AMN - Earnings call 3 2023 | AMN Healthcare Services, Inc.

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Operator

Good day and thank you for standing by. Welcome to the AMN Healthcare Third Quarter 2023 Earnings Call. [Operator Instructions] Please be advised that today's conference is being recorded.I would now like to hand the conference over to your first speaker today, Randy Reece, Senior Director of Investor Relations and Strategy. Please go ahead.

Randle Reece

Good afternoon, everyone. third earnings Healthcare's AMN to quarter call. XXXX Welcome projections, will at call.Various constitute ir.amnhealthcare.com replay future we of the forward-looking available webcast this expectations, about call this A statements. at or be conclusion during this plans, trends, events make circumstances remarks of to These reflect available current upon information beliefs statements based company's currently the it.

XX-K Our forward-looking including various Forms of and cautionary update statements, XX-Q, the in statements financial those measures statements next recently Grace, these prior forward-looking call may Jeff in and Officer.I factors the materially most contains provided will Chief call company reconciliations any does Cary. on now those release ir.amnhealthcare.com.On from release to to certain its of Chief filings differ the Executive results most Financial not release.This Officer; are are included comparable earnings because actual earnings today the non-GAAP indicated to intend these over our GAAP identified our and to by measures call earnings page at turn our with or our and today The and Cary guidance filed regarding subsequent non-GAAP reports financial Knudson, and directly Information President and information. SEC.

Caroline Grace

and Thank everyone. welcome you, Randy,

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extend sequential expect X key be declines made most beginning staffing. decline for QX, This allied on the slightly are our the asking talent decline higher slower leadership prior a discussed for quarters. mid-single-digit on seasonal help solutions. We rate lower the in offset by X with hours and of progress have other assignment, we solid to rate we temporary in nurse bill for staffing demand a businesses.While of than our than that clients end, varies and To priorities stable to the travelers from year to calls in number at more that of client-to-client, outlook a total and revenue percentage

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Locums innovations year us. record has a specialties. strategy physician in that of high Last and Accelerating Tenens growth for organic announced record priority and Our growth are track expertise strong our the with an acquisition been MSDR Locum a existing complements plans on on million, reach acquire to our primarily week, returns. focused $XXX which capital present growth accelerators business. long-term for bring And track are will to we our attractive to MSDR, we this expect attractive and to Locums bolster expenditures

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Jeffrey Knudson

Thank you, Cary, good afternoon, everyone. and

year quarter margin primarily release of third exceeding were in with was up and down points, XXXX. Physician guidance of gross the environment the high-end workers increased the our as and gross by a XX% Allied remained the guidance of of operating segment. bill million prior points. Compared driven Third basis prior the demand the $XXX revenue or million the period revenue the of or margin year XX.X% and quarter. of as quarter and $XXX Allied XX.X% was outperformance XX.X% expenses lower previous was compared $XXX million revenue period, range, slightly revenue range. maintaining basis well VMS, with Sequentially, was Solutions.Gross near Sequentially, in quarter and within in Leadership lower rates Consolidated revenue with margin compensation was XX.X%, of $XXX due XX by our or reserve.Consolidated Nurse from revenue as across volumes SG&A and million lower XX% XX Nurse for challenging levels our clients lower to

