AMN - Earnings call 4 2023 | AMN Healthcare Services, Inc.

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Operator

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

Randle Reece

everyone. afternoon, Good Healthcare's Call. AMN and Year Full Welcome Fourth Earnings XXXX to Quarter A available will the webcast replay this of be this conclusion call. at of at ir.amnhealthcare.com

trends, call Various These statements. available the based future during to we beliefs reflect or this current information remarks expectations, constitute make statements projections, upon plans, company's forward-looking it. events circumstances about currently

filed cautionary SEC. Our any prior to forms today filings our because of statements earnings by these actual forward-looking in our XX-Q, results next may and does guidance provided with its identified factors XX-K differ intend statements, and earnings materially most subsequent or those from update statements to recently The those indicated and not including various forward-looking release company the release.

financial these reconciliations non-GAAP page financial directly regarding call at our included most the our contains non-GAAP to GAAP release information. of measures comparable are reports ir.amnhealthcare.com. earnings in certain and Information on measures and This

today Cary call Executive the over On the and Financial Jeff to turn Knudson, Chief and Cary. Officer; are I now Chief call Officer. will Grace, President

Caroline Grace

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the Growth built In last advisory Chief and of On front Pat have provide on the our under we Business Officer, the we our McCall. acquired This years locum made deal we since year. services expand and a in part leadership scale investments major Meredith our to quarter, experience first Lapointe; diversification large Chief and tenens. to end, MSDR of XX acquisition of last Officer, was XXXX

us high million flow AMN a in XXXX, capital enabling million of to record invest operating cash expenditures. in $XXX generated $XXX

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Early we see a mixed in XXXX, in picture our market.

the expects of show Our business signs Allied search reaching a in bottom. Staffing of and revenue and quarter. Interim leadership stabilization first the sense sequential growth

seen in making that us our entirety wins we early changes market. the to direct continues third-party the market, new and competitive and are since have staffing and of Our progress include technology process XXXX. client both signs sales more staffing largest the In grow we across recent and the pipeline win have

We guidance strongest of Language assumes our is and of a Offsetting one with than run continue be market million. to its than acquisition $XXX more pipeline quarter growing to segment solid expect for rate levels. lower continues slightly revenue And locums strongest Nurse prospects. of organic services our locum businesses our positives, our Allied QX revenue with growth fourth these now in tenens. annualized recent MSDR, in

backdrop guidance year's demand disruption utilization. some revenue in marketplace increase is the is we usual. orders will cancellations typical The indicates First growing, fuel population than the happened X overall assumes earlier labor favorable quarter this and expect that ACA insured the quarter which and XX% needs enrollment in winter of labor

our growth progress. are are green our see accelerated We by market we the total and encouraged pleased shoots strategy with from

unfold will years, Our positive have increasingly our in multiple business we later to and initiatives expect impact XXXX on beyond. strategy over our an and

Jeff call to Now who results I'll latest and our review outlook. the financial will turn over

Jeffrey Knudson

was fourth the by The and the from in organic upper hours towards of the contribution business. $XXX the million, was November Fourth which everyone. expected million by our VMS and segment the X% volume good revenue afternoon, of was Organic included from and lower a mainly revenue quarter driven Cary, range. down $XX and was quarter down MSDR. XXXX. end and lower Allied you, rates, was decrease Consolidated bill sequential worked XX% Nurse revenue Sequentially, end was X%. Thank guidance acquisition of revenue revenue

points. was margin and Technology primarily in prior XXX revenue. down gross slightly shift basis points, XX.X%, guidance bill was due Workforce less and Allied decreased gross business quarter Gross VMS and revenue in due Solutions. lower primarily year and an margin spreads and Nurse margin period, unfavorable for Nurse lower the pay with Allied to basis the XXX margin our range, mix Sequentially, below to the Compared

debt of in expenses SG&A the volumes, costs lower expenses period which previous compared compared XX.X% decrease costs Consolidated $XXX the prior million and primarily and XX.X% or business compensation by with employee million integration quarter. XX.X% reserve. increased expenses. revenue of of other period the year-over-year or prior integration revenue SG&A, revenue of MSDR increase was and lower expense and million The of year revenue year to due in in SG&A with $XXX were million with revenue excludes Sequentially, expenses of revenue $XXX and the $XXX in and bad in in lower quarter SG&A stock-based SG&A in acquisition, Adjusted quarter. for XX.X% million $XXX previous or or other the million along was or XX.X% XX.X% fourth the to led acquisition, $XXX or driven

