6%$84,336 6.4%
Business Metrics (1)
Business Metrics (1)
Business Metrics(1)
Total paid tripsTotal paid trips8,202 7,111 Total paid trips8,824 8,045 25,761 22,987 
Average monthly membersAverage monthly members33,704 32,176 Average monthly members33,660 36,026 33,892 33,998 
Revenue per member per monthRevenue per member per month$4.64 $4.15 Revenue per member per month$4.81 $4.25 $4.76 $4.28 
Revenue per tripRevenue per trip$57.24 $56.38 Revenue per trip$55.07 $57.15 $56.38 $56.96 
Service expense per tripService expense per trip$49.71 $46.70 Service expense per trip$48.51 $49.10 $49.59 $47.89 
Monthly utilizationMonthly utilization8.1 %7.4 %Monthly utilization8.7 %7.4 %8.4 %7.5 %

(1)     These metrics are key performance indicators that Managementmanagement uses to evaluate our performance. Trends established in these metrics can be used to evaluate current operating results, identify trends affecting our business, determine the allocation of resources and understand the underlying drivers of costs and revenue for our business. We believe these metrics are useful to investors in evaluating and understanding our business but should not be used solely in assessing the Company’s performance. These key performance indicators should not be considered superior to, as a substitute for or as an alternative to, and should be considered in conjunction with, the GAAP financial measures presented herein to fully evaluate and understand the business as a whole.

Our NEMT segment is the largest manager of NEMTnon-emergency medical transportation programs for state governments and MCOs in the U.S.

Service revenue, net. Service revenue, net, increased by $68.5$26.2 million, or 17.1%5.7%, during the three months ended March 31,Q3 2023 as compared to the three months ended March 31,Q3 2022. This increase is primarily attributable to a 15.3%13.2% increase in revenue per member per month, which was driven by a 9.7% increase in trip volume. These two factors are correlated due to contract repricing and the partial pass-through of costs associated with our shared risk contracts. This increase to revenue was partially offset by a 6.6% decrease in average monthly members primarily due to Medicaid redetermination. Service revenue, net, increased by $142.9 million, or 10.9%, during YTD 2023 as compared to YTD 2022, primarily attributable to a 11.2% increase in revenue per member per month driven by a 12.1% increase in trip volume, partially offset by a 4.7% increase0.3% decrease in average monthly membership and higher rates per member as compared tomembership.

The change in revenue is impacted by both the three months ended March 31, 2022. Trip volume increased for the three months ended March 31, 2023 when compared to 2022, as trip volume has continued to increase each year following the pandemic. The increasechange in average monthly membership drove highermembers, as well we the rate received per member. The change in average monthly members is correlated to the change in revenue because a majority of our contactscontracts are capitated, and we receive monthly payments on a per member/fixedmember per month basis in return for full or partialshared risk of transportation volumes. While this increaseDeclines in membership under theseover the periods presented were anticipated and primarily related to Medicaid redetermination efforts, along with certain contract losses. While membership decreased, revenue increased due to increases in the average rate received per member, which increases in line with increases in utilization or trip volume in our shared risk contracts. As most of our capitated contracts can lead to additional revenue, we also have certain capitated contracts that limit profit to within a certain corridor and once we reach the maximum profit level within the contract, we discontinue recognizing revenue and instead accrue a liability to refund the customer upon reconciliation at a later date. The increase in trip volume also increases revenue for our contracts that are structured as fee-for-service as higher trip volumes correlatesbeen restructured to a larger number of services performed.

shared risk format, revenue increased despite the
2833



decline in membership. Trip volume increases also positively affected revenue for fee-for-service contracts due to a larger number of services performed.

Service expense. Service expense components for the NEMT segment are shown below (in thousands):

Three months ended March 31, Three months ended September 30,Nine months ended September 30,
20232022 2023202220232022
Amount% of Segment RevenueAmount% of Segment Revenue Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Purchased servicesPurchased services$344,420 73.4 %$277,947 69.3 %Purchased services$363,594 74.8 %$340,138 74.0 %$1,085,206 74.7 %$935,298 71.4 %
Payroll and related costsPayroll and related costs52,036 11.1 %44,960 11.2 %Payroll and related costs51,655 10.6 %46,160 10.0 %155,388 10.7 %136,916 10.5 %
Other service expensesOther service expenses11,230 2.4 %9,189 2.3 %Other service expenses12,772 2.6 %8,683 1.9 %37,010 2.5 %28,587 2.2 %
Total service expenseTotal service expense$407,686 86.8 %$332,096 82.8 %Total service expense$428,021 88.1 %$394,981 85.9 %$1,277,604 88.0 %$1,100,801 84.1 %

Service expense for our NEMT segment primarily consists of transportation costs paid to third party service providers, salaries of employees within our contact centers and operations centers, and occupancy costs. Service expense increased by $75.6$33.0 million, or 22.8%8.4%, for the three months ended March 31,Q3 2023, as compared to the three months ended March 31,Q3 2022, primarily related to higher purchased services of $66.5$23.5 million or 6.8%. Service expense increased by $176.8 million and 16.1% for YTD 2023, as compared to YTD 2022, primarily due to an increase in purchased services of $149.9 million or 16.0%. The increase in purchased services for both Q3 2023 and YTD 2023 is related to an increase in transportation costs driven by higher trip volume. Trip volume for QTD 2023 and YTD 2023 increased by 9.7% and 12.1%, respectively, when compared to the same periods in the currentprior year. For YTD 2023, cost per trip increased by 3.5% due to increased wages for our transportation providers as compared to YTD 2022, however for QTD 2023, cost per trip decreased by 1.2% primarily due to cost savings from our multi-modal strategy, as compared to QTD 2022.

