AMN - Earnings call transcript Q3 2024 | AMN Healthcare Services, Inc.

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Operator

Good day, and thank you for standing by. Welcome to the AMN Healthcare Third Quarter 2024 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 first speaker today, Randle Reece, Senior Director, Investor Relations and Strategy. Please go ahead.

Randle Reece

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

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

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

Caroline Grace

of and sell-side $XXX EBITDA Revenue of quarter range was above million million the Healthcare Thank challenging market story, third adjusted to welcome Randy, upper call. expectations. the of XXXX to industry. Financial of with were today's estimates. our long-term for you, an guidance build [ of end our was the attractive while analyst AMN above deal and simultaneously consensus ] we $XX continues a post-boom for results above

with items, in discrete was beneficial line some guidance. Excluding revenue our

Nurse for most demand markets. in other and stabilizing We market continue a healthy signs to with Staffing increasing staffing demand see Travel of

raising seen from significant raising new for Allied above in Nurse the some in go bill between quarters. Nurse clinicians on performance, the relatively about bill improvement them are to Demand We we lowering and is and stable Any among Allied Nurse, across XX% XX% placed Travel a assignment rates but change staffing and rates have travelers have X evenly clients low rates our divided order are little weeks Locums point July. dynamics level. order and effect clients that on businesses for market top had our rates was increasingly of have past recent near-term been areas also XXXX be since in visible April, through we so below XXXX. expect still stable the as

number from with last Suppliers below these and to about are orders vendor-neutral filling While and wage has levels compressed increasing orders currently. levels gross orders make are competition an in will don't industry fill priced sell. anyone this increased to Allied line increasingly of orders broader priced Unfilled economic quarter programs XX% to and year, at expect margins pay X% Nurse sense. not inflation. housing clinicians And for that

which could estimates over indicate bill rates the to prior of orders in to the they unfilled the help the XX% Our low in have explain of cost permanent XXXX XXXX, premium XX% the of the in reached fourth quarter that maintained end nurses Nurse industry. increase Travel

cost return As of did staffing, industry's for is it In in as state current likely aggressively past to businesses, to environment. Across care point to pressure this is responding more an industry. milestone our to contingent operating an normalize, cases, Reaching AMN improved important expensive. for subside some our already conditions we our the are expect labor margin health the cycles. alternatives continue of to

being reach are most goals. committed We clients to capable partner their workforce for and the helping develop

by the dynamics in orders. in been though across an affected and Nurse that have has positive, increase rates Our progress on internal market unfilled resulted same fill Allied

value competitive, our and we ensuring professionals. While our clients health are delivering and is outstanding pricing quality doing to while we that are care so

continue has to elevated clients I where we a tools health Since technology the us the on In joined build X AMN have them leading board competitive care lagging outstanding from quarters powerful and team help our for MSP net manage their prospects ago, to past few technology. moved to workforce. position our an win-loss moved our the empowered and We access to technology improved around positive months, solutions by XXXX, position to stance.

technology suite in predictive scheduling, integrates planning Our reception WorkWise. in resulted WorkWise our management new Dallas summit recent great vendor solutions candidate workforce engagement. and we client for reporting, a call integrated and

and of increasing are demand month risen in positioning. we of has number our positive Because strategy. a talent uniquely solution solutions positioned for market approximately help our workforce our Throughout resulted about consistently this our we top year, clients solutions. total Our last set, client energized client seen to we feedback, demos have build XX. used to average sustainable are broad by And

line consensus. XXX volume XX% Interim margin the of we of million of that gross several third million, margin mix. Technology by rate Services, up by by favorable $XXX modestly items. Physician revenue third spike Workforce including million, let's lower reported Solutions the consensus. and about from revenue primarily acquisition tenens our of which had our business crowd better with had basis Leadership event quarter, bill approximately XX% revenue we quarter teams points was and Segment in expected had X%. due our offset margin manage and demand. business Allied Nurse $XXX hurricanes beneficial in revenue increased to disruptions the several XX% due with X.X% was was primarily Segment better them caused review consensus projected. up in the impacted hours while recorded million, year-over-year Locum Solutions Now forecast. that to positively revenue million upside Solutions segments. Language performance with X% quarter X% organically. factors by for search down back and through. third operating have Volume Core and of quarter than revenue from in expected $XXX below MSCR lower continue $XX slightly year-over-year, operating for and pressure results organic turn leadership approximately as and third than than the was in to X% by in line quarter client and $XXX the locums help was was