volume was million, quarter, Nurse our average million, was from in was revenue quarter revenue XX% was hours $XXX sequentially. decrease from year-over-year with decline Allied quarter and from segment worked an down by fourth the Sequentially, Year-over-year, and lower the X% worked. experienced bill X% QX volume ticked XX% Average the from in down down hours X% Nurse in Sequentially, both the improvement XX% million, line worked of rate and XX%, hours a down driven QX. rates, year and average $XXX revenue the Travel a ago. in was XX% expectations X%, prior year-over-year sequentially, lower. we period and was X% $XXX the bill sequential were and year down down Allied and fourth down and and X%. revenue quarter. In prior volume both X%

sequentially. points during which fourth basis was to margin gross the from year bill due The the points in margin Allied gross quarter decrease spread and primarily basis and period worked. hours lower and XX.X%, Nurse was XXX decreased pay prior XXX lower

recur, benefits lower gross gross had Third decreased due to margin not a decreased to and a unusually less quarter of year-over-year been Sequentially, margin that some which XX.X% workers' basis compensation release points. points included revenue XXX reserve. mainly Segment margin operating of basis high margin. due XXX operating did

Moving $XXX was addition to revenue offset interim million segment. were Locum million, from in year-over-year in organic tenens, was was including the by flat and quarter the decreases leadership by and and locum from of quarter revenue partially and revenue $XXX MSDR, Physician $XX X% in Sequentially, the Leadership growth Solutions Fourth of MSDR organic search. tenens as to search. interim million lower up due revenue offset MSDR. tenens locum

seasonality. increased lower revenue offset lower mainly in volume by due MSDR, was to organic volume an X% rates. than Slightly down bill business more increase organic revenue the was by X%, Sequentially, in driven Excluding year-over-year.

XX% revenue year-over-year, million down X% of quarter. demand. the and decreased and Interim primarily by $XX search of Interim from was prior X% down year-over-year the revenue sequentially. and lower driven leadership revenue $XX from XX% million prior year Search down were

the year-over-year tenens. and Gross in Leadership Solutions the quarter. locum to and basis XX.X% mainly specialty gross and margin generated line segment XXX the points The was the decline revenue change in for within was Physician down shift mix a third margin XX.X%, due mix in segment year-over-year with the

XX.X% which decreased towards basis margin locum points XX.X% basis of XX%, due Sequentially, to year shift XXXX Segment was mix with operating operating the the full unusually compared quarter high profit XXXX. decreased margin margin the tenens. revenue year-over-year points comparing against XXX XX for in an fourth of

in X% and driven Workforce XX.X% in down the and within million, gross a from for year-over-year sequentially. XX% $XXX and for services gross margin margin and language prior points, of and increased revenue mainly $XX to the XX.X%, was fourth $XX quarter revenue decrease Sequentially, XX% XXX services. was gross Segment revenue quarter sequentially. VMS basis attributable XX% segment. the year-over-year Solutions the year-over-year and million, a sequentially. mix revenue lower Technology year million down XX% of shift margin VMS fell X% revenue was period, lower primarily business by RPO Language

operating was XX.X% and Segment with XX.X% shifted XX.X% the business fourth quarter the as services. in compared margin prior in in prior quarter year the language the toward mix

adjusted decrease sequentially. points. for and XX% Year-over-year the primarily due $X.XX XX% points million, $XX.X was The GAAP down guidance in was EBITDA sequentially for basis period decrease was the midpoint basis the earnings was EBITDA prior gross at EBITDA down the in and year-over-year lower was quarter of the year-over-year Fourth XXX operating XX% quarter year-over-year quarter. the consolidated XX.X% diluted share margin quarter. million, less margin $XXX XXX income Fourth earnings quarter $X.XX quarter quarter XX% and margin was compared Fourth range. $X.XX Adjusted $X.XX share margin year of to was of adjusted EBITDA and in and a prior in was with Adjusted per per sequentially. leverage. the down net

the excluding XX, outstanding, X conversion. to year, sales a days higher system days than prior prior was delays quarter and XX to higher the back-office than billing Days primarily related MSDR, due

of return payments. the historical driven as fourth income million. for the and tax flow of through the of Capital were million, deferred expect to XXXX. use $XX expenditures collections, was for $XX $XX a DSO Operating by to we quarter million We quarter progress levels cash cash timing

and equivalents As of and including cash net leverage ratio billion, million, credit December we a draw of $X.X $XXX million X.Xx XX, $XX long-term our on of had line Xx. debt of a revolving to of

