AMN Healthcare Services, Inc. (NYSE:AMN) Q1 2023 Earnings Call Transcript

A.J. Rice: Hi everybody. Thanks for the question. First of all, just to make sure because sometimes we’re thickheaded here. Jeff, just to take your point. So, before you were looking for $4.2 billion to $4.3 billion in revenue this year, now you’re thinking $4 billion. The EBITDA margin was — previously, you talked about as being $15 million to $15.5 million, now you’re talking about being at the high end of that $15.5 million And if I do the math right, at the midpoint, you were at $650 million before and now you’re thinking $620 million of EBITDA. So, $30 million adjustment on a full year basis with first quarter being a little higher, third quarter being a little lower admittedly. Is — and would you say that is all based on somewhat of a change of view of where you shake out on Allied and travel nursing? Is there any other change you’re making to your outlook of significance?

Jeff Knudson: Yes, A.J., so I would agree with your numbers. I would say, it’s really a travel nurse change predominantly. Obviously, with some of the demand trends that we talked about on the nursing side, that is impacting our VMS business as well. But that’s largely offset by strength within Language Services. So Language Services was up 25% year-over-year in the first quarter. So any hit to the VMS business is largely being offset by Language Services within TWF , and the change is really coming within travel nurse.

A.J. Rice: Okay. And then, when you think about supply and demand of getting nurses who are willing to step up for assignments. You talked about if volume improves, you might have to see a little rate improvement to get that volume. What about this concept of at some point, you hit a breakpoint where it’s going to be really hard to get nurses and it will dramatically pull back. As you’re looking at where you think rates would bottom in the third quarter, are you pretty close to that number where you’d see a meaningful percentage of the people that are willing to take travel assignments today might back off, so that, that gives you a second way to consider where a floor might be, or you still think there’s some leeway there?

Landry Seedig: Hey, A.J., it’s Landry. I mean, I think probably the biggest thing that I would say to that is, right now, what we’re experiencing within travel nurses is it’s not a supply issue for travel, it’s a demand issue. The interest is there, right? There’s not — there’s certainly not enough nurses to go around to fill all of the permanent and temporary and per diem needs throughout in the marketplace. But the desire to work travel is there. So that hasn’t been an issue. On the pay — the pay piece of it, it is economics on supply-demand. So we factored all that into where we believe the demand is going to be and where we think the pay needs to be, and we’re having those conversations with our customers. But still pay is only one factor when the clinicians are making their decision to travel.

Actually, location is the number one preference that goes over everything when they’re making decisions to work contracts. So its things like location. Pay does rank in the top four. But the other things that rank really high is flexibility and working conditions. So, anyways, right now, today, we’re not seeing a supply issue. If we can get the demand to pop back up, we’ll be able to capture it.

A.J. Rice: Okay.

Cary Grace: And I would underscore with that, we just released our nurses survey on Monday. And I think all the points that Landry put in there underscored it. So we’re still seeing a huge interest. And as much as anything, it’s the lifestyle choice.

A.J. Rice: Interesting. One final last question on — you mentioned in the prepared remarks, interest in M&A, willingness to do M&A. I know the company has talked about it before, but obviously, Cary, you’ve had a little time to be there. Does that broaden in any way what you guys might look at, now that you’ve gotten to understand the organization, the competitive landscape out there, or what’s the latest thing, where you might look for deals?

Cary Grace: Yes. Overall, very consistent thinking with — from my comments last quarter. I’ll start first with — we are always interested in looking at M&A as a way to accelerate our growth in key areas. And so, that remains true. I think what we saw for some time period, and this is a general comment across a number of industries, as you saw a relatively slow M&A environment as there was broader market volatility, we would expect that you would see that start to stabilize a bit as we go through the year. And we’re interested in opportunities that we think are going to provide better solutions for our clients, more tech enablement, really strong growth opportunities, particularly in specialized areas where we see continued demand.

Kevin Fischbeck: Okay. Great. Thanks a lot.

Operator: One moment for our next question. Our next question is going to be coming from Bill Sutherland of The Benchmark Company. Your line is now open. I think Bill is not with us.

Jeff Knudson: Please move to the next question.

Operator: One moment for our next question. Our next question is going to be coming from Andre Childress of Baird. Your line is now open.

Andre Childress: Hey. This is Andrea on for Mark Marcon. Thank you for taking our questions. So my first question, just want to follow-up on some previous comments you had on the expectations you laid out. Where do you now bill rates and volumes that exit the year compared to pre-pandemic levels?

Landry Seedig: Yeah. On the bill rate side, we would still expect them to be 30% to 35% above pre-pandemic, Andre, and that’s roughly 30% lower than they were in the peak of the first quarter of last year.

Andre Childress: And then… A – On the volume side…

Andre Childress: I am sorry. Go ahead.

Landry Seedig: Yeah. On the volume side, it would be in the 20% to 25% range above pre-pandemic.