GMR is the largest provider of emergency medical services in the United States and the only national provider to integrate air and ground transport. The company primarily operates through emergent care services, responding to 911 calls and urgent medical needs using ambulances, helicopters, and fixed-wing aircraft. It also provides non-emergent care, such as scheduled transfers between hospitals and rehabilitation facilities. GMR serves municipalities and counties through long-term exclusive contracts, as well as health systems and federal agencies. The company also maintains a membership program for individuals through its AirMedCare Network. GMR operates a fee-for-service business model, billing insurers or patients directly for every transport. Revenue depends on transport volume and the payor mix, as commercial insurance reimbursements are typically higher than government fee schedules. Because GMR must keep crews and aircraft ready at all times, the business has a high fixed-cost structure and significant operating leverage. The company grows by winning new municipal contracts, opening new air bases in rural areas, and acquiring smaller regional providers. GMR also offers a technology platform that routes low-acuity calls to appropriate care settings to improve efficiency for municipalities and healthcare systems.