AMN - Earnings call transcript Q4 2018 | AMN Healthcare Services, Inc.

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Operator

Ladies and gentlemen, thank you for standing by, and welcome to the AMN Healthcare Fourth Quarter 2018 Earnings Call. At this time, all telephone participants are in a listen-only mode, and then later, we will conduct a question-and-answer session. The instructions will be given at that time. [Operator Instructions] As a reminder, the conference is being recorded. I'll now turn the meeting over to our host Director of Investor Relations. Mr. Reece. Randy sir. ahead, go Please

Randy Reece

following statements this afternoon, everybody. current and this Healthcare's quarter replay at the will Details circumstances, earnings expectations, this for projections, future the Welcome XXXX earnings to based our audio amnhealthcare.investorroom.com XX in full-year February afternoon. of the available constitute are AMN currently it. conclusion about call. of be call. statements. conference fourth of issued until Good this the A available webcast company's Various events call or reflect remarks upon information call release we beliefs forward-looking These make the during to plans, replay

financial identified results as intend recent forward-looking prior Form in these differ may with statements those from XX-K forward-looking and actual contains accessed subsequent included today in which to a indicated its SEC. not various the the Reports are of comparable measures next release non-GAAP measures GAAP statements non-GAAP of or of does be filings The company most site, by earnings guidance regarding call any company's page provided those directly our Our result to our can release. certain reconciliations these the to Web at most materially including and on information. amnhealthcare.investorroom.com. Financial the the update factors, and This earnings Information

Salka, Susan Solutions. Professional Scott, turn Brian Workforce Officer; today call now Chief Ralph Executive President call Staffing; and to Services of the Chief and Henderson, will Susan. Officer; the President are Dan On I over of Financial White,

Susan Salka

call. and everyone, Valentine's earnings much, our so you Thank Happy to Day Randy. welcome

and spend AMN million the the management. investments future, amounting of within In deepening we further our leadership new well, Throughout very created for XXXX, won and which under That internal at the $XXX position AMN in acquisitions. marketplace, gross year the and competed back solutions themes year, investments in industry. leadership were our some meant MSPs with Looking we the evolved disruption. our portfolio to at

solution the has thrilled regions that its MSP Our with ability be to XXXX, are clients Tenet serve into United announce in partner AMN continued seeking was their systems and diverse and Healthcare to selected provider total for and workforce is workforce health we the and one a of deep Tenet largest to to the States, California efficiency in and achieve care a goals. patient Arizona. solutions

go-live of Tenet's $XXX estimated management for allied, under is other serve will April. and executive. in contract we for have more contingent clients We interim million, recently staffing at now. needs The launched in MSP and We end XXXX, gross at this the signed targeting a several and implementation nursing, are contracts spend that new

we to Our AMN evolving talent our recruit strategy the delivery are and to or delivery exceed clients. the ensure to meet we continued poised teams new year, these clients. team our Throughout to of leadership fresh strong, ensure expectations that to are

He business the contributions and brings comes Dr. to Cole decades year and career AMN. for mentioned, organization, and insights thank As Hagan Edmonson successful to care Most we industry. AMN's who as our Dr. we recently, Edmonson our strategic Mark were previously is replacing we broad leader Dr. I'd leader. of to senior add as new very and health Officer, a experience. Kelly bringing Marcia how great build us with experienced highly leadership Locum team, our The technology successful spring, Rakowski sales to a visible Locum retiring clinical, Clinical this investments Marcia months with problems welcomed our required Tenens, all had make quality our we Chief operational, help like to innovative more her after on to as a and care, XX she's setbacks. There personally financial Faller, build and and fortunate in what of of to and were systems. done are Last reputation converted these fund we important also In legacy local from particularly goals. backend Locum also Tenens businesses. system and talent, and launched has patient achieve systems. to including migration powerful, their the scalable the Tenens XXXX, first in staffing In in outlook. new quarter model, further can easier we several our three and configuration force operating help fourth is best it we our based necessary navigate. lower revenue it change but clients Through to transformations, to initiatives, issues quarter data

During slowed the got new a and this to up hiring we the service Performance bit time, by that in productivity. sales also sales the necessity the into new customer in began our ramp We quarter, fact producers. that have of was behind hiring maintaining third accelerated hindered good year.

Returning We Tenens Locums priority. top high attractive Locum these is expect that is clients. growth begin hires to benefiting productivity importance second-half market is new of to XXXX. the strategic in of our our an to from

Fourth margin adjusted our revenue $XX million was EBITDA million XX.X% and grew of XX.X% or was $XXX quarter review revenue. X% and outlook. let's results Now of latest consolidated year-over-year. Gross

for of The a more relatively posted Our difficult nurse our expectations. staffing, experience lower with top comparison That premium client. Volume winter nursing for Nurse in a continued year-over-year. year. of in for X% flu that in this rate census headwinds to assignments comparison year-over-year rather at utilization to strong gap dynamics of due reduction one and first do with This nothing service to last season difficult proven specific and deliveries, be the we has rate fill million, of even and year-over-year was has which line high due our our XXXX reduction to a quarter growth We of would grew largest AMN but Allied the knew clients. to very exceptionally business, average segment the assignments utilization improve. X% $XXX lessened, increased Revenue revenue year-over-year. travel

volume be the staffing nurse continued to growth mid winning again its year-over-year was revenue strong year-over-year quarter. expected impact, has up Order Allied fourth or better. the improve continued this in bookings growth single-digit support about growing X% is and to trend in as revenue quarter. continued with first staffing X% streak Excluding

overall, and about the revenue to For X% reduction Allied to first expect I be Nurse year-over-year down we segment to the X% client-specific the due mentioned. quarter in