Recapping points. of XX%. EBITDA billion, reported XXXX, year increase of was financial XX year prior highlights with EBITDA year-over-year. compared XXXX. a year-over-year basis margin was Full $X.X lower was an year. revenue decrease margin for the of $XXX basis for adjusted year million, the the XX.X%, million $XXX we XX%, XX% Adjusted Gross from points XX% of income a decrease XX of of Net full decreased

$X.XX in EPS of million EPS GAAP million. year with totaled GAAP was $X.XX EPS $X.XX and XXXX, compared $XX.XX $XXX from EPS was Full $XXX and was For adjusted cash XXXX. adjusted expenditures operations and flow of capital

Operating down range to consolidated between period. million first be be to projected are quarter year XX.X% in from adjusted to margin of is guidance. X.X%, to to to is revenue XX% SG&A diluted the expenses XXXX project revenue. is XX.X XX% margin shares XX.X% to to Moving Gross margin prior expected to million. are to $XXX be Average be XX% Reported to We XX.X%. X.X% be outstanding projected projected the expected XX% and of to EBITDA $XXX million, approximately be and XX.X%,

be found earnings first guidance Additional quarter can details in release. today's

for call please now questions. the open operator, And

Operator

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

Trevor Romeo

Nurse of of overall the Allied population there. the just professionals on had supply I and kind One and

Nurse applications Allied around that. mentioned roles something somewhere last pre-pandemic think you AMN's like have quarter or and above XX% for XX% might are to levels I

you So guess, I One, X-part that it kind come And population back had take pre-pandemic percentage well a their pre-pandemic. and seeing then they to question would that. a was to assignments your I two, percentage contract contingent of receptive still willingness down as are of overall to clients related to Or workforce? to like above way interest the travel structurally that are a larger all where levels?

Caroline Grace

Trevor, the question. thanks for

workforce. different bit we're touch businesses. in how are and what on supply context of Let in then little a bit bit about me about they're thinking where a our their give I'll seeing And a clients

and over top this off, remain, documented, I It's has the healthcare quarter. organizations. widely priority been not if past the particularly the top issues of First C-suite for Workforce and think priorities. among CEOs

increased an workforce is expense of so a overall part it. on that And management, the And itself X focus able seeing ways. to on conditions, how see mix clients, is what we overall. utilization get really macro looks of to workforce is they I in do from Once with the that's you past as what be what I workforce serve coming then kind and it the One part do I those focus years. the varies continue client to second of how comment, their right ensure have to client we're in demand like see manifest

say of using in I'd saw labor. broad as of all-time off coming a you comment, reset highs a tremendous XXXX, contingent

stabilizing, organizations of the past really about standpoint. contingent or couple a their at talked have lot of in a of of There saw number And it so the being a close XXXX. weeks play are from to over progress you who target through

also to go. who some still have clients some We have systems and some work

I where are, So clients very that think specific. are client

Nurse but we if do allied I'd Allied demand. how say, demand In might some terms do on the be is more speaking, and supply, think than there more generally increasing overall of you look at, we about supply, where have focus you and specialties see

you into lot that of continue the have If think in there, demand be to locums will our case we XXXX. get business, a you and out

And so of a our on we're continue increase focused acquisition the very was which part to MSDR big supply, that. we how

to into TWS Allied and see you look suit go segment. our And healthy then services, demand you in follows with if space. if And see segment, Language at Nurse that demand, VMS we typically continue very you our

on continue how healthy so again, we demand. to our And that supply meet the have is do focus to