We continue to in VMS language services see solution. $XX the our revenue in our line strong with quarter, client million interest in expectations. was third

results. over the turn I'll more about call Now details our for Jeff to

Jeffrey Knudson

everyone. Cary, you, afternoon, good Thank and

to segments quarter Third Nurse and and Revenue search primarily businesses. of sequentially, was the which and offset Sequentially, prior year-over-year revenue interim $XXX in quarter volume year of quarter due and gross and XXXX $XXX or SG&A expenses employee end service revenue above the margin revenue excludes $XXX decrease in high primarily compared was by the to quarter. flat. Adjusted expenses million margin or was third revenue compensation decreased changes revenue with favorable prior consolidated gross XX.X% and lower was period compared expenses. the XXX or Allied, or Sequentially, quarter. settlement the for points, Consolidated in the X% $XXX The guidance. XX.X% million a $XXX revenue stock-based million SG&A, partly in the previous other in costs, was or XX%. XX% XX.X% SG&A shift. previous were integration from of lower and mix in million accrual million $XXX year and professional in with acquisition, gross basis $XXX XX.X% lower were was million million, XX.X% revenue of third all Year-over-year, down or X flat. Consolidated expense of the quarter margin third expenses XX.X% margin legal of down across period by of SG&A due driven revenue of

of in Year-over-year, points the decreased in mainly due decreased revenue favorable the year previous down flat. basis period and period quarter, segment lower down and XXX operating discrete mainly and were deleveraging year-over-year, and gross from year-over-year basis insurance the lower The prior was XX% decreased while the XX% X% average from worked on down X% work XX% and points $XXX year the and and revenue revenue. million, in to driven Average quarter. expenses. driven rate year-over-year were in a margin decrease XXX Allied. average XX%, year-over-year lower was hours a X% items. Travel continued quarter bill $X.XX due from volume volume primarily million adjustments Nurse margin Travel Allied Sequentially, of and gross quarter points, XX% quarter beneficial flat. Third by volume prior gross prior Sequentially, third the deleveraging primarily points Allied Allied Nurse the of $XXX XX% in of third down hours quarter and to XXX was $XXX prior was basis lower SG&A and operating margin of expenses. Nurse margin quarter margin primarily and of XXX rates sequentially. actuarial by housing sequentially. Nurse million, Sequentially, X.X% basis revenue from to due decrease was travel deleveraging was XX%, and increased Segment volume

Moving to the Leadership and Physician Solutions segment.

primarily primarily the $XX attributable prior an Services was the more million to was XXX in shift. was million $XXX and decrease in revenue of down points sequentially. to than gross X% was decrease margin margin third in revenue primarily margin XX% The lower away lower mix and million, the to million, shift by partially down revenue XX% Segment gross to to a X% the Interim period, margin XX% Sequentially, XXX Sequentially, bill year-over-year segment million lower in decrease decreasing the business. year Service declined operating leadership offset year-over-year prior from Solutions VMS year pay in mix the tenens basis primarily partially revenue from sequentially. year-over-year, of in was and margin, the gross gross revenue basis due lower was expense with shift. and XX% as basis from quarter outsourced Services Language for year-over-year and tenants XX% Segment XXX sequentially. Segment X% margin, a revenue and and business. $XX primarily to points Language the year-over-year quarter the Locum margin operating by growth Solutions primarily $XX of Physician Sequentially, the flat. in decreased down sequentially. Gross gross basis gross quarter and a of Leadership revenue and Sequentially, points Sequentially, a Language growth the of mix is from revenue higher XX% X%, XXX margin points XXX mainly driven margin. Technology spreads business. XX% was by decrease margin down year-over-year lower offset the a Services the coming down leverage $XXX was and XX%, X% gross led which VMS period margin volume MSTR the XX% increase points operating from was to by Sequentially, increased basis revenue decreased operating and million, XX% a quarter margin MSTR basis flat XXX businesses. SG&A points. acquisition. Workforce the year to VMS period VMS points Third from decreased by year-over-year for in in $XX revenue XX.X%, third due down up revenue revenue for driven XX.X% was revenue segment the offset basis sequentially. quarter by quarter of driven solutions lower attributable and was lower the acquisition. search management. revenue. was for revenue XXX due was million, due the year-over-year, margin $XXX Locum prior

margin XX% points prior deleveraging consolidated period, and due EBITDA prior sequentially. Adjusted was adjustments deleverage liability Sequentially, year-over-year basis was by favorable quarter actuarial adjusted driven to XX.X% insurance margin quarter quarter lower decrease revenue. and from the gross EBITDA on the the the in adjusted year and EBITDA for professional was XXX on primarily revenue. margin down million, in lower of the down $XX Third a lower XX.X% for XX%

net $X million, year-over-year sequentially. Third XX% down quarter and income was XX%

have was $X.XX. was prior the period in days for share XX, was prior with $XX start lower per prior cash Days X earnings $X.XX quarter year was and the per capital for flow million, for outstanding third our X earnings the lower a share $X.XX the days. Operating quarter. reduced XXXX, sales day Since compared quarter diluted $X.XX in Adjusted by than GAAP quarter quarter DSO we were than and expenditures Third quarter $XX XX the ago. the and year of the million.