XX% of to higher-than-expected of quarter attrition, expected Excluding this XX% expected We fourth is about impact, revenue year-over-year. and there and demand. Ralph million this the Tenens reduced had to lower segment more segment, be the Brian In the of as X%. medicine this will the questions. we On lower I'm clients sure in segment up productivity can experienced, hospital in Locum specialties were greater-than-expected be as also a was have top and bit revenue provide declines $XX down for XX%. to you many Q&A about emergency color

add satisfaction taking our business continues to scores XX% clients and we segment providers and indicating Locum's side, that seen bright now the care challenges. despite MSP of of our are On We've and clients, revenue. client is clinician stable the

first including last $XXX organically. Fourth X% the Workforce up expected in Locum quarter. million, to our segment our to down year-over-year similar was year-over-year be For was is revenue XX% other quarter growth acquisition Solutions quarter, April revenue and Tenens'

by XX% placement RPO. of collectively of comprise leadership year-over-year X% revenue. organic driven placement about and growth permanent business businesses Our permanent with segment's XX% this interim and grew These lines

of continuing mobile additional to important our offerings, XXXX. quarter, segment VMS $XX we and coding revenue Business million innovative offsetting January, was into is Analytics last VMS offering than setting. to specialties. the expected team have April. to quarter. healthcare our division growth revenue Solutions revenue added Solutions fourth the be other with gets made the with down first Workforce revenue the way. acquisition quarter up we improved slower Transfer nice XX% Our primarily in mid-cycle Avantas serving Workforce growth Avantas in total we at Silversheet. overall to the fourth VMS under In continues also finally Workforce our And capabilities, revenue acquisitions year-over-year of and as about other was and the Optimization fourth make Predictive In to includes the progress, produced XXXX in analytics an Solutions new Within where expected in investments for make quarter. continue in revenue Medical Other our Workforce up due and

gives upon digital credentialing worked makes facility. clients at told compliance need us has more hiring, repeatedly platform their credentialing reviewing the of easier, have permanent is one process This while malpractice experience, created cloud based this a verifications the These Our training, be which an education for clinician are healthcare board made staff. history. that process is to but faster and a point basis and reliable. organization licensure, ongoing of on a that clinician's biggest certification Silversheet completely process, that also and workforce work verifying pain their and

their to and set. permanent. even strategic partner. our ask into We gratitude them eager in to who do members to that our of add are owe times and our more. our and every talent, to professionals. people make healthcare the To intent fast client's We all support capabilities growth address and integrate that, We aspects as do solution on must workforce continue place day earning AMN remain them healthcare we future for are possible The labor, contingent deepest amazing them attitude team do this AMN enthusiasm when can Silversheet's

Dan Brian for join a call update the for will session. which the turn will and us I to financial Now, Q&A Ralph over after

Brian Scott

$XXX was Good Thank million quarter $X below afternoon you, the guidance to of everyone. range. low company's fourth revenue million Susan. our The of end

Gross the guidance lower quarter basis lower-than-expected year, the up noted driven Susan was revenue earlier, mainly XX As this points segment. with quarter. XX for Locum points prior by last but basis was margin from at our XX.X%, consistent than Tenens shortfall from our

but acquisition in the and basis quarter coming Locum consolidated million increase driven XX.X% acquisitions with sequentially. new We million, per has driven per April to quarter fourth though year-over-year, lower sequential year and basis, was $X.XX sequentially. points than plus the Locum of in expectations. Tenens Allied gross mainly and down prior a Allied and basis, Fourth than increase revenue fourth of X% points unfavorable diluted XXX and volume, with the margin was points Nurse the a margin quarter volume. stemmed shift. net and basis basis an down quarter leverage down basis from Our system X% X% year-over-year lower $XXX segment and was consolidated million on sequentially. margin by unfavorable declines margin quarter, earnings EBITDA share down margin Tenen's growth variance by recent average. than other prior on the of was segment XX.X% prior reported of up margin X% from and $XX lower sequential flat an was income byproduct to in was X.X%, margin XX.X% XX due year. operating revenue. sequentially. earnings the points points down points from the of was points the year and MedPartners, $XXX basis accretive negative transition at segment affected Gross Segment XX% as mainly Locum with XX% year, lower EBITDA demand. basis Gross was lower revenue $XX from a the basis prior XX% adjusted higher about XXX in million mainly acquisition. prior-year X% were was specialty prior higher down of gross margin adjustments Fourth Solutions gross mixed XXX of $X.XX, basis XXX prior Adjusted of difficulty] EBITDA by consistent $XX X% Tenens Nurse $X.XX adjusted compared year-over-year. our negatively and and quarter. with XX margin was million quarter. year by year-over-year, was share was XX.X%, lower year-over-year year-over-year which of of XX.X% lower increase the gross Adjusted The our EBITDA up segment XXX The On a Fourth points sequentially, was a XX Workforce of [technical

the similar minority was is gain fair in expense was first the quarter a Our on quarter. of includes in million of other a rate income XX% $X credit value quarter of tax adjustment the be XX,XXX, and market investment. the expected Interest to in which and

expense was gain, Cash the $XX by net was million for this million. interest quarter. $X.X Excluding operations provided

were at expenditures $XX XXXX, million. For from XX million. Capital totaled million, XX% days quarter sales fourth operations year-over-year. quarter $XXX At compared year-ago outstanding last cash totaled as days, in with in the flow the cash XX the quarter, $XX full-year December up was end XX, Day quarter. equivalents same