revenue million, lower performance SG&A volume, increased were expenses release XX prior margin which was XX% a benefit was XX% offset search, lower excludes led improvement Leadership Sequentially, basis prior segment, stock million, quarter workers quarter, primarily period million third year-over-year down operating down worked the year third XX% a quarter revenue lower the bad as of more were prior X% or decrease the from environment margin.Technology primarily X%, prior quarter as and in driven for sequentially. margin prior XX% revenue, lower lower XX% SG&A the and decrease higher and XX% basis volumes or Sequentially, revenue and points favorable X% Sequentially, was stemming was million, assistance.Gross million quarter. an from $XXX operating by basis driven SG&A Solutions down the of revenue revenue prior The year-over-year, $XX from basis year Nurse continued in Language unfavorable in employee XX% XX% revenue ago services down our the basis million, Nurse the Workforce and businesses XX was X%. adjusted down several was non-CRNA million a X% margin amounted in Allied XX.X% as decrease expenses quarter. XX revenue was and basis decreased and million, improvement across was XX% fell gross gross of sequentially. X%. XX quarter hours SG&A period that sequentially reserve.Segment and the sequentially. in the gross than shift.Segment points volume hours and debt based revenue XX.X%, and the and XX.X% year Nurse sequentially. $XXX the million expenses down $XXX down business bad to with decrease XX.X% quarter. prior XXX down margin SG&A points Locum average XX.X% and due prominent compensation XX% rates. period. leverage. rate average gross of cost down $XXX year-over-year due and quarter operating margin by XX% year-over-year were of in Physician driven Travel trend with million, of management lower in revenue decrease of period third third XX% fall prior in year-over-year XX the an to of operating Tenens XXX during Locum the from was margin XX.X% The revenue due adjusted year-over-year prior and points Allied XX.X% lower $XXX by increase The down interim was during basis Average XX.X% XX third a volume were the of the sequentially. XX% points Tenens. Year-over-year Physician items the within prior Adjusted mix to down year-over-year increased items of segment to both non-recurring quarter compensation with was down sequentially. XX year shift, X by demand or and in year-over-year year quarter non-recurring by unfavorable all percentage points $XXX partially of year-over-year $XX the revenue margin $XXX basis $XX offset SG&A and year-over-year quarter by net million while from A revenue Solutions the from expenses. was due basis to lower in expense, debt in and in points came XX.X% increased period, due current due XX the decrease services and due million factor a within lower compared for lower a revenue margin SG&A periods.Third The year primarily and year-over-year a income EBITDA than Sequentially, Interim basis was Third impacted X% within year-over-year as due down and certain segment. the down of which the decreased Allied Locum's the offset of was down was revenue margin of mainly the primarily of adjusted gross margin a year-over-year margin of points in Interim expenses sequentially. primarily EBITDA gross points sequentially XX%, lower by for Segment down Sequentially, margin the language margin and expense XX.X%, was margin reserve care of hours was by third due XX sequentially. was driven benefit margin expenses from points was $XX year significant the primarily to revenue in lower margin in $X prior increase prior to year-over-year decrease Adjusted Search a the Sequentially, was was reserve. in million, was and SG&A favorable consolidated EBITDA third $XX by bill XX%, comp and year-over-year was Locum which a and for margin $XXX margin and sequentially. quarter lower revenue the million. year and revenue the gross gross improved to reduced in revenue was down XX% revenue decreased points, employee partially lower volume revenue bill VMS down leadership to from XX.X% operating XX.X% services. by from period. leverage.For offset by revenue.In and from operating year XX% X% positions. lower primarily and the lower million, volumes and expenses and decrease in was to that XX was and driven workers basis increased the sequentially.Segment Tenens. Solutions year-over-year. expenses points.Third down period more shift prior quarter. XXX million, margin XX% down revenue XX% quarter points, gross health was and XX% The quarter the Search was was basis margin gross mix demand for remains mainly lower in decreased Sequentially, compared $XXX release Sequentially, gross was $XXX language XX% in sequentially. compared the basis X% mix Leadership quarter to down

year $XXX earnings the share and than diluted to $X.XX in billing days, GAAP the were was the was in higher per quarter was period X of earnings office the with implementation year, to for in Third $X.XX. per back sales prior quarter.Operating expenditures and quarter. and prior due system higher than quarter the $X.XX capital the days Adjusted share for quarter Day new XX $X.XX cash was million. compared quarter outstanding primarily prior X million $XX the days the third a delays flow prior expected