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

from debt increased maximum down quarter, bringing leverage to to our $XX on XXXX. target million million. We off remain our We to debt proactively to credit and covenant revolver revolving leverage we X.Xx of $XXX year-to-date the on During of down end the X.Xx. focused line Xx paid pay ratio the the of X of through paying returning

the million, is prior we project down to from range For be $XXX year of period. projected to in consolidated to fourth Gross XX% be XX.X% XX.X%. and million the $XXX quarter, revenue margin XX% to between the

Reported be SG&A be to to and expenses to be Average X.X%. XX.X% X.X% are to be outstanding adjusted margin X.X% projected of approximately expected margin to are EBITDA revenue. million. $XX.X projected is diluted to XX% to X.X% is Operating expected shares

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

quarter to call the hand guidance. fourth will I discuss Cary to further Now back

Caroline Grace

Thank Jeff. you,

I a his company finishes X in a conditions. for done values much been Jeff for through he wide him to will and hand him CFO. everything core his his earnings Jeff be wish endeavor. want partnership and AMN in can that success years appreciated joined range new AMN his has at embodies thank AMN's as I strong steady certainty missed, and of with As the he I call has say personally as I we final market

don't tailwinds outlook in fourth guidance to than in labor This The of range low market is higher we million characteristic and revenue, our QX consensus Our quarter X% the conditions. fourth recur outlook end the driven are expect includes $XX that for quarter by revenue headwinds estimate. includes disruption. of revenue current

outlook is X% quarter. for prior the and our than quarter, higher Nurse Solutions For fourth Allied revenue the

The revenue other X about outlook segments have below estimates. a X% consensus

seasonally the XXX Solutions, In for sequentially in normal services Leadership QX, in be expect and we're for language X% and should to staffing market. At There revenue do Solutions, we while consolidated in hours margin seasonality. adjusted to volume we Workforce Technology trend in the to Nurse X.X%. lower trend in that calling including Allied margin. expect our not to the flat point QX, recur of due remain line Physician revenue revenue in For EBITDA benefit XX lower line a to basis VMS midpoint QX, in approximately sequentially with gross of an of with X.X% basis the benefit guidance to and is points

in see market, downward as remains evidence staffing us competitive which go broader XXXX. X could market While years nearly the after through we help of pressure, we normalization of the

than through Our the stabilization travelers quarter. traveler In slightly number of September, first on assignment in year. has higher declined the X and this months of was continued the July count fourth

year. and Some as areas next bill specialties reemerge rates they strong our certain labor need increase are in as for scarcity meet driving These patient to capacity demand. hard-to-fill are to of in forces starting raise one reasons expect where well optimism, we clients as to industries to

operator, Now the open questions. please for call

Operator

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

Trevor Romeo

in first of you heard best circle the makes Cary, end luck maybe those some I pressure wanted EBITDA of I from Maybe to past think if in you It maybe to, the maybe also margin a going margin forward. on working I lot Jeff, couple includes excluding the great that gross outlook. all, on some the kind like across of at based about we've with industry. comments guess, Xs it's the of the years, out, guidance onetime sounds back First called benefit for that, margin sense. of

whether just about plan puts kind going if SG&A of some to for how the Just X%, and forward? at one, get Ultimately, of maybe to sort is takes see think and of normal? Maybe on helpful. you improvement X% gross that balance really guess, you you margins, in ahead, don't I much any can trying thoughts new just be such. Or the thinking that capacity we recruiter talk would for

Caroline Grace

the Yes. for Trevor, thanks question.

So start with if margin improvement. what -- think we and gross would drive I'll

gross pay margin of a has impacted It's bill as what at combination the different look spreads. well throughout we pressure mix been as points really if so our And year. at around

positively us go some you within we those recovery very of at for And broad, look solutions some of if have solutions, of could in because so each set and diverse what segments. our seeing impacted back would a higher-margin

So Nurse and and solution, also our TWS look international next that then visa in been large, business by year search that have this interim would affected we VMS like high-margin PLS. And a has into and year retrogression.