During outstanding our our At $XXX million. million of ratio to X. the stock quarter, we X.X repurchased was XXX,XXX debt times for leverage was end, and shares $XX total quarter

be to is year, by with be quarter first growth approximately growth Adjusted $XXX Tenen's million basis, to a nurse company The to year-over-year. turn primarily expected million. represents of the prior organic X% revenue be Allied XX%. projected Gross segment to EBITDA X% and staffing percentage expected This offset revenue to top expected from line margin be an let's Locum to X%, approximately to Now, due is expects of guidance. approximately XXXX consolidated On to revenue is lower expenses Nurse X% be XX% is SG&A and Allied XX.X%. to as margin approximately revenue. $XXX X% down to are expected revenue. of revenue the lower down the

Amortization less depreciation by $X.XX of quarter. by EPS reduce momentum. million, just $X.X to following: of expense than include is gain EBITDA business this expense amortization million anticipate quarterly the an We still As some $X.XX margin add and million, $X.X million, of expense The count $X acquisition for $X up expense the interest it $X time stock expenses next breakeven XX And of Silversheet part early-stage for they open acquisition. from we to to and company estimates will like this will of points and $X.X reach revenue the in integration intangible of now, quarter XXXX. relates expense million, year, from revenue million Silversheet, first lower valuation of Other XXXX throughout starting XXXX higher basis changes, assets expense approximately Silversheet is and expect in is to based about share million, diluted compensation plan on of compensation call stock-based preliminary remainder year. amortizable per certain quarter of $X.X the million we'd related XX.X shares. questions. the and

Operator

Tobey question first from the Our Instructions] is line [Operator with you. Please Thank ahead. SunTrust. of Sommer go

Tobey Sommer

start understand, could single the much. telling if based difficulty] been you're off then would that have if nurse wondering [technical was on the be on And could us for comment a from you you bit very Thanks. great. Thank client. travel I I has little demand the orders in you what as by maybe like quarter area, guiding pricings,

Susan Salka

which Absolutely. sort of that I favorable have jump more if Ralph on client. honestly specifics little [ph] largely have order in large been positive the bit and a out will single the still, you in trends, take

that actually Regarding rate so, pricing, trends premium continue into would to continued that seen the in have were I mentioned we meaning feeling -- mixed actually that that favorable will expect more headwinds lapping lessening the assignments but will that soon. are going very trends, I we sort see actually quarter, and gone quarter as gap we say and pricing favorable the so very thought and has down, it's those headwinds we year-over-year even headwind environment fourth first second those than a more of at more and quarter. for we even lessening us in be stable the look the we would we

little color nurse on travel more order? a bit maybe Ralph the So,

Ralph Henderson

the In orders were facilities foreign they was up first were year. TOA quarter lower. on rates or orders our are fill positive The program, unfavorable actually mix facilities so Sure. a overall prior fourth are up. with vendor-neutral little with But and up, third-party the side, with versus

start growth are we we an -- pretty deals, the components going on and expect prior in robust some is lower into there a all look not year new other Tenet seasons single and probably because increase implementation we orders demand there, the are we to lap I forward outside demand. forward of that of -- flu as client, in would QX having little and of As probably the see super significant over us last and even look to to further the get but

Tobey Sommer

of than that, does of those growing direct the slowly Thank clients you. imply more of kind outside kind your orders for Ralph, just average your a on a follow-up bit MSP that little exposure? on that is

Ralph Henderson

oddly, basis many down you to just this client for year-over-year kind who's seen good continue is years, Yes, exclude to certainly maybe little one that time, them. and question, we've a of it's client cover you we'll just on kind but once a long just in bit more, that that the a for issue which time first seasonal a of large a but a know, grow probably

it's I think much see they enrollment pretty system they did not as had by so, otherwise I as expected, in think and their impacted But that. we're strong.

been as the an mix demand we for know, rates on it's up, kind can there, XX%, there's that us than across be and The it's of MSPs, often you nothing a not look really our way that third-party increase. an we versus favorable interesting at the on fill it's but they're other third-parties in Board, been different XX% about the mid-teens those just our looks

Tobey Sommer

ask very long Okay. [indiscernible] challenging this? then of the kind MSP. but to? declines queue; so you meeting in talk clients it's that revenue about could the If was and sort revenue those and you fill just questions the for customers couple practitioners, have needs holding I of back a temporary your be and push trends of scores Hopefully I into excuse and steady phenomenon still could mentioned Locums Tenens you're for get curious in satisfaction of for me, I'll can't Could navigating about rates how that you get

Susan Salka

a that opportunity we us positions is those you're at we one we it'll make their help a they're clients and they make vendor, expectations not fill of managers to have are. align hitting strong very us on our affiliate again to but and to only recruiters best the we're have fill than Absolutely, and partners rates, sure make get ways rates fortunate account number obligation. our and everyone fill clients much priority why to is an MSP [indiscernible] an It's those for MSP through which hit even and clients. of that MSP objective clients. the our affiliate whether rate or be through placement, to filled have right. to even our With our And stronger incentives, other vendor for internally And focused always be panel that is

term. have the are that's we our some but third-party, And that jobs at expect MSP argue I longer recurring client even the base, predictable, the think could build builds of You perhaps think our a are other it revenue I we or from business of and direct MSP to pleased we expense XX% how more more revenue actually is mentioned we filling business, stronger, coming our now type I base more Locum's of really that of MSP.