General and administrative expense. General and administrative expense primarily consists of salaries for administrative employees that support the operations of the NEMT segment, occupancy costs, marketing expenditures, insurance, and professional fees. General and administrative expense decreased by $3.5$6.4 million, or 9.3%20.1%, for the three months ended March 31,Q3 2023, as compared to the three months ended March 31,Q3 2022, and by $15.1 million, or 14.7%, for YTD 2023, as compared to YTD 2022, primarily as a result of various cost savings initiatives which resulted in lower administration expensespersonnel and lower professional services costs, as well as lower legal expenses.costs related to a case that was settled in 2022.

Depreciation and amortization expense. Depreciation and amortization expense decreased by $0.3 million, or 4.8%3.7%, for the three months ended March 31,Q3 2023, as compared to the three months ended March 31,Q3 2022, and decreased by $1.3 million, or 5.8%, for YTD 2023, as compared to YTD 2022, primarily theas a result of certain intangible assets being fully amortized.amortized during the period.

Personal Care
34



PCS Segment

(in thousands, except Service revenue per hour and Service expense per hour)

Three months ended March 31,Three months ended September 30,Nine months ended September 30,
202320222023202220232022
Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Operating ResultsOperating ResultsOperating Results
Service revenue, netService revenue, net$174,131 100.0%$159,698 100.0%Service revenue, net$179,979 100.0%$169,226 100.0%$534,435 100.0%$491,661 100.0%
Grant incomeGrant income1,464 0.8%468 0.3%Grant income551 0.3%789 0.5%4,649 0.9%4,587 0.9%
Service expenseService expense136,090 78.2%122,232 76.5%Service expense143,078 79.5%132,746 78.4%417,636 78.1%379,423 77.2%
General and administrative expenseGeneral and administrative expense22,663 13.0%23,133 14.5%General and administrative expense20,252 11.3%22,057 13.0%63,480 11.9%68,536 13.9%
Depreciation and amortizationDepreciation and amortization12,868 7.4%12,505 7.8%Depreciation and amortization12,850 7.1%12,919 7.6%38,590 7.2%37,976 7.7%
Operating income$3,974 2.3%$2,296 1.4%
Impairment of goodwillImpairment of goodwill— —%— —%137,331 25.7%— —%
Operating income (loss)Operating income (loss)$4,350 2.4%$2,293 1.4%$(117,953)(22.1)%$10,313 2.1%
Business Metrics (1)
Business Metrics (1)
Business Metrics(1)
Total hoursTotal hours6,824 6,535 Total hours6,995 6,836 20,752 20,076 
Service revenue per hourService revenue per hour$25.52 $24.44 Service revenue per hour$25.73 $24.76 $25.75 $24.49 
Service expense per hourService expense per hour$19.94 $18.70 Service expense per hour$20.45 $19.42 $20.13 $18.90 

(1)     These metrics are key performance indicators that Management uses to evaluate our performance. Trends established in these metrics can be used to evaluate current operating results, identify trends affecting our business, determine the allocation of resources and understand the underlying drivers of costs and revenue for our business. We believe these metrics are useful to investors in evaluating and understanding our business but should not be used solely in assessing the Company’s performance. These key performance indicators should not be considered superior to, as a substitute
29



for or as an alternative to, and should be considered in conjunction with, the GAAP financial measures presented herein to fully evaluate and understand the business as a whole.

Our Personal Care segment’s services include placements of non-medical personal care assistants and home health aides and nurses primarily to Medicaid patient populations in need of care monitoring and assistance performing daily living activities in the home setting, including senior citizens and disabled adults.

Service revenue, net. Personal care service contracts are generally structured as fee-for-service contracts, with revenue driven by hours worked by our personal care providers. Service revenue, net increased by $14.4 million, or 9.0%, for the three months ended March 31, 2023 as compared to March 31, 2022, primarily due to higher hours worked by personal care providers in Q1 2023 as compared to Q1 2022 as well as higher rates per member.

Grant Income. In the three months ended March 31, 2023 and 2022, the Company recognized income for distributions of the CARES Act PRF and the ARPA SLFRF targeted to providing economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic of $1.5 million and $0.5 million, respectively.

Service expense. Service expense components for the Personal Care segment are shown below (in thousands):

 Three months ended March 31,
 20232022
 Amount% of Segment RevenueAmount% of Segment Revenue
Payroll and related costs$134,393 77.2 %$120,198 75.3 %
Other service expenses1,697 1.0 %2,034 1.3 %
Total service expense$136,090 78.2 %$122,232 76.5 %

Service expense for our Personal Care segment primarily consists of salaries for our employees who provide personal care services and it typically trends with the number of hours worked. Service expense for the three months ended March 31, 2023 increased by $13.9 million, or 11.3%, as compared to the three months ended March 31, 2022, primarily as a result of increased wage rates for our caregivers, particularly in New York, as well as increased direct wages associated with the 4.4% increase in hours of service during Q1 2023.

General and administrative expense. General and administrative expense primarily consists of salaries for administrative employees that support the operations of the Personal Care segment, occupancy costs, marketing expenditures, insurance, and professional fees. General and administrative expense decreased by $0.5 million, or 2.0%, for the three months ended March 31, 2023 as compared to the three months ended March 31, 2022.

Depreciation and amortization expense. Depreciation and amortization expense increased by $0.4 million, or 2.9%, for the three months ended March 31, 2023 as compared to 2022, primarily due to amortization expense on the intangible assets brought on under an asset acquisition completed in Q2 2022.


30



RPM Segment

(in thousands, except Revenue per member per month and Service expense per member per month)

Three months ended March 31,
20232022
Amount% of Segment RevenueAmount% of Segment Revenue
Operating Results
Service revenue, net$18,712 100.0 %$13,857 100.0 %
Service expense6,490 34.7 %4,987 36.0 %
General and administrative expense5,769 30.8 %4,962 35.8 %
Depreciation and amortization5,854 31.3 %4,128 29.8 %
Operating income (loss)$599 3.2 %$(220)(1.6)%
Business Metrics (1)
Average monthly members235 169 
Revenue per member per month$26.54 $27.33 
Service expense per member per month$9.21 $9.84 

(1)     These metrics are key performance indicators that Managementmanagement uses to evaluate our performance. Trends established in these metrics can be used to evaluate current operating results, identify trends affecting our business, determine the allocation of resources and understand the underlying drivers of costs and revenue for our business. We believe these metrics are useful to investors in evaluating and understanding our business but should not be used solely in assessing the Company’s performance. These key performance indicators should not be considered superior to, as a substitute for or as an alternative to, and should be considered in conjunction with, the GAAP financial measures presented herein to fully evaluate and understand the business as a whole.

Our Remote Patient MonitoringPCS segment’s services include placements of non-medical personal care assistants and home health aides and nurses primarily to Medicaid patient populations in need of care monitoring and assistance performing daily living activities in the home setting, including senior citizens and disabled adults.

Service revenue, net. PCS contracts are generally structured as fee-for-service contracts, with revenue driven by hours worked by our personal care providers. Service revenue, net, increased by $10.8 million, or 6.4%, for Q3 2023, as compared to Q3 2022, primarily due to 2.3% higher hours worked by personal care providers in Q3 2023 as compared to Q3 2022, as well as 3.9% higher rates per member. Service revenue, net increased by $42.8 million, or 8.7%, for YTD 2023 as compared to YTD 2022, primarily due to 3.4% higher hours worked by personal care providers during YTD 2023 as compared to YTD 2022, as well as 5.1% higher rates per member.

Grant income. During Q3 2023 and Q3 2022, the Company recognized income for government grant distributions received of $0.6 million and $0.8 million, respectively, primarily from the CARES Act PRF and the ARPA SLFRF. These government grants are targeted to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. These funds were received by our PCS segment and are available to eligible providers who have healthcare-related expenses and lost revenues attributable to COVID-19. During both YTD 2023 and YTD 2022, the Company recognized income for government grant distributions received of $4.6 million, respectively.

35



Service expense. Service expense components for the PCS segment are shown below (in thousands):

 Three months ended September 30,Nine months ended September 30,
 2023202220232022
 Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Payroll and related costs$141,921 78.9 %$132,482 78.3 %$413,995 77.5 %$374,994 76.3 %
Other service expenses1,157 0.6 %264 0.1 %3,641 0.7 %4,429 0.9 %
Total service expense$143,078 79.5 %$132,746 78.4 %$417,636 78.1 %$379,423 77.2 %

Service expense for our PCS segment primarily consists of salaries for our employees who provide personal care services and it typically trends with the number of hours worked and cost per hour of service. Service expense for Q3 2023 increased by $10.3 million, or 7.8%, as compared to Q3 2022, primarily as a result of a 5.3% increase in service expense per hour, driven primarily by increased wage rates for our caregivers, predominately from wage pressures in New York, as well as a 2.3% increase in hours of service during Q3 2023. Service expense for YTD 2023 increased by $38.2 million or 10.1%, as compared to YTD 2022, primarily as a result of a 6.5% increase in service expense per hour and a 3.4% increase in hours of service during YTD 2023.

General and administrative expense. General and administrative expense primarily consists of salaries for administrative employees that support the operations of the PCS segment, occupancy costs, marketing expenditures, insurance, and professional fees. General and administrative expense decreased by $1.8 million, or 8.2%, for Q3 2023 as compared to Q3 2022 and decreased by $5.1 million or 7.4%, for YTD 2023 as compared to YTD 2022. The decrease is primarily related to lower insurance-related expense and lower legal fees during YTD 2023 along with lower integration related expenses during YTD 2023.

Depreciation and amortization expense. Depreciation and amortization expense remained consistent for both Q3 2022 to Q3 2023 and YTD 2022 to YTD 2023 with a decrease of $0.1 million, or 0.5%, for Q3 2023 as compared to Q3 2022 and an increase of $0.6 million, or 1.6%, for YTD 2023 as compared to YTD 2022.

Impairment of goodwill. As a result of our annual goodwill assessment, we determined that the goodwill within our PCS reporting unit was impaired which resulted in an impairment of goodwill charge of $137.3 million during the second quarter of 2023.
36



RPM Segment

(in thousands, except Revenue per member per month and Service expense per member per month)

Three months ended September 30,Nine months ended September 30,
2023202220232022
Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Operating Results
Service revenue, net$19,779 100.0 %$18,760 100.0 %$57,702 100.0 %$49,362 100.0 %
Service expense6,934 35.1 %6,836 36.4 %20,129 34.9 %17,884 36.2 %
General and administrative expense5,685 28.7 %5,816 31.0 %16,781 29.1 %17,520 35.5 %
Depreciation and amortization6,174 31.2 %5,467 29.1 %18,087 31.3 %14,201 28.8 %
Impairment of goodwill— — %— — %45,769 79.3 %— — %
Operating income (loss)$986 5.0 %$641 3.4 %$(43,064)(74.6)%$(243)(0.5)%
Business Metrics(1)
Average monthly members247 230 241 201 
Revenue per member per month$26.69 $27.19 $26.60 $27.29 
Service expense per member per month$9.36 $9.91 $9.28 $9.89 

(1)  ��  These metrics are key performance indicators that management uses to evaluate our performance. Trends established in these metrics can be used to evaluate current operating results, identify trends affecting our business, determine the allocation of resources and understand the underlying drivers of costs and revenue for our business. We believe these metrics are useful to investors in evaluating and understanding our business but should not be used solely in assessing the Company’s performance. These key performance indicators should not be considered superior to, as a substitute for or as an alternative to, and should be considered in conjunction with, the GAAP financial measures presented herein to fully evaluate and understand the business as a whole.