XXXX. We to expect headwind that of quarter the in off second taper

would of conditions we competitive a margin see thing other the way see to all first from us across growth. that standpoint favorable the of So mix our gross very as We would our help going start businesses be businesses. the

this you throughout start as us spreads. natural say, us help. And of get this pay higher-margin seen some growth, go bill some That years headwinds, the third can improvement for to the expect, getting to, would And see if we standpoint cost X look do SG&A. an then some offsets at ways from to is down of EBITDA And we would so getting as of some you in labor and start start one. number kind improvement then you of business when see margin past to leveraging also some lever that I'd we where you've our is

Trevor Romeo

of kind maybe share much medium also growth you running say, wondering how I have runway perspective. is ask but larger kind any of there point, then that hitting helpful. it on revenue, if that left? just maybe especially solutions from could business outlook was continues at for, broader And And that, company like margins the just what services, That's seems if on the nowadays? of I I cross-selling on become to, then wanted including part you an that term, EBITDA updated Okay. language your a to guess, a metrics

Caroline Grace

Yes.

services So the love language we business.

demand is healthy business AMN is for very client it margin the see TWS a within to that continue space. in a We lower segment, It business. high-margin

was QX, ramp If a by the our you we've growth course client of a revenue that hurricanes. delayed of this new due at large look partially to year, talked about affected quarterly single through

clients in expect to QX. resume We ramp-up of the the

So growth you should of next year expect as a go see business. ramp-up in that we into to

Trevor Romeo

digits thinking kind near what for of generally, the is you're But double still term?

Caroline Grace

XX-plus and gross margin. digits percent Double

Trevor Romeo

it. Got

revenue one what would by revenue the expand And Okay. mentioned, one just QX quick then those just QX -- and Nurse other you Cary, really is X% Could be, Allied. on think were? for or you I discrete item maybe benefiting

Caroline Grace

turn and Randy, give to Yes. it over can you I'll some details.

Randle Reece

a and primarily Nurse have and were SLA The margin, the They in sales third quarter. the gross allowance the been XX%. true-up segment Allied discrete items, consolidated in excluding would

basis So it XXX points. benefited by about

Operator

question Marcon W. Baird. next from Robert comes Our with Mark

Mark Marcon

Jeff, we take best for talk working It's at appreciate of Nursing? little just If the quarter -- last disruption a benefit been guide be look appreciate for endeavors. work, where of with guidance the Nursing, the would luck $XX quarter. for the a where over without Can fourth in the help. I pleasure future all years. you we you bit really a million really about for fourth the for Travel just some Travel labor that the X

Randle Reece

all There and you a or Allied. would all -- out the -- items. Nurse -- million, it of most $XX take revenue labor is Travel are of disruption. Nurse that couple of Well, the is of be in other which out that the $XX million of which It's

Mark Marcon

if decline Nursing? would year-over-year I just Nursing, just Travel expect Or meant be pure at Nurse the Right. be? percentage that, the another of look we way, Allied to said what and what would Randy. you got just I Travel

Randle Reece

Yes.

Let's offline. take that

Caroline Grace

where hey, back down -- slightly to slightly said, we to some and Nurse if for Mark, Allied be the quarter, if up. to go I can guidance gave would to we you we see flat expect scenarios last had we that

that gave If you you. strike take guidance the away we

for to to outlook And so we digits. relative that single -- flat the gave core NAS QX low to [ guidance ] before, QX our is to down

about with last in quarter. is what had we it talked So line

Mark Marcon

relevant appreciate you the and you're fillable and that can feel we hit you what in it about Great. bottom. starting quarter, fourth quarter and terms first and as out the are about But thinking to And certain bit really of bit make both seems the out start little just helpful. you are sense, about of basing a I that. wonder and a in beyond thinking That's elements supply talk pricing Okay. that also we're seeing, couple that. more a orders towards like little because there's a a things

I'm just through to sense Travel elements a so the trying And about regards all to with Nursing? how parse you're that of thinking and specifically for get you better when

Caroline Grace

Yes.

of So the back the around broadly the signs if of -- some -- generally made would demand to well The to whether things, the still end that low underneath range want take comments that permanent of stability, see that bill I spend in stabilization, that actually different some you that's getting very contingent we're we in to you see still in places. premium about Mark, costs. rate clients are seeing

And billed, to we'll bill we get some so increase orders rates. have clients

on some clients to them different have we as in utilization are We that places and still trying decrease well. see

certainly progress, front. on want while progress So see to we've we seen that continued

have overcapacity it uptick probably industry competitive in the is opening have comments, unsold environment. We in is now. given balance, Nurse incredibly my in Travel as we which I On I seen, an mentioned right orders, that think significant an

that increasing. unsold a competitive very see to out. orders rationalize of starting still some You're environment But see you and

want clinicians. better matching some So I to think of getting those getting expectations by the and cleared between you'd orders the see clients

Mark Marcon

there, broadly VMS Great. what's with then just that Because orders side? an what you're would first. on MSP be with And your speaking? to because then to order what the side, levels filling seeing on the general how also your we're are the indicator expectation obviously regards -- trends And regards

Caroline Grace

Yes.