So direct having the possible as rates lower think could at with we what of and at our progress than making there, orders. we're said, is lower and that possible but we third-party it we rates expense know good I perhaps be fill fill have

Tobey Sommer

question to you Okay. from of I'll Last the nursing about in me new your Could business… the in roll sort get queue. back talk and out plans systems

Susan Salka

be I to new actually a the operations majority not how the if nursing performance I Officer. done his in them new resources bring has say how also we in to stability for out. as and and team, division. benefit will getting we of, probably embark problem, system rolling than with they're not terms implement but will in improving future. consider will, The business then Mark And the of on of phases you out foreseeable probably us sales you arms the yes, doing anything will for be make clear sure ever bring system a to methodology Information this get it I we for contemplate not and He a to different you third-party right anything the more year, quite you a focused vast like want able more his only summer before dipping getting system last of performance and Chief same it moving sure might, and will to be more thank We have be future. ready this our any the of we will are which in-house the technical onto contractors if Hagan And Locums. whenever improved rolling asked, around we and the the consider of very within the we these honestly of even resources out got on talent make get issues, we're but Locums I want we you our until we mentioned that the we've changes out to good platform. onto We we question, job but anything doing the -- really the also remainder in fix opposed as to we're job as great [ph]. inherited joining told our not for

Tobey Sommer

Thank you much. very

Ralph Henderson

Thanks, Tobey.

Operator

from go is line Suisse. Rice question next of A.J. Credit ahead. with Our Please the

Caleb Harris

for Folks. A.J. is Hi, This Caleb on Harris

Just the of to related the the system. larger like in topic enrollment it's on lower clients, it sounds

there to bleed know that some confined way it's as that could is into So, do well or quarters QX? future we

Susan Salka

to falls There more that falls into say, bit more it, from amount in to it's quarter or continues and little April particular pretty second second every had the and is whether off quarter, of every -- the a the going so much into client up volume this We've a year the quarter, history, sharply different in, spike it the year. a certain that as timeframe. first more happens volume

year-over-year So, year. this in much exceptionally saw this from the the honestly, there last be the likely severe which but high, year quite the will because their on quarter of be, gap much would quarter, first as first makes that we as for was first quarter quarter we just in more even would utilization basis reduction amount it second think of client, some not what

of be shortfall at second is, quarter, it be will will So, short suppose we some going I answer into expect would lesser the but yes, a the there amount amount.

Caleb Harris

game roll quarter, going can on like and throughout to Allied then talked and to about you made Locums progress the the contract that that -- sort of you've it. sense. XXXX, so talk out expansion this That makes the last And you plan areas Got and at point any was about far?

Dan White

this Sure. is Caleb, Dan.

tenen in case, you're think right… this talking about I not

Caleb Harris

That's right.

Dan White

And of implementation till you implementation if we're the where We of see we're rolling sort that currently their year, of under will a about June. the the May, kind in regions for hitting can there, way. really second-half going

And so we'll point, at point. that volume to up start probably the pick that at

Caleb Harris

Okay. general I those or don't that's continue relationships clients. the to you impacts specifically the and what of if one those know dynamics are If MCare deals any but recent sort in topic. even to involved and names lot that in with last been some expanding talk the new it of involved the your happen, have not, fine, LifePoint, big in I clients. And and then that that the in a one, like partner of know relationships and of clients There's broader industry in just a around consolidation things Obviously, want deals? you CHI, about have been when trying past, and are

Dan White

really take Dan again. that that there's speaking, is base customer reasons us. one. This Generally for have, consolidation Okay. benefits And I'll we that. given two actually the

that example. is footprint you those businesses a so gave first are The have often very good pretty combining that in CHI, we

challenges offer that, if good can importantly services. footprint sides or on a then to what them common interim than resources different on more MSP will. at solve to than different house, of solution resources just management total so with a look We you at have if they're those may more a use to depending MSP perspective have, leadership We tools we or their different throw can workforce goals they But struggling problems. spirit can the even both are, firm we and

Caleb Harris

Okay. Thanks.

Operator

Jefferies. from Please is Plagman the ahead. line Next of with question Jason go

Jason Plagman

the for questions. thanks So,

local both on QX kind you the has the words sales business First in of what and all base mentioned QX? you Can and other talent. in of new the hiring in that been one, at aggressive quantify or

Ralph Henderson

the we've hired have is Yes, of we headcount Jason. of and entered in as QX, the over kind business The XXX right, we Ralph. hired XX XX the the to then about coming This XX another months March. we into February likely runs last around XXX, producer in, few in kind and another people in

nearly in you quarters. of up get kind XXX people than So, -- less four

Jason Plagman

Okay.

should so pricing pressure new folks expect ramp? as we gross the year on throughout margin And the those that

Ralph Henderson

No, production, a production producer gross no, year margin It's four investment is what prior XXX,XXX times really to in the be of the second year new margin, probably them like a but that. SG&A. might an more is hoping that's and first that on we being about for for

people, that So why year-over-year but that's why hire to you though made even that's the longer to can't we're immediately going all improvement commit bit going also take we little there. investment those so it's to a

in really and we right, have, packages keeping margins at For are sure place, the making technology works appropriately other that each rates our well set for assignment.

