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The Innovator in Healthcare Workforce Solutions and Staffing Services
Investor Presentation
March 2020
Forward-Looking Statements
This investor presentation contains “forward-looking statements” within the meaning of Section 27A of the SecuritiesAct of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Companybases these forward-looking statements on its current beliefs, expectations, estimates, forecasts and projectionsabout 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 andother similar expressions. In addition, statements that refer to performance; plans, objectives and strategies for futureoperations; 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-lookingstatements. Factors that could cause actual results to differ from those discussed in or implied by the forward-lookingstatements contained in this presentation are set forth in the Company’s Annual Report on Form 10-K for the yearended 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other filings with the SEC.Developments subsequent to this presentation are likely to cause these statements to become outdated with thepassage of time.
2
Non-GAAP Measures
This presentation contains certain non-GAAP financial information, which the Company provides as additionalinformation, and not as an alternative, to the Company's condensed consolidated financial statements presented inaccordance with GAAP. These non-GAAP financial measures include (1) adjusted EBITDA and (2) adjusted EBITDAmargin on slides 10 and 27, respectively. Management believes that adjusted EBITDA and adjusted EBITDA marginserve as industry-wide financial measures. These non-GAAP measures should not be used in isolation to evaluatethe Company's performance. A reconciliation of the non-GAAP measures identified in this presentation, along withfurther detail about the use and limitations of certain of these non-GAAP measures, may be found on the Company'swebsite 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, revenue cycle solutions
Innovator in Workforce Solutions
MSP, VMS, RPO, workforce optimization, scheduling and credentialing solutions
Investing in 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
Evolution of AMN: Driving Towards Workforce Solutions
4
AMN has evolved from traditional healthcare staffing to providing comprehensive workforce solutions
4%
2008
WorkforceSolutions
ClinicalStaffing 67%
Staffing and Recruitment
Workforce Solutions
Leadership
Workforce Technologies
2019*
Workforce Solutions Now Majority of Revenue Mix
* 2019 revenue mix pro forma for acquisition of Stratus Video
Revenue Growth with Operating Leverage
5
($ Millions)
$1,036
$1,463
$1,902 $1,988 $2,136
$2,222
2014 2015 2016 2017 2018 2019
$91
$165
$237 $256
$270 $277
2014 2015 2016 2017 2018 2019
Revenue Adjusted EBITDA
Our Technology Roadmap
6
Candidate Engagement More mobile, two-way, seamlessMobile apps for recruiting and engagement
Customer ExperienceInsightful reporting and predictive analytics More data integrations
Total Talent ManagementIntegrate our technology platformsHelp clients manage/optimize total workforce
AMN OperationsCreating new data assetsProprietary algorithms, large data setsIntegrated omni-channel candidate acquisition
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
Revenue Cycle, Interim Leadership, Executive Search,Credentialing,Allied and Nurse, Float Pool Management, VMS
MedPartners, Leaders For Today Phillips DiPisa,Silversheet, Advanced,b4health
Stratus Video at a Glance
Delivered in Three Key Modalities
Across 1,600+ Healthcare Clients
3,000+ Interpreters
Medically qualified with ongoing continuing
education requirements
$1.2 Billion Market
Video remote interpreting is fastest-growth segment
Stratus has leading share in video segment
Video Hospitals
Community Health Centers
Clinics
Ambulatory Surgery Centers
$108MRevenue in 2019A
$30MAdjusted EBITDA
in 2019A
8
$119MAnnualized revenue
run rate in 4Q19
$34MAdjusted EBITDArun rate in 4Q19
Over the Phone
In Person
Serving a Growing Population