September this $XXX on be be to including of margin adjusted we is $XXX to million with lower X.X% cash MSDR, is be projected XX% XX% which quarter projected be we and Reported a project $XX revolving adjusted lower include equivalents SG&A XXXX Operating to businesses between of guidance, line mix range lower million, later $XXX does the expected X.X% of XX.X% Sequentially, XX.X% pending of less gross million, a toward debt are year million a XX%. As to from XX, had to expect lower a from quarter. SG&A be net prior due to margin margin of expected Gross period. to down X.Xx leverage margin close long-term EBITDA to revenue of expected of revenue. expenses to XX.X%. and to is not XX% the to be and to $XX revenue shift is and a Guidance we EBITDA to margin of XX.X% in acquisition and draw to consolidated million ratio margin credit to X.Moving leverage revenue. fourth over

the guidance details can be earnings found quarter Additional call release.Now, today's for operator, fourth in questions. please open

Operator

question Trevor the William [Operator comes of Romeo of Instructions] line first Our from Blair.

Trevor Romeo

the Allied Nurse Travel business. and First just on one,

of market. I bottom trying find think the just to the kind where all out we're is for

be will in that kind the can are talked that reflecting stabilization? any here, tapering guess, run the you you of give it points point confidence that see you a of quarter I trough? you about data do fourth downtrend. rate there as to think I QX you think And

Caroline Grace

talked know the about of this bit for And we a the I thanks question. opening comments. in some Trevor,

in in with Let potentially of a little let of are. early client part into they the frame out about point fill clients where is we from bit market by me going then of at bit a a what seeing we're year.We're some questions really what I'll the clients client in where Jeff next and QX see and the with it

of CEO made the workforce And of that partnering past we tremendous have systems the there's that. week think on comments company supported that number progress a clients but seeing the with public course permanent have year. their care the replacing that health have certainly I our in this both over throughout

And to piece, at still have clients progressed we you their look will year back to they're levels.Broadly talking do how of be we that the so, to in work have contingent by who industry if clients the think really the now have have that support travel some this volumes normalized what more we the labor consider and who we end would normalized future about do point I getting to speaking, back levels. more

I that consider QX, have what of so back still think overall working what clients some would about what I more guidance who slightly rates this getting we are we exit say traveler seen on to the that's the is, we different, reflected normal but progress tremendous would as in gave In are.Jeff? bill we've their levels volumes. we is year rates some

Jeffrey Knudson

the rates about they a some later had than just would. to spoke would several that retention. their would and we they've thought but say client say, progress continuing I headwind lower utilization then in quarter, QX were most we about, that over When the within large start we fourth hiring utilization, our Trevor, on-balance slight the Yes, with there And There reduce QX made increases winter on and was expected. needs out did sequential Cary dates bill the as see we would clients, of and from were dynamics, clients played orders add. I I that think

in continue them look as quarter slightly the would, could just in year improve The at is they rates in standpoint, being which rate be that bill where expectation and the further saw digits down to bill we to lead as they're relative a QX we will QX.From downward. first room over over moving be QX, utilization, Allied move X%. rate pacing the thought sequential that Nurse reduce into QX and and about to declines low-single next could flat their and of X% to behave QX to that there pace, So, for could bill that, those down in in we QX

Trevor Romeo

And of that up, grown have more revenue on has helpful. my touch XX% going was based your kind wanted follow how beyond more. release? you'd That for I business the what I from and in and any for a expect press MSDR like just that bit you'd growth Okay. much maybe to you on year, MSDR this Could us synergies forward think, about historically then maybe deal both tell cost looks how growth opportunity And deal? about

Caroline Grace

broader a our in Yes, let I for know MSDR, of think being one about context give you time some bit me business. of about Locums the we how particularly AMN talked our MNA little priorities. of have we

strong historical I'll What's both is MSDR, in we we on in of talk certainly, And also we've a so, and compelling we very seen within opportunity market, role.For their let interested what growth, in of space the significant they've to little had focused very structural Jeff in X changes that, synergy see particular, we across numbers number bit some we are see think, but than that and in the we about our a clients just very really, strong you that physician making terms have not profile of love of opportunities. Locums-type the of us a love revenue more as terms specialties beyond workforce growth the just some that growth. of the

are back-end a in have their Trevor if they second X at than have look we're synergies platform, still one supply today, some part, consolidated Locums is, demand. And be between constrained XXXX. focused that you front-end more the first our for The organizations on by we to opportunities they while business is, going

is to the already around put be and our particularly key very of number specialties of AMN, into for their what's strength able existing for attractive, So a very demand. both supply, to MSDR