Brian Scott

the compressed period back have that and people sales in of quarter as they Yes. margin those This themselves start year. extra is first a for of for guidance we really Brian, the Locum's one be bit we EBITDA said pay a to that in will of that's reflected will that time half

growth bit, that, feel absolutely in of getting we guide right our it's So that is of but on will the trajectory. to that know already critical back the we first reflected little the

Jason Plagman

business, on given XXXX? revenue just back your in is that, to follow-up million run achievable in the do of that rate plus is take get Yes. $XXX quarter, assignment long And likely or how it by XXXX know think more times you end of, that to Locum you prior will the long a

Brian Scott

new say wish is, as that before we I mean To longer production will well. could happen time that better right it hires, It'll I there from point, last quickly. XXXX. than still take those hiring, there's

play to how year going is So think climb to this hill we as as we about we've out, got here.

lot be, to years of likely narrow but to see to we the a before couple would to unless of had and there's years back we it to and you. our go get can to really in through as get that million, increases start is started pretty we've but of, significant $XXX significant a we're it there, that where contracts the more some able you getting to with we've path So, revenue to be there's it some in, demonstrate would for gap we a back if want progress number there the negative year, goal take we look had And ways chart a increase. bringing

Jason Plagman

makes question. the That Thanks Okay. for sense.

Operator

Mark with we'll go Baird. to Please Marcon R.W. ahead. go And

Mark Marcon

in questions, larger usage travelers change with of it of Good of of with just regards sort little client just if to terms function or Couple a the all there afternoon. Nurse you senses? was bit talk their purely one to different can behavior more a at about regards of Travel any is their

Ralph Henderson

Ralph. There users one. strategic contingent handle of I'll is labor. are This very that

And in so, no that behavior. there's really change

I just think little utilization. them bit season and combined and sense lower flu of a a the decreased lighter of

Mark Marcon

And they recruiting that any been their has everything utilization occurred? you sort assuming goes for to was it up, that would there are strategy back census of is the giving their change where Okay. terms nurses in signals that of go or full-time

Ralph Henderson

to Yes, of labor. is that's strategic them desirable are a question. contingent workforce percent certain user for they be a good follow-up a their Because

fluctuations their no change them there. for just and adjust, do strategy like So help so, in to this one really there's

that usage. have. harder something working impact a are labor that staff continual healthcare on But hiring material and All not would of they have retaining our the their on systems that's

Mark Marcon

the In completely just you Okay, stabilizing? coming in great. you back you gave And away are quarter, the we then confident for guidance far I'm of like least terms feel on us from having the going but resolved? words, trends wondering at do how just are systems other year-over-year Locums, issues how

Ralph Henderson

is that This will Yes. well. I one as Ralph. handle

doing weeks new releases software about now. of two We are every the

incremental XXth I each think or a something bit release improvement we with we're And of our release. little that. like get like on

So aren't hardwired, can more in workarounds could systems these had things you into always old actually of configurable, over built of putting point it the any our technology change is place it's all a you to with them, they're it's hardwired. the so Whereas around work time be technology. manual

are new we actually some So levels stabilization, have while we so the that prior our adjustments of that the to gives tenured it are the as of to recruiters making we'll and getting we're were getting experience us producing But a are level system implementation candidates constantly they system people sense that that. for that make to that who producers think for well. our a better I past

a is three about continuous question systems, in it item maybe a there So basis at parity not maybe on see, we're it aggregate. guess will think but probably at I versus do be to evolution, parity the I more -- look disparate -- we're going but line

more just so that productive just that then make users the And And that to in system. the we'll it's to about make those system. getting continue used we'll that them now them becomes more it enhancements

Mark Marcon

typical Okay, already would up to of great. filling on you regards your you doing much And anticipate then congratulations how their that, value? with that Tenet, end total percentage would with are that you them and contracted

Dan White

So take one. that Mark, I'll this is Dan.

Tenet serve a regions we that a through today as there for these third-party rates small. So and our fill are result of relatively

any And $X running a is at this that's now. see MSP fill incredibly rate that we business sort right are So don't the knowledgeable total I client program particular normal happens business, good and million for so have what going there would this to very couldn't get be good least we MSPs to rates believe in particular also others. as well consider today. would are or quite our something maybe this a of like legacy reason user, as client. that why going at into of that It that fill be we implementations

our have being that international technology in another much differently outcome few circumstance. mentioned you than know, this some that to of business. we are the help driven on extremely I'll things so just here, AMN all are in us quite We're which of benefit remarks, services add running and Susan perhaps nursing other control is opening The those a her exact through profitable,

Brian Scott

All points. good

On percent total the so we is handle of a there's today, upside business of their lot of between to there. the XX% XX% spend today

Mark Marcon

do And utilization? two up you take think kind like it to to will ramp Great. of years full

Brian Scott

XX-ish an MSP you'll next roll kind so of see the over sometime kind period year. month utilization definitely full typical is A of out

Mark Marcon

Okay. Great. Thanks.

Operator

with go Our ahead. Stephens line Jacob Inc. of next from question is Johnson the Please

Jacob Johnson

Maybe like in been other pieces are But How taking organic and quarter for it's sounds it leadership outlook it management if can X% the the fourth X%. search growing VMS the question. sounds to Workforce we like you can deals takes sounds segment for nicely. segment? drag, but like improving, slowed the growth should through growing was well, the Revenue like talk in was is there? thanks think cycle a walk we just you puts year my about the last as about Hey, other Solutions if lap It the April. and

Susan Salka

Sure.