Trevor Romeo

anything of should rest typical great your for volume like be in Allied and Or the quarters? coming really for does the you an to preliminary of should the Jeff, then I business be we sense for I for for Nurse kind coming to guess. the That for bill the the be then in And maybe seasonality think rate assumptions building segment, seasonality still normalization? and XXXX. TOA additional X QX helpful. back It'd was And year, rest a then and guess, as room have it we of feel the about get

Jeffrey Knudson

So flat rates levels. over first Trevor, be the will quarter, QX bill in

revenue And and Allied so be any in Nurse by will the change driven volume.

guidance is entirely that X% it down to be So and the by driven that X% will will Allied implied for TOA. Nurse and sequentially, be

still on XXXX down forward, demand trends from XX% above demand seeing look Travel range is Xx the Nurse. within healthy. labor from would be QX impact Allied QX revenue, low to we Nurse right currently, sequentially, Allied mid- the As acquisitions that we're down the single with from It's disruption and around demand QX, historically, excluding average in X%. or over seasonality any of levels point, levels. high And digits remains an

demand digits And where expect driven rate, bill now, second midpoint be of X/X of X/X in our the revenue off single that which be the that trends split end quarter with would sit that than high QX guide, down would volume about given Just we range. of high and Allied right Nurse would there. at more by the to would be

Operator

Our UBS. line of comes with next A.J. the Rice from question

Albert Rice

speaking, And I had generally quarter. quarter, in guided points. off, when got points And fourth basis XXX, for your know I item the pretty even dropped normalizing XXX you -- the the good guidance guys it. quarter gross decline, had third visibility you've about for for think, on basis XXX the in you First unusual ahead, margin gave this time,

was tightening. pay thought as that you than the I pressure spread ended it the in singled forecast. already bill assume it you quarter? worse that the I think as of well VMS out in out surprise up played Where was being I some wondered, as

Jeffrey Knudson

Nurse capture and needs and bill spread needs to there drive predominantly took I would those on orders higher within really Travel a it winter internal say, we pay was winter orders. the the that on A.J.,

Albert Rice

pay spread around -- and for thinking comments dynamics what give seeing nurses might pay tightening? more into that are trying spread keep is it additional bill Would competitive about that start quickly to in the them the little how -- 'XX, of that the assignments? about -- driving impact cushion Are you're you a the On and recover. to bill taking to us

Jeffrey Knudson

Yes.

so talked about rates lag quarter clinician a we settle X in compensation where typically A.J., expectations. out that ago, a think between had there's quarter I bill or and

business the will As the mix we will bill year, over move spread, pay impact Allied move the spread we we QX trending with is And be our Underlying improvement in the into increase visa and margins throughout modestly is the levels. this be Nurse international revenue flat issue will sequentially and of nurse as pay to but quarter from of the year. improve visa that. that would continue retrogression. where impact that, year the first neutralize expect there with some But masked gross expectation retrogression the bill through that down that the by will

Albert Rice

-- ask like that or maybe last Is one to well in business VMS one doing of as the the affecting And upgrade the you're as sounds about conversion, volume VMS the the that's ShiftWise that DSOs. change.

of this seeing pressure of and the impaired? see Or pressure receivables hopefully that to other what's system is is similarly, recover impaired? the or For The completely example, quickly are some that in delay is in And DSO is done? business or is putting it it the hope a you'll you'll upgrade in that of integration dynamics collection because VMS, just once that there? happening the revert transition you're

Jeffrey Knudson

do also nothing to from some unapplied to Classic the implementation billing delays year, That an ShiftWise the the receivables. to so back-office honestly, the and quarter of third A.J., cash ShiftWise last quite made it then through to working we're have Flex, which just post was ERP in has led that spiked and collect with up Yes, implementation, harder, DSO. that

clients right ShiftWise So There's do also a VMS onto within transitioned handful that and isn't nothing to now have volumes Flex with ShiftWise Flex, business. that Flex. the any only of impacting has

Caroline Grace

that with client very in week. our is started the would Flex largest that what implementation this well announced implemented as we're I And to what seeing have received. being add it's market we the is We A.J., clients. ShiftWise we've actually

And Flex implementation so is ShiftWise going well. the

Operator

of America. with line the from comes question of Bank Kevin next Fischbeck Our

Kevin Fischbeck

a MSP about in to quarter. sounds the timing you past, about think customer about it -- the you talked you starts? how MSP still MSP contract of should long most if that. to in start relying And would signed like I guess business that the you've to still ask provide the we How that think vendor incumbent do an we contract, win contract, within be I to an wanted of as to contract ramp an lose were you about how when would I incumbent as because that? servicing large on the be guess, you the replace

Caroline Grace

Yes.

