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TRANSCRIPT
The Innovator in Healthcare Workforce Solutions and Staffing Services
Investor Presentation
May 2019
Forward-Looking Statements
This investor presentation contains “forward-looking statements” within the meaning of Section 27A of the Securities
Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Company
bases these forward-looking statements on its current beliefs, expectations, estimates, forecasts and projections
about future events and the industry in which it operates. Forward-looking statements are identified by words such as
“believe,” “anticipate,” “expect,” “intend,” “plan,” “will,” “should,” “would,” “project,” “may,” variations of such words and
other similar expressions. In addition, statements that refer to performance; plans, objectives and strategies for future
operations; and other characterizations of future events or circumstances, are forward-looking statements.
The Company’s actual results could differ materially from those discussed in, or implied by, these forward-looking
statements. Factors that could cause actual results to differ from those discussed in or implied by the forward-looking
statements contained in this presentation are set forth in the Company’s Annual Report on Form 10-K for the year
ended December 31, 2018 and its other periodic reports, its current reports and its other filings with the SEC.
Developments subsequent to this presentation are likely to cause these statements to become outdated with the
passage of time.
2
Non-GAAP Measures
This presentation contains certain non-GAAP financial information, which the Company provides as additional
information, and not as an alternative, to the Company's condensed consolidated financial statements presented in
accordance with GAAP. These non-GAAP financial measures include (1) adjusted EBITDA and (2) adjusted EBITDA
margin on slides 10 and 27, respectively. Management believes that adjusted EBITDA and adjusted EBITDA margin
serve as industry-wide financial measures. These non-GAAP measures should not be used in isolation to evaluate
the Company's performance. A reconciliation of the non-GAAP measures identified in this presentation, along with
further detail about the use and limitations of certain of these non-GAAP measures, may be found on the Company's
website at http://amnhealthcare.investorroom.com/financialreports.
Key Investment Highlights
3
Leader in Attractive Market
Trusted partner in healthcare staffing services: nurse,
allied, locum tenens, physician and executive search,
interim leadership, mid-revenue cycle
Innovator in Workforce Solutions
MSP, VMS, RPO, workforce optimization, scheduling and
credentialing solutions
Differentiated by Technology
Enhances recruiting capabilities and improves efficiency
Scalable Operating Model
Ability to drive attractive cash flow and earnings growth
Strong Cash Flow and Balance Sheet
Disciplined management and conservative balance sheet
AMN at a Glance
Supply ↔ DemandAge demographic shift creates
growth opportunities for AMN
workforce solutions
Diverse Client Base with over 100 MSP clients, which
includes many leading
healthcare systems
Recognized as
largest U.S.
healthcare
staffing firm
2013-18
Revenue Growth
16%
CAGR61%18%
21%Nurse andAlliedSolutions
LocumTenensSolutions
OtherWorkforceSolutions
$2.1B2018 Revenue
Top performer in revenue,
profits, and stock returns
HRO Today’s Recruiting Excellence
Award and Diversity & Inclusion
Excellence award
Innovation leaders 2018 Impact
Awards -Named largest healthcare staffing
firm in the US
4
Our Mission
5
Every day, we . . .
Deliver the best talent and insights to
help healthcare organizations optimize
their workforce
Give healthcare professionals
opportunities to do their best work
towards quality patient care
Create a values-based culture of
innovation where our team members
can achieve their goals
A Recognized Leader
2011-
Peer Review Designation
to AMN MSP (Managed
Services Programs) since
2011
2018
Largest Healthcare
Staffing Company in
the U.S.
Re-Certified through 2020
First Corporate
Certification for Staffing
Services by the
Joint Commission
2018
Exemplary
Compensation
Discussion & Analysis
(CD&A) Award Winner
2016
Healthcare Leader
Based on Customer
Satisfaction and
Quality
2018
The Top Size of Deal
Provider
Based on Customer
Satisfaction and Quality
2018
2019
Gender Equality Index
2018
Top performer in revenue,
profits, and stock returns.
