On this page of StockholderLetter.com we present the latest annual shareholder letter from AMN HEALTHCARE SERVICES INC — ticker symbol AMN. Reading current and past AMN letters to shareholders can bring important insights into the investment thesis.

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AMN Shareholder/Stockholder Letter Transcript:

2023
Annual Report
Copyright    2024 AMN Healthcare

A Letter from Our President and CEO
Dear AMN Healthcare Shareholders,
The year 2023 began the return to normal after a global pandemic, which meant profound change for AMN Healthcare and the industry that supports
the labor needs of healthcare. Hiring and labor cost were leading priorities for healthcare organizations, after hiring had plateaued and the use of
contingent labor spiked to record levels in the previous two years. Care providers accelerated permanent hiring and reduced use of temporary staffing,
leading to a down year for healthcare staffing industry volume and revenue.
This highly dynamic environment brought out the best from AMN, as our company has a history of excelling at customer-centric innovation in times
of rapid change. Throughout the year, our corporate team members worked to transform AMN in response to an abrupt shift in clients    needs postpandemic. Our broad set of differentiated talent solutions equipped us well as healthcare organizations sought more ways to meet growing patient
demand with high-quality care in a timely and cost-effective way.
Healthcare delivery was disrupted and severely challenged in the pandemic. Early in the pandemic, AMN focused on serving our managed services
program (MSP) clients, using our industry-leading vendor management systems (VMS) for any new clients seeking help at a time when implementing
a new MSP was difficult. Even with this dedicated focus on our most strategic clients, demand was so high that some clients used multiple technology
and service solutions to meet their needs. As the pandemic began to ease, AMN focused on reestablishing strong relationships with our clients and
serving the whole market again. Our internal realignment and investments have focused on bolstering our ability to serve clients in an evolved postpandemic environment no matter what kind of relationship they want with AMN. We expect to regain market share we lost during the pandemic in
some of our larger businesses as these initiatives ramp over the coming years.
Among the major changes inside AMN:
    A turn in strategy toward becoming what the healthcare industry needs us to be now     a technology-centric total talent solutions company.
    Numerous concurrent initiatives to improve, reinforce, and better deliver our unique value proposition.
    We managed our expense base down as demand dropped to ensure we are rightsizing the organization to our current environment.
    We moved nine nurse and allied brands to One AMN branding with an upcoming transition to one front-end system, the new cloud version of
our staffing platform.
    As workforce management became a top strategic concern for clients, we developed the ability to design our services around customers    needs
and preferences, and we have built the flexibility to deliver a comprehensive range of solutions through one platform.
    We launched ShiftWise Flex, the rearchitected and cloud-enabled version of our industry-leading VMS software platform.
    Our Passport mobile app for healthcare professionals continues to add features and professional specializations that are making it increasingly
central to our workflows. Passport is the industry   s leading app by number of users with very high user satisfaction ratings.
    The pandemic made labor cost a C-suite priority, and we have strengthened our team to deal directly with the C-suite, including the CTO.
    We are leveraging the best new technology to make our services easier to use, faster to deploy, integrated with our clients    technology, and
more effective.
    We accelerated the timetable of IT transformation across the company and successfully completed the largest upgrade project in AMN history.
    The $293 million acquisition of MSDR, which closed in the fourth quarter of 2023, strengthened our growing locum tenens business and was our
first major M&A transaction since 2020.
    Recognizing the importance of attracting top talent, we continued our commitment to supporting the mental, physical and economic well-being
of our team members and healthcare professionals, as well as leveraging global partnerships to support our 24/7 client service model.
Now that leading healthcare organizations seek multi-faceted solutions to their labor management challenges, we believe AMN is in a great position
with the broadest and deepest set of talent solutions tailored for healthcare. We are seeing encouraging early results from our investments and
internal improvements to expand our share capture, which we expect will build momentum throughout 2024. According to recent surveys, labor
management remains a top priority for healthcare executives, and this persistent issue will remain the foundation of our Company   s long-term
growth opportunity.

