AMN Healthcare Services, Inc. Q4 FY2025 earnings call

• Healthy seasonality in Nurse and Allied staffing, return to sequential growth in international nurse staffing, increasing demand in leadership and search businesses, and extraordinary labor disruption need. - Reduced debt by $285 million in 2025. - Developed and deployed a new strategy for language services to address price competition. - Invested in AI technology enablement for language services. - Rolled out enhanced capabilities in VMS. - Built a technology and operating model to support strike events with a dedicated strike team and playbook. - Expect to return businesses to growth in 2026, with long-term outlook of 4%-6% organic revenue growth and 10%-15% adjusted EBITDA growth.

For the full year 2025, revenue was $2.73 billion and adjusted EBITDA was $234 million. Fourth quarter revenue was $748 million, 2% higher year-over-year. Nurse and Allied Solutions revenue $491 million, grew 8% YOY; excluding labor disruption, segment revenue down 7% YOY but improved from prior quarter. Physician and Leadership Solutions revenue $170 million, down 2% YOY. Technology and Workforce Solutions revenue $88 million, down 18% YOY. Labor disruption revenue in Q4 was $124 million, nearly doubled YOY. First quarter 2026 Nurse and Allied revenue expected up over 135% YOY (excluding labor disruption, up 2%-4% YOY and 4%-6% QOQ). Physician and Leadership revenue expected down 5%-8% YOY. Technology and Workforce Solutions revenue expected down mid- to upper teens YOY (excluding Smart Square).

• First quarter 2026 consolidated revenue projected $1.225B - $1.24B, including ~$600M labor disruption. - Gross margin projected 23.5%-24%. - Reported SG&A expenses ~14.5%-15% of revenue. - Operating margin expected 5.9%-6.5%, adjusted EBITDA margin 9.7%-10.2%. - Nurse and Allied revenue expected up over 135% YOY in Q1 (excluding labor disruption, up 2%-4% YOY and 4%-6% QOQ). - Physician and Leadership revenue expected down 5%-8% YOY in Q1. - Technology and Workforce Solutions revenue expected down mid- to upper teens YOY (excluding Smart Square) in Q1.

• Risks related to competitive environment in language services leading to pricing pressure. - Uncertainty around duration and impact of labor strikes on business. - Potential impact of external factors like immigration policies on international staffing. - Seasonal fluctuations in demand for certain segments.

Q: Jeff Silber asked about separate operating procedure and sales force for labor disruption and countering AI fears in language translation.

A: Caroline Grace said they have a developed system and dedicated strike team, and language services are focused on clinical setting with government regulation requiring human interpreters, and they're using AI enablement.

Q: A.J. Rice asked about labor pool for strikes, Kaiser contract, and visa bulletin impact.

A: Caroline Grace and Brian Scott discussed supply sources for strikes, Kaiser contract RFP, and visa bulletin advancing helping international staffing.

Q: Kevin Fischbeck asked about labor pool crowding out core business and AI disruption in language services.

A: Caroline Grace and Brian Scott said no meaningful impact on core business and language services pricing pressure is from competitive environment, not AI.

Q: Tobey Sommer asked about seasonality past Q1.

A: Brian Scott discussed normal sequential decline in Nurse and Allied in Q2, growth in Physician and Leadership and Technology and Workforce Solutions in Q2.

Q: Constantine Davides asked about cash flow and pipeline.

A: Brian Scott talked about CapEx and cash flow expectations, and Caroline Grace discussed healthy pipeline in Nurse and Allied.

Q: Jack Slevin asked about strike number and margin.

A: Brian Scott and Caroline Grace said first quarter impacted by strikes but underlying business trends consistent, and margin expectations aligned with prior thinking.