2019
Corporate Equality Index
2018
Best Proxy Statement
6
History of AMN Healthcare
7
Strategic Transformation in Workforce Solutions
1980s 2000–08 2014-15 2018-19
1990s 2010-13 2016
Travel Nurse
American Mobile Nurses:
A founding company
Nurse and Allied
Expansion
Preferred Healthcare,
Medical Express,
NursesRx
Workforce Solutions:
MSP, RPO and VMS
MedFinders,
ShiftWise
Nurse, Physician,
VMS, Interim Leadership,
Workforce Scheduling
Onward Healthcare,
Locum Leaders,
Medefis, The First String,
MillicanSolutions, Avantas
Physician, Allied, Nurse and
Search Expansion
Merritt Hawkins,
Staff Care,
MedTravelers,
O’Grady Peyton
Interim Leadership and
Executive Search, Labor
Disruption, Medical Coding
BE Smith, Peak Health,
HealthSource Global
Mid-Revenue Cycle,
Interim Leadership,
Executive Search,
Credentialing,
Allied and Nurse
MedPartners,
Leaders For Today
Phillips DiPisa,
Silversheet, Advanced
Evolution of AMN: Driving Towards Workforce Solutions
8
AMN has evolved from
traditional healthcare staffing to
providing comprehensive
workforce solutions
4%
2008
WorkforceSolutions
Staffing63%
➢ Staffing and Recruitment
➢ Workforce Solutions
➢ Leadership
➢ Workforce Technologies
2018
Workforce Solutions Now Dominate Revenue Mix
Revenue Growth with Operating Leverage
9
($ Millions)
$1,012 $1,036
$1,463
$1,902 $1,988
$2,136
2013 2014 2015 2016 2017 2018
$85 $91
$165
$237
$256 $270
2013 2014 2015 2016 2017 2018
Revenue Adjusted EBITDA
2019 – A Year of Focus and Investment
Tailwinds
• Recent MSP wins and
strong MSP pipeline
• Healthy demand across
staffing service lines
• Bolstered our Allied and
Nurse capabilities
• Added to high-growth
School staffing offering
• Added new SaaS
credentialing and
Teletherapy platforms
10
Headwinds
• Locum Tenens
turnaround
• Lower staffing volume
with large client
• Tough Q2 comp due to
$25M strike revenue
• Margin impact from
Silversheet acquisition
and investments
Investments
• Locum Tenens
enhancements and
headcount
• Candidate and client
engagement
• Digital and mobile
• Data management,
analytics, and reporting
• Team member retention
and development
Industry Overview
Healthcare Staffing: Large, Fragmented Market
Sources: US Staffing Forecast, Staffing Industry Analysts, April 2019; AMN internal estimates of other markets
U.S. Temporary Healthcare Staffing
12
• Growing economy
• Shortage of clinicians & physicians
• Aging population & medical advances
• Adoption of outsourced solutions
• New emerging clinical roles
Demand Drivers($ Billions)
$15.2
$16.2$16.8
$17.3$17.9
$10
$15
$20
Other Addressable Markets: Greater Than $5 Billion(Interim Leadership, Perm/Search, RPO, Mid-Revenue
Cycle, Workforce Consulting, VMS, Credentialing)
Healthcare Needs Help with Labor Supply
13
Job Openings
Hires
Quits
1%
2%
3%
4%
5%
6%
7%
2013 2014 2015 2016 2017 2018 2019
% o
f E
mp
loym
en
t
5%
12%
11%
Hires Openings Quits
Five-Year CAGRs
JOLTS = Job Openings and Labor Turnover Survey
• Healthcare open jobs are 1.9x monthly hiring
• Hiring is largely offset by rising voluntary attrition
• Stepped-up hiring efforts have made a minor difference
Healthcare Hires, Openings and Quits
Data source: Job Openings and Labor Turnover Surveys, US Bureau of Labor Statistics
Projected Healthcare Labor Shortage in 2030Aging Healthcare Professionals
~ 50% of RNs and physicians are age 50+
Annual Growth in Healthcare Spend Aging Population and Healthcare Utilization
Drivers of Healthcare Employment Growth
Sources: National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers – 2013 data and Association of American Medical Colleges
April 5, 2016; AMN Healthcare survey, November 2017; AMA Physician Master File and 2012 Physicians Foundation Survey conducted by Merritt Hawkins – 2012 data; National
Health Expenditure Projections – CMS, February 2019; AMN Healthcare 2013 Clinical Workforce Survey of Hospital Leaders; “The Complexities of Physician Supply and Demand,”
Association of American Medical Colleges, March 2018; Future of the Nursing Workforce, Health Resources and Services Administration, December 2014.