So typically, you would see that take a couple of it. quarters to start seeing the impact of

you back So expect of would that wins should those half more XXXX. affect the

lot process to We around have a that's initiatives to of but half speed, going phenomena. back of continue on do that, improvement a more expect

Kevin Fischbeck

renewal, any even that just you customer related to decided you guess, looking I give and or on contracts to maybe And How were I -- somewhat means lot change? also things for it of just guess what maybe fit guess, did solve if a in I to they Can large specifically that? there then, change, broadly, -- to contract color, a are kind a which sounds broader defend. comment of

So any rate, on commentary like maybe well. retention as rates win

Caroline Grace

Yes.

you are on give renewals. Let we where me first

into X renewals were taking going if in had So XXXX, effectively of years XXXX. place that we

RFP that really go clients XXXX, through XXXX cycle into pushed would in those and normally XXXX. during an So COVID,

the book. a because of because year, Last cycle, call range were typically defending, to X- any So the given XXXX, if clients have to high of be that we of X-year we about buildup. we in have would RFP in our end it, beyond X/X X-year year typically XX%

year If you are X XXXX, in. processes lower look we that end last of that the into at on came renewals, RFP the including as from range, we start year

that year. we different year, looked as did last it than this very start So

So one comment renewals. that's on

from comments. we have year sales a pipeline, overall a the the restarted like-for-like to continuation seen second If of we at pipeline talked quarter progress. really of our on standpoint my opening And We have look that sales we last of sales also build pipeline. in our the sales continued about wins we've as see growth in

to in build wins. both convert So we're our and seeing that continuing sales pipeline down progression to continuing into

client for point Kevin, this would in starting on what really It your question serve to their is on depends where be -- how of and typical we about them. large go. insert a where they want terms

go Our our their no can want strategy We ideally want vendor the because they can do baseline they direct VMS can matter they provider go go model be as MSP, neutral, preferred MSP, shift what VMS to technology we they can is want. in, our have any without technology. technology once to go in they they having

role we be so starting take from and technology MSP active neutral, a supplier. to if a from needs serve And both on our is would their neutral going a starting typically and we going VMS to client we vendor still and and vendor more supplying would a in If MSP, them. client would

starting it So really depends is. point on what their point and their ending

Kevin Fischbeck

it's growing looking going expectations? what that in. degree, guess the tell still your normalizing you're in some what's industry? say on hard outside you tell industry? industry in share you are the QX with guidance to guess gaining you as is within think Or I market I happened the exactly to And what helpful. within those in That the maybe you're can and That's because about would that QX, for that the you losing share line from

Caroline Grace

What Yes. of and mix especially business given overall, than it's because I hard industry get may in different any would say, particularly a the of we solutions have our benchmarks, others because have. to quarter, breadth

momentum vendor-neutral, relative while into as you during we we left think MSPs, and grew the market that some the -- a we have XXXX focus positioned on COVID years in particularly direct, relative MSP COVID. overall, basis, entire market go again, ourselves XXXX, our we parts of the at you positioning look for across as clients entire during And saw is, I we're didn't COVID lost against getting on what if we given the industry.

Kevin Fischbeck

it question. little order similar bill the QX just X/X one Or normally the that the than about volume, volume, a that of to single-digit The Or X/X of rate. commentary both? Is bit of being it's bit normal to Is mid-single higher the normal, X/X a ] last magnitude breakout And think a from just [ the to bill X/X then rate I breakout? digit QX? QX moving for seasonality this little maybe -- seasonality them driver high of higher QX more and is from of really seasonality?

Jeffrey Knudson

rate we the just typically QX, decline quarter. in off as would a bill orders second over low QX needs the rate to roll see bill single-digit Yes. higher winter

has in So this the a it side it's slanted volume more totality than been little maybe quarter historically, to Kevin.

