AMN - Earnings call transcript Q4 2024 | AMN Healthcare Services, Inc.

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Operator

Hello, and welcome to AMN Healthcare Fourth Quarter 2024 Earnings Call.

[Operator Instructions] I would now like to turn the conference over to Randy. Sir, you may begin.

Randle Reece

Good afternoon, everyone.

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

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

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

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

today On Executive Financial the Officer. call with and Operating Scott, are Cary and Brian Officer; President Chief Chief and Grace, me

the turn call to Cary. now will I over

Caroline Grace

Thank quarterly and to call. welcome you, conference Randy, our

adjusted as quarter of results, $XX We report with started financial Healthcare has EBITDA also the that high and above expectations. million revenue guidance Fourth we've continued And that $XX our ended are solid XXXX. range. of $XXX trend was XXXX AMN to pleased million exceeded of end million

from Technology target high beat volume. Solutions Leadership X% was and labor outperformance revenue than the by was revenue. in X% language revenue end upside segment revenue guidance excluding services disruption better Solutions Allied Solutions guidance by was above physician and improved and Nurse as on X%, and of placement. Our the Workforce saw still permanent aided Physician

quarter During the million by $XX repaid revolver strong another in quarter, flow. enabled cash of debt, we

typically years trend continues below quarter, November XXXX down April Nurse orders industry still pre-pandemic. year drop remain level, grew the in this XX% XX% with QX. new than X though in of demand orders orders last stabilization. and with line X% is and year-over-year QX seasonality. in past Travel the rising see Tenens Locum Consistent above to These seasonality, from Allied to signs less better pre-pandemic than was year-over-year. Our the orders normal the after much fourth quarter up with X%

rates stabilization declined margins firms across jobs gross our and resist continue accept over Staffing and XXXX, staffing businesses. the fourth candidates as pay pass programs are of the Unfilled staffing seeing more we margins. increased again recently to more and through pressure vendor-neutral in to orders quarter low with margins unprofitable

hiring, that has XXXX inflation deficit that X macro especially cost-effective has caused qualified high, health flexibility. fundamentals As erased industry that trajectory years towards grew to as returned eased than our to rates sector step utilization would next us to of XXXX. unfolds, indicators the permanent behavior to stepped-up detach from the highly remained on professionals. more Nurse XXXX for tell a Factors to labor Wage staffing after long-term continue from objectives normal focus Travel have The bill market for client renewed moving be levels. see have and care

acute. this X% costs, XXXX. of to fourth labor in analyst X% in admissions employment to end XXXX recent Despite and grew accommodate the were hospital last X% offset Hospitals back and hospitals workforce volume year. of for growth, than X% strong survey higher called volume to patient experienced year XX% that growth most in quarter XXXX growth tactics at inflation up moved wage when difficulties the was year-end To

which instances lowest their for levels to average Consistent travelers are low, many vacant a reducing client hours their average wage to In workforce negatively that industry's of across organization hours open at pressures also permanent using positions impacting with XX-year to Nurses to aggressive we managed and an margin. by can Healthcare needs, XXXX. overtime, alternative last Travel since hiring. year worked leaving attractive that, demonstrate now the even are staffing gross is

staffing recovery boost in demand of As XX% specialty our to XXXX was efforts to revenue, Nurse our Travel any would growth. return this

locum rates Since rise our to report, have stable see have last continued we staffing, rates continued Nurse and to bill Allied and for bill in tenens.

by driven international offset third-party Allied large single retrogression and by assignments MSP For quarter first due the nurse other by few digits in channels. in of to mostly quarter utilization low the expected our Nurse and down clients our lower the clients, segment, fourth compared volume lower outlook growth with assumes visa and and average, a direct

For prior quarter. expect the down be Leadership from we quarter Solutions, first to slightly Physician and revenue

expect Our QX. modestly up. Language trend Technology services lower that the due volume low to compared for quarter single-digit QX a delivered minutes and outlook solutions in services first QX assumes with VMS continue language and Workforce dip Solutions our and we with to outsourced in highest achieved

industry needs, long-term and care for They its Americans. the health the more diverse health more Clinicians clients voices and professionals for and of AMN seeks made care the our and that of want control. service millions organizations their workforce behind have united is choices, more care to As clear. visibility team innovation solutions mission provide

tools professionals provide give We what information-rich and are that care clients to they uniquely need positioned now. health technology

control, data-packed surveillance, Flex in best-in-class clients ShiftWise our By With successfully its for VMS, more, had pool to scaled resource next-generation that nonclinical pricing unprecedented automation to technology ease and management poised support attract out functions, rolled beyond. and of and mobility of launched new almost year, is staffing end provide and ShiftWise the cost users. we ShiftWise of Flex, XXXX use, internal roles, visibility, we our and XXXX, efficiency all and key clinical market the In management. solutions

