AMN Healthcare Services (AMN) 16 Feb 232022 Q4 Earnings call transcript

Good day, and welcome to AMN Healthcare Fourth Quarter 2022 Earnings Call. At this all participants are in a listen-only mode. After the speaker presentation there will be a question and answer session. [Operator Instructions]. Please be advice that today's conference is being recording.

to call like speaker to now Mr. would hand over the your I Director Investor Reece, of Randle Senior Relations. ahead go Please sir.

replay will Good afternoon, the year A full fourth conclusion quarter this everyone. Welcome to XXXX AMN of this earnings ir.amnhealthcare.com available at be Healthcare’s call. and of following webcast call.

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

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

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

Nursing Group James Knudson, Physician and today Operating and Talent call Jeff unavailable Executive Solutions; Officer, in of Rakowski, today. Financial Landry of and Officer; Grace. Taylor, Kelly and President Seedig, Chief and the are Group of Strategic Solutions. Cary COO President On and Officer Chief Allied COO President Chief Leadership Solutions,

over call turn Cary. now to will the I

more gratitude all for CEO investors November. clients why our welcome joined confirmed our and Randle, team, in and time begin warm everyone. expressing I months the past you, my AMN. few as and welcome reasons my have to since analysts Thank directors, have The the late received than want I of I the board AMN began by by

delivery and AMN help AMN timeliness service quality stands valuable through large at that next phase in of and acquisitions well care. difference nexus an to combine guide the growth. me increasingly positions client growth of My and centered healthcare businesses running organic talent, where experience make of we its the

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leadership every day, and our to everyone team in opportunities Our create the for is live in entire committed making we long-term great organization. sure AMN difference

I'm especially outlook. with for country for strong conference XXXX, healthcare you members grateful our to AMN fourth impact my call through a than outstanding in as and professionals good first our and first in quarter results, valuable report placements XXX,XXX the Thank making to news quarter clients pandemic. with more our a managed team

in the costs, and moderated in clients spent how long-term. care delivery manage to are workforces labor preferred clients with rates than bill of We as partner of proud our $XX reducing their am MSP we urgency and more partnering remain demand labor help I to investing transform our clients billion for optimize solutions their of and over BMS the healthcare managing programs models the with XXXX. tech-enabled

Gender and preferred by row. Corporate the a for of is being as our gender a Bloomberg National the year Equality to named corporate Equity accolades professionals healthcare a equity Diversity and members, and award Index in employer Association and to received, including several sixth from for for commitment Directors AMN Inclusion recent the equality we team demonstrated

with a managed looking extremely the we year a the high past anticipating expectations our ahead, down through exceeded we year, the we demand, ago. businesses moderation of out Over as were wind pandemic, the laid

business million. outlook in and market. fast quarter. results EBITDA billion of $X.XX latest the our changing what Our continues segment was be and quarter $XXX for Fourth Every financial with of apparent to guidance exceeded is high a performance level adjusted current revenue

segment than with the despite revenue. rates of rate quarter fourth with we nearly ahead The flat coming expectation first of somewhat than lower XX% the labor a peak. the quarter, less was lower moderation was Nurse and in bill Allied segment quarter average bill had disruption third anticipated, revenue since

lower by healthcare the in offset sector volume impressive rate. was pace third of maintained hiring average an the travel above eight the nurse expected permanent than quarter higher As travel Demand past months. bill over levels, after remains for XXXX the even nursing

Our Allied sequential a pivoting a and year-over-year did revenue specialties, from phenomenal The increase. business team X% with other job areas. has growth related therapy focus pandemic X% to

comparison in XXXX, we sequentially, to first down the For our XX% and to most and year. Allied year-over-year quarter be of Nurse difficult expect stable against of revenue the XX% Solutions

and guidance. high quarters Leadership In consistently year. level of than consecutive achieved segment, slightly high our Solution over Interim fourth better our four $XXX quarter million Search revenue revenue record for with operating tenens Leadership a revenue. Physician Locum at was is and the

business Search expected, Solutions prior demand year. revenue flat revenue clients and In at Leadership XX% pandemic to was Leadership for some we first savings. related in year-over-year, be XX% to quarter fourth quarter, be term to Interim focus cost projected lower and and excluding would on the the short Physician down we As

well for guidance than is year-over-year, and permanent levels Demand XX% tenens our growth. grew above Workforce placement. and locum about Technology XX% revenue In pre-pandemic physician of better Solutions

of business Language outperformance Our Services was the the primary driver

making further communities in Since its to the Services innovation, can impact evidence quality has of doubled serve. AMN patient company we we how XXXX, positive revenue, value to acquisition. add example of a care, with Language It supporting our acquired a and the great is commitment

care alone, XXXX our its Also with outcomes continued enhance in moderation revenue patients over interactions. in million the health we segment, expectations. this line experience In VMS for in XX

expect revenue. and to revenue For lower the be Solutions we quarter, down Workforce year-over-year XX% and XX% to VMS first to Technology due

a to call our after will focus I XXXX outlook, details Now, provide which I'll turn for glimpse and more and beyond. areas to return the at about results Jeff for our over