Operator

Tobey Our next of question line Securities. Truist from the Sommer comes from

Tobey Sommer

of your heavy I a the market, resulted, CapEx coming years? that lower what to expect was a characterize of last kind but you referenced of could you and products in and development of wondering, year new think, best-in-class? aspects what the sales, is. trend tech And top maybe out You as called wondering list you You year. many, would the that of ahead are have solutions percent

Caroline Grace

expect of as what our So the as you they the and spent around we're dollars that if you and clinician-facing to think to solutions, not of solutions, we to number continue need client-facing how you in breakdown around CapEx, our one, a we is our me see and our supporting rebuild And ensure clients range. how us year XXXX, look including strategically -- it that of details should half innovative let maybe about this more their in sustainably. percentage to spend about workforces roughly our spending where on a as in but high solutions, quite One that directionally as give continue was can at we try CapEx. philosophically give revenue

which talked speed of last about a getting solutions, a lot we our about. us spend were bit year also And big Tobey, saw You and talked We've our Passport. efforts agility. around Flex, around ShiftWise quite in

has things are past that you the of demand. the and years matching not the that you One is are that accelerated but just over supply speed demand, supply X how and matching

markets, ERP and around a we big particularly we spend, that it's an standpoint, around have, of the rest The in And how both think our serving doing Jeff That's from so but speed. our of important and have market. organization the the it we mentioned, milestones VMS all as huge operational and direct efficient. tech CapEx some important on standpoint in more projects make about were

Jeffrey Knudson

year-over-year totality, over rolling off And in should would $XX larger not of roughly just into be say, down year with about 'XX. and just those Tobey, I million carrying CapEx this projects the some

Tobey Sommer

that of if that your was few business the -- -- I MSP lens -- rates has talk rate of you been and if maybe, the could a as you fill with and sort for about some years. where fallen to if direct number they've sits numbers in has years, looking lens wondering to currently. us fill flexed if theoretical the us the give about fill demand and And last of

Caroline Grace

environment, get kind in demand see If look that lower typically back MSPs going you you in of and is up you at as see what demand going you go capture and your typically would down, go internal up.

would higher that As typically capture you internal you demand go environments, get see down.

as you COVID, in of in accelerated -- filling saw also MSPs got But so were we if our phenomenon that. into just this that other back a clients. capture number our you had for who suppliers And demand, rates of obviously you took in we spike during go internal our roles big some where

fill our QX, XXX we at internal rate XXXX, points. for During went year-over-year QX, basis if up MSPs look

that internal we nurse do in really not opportunities are as to ourselves for broader a significant across would we to in VMS, seen environment. continue fill XXXX. have that we gone go will the we we in for direct, efforts more seen MSPs, the demand bigger that all to think doing -- increase be any space market, demand expecting position We're there to demand, have expect we down, plan has XXXX as up. So we've our for in capture the And

Operator

question Jefferies. the comes with Brian from line next of Our Tanquilut

Unknown Analyst

This is in [indiscernible] for Brian.

Looking at down in sequentially. And payroll impact expect be looks QX, QX? expected tax of QX like guidance, in it sequential the revenue is possibly slightly usual roughly given should flat in decline a EBITDA we increases to to

Jeffrey Knudson

run $X year per about talked the as SG&A EBITDA in margin a million That's that payroll decline QX. variable driven QX And rate quarter to would QX, be points But plans quarter. dollars segments. in by the is in There PLS there calendar reset $X the also, first compared dollar a primarily QX by over then be and last million to had Yes. EBITDA XX XXXX we gross compensation about within quarter headwind partially and will margin sequential in the with in mix TWS basis down tax. driven

Unknown Analyst

current shed increased not? the light in just you're given And into on reporting of Should for volumes of could the mimic of or EBITDA systems, the health vision can line various also, it this And cadence in terms growth some what further more year? next just top of across utilization the provide pre-COVID also, given on color you seeing your you patterns couple quarters? some

Jeffrey Knudson

Yes.

they talked orders had the in travel range currently we a from nurse are little in earlier low sat the down QX. where XX% So that

touched QX, in QX would the revenue And an think orders. were and I we on quarter the then seasonality fourth expecting. we would flattish with typically, see we uptick over that the QX then winter be needs

number on predominantly new of the well tailwinds as talked headwinds think capture then client as activity the just to we internal clients have well in about. Cary would as our it work half the potential as demand through would relates that there where a wins side. face that as I are that the with go to trends MSP we renewal back be to our But increase client the current