say clients different minus the be the patterns in we third that quarter. industry. you in the is places. was to broader side the similar VMS so say it would Again, I does expect in And would the or track down VMS have I fourth plus quarter, across seeing market. what And on down we're

we we that we be would clients this increasing growing position focused a have versus have that So is have may some seeing position some that's the this other last underneath industry would trends, we quarter, year. any be year-to-date a If in to portfolio on the loss moved piece MSPs are and we that net our net have trend, the win very been MSP year decreasing. of

Randle Reece

mentioned Mark, in versus that remarks the the VMS vendor-neutral increase orders how is prepared indication been during market. mispriced of which in there within our we also had and might unfilled orders, quarter be the business, an an many

in path addition, is growth VMS our to In we are sometime resuming year. hopeful next and revenue a sequential see in

Mark Marcon

Great. eventually like got last do you're a that, in about because things terms turn? we margins in partially there. et Does at cetera? one we of excess of at the capacity the getting experiencing hey, the deleveraging that When And feel SG&A stabilization? this you recruiters, when think look then And you've incremental we're some -- margin some so, account the managers, one. And you're the is profile thought that that with take how maintaining terms capacity point if and should

Caroline Grace

think you some our X So of about conditions on our off base current as fronts. we expect would capacity get productivity to improve. One, should market producer

we automation the projects particularly complete we as been that focused some past over on the think capacity, is we've of couple So quarters. of there that do

international our nurse -- have embedded internal our capacity within We business. also

and line intentionally go. so have And of visa candidates temporary this in ready period all retrogression of to been to we during our keep very

in retrogression have improve, candidates client immediately the get we them. requested our placed that as can the dates So

to that capacity from Mark, we expect there's XXXX. front, seeing in that start you would So

Randle Reece

the of we will points. improve leverage, that if -- adjusted nurse EBITDA when were in XXXX. improving the have we in we to of Mark, add expect XXX our to That's consolidated operating growth $XXX margin international it would by million revenue, we resume levers we would basis of back one best terms believe and

Operator

A.J. with Our next Rice UBS. from question comes

Albert Rice

couple but make net then just exiting sure But rate in wins about out you A want about economics get on we're more on the your the talking well? at. to I MSP MSPs picked specifically, reflecting become saying for spread competitive, you're about the ask anything places. as I and there bill ones, we're itself also 'XX, of Is increased other and the landscape is pay competition the year MSP, run you competitive that's competition

Caroline Grace

across MSPs Yes. the you -- is And number a The COVID. particularly competitive changed models, intense time landscape lead during A.J. just had entire of how all of across service features much

wouldn't overall say that market, so entire about the market unique MSPs there's is to anything And I relative the competitive.

Albert Rice

Okay. And mentioned business, placements specialty what mix little on the where of margin pressure? right, a having more I you elaborate it Locums types that's Can you placements was the dynamics I impact on Locums margin. maybe now strength the is that a on making, you're on in comment some think right in got if and

Caroline Grace

the primary pay you're seeing everywhere it there's as pressure factor. One X So same bill things about in the space. else Locum is you're the seeing that

closely pay even of because you would see demand parts acute in the them tied is in more Nurse and Allied for shortage of even Locums the of physicians because the expectations revenue. and so to so And than just they're

lower still see does some business. a our tend to the in strong specialties. which But really been that, it that, pressure bill Underneath headline big than more have we we're of CRNA, parts in demand besides margins other the spread. of So is seeing I pay think that other has the of same some

Albert Rice

take you're quarter relate to run run to know that apply if annualized and you point? back, then margin you EBITDA to an in you the the jumping rate made, million me and places which obvious could $XXX would a is that the 'XX? of XXX off comments look a an year saying, for I fourth that on on and at would off to the think are have would make for exit me gets doing Randy out improved that, would points, for difference. performance EBITDA if X% jumping like off rate the revenue fly that suggest And strike you're that basis, just And But sort there run But of from Last trouble. I 'XX the always be said get rate. math Okay. you basis question international now obviously,

Randle Reece

modeling The to recur XXXX, $XXX of way would of you be present I normalize suggest million. adjusted midpoint about it. do the go don't midpoint a bit to it's you would When little expect revenue we you X.X%. different that the than but margin be that The guidance revenue EBITDA excluding the QX, guidance,

on higher run So rate there. EBITDA you're several million the quarterly

Caroline Grace

A.J., hard to then that took out other is we because the And things predict it's strike.

been you next ] the are labor pipeline. up And We a that then put I've businesses the there. see and to year. here. seasonally low quarter, disruption is since that modest it pipeline services PLS the to we don't coming [ largest off particularly strong quarter. a fourth in very just in but would It's TBAs that predict, growth fourth of start have so language in hard are And There's number like

Randle Reece

way, out Yes. conservative material We next of labor labor disruption revenue. have the taking to a But just all normalized QX revenue expect we in disruption year.

