Earnings Call Transcript - AMN Q2 2025

Randle G. Reece, Vice President, Investor Relations

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 and 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 Cary Grace, President and Chief Executive Officer; and Brian Scott, Chief Financial and Operating Officer. I will now turn the call over to Cary.

Caroline Sullivan Grace, President and CEO

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 impact 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 in 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 in 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 Schools 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 2 to 3 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 3 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 tenens demand so far this quarter is 5% higher than Q2. We recently completed the last stages of the MSCR 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 in locum. 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 showed 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 search firm 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 tenens specialties. We also have extended Passport 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 Allied 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 Smart Square scheduling software to a new commercial business partner, symplr. 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 2.5 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.

Brian M. Scott, Chief Financial and Operating Officer

Thank you, Cary, and good afternoon, everyone. Second quarter consolidated revenue was $658 million, at the high end of guidance driven primarily from better-than-expected performance in our Nurse and Allied segment. Revenue was down 11% from the prior year and down 5% sequentially. Consolidated gross margin for the second quarter was 29.8%, 80 basis points above the high end of our guidance range. Year-over-year, gross margin decreased 120 basis points, while sequentially gross margin increased by 110 basis points. Consolidated SG&A expenses were $155 million compared with $149 million in the prior year and $148 million in the previous quarter. Adjusted SG&A, which excludes certain expenses, was $140 million in the second quarter compared with $137 million in the prior year and $136 million in the previous quarter. The sequential SG&A increase was primarily due to a $5 million unfavorable professional liability reserve adjustment and $2 million in higher bad debt expense more than offsetting lower employee costs and other expense management efforts. The majority of the professional liability reserve adjustment was recorded in the Nurse and Allied segment, while the bad debt charge was in the Physician and Leadership Solutions segment. Second quarter Nurse and Allied revenue was $382 million, down 14% from the prior year, driven mainly by lower volume, partially offset by labor disruption revenue. Sequentially, segment revenue was down 8%, primarily due to lower labor disruption revenue and seasonally lower volumes. Labor disruption revenue in the quarter was $16 million, compared with $39 million in the first quarter and 0 in the prior year quarter. Year-over-year, segment volume decreased 16%. Average rate was down 2%, and average hours worked down 1%. Sequentially, volume was down 3%, while the average rate and hours worked were both flat. Travel Nurse revenue in the second quarter was $208 million, a decrease of 25% from the prior year period and 4% from the prior quarter. Allied revenue in the quarter was $146 million, down 4% year-over-year and 1% sequentially. Nurse and Allied gross margin in the second quarter was 23.9%, an increase of 10 basis points year-over-year. Sequentially, gross margin was up 120 basis points due to lower payroll taxes and a favorable business mix. Moving to Physician and Leadership Solutions segment. Second quarter revenue of $175 million was down 6% year-over-year driven by lower volume across the search and interim leadership businesses. Sequentially, revenue was flat. Locum tenens revenue in the quarter was $143 million, flat year-over-year and up 1% sequentially. Interim leadership revenue of $23 million decreased 25% from the prior year period and 5% sequentially. Search revenue of $9 million was down 29% year-over-year and 2% sequentially. Gross margin for the Physician and Leadership Solutions segment was 28.2%, down 230 basis points year-over-year on a lower bill pay spread and an adverse revenue mix shift. Sequentially, gross margin increased 90 basis points, mainly due to a favorable sales allowance adjustment in the locums business. Technology and Workforce Solutions revenue for the second quarter was $102 million, down 9% year-over-year, primarily driven by declines in our VMS and outsourced solutions businesses. Sequentially, revenue was flat. Language Services revenue for the quarter was $76 million, up 1% both year-over-year and sequentially. VMS revenue for the quarter was $19 million, a decrease of 31% year-over-year and 2% sequentially. Segment gross margin was 55.1%, down 510 basis points from the prior year period, primarily due to lower revenue from VMS and outsourced solutions. Sequentially, gross margin declined 40 basis points. At the start of July, we completed the sale of Smart Square for $75 million, with $65 million paid at closing and $10 million in an 18-month note. This business was included in our Technology and Workforce Solutions segment. Starting in the third quarter, this transaction will reduce annualized revenue by approximately $17 million and adjusted EBITDA by about $6 million. Second quarter consolidated adjusted EBITDA was $58 million, down 38% year-over-year and 9% sequentially. Adjusted EBITDA margin for the quarter was 8.9%, down 380 basis points from the prior year period and 40 basis points sequentially. During the second quarter, we recorded a noncash goodwill impairment charge of $110 million related to our Physician and Leadership Solutions segment. We also recorded a noncash intangible asset impairment charge of $18 million related to our Nurse and Allied segment. Second quarter net loss was $116 million, driven by the goodwill and intangible asset impairment charges. This compared with net income of $16 million in the prior year period and a net loss of $1 million in the prior quarter. Second quarter GAAP diluted loss per share was $3.02. Adjusted earnings per share for the quarter was $0.30 compared to $0.98 in the prior year period and $0.45 in the prior quarter. Day sales outstanding for the quarter was 54 days, which was 9 days lower than a year ago and 1 day lower sequentially. Operating cash flow in the second quarter was $79 million and capital expenditures were $10 million. The quarter and year-to-date cash flow has been favorably impacted by an approximately $50 million increase in client deposits related to labor disruption events. These deposits will be repaid during the third quarter somewhat offsetting the proceeds received from the Smart Square sale. As of June 30, we had cash and equivalents of $42 million and total debt of $920 million, including $70 million drawn on a revolver. We ended the quarter with a net leverage ratio of 3.3x to 1. Moving to third quarter guidance. We project consolidated revenue to be in a range of $610 million to $625 million. This revenue guidance includes $5 million related to labor disruption support. Gross margin is projected to be between 28.7% and 29.2%. Reported sympathies to his wife Laura and his entire family. I know I speak for many in saying how deeply he will be missed. Among the many SG&A expenses are projected to be approximately 23% of revenue. Operating margin is expected to be 6% to 6.5% and adjusted EBITDA margin is expected to be 7.7% to 8.2%. Additional third quarter guidance details can be found in today's earnings release. And now let's go back to Cary for some closing remarks.

Caroline Sullivan Grace, President and CEO

Thank you, