GMR Solutions (GMRS) Q1 2026 earnings summary

Executive summary

• Largest U.S. EMS provider, serving 1,400 counties and 60% of the population, with ~5.5 million annual patient encounters.

• Q1 2026 net revenue was $1,457.6 million, up 6.6% year-over-year; net income rose 179.7% to $106.3 million; Adjusted EBITDA increased 9.7% to $305.1 million.

• Completed IPO in May 2026, reducing debt and preferred equity by $1.15 billion and raising $454.8 million in net proceeds.

• Strong liquidity with $426.1 million in cash and $691.6 million undrawn ABL facility.

• Net leverage post-IPO at 3.5x, expected to fall below 3.3x by year-end.

Financial highlights

• Q1 2026 revenue: $1,457.6 million, up 6.6% year-over-year.

• Net income: $106.3 million, up 179.7% year-over-year.

• Adjusted EBITDA: $305.1 million, up 9.7% year-over-year.

• Operating income: $218.9 million, up 23.1% year-over-year.

• Net transport revenue per ambulance transport: $1,360, up from $1,260 year-over-year.

Outlook and guidance

• Full-year 2026 revenue guidance: $5.89–$6.18 billion; Adjusted EBITDA: $1.135–$1.195 billion.

• CapEx and aircraft financing expected at 5.1–5.3% of revenue.

• Guidance incorporates payer mix degradation, higher fuel costs, and normalized collection timing.

• Targeting net leverage below 3.0x by 2027.

• Expect continued demand growth due to rural hospital closures, aging population, and rising chronic conditions.