Full Press Release Details
AMN HEALTHCARE ANNOUNCES FOURTH
QUARTER AND FULL YEAR 2023 RESULTS
Quarterly revenue of $818 million;
GAAP EPS of $0.33 and adjusted EPS of $1.32
DALLAS - (February 15, 2024) - AMN
Healthcare Services, Inc. (NYSE: AMN), the leader and innovator in total talent solutions for healthcare organizations across the United
States, today announced its fourth quarter and full year 2023 financial results. Financial highlights are as follows:
Dollars in millions, except per share amounts.
| Q4 2023 | % Change Q4 2022 | Full Year 2023 | % Change Full Year 2022 | |
| Revenue | $818.3 | (27%) | $3,789.3 | (28%) |
| Gross profit | $260.9 | (30%) | $1,249.6 | (27%) |
| Net income | $12.5 | (85%) | $210.7 | (53%) |
| Diluted EPS | $0.33 | (83%) | $5.36 | (46%) |
| Adjusted diluted EPS* | $1.32 | (47%) | $8.21 | (31%) |
| Adjusted EBITDA* | $104.0 | (40%) | $579.1 | (32%) |
* 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.
2023 & Recent Highlights
healthcare professionals and corporate team members were resilient in 2023, working through the largest cyclical reset of staffing demand
in industry history," said Cary Grace, AMN President and Chief Executive Officer. "While partnering with clients to help them
rebuild sustainable workforces, our team simultaneously accelerated innovation, enabling AMN to enter this year better positioned to
deliver the technology-centric total talent solutions that healthcare needs now.
invested heavily in our growth opportunities with more than $100 million of capex while rigorously managing financial discipline in operations,"
Ms. Grace added. "We are consolidating our businesses under our One AMN branding and platform initiative and building a unified,
client-centric sales and service organization. Our service lines are infused with new technology that speeds our operations, better integrates
us with clients, and delivers powerful mobile tools that give clients and healthcare professionals more control and flexibility. Further,
we strengthened our capabilities in locum tenens with the acquisition of MSDR. These accomplishments were enabled by our strong cash
flow, the talent and passion of our team members, the uniquely strong AMN culture, and a commitment to performing for our stakeholders."
Fourth Quarter 2023 Results
Consolidated revenue for the quarter
was $818 million, a 27% decrease over prior year and 4% lower than prior quarter. Net income was $12 million (1.5% of revenue), or $0.33
per diluted share, compared with $82 million (7.3% of revenue), or $1.88 per diluted share, in the same quarter last year. Adjusted diluted
EPS was $1.32 compared with $2.48 in the year-ago quarter.
Revenue for the Nurse and Allied
Solutions segment was $538 million, lower by 35% year over year and down 6% sequentially. Travel Nurse revenue was down 40% year over
year and 8% sequentially. Allied division revenue declined 16% year over year and 2% versus prior quarter.
The Physician and Leadership Solutions
segment reported revenue of $168 million, flat year over year and up 5% sequentially. Organic locum tenens revenue grew
7% year over year and was down 2% versus the prior quarter. Interim leadership revenue was down 35% year over year and 5% sequentially.
Search revenue was lower by 20% year over year and 6% quarter over quarter. The MSDR acquisition closed in late November and contributed
revenue of $13 million for the quarter.
Technology and Workforce Solutions
segment revenue was $113 million reflecting a decrease of 16% year over year and 7% sequentially. Language services revenue was $68 million
in the quarter, up 18% year over year and 3% compared with the prior quarter. Vendor management systems revenue was $31 million, 45% lower
year over year and down 20% sequentially.
Consolidated gross margin was
31.9%, lower by 140 basis points year over year and lower by 200 basis points sequentially. The year-over-year decline in gross margin
was primarily driven by lower margin in Nurse and Allied Solutions and lower VMS revenue. On a sequential basis, gross margin decreased
due to the same factors and benefits in the third quarter gross margin that did not recur in the fourth quarter.
SG&A expenses were $185 million
or 22.7% of revenue, compared with $219 million, or 19.5% of revenue, in the same quarter last year. SG&A was $163 million, or 19.1%
of revenue, in the previous quarter. The year-over-year decrease in SG&A costs was primarily due to lower employee expenses given
lower revenue. The quarter-over-quarter increase was driven primarily by increased acquisition, integration and other costs, including
MSDR acquisition costs, and the absence of favorable items included in the third quarter results.
