Emergency Medical Services Announces $0.43 Diluted EPS and Increases 2008 Guidance

Highlights:

-- Net revenue was $571.1 million, an increase of 10.5% compared
to the second quarter of 2007;

-- Diluted earnings per share was $0.43, an increase of 22.0%
compared to the second quarter of 2007;

-- Free Cash Flow of $65.4 million in the quarter compared to
$6.4 million for the same quarter last year;

-- Entry into the outsourced anesthesiology services market with
the pending acquisition of the management services entity of
Clinical Partners; and

-- Increases 2008 diluted EPS guidance to an expected range of
$1.70 - $1.75 from $1.57 - $1.63, and Adjusted EBITDA guidance
to an expected range of $227 million to $232 million, from
$225 million to $230 million.
GREENWOOD VILLAGE, Colo.--(Business Wire)--
Emergency Medical Services Corporation (NYSE: EMS) (EMSC or the
Company) today announces results for the second quarter ended June 30,
2008.

William A. Sanger, Chairman and Chief Executive Officer, said,
"EMSC continues to produce strong revenue and earnings growth, both
sequentially and year over year. We had excellent cash flow in the
quarter driven by improvements in our DSO and reductions in insurance
collateral requirements. We again demonstrated our ability to leverage
our unique market position by signing another national agreement
offering both medical transportation and hospital-based physician
services. We continue to expand our scope of services, as evidenced by
yesterday's announcement of our entry into the outsourced
anesthesiology services market."

Results of Operations for the Second Quarter 2008

For the quarter ended June 30, 2008, EMSC generated net revenue of
$571.1 million, an increase of 10.5% compared to the same quarter last
year. Adjusted EBITDA was $55.5 million, an increase quarter over
quarter of 5.9%. The three months ended June 30, 2007 included
incremental revenue adjustments of approximately $4 million, with a
positive Adjusted EBITDA impact of approximately $1.9 million. A
reconciliation of non-GAAP to GAAP financial measures is included in
this news release.

EMSC generated net income of $18.3 million, or $0.43 per diluted
share, for the second quarter of 2008, compared to net income of $15.1
million, or $0.35 per diluted share, in the second quarter of last
year, an increase of 22.0%. The increase in earnings is attributable
primarily to the net impact of higher rates and volumes on existing
contracts, increased volume from net new contracts and acquisitions,
gains on insurance collateral investments and lower interest expense,
partially offset by higher provider compensation, fuel costs and
income tax expense.

Free cash flow was $65.4 million in the second quarter 2008
compared to $6.4 million in the same quarter last year. Cash provided
by operating activities was $58.2 million in the second quarter 2008,
compared to $23.1 million for the same quarter last year, primarily
from an improvement in accounts receivable. Cash provided by operating
activities in the second quarter 2008 was positively impacted by
improved collections in both segments. EMSC's DSO decreased 2 days in
the second quarter of 2008.

Net cash provided by investing activities was $0.5 million for the
quarter ended June 30, 2008, compared to cash used in investing
activities of $17.2 million for the same period in 2007. The change is
due to a $14.9 million reduction in net insurance collateral
requirements and reduced net capital spending of $6.8 million compared
to the same period last year, offset by an acquisition of $6.7 million
during the second quarter 2008.

For the quarter ended June 30, 2008, net cash used in financing
activities was $1.8 million compared to $6.3 million for the same
quarter last year primarily due to changes in the amount of
outstanding checks.

Results of Operations for the Six Months Ended June 30, 2008

EMSC's net revenue was $1.14 billion for the six months ended June
30, 2008, an increase of 9.3% compared to the same period last year.
Adjusted EBITDA was $109.9 million, an increase of 3.0% from the same
period last year. The six months ended June 30, 2007 included
incremental revenue adjustments of approximately $13 million, with a
positive Adjusted EBITDA impact of approximately $10 million.

EMSC's net income for the six months ended June 30, 2008 was $35.4
million, or $0.82 per diluted share, compared to net income of $31.7
million or $0.74 per diluted share, an increase of 11.6% over the same
period last year. The increase in earnings is attributable primarily
to the net impact of higher rates and volumes on existing contracts,
increased volume from net new contracts and acquisitions, gains on
insurance collateral investments and lower interest expense, partially
offset by higher provider compensation, fuel costs and income tax
expense.

