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AMN Healthcare Announces First Quarter 2024 Results

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AMN Healthcare Services, Inc. announced its first quarter 2024 financial results with revenue of $820.9 million, a decrease of 27% from the previous year. The GAAP EPS was $0.45, and adjusted EPS was $0.97. The company saw progress in various business segments, including language services, allied therapy, imaging, and schools. However, nurse staffing revenue declined significantly. The company remains focused on managing expenses amidst lower demand, aiming to enhance long-term value for stakeholders.

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Quarterly revenue of $821 million;
GAAP EPS of $0.45 and adjusted EPS of $0.97

DALLAS, May 09, 2024 (GLOBE NEWSWIRE) -- AMN Healthcare Services, Inc. (NYSE: AMN), the leader and innovator in total talent solutions for healthcare organizations across the United States, today announced its first quarter 2024 financial results. Financial highlights are as follows:

Dollars in millions, except per share amounts.

 Q1 2024% Change Q1 2023
Revenue$820.9(27%) 
Gross profit$257.5(30%) 
Net income$17.3(79%) 
GAAP diluted EPS$0.45(78%) 
Adjusted diluted EPS*$0.97(61%) 
Adjusted EBITDA*$97.7(46%) 

* See “Non-GAAP Measures” below for a discussion of our use of non-GAAP items and the table entitled “Non-GAAP Reconciliation Tables” for a reconciliation of non-GAAP items.

Business Highlights

  • First quarter revenue was in line with expectations with all business segments in line with or slightly better than expectations. Earnings were better than expected, driven primarily by proactive expense management.
  • AMN made progress in the first quarter, with year-over-year volume growth in language services, allied therapy, imaging and schools, and stabilizing trends in interim leadership.
  • Rollout of our ShiftWise Flex platform surpassed 36% of our VMS clients' spend, and Technology and Workforce Solutions produced 37% of total segment operating income.
  • Cash flow from operations was strong at $81 million in the first quarter.
  • Our net leverage ratio at quarter end was 2.4:1.

“While we see healthy trends in some key businesses in our diversified set of solutions, this is overshadowed by weaker demand and a continued competitive environment in our largest business, nurse staffing,” said Cary Grace, President and Chief Executive Officer of AMN Healthcare. “AMN continues to innovate and modify our solutions to partner with health systems as they make transformational changes that include new labor models. This includes broadening our market reach to help more clients develop and implement cost-effective, high-quality workforce solutions to enable them to meet the growth in healthcare demand.”
Ms. Grace continued, “We continue to proactively manage expenses and capital spending in the near term amidst lower travel nurse demand, while maintaining progress on key long-term objectives that will build value for all our stakeholders.”

First Quarter 2024 Results

Consolidated revenue for the quarter was $821 million, a 27% decrease from prior year and flat compared with prior quarter. Net income was $17 million (2.1% of revenue), or $0.45 per diluted share, compared with $84 million (7.5% of revenue), or $2.02 per diluted share, in the first quarter of 2023. Adjusted diluted EPS in the first quarter was $0.97 compared with $2.49 in the same quarter a year ago.

Revenue for the Nurse and Allied Solutions segment was $519 million, lower by 37% year over year and down 3% from the prior quarter. Travel nurse staffing revenue dropped by 44% year over year and 5% sequentially. Allied division revenue declined 13% year over year and was up 4% versus prior quarter.

The Physician and Leadership Solutions segment reported revenue of $189 million, up 14% year over year and 12% sequentially. Locum tenens revenue was $145 million, 36% higher year over year and 17% higher sequentially, with growth coming primarily from the MSDR acquisition. Interim leadership revenue was down by 25% year over year, though it grew 3% from prior quarter. Our physician and leadership search businesses saw revenue decline by 29% year over year and 12% quarter over quarter.

Technology and Workforce Solutions segment revenue was $113 million, a decrease of 17% year over year and flat sequentially. Language services revenue was $71 million in the quarter, 16% higher than the prior year and up 4% sequentially. Vendor management systems revenue was $29 million, 46% lower year over year and down 5% from the prior quarter.

Consolidated gross margin was 31.4%, 140 basis points lower year over year and down 50 basis points sequentially. Gross margin dropped year over year primarily because of the growth of lower-margin locum tenens revenue, lower nurse staffing margin, and less revenue from the higher-margin business lines. That change was offset in part by a revenue mix shift toward higher-margin segments.