Our RPM segment is a provider of remote patient monitoring solutions and manages a comprehensive suite of services, including personal emergency response systems, vitals monitoring and data-driven patient engagement solutions.

Service revenue, net. RPM contracts are generally structured as a fixed fee per enrolled member per month, and therefore revenue is generally driven by the number of enrolled members. Service revenue, net, increased by $4.9$1.0 million, or 35.0%5.4%, for the three months ended March 31,Q3 2023 as compared to the three months ended March 31,Q3 2022, primarily related to a 7.4% increase in average monthly members from Q3 2022 to Q3 2023. Service revenue, net, increased by $8.3 million, or 16.9%, for YTD 2023 as compared to YTD 2022, primarily related to incremental revenue of $4.7$7.2 million from the GMMan acquisition that occurred in May 2022.

Service expense. Service expense components for the RPM segment are shown below (in thousands):

Three months ended March 31, Three months ended September 30,Nine months ended September 30,
20232022 2023202220232022
Amount% of RevenueAmount% of Revenue Amount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment RevenueAmount% of Segment Revenue
Payroll and related costsPayroll and related costs$3,216 17.2 %$2,349 17.0 %Payroll and related costs$3,414 17.3 %$3,323 17.7 %$9,941 17.2 %$8,646 17.5 %
Other service expensesOther service expenses3,274 17.5 %2,638 19.0 %Other service expenses3,520 17.8 %3,513 18.7 %10,188 17.7 %9,238 18.7 %
Total service expenseTotal service expense$6,490 34.7 %$4,987 36.0 %Total service expense$6,934 35.1 %$6,836 36.4 %$20,129 34.9 %$17,884 36.2 %

Service expense for our RPM segment primarily consists of salaries for the employees providing the remote monitoring services and it typically trends with the number of hours worked. Service expense for the three months ended March 31,Q3 2023, increased $1.5remained consistent for Q3 2023 as compared to Q3 2022 with an increase of $0.1 million, or 30.1%1.4%, as compared to the three months ended March 31,Q3 2022. Service expense for
37



YTD 2023 increased $2.2 million, or 12.6%, as compared to YTD 2022, primarily as a result of an increase of $0.9 million in direct wages of which the majority of the increase was related todriven by the additional hours worked to service the 39.1%19.9% increase in average monthly members primarily attributableas well as an increase in device connectivity costs related to the acquisition of GMMadditional devices deployed to service the increase in May 2022.average monthly members.

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General and administrative expense. General and administrative expense primarily consists of salaries for administrative employees that indirectly support the operations, occupancy costs, marketing expenditures, insurance, and professional fees. General and administrative expense increased by $0.8 million, or 16.3%, for the three months ended March 31,remained consistent in Q3 2023 as compared to Q3 2022 with a decrease of $0.1 million, or 2.3%, for Q3 2023 as compared to Q3 2022. General and administrative expense decreased by $0.7 million, or 4.2%, for YTD 2023 as compared to YTD 2022, primarily related to a decrease in legal costs associated with an acquisition that occurred in May 2022.

Depreciation and amortization expense. Depreciation and amortization expense increased by $1.7$0.7 million, or 41.8%12.9%, for the three months ended March 31,Q3 2023 as compared to March 31,Q3 2022, primarily related to additional depreciation expense related to the additional devices in service related to a 7.4% increase in average monthly members from Q3 2022. Depreciation and amortization expense increased by $3.9 million, or 27.4%, for YTD 2023 as compared to YTD 2022, primarily related to additional depreciation and amortization expense of $1.2$2.1 million related to the assets acquired from an acquisition that occurred in May 2022 as well as additional depreciation expense related to the additional devices in service related to a 19.9% increase in average monthly members from the acquisition of GMM.YTD 2022.

Impairment of goodwill. As a result of our annual goodwill assessment, we determined that the goodwill within our RPM reporting unit was impaired which resulted in an impairment of goodwill charge of $45.8 million during the second quarter of 2023.


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Corporate and Other Segment

(in thousands)
Three months ended March 31,Three months ended September 30,Nine months ended September 30,
202320222023202220232022
AmountAmountAmountAmountAmountAmount
Service revenue, netService revenue, net$1,216 $— $3,812 $— 
Service expenseService expense1,181 — 3,366 — 
General and administrative expenseGeneral and administrative expense$17,406 $11,380 General and administrative expense18,772 16,201 61,189 43,316 
Depreciation and amortizationDepreciation and amortization205 208 Depreciation and amortization239 207 683 623 
Operating income (loss)Operating income (loss)$(17,611)$(11,588)Operating income (loss)$(18,976)$(16,408)$(61,426)$(43,939)

Our Corporate and Other segment includes the Company's executive, accounting, finance, internal audit, tax, legal, public reporting, and corporate development functions. This segment also includes the results of our equity investment in Matrix.Matrix and the operating results of investments in innovation related to data analytics products and solutions, which contributes to our strategic investment in growth.