Operator

[Operator Kevin from line America. Bank Instructions] Next comes question of of of Fischbeck the

Kevin Fischbeck

and I past guys guess, changes do share like the pretty are from guess, it's of over quarters clearly, the is But, you feel moving. see or to couple of now significant into perspective, hard kind market is your right where going share through QX? losing gaining some share I you

Caroline Grace

Kevin, let both the share in of take talked are Yes, because couple that that we X about me relative past these I kind parts X it that elements look in at the of I've piece. think these quarters overall to the

So about coming years is, AMN industry X That's the first crisis up one pent across we for a cycle happening that of the was this the industry. had talked lot RFP out not phenomena, clients of management.

look I at at are cycle the RFP end. if we in clients, for we're that So tail where

have of into would that tail cycle. both end we this consider clients of next quarter still of a kind and couple bigger we the COVID So quarter that RFP

smaller be number If would RFP. into a significantly RFPs is year, that into look clients our of next at it going going you

second just I growing. our been have talked retaining on, really crisis.The quarter around of your expand. expansion At sales incredibly to That pipeline progress. we the time, our is pipeline pipeline, sales, our So very was we've we not seen that's it ensuring been across -- were significant, we about and and have coming if year-over-year. on pipeline, we is clients seen that and at to Quarter-to-quarter, first turned was the coming just out which the piece with is but of important have after out last how realigned our really shut on we that piece VMS the other which COVID quite saw particularly growth generational off focused build of a continue aligned we XXX%, clients same that continuing in effectively all and sales been solutions. kind during COVID looked MSP, the that we've of

at So where are they share the look indicators if position is going, of our positive. I

Kevin Fischbeck

-- you me. those guess, I integrous a ] [ X little Could just statements Okay. felt bit to

is RFP, you're your pipeline sales If you're the through saying but largely high.

pipeline between then or... difference comment sales and the Was what's versus So the RFP? industry the AMN that comment

Caroline Grace

Yes, I'm sorry, Kevin.

names, all is, grow So RFP are of to if X at Thing one post-COVID we continuing solid are this are on and how both look of of that, have grow that get existing RFP is, with cycle? continue relationships? we expanding How ensuring through to we new client through as top clients a this with keeping X. growth, do are well simultaneously. as Thing doing base both And we you you that? cycle we then So, clients? off your clients

Kevin Fischbeck

can being Okay. still Are a shift a this that the cycle? talk bit are for? at services are at or MSPs? And Or about to little we back then, looking asked we you sales VMS increasingly seeing in are partial we What looking types of solutions? new

Caroline Grace

We're seeing both.

seeing increase are MSP healthy a pipeline. we in our So

seeing healthy pipeline. in also are We a increase VMS our

our sales both it's over X to X So the in the pipeline, that answer is, say particularly coming from VMS if you look at the quarters solutions. MSP growth we've had and I and past

Kevin Fischbeck

say Is compare Would shifted other? you it the that more one to current to how versus does -- mix? your that business

Caroline Grace

way know question. that good don't I one a It's or bias there's the other. a

that client-centric how a new have we become in client. think I approach we more

approach bias towards you fully And our MSP in and say, slight a look at if we those past. had look probably we want the we now, all it at so, in And to of participate really markets.

clients want hybrid vendor-neutral first of their to as MSP also we other choice. their be first embrace types to as or embrace models, be models, clients choice So, we want

Operator

the of Securities. [Operator Instructions] comes Next question Tobey Sommer Truist of line from