clinicians for locum competing the Our tenens by enabled apply powerful opportunities, attractive healthcare to market-leading automatically first most Passport, position. time. Passport supports also enables store for a preferences app advantage for their now for AI professionals, matching and in the

increasingly language with scheduling demand bar by convenient reception workforce WorkWise, looking technology disruption strength sourcing, have integrates a enabling solutions and WorkWise of and We made labor a integrated are prospective rolled language, services pleased WorkWise powerful which location our staffing in out received partner management AMN also and predictive into advantages. broadening and business, forecasting, are we recently scheduling where effective platform. with and platform. interpretation for our very the capabilities clients management our current scale our from and financial higher supporting has event capabilities Clients of are system next-generation solutions, in-person scheduling the we raised our events The during launched interpreter And the clients. have more

drive but embrace service parts us channels. all $XX offerings third-party our to in billion direct and operational just and share, addressable market, scale our capture of in innovations enabling the MSPs also and strategy not our Technology to expand

Our Allied has improved business direct months. market its rates fill in recent

by support locum's on which of is Our reinforced ShiftWise being the volume locum's addition uptrend, an Flex. to is MSP

to evolved a Though summary, flexible and AMN to we each form customized of provide of AMN many capable that needs In we care XX delivering work unique clients situation. client's the of highly health to different organization ways identify has solutions service in in AMN, professionals. One and and value is on focus one changing thousands as clients,

more full clients broader management, making opportunities. access access AMN operate, we the solutions in we a changed workforce to for differentiated easier will to the way success of our it have enable The set in be of the for and range We marketplace. client more clinicians easier

our time, client-centric to over for expect value strategy stronger our We get all long-term building stakeholders.

outlook. results Scott, and Now add his perspective on Brian I'm thrilled our will who to reintroduce

Brian Scott

and you, Thank . Cary, good afternoon, everyone.

Let by am how to I AMN. me start back saying at honored be

caught getting is see this energized values organization for has the about up still on it didn't still same passion the in the take our that future. and and industry, I'm Although me changes long and to team

aligning to AMN unified technology has progress strategy as and in efficiency a that XXXX. placement faster with XX% than go-to-market our under enabler clearly is using made speed meaningful improving operational differentiated a

However, there have our value changes services, on and to and make and our I we forward progress. profitability will to is opportunity to more drive future sustained deliver speed our and efforts These and strategy efficiency ability to and Cary and underpin talent we look happen. providing this to use customers our updates growth the to drive across consistently process know automation still to shareholders.

our Nurse and and the was guidance above driven million, $XXX high Revenue consensus end Turning revenue the segment. disruption up Fourth now and of down revenue in results. prior labor Allied sequentially. quarter XX% year consolidated primarily to the was by higher-than-expected from X%

shift. Allied offset range. Consolidated XXX segments, was basis segment in lower for the points high by of at segment driven well margin gross basis gross guidance as all the mix unfavorable Year-over-year, XXX X mix quarter gross was margin decreased our a due to margin lower by across partly the margins Sequentially, an margin and shift. segment as favorable Nurse end down XX.X%, points, fourth

Consolidated with or quarter-over-quarter revenue quarter. of or audit efforts from prior primarily revenue our along unfavorable million revenue were with prior tax quarter in state offset accruals reduce XX.X% labor the million XX.X% in fourth XX.X% in support increase year partially or revenue decline with to million XX.X% lower compared in driven sales Adjusted revenue. The period, $XXX or in revenue $XXX expenses, or of quarter. professional was previous the compared disruption revenue SG&A, $XXX reduction in along by liability, The the the SG&A which reflected of year million and expenses million, SG&A previous efforts. certain excludes the a was XX.X% expenses and $XXX and expenses, by year-over-year XX.X% costs, $XXX of million cost a with $XXX or of of

down revenue lower revenue. Allied Sequentially, and XX% average Allied was labor volume primarily down offset Nurse year-over-year rate down disruption segment Nurse. Nurse offset million, decreased hours and volume and quarter X%. was and from was from XX% in worked segment more Fourth disruption prior flat than an labor was Travel volume X%. quarter average fourth partially up revenue Year-over-year was down work average in by Sequentially, increase lower X% sequentially. volume hours the The bill revenue while and $XXX flat, was as year, rates, was XX%

