Full Press Release Details
AMN HEALTHCARE ANNOUNCES THIRD QUARTER 2023 RESULTS
Quarterly revenue of $853 million;
GAAP EPS of $1.39 and adjusted EPS of $1.97
DALLAS - AMN Healthcare Services, Inc. (NYSE:
AMN), the leader and innovator in total talent solutions for healthcare organizations across the United States, today announced its third
quarter 2023 financial results. Financial highlights are as follows:
Dollars in millions, except per share amounts.
| Q3 2023 | % Change Q3 2022 | YTD September 30, 2023 | % Change YTD September 30, 2022 | |
| Revenue | $853.5 | (25%) | $2,971.0 | (28%) |
| Gross profit | $289.5 | (25%) | $988.6 | (26%) |
| Net income | $53.2 | (42%) | $198.2 | (45%) |
| GAAP diluted EPS | $1.39 | (34%) | $4.99 | (38%) |
| Adjusted diluted EPS* | $1.97 | (23%) | $6.86 | (27%) |
| Adjusted EBITDA* | $133.7 | (26%) | $475.1 | (29%) |
* 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
"The AMN team did an impressive
job balancing business execution in the third quarter alongside our initiatives to sharpen our strategic plan and implement powerful advancements
in our technology platform and processes," said Cary Grace, President and Chief Executive Officer of AMN Healthcare. "At the
same time, we made an important strategic move with the pending acquisition of MSDR, which will bolster our presence in the robust locum
Ms. Grace continued, "I
am pleased to report that, through the course of 2023, we have progressed from identifying needed changes to delivering enhanced technology-enabled
solutions that help clients with their ongoing workforce objectives. These are key milestones on our path toward defining the new normal
for healthcare workforce solutions."
Third Quarter 2023 Results
Consolidated revenue for the quarter
was $853.5 million, a 25% decrease from prior year and 14% lower than the prior quarter. Net income was $53 million (6.2% of revenue),
or $1.39 per diluted share, compared with $92 million (8.1% of revenue), or $2.10 per diluted share, in the third quarter of 2022. Adjusted
diluted EPS in the third quarter was $1.97 compared with $2.57 in the same quarter a year ago.
Revenue for the Nurse and Allied
Solutions segment was $573 million, lower by 31% year over year and down 17% from the prior quarter. Travel nurse staffing revenue dropped
by 34% year over year and 20% sequentially. Allied division revenue declined 12% year over year and 8% versus prior quarter.
The Physician and Leadership Solutions
segment reported revenue of $160 million, down 9% year over year and down 9% sequentially. Locum tenens revenue was $113 million, 6% higher
year over year and down 8% sequentially. Interim leadership revenue fell by 35% year over year and was down 15% from prior quarter. Our
physician and leadership search businesses saw revenue decline by 25% year over year and 10% quarter over quarter.
Technology and Workforce Solutions
segment revenue was $120 million, a decrease of 11% year over year and down 4% sequentially. Language services revenue was $66 million
the quarter, 20% higher than the prior year and up
4% sequentially. Vendor management systems revenue was $38 million, 37% lower year over year and down 18% from the prior quarter.
Consolidated gross margin was
33.9%, 10 basis points higher year over year and improved by 60 basis points sequentially. Gross margin improved year over year and sequentially,
primarily from the release of a workers' compensation reserve in the Nurse and Allied Solutions segment. On a sequential basis, improvement
was partly offset by a drop in margin for Technology and Workforce Solutions from a change in revenue mix within the segment.
Consolidated SG&A expenses
were $163 million, or 19.1% of revenue, compared with $215 million, or 18.9% of revenue, in the same quarter last year. SG&A was $202
million, or 20.4% of revenue, in the previous quarter. The year-over-year decrease in SG&A costs was driven primarily by lower employee
compensation with the drop in revenue and a higher allowance for bad debt in the prior-year period. Several favorable items that we expect
will not recur in the fourth quarter reduced SG&A expense by $5 million in the third quarter.
Income from operations was $87
million with an operating margin of 10.2%, compared with $136 million and 12.0%, respectively, in the same quarter last year. Adjusted
EBITDA was $134 million, a year-over-year decrease of 26%. Adjusted EBITDA margin was 15.7%, 30 basis points lower than the year-ago period.
At September 30, 2023, cash
and cash equivalents totaled $29 million. Cash flow from operations was $172 million for the third quarter, and capital expenditures were
$30 million. The Company ended the quarter with total debt outstanding of $945 million and a net leverage ratio of 1.4 to 1.
MSDR Acquisition Agreement
In October 2023, AMN signed a
definitive agreement to acquire MSDR, which includes two locum tenens and advanced practices staffing companies, Medical Search International
and DRW Healthcare Staffing. The purchase price is approximately $300 million, which we expect to
fund with cash on hand and borrowings on our revolving
credit facility. Closing of the transaction is anticipated in the fourth quarter, subject to customary closing conditions and regulatory
Stock Repurchase Update
We completed the $200 million
accelerated share repurchase program in August 2023. As of September 30, 2023, $227 million remained on the repurchase program authorized
by our Board of Directors.
Fourth Quarter 2023 Outlook
| Metric | Guidance* | |||
| Consolidated revenue | $790 - $810 million | |||
| Gross margin | 32.3% - 32.8% | |||
| SG&A as percentage of revenue | 21.0% - 21.5% | |||
| Operating margin | 5.9% - 6.5% | |||
| Adjusted EBITDA margin | 12.5% - 13.0% |
*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 fourth quarter
of 2023 is expected to be 28-30% lower than prior year and 5-7% lower sequentially. Nurse and Allied Solutions segment revenue is expected
to be down 33-35% year over year. Physician and Leadership Solutions segment revenue is expected to be down 12-14% year over year. For
the Technology and Workforce Solutions segment, we expect revenue to be approximately 18% lower year over year. Guidance does not include
any contribution from the MSDR acquisition, which we expect to close later in the fourth quarter.
Fourth quarter estimates for certain
other financial items include depreciation of $17 million, depreciation in cost of revenue of $1.5 million, non-cash amortization expense
of $22 million, share-based compensation expense of $5 million, integration and other expenses of $7 million, interest expense of $11
million, an adjusted tax rate of 28%, and 38.2 million diluted average shares outstanding.
Conference Call on November 2, 2023
AMN Healthcare Services, Inc.
(NYSE: AMN) will host a conference call to discuss its third quarter 2023 financial results and fourth quarter 2023 outlook on Thursday,
November 2, 2023 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.
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