Fourth in the the all Thank the down line you, of contributing year-over-year excluding quarter was revenue afternoon XX% disruption sequentially, prior three and revenue X% with quarter. good everyone. was $X.XXX our billion and Consolidated Cary, above segments revenue, with end consolidated revenue to of outperformance. labor guidance X% range was high

than XX due margin basis down towards the seasonal shift was and Gross margin Year-over-year, prior margin points the points for staffing. shift revenue the typical year to mix XXX Sequentially, sequentially. a to due was the lower businesses. hired basis quarter was mix margin toward higher XX.X%, revenue higher

expenses SG&A ago of in compared quarter, revenue, or $XXX Consolidated of XX.X% or previous of $XXX million were $XXX revenue and in or million the quarter. with XX.X% year XX.X% million revenue the

drove SG&A for expenses Higher related reserve revenue increase to less quarter. due and normal operating primarily legal credit were SG&A year-over-year lower given conditions. the compared lower expenses, and with expenses employee in allowances more the prior losses

quarter, $XXX or revenue in quarter. excluding certain less leverage SG&A. operating revenue and the this Adjusted or million compared year of came ago on increase of stock-based SG&A compensation margin in expense $XXX was million adjusted The XX.X% non-recurring revenue. XX.X% expenses from lower with

was hours XX% offsetting $XXX higher down lower fourth quarter, than down and sequentially. and bill X% was rate quarter-over-quarter slightly the Allied year volume. Nurse prior X%, In X% revenue average lower Average million, and by

revenue flat year nurse prior prior was prior year X% of down quarter. XX% Nurse year and and growing was above lower margin travel Our points from gross revenue quarter. the Allied sequentially. was than versus prior Allied million and and X% prior XX basis $XXX XX.X%

the by insurance revenue, bill expenses caused was higher change lower in offset and hours year-over-year improvement by pay partially disruption average spread. labor less The

lower that the in lower workers from than basis compensation Sequentially, than segment credit XX.X% year favorable quarter, adjustments reflecting operating for higher the QX, points decreased losses. XXX margin the prior occurred prior stem basis of was margin allowances primarily and points XXX

XX%, Physician in by higher X% X% year was $XXX growing fourth higher and revenue. excluding or prior the quarter $XXX revenue year-over-year X% Leadership down Locum Solutions related revenue than was and tenens million, sequentially. million, pandemic

prior from points basis XX%, and Interim for quarter higher down leadership than basis Search XX% was down X% declined year prior from segment was sequentially. revenue prior prior increased X% and from and XX% Gross quarter. margin year over revenue down year. XXX XX points was year this

was margin by margin tenens for increase due The to points XXX primarily mix. operating basis and a came profit sequentially. gross last XXX from locum and adjustment. offset up favorable year higher lower actuarial higher sequential losses margin margin a Segment primarily from credit basis points for was The up XX.X%, allowance partially

with million the revenue year-over-year Solutions million and year-over-year quarter from down was $XX X% grew was X% XX% fourth down Workforce growing and BMS out year-over-year, which quarter, $XXX of X% of million, prior sequentially. X% revenue stood grew expected. revenue and Technology and Language quarter-over-quarter, Services as in had XX% $XX we

XXX BMS over year points was XXX basis sequentially. and The prior gross the track Segment points XX.X%, higher sequential and revenue comparisons up changes business. basis down margin year-over-year for margin

points basis and XXX of Segment by basis of of down XXX Consolidated was adjusted XX.X% XX.X% and year-over-year operating sequentially. down was the and year-over-year points EBITDA prior XX lower points basis quarter. fourth lower EBITDA from down X% Adjusted million XX% points $XXX basis XX year-over-year quarter margin was margin up sequentially.

in income higher net than earnings ago and $XX came of days, than sales diluted less the expected million quarter. Adjusted in per year outstanding with reported the compared per and year. was two share XX prior share days days than better the $X.XX We quarter. Day prior $X.XX quarter earnings four at of in $X.XX

million capital expenditures were Operating cash flow and million. quarter the for was $XXX $XX

a we long-term ratio time As December million equivalents net XXst, of to had one million, of leverage one debt cash of $XXX $XX and of

compared we higher year. income $XXX a financial up billion, Recapping with million, basis points was year Full which adjusted of of year-over-year full from net million, was highlights prior EBITDA reported Adjusted the of $XXX increase XXXX, margin revenue XX XX% and year-over-year. by year for X XX.X% XX% XX% $X.X XXXX. EBITDA grew