XX basis gross expense due margin Segment The points quarter was of gross revenue points lower fourth leverage. was XX.X%, year-over-year of sequentially. and negative margin, basis XXX mainly year-over-year from Nurse a points Nurse to in the international fourth bad debt and XX% and due the was up X% year-over-year Allied a X% million, XXX down the X% operating quarter decreased Travel to from in quarter. $XXX increased basis year-over-year decrease sequentially. X.X% XXX was in primarily year decrease the sequentially million, $XXX quarter decline and prior period of revenue and points revenue. margin decline basis Nurse Allied the in prior operating and the

increased X% was up quarter coming locums interim within normal revenue in million Physician with driven million, by in acquisition. to Locum Solutions acquisition. MSDR the $XXX the the Fourth MSDR segment. primarily Sequentially, businesses. year-over-year growth was the down XX% with Sequentially, quarter revenue volume the lower driven revenue Moving and Leadership is year-over-year, down and X%, line Tenens of revenue from by seasonality. X%, $XXX

leadership an million and was bill down revenue the points. Leadership year and Interim and XX XX% mix Physician tenens Gross gross basis XXX a increased Sequentially, basis shift. lower primarily to period lower revenue sequentially. due and volume prior locum revenue XX% XX.X%, and spread Solutions down in from decreased year-over-year pay million attributable X% points $XX $XX rate. sequentially segment the up Search margin was of margin for to year-over-year, unfavorable X% of

Sequentially, primarily XX lower adjustment, and Segment lower the to gross employee decreased decreased negative expenses which lower margin margin professional operating margin year-over-year, offset basis basis due operating XXX actuarial and points partially points. debt. by was liability bad X.X%, the

VMS year-over-year quarter services Technology Sequentially, million, language for solutions. offset revenue down the down and more in and Solutions than Workforce decreases X%. revenue by in was as was X% growth fourth outsourced was $XXX

revenue mix period, improvements XX% margin Language the decrease language VMS by primarily outsourced $XX X% year-over-year was was services mix year increase declined $XX gross and a partially revenue basis shift. of XX% of million, of offset and the XX.X%, prior Segment sequentially. mainly due down due points solutions revenue was revenue, points, for sequentially. XX to from gross basis XX% million, Sequentially, the VMS quarter a XXX lower margin and for to year-over-year margin services. an quarter within the

expense. partially of Segment operating increase from margin primarily an by lower the prior XX the lower XX.X%, operating driven was management, the the the period, gross margin XXX expense debt points basis in declined basis margin. Sequentially, and bad year quarter points by margin fourth on increased by offset gross

and XX year, year-over-year offset gross of X% EBITDA million, lower the up leverage. gross Fourth was for was Adjusted margin, adjusted management. prior down quarter down basis negative down due was quarter from operating margin points margin partially the XXX basis primarily driven consolidated the and points expense $XX EBITDA XX% adjusted lower by by sequentially. EBITDA margin to Sequentially, XX.X%

our of Physician the quarter interest noncash and fourth equity investments. a Net and other test we charge and of Leadership to During assessment $XX impacting $XXX included a impairment the charge goodwill. quarter, of in a quantitative noncash This Allied million, and minority impairment resulted expense performed Nurse the in related million the revaluation segment. Solutions was million and $XX a

Adjusted in income goodwill $XX.X by loss of share large million quarter and $X.XX net in the $XXX quarter. quarter diluted quarter year $X with Fourth prior in $X.XX. prior million Fourth with earnings the net $X.XX charge. the quarter. year noncash part the prior was per $X.XX compared was was compared million, in in driven per the the share impairment for This prior loss GAAP and

outstanding quarter labor the sales part the which Days on recognized due payment the was revenue XX improved in disruption for year during days ago. DSO days, quarter. than to Sequentially, lower X large was by a days, upfront XX

Operating and $XX cash $XX the fourth million, in flow expenditures quarter was capital million. were

XX, of drawn million $X.XX debt debt billion, in in long-term of $XXX down reduction, quarter ended equivalents With with full credit. net of we $XX year year. revolver a and As cash the for $XX the million X.Xx million XXXX of X. the the and including and million on of $XXX line ratio by revolving We a leverage December paid we to on focus had

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

For and XXXX, the $X.XX million. flow EPS from compared and capital $X.XX share $XXX EPS of $X.XX operations year of $X.XX. prior we of Full per was was $XX reported expenditures a EPS loss GAAP million adjusted and year GAAP adjusted cash with totaled

Moving to now to Operating be assumption disruption positive of year projected is XX.X% $XXX first guidance. X.X% of be margin to to down expected includes be EBITDA XX% and be Reported X.X%. XX.X%. revenue. from is of is are to consolidated quarter the prior to to to project in adjusted labor X.X% SG&A X.X%, This minus expenses between to revenue margin projected million, the XX.X% period. to million to XX% XX.X% million guidance Gross an revenue. We and a range $XXX be of margin expected $XX

