SEGMENT INFORMATION | SEGMENT INFORMATION The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. The Company has three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse staffing (including international nurse staffing and rapid response nurse staffing), labor disruption staffing, local staffing, international nurse and allied permanent placement, allied staffing and revenue cycle solutions businesses. The physician and leadership solutions segment includes the Company’s locum tenens staffing, healthcare interim leadership staffing, executive search, and physician permanent placement businesses. The technology and workforce solutions segment includes the Company’s language services, vendor management systems, workforce optimization, virtual care, and outsourced solutions businesses. The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Revenue Nurse and allied solutions $ 573,426 $ 828,317 $ 2,086,921 $ 3,157,834 Physician and leadership solutions 159,554 175,152 501,540 530,355 Technology and workforce solutions 120,483 135,117 382,524 429,542 $ 853,463 $ 1,138,586 $ 2,970,985 $ 4,117,731 Segment operating income Nurse and allied solutions $ 82,882 $ 115,182 $ 299,320 $ 471,141 Physician and leadership solutions 21,609 23,904 73,165 64,280 Technology and workforce solutions 50,664 71,145 173,297 232,526 155,155 210,231 545,782 767,947 Unallocated corporate overhead 27,196 34,635 108,286 116,356 Depreciation and amortization 39,175 33,239 113,599 96,169 Depreciation (included in cost of revenue) 1,552 1,091 4,196 2,918 Share-based compensation 306 4,898 15,442 24,670 Interest expense, net, and other 11,541 8,961 33,975 28,630 Income before income taxes $ 75,385 $ 127,407 $ 270,284 $ 499,204 The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Balance, January 1, 2023 $ 382,005 $ 152,800 $ 400,559 $ 935,364 Goodwill adjustment for Connetics acquisition 415 — — 415 Balance, September 30, 2023 $ 382,420 $ 152,800 $ 400,559 $ 935,779 Accumulated impairment loss as of December 31, 2022 and September 30, 2023 $ 154,444 $ 60,495 $ — $ 214,939 Disaggregation of Revenue The following tables present the Company’s revenue disaggregated by service type: Three Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 384,102 $ — $ — $ 384,102 Labor disruption services 777 — — 777 Local staffing 16,991 — — 16,991 Allied staffing 167,622 — — 167,622 Locum tenens staffing — 112,514 — 112,514 Interim leadership staffing — 30,910 — 30,910 Temporary staffing 569,492 143,424 — 712,916 Permanent placement 3,934 16,130 — 20,064 Language services — — 66,406 66,406 Vendor management systems — — 38,116 38,116 Other technologies — — 5,052 5,052 Technology-enabled services — — 109,574 109,574 Talent planning and acquisition — — 10,909 10,909 Total revenue $ 573,426 $ 159,554 $ 120,483 $ 853,463 Three Months Ended September 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 583,463 $ — $ — $ 583,463 Labor disruption services 19,479 — — 19,479 Local staffing 31,814 — — 31,814 Allied staffing 190,044 — — 190,044 Locum tenens staffing — 106,055 — 106,055 Interim leadership staffing — 47,559 — 47,559 Temporary staffing 824,800 153,614 — 978,414 Permanent placement 3,517 21,538 — 25,055 Language services — — 55,502 55,502 Vendor management systems — — 60,304 60,304 Other technologies — — 7,290 7,290 Technology-enabled services — — 123,096 123,096 Talent planning and acquisition — — 12,021 12,021 Total revenue $ 828,317 $ 175,152 $ 135,117 $ 1,138,586 Nine Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,453,988 $ — $ — $ 1,453,988 Labor disruption services 11,515 — — 11,515 Local staffing 61,038 — — 61,038 Allied staffing 545,959 — — 545,959 Locum tenens staffing — 341,129 — 341,129 Interim leadership staffing — 107,553 — 107,553 Temporary staffing 2,072,500 448,682 — 2,521,182 Permanent placement 14,421 52,858 — 67,279 Language services — — 191,732 191,732 Vendor management systems — — 138,843 138,843 Other technologies — — 18,191 18,191 Technology-enabled services — — 348,766 348,766 Talent planning and acquisition — — 33,758 33,758 Total revenue $ 2,086,921 $ 501,540 $ 382,524 $ 2,970,985 Nine Months Ended September 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 2,329,240 $ — $ — $ 2,329,240 Labor disruption services 102,549 — — 102,549 Local staffing 109,265 — — 109,265 Allied staffing 611,226 — — 611,226 Locum tenens staffing — 324,663 — 324,663 Interim leadership staffing — 139,519 — 139,519 Temporary staffing 3,152,280 464,182 — 3,616,462 Permanent placement 5,554 66,173 — 71,727 Language services — — 158,031 158,031 Vendor management systems — — 210,470 210,470 Other technologies — — 21,787 21,787 Technology-enabled services — — 390,288 390,288 Talent planning and acquisition — — 39,254 39,254 Total revenue $ 3,157,834 $ 530,355 $ 429,542 $ 4,117,731 |