repurchases adjusted the $X.XX, by during was from our XX%. EPS in was prior of EPS XX% than higher year-over-year, $XXX million benefited EPS year stock GAAP year. up $XX.XX

our nearly from from was Act of which Act, from cash million, flow taxes cash deferred was a of Capital Full totaled repayment. million expenditures XX for flow year into Cares EBITDA operations. Cares adjusting XX% the payroll million. $XX operations $XXX converted payment the adjusted included

capital an of is million Since of $XXX obtained to with million $XXX XXXX, capacity borrowing its The line bolstered total interest facility terms. for credit to strategy, the two end line our in revolving we the XXXX. of expanded our extended adding have with of tenor rate events expansion previous

$XXX expanded of repurchase call, by potential authorization the Board we for million of bought last $XXX addition, million. Directors In latest $XXX stock buybacks. in X.X a gives shares our of back share us earnings Since total authorization million. million The our

billion, prior a billion to projected Now be down $X.XX looking XXXX project to first of to Gross range XX% in XX% We $X.X to is to year. XX.X%. margin quarter at XX.X% over be consolidated guidance. revenue

expenses share margin our guidance EBITDA repurchase details XX% be $XX expected projected activity. XX.X% can reflecting is million, be to XX.X% Average shares expected Operating to XX.X% of XX.X%. be are release. diluted to be adjusted be Reported revenue. quarter to today's earnings recent found to first to to and is XX.X%, SG&A projected Other outstanding are margin in

pattern. quarter, Last seasonal XXXX about a we returning to talked normal

in came expected, Allied with driver. than a outlook After quarter first Nurse key a suggest QX and results stronger we seasonality. QX than quarter rates that being trends for fourth strength Our the decline higher and normal is bill greater had business current revenue in

While demand in conditions line market and remain pre tight levels, is normal with still we have seasonality. contingent And of go and will pursue above some seen near Labor clients vacancies believe back reduce term attrition. demand high utilization up cost staff. over savings very summer with we staffing pandemic the

now, I'd back to like And the hand to call Cary.

Jeff. you, Thank

years, for acute employment remains While more difficult Voluntary intense, than X XXX,XXX. inflation highest XXXX, a care. wage elevated. and conditions in turnover spree clients XX people Competition than net in remains the of at healthcare our level in resulted less for than the increase hired are more sector most that million is and in hiring talent

Recognizing are stakeholders. our that areas key we long-term will we these four for value enduring on drive focused all issues, believe

as strategy optimize to continue organizations, be they long-term in preferred for continued partner workforce increases to will the we utilization. their health First, meet care

solutions for current making be serving and and and in clients. differentiated building We clients go-to-market professionals and both work winning easier path, healthcare clients Our with more see strategy. brand with that internal great strengthen ability our new is and our and as equity so us. On acquisition that investments it opportunity will to comprehensive to will we AMN better one

to quality. on to traction improve gaining leading already industry are deliver our while We maintaining speed our initiatives

from has MSP our receded extreme its demand to gain share. As strategy better positions highs, us

benefits for and healthcare mentoring Second, efforts employer in diversity, flexibility, initiatives ensuring pay equity on team and and standing pathing These at inclusion. levels, programs we competitive all and AMN preferred leadership are to career our ensure workplace include and industry equality, professionals members. the is new

having the from accessed in technology. Our professionals health opportunities industry, benefit job care selection mobile easily of through largest the

Third, keep solutions that we want our improving portfolio to and is building total diversified for expanding healthcare. talent

of AMN. in aggressively to aspect every technology strategies Our increase enablement

expenditures capital with of Our approximately heavy will revenue a plan focus innovation. X% digital allocate to on

the our These to add sustained for up technology keep a with investments solutions of demand. mismatch care will led and outcomes amidst of improve supply delivering solutions, and challenge existing new

Passport, than Digital are And to and always we initiatives to in are We good XXX,XXX connection invest continuing AMN growing. capital. nurses are on of as First being such finally, committed with more stewards

doubled more than enabling us to industry improvements. Our capital the over and three expenditures past lead technology our years,

free and strategic have We built high us options. with quality cash company strong give that of a earnings flows

opportunity. and balance is the framework strong which we to a capacity, while make a With sheet borrowing attractive also we have great stock, and acquisitions, expanded investment flexibility believe repurchasing

open questions. Now, call for please let's the

of Instructions] [Operator come will you. with And our of ahead. Fischbeck question Please from Thank line Kevin Bank first the America. go

