AMN Healthcare Services Inc

Good afternoon, and thank you for standing by. Welcome to AMN Healthcare's second quarter 2025 earnings call. At this time, all participants are in listen-only mode. After the presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 1 1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1 1 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Randy Reese, Vice President, Investor Relations. Please go ahead.

Good afternoon, everyone. Welcome to AMN Healthcare's second quarter 2025 earnings call. A replay of this webcast will be available at ir.amnhealthcare.com at the conclusion of this call. Remarks we make during this call about future expectations Projections, trends, plans, events, or circumstances constitute forward-looking statements. These statements reflect the company's current beliefs based upon information currently available to it. Our actual results may differ materially from those indicated by these forward-looking statements. Because of various factors in cautionary statements, including those identified in our most recently filed forms 10-K and 10-Q, our earnings release, and subsequent filings with the SEC. The company does not intend to update guidance or any forward-looking statements provided today prior to its next earnings release. This call contains certain non-GAAP financial information. Information regarding and reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are included in our earnings release and on our financial reports page at ir.amnhealthcare.com. On the call with me today are Carrie Grace, President and Chief Executive Officer, and Brian Scott, Chief Financial and Operating Officer. I will now turn the call over to Carrie.

Thank you, Randy, and welcome to our second quarter conference call. Second quarter revenue of $658 million was at the upper end of our guidance range. Adjusted EBITDA of $58 million and gross margin of 29.8% exceeded the high end of guidance. At the end of the second quarter, the balance on our revolving line of credit was down to $70 million after we repaid $80 million during the quarter, and we expect further debt reduction this quarter. Through the quarter, uncertainty about government policy impacts placed the healthcare sector in a more cautious stance compared with the first quarter, directly impacting our industry. The strongest indications we had of clients' uncertainty were declines in staffing orders and extensions. Travel nurse orders in June were 15% lower than March, and our rebook retention rate for travelers fell through the quarter. Our language services business also billed fewer minutes in June compared with May. Hiring freezes hampered our physician search business and likely affected demand and volume in locum tenens. Our academic medical center clients have taken the strongest measures to reduce spending in response to cuts in federal funding for research. Academic medical centers made up about 20% of our consolidated revenue year to date. Other hospitals have seen some slowing in patient utilization, though still growing year over year. With the new tax bill now finalized, our clients have some clarity on future changes to reimbursement and their insured population mix, much of which will happen gradually over several years. July saw improvement in key metrics across most of our businesses. In nurse and allied, traveler extension rates rebounded sharply in July, which underscores that our clients still have the need for flexible staffing. Travel Nurse is largely an acute care business, and while orders have been stable since the second half of June, they are running below prior year levels, and we need to see higher order levels to regain volume growth. Allied draws from a more diverse client base with about half of its business coming from non-acute care. While Travel Nurse orders fell more than 10% from March to July, Allied orders in July were up 3% from March, benefiting from our strength in outpatient therapy, rehabilitation, and imaging. We also anticipate a strong year for our allied school business, built on robust bookings in the first half selling season and the benefit of innovative solutions like our Televate virtual care platform. Q3 is the seasonally lowest quarter of the year for school staffing, and our improved bookings will be more visible in Q4, where we expect double-digit volume growth from the prior year. Our international nurse staffing business is positioned to resume sequential growth in volume and revenue in the fourth quarter, with growth trends continuing into 2026. We expect this business to have outsized growth opportunities over the next two to three years as visa retrogression dates move forward. Language services revenue was up 1% year-over-year in the second quarter, with utilization up 6% from a year ago, mostly offset by competitive pricing pressure. Utilization declined from May to June and grew again in July, and our sales pipeline continued to increase and progress over the past three months. Revenue for our locum tenens business was flat year-over-year in the second quarter, and we see good opportunity to deliver consistent year-over-year growth starting in the third quarter. Locum tenants demand so far this quarter is 5% higher than Q2. We recently completed the last stages of the MSDR integration and are seeing traction in adding more locums programs into our existing MSP clients as clients seek consistency and cost efficiency in their locum spend. We expect MSP revenue to reach a historic high this year with higher same client sales and new opportunities for additional growth and welcome. Our labor disruption business has had a successful start to the year, and we could have more activity from now into 2026, supporting a number of clients in large upcoming collective bargaining agreements. Our recently completed AI-enabled event management technology has had positive client reaction and combined with our deep expertise enables us to scale to support more clients. The staffing industry analysts recently released 2024 market share rankings show that AMN retained market share in an intense competitive environment in Travel Nurse and Allied while gaining share due to acquisition in Locum Tenens. In May, AMN was named the largest healthcare leadership and search form by Modern Healthcare. This year to date, our growth strategy to serve all market channels has progressed, supported by our work-wise technology infrastructure. Our operational speed and automation initiatives have resulted in steadily improving fill rates in both our AMN-led MSPs and vendor-neutral programs. These efforts have been greeted by a healthy pipeline of vendor-led and vendor-neutral MSP opportunities, and we are also building up our client list for direct staffing relationships. We continue to make good progress on diversifying our revenues and building on our technology-enabled services. AMN Passport is one of our best success stories. Passport, our industry-leading app for healthcare professionals, now covers travel and per diem nurse, allied and locum tenant specialties. We also have extended Passport's capabilities to manage float pool workers and labor disruption events. These additions have given a boost to Passport, which recently surpassed 300,000 registered users. More significant is the impact Passport is making on our efficiency and user engagement. More than 20% of our nurse and ally placements are now assisted by passport automation. We have seen other early successes from our rollout of AI capabilities across all facets of our operations, and this will continue to be a key area of focus for us. In early July, we completed the sale of our SmartSquare scheduling software to a new commercial business partner, Simplr. This transaction enables us to expand the potential work-wise network of technology partners to deliver workforce planning, staffing, and talent deployment to the benefit of our current and future clients. In two and a half years, we have rebuilt our ability to address all channels of the healthcare staffing market. We have stabilized and in some areas modestly grown our staffing market share and we are well positioned to win as demand recovers. For the near term, we continue to manage our cost structure and drive for operational efficiency. Our financial strength and level of innovation stand out in the industry at a time when many competitors are struggling. Now, I will hand over the call to Brian for a review of second quarter results and third quarter guidance.