Consolidated SG&A expenses were $175 million, or 21.3% of revenue, compared with $206 million, or 18.3% of revenue, in the same quarter last year. SG&A was $185 million, or 22.7% of revenue, in the previous quarter. The year-over-year decrease in SG&A costs was driven primarily by lower employee compensation amid lower placement volumes. Compared with the prior quarter, SG&A expenses were lower as fourth quarter 2023 expenses were increased by acquisition, integration and other costs associated with the MSDR acquisition.

Income from operations was $40 million with an operating margin of 4.9%, compared with $126 million and 11.2%, respectively, in the same quarter last year. Adjusted EBITDA was $98 million, a year-over-year decrease of 46%. Adjusted EBITDA margin was 11.9%, 400 basis points lower than the year-ago period.

At March 31, 2024, cash and cash equivalents totaled $51 million. Cash flow from operations was $81 million for the first quarter, and capital expenditures were $18 million. The Company ended the quarter with total debt outstanding of $1.275 billion and a net leverage ratio of 2.4 to 1 as calculated under the terms of our credit agreement.

Second Quarter 2024 Outlook

MetricGuidance*
Consolidated revenue$730 - $750 million
Gross margin30.7% - 31.2%
SG&A as percentage of revenue21.5% - 22.0%
Operating margin3.0% - 3.7%
Adjusted EBITDA margin11.0% - 11.5%

*Note: Guidance percentage metrics are approximate.   For a reconciliation of adjusted EBITDA margin, see the table entitled “Reconciliation of Guidance Operating Margin to Guidance Adjusted EBITDA Margin” below.

Revenue in the second quarter of 2024 is expected to be 24-26% lower than prior year and 9-11% lower sequentially. Nurse and Allied Solutions segment revenue is expected to be down 36-38% year over year. Physician and Leadership Solutions segment revenue is expected to grow approximately 10% year over year. Technology and Workforce Solutions segment revenue is projected to be approximately 12% lower year over year.
Second quarter estimates for certain other financial items include depreciation of $18 million, depreciation in cost of revenue of $1.8 million, non-cash amortization expense of $25 million, share-based compensation expense of $7 million, integration and other expenses of $7 million, interest expense of $16 million, an adjusted tax rate of 30%, and 38.3 million diluted average shares outstanding.

Conference Call on May 9, 2024

AMN Healthcare Services, Inc. (NYSE: AMN) will host a conference call to discuss its first quarter 2024 financial results and second quarter 2024 outlook on Thursday, May 9, 2024 at 5:00 p.m. Eastern Time. A live webcast of the call can be accessed through AMN Healthcare’s website at http://ir.amnhealthcare.com. Interested parties may participate live via telephone by registering at this link. Registrants will receive confirmation and dial-in details. Following the conclusion of the call, a replay of the webcast will be available at the Company’s investor relations website.

About AMN Healthcare

AMN Healthcare is the leader and innovator in total talent solutions for healthcare organizations across the nation. The Company provides access to the most comprehensive network of quality healthcare professionals through its innovative recruitment strategies and breadth of career opportunities. With insights and expertise, AMN Healthcare helps providers optimize their workforce to successfully reduce complexity, increase efficiency and improve patient outcomes. AMN total talent solutions include managed services programs, clinical and interim healthcare leaders, temporary staffing, permanent placement, executive search, vendor management systems, recruitment process outsourcing, predictive modeling, language services, revenue cycle solutions, and other services. Clients include acute-care hospitals, community health centers and clinics, physician practice groups, retail and urgent care centers, home health facilities, schools and many other healthcare settings. AMN Healthcare is committed to fostering and maintaining a diverse team that reflects the communities we serve. Our commitment to the inclusion of many different backgrounds, experiences and perspectives enables our innovation and leadership in the healthcare services industry.

The Company’s common stock is listed on the New York Stock Exchange under the symbol “AMN.” For more information about AMN Healthcare, visit www.amnhealthcare.com, where the Company posts news releases, investor presentations, webcasts, SEC filings and other material information. The Company also utilizes email alerts and Really Simple Syndication (“RSS”) as routine channels to supplement distribution of this information. To register for email alerts and RSS, visit http://ir.amnhealthcare.com.