And being hear in again, And QX always drop basically think you're last it's into just view should but the here higher you QX. about around from the it comments change QX flat change? more sequentially, is staffing your from about demand? healthcare of Great. to and to you big when QX I kind in now, is lower? to the earnings of, than giving new normal where right debate seasonality your QX, QX we I as were there's stability Thanks. QX guess, view being time? was I QX speak guidance were seasonal some kind I really about But Is there. be it that your helpful where on guess,

the over patterning I'll for and talk QX, to questions. little we'll I can more Hi, about bit Landry little then what turn a and demand. QX, Kevin, bit the do thanks of broadly talk a who'll about Jeff, Maybe it is,

Kevin. Yes,

at higher that's partially quarter higher rates, that by orders than first the off So, be what we'll thought bill have guidance we QX. of is mix from primarily originally end with higher driven rolling would and driven rate a really the some

just than a think as revenue sequential case. quarter second the EBITDA and going the and if a into So, QX. QX about year, we higher still Nurse in are be step and that to to expecting is would And normal expected and lowest revenue the we quarter QX of result, Allied we decline the from year, margin the back have

sequential and equal by Allied both winner be we decline second side, the normalized normally historical at bill X% and Nurse labor by would the the On and orders and X% in winding driven patterns quarter, would that's expect a volume down that for in looking rates. driven disruption declines

single second rates bill So, were historical both in as that bill first in and do but bill the be second expect fourth again, by mix rate now and influence than the sequential the QX quarter our seasonality. from the we higher decline the primarily quarter, expect digit we the quarter, then, to driven a decline declines. would And the seasonality, than rate higher volume less normal high

and of little I'll been is of around then, comment back supply demand seeing. have of some me on Hey, what we that bit Kevin, shape perspective kind step and let you more factors demand we're we Landry if see And kind a what a on more question, we've seeing of recently. the the give take the

the it supply the enduring So, for the the professionals. across supply/demand if of still the of we've we imbalance demand health emergency levels, healthcare structural these in moderated onset into I workforce. down really And we change from an during an care saw accelerated go demand the have as pandemic, back and pandemic, existing

five utilization things kind annually. track I plus the and growing, somewhere So continuing that seeing pegging seeing to it people you're think are percent is are we demand so continued of

supply, healthcare being supply is impacted already the of with especially professionals the increases, retirement. nurses of up keeping these by new constrained is The not and

and driving also continue demand, some that are jobs And care are see stressful and demographics driving of our in of accelerated elsewhere. same the also the increases of care leaving retirement the health less bedside health to some So, professionals. we taking in clinicians

high economic pressure inflation supply/demand across these sectors, Beyond all upward on we're as wages. increased that have seeing compensation enduring imbalances, has put expectations

throughout And happening pandemic. so really the was that

to cost patients help their to conversations is, about serve and the the how clients a been we've in they talking them workforce do need So, retain way. our effective attract we

enduring over I'll kind structural turn bit imbalance, we're about leaving pressure on from upward, a point pandemic the to little it continued demand And So, Landry more seeing to what of of recently. supply talk wages.

Yes. Hi, Kevin.

by see today, did really industry those of nurse during So, continue never characterize of and you about think we as do spikes. that industry. as and of have demand to a of the major to irrelevant, we above at the travel what we of is demand filled that in get down is it we allied COVID from levels. as But saw the highs It lot that some kind would peak, overall some pre-pandemic the

things you that spiking that of demand have So because extreme inadequate predicting along demand and all labor had supply of exist wouldn't there We've the been exists. that the needs high be we universal some as whenever those demand the still down. to settle due higher on than Yet, -- pre just those healthcare. pandemic issues of within some labor of would to levels, that

a marketplace reports seen is some our our while of decline as demand out as that not what reflect of the I be in have there steep what on suggest. down, as the those just We been And has others mentioned, seeing demand couple in industry. might reports

a I think reasons that. couple there's of for

of about their with reducing highly over the that couple understaffed remain But are business years. even now past of the reality the today. that AMN cost. consider is years. few I stay MSP kind chase And what of think true not one we really did customers of our the also over reason we team to facilities is past our would Lot the any clients short-term conversations right

some so expense contingent in to targets. try really looking if their Bill to volume most supply rates, lot underlying at the is the And demand, look and of drivers marketplace. expect accomplish really are short-term, clients for part, overall labor that sustainable a then, decreases just not we the their be to pullback you pretty in of order they've and going moderated of for it's the

So, our as bit quite a last healthy also our partners. levels. to then like saw increasing pandemic MSP also capture pulling the throughout returning and over we fill of rates, things which in to throughout were now, of We high a we highly some mentioned There's environment little expect our historical demand had see our was focus that have to opportunities couple progress a is bit year. the dip supplier we do we're that I'd on levers internal more the really on been that years. whenever we that demand and then that And reliant previously we think the non-MSPs, right past

to out this fantastic. kind to go CEO, what on think there's thing to comments, one see And of always as new I stuck what in Thanks. kind how what whenever kind the as I opportunity now. And That's mean? one Any Okay. more. just way see a you me. could about focusing AMN do and size Cary, they're your of I guess, more should prepared of guess that looking we