Service revenue, net and Service expense: At the end of the first quarter of 2023, we made an investment in innovation related to our data analytics capabilities within our Corporate and Other segment, which contributes to service revenue and service expense.

General and administrative expense and Depreciation and amortization: Our Corporate and Other segment includes costs incurred related to strategy and stewardship of the other operating segments. These expenses are primarily general and administrative expenses, with a smallminimal amount related to depreciation. The general and administrative expense increased by $6.0$2.6 million and $17.9 million for the three months ended March 31,Q3 2023 as compared to March 31,Q3 2022. This increase is primarily related to software implementation costs for ongoing system integration projects, including the Personal CarePCS and RPM general ledger and personnel management system integrations. This balance has also increased due to consulting costs and litigation costs related to executive turnover.

Seasonality

Our NEMT segment's operating income and cash flows normally fluctuate as a result of seasonal variations in our business, principally due to lower transportation demand during the winter season and higher demand during the summer season.

Our Personal CarePCS segment’s operating income and cash flows also normally fluctuate as a result of seasonal variations in the business, principally due to somewhat lower demand for in-home services from caregivers during the summer and periods with major holidays, as patients may spend more time with family and less time alone needing outside care during those periods.

Our RPM segment’s operating income and cash flows do not normally fluctuate as a result of seasonal variations in the business.

Liquidity and capital resources

Short-term capital requirements consist primarily of recurring operating expenses, contract start-up costs on new revenue contracts and costs associated with our strategic initiatives. We expect to meet our cash requirements through available cash on hand, cash generated from operations, net of capital expenditures, and occasional borrowings under our Credit Facility. For information regarding our long-term capital requirements, see below under the caption "Liquidity".

Cash flow used in operating activities during the threenine months ended March 31,September 30, 2023 was $2.7$57.3 million. Our balance of cash and cash equivalents, including restricted cash, was $13.4$8.6 million and $15.0 million at March 31,September 30, 2023 and December 31, 2022, respectively. We had restricted cash of $0.5 million and $0.5 million at March 31,September 30, 2023 and December 31, 2022, respectively. Restricted cash amounts are not included in our balance of cash and cash equivalents in the unaudited condensed consolidated balance sheets, although they are included in the cash, cash equivalents and restricted cash balance on the accompanying unaudited condensed consolidated statements of cash flows.

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We may, from time to time, access capital markets to raise equity or debt financing for various business reasons, including acquisitions, repurchases of common stock, investments in our business and possible refinancing activity. The timing,
39



term, size, and pricing of any such financing will depend on investor interest and market conditions, and there can be no assurance that we will be able to obtain any such financing on terms acceptable to us at the time or at all.

YTD 2023 cash flows compared to YTD 2022

Operating activities. Cash used in operating activities was $2.7$57.3 million for YTD 2023 compared to cash provided by operating activities of $71.5$45.5 million for YTD 2022. The decrease of $74.1$102.9 million was primarily a result of a decrease in cash provided by changes in working capital of $71.2$94.2 million. The working capital changes were related to a decreasean increase in the change in accruedcash paid for contract payables of $41.1$22.9 million primarily related to repayments on previously accrued contract payable amounts combined with lower liability reserves on certain risk corridor, profit rebate and reconciliation contracts due to higher trip volumes during YTD 2023. Also contributing to the decrease in working capital is a decrease in the cash received from contract receivables of $22.6 million primarily related to a build of receivables related to certain risk corridor, profit rebate, and reconciliation contracts, as well as an increase in the cash paid for accounts payable and accrued expenses balance of $52.1$58.3 million, primarily related to timing of vendor payments andpayments. These working capital changes are partially offset by an increase in cash used for prepaid expenses and otherrelated to an increase in accrued transportation costs of $9.0 million, partially offset by a decrease in the accounts receivable balance of $40.9$19.3 million, primarily related to lower receivables recorded ontiming of payments to our reconciliation and corridor contractstransportation providers, as compared to YTD 2022.

Investing activities. Net cash used in investing activities was $13.3$31.1 million in YTD 2023, which increaseddecreased by $4.7$73.2 million as compared to YTD 2022, primarily as a result of acquisition activity during YTD 2022 related to an increase in cash spent on property and equipment.acquisition made under our RPM segment.

Financing activities. Net cash provided by financing activities was $14.4$82.1 million for YTD 2023, compared to cash used in financing activities of $1.8 million for YTD 2022. The change of $16.2$83.9 million was primarily a result of proceeds from our short-term borrowing on our Credit Facility of $15.0$83.0 million during YTD 2023, compared to no proceeds from debt or other short-term borrowings during YTD 2022.

Obligations and commitments

Senior Unsecured Notes. On November 4, 2020, the Company issued $500.0 million in aggregate principal amount of 5.875% senior unsecured notes due on November 15, 2025 (the “Senior Notes due 2025”). Subsequently, on August 24, 2021, the Company issued an additional $500.0 million in aggregate principal amount of 5.000% senior unsecured notes due on October 1, 2029 (the “Senior Notes due 2029” and, together with the Senior Notes due 2025, the “Notes”). For information related to the Company's Senior Unsecured Notes, refer to Note 89 of the Notes to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements”.