I We in have leadership, It searches. interim the So trends the underlying relatively online. the new do we'll close going you're right. of in on as to do be with we we're organic And able Tenens, just look quarter MSPs if an more good adding the bringing clients. business as that fourth well was flat quarter. as first other already some at actually to new we really in that in believe of to They basis terms be and but work mentioned, some new we're

single softer reasonable feeling we're into about So the larger think small even the very fourth in something the -- is had enterprise than to and large up that. facility less really probably first Physician mid-single quarter in with the searches. range also a though than flip winning well the business really they've side in growth on bit X% starting the very clients that. volume been the nice coming a good getting a demand in was it practices. digit place about year we're But as quarter, that to it term doing seen behind They've of about

lap was regardless. still business if mid-single bit reasonable And clients, probably So the and a client, a did largest coders a and who in Peak created of XXXX by little same new most then the driven division business but sort search something signed again more for fantastic to time, a bring there, place of client. of But they're which one headwind just growth, finished of and in will mid be that acquisitions. cycle bit the actually created new MedPartners the low And in all last quarter sort but a decided of we they adding that's had to acquisition organic year in-house once of mid-revenue businesses businesses our at perm with total our their of they of our single-digit there growth looking many Physician so fact have these and we're their sort full had growing. add digits the of businesses, headwind business. there up first search perm our it's the then for But outsourcing strong, across year. is that of sort of you a deal that a really at

case all is team solid good So, we that part demand, across about seeing the feel mid revenue coding, MedPartners documentation improvement. really which there. really we're cycle, categories, of really management,

really We some more top you would might see with we're that absence which there. to helpful? revenue out main good. organize is have factors we're the from the market mid cycle, are a grow, we that integration, sure that disruption the up feeling but so working opportunity make showing probably the message you the we're to had a little but pain of guess on that, brands plenty expect, variety I and recall to moment, we of the getting due of two in dealing that markets our synergies Does opportunity the leadership layered had we at and and from of bit

Jacob Johnson

change EBITDA does you. push or it it just then run at goal at rates the the a on Yes, And very Thank little disruption margin out bit or maybe margins, so. all? all not of much XX% does Locums

Brian Scott

is our timing, have. said already This long-term Locums, no with To There's the with your businesses there we're of change going No, that, the way and point with to is to drag is will the equally get that Brian. and out that the pushed but in not towards strategy achieving the be answer a we no. view long-term the changed. way we're that has we've coming

Jacob Johnson

Got me. longer you'd you have I to term it. Susan, with Kaiser, like what's think to, this? And then Institute workforce a last of one know, if goal from the new

Susan Salka

but in Yes. the mentioning Kaiser to quite Organization this to innovative Thank that in are alignment new with create innovation really so institute. at they our themselves, Kaiser to that. being just is for to have your and you help helping and And progressive innovation large going community an honestly themselves not commitment benefit, solutions

looking training that some for but the at workforce future that more And collaborating we're things to to workforce. as going right to now we're the so, also specific the innovation in clinicians be help could also healthcare ideas efficiency ensure on but continues change create then

we made our working a will next commitment So, over them. them we've that years five contract alongside to be the with

but innovative industry. and a focused overtime too be develop shortage with put of on the example new So are categories where not the upskilling can things. them. the They to game ones how innovative some with by of we They way overall really the the of on other going only great most in will this. we're just excited things training some some clients will initially, to of both really skin there they're interesting benefit are We're and that and particular areas working but evolve it's severe really nurses in that some will appreciative and work

Jacob Johnson

questions. Great. Thanks for the taking

Susan Salka

Thank you.

Operator

with we'll Please Markets. Capital Silber go BMO And go next to Jeff ahead.

Jeff Silber

for you're to go some or the going your internal the Unfortunately, up want second. to there to hiring. business else the competition I much. Has help. guess the really internal of underperforming really Hopefully, changed? Is be hiring will your ramping that for something I a solve think you be has that some of the do to back able ramping going segment issues? some so you been market just local Thank realize up I time. on

Ralph Henderson

a is marketplace. Yes. competitive a I mean it's it super --

of slightest. the very it's still to down other it's they MSP, is small So now, in our but slowed business percent. XX% just small percentage A a relative

else Recruiters competition felt. slowed down on order all, So is get of it. a somebody lot each then at

nature and why business the to levels speed people up system up. get this the in we of just the that's problem the So our to on staffing need

the decreases significant virtual shift Well change hospitals decreases is think management demand their doctors I'll created back to over so -- physician the demand XX% little Some are, a other give hospital bit have XX% A the sort you down are as One also in of hospitals. year-over-year. growth. The a of slower down don't. been industry. want medicine. volumes cost to specialties movement care And take less care to urgent that They demand there's is I in those. primary for year-over-year, of little close couple companies, a

So those they ones, not changes. changes. just the competitive big They're market are are actually

Jeff Silber

issues Do think space well? the other in the least that at you you are the latter mentioned companies as that facing

Ralph Henderson

to they And I Yes, if they're of if service they year. are they're There their see not. specialties talked are like us and feeling trends. that And some specialties. doesn't would yes pretty this all similar course one do they're in about hospitals. But good that those any week

the -- we're candidate we're Now we on how a would going getting order they would of and there. so factor. lot they about right not have destruction now therefore probably the on been spending are get they're that time this to And a faster call job talking

Jeff Silber

what this or be flu quantify is sometimes for quantify to did company and difficult will this what quantify, know benefit I headwind year? And you year think was it. you you Got the but last the can your

Brian Scott

Sure.

million it somewhere brands. a travel the along $XX we year and additional extensions, rapid response probably think across volume in was with our nurse, really demand some range, we couple For quarter first that some the of of last across

an really a just talk we seasonal a it's a was last flu. much, utilization it, if with -- such normal anomaly, incremental too significant amount we see definitely lot don't we year decline an about don't So, a really of or

part comp headwind anyway. necessarily weaken us think it helped talked of this face, even don't that about, year certainly would so it's whether - in So -- it hasn't was knew I and we've the we demand, but being that weaker we that

Jeff Silber

fourth was missed the Got if any in forgive quarter revenue I disruption this, any are in me there the And expecting quarter? -- it. you first labor

Brian Scott

before the year the small well. fourth as similar A and amount in quarter pretty to

Jeff Silber

so Thanks much. Great. Okay.