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

For to million modeling of stock-based purposes, million of full year XX% we $XX expenditures to of compensation expense anticipate capital and non-GAAP $XX tax rate $XX a XX%. million,

I questions, to Cary. hand call up the the open for we will back Before call

Caroline Grace

and Brian, you, welcome back. Thank

the as company Mark organization his past XX Doug AMN take Chair both and We to our as our our month as thank I long-time earlier of the CFO. announced to leadership Mark has board and I to welcome the and and the Emeritus. public want invaluable this Board company guidance Q&A, Chairman. experience, to Before new leadership Foletta years, retirement Wheat, who Healthcare's Directors, company and helping for public ago. thank service Board open Chairman management of the a Doug a over has and deep XX Doug member his including become governance provided years Board call

call questions. for please open operator, the Now

Operator

Truist. question [Operator Our of Tobey first the line Sommer comes with from Instructions]

Jasper Bibb

might Tobey. ago? in to gross on you otherwise revenue to that Bibb margins extrapolate wanted maybe be Nurse like Allied. about gross I about thinking versus could and margin ask quarter, the segment Jasper for year and labor the what structural first how comparable are the for might margins a us How in you It's there influence

Caroline Grace

Jasper, margin welcome piece. the a to gross than there's question nothing first in Brian like a back

have -- we'll from We international talk XXXX. part really XXXX have in that's got I big particularly into we bit So that will continue mix and that saw of throughout headwinds seeing. obviously little a points that about that the a we're coming you we think it

maybe you if want Brian, to So a... give

Brian Scott

there's on on sales thanks Cary. the parts part, probably Thanks, XX.X% took that we talked moving and we reserves had some Jasper, the the last about Allied Yes. quarter for quarter quarter. reversals fourth few margin, question. that a at as the specifically, margin in you in Yes, the Nurse fourth the Within gross know. in reflected

of take that it, our have if would call QX the to, And in XX.X%. you closer we -- context so been that guidance,

with so and and looking team that's similar is bill to packages to our of up in the be rates a modestly in first quarter, margin at relatively doing and the quarters really expectation seeing segment. trends stabilizing And pay Nurse couple the Allied stable trends the pretty for the in And gross seeing of the negotiating. we're we're QX fourth job good quarter, last and expected

Jasper Bibb

you then year? of think volume the do What sequentially market and the bit need conditions. start remarks, prepared quarter. rate's to up demand normalization Nurse Allied a bill you the see this in growing mentioned, to And in the the you first obviously, In little

Caroline Grace

Yes.

quarter and care to And speak systems really of layer more a normalization. a contingent I and what back staff. of layer last much I a health number staff we permanent, getting a into signs flexible about what really think parts between all of seen normal they we've think quarter talked and different this of around of mix is

of the -- some typically And buying of premium. things so behavior you we've -- normalization seen when of that a drive at look would lot

lower what over premium you spread seen historically. end the So of our would is loaded cost fully of about have labor XX%, estimate today

so want go we reports getting in tailwinds. then X% you'd of picked analyst up through And predicting and reflect healthcare, increasing want we Jasper, still patient that in probably to see wage of above-average terms to are recent orders seeing now, the is to of as what inflation demand those X%, some start if see play you through year some to

Operator

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

Albert Rice

feel pre-pandemic? strike -- do you seeing things the that other a revenue. if I'm feel some trajectory there's of seasonality. in looking about there's progress have through got thoughts might what for the the trying you rest any how first are we've got wondering Do to What still seen would and was the revenue going you And how year? do understand trends as you're we like to fourth rest Just of We've in for you play quarter, the pattern normal year the softness. of early 'XX and similar the then like here on terms out? -- you of

Caroline Grace

with Let And We've I we seen. return on about Brian a we've me normal. to team can what talk more what tag expect. then seen

look If you normal pre-COVID. what seen have being at we would

And remarks, We opening last much order saw increases had an as talked of some so November the since actually nursing in see pre-COVID. April. example, in this from was would we've that. normally We off those drop as as not of orders. and about now, we I It seen seen a until

normal. the for year. return end of see little a of to bit starting of typically see to seasonality really at Locums, you're the weakness you us So that more

as seeing the are as much have But couple normalcy visibility years. we like. have what And more than don't we we we ideally we enter in of as XXXX seen visibility in, have past we would so do