Operator

comes Our from next Baird. Marcon question with of the Mark line

Mark Marcon

I if could asked. was Most you was I of bit. been wondering Cary, have questions -- a one, my elaborate little But

of current have us have. some levels they give that taken that mentioned in dimension for their or earlier down But some the clients, of approximate hospital are others basically working the You contract an ideal see is -- levels? trying base you in get pressure hospital it when with Just level. further systems understand work like are and we of to stabilization that that? should that to down we points truly third? terms half that about might census large staff appropriate think to levels down. we how of still Or nursing you Can optimized the the of down kind a systems Or

Caroline Grace

here's frame I Yes. how I it up. mean,

the we're aggregate. was And significant obviously, made it was you If can other's look into XXXX again, nursing it in see time, side. started saw hiring. where getting aggressive in where numbers permanent versus on Clients contingent same -- our starting back at them And progress. the rate. particularly you And you really at it numbers, more and we normalized XXXX

that really So was the story for XXXX.

would complex If how really fast. is clients, they typically of most have you go larger seen Mark, the and you at back, and categorize moved we clients what is different some look

focused been didn't quite some who but were on You as fast. XXXX clients have see move --

and have think So make And least at at I target do. can't to in that of work of a clients. XXXX, didn't again, are client their number we still progress a our them

It lot would dimension this so as market. And of the a and labor is to to is want doctors flexible there because supply piece there's significant demand in well, a other the be a focus portion the around healthy quantify but and a hard dimension who environment. is we portion, nurses still more a work

are so market. to balance of access XXX% they getting management spend of available how that ensuring they it's the this And with also

Mark Marcon

balance contribute then year? QX over what for expectations then And to the are the of in the MSDR and

Jeffrey Knudson

the million we Mark, month said Yes. did XXXX. in so of had $XX last MSDR

QX we with the from You second third MSDR. growth in rate. in the then that run sequential line can expect quarter And think would about expectations to

Mark Marcon

the And you've gone up It it. Wondering any sounds incremental terms basically the in if like comments seeing regards seeing the savings you're regards some And we names, brand terms got with with sounds sort it in well. channel. from end of of would some then that at consolidation? to drop-off to consolidation really other of any supply like point that's additional not

Caroline Grace

Yes.

from of in took I when the we on, it. it focus that would preparation of has to talk consolidation, gone Mark, are terms very about well planning -- several there elements couple our So things and and of that brand lot a team. The

other all clinicians come are potentially So one increasingly all-time we our brands, it's the obvious interested now we in. That's clinicians an around the highs way where professionally a unaided get in But basis. including is about both around the and doors, and our on Passport, -- aided the importantly, have, to our and at of between they opportunities awareness for logo. lot front that one find Internet of

careers shorter-term see longer-term options we holistically whether an for us we more engage their entirety or to able So throughout opportunity it frankly, that of with and a assignments different of clinicians revenue have for as professional be much the are to range the from some permanent more them, those standpoint, of assignments.

be is brand we're a a X going be continue able efficient of Healthcare get efficiency support and brands, when standpoint would for awareness from to more more brand. you handfuls see don't to it forward we in some and the way spend supporting substantive to Where to will us meaningful AMN but increase have

Mark Marcon

for Are then What's you seeing in last that was question. over has industry? attribute bright demand the that spot. you Locums to up. And a the changed It would pickup picked that would demand? And what last if sounds lead the year so, like to? you that across

Caroline Grace

locums we looking phenomenon. systems in to an meet expect the than utilization an of how to more that's What we and industry continued see they to continue really AMN going have We phenomenon experiencing. are seen at are that have And in is really strong demand XXXX. just increases they

about have shortages, you you think the don't well-publicized a on is particularly, the physician and to physician it constraints revenue right as when serve ability support. And so on drag very patients

And portfolio. really so that a our the is we're seeing that lot of driving demand in