Operator

Our question from Truist. Tobey with next comes Sommer

Tobey Sommer

data that demand it you're indicative we're filled? sure rates know. Maybe rates don't that scrubbed just more that I be of volume of we're What's of conveying to change profitably something today? low data outlier you coming travelers not are orders filled the want I that also instead to way, kind have the that wanted of assignment already including in -- could around make too reasonably just ask the and that's you've be in of are and bill orders. sort I of about and to the trafficking prevailing on

Caroline Grace

underlying then that's a probably of have is in the because in out of role, Tobey, and group think them I you some the at put that that group they are of guess, we number as a just categories affecting coming to there's you a a group if in dynamic. orders look if there's fillable. I If it middle I in piece that's dynamic we can of be ground. And very unfillable them, you a would is There's them those until in. that expectations, of number that that see get -- there's interested clinician come at a look pay incremental sometimes part -- they're don't specific go of

[ is high in annualized Pay ] RM digits. single so the And

But increased quarter-over-quarter. this expected I'd orders And quarter so see first has are what at, they number we in how -- that seen and overall year the we we that's dynamic. think look nobody we've of would fill, that the what say, also have

Randle Reece

VMS We of on that orders pricing. and orders unfilled QX the our that's of representative in vendor-neutral did saw of extreme probably of business, an XX% Tobey, we proportion are kind note, that the

Tobey Sommer

market So in percentage you periods to conditions? that at filtering and prior sort the when are adjusting price compared of are in you out the pre-pandemic, of non-sensible a convey orders the orders change

Randle Reece

No.

Tobey Sommer

at see fair refine I'm assumption like looks kind Okay. What's with the And cash? profile for cash because conversion declining to we of pretty to just had how do from margins? CapEx trying lifting and CapEx EBITDA the you some company. free heavy free a just what

Randle Reece

just We XX% flow, assume CapEx. would normally have then EBITDA conversion to would cash adjusted operating of you and

completed expect year. have a we that line We CapEx lower to number -- it higher had. That's of in lot in we just that this CapEx the with quarter revenue we've the be our projects fourth reducing

Caroline Grace

Tobey, on to the details we And completed. of some just projects give

ShiftWise Flex there. the done that we've a and So about lot work we talked

the on We applicant QX. VMS And this are end and same Flex, we'll -- replatforming our should be of up thing we tracking system that the ShiftWise our will the finish we year. this our The MSP with complete completed clients by for be of that getting majority virtually completed year. and in clients

we done. will So there's place some that have significant be in projects that

overall kind from a that year. we are So in will between standpoint, completion next CapEx we down where revenue be and of

Randle Reece

that EBITDA this seemed in X-day improvement a year the quarter. in third flow You adjusted have to we quite may have a cash And good date. percentage of DSO operating as our did noticed

it quarter operating for an have flow settlement, really boom would outflow Our legal that. so this without included cash a quarter been

Tobey Sommer

business If a X.X guess, of you've X I of or brands. years do traction reengagement from as are stage last customers bunch of process on, I or What of in still noncore ago. so, of to that? a -- kind from may with the one market unified reengaged sneak sort Under related customers kind sales in in. is quarter? years with perspective fully the you're Or third the last X that the And of were the it seeing more the you you that think calling and of you ramping sort that

Caroline Grace

and of still sales on the because language what not least that as Depending is is think ramping sales services, the in phase on the long. which I of cycle. are typical not we is it cycle

If you're plus. talking about a an MSP, it can year be a year to

we've vendor-neutral but doing, It's broadly aligning clients just that growth has pipeline biggest a seen growth around reengagement not of we've and growth. The more ourselves been the so prospects, quarter-over-quarter work And in across with sales from have all just the in market. we the been that signs standpoint, factor prospects. that the

we So capabilities. pipeline those seen pipeline successful Flex when the at in very the also of we progression of those ShiftWise really a year, around the have through We've beginning been building opportunities. launched

-- we So look year-to-date an leading that's those would one year. And we is at We're win which saw in in comments from last we position MSPs we number are the the look is average net indicators if of then final the know we what piece, this a of we for at. our them. that with and the top is mentioned have solutions improved improvement I our clients,

set. be we we our in that want able solutions -- client with more expand it's get and then So solution pipelines to into to to want

Operator

Our America. of next Joanna Gajuk from question Bank with comes

Joanna Gajuk

talk commentary I you're did And there? the So know maybe you relates But it I missed guess, orders, or sequentially but I year-to-date to it guess, I follow-up, as it. where seasonal first, compared a the seeing XXXX, to maybe trends, demand comes it when you to any demand? also about

Caroline Grace

Yes.