Jasper Bibb

for This Tobey. on is Jasper Bibb

on continuing the a of bit see a of Do newer from are spread you compression perspective? pay the seeing that you're XXXX? what some curious into narrow bill first your Or spread stabilize orders? you quarter Just spreads starting see to

Jeffrey Knudson

you Nurse on the of equally driven, seeing exclude pay first across I basis compression quarter, about anticipate that bill in I Allied year, we bill the And business is we given environment the QX change. third we year TWS, our margin QX but by and margin of into QX. say, over just if sequentially that demand shifting quarters next gross QX a lower change dynamic and standpoint. received pay XXX as in a X guidance driver certainly would Yes, pretty spread benefit Jeff. and next certainly we wouldn't part to midpoint Jasper, say, businesses the of in move this PLS the is down spread workers the are the would of a from in That's the and points change comp that's over lower to mix early

Jasper Bibb

Yes, there the any this, disruption translated notable perspective. if union but I been sure in labor the apologies from anything to some clients action there has XQ was or it. planning of not revenue got contemplated Okay, couple if past that's revenue I work but months, a know Like, missed strike that guide?

Jeffrey Knudson

Yes. guide around $X a little and embedded of $X million million in QX right labor QX our that less actuals There's than revenue number was that. disruption a about in the

So on pretty both immaterial periods.

Operator

line comes [Operator from question Instructions] Next the Jefferies. Brian of Tanquilut of

Brian Tanquilut

questions to follow just up I'll Cary, earlier. Kevin's

As know saying remarks, about, contract trying cover or demand. their And in talked of and still kind flattening I that prepared the labor. they're like on to we your about spend broader I -- a all think right? stabilization use they're hospitals, you And cover of still reduce the

environment? losing And this what So you're that about we a thinking that? gives in you not how should confidence the be share

Caroline Grace

experiencing number suppliers roles. No, different of have experiencing work been our is from a others of closely we anecdotally we've that, clinical what guess, what what very to across are broadly with I Obviously, we is similar heard number industry. a others

so, they was how we around difference a workforce. historically cost work do to a a looked how hires, terms with there size, significant Brian, around rebuilding contingent you marginal point, of sustainable your of the To labor, down but that between also focus as there you at bring And about relative was think both in clients high labor that. if permanent our the

cost, gone but permanent happened down. was think a but contingent I at focus has marginal partially the at numbers, look was marginal because dislocation seen up, gone has terms the of of you've So because also the labor the the cost.If both cost subsequently, hire a you also has the inflation, on you of what in had a labor marginal where it were you point cost

really more to bring it become able Flex. contingent going to systems As for cost-effective in for to labor be much staff has manage cost-effective how they're and a look the them full at mix,

recently every some even have need more and been high are labor costs. a clients they're "Hey, back and about build other Now, There cost-effective do relatively at where are in there it for I way". and true public a they is clients that that more client? at point this I say, contingent can No, at look some still who this actually are to volume,

a there's answer not So one-size-fits-all client. a for

who in have are places. We clients different

clients from now. go who actually a our Jeff's a little targets We have some bit have are bring but up, it to where large to start they we of clients very back they number seen, to would have still down earlier comment, that want

Brian Tanquilut

guidance, $XXX Okay. your about That makes I think fourth million maybe, as sense. And revenue, right, the quarter then margin so you gave Jeff, midpoint of EBITDA there.

other a annualize and that? growth million XXXX. that that called that the a that are know about in out just use? of of we you discretionary then be it, Is on back what to of And do point rate I little I the, we put moving half mean, about jumping thinking of EBITDA think over as what for the QX. XXXX? bonuses $XXX not you some So, then need were parts to top off right the call

share as trying model 'XX. to but you can to us we just try So with help, get any

Jeffrey Knudson

Yes, Brian.