Brian Scott

out through that as the -- and event I labor I than and into in flowing some fourth Brian. mean, the anticipated, revenue overall first longer it's additional Yes, guidance. added Obviously, disruption quarter, fourth quarter expected. went fourth our A.J., quarter is played think, the we

call of sales that the million-ish QX, of probably strip to take at decline kind that talked the to you quarters out reserves of the looking in reversal it, bit midpoint -- little try million you in we've both we guidance our and take of $XX are $XX If also or out so. a million a $X about,

few a there. pieces there's And

in we're flow-through with behavior, changes 'XX. we're I client early point, of about normalization. Cary's some as think more the think for client we some seeing from residual I part, to most of There's good moving really much seeing during into the locums. runoff as trends QX, some think exits still But

positive, first booking to the to which I overall, think that flat MSDR business through the trends growth up. few in second be the over for is last the to integration, up which in We're it pretty quarter, especially quarter but see first still expect we'd that the and normal be beyond. also the slightly we'd weeks confidence us working been expect really have gives to but quarter, both in

It grew services to QX. in sequentially. Language continues grow

through orders market But with that, -- And seasonal million have still, the impacts We and as some then little bit decline $X just think, about, $X well, to kind reduction sequentially start more of a the bit more of are off. bit a roll the you of again, we 'XX QX in to quarter a also about the grow see And still down talked headwind, as from their the way buying a we International working nursing behavior, some expect and normal environment through the VMS and that it million there's a some there. that side going retrogression Nurse reflective the the then with of of $X in are on expected winter right, of first I system. as of to little is as continuing, just QX. year. kind on a in Allied a business, have losses we underneath client

lot we as good and grow most sets our see momentum marker of lines. a about think, I good businesses that we a in strike. of the really QX, and good a year, opportunities service of for for foundation good really rest it's the the think ex XXXX, And So to

Albert Rice

a answering and have the mentioned what great. Do of the impact That's if remarks, a bit of 'XX would just Okay. overall. the got a it sense they international 'XX a little you I'm how of Maybe demand impact looks, I'll or you varies versus sure follow-up, curious international couple there. on figure be you I'm in headwind. but depending mentioned EBITDA times ask. prepared In revenue a

seemingly because themselves, the prepared a they're Are about it the in changed other volume flush large more? then remarks bit. -- stepping comment a And that they've doing back was was little little they vendor? that made issues? Was What maybe out client having

Caroline Grace

Yes.

Let the me answer first one.

is, what expect similar our at that we business full would So you last quarter $XXX about was very million. we if and talked XXXX what in year before look total to international revenue business, so take started, at retrogression

$XXX between headwind that, about and XX% expect XXXX We About revenue XXXX. million be would in XXXX. A.J., of

mostly remainder we and so And in X first the XXXX, headwind quarters of the of the XXXX. have in

And would that that expect of XXXX, that the you year. business the after so to in would in flatten start back And out would again. we then to see in get that you half growth start

to seeing about we're of some we from standpoint, question what color give client like always top your in clients. On our a

that the of it seen have MSP largest clients relatively they their still a we contingent of and staff target permanent reducing a of mix necessarily we And reflection a and models. on TOA. commentary of while so changing that are getting is a just to into majority our growing, isn't where just flat are in large really It's them And have couple kind flexible clients back be process. and of

Operator

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

Jeffrey Silber

question company, to a know back, with I you know the few Welcome on been back you. let and me it's your changed the start years do a you you think I And lot get industry, for have things track? left but company help a do in can actually, the from Brian. perspective, what since

Brian Scott

back. to team get It's this be tremendous already on I'd company amount this track. has of done Well, this, with Well, I to work think thanks. good start a

of can to that, a that amount been help laying do foundation. but already there's here work what I'm So I tremendous to

I've of I for we've of my a amount. unified really years have great a fantastic our going got, well think with changed it the As are we both the just point organization, a has remarks, that much seeing also really It still some over think approach of a lot folks a fair use I needed. because, there's of an more technology that's but the team branding, new known think, And blend several talent technology our of acceleration work just a work, in up with strong that's that to already from been has industry mentioned infused view, -- the I here, here, I opening said, really good you in clients engage which I'm as been But good I done set tremendous of years. industry been digitization towards last clients. way operate was, also -- us our and but was internally, that think, of

internally the of our our And applicant ERP. back solutions a that ShiftWise office then see Flex, tracking gap, but think, Passport system, the businesses a more done on best-in-class common close things there you And externally with both and lot so I maybe up on really, the web team a new little upgrading solution. catch to here, has standardizing our bit -- side, our of with

that then become and also help going speed services of deliver us resonate efficient, more All is to to allow have with market that listen better us more. clients to really and

service when we mix larger left, to of managed our programs. business had I obviously, think, tied a I

think industry still part that critically want for and clients a important I that's that service. of the

and of vendor-neutral well to across or delivered a we able now, that I that I meet the be I more of can well. hybrid see a But we're organization. want kind to clients walk now think positioned think and we better as solution really walk that

foundation. a of right the So lot I -- think we're laid

it's of efforts year, we're this we'll year. think to through and I we're And the going we feeling benefits move -- see investments of those the the of good kind a year execution. that as our