Non-GAAP Measures

This earnings release and the non-GAAP reconciliation tables included with the earnings release contain certain non-GAAP financial information, which the Company provides as additional information, and not as an alternative, to the Company’s condensed consolidated financial statements presented in accordance with GAAP. These non-GAAP financial measures include (1) adjusted EBITDA, (2) adjusted EBITDA margin, (3) adjusted net income, and (4) adjusted diluted EPS. The Company provides such non-GAAP financial measures because management believes that they are useful to both management and investors as a supplement, and not as a substitute, when evaluating the Company’s operating performance. Additionally, management believes that adjusted EBITDA, adjusted EBITDA margin, and adjusted diluted EPS serve as industry-wide financial measures. The Company uses adjusted EBITDA for making financial decisions, allocating resources and for determining certain incentive compensation objectives. The non-GAAP measures in this release are not in accordance with, or an alternative to, GAAP measures and may be different from non-GAAP measures, or may be calculated differently than other similarly titled non-GAAP measures, reported by other companies. They should not be used in isolation to evaluate the Company’s performance. A reconciliation of non-GAAP measures identified in this release, along with further detail about the use and limitations of certain of these non-GAAP measures, may be found below in the table entitled “Non-GAAP Reconciliation Tables” under the caption entitled “Reconciliation of Non-GAAP Items” and the footnotes thereto or on the Company’s website at https://ir.amnhealthcare.com/financials/quarterly-results. Additionally, from time to time, additional information regarding non-GAAP financial measures, including pro forma measures, may be made available on the Company’s website.

Forward-Looking Statements

This press release contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among others, statements concerning future demand for staffing and other services, wage and bill rates, our ability to modify our solutions and meet the needs of our markets or align with our clients, the competitive environment in nurse staffing, our ability to manage expenses, our long-term growth opportunities and sales pipeline, second quarter 2024 financial projections for consolidated and segment revenue, consolidated gross margin, operating margin, SG&A as a percent of revenue, adjusted EBITDA margin, depreciation expense, non-cash amortization expense, share-based compensation expense, integration and other expenses, interest expense, adjusted tax rate, and number of diluted shares outstanding. The Company bases these forward-looking statements on its current expectations, estimates and projections about future events and the industry in which it operates using information currently available to it. Actual results could differ materially from those discussed in, or implied by, these forward-looking statements. Forward-looking statements are also identified by words such as “believe,” "project," “anticipate,” “expect,” “intend,” “plan,” “will,” “may,” “estimates,” variations of such words and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.
The targets and expectations noted in this release depend upon, among other factors, (i) the ability of our clients to increase the efficiency and effectiveness of their staffing management and recruiting efforts, through predictive analytics, online recruiting, internal travel agencies and float pools, telemedicine or otherwise and successfully hire and retain permanent staff, (ii) the duration and extent to which hospitals and other healthcare entities adjust their utilization of temporary nurses and allied healthcare professionals, physicians, healthcare leaders and other healthcare professionals and workforce technology applications as a result of the labor market or economic conditions, (iii) the magnitude and duration of the effects of the post-COVID-19 pandemic environment or any future pandemic or health crisis on demand and supply trends, our business, its financial condition and our results of operations, (iv) our ability to effectively address client demand by attracting and placing nurses and other clinicians, (v) our ability to recruit and retain sufficient quality healthcare professionals at reasonable costs, (vi) our ability to anticipate and quickly respond to changing marketplace conditions, such as alternative modes of healthcare delivery, reimbursement, or client needs and requirements, including implementing changes that will make our services more tech-enabled and integrated, (vii) our ability to manage the pricing impact that the labor market or consolidation of healthcare delivery organizations may have on our business, (viii) the effects of economic downturns, inflation or slow recoveries, which could result in less demand for our services, increased client initiatives designed to contain costs, including reevaluating their approach as it pertains to contingent labor and managed services programs, other solutions and providers, pricing pressures and negatively impact payments terms and collectability of accounts receivable, (ix) our ability to develop and evolve our current technology offerings and capabilities and implement new infrastructure and technology systems to optimize our operating results and manage our business effectively, (x) our ability and the expense to comply with extensive and complex federal and state laws and regulations related to the conduct of our operations, costs and payment for services and payment for referrals as well as laws regarding employment practices, (xi) our ability to consummate and effectively incorporate acquisitions into our business, (xii) the negative effects that intermediary organizations may have on our ability to secure new and profitable contracts, (xiii) the extent to which the Great Resignation or a future spike in the COVID-19 pandemic or other pandemic or health crisis may disrupt our operations due to the unavailability of our employees or healthcare professionals due to burnout, illness, risk of illness, quarantines, travel restrictions, mandatory vaccination requirements, or other factors that limit our existing or potential workforce and pool of candidates, (xiv) security breaches and cybersecurity incidents, including ransomware, that could compromise our information and systems, which could adversely affect our business operations and reputation and could subject us to substantial liabilities and (xv) the severity and duration of the impact the labor market, economic downturn or COVID-19 pandemic has on the financial condition and cash flow of many hospitals and healthcare systems such that it impairs their ability to make payments to us, timely or otherwise, for services rendered.
For a discussion of additional risk factors and a more complete discussion of some of the cautionary statements noted above that could cause actual results to differ from those implied by the forward-looking statements contained in this press release, please refer to our most recent Annual Report on Form 10-K for the year ended December 31, 2023. Be advised that developments subsequent to this press release are likely to cause these statements to become outdated and the Company is under no obligation (and expressly disclaims any such obligation) to update or revise any forward-looking statements whether as a result of new information, future events, or otherwise.