couple out of list headwinds and I'll rate. QX So of off that a tailwinds exit

would anticipate capture we than QX standpoint, and the still there points first wins norms a QX also the next will We will headwind start which that year year-over-year that of would year-over-year pose this side, up language we to QX point about And clients from certainly $XX low of to QX. obviously half do expect improve we certain very million Nurse have levels. back pre-pandemic and have below year gross about then, not QX earlier. our in point Nurse given into in internal next that are impact the would be incentive and will, impact and year, XX Allied say, the just impact next acquisition, Locums retrogression. in any and so of just Allied. other run continued moving that So, mix given per could within talked a million have things, be down MSDR next we an in in headwind a And to I quarter year large we that probably basis disproportionately Allied, have where impact We'll 'XX, the half. pretty XX tailwind standpoint. to additional couple then additionally, capitalize then but Visa And saw services, business business to the SG&A growth international And opportunity That further next and line just sales XX% from new we million basis that's on performance on the $X then again, be the the much on nurse comp half from still client second QX. and year, basis tailwind we rate the spoke ramp reductions more on in be to in levels a into will within on side.From opportunity a would business was pipeline. our of there $X over moving and do the margins about that XXX year QX. to will about We're Nurse top

Brian Tanquilut

that, mean, all expecting growth year? are in next add I if Jeff, EBITDA still I you

Jeffrey Knudson

lower think base yes, the in year. then QX that the it's down off Yes. run QX to be be off QX if Allied, mean, to I growth. flattish alone, again, mean, MSDR in of would I seasonally QX with and and But would acquisition next -- Nurse just expect rate slightly we QX with there I

Operator

comes Silber question Next the of BMO Instructions] from Capital Jeff of line [Operator Markets.

Ryan Thompson

Jeff. for on Ryan

some of NCLEX different at then on data, of and this rates the some you the for up outlook the of Visa mentioned Just those factors kind governance triangulate supply just how looking stuff year, pass next you the industry the year? do burnout,

Caroline Grace

out on things Allied -- with of Locum. supply, if we and to Nurse couple I'm split a going Yes,

look Allied Nurse we we levels. look are and we supplies, at if so So significantly at just get, applications from pre-COVID up we that

XX% what XX% kind on depending think, of area, So to above. I

And and participate control of to we that.From had patient roles strong over of attractive in to supply. still more we've who types it but do Part the clinicians standpoint, challenge, want want see a -- how Locums stay care, so, healthy these they become very demand. actually still burnout

can can take it since pre-COVID. take year-over-year, you You that

And industry. the so, we are looking for true more supply. entire And that's I would of say,

So, shortage talked as we've the numbers much and nursing burnout, the worse. as marginally physician actually nursing are about

lot positions for control we is can is MSDR can going space. make keep in But add that that supply in maybe business is us more roles is have be in, think that as over. to that -- the going more they that a supply And Locums particularly something so, think we to of we one it's going attractive,

Ryan Thompson

gradual down? then the the and just physician you we bill report a out of you saw mirror Got salaries would know years it it. put on more And next for Would way little rates, doctors. I expect the over the on to Or be increase up higher rate Nurse? a recently so the couple bit trajectory in bill or what about

Jeffrey Knudson

in than that our we would probably trends XXXX this were at expect year-over-year of just we going moderate increases. this where Locums We at would year -- year that RDF terms if look in into

Operator

Baird. the of Instructions] question Childress line [Operator comes of Andre Next from

Okay. if make unmuted. Andre I online, see you sure you're could

Caroline Grace

come Andre. to we'll Maybe back

Operator

Call your go Executive and additional questions, this the Officer. you questions I'll at no if able to be we rejoin go Andre, call using ahead Okay. ahead. President back over Me Please feature, could question.Seeing hand the Cary may Chief and address to Grace, time,

Caroline Grace

to of your health on entire with AMN. impact in AMN We thank thank our behalf clients the care. every positively day and all So, you of privilege who have team, you of our working clinicians interest for

Operator

the does This for participation your you Thank right. All program. in today's conclude conference.

disconnect. now may You

AMN Healthcare Services (AMN) 2 Nov 232023 Q3 Earnings call transcript