Yes.

thanks, Kevin. -- me Let

me as throughout you a the give at calls to color continue I'll Let And little on bit it. on macro level. these perspective put a continue we year, of

where will very know start physical be there's to AMN, going one together. So a brands I come you of see our representation to that,

continue one the more are we parts But year incredibly on look to of company. is the work make and do together. AMN throughout integrated things cohesive So and actually the lot will how as across we seamlessly a all working we really, that more will literally hard

that our processes work solution to platform. doing of across So there's for lot to set our a our XX streamline streamline we're implications

with, our very like to a is for and we so business of feel for own for want AMN lot all what both our of feel importantly members. clients, clinicians, do team And easier our to to

if of our solution, largest the financials, If what eight. clients, our have proxy example XX expect of look I our start gave average XX we of would it to right in of you you at terms as of an now, I a an changing shape

and XX for if us And kind and that solutions, so created more a much of there's did those client math opportunity doing we'll And then obviously, have that's client across penetrate the base and around tremendous to to them. meaningful compelling we've further our value much, success real proposition our relationships. you went in further

Thanks.

Credit for moment One of our question, you. from Rice the Thank Suisse. will come next that A.J. with line

is Your open. line

Hi, everybody. your here. Cary congratulations, quarter first And on

maybe bit the just a of little on me down further Let was stuff saying. some that drill Landry

peak, fill if look percentage. accounts, the subcontracting couldn't fill So to orders, having you out all the but couldn't entire you were meaningful at MSP you -- your I a the the in orders, know all you industry were

subcontracted percentage you is that of even the your at potentially If filling are accounts? those Or you you're fair up to look orders meaningfully? say, and that still QX, MSP number QX a open going are among stepping it being

going was thank that. say, I A.J., for you to

doing what You talk Landry got what strategy. can around and strategy our were have our let MSP we off been doing throughout the then Kelly pandemic, a we kind little and broader about kick of bit also subsequently. I'll

Yes.

Kelly, to just strong. QX that turn both to and going QX I'm to going A.J., mention, but I are So was

So quarter. high in the we demand were in living really fourth

then into are so let little -- seeing QX. I'll look detail. as you progress we that and increasing to now increases And on QX on as through And being Kelly And more going we then a at right bit provide pretty focus those but our is that, flat. have that

seeing Yes. us from increased some We're demand A.J., in for favorable -- increases capture. on to those as fulfillment build just internal as certainly both as QX that, lower QX. demand trend well to incremental our that increases --

as of for critical remain our to AMN's of COVID the fulfillment our remain -- network, have throughout our or of were in our specialized were that we us to fortunate capabilities our suppliers our strength areas a also supplier of ability behalf as on regional which will very fulfill achieve and model strength clients. We clients, augment to well as but combination will is the

And for that have us, as additional to capacity new although, perspective, won't A.J. opportunities seeing strategy pipeline demand a that. business creates we're and change, strong grow pretty also from do So it we

market. in for couple a year. active and very in added few the last a been starting quarters we've new So the here the of us We MSPs healthy pipeline

So we of part And client grow of be strength our to will that continue growth. will the a network key our again, base.

follow-up. Okay. Is another comment then you And were just guys a making.

what new had said, So in in competitors MSP and there the had -- some happened ones And you probably and come like pandemic, grab marginal to less about some accounts when the your you of got you some always share. other think you emphasize was focus.

As the you're whether the wondered thinking but about you are businesses, sticky might some there opportunities having pretty adjacent And a if the and your lot I core Travel Are Nursing, Locums might traditionally, I know side. M&A to opportunity Allied of opportunities to were at. wondered go on with also has it create business, look of in M&A emerging finding new back I that been business competitors? that the back -- it come you willing after people how are you some easily. people is to

So is can A.J., this it. with Landry. I start

business, the and very transparent cover those to holders it. VMS MSP some we marketplace. are whether -- or changed our we never we those out nothing direct were in We we maybe left relationships. So with a are deprioritized in third-party it where other non-MSP of still contracts We or the just

whether was businesses. or that system were We help other our even our that of VMS to through try business clients was So out, trying some those to solutions other some find hidden. there local different types to being nothing or of was

still them exist. still within those our those We contracts higher So, numbers. prioritize get We can rating order orders. all just

Some setting state or to some of have. vaccine of or just up the programs some other was FEMA, point of at was that I they, we go that centers, in hospitals, away that contracts fact, referring up the and or would business stand kind facilities short-term some more of those we're that thought that of for

our has out think focused customers our run to well been will I highly for retention play in long staying MSP continue had and has on new strategy So MSP customers is rate the us. of our