Mark Marcon

some That's great. Could we see rate increases there? bill

Jeffrey Knudson

we course so when year-over-year driven locums than of Mark, volumes. look were increases of more last rate by Yes. most over the year, the within the side

Operator

with from Silber line Markets. BMO question comes Capital Jeff of next Our the

Jeffrey Silber

obviously XXXX? know in over would what how is role forward? been little year. in a for going that one. this know what if strategy differently And we business. it's you understand tough this a knew now, late. I year really have does just you your And all I'll a your you you've ask done Cary, But impact

Caroline Grace

started the question. reset on the single for the release, XXXX thanks AMN of -- reflect very beginning as did the Jeff, writing were the we XXXX biggest And I and I historical at cyclical industry. in also started press

started the were our were We in more able things as navigate against our very of we that to be we our we quickly our the simultaneously. that were doing, initiatives certainly through transformational participate putting market we X end unprecedented going were as members, a of our to about ensure but And company And were frankly, I doing we customers, helping we reset. the fully team of of to reset. reset successfully to went also opportunity, series tail both what so enable the place as company think out that came entirety

things the think focused we we I incredibly strategy at look and well on underscore the on we go-to-market our a that clients year, focused in tough extraordinarily quickly. got did very back go and I that If and I'll things

I this role, is And on think breadth sales I into did. a we the selling team now our and for we We about thing first that clients, that came actually force. back was we completely As turned the of realigned how responsible full our have solutions.

engaged difference in the brand, very a AMN our One, transformative initiatives started series initiatives. brand One see make of talked about starting we're really, big technology We in already experience, we transformation series the just and of a We operational to also that but business. a

time financial that had the that we of going were ensuring we discipline lot match that through. a reset spent we then And

some we bought in MSDR very we both the made also around shares. in to million market market systems back actions sure and capital down $XXX but down. strategic that make expenses also coming were in our parts coming and growing took of early we investments, as So the was And

the So XXXX. strongly and getting what we more I XXXX did and through am very in positioning pleased with ourselves both reset for

Operator

Company. comes Sutherland with Our the line question of Benchmark the from next William

William Sutherland

look here like the are me, they are level equilibrium at feel recent going on the wondering call was trend orders, do we've you I to rate as in a you I decent already? rates down most questions. an at where have can You X fill Or the right into And direction? just the fill go got to Bill.

Jeffrey Knudson

On the rates, bill Bill?

William Sutherland

The fill rate.

Jeffrey Knudson

new moved like mentioned rates. as in that we on to think Cary basis of we make those wins we And and of time year. of up internal some drag mean, the move continue be as some progress But to ramps a business book we'll the as see I half. XXX progress ramp throughout I should initially this will client through take first back in So internal capture But it we had that on will those onboard earlier that the course half, XXXX. capture that points

William Sutherland

with Yes, I and was just your of heard actually just How Nurse business. book about rate orders the is fill in thinking regular going MSP commentary. I regular the Allied?

Jeffrey Knudson

internal back line in Overall, so the with pre-COVID generally that's trends. fill rates, capture. Overall we're in

William Sutherland

are. There you

Okay.

mean, I I in equilibrium kind -- is there consider So of market. the that for the metric

I actually the repurchase in plans, capital any since deployment And share the last Jeff, just sort CapEx would beyond lean rather how was you'd significant then prioritize there's of on you side? about And thinking quarter. the were last one, so active considered? M&A employment, whether you being Or

Jeffrey Knudson

Yes.

at in we're is focused term we cash X.Xx Leverage the probably acquisition, on be debt the end excess right certainly think the the flow will free repayment. as deployed towards integration. and that in now, near with near year I term, MSDR

Operator

further Grace to I'm I'd back no time. to call remarks. Cary closing turn Ms. questions currently over this like showing at for the

Caroline Grace

against strongly important opportunity. as position our healthcare doing providers. is our want the working healthcare I the to to we look next Thank resilience organization required in biggest our you market you XXXX call great AMN both and team and quarter. to company the to forward a work to navigated our in continued earnings for our reset workforce. interest you while industry listening talking your say special to members thank We our total

Operator

you for your conference call. This participation. Thank concludes today's

a day. You have disconnect. Everyone, wonderful now may

AMN Healthcare Services (AMN) 15 Feb 242023 Q4 Earnings call transcript