• Over 65 - 3x more
hospital days
• Over 75 - 4x more
healthcare days
2010 2015 2020 2025 2030
Source: U.S. Department of Health and Human Services
5.5%
4.4%3.9%
40
72
U.S. population aged 65+in millions
55% of RNs who plan to retire will do so by 2020
~38% of active physicians are age 56 & older Up to 104,900
physician shortage
Regional & specialty
nurse shortages
2018–272017 2018
15
Business Overview
Staffing and Recruitment
• Travel nursing
• Allied staffing
• Locum tenens
• Local staffing
• Physician placement
• Rapid response
• EMR implementation
• Labor disruption
Workforce Solutions
• Managed services programs
(MSP)
• Vendor management systems
(VMS)
• Recruitment process
outsourcing (RPO)
• Mid-revenue cycle workforce
solutions
• Scheduling and labor
management
• Credentialing solutions
AMN Portfolio of Solutions
Executive
Leadership
• Interim leadership
• Executive search
• Physician leadership search
• Nurse leadership search
• Leadership training and
development
• Workforce analysis and
optimization
• Predictive modeling and analytics
• Education services
17
Value through leadership, innovation and strategic insight
Staffing and
RecruitmentWorkforce Solutions
Leadership and
Consulting
Leader in Managed Services Programs (MSP)
18
Outsourced partner to manage all supplemental workforce needs
AMN manages staffing vendors, credentialing, clinical support,
reporting, consolidated invoicing
500+ affiliates
Client Benefits AMN Benefits
• Higher fill rates
• Improved fulfillment time
• Staffing optimization
• Controlled spend
• Accountability
• Credentialing compliance
• Cross-selling opportunities
• Recruitment advantages
• Less cyclicality
• Improved demand visibility
• Strong client relationships
• High client retention
2010 2011 2012 2013 2014 2015 2016 2017 2018
$134 $185$265 $296
$350$454
$649
$786$892
$85
$106
$115$110
$154
$308
$369
$379
$346MSP Direct Fill Revenue
Filled by Affiliate Network
MSP: Growth Engine
19
Adoption of MSP has gained momentum
(1) Staffing revenue consists of Nurse, Allied, and Locum Tenens revenue; on a consolidated basis, MSP was 42% of 2018 revenue
MSP direct fill revenue grew from 1% of AMN staffing revenue in 2008 to 51% today (1)
MS
P G
ros
s B
illi
ng
s U
nd
er
Ma
na
ge
me
nt
($M
)
Nurse and Allied Solutions
20
Short- and Long-term
Travel and Local Staffing
• AMN is the largest travel nurse
and allied staffing company
• Travel nurse assignments are
typically 13 weeks
• Over 60% of segment
revenue comes through
exclusive MSP relationships
61%of 2018
AMN
Revenue
Robust Demand: Key Drivers
Shortage of nurses
Shift to MSP relationships
Shift to flexible staffing models
Aging U.S. and clinical population
Favorable economy
Skill Specialties
All nursing specialties
Physical, occupational, speech therapists
Respiratory, imaging, lab
Pharmacists, technicians
Locum Tenens Solutions
21
Shortage of physicians
Growing demand for healthcare services
Specialty-specific demand
Aging physician population
19%
Robust Demand: Key Drivers
We place physicians, advanced
practice clinicians and dentists on
temporary assignments
throughout the United States
Typical assignments range from
days to multiple months
Areas of Practice
18%
• Hospitalists
• Anesthesia/CRNA
• Emergency Medicine
• Internal Medicine
• Psychiatry
• Surgery
• Advanced Practices
• Radiology
• Primary Care
• Dentistry
Locum Tenens Turnaround in Progress
22
Before: Multiple, unintegrated,
inflexible, aging technologiesToday: Integrated, scalable, agile
technology platform
Our focus for growth:
• Enhance system adoption and usability
• Improve data quality and integration
• Sales hires and productivity ramp
• MSP and new client sales
Inconsistent operating model across brands Single, cohesive operating model
Other Workforce Solutions
Workforce and leadership shortages
Rising healthcare costs
Increased administrative complexity
Revenue integrity/capture, quality
reporting
Increased need for data-driven insights
Interim and permanent executive leadership
and permanent physician placement
Recruitment process outsourcing
Mid-revenue cycle solutions
Vendor management systems
Workforce optimization solutions
Credentialing solutions
Informed decision-making
Reduced complexity
Flexible access to scarce talent
Drive optimal workforce mix
Key Demand Drivers
Business Lines
Key Advantages
21%
23
Terms/Impact of AcquisitionSolution Set
Silversheet Acquisition
Subscription-based credentialing and
privileging software platform
Credential Verification Organization
services
Implementation services
$30 million cash
Up to $25 million earn-out based
on revenue and earnings targets
for 2019-20
Near term dilutive; long-term
high-margin, recurring revenue
24
Credentialing Solutions
Provides sophisticated, cloud-based software solutions to
reduce the complexities and challenges of the credentialing
process for clinicians and healthcare organizations
Terms/Impact of AcquisitionSolution Set
Advanced Medical Pending Acquisition
Travel therapy staffing
School therapy staffing
Travel nurse staffing
Teletherapy offering
$200 million cash plus up to $20
million earn-out
Run rate $140M revenue and
$20M EBITDA
Expect to be immediately
accretive to adjusted EPS
Anticipate closing early June
25
Allied and Nurse Staffing Solutions
Innovative healthcare staffing company specializing in
placing therapists and nurses in contract positions across
multiple settings including hospitals, schools, clinics, skilled
nursing facilities and home health
Diverse Client Base
26
As the market leader, AMN delivers a broad suite of
workforce solutions to many leading health systems
AMN knows the
national landscape. They
know what’s out there
and what the trends are.
