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    AMN Healthcare Services Inc (AMN)

    Q1 2024 Earnings Summary

    Reported on Jan 22, 2025 (After Market Close)
    Pre-Earnings Price$60.85Last close (May 9, 2024)
    Post-Earnings Price$56.43Open (May 10, 2024)
    Price Change
    $-4.42(-7.26%)
    • AMN's Schools business grew assignment headcount by 20% year-over-year in Q1 2024, and this growth is expected to continue, with teletherapy growing faster than 20%.
    • AMN is making significant progress in technology modernization, including the rollout of ShiftWise Flex, a new generation of their VMS, which has been 40% completed and is expected to be majority completed by the end of the year. They have also reduced order-to-fill time by half, leading to increased clinician and client satisfaction.
    • AMN is reengaging with clients and expects to retake market share in Travel Nurse staffing, seeing early signs of success, with almost half of their sales pipeline in vendor-neutral opportunities. They expect these early success signs to continue throughout the year and into 2025.
    • Declining volumes in the Nurse and Allied segment: The company projects volume within the Nurse and Allied segment to be down in the low double-digit range in Q2 compared to Q1, indicating a significant decrease in demand.
    • Continued pressure on gross margins due to various factors: The company is experiencing pressure on gross margins in the Nurse and Allied segment due to higher housing and travel expenses, a mix shift away from international nurses because of visa limitations, and reductions in hours worked, particularly within Allied.
    • Ongoing decline in international nurse staffing with no near-term improvement expected: International nurse staffing revenue is expected to continue declining each quarter throughout 2024 due to visa retrogression, with no change anticipated for the remainder of the year or in 2025.
    1. Travel Nurse Demand Bottom
      Q: When will Travel Nurse demand bottom and impact revenues?
      A: Management expects June to be the low point for travelers on assignment within Nurse and Allied, projecting about a 10% decline from the second quarter average. This downward trajectory is expected to carry into the third quarter.

    2. Revenue Guidance: Bill Rates and Volumes
      Q: What are expectations for bill rates and volumes affecting revenue?
      A: For the Nurse and Allied segment, bill rates are expected to decline in the low single digits compared to Q1. Volume is projected to decrease in the low double-digit range quarter-over-quarter.

    3. Allied Segment Outlook
      Q: When will the Allied segment show year-over-year growth?
      A: Year-over-year comparisons for Allied are expected to improve in the back half of the year but likely into 2025 before seeing actual growth.

    4. International Nurse Staffing Impact
      Q: How are visa limits affecting international nurse staffing?
      A: Visa retrogression is causing declines in the international nurse staffing business, with no change expected for the remainder of the year. Quarter-over-quarter declines are anticipated, with the fourth quarter being the low point.

    5. Competitive Environment and Market Share
      Q: Can AMN retake market share in Travel Nurse staffing?
      A: Management believes they can retake share by expanding partnerships and targeting the entire market. Early signs of success include a sales pipeline where almost half is vendor-neutral , positioning the company well as demand returns.

    6. Locum Tenens Business and MSDR Acquisition
      Q: How is the MSDR acquisition impacting the Locum Tenens business?
      A: The integration of MSDR has gone well, and they are starting order sharing with AMN. Although revenue growth during integration was below expectations, the core locums business was up 1% year-over-year, with expectations of sequential growth moving into Q2.

    7. Technology Modernization Efforts
      Q: What progress has been made in technology modernization?
      A: Significant advancements include the rollout of ShiftWise Flex, a new generation VMS, with almost 40% completion based on spend under management. Automation efforts have reduced time to fill by half, improving satisfaction and internal capture rates.

    8. Supply Trends and New Recruits
      Q: How is the supply of travel nurses trending?
      A: New applications remain above pre-pandemic levels. A core group of nurses continues to show strong interest in travel roles, driven by lifestyle and well-being rather than just pay.

    9. Education Segment Growth
      Q: How is the education segment performing?
      A: The education business was up 20% year-over-year in the first quarter, with expectations for this growth to continue. Growth is coming from both on-site clinicians and faster growth in teletherapy.

    10. Interim Management Improvement
      Q: Why is interim management improving now?
      A: Clients are returning to ensure they are staffed from a leadership standpoint after cost management impacted these businesses. Despite being down 25% year-over-year, the business saw stabilization in price and volume—the first since the second half of '22.