Credit Facility. OnThe Company is a party to the amended and restated credit agreement, dated as of February 3, 2022, (as amended, the Company entered into a credit agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent, swing line lender and an issuing bank, Wells Fargo Bank, National Association, as an issuing bank, Truist Bank and Wells Fargo Bank, National Association, as co-syndication agents, Deutsche Bank AG New York Branch, Bank of America, N.A., Regions Bank, Bank of Montreal and Capital One, National Association, as co-documentation agents, and JPMorgan Chase Bank, N.A., Truist Securities, Inc. and Wells Fargo Securities, LLC, as joint bookrunners and joint lead arrangers, and the other lenders party thereto. The Credit Agreement provides the Company with a senior secured revolving credit facility (the “Credit Facility”) in an aggregate principal amount of $325.0 million. The Credit Facility includes sublimits for swingline loans, letters of credit and alternative currency loans in amounts of up to $25.0 million, $60.0 million and $75.0 million, respectively. On June 26, 2023, the Company entered into an Amendment No. 1 (the "First Amendment") to the Credit Agreement which amended and restated the maximum permitted Total Net Leverage Ratio under the Credit Agreement. For information related to the Company's Credit Facility, refer to Note 89 of the Notes to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements”.

Liquidity
 
Liquidity measures our ability to meet current and future cash flow needs on a timely basis and at a reasonable cost. We manage our liquidity position to meet our daily cash flow needs, while maintaining an appropriate balance between assets and liabilities to meet the return on investment objectives of our shareholders. Our liquidity position is supported by management of liquid assets and liabilities and access to alternative sources of funds. Liquid assets include cash of $12.8$8.1 million and accounts receivable, contract receivables, and other receivables of $299.0$340.8 million. Liquid liabilities which totaled $660.3$691.7 million at period end as detailed in the table below, included $67.2$68.5 million in guarantees and letters of credit that are not actually expected to be paid in cash in the next 12 months. Other sources of liquidity include amounts currently available under our Credit Facility of up to approximately $160$164.0 million as of March 31,September 30, 2023 based on our total net debt leverage ratio covenant of 5.00:1.00.5.25:1.00, and expected future cash generated from operations.

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In the ordinary course of business we have entered into contractual obligations and have made other commitments to make future payments. Our short-term and long-term liquidity requirements are primarily to fund on-going operations. These liquidity requirements are met primarily through cash flow from operations, debt financing, and our Credit Facility. For
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additional information regarding our operating, investing and financing cash flows, see “Condensed Consolidated Financial Statements— Condensed Consolidated Statements of Cash Flows,” included in Part I, Item I of this report.

The Company has cash requirements of $660.3$691.7 million due in one year or less in addition to $1,314.4$1,245.2 million due in more than one year as of March 31,September 30, 2023. The following is a summary of our future cash requirements for the next twelve months and the period extending beyond twelve months as of March 31,September 30, 2023 (in thousands):

 At March 31, 2023
  Less thanGreater than
Total1 Year1 Year
Senior Unsecured Notes (1)
$1,000,000 $— $1,000,000 
Interest (1)
238,712 54,375 184,337 
Contracts payable (2)
187,620 187,620 — 
Transportation costs (3)
93,726 93,726 — 
Deferred tax liabilities (4)
53,612 — 53,612 
Operating leases (5)
51,058 11,686 39,372 
Guarantees (6)
34,392 34,392 — 
Letters of credit (6)
32,833 32,833 — 
Purchased service commitment (7)
79,875 42,750 37,125 
Short-term borrowings (8)
15,000 15,000 — 
Other current cash obligations (9)
187,965 187,965 — 
Total$1,974,793 $660,347 $1,314,446 
 At September 30, 2023
  Less thanGreater than
Total1 Year1 Year
Senior Unsecured Notes(1)
$1,000,000 $— $1,000,000 
Interest(1)
213,996 56,847 157,149 
Contracts payable(2)
133,576 133,576 — 
Transportation costs(3)
102,974 102,974 — 
Deferred tax liabilities(4)
42,001 — 42,001 
Operating leases(5)
42,299 8,902 33,397 
Guarantees(6)
29,666 29,391 275 
Letters of credit(6)
39,074 39,074 — 
Purchased service commitment(7)
61,875 49,500 12,375 
Short-term borrowings(8)
83,000 83,000 — 
Other current cash obligations(9)
188,398 188,398 — 
Total$1,936,859 $691,662 $1,245,197 
 
(1)See Note 89 of the Notes to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements” for further detail of our Senior Unsecured Notes and the timing of expected future payments. Interest payments on our Senior Unsecured Notes are typically paid semi-annually in arrears and have been calculated at the rates fixed as of March 31, 2023.September 30, 2023. Interest payments on our short-term borrowings have been calculated by taking the expected borrowing on the Credit Facility for the next year at the interest rate of 9.8%.
(2)See Note 4 of the Notes to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements” for further detail of our contracts payable.
(3)See Note 1 of the Notes to the consolidated financial statements included in Part II, Item 8, “Financial Statements and Supplementary Data” of our Form 10-K for the year ended December 31, 2022 filed on March 7, 2023 for further detail of our accrued transportation cost.
(4)Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes.
(5)The operating leases are for office space. Certain leases contain periodic rent escalation adjustments and renewal options. See Note 17 of the Notes to the consolidated financial statements included in Part II, Item 8, “Financial Statements and Supplementary Data” of our Form 10-K for the year ended December 31, 2022 filed on March 7, 2023 for further detail of our operating leases.
(6)Letters of credit (“LOCs”) are guarantees of potential payments to third parties under certain conditions. Guarantees include surety bonds we provide to certain customers to protect against potential non-delivery of our non-emergency transportation services. Our LOCs shown in the table were provided by our Credit Facility and reduced our availability under the related Credit Agreement. The surety bonds and LOC amounts in the above table represent the amount of commitment expiration per period.
(7)The purchased service commitment includes the maximum penalty we would incur if we do not meet our minimum volume commitment over the remaining term of the agreement under certain contracts. See Note 19 of the Notes to the consolidated financial statements included in Part II, Item 8, “Financial Statements and Supplementary Data” of our Form 10-K for the year ended December 31, 2022 filed on March 7, 2023 for further detail of our purchased service commitment.
(8)Short-term borrowings shown in the table were provided by our Credit Facility and reduced our availability under the related Credit Agreement. See Note 89 of the Notes to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements” for further detail of our Credit Facility.
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(9)These include other current liabilities reflected in our unaudited condensed consolidated balance sheets as of March 31,September 30, 2023, including accounts payable and accrued expenses as detailed at Note 78 to the unaudited condensed consolidated financial statements included in Part I, Item 1, “Financial Statements”.