Operator

to with next Ramgopal go Mitra go Please we'll Sidoti & And ahead. Company.

Mitra Ramgopal

Yes. for questions. MSP wanted might Or Hi. include the the have only for -- earlier? to what if it's And Allied also up you business, is on does it taking the afternoon. and just Locums Good follow I thanks done to Kaiser arrangement nursing? similar tenen with

Susan Salka

and agreement and it tenen nursing, interim which international of as the local forms nursing and Allied includes would The be travel all then peredium nursing well includes leadership. nursing,

Mitra Ramgopal

And full with arrangements? increasing other more are clients service relates as to conversations Great. the MSP you having Okay. it

Brian Scott

say you little maybe a QX you more that, I'll interesting bit it's our color on give and pipeline. QX So,

think at mentioned million $XX making So, release the little I $XXX quarter mean we year. in for we over spend, QX press about I about in in me, that million revenue. finished it their gross the excuse

million and and $XXX of were that that our that new break MSP competitive at customers expansion never is brand had then look you about the into before, down If wins rest it million about by $XX million $XXX $XX million existing base. of was

already, of the addresses it in opportunity that and turn We I'll hopefully as the seeing pipeline there others. couple signed and mention, at a QX thrilled to so new And well. time did new I'm we're same that out be competitive. they're we've that our brand still continuing

signed well. in that $XXX for really of the have spend quarter a gross set we've now and I'm deals contracting robust So, over as million we right already

been that very has that, the back signed moving question places spend of that feel the come a is that that So and do about clearly terrific is, well. we we'll strongly revenue quarter a already about about room to have our grow to as growth into third we Xspecific advantage

compete. strong feel I to really So ability about our

Mitra Ramgopal

the Workforce quick a then And Solutions side. great. that's and Okay, question on

Given to do right how for got I down terms an wondering system the of you the is Locum you implement have something ERP now, workforce. different you road if have that to in would for was just businesses there.

Ralph Henderson

No, as some have on again, there No, business lines we systems. Mitra, and cases in we -- said, different no. this different

for MedPartners been be partner So system one, well. systems. that's for proven really years, example will on They on we've are a to different combining Peak on the but works system and net working the

It's has is one built been well not common Locums moved a that's onto as list. business for doing we and on it had platform, it's that for same the business be very interim about XX done feel to. They'll So We really well. small already the we'll there. be interim migration. for and that it days but at one migrating so the string least first The

So, business that the can the line get make sure onto in system, right we we system single to to in business line. are ways other looking one every data. for want right is not client We capture

So on there's no going major in that list segment.

Mitra Ramgopal

again the for question. Thanks Great. taking

Operator

Company. have ahead. we our next And with go question Sutherland The from Bill Please Benchmark

Bill Sutherland

seems a the elements back we It group. Thanks. a growth I of bit here. a really one it just left almost just of can view other more to most just you and Solutions Thanks. little of little potential or over could have important if and year back just, a characterize forth with like think and for longer bit Workforce each In two about there's been maybe two timeframe. that little pace Susan one step a

Susan Salka

conservative Sure. think more think be. be not our expect the hope place the When some those that but for usually rates and in X% in XXXX are growth at I Sure. are to, into growth for anyone range historically of about to sort And businesses, is in reasonable the for of a placement perm who more range of digit sort of volatile more us just referred to mid-single business so we we're would is have just probably something XXXX. the that markets, you where and end been the

But XX% the still more Interim be we range, market usually think and we're a really more X% businesses where go-to-market trying bit and momentum still you continue leadership is, organized create XX% generally you've the but of margin. I very, a XX% more strategy, better, we're would that that to to we we've get very them team optimistic. up our pull depends a because different more trying is, is of categories, cohesive in just to different help those are all great be lot been have more running a on there, will in also and top we're there. we X% but a economy than, That's bit should focused line right course, I are good on leadership now across to to kind really always have say to growth. a flat do Now good more leverage areas as a considering shortages together and there noticed EBITDA teams where going

cases sure. margins other staffing so, high management single-digits again they necessarily Again think there. be very still teens businesses growing traditional can not higher but for our high think industry, in And is XX% the it's but I then to reasonable emerging something similarly XX%, some of And much then faster mid cycle, I an we categories. revenue case should some and very

growth I think of single-digits. near but slower something coating case the in more upper looking the higher in single-digits areas low are particular other is probably at probably because management growing

So the with we hopefully you along to probably businesses and is they together. to our are sort has that's tend businesses growing of helpful our staffing to VMS, that kind growing. and Allied ride piece think of similar and House for Staffing market Nursing businesses MSP how

staffing the that's probably mid market grows. a growth at single-digit you're were looking and So if upper there

Bill Sutherland

on curious just a And that you. Thank that helpful. Tenen, was That's takeaway business?

Susan Salka

See that we to provider are and we're capabilities with fact of wanted they that of some regions due provider they that available. and the -- working the to decided with many the of another still a change in service part just have make other

Bill Sutherland

strengths your markets. it You the think have sectors think that probably placed of you opportunity for you other in certainly those tenen? Do

Susan Salka

in confident expectation to in we we just those taken the market that Well, on our and exceed is the first feel focus very markets.

prudent to get and things able you we being track a ramped up record of As have say, these deliver very quickly.

there opportunity expand we add believe and new yes, of existing have be to So we clients. on want But first. successful our course, to we always clients

Bill Sutherland

so Thanks Understood. much.