Free cash flow was $62.9 million for the six months ended June 30,
2008, an increase of $66.4 million over the six months ended last
year. Cash provided by operating activities for the six months ended
June 30, 2008 was $55.4 million, compared to $19.3 million for the
same period last year, driven primarily from improvements in
collections and reduced insurance collateral. EMSC's DSO improved 3
days in the six months ended June 30, 2008.

Net cash used in investing activities was $12.4 million for the
six months ended June 30, 2008 compared to $23.2 million for the same
period in 2007. The change in investing cash flows was affected by
reduced insurance collateral requirements of $17.9 million, reduced
capital expenditures of $12.5 million, offset by additional
acquisition costs of $19.5 million.

For the six months ended June 30, 2008, net cash provided by
financing activities was $1.2 million compared to cash used in
financing activities of $5.9 million for the six months ended June 30,
2007 primarily from changes in the amount of outstanding checks.

Segment Results

EMSC operates two business segments: American Medical Response,
Inc. (AMR), the Company's healthcare transportation services segment,
and EmCare Holdings Inc. (EmCare), the Company's outsourced emergency
department and hospital-based physician services segment.

American Medical Response (AMR)

For the quarter ended June 30, 2008, AMR generated net revenue of
$323.7 million, an increase of 9.6% compared to the same quarter last
year. Adjusted EBITDA was $26.0 million, an increase of 11.2% compared
to the same quarter last year. The increase in Adjusted EBITDA is
attributable primarily to the net impact of higher revenue in existing
markets and acquisitions partially offset by higher fuel costs of $4.3
million and a reduction in favorable prior period insurance
adjustments of $2.4 million compared to the same quarter last year.

For the six months ended June 30, 2008, AMR's net revenue totaled
$650.0 million, an increase of 7.7% compared to the same period last
year. Adjusted EBITDA was $54.4 million, an increase of 12.6% compared
to the same period last year, or 7.6% excluding restructuring charges
of $2.2 million recorded during the same period in 2007.

EmCare

For the quarter ended June 30, 2008, EmCare generated net revenue
of $247.4 million, an increase of 11.7% compared to the same quarter
last year. The increase in revenue is primarily driven by volume
increases at existing contracts and 37 net new contracts added since
March 31, 2007. Adjusted EBITDA was $29.5 million compared to $29.1
million last year, an increase of 1.7%. The three months ended June
30, 2007 included incremental positive revenue adjustments of
approximately $4 million, with an Adjusted EBITDA impact of
approximately $1.9 million. Insurance expense in the second quarter
2008 included a reduction in favorable prior period adjustments of
$2.9 million compared to the same period last year. Compensation
increased as a percent of net revenue due to increased provider costs
in both new and existing contracts offset by lower operating costs.

For the six months ended June 30, 2008, EmCare's net revenue was
$486.9 million, an increase of 11.5% compared to the same period last
year. Adjusted EBITDA was $55.6 million compared to $58.4 million last
year. The six months ended June 30, 2007 included incremental positive
revenue adjustments of approximately $13 million, with an Adjusted
EBITDA impact of approximately $10 million.

Guidance

EPS guidance is updated to an expected range of $1.70 to $1.75 per
diluted share from previously announced guidance of $1.57 to $1.63 per
diluted share, and Adjusted EBITDA guidance is updated to an expected
range of $227 million to $232 million from previously announced
guidance of $225 million to $230 million.

Conference Call

EMSC management will host a conference call and live audio webcast
on Tuesday, August 5, 2008, at 11:00 a.m. EDT, to discuss the
Company's financial results. A 30-day online replay will be available
approximately one hour following the conclusion of the live broadcast.
A link to the live broadcast and online replay is available on the
Investor Relations section of the Company's website at www.emsc.net.

About Emergency Medical Services Corporation

Emergency Medical Services Corporation (EMSC) is a leading
provider of emergency medical services in the United States. EMSC
operates two business segments: American Medical Response, Inc. (AMR),
the Company's healthcare transportation services segment, and EmCare
Holdings Inc. (EmCare), the Company's outsourced emergency department
and hospital-based physician services segment. AMR is the leading
provider of ambulance services in the United States. EmCare is the
nation's leading provider of outsourced emergency department and
hospital-based physician services. In 2007, EMSC provided services to
10.6 million patients in more than 2,000 communities nationwide. EMSC
is headquartered in Greenwood Village, Colorado. For additional
information visit www.emsc.net.