Income from operations was $34
million, or 4.2% of revenue, compared with $119 million, or 10.6% of revenue, in the same quarter last year. Adjusted EBITDA was $104
million, with a year-over-year decrease of 40%. Adjusted EBITDA margin was 12.7%, lower by 280 basis points year over year and a decrease
of 300 basis points sequentially.
Full Year 2023 Results
Full year 2023 consolidated revenue
was $3.789 billion, a 28% decrease from prior year. Full year net income was $211 million (5.6% of revenue), or $5.36 per diluted share,
compared with $444 million (8.5% of revenue), or $9.90 per diluted share, in the prior year. Adjusted diluted EPS was $8.21 compared with
Nurse and Allied Solutions segment
revenue was $2.625 billion, a year-over-year decrease of 34%. The Physician and Leadership Solutions segment recorded revenue of $670
million, 4% lower compared with the prior year. Technology and Workforce Solutions segment revenue was $495 million, 12% lower year over
Full year consolidated gross margin
was 33.0% compared with 32.7% for the prior year. The slight increase in gross margin year over year is primarily attributable to a favorable
revenue mix shift and higher margin in Nurse and Allied Solutions, partially offset by lower margin in Technology and Workforce Solutions.
Full year consolidated SG&A
expenses were $756 million, representing 20.0% of revenue as compared to $937 million, representing 17.9% of revenue, for the prior year.
The year-over-year decrease in SG&A expenses was primarily due to lower employee compensation and benefits.
Full year income from operations
was $338 million, or 8.9% of revenue, compared with $647 million, or 12.3% of revenue, in the prior year. Adjusted EBITDA was $579 million,
a year-over-year decrease of 32%. Adjusted EBITDA margin was 15.3%, 80 basis points lower year over year.
At December 31, 2023, cash
and cash equivalents totaled $33 million. Cash flow from operations was a use of $41 million for the quarter. Cash flow from operations
for the full year was $372 million. Capital expenditures were $30 million in the quarter and $104 million for the year. The Company ended
the year with total debt outstanding of $1,310 million and a net leverage ratio of 2.2 to 1.
First Quarter 2024 Outlook
| Metric | Guidance* | |||
| Consolidated revenue | $810 - $830 million | |||
| Gross margin | 31.0% - 31.5% | |||
| SG&A as percentage of revenue | 21.0% - 21.5% | |||
| Operating margin | 4.2% - 4.9% | |||
| Adjusted EBITDA margin | 11.2% - 11.7% |
*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"
Consolidated revenue in the first
quarter of 2024 is projected to be 26-28% lower than the year-ago period. Nurse and Allied Solutions segment revenue is expected to be
down 36-38% below prior year. We expect Physician and Leadership Solutions segment revenue in the first quarter to be 11-14% higher year
over year. Technology and Workforce Solutions segment revenue is projected to be down 18-20% year over year.
Other first quarter estimates
include depreciation expense of $17 million, depreciation in cost of services of $2 million, non-cash amortization expense of $25 million,
stock-based compensation expense of $7 million, interest expense of $16 million, integration and other expenses of $6 million, an adjusted
tax rate of 30%, and 38.2 million weighted average diluted shares.
Conference Call on February 15,
AMN Healthcare Services, Inc.
(NYSE: AMN), the leader and innovator in total talent solutions for healthcare, will host a conference call to discuss its fourth quarter
and full year 2023 financial results and first quarter 2024 outlook on Thursday, February 15, 2024, at 5:00 p.m. Eastern Time. A
live webcast of the call can be accessed through this webcast link, which also will be available
at AMN Healthcare's investor relations website. Interested parties may participate live
via telephone by registering at this conference call link. Please follow the link and register
with a valid e-mail address. A PIN will be provided to you with dial-in instructions. If you lose track of these details, please re-register
at the conference call link above.
About AMN Healthcare
AMN Healthcare is the leader and
innovator in total talent solutions for healthcare organizations across the United States. 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,
direct higher and retained search solutions, vendor management systems, recruitment process outsourcing, predictive modeling, language