And -- okay…

new we're with to early A.J., a some go-to-market some more bringing set business challenging comprehensive we as more around I solutions and the seeing as as faced solution they really of just reflect clients your relationships looking we and market. and traction are comment last new in, for on strategic emphasizing that a

the we have the up number saw started in business past, where and service growth going lines of one So seen as with our per indicator, early over contracts with is we new versus time. contract

see trend we'll as to expect that well. So continue

Hey, A.J., continue on be part important M&A to growth M&A the side, our we of expect an strategy. to

our more And have M&A, should ways so help can especially think expect as to you it a proactive us we that focus us on serve clients effectively.

at We fit, will look look management. look of at cultural we strategic quality fit, we'll at fit, financial

will assets. We look at staffing traditional more

We and tech-enabled solutions. have also on a will look at focus

in the but relatively from staffing of say it's would early I What year, traditional seen more saw assets. I we're solutions up. seeing we know we what kind have relatively come more standpoint, last year, tech-enabled probably on bias

broadly, will in growth will And so we that are look know very strategy. interested M&A as we look a we and

lot. a Okay. Great. Thanks

come moment for our Truist. with Sommer Thank Tobey you. line will One from that next of question, the

open. is line Your

some -- the giving larger VMS MSPs? for and recompetes see what and timing MSP touch on us on Thank also time particular, you. your like rapid you maybe adoption VMS you. spend In any speak could of trends. solutions Thank color more if of to and some if wanted could vendor-neutral I seems to MSPs you

of We Hey, second, conversation, different retention a their recruiting, frame set a different that over Tobey. Kelly I'm have staffing very needs; a as they strategies to built manage and broad they intentionally strategies. to going capabilities. have up we to know workforce want but clients have for this turn in how it for

trends those look start them and helpful Kelly about to around to can the of some that strategy. And we how really then talks from they want we so need this and at with think we that client it be how of do execute as and work that and we

I'll So, turn Kelly, you to it over to trends. those talk of some about

any given Yes. say, sure those seeing pretty we're own year Hi, some business. typical on from we I'm it's I trends. mix see say, of of our I and would Tobey, will not typically

little a during years, our at saw two changed look of last heavier it the XXXX, over COVID. in But Now technology-only solution. we pipeline bit mix

to that start we Now come see back.

say our today more weighted is MSP heavily pipeline full would towards I So programs.

their And into -- want our nearly any and also, in-house, client multiple we clients see such want to in typically, year, a in because who in-house large from we'll those from given solution program. XXX, and who an MSP base, solutions have our conversely see take some VMS transition to transition we business

of I what that both say those had we've in again, would we've the is So seen And pretty out past. play client base. typical in our to

more are want to we would course, Nurse. of type clients of it's Travel an to So ability have add use workforce, say, more I solutions inside their flexible to their seeing, to of

flow like things pool. So internal

You them some accommodate And using to agency meet solutions help internal they're activity VMS we their local did to partnering needs. that. in customized are with certainly, see where highly ways

the and your had second rate strong renewals contracts. Tobey, part year. a Again, On last of our our around retention outlook for question, we very

terms. at contracts coming period, very a to as look have typical our We we renewal

this We have renewals. outlook for very a year strong

verbal. In year. It's not this fact, we've got several contracted already in

contracting for of and So, nothing over is the accelerating that a happened the or have year. it really changing and COVID catch-up past played laser out lot that that

Thanks.

think a reliance history, are to see as wanted that's you get for what you and Travel I follow-up, that a telling on why you, if and how the in to customers demand get of conclusion? I nearly talk product you of do reflection a if And about could rebounds my sort conversations For Nurse. of summer

of really are some the it back goes think, making. I comments a of and that No, Jeff combination Landry to

and of in at on macro backdrop and supply demand -- if just continued there's we structural look standpoint look -- a research in a So at some published you against it imbalance just this the on from just timing the and and access. delays

know get up. the their very containment, continues to going staff right they We And demand as to are that to demand. on pent are focused on now as cost they also are extremely much how meet clients focused

what seeing of combination we're a it's So, structurally.

through seen where summer. winter have And to second, start typically patterns that go as orders get you we seasonal the you

of So, it's things. of really a combination both those

is just really It's -- Yes, not Tobey, would I just it sustainable. add.

that is it We're purely a Nothing CMOs, seeing still financial not It's demand unit from a They it's for has the that, they QX right is good, savings, decision. demand has just right. felt CFO purely pain, lower volumes the changed All understaffed. solution they're And the back. the the That's not decision it of cost been from our are are haven't managers. reality pulled seeing thinking we're there. now.

our clinicians there still now. right So are

last those coming just higher whenever off, it's start experience It's the the saw get pandemic, seen that staff a shortage noisy, whenever be sustainable a years. XX have there And getting facility, poor over within not internal labor. it's throughout the this we not we'll it but a is we've will even so -- noisy, not also to clinicians their turnover. it will decision And