Forward-Looking Statements

Certain statements and information herein may be deemed to be
"forward-looking statements" within the meaning of the Federal Private
Securities Litigation Reform Act of 1995. Forward-looking statements
may include, but are not limited to, statements relating to our
objectives, plans and strategies, and all statements (other than
statements of historical facts) that address activities, events or
developments that we intend, expect, project, believe or anticipate
will or may occur in the future. Any forward-looking statements herein
are made as of the date of this press release, and EMSC undertakes no
duty to update or revise any such statements. Forward-looking
statements are not guarantees of future performance and are subject to
risks and uncertainties. Important factors that could cause actual
results, developments and business decisions to differ materially from
forward-looking statements are described in EMSC's filings with the
SEC from time to time, including in the section entitled "Risk
Factors" in the Company's most recent Annual Report on Form 10-K and
subsequent periodic reports. Among the factors that could cause future
results to differ materially from those provided in this press release
are: the impact on our revenue of changes in transport volume, mix of
insured and uninsured patients, and third party reimbursement rates
and methods; the adequacy of our insurance coverage and insurance
reserves; potential penalties or changes to our operations if we fail
to comply with extensive and complex government regulation of our
industry, both as it exists now and as it may change in the future;
our ability to recruit and retain qualified physicians and other
healthcare professionals, and enforce our non-compete agreements with
our physicians; the loss of one or more members of our senior
management team; the outcome of government investigations of certain
of our business practices; our ability to generate cash flow to
service our debt obligations and fund the cost of capital expenditures
to maintain and upgrade our vehicle fleet and medical equipment; and
the loss of existing contracts and the accuracy of our assessment of
costs under new contracts.

Non-GAAP Financial Measures Reconciliation

This press release includes presentations of Adjusted EBITDA,
which is defined as net income before equity in earnings of
unconsolidated subsidiary, income tax expense, interest and other
income, realized gain on investments, interest expense, and
depreciation and amortization. Adjusted EBITDA is commonly used by
management and investors as a performance measure and a liquidity
indicator. Adjusted EBITDA is not considered a measure of financial
performance under U.S. generally accepted accounting principles
(GAAP), and the items excluded from Adjusted EBITDA are significant
components in understanding and assessing our financial performance.
Adjusted EBITDA should not be considered in isolation or as an
alternative to GAAP measures such as net income, cash flows provided
by or used in operating, investing or financing activities or other
financial statement data presented in our consolidated financial
statements as an indicator of financial performance or liquidity.
Reconciliations of non-GAAP financial measures are provided in this
news release. Reconciliation for the forward-looking Adjusted EBITDA
projections presented herein is not being provided due to the number
of variables in the projected Adjusted EBITDA range. Since Adjusted
EBITDA is not a measure determined in accordance with GAAP and is
susceptible to varying calculations, Adjusted EBITDA, as presented,
may not be comparable to other similarly titled measures of other
companies.

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EMERGENCY MEDICAL SERVICES CORPORATION
Consolidated Statements of Operations and Other Information
Including a Reconciliation of Income from Operations to Adjusted
EBITDA(1)
(unaudited; in thousands, except shares, per share data and other
information)

Quarter ended June 30, Six months ended June 30,
------------------------- -------------------------
2008 2007 2008 2007
------------ ------------ ------------ ------------

Net revenue $ 571,079 $ 516,712 $ 1,136,865 $ 1,040,031
------------ ------------ ------------ ------------
Compensation and
benefits 400,501 357,309 794,852 712,241
Operating expenses 83,704 76,262 166,927 156,258
Insurance expense 17,568 17,476 38,531 37,777
Selling, general
and administrative
expenses 15,520 14,901 30,112 28,206
Depreciation and
amortization
expense 17,446 17,577 35,163 34,356
Restructuring
charges - - - 2,242
------------ ------------ ------------ ------------
Income from
operations 36,340 33,187 71,280 68,951
Interest income
from restricted
assets 1,735 1,660 3,490 3,375
Interest expense (10,354) (11,395) (20,270) (22,629)
Realized gain on
investments 1,571 22 2,243 59
Interest and other
income 287 532 589 1,189
------------ ------------ ------------ ------------
Income before
income taxes and
equity in
earnings of
unconsolidated
subsidiary 29,579 24,006 57,332 50,945
Income tax expense (11,348) (9,012) (22,032) (19,474)
Equity in earnings
of unconsolidated
subsidiary 104 101 54 255
------------ ------------ ------------ ------------
Net income $ 18,335 $ 15,095 $ 35,354 $ 31,726
============ ============ ============ ============