Jeffrey Silber

focused could All if to of right. step hear. pressure hospitals full-time on the still labor? reduce contract That's in census just wondering you they're seeing still up, the their Maybe great and trying I back broader is a I question you're on I and know that just seeing of But I'm ask Are to know side house? marketplace. employment. terms overall

Caroline Grace

I would seeing on as even Yes. the utilization still the contract spread broadly down. you've seen come as What labor. a that say savings was premium lever cost it It's not you've is focus we're normalize, ago, seen year right, especially a

Now overall they down. and still and increasingly still partner pre-COVID their looking there as I'd to high-quality, increasing the they're have they're need they where a above to be want with of to But line wanting systems at workforces demand. on are back help what who's some item, are really they see come where to end say still patient what meet is probably or to workforce we're of build how seeing kind that but they stepping that that cost-effective were focused them going

what the help So solutions to a workforce They're sustainably coming on yes, the focused -- the for on increasingly we're broader me build years. workforce it. round focused in is next of

Operator

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

Joanna Gajuk

or of to And coming call, talking third it hospitals able remember is on Or on some a I that you on you actually on? were seen going the and back that it, maybe the comment. quarter bit to call, about how So I fill some be guess of the higher the of more last same? offering little you like Have dynamic staff. rate less see

Caroline Grace

systems adjust significant point, at orders. able bill seeing some clinicians if know will particularly we've I don't those rates as to were back see, for will and this you at the uptick higher, get those their systems we to of about continuing than crossed what go We need some a fill orders, see seen would for to the given one bill get increase end commentary look rates orders stabilizing increasing the unfilled the just X. those next quarter of more of of But in demand is or some sign earlier year. of the be you my over

Joanna Gajuk

Okay.

there. headed in this revenue maybe were because I QX Another grow we the quarter, and moving of you the and seasonality, I'm I X.X% QX follow-up EBITDA about pieces, about margin -- then strike like last obviously about think versus where guidance, with on from such. the comment margin for the QX kind that's and QX, like when guess, talking EBITDA appreciate But there's and

margin there there, EBITDA. now guess strike fact in a revenue guiding you're lower I So despite some that is the to in

should that a year there's on, how how think should of EBITDA seasonality? about the margin So point better of and moving, this sort be normal starting X% goes just we assuming as is kind

Brian Scott

Sure. Yes. Thanks.

said seasonality assignments. think both nursing X%. Nurse And think that through to see as QX, that would single I we off roll year, typically, down as -- Allied in down. the are we I low well second expect is that as we digits the the starting quarter, a and move far in good winter as point is that

other margin, language. And that continued as schools some of growth the and But impact are businesses in growth in expecting on get locums summer interim our months. higher the search business, we also Allied we're into and like

we G&A of of operating way where the the those EBITDA all in gross probably think So of half kind to but in our start as should I right And growth that will be -- somewhat degree improvement revenue mix back on of and some to continued margin lift back and year. is our more we the we a businesses, then year we'd second continue as across -- half see half year. I first to get manage gross as good that see expect them margin think leverage, the a to the quarter, into then favorable margin move the each we that's think the on X% the good those about offset -- to other should now, that of

Joanna Gajuk

on going your expectations comments to is there But in this? mean, then any I be sort question, the of business? is appreciate half. growing first you kind then it like around of to may, So June business that's and international your half because and I risk to if international another can things come back second I XX change

Caroline Grace

improvement we've the So of forward. assumed date moving marginal some

the date XXXX. I at December think pretty now It is modest.

the we towards movement, first half. what be might marginal risk or year, the expect So if end kind smaller we've back there of the was either there some in in XXXX seen of what relative to no

So of we outlook through we're giving retrogression seen gone you historically a period. you've when our what have

Brian Scott

Yes.

pipeline build. continues be But to this that again, unlikely upside there's we've to So got 'XX. in

bit, the 'XX function just but it If accelerate don't just that a we into forward get really will beyond. little it's timing. meaningful won't business a the a dates recovery So -- move in this as of it on year, that have we impact and

Operator

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

Mark Marcon

Welcome the well. in back, can VMS is assuming quarter? Technology of language terms you revenue Solutions, Workforce it you Great sounds bit to have on are like Brian. a and doing talk first on for So Wondering the call. what you if little

figure So I'm part just to out. trying that

Brian Scott

under it's going in million little be to first quarter. a Yes, the bit $XX likely

first -- we a So $XX in million under the little quarter.

