AMN HEALTHCARE SERVICES INC (AMN) Q3 2025 Earnings Summary

Executive Summary

Q3 2025 revenue was $634.5M, down 8% YoY and 4% QoQ, with Adjusted EBITDA of $57.5M (9.1% margin) and Adjusted EPS of $0.39; management cited better-than-expected Nurse & Allied and Physician & Leadership performance and disciplined SG&A as drivers .
Results beat S&P Global Wall Street consensus on both revenue and EPS for Q1–Q3 2025; Q3 revenue was $634.5M vs $618.1M estimate and EPS was $0.39 vs $0.20 estimate (see Estimates Context table; values marked with asterisks from S&P Global)*.
Q4 2025 guidance: revenue $715–$730M including ~$100M labor disruption revenue (ex-strike “just over” $620M); consolidated gross margin 25.5%–26.0% (about 100 bps lower due to lower-margin strike mix), SG&A 20.0%–20.5%, Adjusted EBITDA margin 6.8%–7.3% .
Setup into Q4/Q1: winter orders and sequential volume improvement, early signs of bill rate increases in Nurse & Allied (first YoY uptick in ~3 years), and a strong labor disruption pipeline, balanced by pricing pressure in Language Services and lower-margin revenue mix .

What Went Well and What Went Wrong

What Went Well
- Outperformed guidance with $634M revenue and Adjusted EBITDA $57.5M; “All three business segments beat consensus revenue estimates” (led by $12M upside in Nurse & Allied) .
- Demand recovery signs: travel nurse winter orders modestly above prior year; extension rates rebounded; management expects Q4 Nurse & Allied revenue to be up low-single digits YoY (down ~6–8% ex-strike) .
- Strategic/financial execution: zero revolver balance exiting Q3; completed October refinancing (new 2031 notes, revolver downsized with higher leverage covenant) improving flexibility .
- Quote: “We expect bill rates for nurse and allied staffing to be at modestly year-over-year in the fourth quarter for the first time in three years.” — Cary Grace, CEO .
What Went Wrong
- Margin pressure: consolidated gross margin fell 190 bps YoY to 29.1% with decline across all segments; mix and competitive pressures cited .
- Technology & Workforce Solutions (TWS) headwinds: revenue down 12% YoY/7% QoQ (SmartSquare sale, VMS decline), with segment gross margin down 640 bps YoY and expected to step down ~100 bps in Q4 .
- Language Services: minutes growth modest but pricing pressure offsetting top-line; management expects pressure to persist into Q4; operating model changes aimed at 2026 cost-to-serve improvements .

Financial Results

Consolidated performance (oldest → newest):

Metric	Q1 2025	Q2 2025	Q3 2025
Revenue ($USD Millions)	$689.5	$658.2	$634.5
Gross Margin %	28.7%	29.8%	29.1%
Adjusted EBITDA ($USD Millions)	$64.2	$58.3	$57.5
Adjusted EBITDA Margin %	9.3%	8.9%	9.1%
GAAP Diluted EPS ($)	($0.03)	($3.02)	$0.76
Adjusted Diluted EPS ($)	$0.45	$0.30	$0.39

Segment revenue (oldest → newest):

Segment Revenue ($USD Millions)	Q1 2025	Q2 2025	Q3 2025
Nurse & Allied Solutions	$413.3	$381.9	$361.5
Physician & Leadership Solutions	$174.1	$174.5	$178.2
Technology & Workforce Solutions	$102.2	$101.8	$94.8

Key KPIs (oldest → newest):

KPI	Q1 2025	Q2 2025	Q3 2025
Average Travelers on Assignment	8,981	8,700	8,203
Locums Days Filled	51,342	51,325	52,723
Locums Revenue per Day Filled ($)	$2,743	$2,777	$2,764

Additional details:

Nurse & Allied gross margin: 24.1% in Q3 (‑90 bps YoY; +20 bps QoQ) .
Segment details Q3: Travel Nurse revenue $196M (‑20% YoY; ‑6% QoQ), Allied $142M (+1% YoY; ‑2% QoQ), labor disruption revenue $12M .
Physician & Leadership Q3 GM 27.2% (‑110 bps YoY) with locums revenue +3% YoY; interim leadership ‑20% YoY .
TWS Q3 GM 51.5% (‑640 bps YoY), driven by VMS mix, SmartSquare sale, and lower Language margin .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Consolidated Revenue	Q4 2025	N/A	$715–$730M	New
Revenue (ex-labor disruption)	Q4 2025	N/A	“Just over” $620M	New
Labor Disruption Revenue	Q4 2025	N/A	~ $100M	New
Gross Margin	Q4 2025	N/A	25.5%–26.0% (≈100 bps lower due to strike mix)	New
SG&A as % of Revenue	Q4 2025	N/A	20.0%–20.5%; includes ~$5M strike support	New
Operating Margin	Q4 2025	N/A	0.2%–0.8%	New
Adjusted EBITDA Margin	Q4 2025	N/A	6.8%–7.3%	New
Nurse & Allied GM	Q4 2025	N/A	≈21%	New

Notes:

Management indicated consolidated GM would be about 100 bps higher ex-labor disruption revenue .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q1 2025, Q2 2025)	Current Period (Q3 2025)	Trend
AI/Technology & Passport	Q1: Recognition for WorkWise/Passport; >300k Passport users; automation improving fill rates . Q2: Continued AI rollouts; SmartSquare sale/partnership to expand WorkWise .	Continued tech/process focus; doubled fill rate in vendor-neutral; integrating locums into ShiftWise Flex and Passport .	Improving tech-enabled execution.
Demand & Winter Orders	Q1: Improving bookings; labor disruption activity supportive . Q2: Orders stabilized in July; extension rates rebounded; winter orders expected .	Demand up from May low; winter orders modestly higher YoY; sequential volume improvement into Q4 .	Stabilizing to improving.
Bill Rates & Pricing	Q1–Q2: Stable bill rates; pressure in Language Services pricing .	First YoY bill rate uptick for Nurse & Allied in ~3 years expected in Q4; use rate increases to improve fill/volume; LS pricing pressure persists .	Turning positive in N&A; persisting pressure in LS.
Segment Mix & Margins	Q1–Q2: Margin headwinds; mix (VMS, SmartSquare divestiture) pressured TWS; locums stable .	Q3 GM down YoY across segments; Q4 GM down on strike mix; ex-strike consolidated GM ~100 bps higher .	Mix headwind near term; ex-strike margin floor forming.
International Nurse	Q1–Q2: Expect sequential growth resuming in Q4; multi-year growth as retrogression improves .	Management expects >20% revenue growth in 2026 for International Nurse (higher margin) .	Building 2026 tailwind.
Labor Disruptions	Q1–Q2: Strong pipeline; tech-enabled event mgmt; deposits boosted cash flow .	Q4 guidance includes ~$100M strike revenue; $5M extra SG&A; healthy 12-month strike pipeline .	Active into next 12 months.
Academic Medical Centers (AMCs)	Q1–Q2: AMCs weaker due to funding; stabilization signs starting in Q3 .	AMCs still lag non-AMCs but nearing stabilization into 2026 .	Stabilizing.

Management Commentary

“We expect bill rates for nurse and allied staffing to be at modestly year-over-year in the fourth quarter for the first time in three years.” — Cary Grace, CEO .
“For the fourth quarter, we expect about $100 million in labor disruption revenue.” — Cary Grace, CEO .
“Gross margin is projected to be between 25.5%–26%. Excluding the impact of labor disruption revenue, our gross margin would be higher by about 100 basis points.” — Brian Scott, CFO/COO .
“At the end of the third quarter, we had a zero balance on our revolving line of credit… In early October, we completed a debt refinancing… extended our earliest debt expiration to 2029.” — Cary Grace, CEO .
“If you… remove [strike impact]… you’d be looking at 26.5%–27% [consolidated gross margin]… a reasonable floor.” — Brian Scott, CFO/COO .
“We expect international nurse to be up… 20+% [revenue]… and that is a higher margin business.” — Cary Grace, CEO .

Q&A Highlights

Gross margin drivers Q3→Q4: After normalizing for Q3 strike benefit (~100 bps) and adding back ~100 bps to Q4 for strike mix, the underlying sequential GM change is “a little over 100 bps,” driven primarily by segment mix (declines in higher-margin PLS and TWS) and seasonality (lower hours in N&A) .
Underlying EBITDA ex-strike: Management indicated mid-6% Adjusted EBITDA margin for Q4 excluding the large strike event .
Demand and pricing: Demand up ~50% from mid-May lows in travel nurse; winter orders higher YoY; supply is healthy when orders are priced right; targeted rate increases are aimed at improving fill and volume rather than near-term margin expansion .
Language Services: Minutes growth offset by pricing pressure in Q3; expect continued pricing pressure in Q4 with operating model changes targeting 2026 margin improvements .
VMS/TWS: Q3 TWS revenue down mainly on SmartSquare sale and VMS decline; expecting further modest step down in Q4; management anticipates a return to VMS growth in 2026 as marketplace runoff ends and wins layer in .

Estimates Context

Consensus vs. actuals (S&P Global) — beats in bold:

Metric	Q1 2025	Q2 2025	Q3 2025
Revenue Consensus Mean ($USD Millions)*	670.08	651.93	618.10
Revenue Actual ($USD Millions)	689.53	658.18	634.50
EPS (Primary) Consensus Mean ($)*	0.205	0.186	0.200
EPS Actual ($)	0.45	0.30	0.39

AMN beat on both revenue and EPS in each of Q1–Q3 2025; Q3 beats were ~+2.7% revenue and ~+$0.19 EPS vs consensus (derived from table above) .
Management stated all three segments beat consensus revenue in Q3 .

*Values retrieved from S&P Global.

Key Takeaways for Investors

Q3 execution and three straight quarterly beats vs consensus support credibility; near-term stock catalysts center on Q4 strike-driven revenue inflection vs lower consolidated margin mix .
Underlying margin “floor” emerging: ex-strike, management frames consolidated GM around ~26.5%–27% for Q4, with opportunity to rebuild via mix (international nurse, leadership/search, VMS normalization) into 2026 .
Demand signals are improving (winter orders, extension rates, travel nurse demand from May trough), and initial bill rate increases should help fill rates/volume even if near-term spreads don’t expand materially .
TWS and Language Services remain pressure points (VMS runoff, SmartSquare divestiture, pricing) near term; 2026 cost-to-serve actions and VMS normalization are key to watch .
Labor disruption pipeline is active over next 12 months; model lower margin on strike revenue and ~$5M incremental Q4 SG&A to support events .
Balance sheet flexibility improved post-refi; zero revolver balance at Q3-end reduces risk and affords optionality for growth execution .

Appendix: Prior Quarter References and Other Q3 Press Releases

Q2 2025 results: revenue $658.2M, Adjusted EBITDA $58.3M, Adjusted EPS $0.30; noted SmartSquare sale, margin dynamics by segment .
Q1 2025 results: revenue $689.5M, Adjusted EBITDA $64.2M, Adjusted EPS $0.45; stronger bookings and early signs of locums growth .
Other Q3 2025 press releases included the earnings call logistics announcement on Oct 8, 2025 (no incremental financials) .

Sources: Q3 2025 earnings 8-K/press release and exhibits -; Q3 2025 earnings call transcript -; Q2 2025 release/transcript - -; Q1 2025 release -.