Susan Salka

Thank you.

Operator

with And we'll to SunTrust. Sommer Instructions] [Operator go Tobey

Your line open. is

Tobey Sommer

neutral ask seeing business your maybe you in frequently? the Is lines provide the those business, you one weigh kind and of question can a well are for market. of model your more If between of could coming tendency you what trends new both services to to where there well as either MSCP existing things you. Thank the I categories of front vendor a sort across as on as

Dan White

combine those I'll me little bit a are to The answer is to is to a important is choice more system, has and it recruitment the predictable more it ability because honest, especially discussion tends it program religious you this trends capability a very in-house that probably to When MSP candidly well kind understand you the manage more that's on going the specifically they're wants be going but larger a of neutral is we take combination our be. to and what in a the component with those is So that makes lot the two do be for likely vendor The strong outcome so large compelling between Dan, that skin it to one. that have a extremely how of that. the to game. that that that system the certainly to we things of a very to

see the And they get, and consolidation so is our things more question typically bigger it after we that, in warehouse. like the

Tobey Sommer

Thanks. Right.

sense have for Just do a year. quick tax this you Brian, for the numerical question rate a

Brian Scott

the likely the in to will rate mentioned and I be hold quarter that that would first for rate it XX%, year. the

Tobey Sommer

you rate anticipate or good that Okay. variation at time. long-term moving that are a expecting Is this you could a forward

Brian Scott

rate. I would as use long-term that the

Tobey Sommer

Tenent that kind on would business focused few Susan, into it or for be staffing when focus, not think we that acquisition. the you anticipate quarter what improving just might quarters is a a so this we and workforce Locum also And be be had news your last function Okay. here your next Should over of at business, and operations me. singularly but internal question small might solutions at [indiscernible]? other then point this focus consummated top the M&A the

Susan Salka

lot. is and it upon. going to few looking do clients, you very staffing in, in right even help would might house to would now a obviously at between interest we they're we're have why tell, innovative which good because I small. on got think, new we've not When with own lot as our very an and I that but say be we get clear yes, to And always we strategic about that can be acquisition, want Silversheet, on a with looking order we've far be area while would it's is build Locums a an other have relatively made still solutions, additional Allied. think our growth we Allied it's area an platform for strong to workforce you solutions and

a market. opportunities, team overseeing a it's of the We very fragmented leader have still strong more honestly and business that who part very and lot quite there's

small and we're still the of Allied number in yet piece our We one overall a puzzle. are relatively

know you so list that's category staffing. within would And I one, at the could just one top probably if my I choose the of if be

Tobey Sommer

very Thank much. Prefect. you

Susan Salka

Tobey. Thanks,

Operator

Marcon last question will Mark Please ahead. our And be R.W. with go from Baird.

Mark Marcon

should detail couple just and think questions, basis? A corporate on those quick of the go about -- how we the a forward expenses, unallocated

Brian Scott

revenue right X.X% of announced… It's around Hi.

Mark Marcon

Okay.

Brian Scott

Yes.

Mark Marcon

we would from And the OWS, how of then come anniversary in just should terms went through details, consolidated but just you out? that we acquisitions Great. the as growth consolidated - the how organic rate Susan basis on a

Brian Scott

Our Workforce Solutions?

Mark Marcon

Yes.

Brian Scott

year? through -- think the so about as Yes, you the

Mark Marcon

Right.

Brian Scott

Yes.

first acquisition quarter, digits. first in were things expat the our the traction and the the we And Susan mentioned, up still some there, of we the - flat and fourth back quarter with described, the move related in in the in back pretty to quarter, quarter. X% Susan half mid-single can get get the on we pretty in first as we flat that of as the in with year, So, we're the first if

track just to level. where we -- are up that just that I So, from

Mark Marcon

from and balance capital in the perspective Great. we a buybacks particular think you And should allocation and have flexibility with sheet? how that, then about that

Brian Scott

sheet look both share got continue will if still extra debt million I over but meantime of Yes. as and reduction, we talked balance evaluating from the at drawing about will we've plenty we still opportunities cash repurchases down are so the pay This use capacity we flow do we that, no balance cash acquisition got we've change, and to $XXX in is we to real have as of we that free generate Brian sheet There think revolver is to debt. again. a

be capacity authorization see on similar left you'll of the you've have probably our activity over I -- think, opportunistic. to repurchase and So, quarters. still last share, We room we'll continue that seen couple

Mark Marcon

Thanks. Great.

Susan Salka

Thanks, Mark.

Operator

it turn comments. I'll And speakers for any back closing to our

Susan Salka

certainly AMN. shot and for today Great. Thank to interest do Silversheet in one team. I your us last continued give everyone you joining out want to the

AMN level We created you what them. introduce we've excited everyone to have family them certainly is our you've help very also as excited next joining clients today work I to are already the and very, with and some and to of very of impressed with the capabilities to built to your you kind excited begun but take also are to know

you on our will updating be we you call. thank next our for on and So, AMN joining progress all earnings

Operator

ladies teleconference thank will Thank you this AT&T We gentlemen, for you. using And teleconferencing. for the today. conclude and

You may now disconnect.

AMN Healthcare Services (AMN) 14 Feb 192018 Q4 Earnings call transcript