Allied that demand saw Part and in been seen lower was has Travel demand than above below levels into the quarter. We're Locums Joanna. fourth seeing in And third tracking seasonal what continue have pre-COVID. seen since XX% quarter, seeing you at the last you has what would demand demand of the businesses, demand above April, we of if healthy welcome increased at in demand you Nurse and so and in look XXXX. since different orders, while are quarter We're we've beginning healthy the XXXX. in about second that still year, So while still

Joanna Gajuk

follow-up another on Okay. guess margins. And on the That's discussion the gross I helpful.

still you're on So the compensation. but rates this stable, pressure are there's saying that

be So international year? you some of next back how out play piece, comes mix kind understand there. and But expect competition also if Nurse business margin? could talked just how the Because into this such. the expect about you do benefit you gross on this to I there maybe just

in any change any easing So indication is pressure? that like there as it competition of

Caroline Grace

of of cycles When as we're in, an work and will you you and and you'll margin come out out, that. part see at that you back cycle way the see go the look that overcorrection sometimes will its improvement some

that a so we would to work for take of through. will expect happen. bit That that And to time

we out started We So the of from started suppliers is to see saw business supplier Nurse a the it COVID. part that. see overcapacity of quarter. an to retrench coming third We've in of Travel

you're think rationalization. to of starting I a bit that So see

demand So that would of be, I'd say, piece the it.

to We in will expect impact been as look If off have And margin our would and international a would in accelerate then Nurse nurse that Allied And as we results. expect and on the for mix growth end, biggest that for exit at we'd growth a of we see that into expect XXXX some -- second at we challenge taper for and XXXX. positive see you margin then have retrogression. the as mix really get off. gross standpoint, has the visa mode quarter to our consolidated would that from And business a EBITDA XXXX. business, Nurse in back both will tapers in we both that that a

Joanna Gajuk

a or if about maybe that were particular some offering on would do you Right. service, be there expect picked assets and people And -- I to up when some market the competition that in? understand. interested in something not last be consolidation? squeeze one I like Is you may you talking as leaving the

Caroline Grace

just you solutions. and along more the shape of fragmentation, some industry if think I of wanting look with the clients tech-enabled at the

things I industry. the will in think X those drive consolidation

or to always give are we don't scale us, significant opportunity. us look some us For to see opportunities unique something going either at that an we where capabilities give would that have ability we

Operator

with Tanquilut Jefferies, from comes Brian question my apologies. next Our

Brian Tanquilut

this Joanna's question QX, on and -- quarter to on Maybe QX. thinking touched question. what I seasonal just that think should you're seeing qualitative we on from next? progression placements, seasonal just orders given a don't we've commentary, terms commentary in follow Cary, How of into about expectations to of with like be up for to kind on QX heading

Caroline Grace

an would QX. we you We have saw transparency example, we and what phenomenon But through year year, don't this We much saw went into and point QX, if now. start this year. had typically as that see at we winter date this into play as last look have that we orders, this at last same again

that for a help So us. will be

after happens QX. a of would would QX see we to from really off that versus QX winter We typically So orders, more expect that QX standpoint, be helpful but drop overall. some

Brian Tanquilut

guidance follow on I'll at at QX, roughly million that your question a look we A.J's landing up if $XXX implied tying for factor rate. of seasonal mean back adjust right, and I QX that, from Maybe to QX for earlier. and we're run then

would that of that curious that number to be significantly get what rate? run just grows pieces sort the missing So to a from

Caroline Grace

do to just out, try we don't we everything to give a taking which predict. labor While core disruption, including is hard what have guidance, give typically some It's -- we you in.

client went in off would deployment, -- then not look you quarter, businesses, commentary lows. and Nurse with growth expect Allied, typically, range language I PLS you traveler I And be to thing guidance and go services, more that some in the low-end think would see back language what that quarter. QX particularly typically the EBITDA second of services you and the would gave decline we margin different at don't the in kind of of in And if first of A.J of seasonal about and you you see would a on would in one through. you look would

Operator

Our question Citizens JMP with comes from next Davides Constantine Securities.

Constantine Davides

could just on the you tapers out on international you business. little quarter? it 'XX, second updated a on that give there provide third in that bit you on Cary, performed bottoms? One follow-up how run Did you more just business color thoughts quarter the a when think where say rate And

Caroline Grace

Yes.

business, we business. million that a international you looks if take and pre-visa like the So retrogression, what look it at was $XXX

And would get we be would at QX in expect as That's expect a comparison. we a in end $XXX you the have look tapering then XXXX. to meaningful in XXXX, expect would of year-over-year then QX. million. of If impact year-over-year we that another We it for in $XX And to cadence we million growth it to XXXX.