Basic earnings per
common share $ 0.44 $ 0.36 $ 0.85 $ 0.76
Diluted earnings
per common share $ 0.43 $ 0.35 $ 0.82 $ 0.74
Weighted average
common shares
outstanding, basic 41,573,893 41,544,901 41,572,162 41,533,093
Weighted average
common shares
outstanding,
diluted 43,022,034 43,211,661 43,052,668 43,120,416

Other Information
EmCare patient
encounters 2,019,145 1,821,307 3,984,660 3,565,328
AMR ambulance
transports 737,200 702,621 1,488,840 1,430,028
AMR weighted
transports 748,606 715,462 1,512,120 1,457,132

Reconciliation of income from operations to Adjusted EBITDA
Income from
operations $ 36,340 $ 33,187 $ 71,280 $ 68,951
Depreciation and
amortization
expense 17,446 17,577 35,163 34,356
Interest income
from restricted
assets 1,735 1,660 3,490 3,375
------------ ------------ ------------ ------------
Adjusted EBITDA $ 55,521 $ 52,424 $ 109,933 $ 106,682
============ ============ ============ ============

(1) These statements provide a reconciliation of Adjusted EBITDA to
income from operations; and a reconciliation of income from
operations to net income.
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EMERGENCY MEDICAL SERVICES CORPORATION
Reconciliation of Adjusted EBITDA to Cash Flows Provided by Operating
Activities
(unaudited; in thousands)

Quarter ended June 30, Six months ended June 30,
---------------------- -------------------------
2008 2007 2008 2007
------------ --------- --------------- ---------

Adjusted EBITDA $55,521 $ 52,424 $109,933 $106,682
Interest paid (9,827) (10,864) (19,164) (21,609)
Change in accounts
receivable 12,556 (35,783) (13,752) (63,934)
Change in other
operating
assets/liabilities 659 17,164 (22,081) (3,718)
Equity based
compensation 562 400 1,124 800
Other (1,314) (215) (681) 1,059
------------ --------- --------------- ---------
Net cash provided by
operating
activities $58,157 $ 23,126 $ 55,379 $ 19,280
============ ========= =============== =========
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EMERGENCY MEDICAL SERVICES CORPORATION
Reconciliation of Segment Income from Operations to Adjusted EBITDA
(unaudited; in thousands)

Quarter ended June 30, Six months ended June 30,
---------------------- -------------------------
2008 2007 2008 2007
-------------- ------- ---------------- --------
AMR
Income from operations $11,176 $8,934 $24,506 $19,408
Depreciation and
amortization
expense 14,118 13,711 28,504 27,461
Interest income from
restricted assets 682 719 1,364 1,440
-------------- ------- ---------------- --------
Adjusted EBITDA (1) 25,976 23,364 54,374 48,309
-------------- ------- ---------------- --------

EmCare
Income from operations 25,164 24,253 46,774 49,543
Depreciation and
amortization
expense 3,328 3,866 6,659 6,895
Interest income from
restricted assets 1,053 941 2,126 1,935
-------------- ------- ---------------- --------
Adjusted EBITDA (2) 29,545 29,060 55,559 58,373
-------------- ------- ---------------- --------

Total
Income from operations 36,340 33,187 71,280 68,951
Depreciation and
amortization
expense 17,446 17,577 35,163 34,356
Interest income from
restricted assets 1,735 1,660 3,490 3,375
-------------- ------- ---------------- --------
Adjusted EBITDA $55,521 $52,424 $109,933 $106,682
============== ======= ================ ========

(1) AMR Adjusted EBITDA includes $2.2 million of restructuring charges
for the six months ended June 30, 2007.
(2) EmCare Adjusted EBITDA includes the net impact of approximately
$1.9 million of positive revenue adjustments for the quarter ended
June 30, 2007 and approximately $10 million of positive revenue
adjustments for the six months ended June 30, 2007.
*T

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EMERGENCY MEDICAL SERVICES CORPORATION
Condensed Consolidated Balance Sheets
(in thousands)