I we'll particularly just I the know at that XX you it Tobey, survey part that look add publish fragile to I months over workforce, in is we've do nurses. really of would XX of hours. May. last data so over And the talked state past of the a the past some kind XX got about, of the when the And biannual months we

between level you and has if saw it levels, macro to nursing look XX%, career we the that number XX% decade. at XX% for a job, satisfaction for And nursing been drop down current

And still our be keep do so making to clients balance able down, for high turnover they -- is to standpoint an of environment the lot their also how between that containment. retain the they a pace rate cost levels very balance staff. from you of But that find going and there at sure a have satisfaction that precious going is when look this

you. Thank

question Blair. One William the with of moment next and line from Mulrooney our Tim will come that for

open. line is Your

Landry, Jeff, afternoon. Cary, good Kelly

afternoon. Good

here is lot parts of to expected moving a to quarter with first lower than quarter second be stronger, expected there's So be normal.

So you laid out ask want in XX% that in I today? annualized than expectation for just $X quarter, margins. a to more different of a billion framework revenue XXXX way. EBITDA and Is your still it Last

Yes, Tim.

So right. you're

a for with everything we about half, year had that's thought. in that normal a the and that rates, higher plays seasonal demand talked what The driven But rates again, second half, also that's normal what's we QX, second full talked from level out decline, lower that first expectation we and QX in And that, higher that follow about and just we increasing the that pattern a primarily our bill bill higher Landry quarter of is will earlier. given that also we believe off QX would driving normal path in laid out that seasonality see call. into to than last than if sequential expectation guidance the

just that. – few last building on The you're Thanks. years, Okay.

you to You've where is 'XXXX? ultimately you bill bill provided think year. you the settle What in expectation exit for as your rates had rates exit as expectation an

that still It's quarter fourth haven't. Because were first year really originally higher second decline when in and the exiting thought with quarter, in weren't They quarter fourth the they're with there they thought and just then first into the we the be. we the where quarter. single-digit high quarter they the would they and

Thank you. Okay.

line come Thank you. Mark moment of our from Baird. next for Robert and One W. will question, the with that Marcon

is Your line open.

With rearview Hey, quarter, to regards everyone. fourth the just good just afternoon, the mirror.

some margin mentioned and Nurse in quarter. operating regards was Jeff, what You adjustments to that the what fourth the credit for happened? Allied exactly, with

Yes.

macro there reserve drove have primarily dollars. losses, out. a just what was bad was general reserve that took one Mark. given credit concerned expected Allied, and credit just is losses Nurse then There accounts for a that we specific slightly also we MSP And the and environment, or those also larger-than-normal So debt, impacted for

And Or – MSP one relatively account one? contained? large is it is a that well

contained. It's one our not of well accounts. relatively It's larger

QX, were that being seeing little terms specialties that bit a than that does the specialties kudos a disclosing greater and extremely utilization is it like What that. bill higher off into why of to rate a Okay. that, certain Great. And bill appreciate that now to QX? both to in helpful. as terms extent. what into for in specialties you're the Jeff, drop Cary, the look in QX I high And and more QX QX. due utilized QX? are seeing our basically usual and like it you are that of then rates are sound the of lot sounds going would mean, bill relates change to you in forward it That's basically expected really rates, higher than

Yes.

for number Mark, by a received drove just in So is orders off why of into bill first up in first standpoint, a the the a really, specialties needs our higher exit the quarter down we sequentially They urgent that we And is and quarter a first higher QX. those and about they bill of would of up carried from that's rate going expectation into mid-single quarter fourth coming X% decline they digits. end rate the that into that ended increase then bill then bill predominantly driver rates that rates really as the roll mix the quarter, over levels. will QX the

the And just variance in workload cheat versus managing the Great. among if one discipline behavior floors? the they're of are then I more. XX terms just in How and terms how treating the need cost could on much largest you of seeing ask for your clients

communities just different because Mark, it's serve. different of those settings, of country, we that makeup in XX Kelly. the little lot across I'm they sizes, had a variation the different bit, chuckling a

will I There's one I So started there's they're it. forward. improvement a very their around that expenses of coming so the looking think to it's out Landry But hand, a coming general, bottom systems, on and high the We're in sensitivity largest still item on financials, line to the sort able about line the to talked financial going industry, be particularly peak, to December, still say to difficult from while peg consistency. off – the their the see considerable in hospital manage strain of industry of volume.

doing those cost our through sensitivity levels. bring referred to them largely help that some needs them bill rates us to that that to of with help can down Jeff them normal backfill seeing urgent the just resources to still they utilizing there's planning, rates, say would predictive We're to through back so management, more that I to. turn So, permanent vacancy

the So, high sensitivity cost.