the rolling sometimes So as bit is timing of way we transitions, up with little just we've difficult about, the they the off predict. -- client to a some talked of end

actually declines But one bit for first it longer as where was bit as that's quarter some. in of settles little more out, fourth step an It quarter. upside utilization a down as that volume some took down you're as a little the has seeing So the us QX. in come actually well in

start this At we the current into the the execute that that ShiftWise as be start to to seeing see think low should should they 'XX. then of roll implemented wins with of we're grow as We we through with those base some that We've doing stabilized getting Flex what some and point is year. more everything and these are low to then the see our had and kind be is to recent client can wins move client QX watermark. point, team

Mark Marcon

the terms VMS, how overall the MSP elements seeing Okay. transition, terms general, ShiftWise from that of filling, that not in you're in as trending? just of volumes in just what you're And well across just is the as aside

Caroline Grace

I look we shape the of market So bit into our would looks focused MSP, COVID. during little demand and that if kind had overall us, supply post we of -- true COVID different of at a say that in because -- all both is for this

space look because Everything they our there. us. that to position our volumes, at you point starting down opportunity that in MSP doing, was ourselves so when an really has So earlier talked we've were Mark, naturally been non-MSP Brian about the for going been high to go

look now, of be seeing we're and business, Nurse our at MSP looked XX% our and from demand in of from XX% coming right we the where would as about so mix coming demand, is about And overall, non-MSP.

And so broader it for been was the incredibly really X taking that we a to important opportunities us ourselves market have of over advantage incremental for because years demand past that reposition lot we see of. against us

overall around started healthy trends similar space very increasing the similar in We've since last April. particularly Allied seeing nurse we're demand So XXXX demand we and in seen locum. as for

Mark Marcon

would of also a relative obvious of question. Great. what some in then from -- consolidation PCRN signs appreciating you There's And in how been [ industry in broader and what's reports partners that competitive what seeing overall your and other space a demand consolidation, terms demand could the looking clinicians you I see perspective? what be might since that on from competitive provide strength? for also you're a shakeout natural seems hospitals to from that terms was translates to be pricing. a And seeing and like bit little your the to happened companies terms XXXX. And position and the in of AIA are perspective, are terms of if There's both commentary of dynamic of and of in been kind wondering level given little any bit But of just it a ]. some of

Caroline Grace

we COVID about nursing in see Yes. recent also in coming the had and the excess part consolidation, talking to COVID. depending would solution we between became what you terms look very built saw most space capacity And question Mark, we some If but it. or What the the different significant players about. really But to I competition I of strong had is acquisition space competitors when announcement, environment, is at, competitive the so of TAM on out broadly say consistently about that what seen your of space. would you're competitive what across the out both even of recent that getting there you acutely during started draw been first say we've exiting

bit started that really you've of excess start a a shake some from nursing see I to think capacity out to standpoint. little

What us from for as for client stepping depth partner think about that me build perspective and to well going a sustainable I want back to our future, the be that those partner very are we're a really a breadth the help how to for positions saying, who's is seeing of conversations clients them. and capabilities particularly workforce and

amount It's not to have relevant solutions done that of clients. integrated those tremendous have. it's that So we and make have that just increasingly we to a more we more work the solutions those

we approaching are total we clients market workforce a seeing from want standpoint. So how are the

clients we to you of pieces need From clinicians be a this throughout is think seeing. to want investments. really to clinician least to in the technology One, because continue are that going scale But say standpoint, I'd and which and X there's all we your able there's choice this, do competition. market, not consolidation be and

beneficial in we is work they us player any very like And to standpoint, with want type also their so a career. can role because support it for them from of throughout a them clinician

to then go and if want assignment we a for go to so support and know help an We we And partner permanent. them are contract them can they appealing them. on want

Mark Marcon

Great. there saying mean, a is -- your the because Or that because bit Cary, like it tough. of just is sounds of of consolidation, to are little I some the given the have sounds position -- you competitive in been of competition exits capacity reduction it follow-on better on occurred? a that. that that and like still appreciably has that

Caroline Grace

Yes.

for early the too exits. it's of some think I

recent. of is that lot a think I much more news

clients. I significant still competition very I'll know that One take of of new yet is we of an So impact see the we've don't in getting that. competition seen kind X around phases. kind

out has different. really most really coming and a getting demand see environment that little business, to there. been, demand we parts COVID, of a bit so But for this And locums our access competition do very strong is of

not are On that where side, be in rational, appropriately to we're go competitors have bill why priced which seeing or very rates with going seen, it's suspect the unsold going orders and seen fill especially we increase for supply and we to order. is an not they're stabilizing, be unprofitable priced them, we have

that are particularly So supply side. competitors an have it's you on making, competitive of decisions rational environment, still a but very the underpinning