26M+ Limited English Proficiency | 11M+ Deaf/Hard of HearingNote: Stratus financials are unaudited and subject to change
• 35 languages today
• Improves patient experience
• Available on any device, anytime
• Applicable for nearly all in-person interactions
Stratus Video Core Services Overview
Video 66%
In-Person
& Other11%
Phone 23%
Video Remote Interpretation
• 200+ languages available
• Covers less common languages and roll-over support for VRI
• Applicable for inbound patient calls, scheduled calls
Over-the-Phone Interpretation
• Tech-enabled, efficient deployment
• Enables hospitals use of in-house and contract interpreters
• Applicable for complicated / sensitive appointments
In-Person InterpretationStratus Revenue Mix
Note: Revenue mix is based on 2019A
Hospital Request
Interpreter Response
Provider Requests Interpreter
Provider Hires Interpreter
Interpreter Arrives
Interpreter Receives Requests
Interpreter Accepts & Confirms
Interpreter Sees Earnings & Ratings
9
Stratus Key Financial Metrics
($ in Millions)
$68
$84
$108
$-
$20
$40
$60
$80
$100
$120
2017 2018 2019
$33
$40
$51
49%47% 47%
40%
45%
50%
55%
60%
65%
70%
$0
$15
$30
$45
$60
2017 2018 2019
Gross Profit and MarginTotal Revenue
Adjusted EBITDA and Margin
$14
$21
$30
20%25%
28%
0%5%10%15%20%25%30%35%40%45%50%55%60%
$0
$15
$30
2017 2018 201910
Key Financial Highlights
• Purchase price: $475 million cash
• Proposed financing: $250 million Term Loan, $175 million revolver draw and $50 cash
• Pro forma leverage: Debt/EBITDA 3.3x
• Immediately accretive to gross margin, EBITDA margin and adjusted EPS
Stratus financial results are pro forma for acquisitions
Industry Overview
Healthcare Staffing: Large, Fragmented Market
Source: AMN internal estimates of other markets
12
Hires, Openings & Quits
Other Addressable Markets: Greater Than $5 Billion
Interim Leadership, Perm/Search, RPO, Revenue Cycle, Workforce Consulting, VMS, Credentialing,
Language Interpretation
2019E17.5
$0
$5
$10
$15
Re
ve
nu
e in
$ B
illi
on
s
Source: Staffing Industry Analysts/Crain Communications
US Healthcare Staffing
Job Openings and Labor Turnover• Healthcare hiring has struggled to match need
• Hiring is largely offset by voluntary attrition
• One-third of the healthcare workforce turns
over each year
Source: Job Openings and Labor Turnover Survey, US Bureau of Labor Statistics
3%
5%
8%
Hires Openings Quits
Five-Year CAGRs
Healthcare Staffing Market Landscape
13
Top 10 largest firms ranked by estimated US healthcare temporary staffing revenue
(1) Medical Solutions includes acquisition of Aureus Medical Group
Source: Staffing Industry Analysts FY 2018 estimates of total healthcare temporary staffing revenues
(1)$0
$500
$1,000
$1,500
$2,000
Most Comprehensive Set of Solutions
14
Staffing Solutions Staffing Solutions Workforce SolutionsWorkforce Solutions
Travel NurseTravel Nurse Allied HealthAllied Health Locum TenensLocum TenensLeadership &
SearchLeadership &
SearchRPORPOMSPMSP VMSVMS
Revenue Cycle Services
Revenue Cycle Services
#1
✓
#1 #3 #1
✓ ✓
✓
#1 #1 #1
✓ ✓ ✓ ✓✓
✓ ✓ ✓ ✓ ✓ ✓✓
✓
✓✓
Projected Healthcare Labor Shortage in 2032Aging 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, April 2019; 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 2030Source: U.S. Department of Health and Human Services
5.5%
4.4%3.9% 40
72
U.S. population aged 65+in millions
~38% of active physicians are age 56 & older Up to 121,900physician shortage
Regional & specialty nurse shortages
2018–272017 2018
15
Business Overview
Staffing and Recruitment
• Travel nursing
• Allied staffing
• Locum tenens
• Local staffing
• Revenue cycle solutions
• Rapid response
• EMR implementation
• Labor disruption
Workforce Solutions
• Managed services programs (MSP)
• Vendor management systems (VMS)
• Language interpretation
• Scheduling and labor management
• Credentialing solutions
• Education services
• Float pool management
AMN Portfolio of Solutions
ExecutiveLeadership
• Interim leadership
• Executive search
• Physician permanent placement
• Clinical leadership search
• Leadership training and development