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Our primary sources of funding include operating cash flows and access to capital markets. There are statutory, regulatory, and debt covenant limitations that affect our ability to access the capital market for funds. Management believes that such limitations will not impact our ability to meet our ongoing short-term cash obligations. Management continuously monitors our liquidity position and adjustments are made to the balance between sources and uses of funds as deemed appropriate. Our management is not aware of any events that are reasonably likely to have a material adverse effect on our liquidity, capital resources, or operations. In addition, our management is not aware of any regulatory recommendations regarding liquidity, which if implemented, would have a material adverse effect on us.

Off-Balance Sheet Arrangements

There have been no material changes to the Off-Balance Sheet Arrangements discussion previously disclosed in our audited consolidated financial statements contained in our Annual Report on Form 10-K for the year ended December 31, 2022.

Item 3.   Quantitative and Qualitative Disclosures About Market Risk.

We have exposure to interest rate risk mainly related to our Credit Facility, which has variable interest rates that may increase. We had $15.0$83.0 million of short-term borrowings outstanding on the Credit Facility and $32.8$39.1 million of outstanding letters of credit under the Credit Facility at March 31,September 30, 2023. Interest rates on the outstanding principal amount of the Credit Facility vary and accrue at a per annum rate equal to the Alternate Base Rate, the Adjusted Term SOFR Rate, the Adjusted Daily Simple SOFR Rate, the Adjusted EURIBOR Rate or the Adjusted Daily Simple SONIA Rate, as applicable and each as defined in the Credit Agreement, in each case, plus an applicable margin. We completed an interest rate risk sensitivity analysis with the assumption that the short-term borrowing amount that was outstanding as of March 31,September 30, 2023 was outstanding for the fiscal year with an assumed one-percentage point increase in interest rates. Based on this analysis, the one-percentage point increase would have an approximate $0.1$0.8 million negative impact on our pre-tax earnings.

Item 4.   Controls and Procedures.

(a) Evaluation of disclosure controls and procedures
The Company's management, under the supervision and with the participation of its principal executive officer and principal financial officer, evaluated the effectiveness of the design and operation of the Company’s disclosure controls and procedures, as defined in Rule 13a-15(e) of the Exchange Act as of March 31,September 30, 2023. Based upon this evaluation, the Company’s principal executive officer and principal financial officer has concluded that, to the extent of the material weaknesses identified in internal control over financial reporting as described in the Company's Annual Report on Form 10-K for the year ended December 31, 2022, such disclosure controls and procedures were not effective to provide reasonable assurance that information required to be disclosed by the Company in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and accumulated and communicated to the Company’s management, including its principal executive and financial officer, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.
In light of the material weaknesses described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022, management performed additional analysis and other procedures to ensure that our unaudited condensed consolidated financial statements were prepared in accordance with U.S. generally accepted accounting principles (GAAP). Accordingly, management believes that the unaudited condensed consolidated financial statements included in this Quarterly Report on Form 10-Q fairly present, in all material respects, our financial position, results of operations, and cash flows as of and for the periods presented, in accordance with U.S. GAAP.
(b) Changes in internal control over financial reporting
We, with the oversight of the Audit Committee of the Board of Directors, are in the process of ongoing remediation efforts related to the material weaknesses previously reported in our Annual Report on Form 10-K for the year ended December 31, 2022.
During the threenine months ended March 31,September 30, 2023, our management continued updating certain internal controls and supporting processes to address the material weaknesses in our internal control over financial reporting described in our Annual Report on Form 10-K for the year ended December 31, 2022. The remediation plan put into place by management includes the hiring of a third partyworking with our third-party specialist to lead the remediation efforts as well as the addition of resources within the
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organization to improve structure and help mitigate risks previously identified. Key focus areas have been identified as general information technology control (GITC) deficiencies, payroll controls, revenue process controls and risk assessment related to changes and business acquisitions.
To that effect, the Company has:
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Implemented a new personnel management system in 2023 after sunsetting the legacy system in which a weakness was identifiedDesigned and are in the process of designingimplemented a new suite of internal controls with appropriate authorities around the payroll process.process at the NEMT and Corporate and Other segments.
EnhancedContinued to execute our enhanced risk assessment process to identify and assess changes in our internal control environment, specifically related to new information technology ("IT") systems and newly acquired companies.
Continued to design, enhance and implement GITCs, including change management and logical access controls, to support process-level automated controls intended to ensure that information needed for the operation of manual process-level controls and financial reporting is accurate and complete.

The companyCompany is focused on projects that address processes and technologies to integrate each of the business segments into One ModivCare and standardize our control environment. Management is confidentGiven the nature and complexity of the integration, management expects that the steps being taken to implement an effective control environmenttest of operating effectiveness of remediation will remediateextend into 2024 for the material weaknesses identified.PCS segment. The material weakness will not be considered remediated until the remediation plan has been implemented and there has been appropriate time for us to conclude through testing that the controls are designed and operating effectively. Management will continue to monitor the progress of these efforts to ensure remediation.