Contact:
Randle Reece
Senior Director, Investor Relations & Strategy
866.861.3229


AMN Healthcare Services, Inc.
Condensed Consolidated Statements of Comprehensive Income
(in thousands, except per share amounts)
(unaudited)
 
 Three Months Ended
 March 31, December 31,
  2024   2023   2023 
Revenue$820,878  $1,126,223  $818,269 
Cost of revenue 563,372   757,377   557,321 
Gross profit 257,506   368,846   260,948 
Gross margin 31.4%  32.8%  31.9%
Operating expenses:     
Selling, general and administrative (SG&A) 174,842   205,599   185,463 
SG&A as a % of revenue 21.3%  18.3%  22.7%
      
Depreciation and amortization (exclusive of depreciation included in cost of revenue) 42,719   37,577   41,315 
Total operating expenses 217,561   243,176   226,778 
Income from operations 39,945   125,670   34,170 
Operating margin(1) 4.9%  11.2%  4.2%
      
Interest expense, net, and other(2) 16,628   10,259   20,165 
      
Income before income taxes 23,317   115,411   14,005 
      
Income tax expense 5,989   31,301   1,516 
Net income$17,328  $84,110  $12,489 
Net income as a % of revenue 2.1%  7.5%  1.5%
      
Other comprehensive income:     
Unrealized gains on available-for-sale securities, net, and other 84   146   187 
Other comprehensive income 84   146   187 
      
Comprehensive income$17,412  $84,256  $12,676 
      
Net income per common share:     
Basic$0.45  $2.03  $0.33 
Diluted$0.45  $2.02  $0.33 
Weighted average common shares outstanding:     
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FAQ

What were the financial results for AMN Healthcare in the first quarter of 2024?

AMN Healthcare reported a revenue of $820.9 million, a 27% decrease from the previous year, with GAAP EPS of $0.45 and adjusted EPS of $0.97.

What segments showed positive growth for AMN Healthcare in the first quarter of 2024?

Language services, allied therapy, imaging, and schools demonstrated year-over-year volume growth for AMN Healthcare.

What was the net leverage ratio of AMN Healthcare at the end of the first quarter of 2024?

The net leverage ratio of AMN Healthcare at the end of the first quarter of 2024 was 2.4:1.

How did the revenue for the Nurse and Allied Solutions segment compare to previous quarters?

The revenue for the Nurse and Allied Solutions segment was $519 million, down by 37% year over year and 3% from the prior quarter.

What was the outlook for AMN Healthcare in the second quarter of 2024?

AMN Healthcare projected revenue in the second quarter of 2024 to be 24-26% lower than the previous year, with nurse and allied solutions revenue expected to decline by 36-38% year over year.

AMN Healthcare Services, Inc.

NYSE:AMN

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