• Workforce analysis and optimization
• Predictive modeling and analytics
• Recruitment process outsourcing (RPO)
17
Value through leadership, innovation and strategic insight
Staffing and Recruitment Workforce Solutions Leadership and
Search
Green text represents solutions offered within managed services programs
Leader in Managed Services
18
Outsourced partner to manage all supplemental workforce needs
AMN manages staffing vendors, credentialing, clinical support, reporting, consolidated invoicing
Complete range of solutions from vendor management systems (VMS) to vendor-neutral and staffing-led managed services programs (MSP)
Client Benefits AMN Benefits
• Faster and higher fill rates
• Increased visibility
• 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 2019
$134 $185 $265 $296 $350$454
$649$786
$892$985
$85$106
$115 $110$154
$308
$369
$379
$346
$451MSP Direct Fill Revenue
Filled by Affiliate Network
Managed Services Programs Drive Growth
19
AMN Leads the Staffing-Led MSP Wave
AMN manages another $1.3 billion of client spend through VMS and vendor-neutral MSP
MS
P G
ros
s B
illi
ng
s U
nd
er
Ma
na
ge
me
nt
($M
)
AMN Healthcare Segments
20
• Short- and long-term travel and local staffing
• Nursing, therapists, respiratory, imaging, lab
• Travel assignments are typically 13 weeks
• Over 60% of segment revenue comes through exclusive MSP relationships
61%of 2019
AMNRevenue*
Nurse & Allied Solutions
* 2019 revenue mix is pro forma for the acquisition of Stratus Video
25%
14%
Locum Tenens Solutions
• Placement of physicians, advanced practice clinicians and dentists throughout the United States
• Typical assignments range from days to multiple months
Other Workforce Solutions
• Interim and permanent executive leadership and physician placement
• Recruitment process outsourcing
• Vendor management systems
• Revenue cycle solutions
• Workforce optimization
• Credentialing solutions
• Language interpretation
Financial Overview
Financial Summary
22 ($ in Millions)
$1,463
$1,902 $1,988 $2,136 $2,222
$-
$500
$1,000
$1,500
$2,000
$2,500
2015 2016 2017 2018 2019
$469
$620 $644 $696
$743
32.1% 32.6% 32.4% 32.6%33.5%
25%
30%
35%
40%
$0
$200
$400
$600
$800
2015 2016 2017 2018 2019
$165
$237 $256
$270
11.3%
12.5%12.9%
12.7% 12.5%
5%
10%
15%
$0
$50
$100
$150
$200
$250
2015 2016 2017 2018 2019
Gross Profit and MarginTotal Revenue
Adjusted EBITDA and Margin Free Cash Flow
$29
$110
$134
$192 $190
$0
$50
$100
$150
$200
2015 2016 2017 2018 2019
Historical Credit Statistics
23
Capital Expenditures Return on Invested Capital
Total Leverage Ratio* Debt and Credit Facilities
($ in millions)
$27
$22
$27
$35 $35
$0
$10
$20
$30
$40
2015 2016 2017 2018 2019
1.4x1.6x
1.3x
1.7x
2.0x
0.0x
0.5x
1.0x
1.5x
2.0x
2.5x
2015 2016 2017 2018 2019
* As defined by AMN’s credit agreement
Balances as of 2/14/20. Pro forma leverage ratio is 3.3x.
Interest Rate
Maturity Date
Debt Outstanding
Available Borrowing
Senior Unsecured Notes 5.125% Oct 2024 325.0$ -
Senior Notes 4.625% Oct 2027 300.0$ -
Term Loan 3.500% Feb 2025 250.0$ -
Revolving Credit Facility 3.500% Feb 2025 175.0$ 207.6$
16%14%
16%14%
10%
0%
5%
10%
15%
2015 2016 2017 2018 2019
Allocation of Strong Free Cash Flows
24
($ Millions)
* Pro forma for acquisition of Stratus Video
$657
$-
$100
$200
$300
$400
$500
$600
$700
2015 2016 2017 2018 2019
$ M
illio
ns
Cumulative Free Cash Flow
$657 Million Free Cash Flow Generated Since 2015
$(1,260)
$(119)
$888
$(1,500)
$(1,000)
$(500)
$-
$500
$1,000
Acquisitions Stock Repurchases Net Borrowing
$ M
illio
ns
Selected Other Uses and Sources of Cash*2015 to Date
$1.4 Billion Spent on Acquisitions, Stock Buybacks
Balance Sheet Remains Strong
Key Investment Highlights
25
Leader in Attractive Market
Trusted partner in healthcare staffing services: nurse, allied, locum tenens, physician and executive search, interim leadership, revenue cycle solutions
Innovator in Workforce Solutions
MSP, VMS, RPO, workforce optimization, scheduling and credentialing solutions
Investing in 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