keep same retention. CHRO's hear We a need nurses the around environment. time, professionals on have retention recruitment know safe the we have need people don't their I there's is creating and have. a most work fulfillment. still the Landry floor, a retention I still I talk they – And mentioned a positive around about, I challenge, the challenges need At challenge, there's biggest to allied factor the to

staff. – they want use not of So don't relinquish to they're the contingent

helping all help bear our to capabilities with on also a to term. bringing So from but our costs, solution teams the of perspective, fronts, short-term manage just continue them to work with them parts and them long those other

very broad-brush of the a probably kind lay that's think of I So mark. universal land

Thank Appreciate you. that, Kelly.

question, moment Capital Silber and come from next that our Jeff One you. Markets. Thank the of for line with BMO will

Your line is open.

just Hey. drivers ask wanted workforce. question a segment Jeff. This the is and are what Ryan for on the I quick year the the for curious, I'm to just tech on for going forward? headwinds think comps language the Thank do its drive really continue service segment and and you some trajectory VMS? And can you you. challenging the some as strong in business lap

that that the look rest Ryan. as be we through of expect growing year-over-year move when services high-teens the to the year. for Thanks, still comparisons would rest you year we at the Yes. would I of say in language the rate

compares, the sequentially we the very As you frame. bill and play dynamics tough in QX QX in time second front and as noted, – year. on QX QX Nurse particularly in quarter that have about of they'll Allied will VMS And some also rate challenged beyond half some of the out and the be the talked these

retention this high-quality That very team we in Services, well add, the on very just mean, heard I'll of clients Cary three-year with AMN services, mentioned, anniversary I account week. as celebrated to as And of strong just continues Ryan, Language kind you growth. deliver

expand. see there other results and increased systems accounts, still our have we So growth still for that model, as continue they might base where they base. few to where their grow new of cases, we acquisition hospitals. have the be patterns organic health a see working a pipeline within within They some we adoption account existing And and we strong our business to and an MSP opportunity with on in

tremendous value they to customers, to their team thrilled that for just as that and a part AMN. just to bring of them their we're have out shout So,

follow-up, some cost. about grumblings second and my Sure. rolling you. of given in off as Thank the the And clinicians just quarter CFO

offer And rates the are Just lower, to for to the later wondering if in you then return on second the of concessions room normal ease year. in seasonality any kind there's move to financial expecting burden half? any providers

go bill The but our bill on rates rates of that down, in was a the because level placements saw go tricky low pace. a the it orders, bill to we placements the necessarily impacting last down year throughout. negatively one, rates rate a did our down is Well, not because on went bill orders

that So confidence bill that's rates are normalize. where think to the in some got we going we've why

a that's little So bit tricky one.

thing go I to think with overall the problem. better labor offer more the is and to solutions help

part And offering it's whether of or sorts I some clients – of with your not of then brand new, to new, now. year that's think half new second question to RPO So seasonality. your all that not things type are other the right solutions solutions but something do try had local the more looking of

which of typically second of would to modestly mean and then little would seasonality, QX in expecting be over year levels. half the up On growth the we fourth stronger bit a are the QX quarter out, the over QX play

Got it. Thank you.

from come moment will the Taji of with that One our for and Phillips Jefferies. you. Thank next question, Brian line

open. Your line is

Tanquilut. or guess the the lot of expectations I your about going my good in predictions. Hey, a chatter Brian talking good for around There's a are decline of forward in space, the competitive guys. some afternoon, team. incremental rates of for dynamics bill It's competitors their question bit where

the from in of of is seeing potential price of terms So in the some what at hearing this competition just the you're aggressiveness a -- you're players the curious point? for market there in market what terms and in

from now not large something is So a from what small Jeff move sequential competitors we're competitors. rate our we've mentioned From out bill we QX. might competition, some there that margin to there move. as anticipating make of seeing pockets of Landry, bill or QX are from Brian. seen the any that of decline right It's rate that this that in is

Got it.

Okay. Awesome. Thank have. you. That's all I

over in turn like call speakers, showing I further you. no this any would now at to I'm questions And to remarks. the management the Thank time. closing back for queue

you. Thank

say, talk businesses. we PLS. didn't talked quite much our as our bit We couple about about of goodbye, we've know a final I Before a

just a look business, hitting I at the including quarters want you four terrific to go So big recognition in -- XXXX. as revenue. of They million had consecutive throughout locums give and a year, them for $XXX just over of

a shout deserves special so And out.

We wonderful months. spending us. you time being this going I'm looking am I AMN be Thank I appreciate started, of to team, with which with how is with all weeks could not all for and questions part end the I the you all interest. be and to the thrilled coming all forward to and more in of

program. participating. you today's This for Thank all concludes

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