June 30, December 31,
2008 2007
----------- ------------
(Unaudited) (Audited)
Assets
Current assets:
Cash and cash equivalents $ 73,019 $ 28,914
Trade and other accounts receivable, net 512,027 495,348
Other current assets 156,314 146,498
----------- ------------
Total current assets 741,360 670,760
Non-current assets:
Property, plant and equipment, net 127,745 143,342
Goodwill and other intangible assets, net 405,412 394,841
Other long-term assets 227,667 270,620
----------- ------------
Total assets $1,502,184 $1,479,563
=========== ============

Liabilities and Equity
Current liabilities $ 301,490 $ 306,891
Long-term debt 476,186 478,166
Insurance reserves and other long-term
liabilities 240,945 245,010
----------- ------------
Total liabilities 1,018,621 1,030,067
Total equity 483,563 449,496
----------- ------------
Total liabilities and equity $1,502,184 $1,479,563
=========== ============
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EMERGENCY MEDICAL SERVICES CORPORATION
Condensed Consolidated Statements of Cash Flows
(unaudited; in thousands)

Quarter ended June 30, Six months ended June 30,
---------------------- -------------------------
2008 2007 2008 2007
--------- ------------ --------- ---------------
Cash Flows from
Operating Activities
Net income $ 18,335 $ 15,095 $ 35,354 $ 31,726
Adjustments to
reconcile net income
to net cash provided
by operating
activities:
Depreciation,
amortization,
deferred taxes and
other 26,607 26,650 55,858 55,206
Changes in operating
assets/liabilities,
net of
acquisitions:
Trade and other
accounts
receivable 12,556 (35,783) (13,752) (63,934)
Insurance
accruals (3,741) (5,020) (7,140) 4
Other assets and
liabilities 4,400 22,184 (14,941) (3,722)
--------- ------------ --------- ---------------
Net cash provided by
operating activities 58,157 23,126 55,379 19,280
--------- ------------ --------- ---------------

Cash Flows from
Investing Activities
Purchases of property,
plant and equipment,
net (7,496) (14,256) (9,960) (22,452)
Acquisition of
businesses, net of
cash received (6,679) (477) (19,957) (477)
Net change in
insurance collateral 12,731 (2,123) 14,856 (3,033)
Other investing
activities 1,975 (306) 2,628 2,715
--------- ------------ --------- ---------------
Net cash provided by
(used in) investing
activities 531 (17,162) (12,433) (23,247)
--------- ------------ --------- ---------------

Cash Flows from
Financing Activities
EMSC issuance of class
A common stock 33 76 45 249
Borrowings under
revolving credit
facility - - 14,000 -
Repayments of capital
lease obligations and
other debt (1,570) (1,058) (16,721) (3,391)
Increase (decrease) in
bank overdrafts (287) (5,330) 3,835 (2,743)
--------- ------------ --------- ---------------
Net cash provided by
(used in) financing
activities (1,824) (6,312) 1,159 (5,885)
--------- ------------ --------- ---------------

Change in cash and
cash equivalents 56,864 (348) 44,105 (9,852)
Cash and cash
equivalents,
beginning of period 16,155 29,832 28,914 39,336
--------- ------------ --------- ---------------
Cash and cash
equivalents, end of
period $ 73,019 $ 29,484 $ 73,019 $ 29,484
========= ============ ========= ===============

Non-cash Activities
Capital lease
obligations incurred $ 682 $ - $ 682 $ 8,038
========= ============ ========= ===============

Free Cash Flow $ 65,367 $ 6,441 $ 62,903 $ (3,490)

Reconciliation of free cash flow to net cash provided by operating
activities
Free cash flow $ 65,367 $ 6,441 $ 62,903 $ (3,490)
Purchase of property,
plant and equipment,
net 7,496 14,256 9,960 22,452
Net change in
insurance collateral (12,731) 2,123 (14,856) 3,033
Other investing
activities (1,975) 306 (2,628) (2,715)
--------- ------------ --------- ---------------
Net cash provided by
operating
activities $ 58,157 $ 23,126 $ 55,379 $ 19,280
========= ============ ========= ===============
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Emergency Medical Services Corporation
Deborah Hileman, 303-495-1210
Vice President
Corporate Communications & Investor Relations
Deborah.hileman@emsc.net

Copyright Business Wire 2008