Randle Reece

tapering about from that. headwind XX points and at being in the minuscule gross in margin looking basis QX points after international to from basis We're then QX about XX

Constantine Davides

talk I that XX up then just broadly top or alluded having notion just in you clients following entering on the past clients guess, changed are X? solutions. define an of about Can those penetration And opportunities just average this to, best that how to the And has you discrete maybe Cary, a solution, where further XXXX? penetrate year how you

Caroline Grace

X diem. go per business and major would so under our say you'd you'd we'll solution have have have So we look in disruption solutions international, would our Travel you at we Nurse labor where have categories lines, there,

number and and solutions. about it, That gone solutions. X now XX for to technology You call from, workforce list has then the down go PLS for

things have we in The couple quarters, there's of management. past the been seen a revenue over that interest renewed cycle

We -- neutral. We're vendor the strong past programs Locums trend centrally program. really actually launched ShiftWise capabilities on revenue interest focused a base. systems out helped and may that managed Allied an growing we as this maintaining in getting same And teams have Locums have manage We've are Flex seeing quarter. think I building have pipeline of there. Locums in just Nurse seen in and their more

we're scheduling. than and a Locums workforce to way who serve have quarters different our of a were even with clients us So positioned we interest ago. MSP to we We've X in able advisory think and seen don't planning number be in well

Constantine Davides

that that that those or are have the your just clients of And sticky of businesses sort -- you book? rest seeing those those X more XX than solutions, they're -- are inherently

Caroline Grace

ways gives parts engage with organization. and to They're it more sticky, the inherently of more different us

pull different solutions So time between procurement, in finance, Those technology. leadership. will at HR, points different

have gives more sticky, it system. so to us And an opportunity not be just across broader relationships the but to

Operator

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

Jeffrey Silber

one. it's know And ask question, I'll a so late. me. I forgive just maybe stupid

a are what the it something Is clinicians market there I between out? to anything work can gap? of pay, we willing You've have the is the the to willing itself providers accept. to kind guess, in industry or do Or else about, just imbalance the you what times to proactively talked few wait are that anybody narrow to for

Caroline Grace

needed you've look they neutralized COVID, at normalized, One X end that been quickly. there's their workforce. a some same wage changing done, expectations fast have the underlying happening data increases about that that specialties we're think of being we've of lot ShiftWise are and pretty out. work piece bill to clients how had they is included this the in at and that dynamic. ownership dynamic that are point that incredibly That's that it when thing our platform. expectations as Flex market fairly way The fast really between does things fill. where physician need increasing rates. to health you were both either change the of And have in It's and hard data Jeff, where including we -- see transparency, is if down care rates time, you across starting of bill its And went we not fast. that seeing At clinician happen don't

a happen. some from of would see starting And happening kind so still there's expect behavior has lot market normalized of more you're a to you that but that that to

Operator

question next Benchmark Company. with The from Bill comes Sutherland Our

William Sutherland

it Jeff. wishes, I'll too. brief, Maybe Best ask X. keep

the for premiums Or question got given sense we that kind flexibility a and the And into now head others? flu Jeff's hiring? this is do a is pretty mindset travelers assuming of that the they're are with on particularly switches retention their they you a there more kind they've up a hospital patient -- as here census Following sense season. of there is that maybe thing the where and about work with right in-house season, normal winter happy can and that

Caroline Grace

on it client. depends think I the

of hiring need you rebuild We permanent And significant are -- amount happen, needed board. permanent to base. they the been across that -- needed to there's their a really

contingent they that's "Hey, able So be saying, come I need where have We're in, for some rate clients we're attract that to the still seeing workforce bit they may looking increase some and clients, talent. little and bill seeing where be of to capacity." really a to

assignments. demand, take now, premium You for for attractive folks affordable becoming to we're typically, of of especially clinician lower historical But contingent now patient sometimes this that's holidays, we're would as the actually those get underlying some really and over that right we just increased the spread pressure expect December, the is at systems. capacity It option normal averages. with these in the to end excess that at not

William Sutherland

any last the kind as this any Got or it head require of count actions? did you quarter, more plan new seeing And you. Or you into you're assumptions further where that SG&A, actions one, do head the year?

Caroline Grace

third count head the quarter, had beginning do third of beginning of actions. the the some We in did in any actually, quarter. include at beginning very -- the reduction didn't It taken we the

same our to at we that So we ways play We in are make time, managing in them. at demands businesses. at sure are We we positioned you'll to it look them. we expenses. prudent as us looking to did really that of for And always take through. want different the see advantage be see And that,

Operator

I'd I'm closing to now to showing no it further Grace questions turn remarks. time. this for like at back Cary

Caroline Grace

Healthcare, in you clinicians all you to appreciate dedicated health the positive interest a of so on thank make Thank do. AMN's impact everything and you for team We to of members AMN and your many.

Operator

Thank the participation for your concludes you in program. conference. This today's

disconnect. may now You

AMN Healthcare Services (AMN) 7 Nov 242024 Q3 Earnings call transcript