(c) Limitations on the effectiveness of controls

Because of its inherent limitations, internal control over financial reporting can provide only reasonable assurance with respect to financial statement preparation and presentation. The design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be detected. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. The Company conducts periodic evaluations of its internal controls to enhance, where necessary, its procedures and controls.
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PART II—OTHER INFORMATION

Item 1.    Legal Proceedings.

From time-to-time, we may become involved in legal proceedings arising in the ordinary course of our business. We record accruals for outstanding legal matters when it is believed to be probable that a loss will be incurred and the amount can be reasonably estimated. Management, following consultation with legal counsel, does not expect the ultimate disposition of any or a combination of any such ongoing or anticipated matters to have a material adverse effect on our business, financial condition or operating results. We cannot predict with certainty, however, the potential for or outcome of any litigation. Regardless of the outcome of any particular litigation and the merits of any particular claim, litigation can have a material adverse impact on us due to, among other reasons, any injunctive relief granted which could inhibit our ability to operate our business, amounts paid as damages or in settlement of any such matter, diversion of management resources and defense costs. Interested parties should refer to Note 12,13, Commitments and Contingencies, in this report for information concerning other potential contingent liabilities matters that do not rise to the level of materiality for purposes of disclosure hereunder.

Item 1A. Risk Factors.

The risks described under the caption “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2022 (the “Annual Report”) could materially and adversely affect our business, financial condition, and results of operations, and could cause the trading price of our common stock to decline. The discussion of the risks included under that caption in our Annual Report remains current in all material respects, and there have been no material changes from the risk factors disclosed in the Annual Report. The risk factors that we have discussed do not identify all risks that we face; our operations could also be affected by factors that are not presently known to us or that we currently consider to be immaterial to our operations. Due to risks and uncertainties, known and unknown, our past financial results may not be a reliable indicator of future performance and historical trends should not be used to anticipate results or trends in future periods.

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Item 2.  Unregistered Sales of Equity Securities and Use of Proceeds.

Issuer Purchases of Equity Securities

The following table provides information with respect to purchases made by or on behalf of us or any “affiliated purchasers” (as defined in Rule 10b-18(a)(3) of the Exchange Act) of our common stock during the three months ended March 31, 2023:

PeriodTotal Number
of Shares (or Units)
Purchased
Average Price
Paid per
Share (or Unit)
Total Number of
Shares (or Units) of Common Stock
Purchased as Part of
Publicly Announced
Plans or Program
Maximum Number (or Approximate Dollar Value) of
Shares (or Units) that May Yet Be Purchased
Under the Plans or Programs (000’s)(1)
January 1, 2023 to January 31, 2023— — — $— 
February 1, 2023 to February 28, 20234,896 (2)$107.66 — $— 
March 1, 2023 to March 31, 20231,104 (2)$84.93 — $— 
Total6,000 — $— 

(1)     No stock repurchase program was authorized during the period ended March 31, 2023.

(2)     Redeemed shares of Common Stock issuable in respect of vested restricted stock tendered in lieu of cash for payment of income tax withholding amounts by participants in the Company’s 2006 Plan (as defined below). These shares were not part of a publicly announced program to purchase common stock.None.

Item 3. Defaults Upon Senior Securities.

None.

Item 4. Mine Safety Disclosures.

Not applicable.

Item 5. Other Information.

On May 1,During the three months ended September 30, 2023, none of our officers or directors adopted or terminated any contract, instruction or written plan for the Company entered into a separation agreement and general release (the “Release”) with Mr. Grover Wray in connection with Mr. Wray’s separationpurchase or sale of employment withour securities that was intended to satisfy the Company effective asaffirmative defense conditions of May 1, 2023, pursuant to which Mr. Wray received, in exchange for a full general release of claims in favor of the Company, the severance compensation described under the caption “Potential Payments Upon TerminationRule 10b5-1(c) or Change in Control” included in the Company’s definitive proxy statement filed with the Securities and Exchange Commission under cover of Schedule 14A on May 1, 2023, which information regarding Mr. Wray’s severance is incorporated herein by reference. The foregoing is a summary only of the more detailed information provided in the Release, a conformed copy of which is filed herewith as an exhibit and incorporated herein by reference. Interested parties are encouraged to read the Release in its entirety because it contains important information not included in this summary.any “non-Rule 10b5-1 trading arrangement.”

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Item 6.  Exhibits.

EXHIBIT INDEX 
Exhibit
Number
Description
10.1*3.1
10.2*3.2
3.3
3.4
3.5
3.6
4.1
4.2
10.1*
31.1*
31.2*
32.1**
32.2**
101.INS*Inline XBR Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCH*Inline XBRL Schema Document
101.CAL*Inline XBRL Calculation Linkbase Document
101.LAB*Inline XBRL Label Linkbase Document
101.PRE*Inline XBRL Presentation Linkbase Document
101.DEF*Inline XBRL Definition Linkbase Document
104*Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)
*Filed herewith.
**Furnished herewith.

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SIGNATURES
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
ModivCare Inc.
Date: May 3,November 2, 2023By:/s/ L. Heath Sampson
L. Heath Sampson
Chief Executive Officer
(Duly AuthorizedPrincipal Executive Officer)
Date: May 3,November 2, 2023By:/s/ L. Heath SampsonBarbara Gutierrez
L. Heath Sampson
Barbara Gutierrez
Chief Financial Officer
(Principal Financial Officer)

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