They bring that valuable
information to us so that
we can better plan as
partners.
Chief Nursing Officer,
Large Integrated Health System
& AMN MSP Client
“
”
Financial Overview
Financial Summary
28 ($ in Millions)
$1,463
$1,902 $1,988
$2,136 $2,146
$-
$500
$1,000
$1,500
$2,000
$2,500
2015 2016 2017 2018 LTM 1Q19
$469
$620 $644 $696
$705
32.1% 32.6% 32.4% 32.6% 32.9%
25%
30%
35%
40%
$0
$200
$400
$600
2015 2016 2017 2018 LTM 1Q19
$165
$237
$256 $270 $270
11.3%
12.5%12.9%
12.7% 12.6%
5%
10%
15%
$0
$50
$100
$150
$200
$250
2015 2016 2017 2018 LTM 1Q19
16%14%
16%14% 14%
0%
5%
10%
15%
2015 2016 2017 2018 LTM 1Q19
Gross ProfitTotal Revenue
Adjusted EBITDA Return on Invested Capital
Historical Credit Statistics
29
Capital Expenditures Free Cash Flow
Total Leverage Ratio* Debt and Credit Facilities
($ in millions)
$27
$22
$27
$35$37
$0
$10
$20
$30
$40
2015 2016 2017 2018 LTM 1Q19
$29
$110
$134
$192
$167
$0
$40
$80
$120
$160
$200
$240
2015 2016 2017 2018 LTM 1Q19
1.4x
1.6x
1.3x
1.7x
1.9x
0.0x
0.2x
0.4x
0.6x
0.8x
1.0x
1.2x
1.4x
1.6x
1.8x
2.0x
2015 2016 2017 2018 Q1 19
* As defined by AMN’s credit agreement
Balances as of 3/31/19. AMN’s $400M revolving credit facility has $15 million
pledged as collateral for letters of credit. Does not include the impact of the
pending $200M acquisition of Advanced Medical, which on a pro forma basis
would increase our leverage ratio to 2.3x.
Interest
Rate
Maturity
Date
Debt
Outstanding
Available
Borrowing
Senior Unsecured Notes 5.125% Oct 2024 325.0$ -
Revolving Credit Facility 4.000% Feb 2023 150.0$ 235.0$
Allocation of Strong Free Cash Flows
30($ Millions)
$504
$-
$100
$200
$300
$400
$500
$600
2014 2015 2016 2017 2018 YTD 2019
$ M
illio
ns
Cumulative Free Cash Flow
$504 Million Free
Cash Flow
Generated Since
2014
$(580)
$(118)
$315
$(600)
$(400)
$(200)
$-
$200
$400
Acquisitions Stock Repurchases Net Borrowing
$ M
illio
ns
Selected Other Uses and Sources of Cash2014 to Date
$699 Million
Spent on
Acquisitions,
Stock Buybacks
Balance Sheet
Remains Strong
Key Investment Highlights
31
Market leader and trusted partner in healthcare staffing
services - nurse, allied, locums, physician and executive
search, interim leadership
Innovator in healthcare workforce solutions: MSP, VMS, RPO,
medical coding, workforce optimization; expanding solutions to
support clients
Positive secular trends supported by aging population and
clinical labor shortages
Investment in technology differentiates AMN services,
enhances recruiting capabilities, and reduces costs
Scalable operating model with leverage
Strong cash flow and balance sheet