Operator

Our next Jefferies. question comes line of Slevin from with the Jack

Jack Slevin

a been so mine A pretty one. quick maybe have asked lot already, of

You and around they if revenue color in gross disruption terms could you from when labor margin but the can frame in adjusted me it, impacts see that margin gave Apologies some guided if help guide? XQ. EBITDA XQ missed just of the I you the out

Brian Scott

labor As disruption? the it relates to

Jack Slevin

right. That's

Brian Scott

I labor difference margin on mean mean I material the revenue. not -- -- disruption it the a in not doesn't there's there's

the the bigger it's bigger sales on the reserve or the a but And decline are a gross changes on segments the we're particularly from as to then that through, really margin, either through QX we relates does EBITDA, flow getting are the influences -- QX. basis, or headwind adjustment. the The margin. around obviously, within impact not it international So really between notable higher mix consolidated some it's have mentioned segments QX, a influence. Those on

business, it's pretty revenue was a flow a have and just in in was including in couple our labor just performance in through that margin, influence high areas and they're it's adding outperformance of in that gross itself, similar better on margin. disruption had EBITDA. fourth the of part events itself we labor some -- nice had a The that EBITDA the interim the flow-through it disruption quarter VMS other the It -- of but with was -- wasn't business And our also that businesses, margin. been Strike the big it. largest that

Jack Slevin

trying normalized One it. give had on quarter. benefit the of cash some helpful. we I'm square just could should conversion where sit at just going you converting free first or in face probably to about I you cash forward? the you cash Got appreciate sort thinking but about the taking QX maybe guess reverses, that flow a free how business basis, I hoping a Really That's in how I on it. think generation. little of follow-up. guess Okay. value color was quick you're

Brian Scott

as talked XXs in the think I typically of mean conversion a would Yes. good flow I that still range. I we've the use kind that marker. free cash

year to EBITDA. current revenue our expected We reflect and in adjusted have this the environment CapEx

So is marker to for use any still good think, a that, I modeling.

that Does help?

Jack Slevin

That's Yes. great.

Operator

of question William Trevor Romeo comes line from Blair. the with Our next

Trevor Romeo

Brian. Really to to back on calls. you back good have Welcome these

for of a quick couple me. ones left Just

think I I on you think, last about trended order a one, they wondering in traveler your could but quarter, and already on if monthly we I about September. momentum was positive talked basis? volumes a how talk you volumes bit, maybe had maybe assignment some

months how from maybe have wondering gone X last the a perspective? just So TOA

Caroline Grace

Yes.

if off. about would What headwind of If that seen looked increase year, is you you a Allied, nursing say, and you into at go a coming comments slight you And over in quarter, a slight we in travelers. headwind say, see, we would kind travelers had of see the decrease. would of have international have and travelers the you with ended is I Nurse seen the before pick talked do then business up as I'd from that total you total as first I where international for about of the one the some reflective we which talked would is

you QX, orders, winter orders look typically, So the when X/X at are in in winter QX. with X/X about of

a there's aspect that. seasonal And to so

Trevor Romeo

of in school kind demand That's Got one. it. quick what business. staffing your one was I helpful. other And seeing then just wondering you're

heard from I some an kind positive of recently. think others trends area that's we've

couple of I in lately. a acquisitions that area think been there's

there? So bit more seeing if you're color on you give just what wondering could a

Caroline Grace

in of schools affected clients. starting some the we're XXXX. that of XXXX. and level of of COVID kind and a programs at We a to of we're terms how good had cuts consolidation XXXX There start schools in off headwinds that the off a affected and that of some we budget at bookings, look start. love were business, to in We some we some good Yes. coming couple districts the upcoming supported district out and a if But we're

Brian Scott

in of is year. a always now activity it's we're booking business the this where Yes, impacting the fall

this recent we as time so at And last our of trends, ahead running booking year. we're look

Caroline Grace

Yes.

Brian Scott

a it of as is in volume year, school So get gives into good higher our was fall the 'XX that expected be confidence to year. us we than 'XX school that degree the

Caroline Grace

would to introduced us technology great we other which that part, be able for the And to I support. is virtual say a do Trevor, is Televate

so And over the gone very upcoming has especially the well, started bookings that year. school for as we

Operator

back the Ladies like would to and no now over the gentlemen, I Cary in call questions closing to remarks. for further showing I'm turn queue.

Caroline Grace

all clinical day want in have enable corporate appreciate to continued work a hard patient Great. AMN to you interest your care. special Thank employees you. our of thank who every to I Thank and Healthcare, We you. and

Operator

call. that your gentlemen, you and Ladies conference today's participation. for concludes Thank

now may disconnect. You

AMN Healthcare Services (AMN) 20 Feb 252024 Q4 Earnings call transcript