Year in Review
In 2023, AMN earned $211 million in net income on revenue of $3.8 billion. Of that revenue total, $1.7 billion revenue came in the second half of the
year as clients reset their utilization of contingent labor. Prior to the COVID-19 pandemic that ended in the first half of last year, our highest annual
revenue had been $2.2 billion in 2019.
Full-year revenue last year was 28% lower than in 2022. Consistent with this change, the value of AMN shares fell by 27% in 2023. We believe
the performance of AMN shares was hampered by uncertainty about the magnitude and duration of the post-pandemic staffing market downturn.
Across our business segments:
    Nurse and Allied Solutions revenue was $2.6 billion, 34% lower than in 2022. Nurse staffing had surged the most in the pandemic and showed the
greatest impact from the market reset, with revenue down 40%. Allied staffing of $710 million held up well, down 12%. The leading performer
was international nurse staffing with 28% revenue growth.
    Physician and Leadership Solutions revenue was $670 million, down 4% year over year. Pro forma for a full-year contribution from MSDR, our
PLS revenue would have been more than $810 million. Our locum tenens business grew revenue 5% organically and was one of the highlights of
the year. That growth was partly offset by declines in interim leadership and search, where demand softened amid clients    short-term cost-control
focus, as many facilities were operating at below-normal profit margins in 2023.
    Technology and Workforce Solutions revenue was $495 million, down 12% from 2022. Within this segment, language services recorded
outstanding revenue growth of 20%, reaching a full-year total of $260 million. Language services has been a strong performer since we entered
the business by acquisition in 2020. Our vendor management systems (VMS) business tracked the nurse and allied staffing markets with a 36%
drop in revenue. Workforce analytics and outsourced solutions also had a down year as clients were focused on cutting costs.
During the year, AMN generated $372 million net cash from operations, which funded capital expenditures of $104 million including technology
investments to better position us competitively to serve the evolving talent needs of our clients. The Company had sufficient financial flexibility to
repurchase $425 million of its own shares and acquire MSDR for $293 million. We plan to continue a balanced approach to capital deployment.
In a year of swift change and strategic shifts, AMN was steadfastly committed to its core values and the well-being of all its stakeholders. Our culture
of diversity and inclusion was recognized by the Bloomberg Gender-Equality Index, Newsweek   s America   s Greatest Workplaces for Diversity, and the
Human Rights Campaign Corporate Equality Index. We have a total of 10 Employee Resource Groups that foster our team members    ability to build
communities and collaborate on important issues. Approximately 40 percent of AMN team members participate in one or more ERGs.
Importantly, AMN   s commitment to sustainability, social impact, and responsible governance is well aligned with the values of the healthcare
industry we serve. Trust and common values are essential to our ability to build long-term partnerships with the nation   s leading, most innovative
healthcare organizations.
Looking Ahead
Our entire team at AMN is eager to demonstrate the benefits of our customer-focus, technology investments and process improvements. As we move
through 2024, we expect AMN to go to market with more technology-enabled solutions, unified branding, a more cohesive and efficient outreach to
healthcare professionals and their employers, a more complete and visible demonstration of our value proposition, and service delivery that is faster
and easier to work with. As we progress, you should see long-term benefits for shareholders as AMN deploys a stronger, diversified growth engine
and enhanced profitability from improved speed and efficiency.
We anticipate age demographic pressures will continue to test the supply of and demand for healthcare services. Future solutions to healthcare talent
demands and constraints will need to be wider-ranging, more flexible and tech-intensive. This opportunity is why AMN is so committed to being the
leader in tech-enabled total talent solutions.
The success of AMN in the marketplace is propelled by our 3,500+ outstanding team members, whom we view as the most talented and passionate
people in our industry. In 2023, we also placed over 148,000 healthcare professionals in temporary and permanent roles across the country. Both
our corporate employees and our healthcare professionals are the product of our unwavering commitment to passion, trust, respect, customer focus,
innovation, and continuous improvement. We are grateful and respectful of the opportunities and responsibilities that our industry position accords
us. Thank you for your interest in and support of our mission at AMN Healthcare.
CBSPMJOF 4  (SBDF
President and Chief Executive Officer



 3/5/2024 Letter Continued (Full PDF)