Mark Marcon: And then in terms of the consolidation with regards to the brand names, it sounds like that’s gone really well. It sounds like you’re basically not seeing any sort of drop-off in terms of the supply channel. Wondering if you’ve got any other additional comments with regards to it. And at some point would we end up seeing some incremental savings from that consolidation?
Cary Grace: Yes. So it has gone very well and that took a lot of planning and preparation from our team. The couple of things that I would focus on, Mark, in terms of — when we talk about the brand consolidation, there are several elements to it. So one is the obvious around the logo. That’s where we get a lot of the all-time highs around awareness of our brands, both on an aided and unaided basis. But importantly, it’s about — we now have, between our Internet and other front doors, including increasingly our clinicians at Passport, one way for clinicians to come in and find all the opportunities professionally that they are potentially interested in. So we see it as an opportunity frankly, more from a revenue standpoint, for us to be able to engage clinicians much more holistically throughout the entirety of their professional careers with the range of different options that we have for them, whether some of those are shorter-term assignments or longer-term and permanent assignments.
Where you would see some efficiency from a spend standpoint is it will be more efficient for us going forward to be able to continue to increase and get brand awareness when we don’t have to support 2 handfuls of brands but we’re supporting in a more meaningful and substantive way the AMN Healthcare brand.
Mark Marcon: And then, the last question. Locums was a bright spot. It sounds like demand for you has picked up. Are you seeing that across the industry? And if so, what would you attribute that to? What’s changed over the last year that would lead to that pickup in demand?
Cary Grace: We continue to see and we expect locums to have continued strong demand in 2024. And that’s really more of an industry phenomenon than just an AMN phenomenon. What we have seen is systems really looking at how are they going to meet the increases in utilization that they are experiencing. And so particularly, as you think about the very well-publicized constraints on physician shortages, it is a drag on revenue and ability to serve patients when you don’t have the right physician support. And so that really is driving a lot of the demand that we’re seeing in our portfolio.
Mark Marcon: That’s great. Could we see some bill rate increases there?
Jeff Knudson: Yes. Mark, when we look over the course of last year, most of the year-over-year increases within locums were driven by the rate side more so than volumes.
Operator: Our next question comes from the line of Jeff Silber with BMO Capital Markets.
Jeff Silber: I know it’s late. I’ll just ask one. Cary, you’ve been in your role a little over a year. And obviously we all understand this is a really tough year for this business. But if you knew what you know now, what would you have done differently in 2023? And how does that impact your strategy going forward?
Cary Grace: Jeff, thanks for the question. And as we were writing the 2023 press release, I did reflect on — I started AMN and 2023 also started at the very beginning of the single biggest historical cyclical reset in the industry. And so as I think about what we were doing, we were doing 2 things simultaneously. We were helping our customers, our team members, our company successfully navigate that unprecedented reset. And we very quickly also started to ensure that we were putting in place a series of transformational initiatives that were going to enable our company to be able to more fully participate against the entirety of our market opportunity, frankly, both as we went through the tail end of the reset but certainly as we came out of the reset.
If I go back and look at the things that we focused on and I’ll underscore the things that I think we did extraordinarily well in a very tough year, we got focused on clients and our go-to-market strategy incredibly quickly. As I came into this role, that was actually the first thing I did. And we turned back on sales full force. We realigned how we think about our clients and we have a team now that is completely responsible for selling the breadth of our solutions. We started a series of One AMN transformation initiatives. We just talked about the brand, the brand experience, One but we also engaged in a series of transformative technology and operational initiatives that really, we’re already starting to see make a very big difference in our business.
And then, we spent a lot of time ensuring that we had financial discipline that match the reset that we were going through. So we took early actions around expenses to make sure that we were coming down as the market was coming down. And we also made some very strategic capital investments, both in our systems but also in MSDR and growing parts of the market and bought back $425 million in shares. So I am very pleased with what we did both in getting through the reset and positioning ourselves more strongly for 2024 and 2025.
Operator: Our next question comes from the line of William Sutherland with The Benchmark Company.
William Sutherland: You can call me, Bill. And I have just down to 2 questions. I was wondering on the fill rate trend as you look at the most recent orders, do you feel like we’ve got into an equilibrium here where the fill rates are going to go in the right direction? Or are they at a decent level already?
Jeff Knudson: On the bill rates, Bill?
William Sutherland: The fill rate.
Jeff Knudson: So I mean, Cary mentioned earlier that on internal capture we had moved that 450 basis points throughout the course of 2023. And I think we’ll continue to make progress on that as we move through this year. But as we onboard and ramp up some of those new client wins in the back half, that will be a drag initially as it will take those time to ramps like book of business internal capture rates. But we should see some progress in the first half.
William Sutherland: Yes, I heard the MSP commentary. I was thinking actually about just your regular book of business. How the fill rate is going with just regular orders in Nurse and Allied?
Jeff Knudson: Overall, so that’s internal capture. Overall in the fill rates, we’re generally back in line with pre-COVID trends.
William Sutherland: There you are. Okay. So there is — I mean, I kind of consider that the metric for equilibrium in the market. And then the last one, Jeff, I was actually thinking about capital deployment since you were so active last quarter. And beyond just the CapEx plans, how would you sort of prioritize employment, whether there’s any significant M&A being considered? Or you’d rather lean in on the share repurchase side?
Jeff Knudson: Yes. I think in the near term, right now, with the MSDR acquisition, we’re certainly focused on that integration. Leverage is at 2.2x as we end the year and in the near term excess free cash flow will probably be deployed towards debt repayment.
Operator: I’m currently showing no further questions at this time. I’d like to turn the call back over to Ms. Cary Grace for closing remarks.
Cary Grace: Thank you for listening to our earnings call and your continued interest in the important work our company is doing in the healthcare workforce. I want to say a special thank you to our AMN team members and our healthcare providers. 2023 required great resilience as we navigated both the biggest industry reset while working to position our organization strongly against our total market opportunity. We look forward to talking to you next quarter.
Operator: This concludes today’s conference call. Thank you for your participation. You may now disconnect. Everyone, have a wonderful day.
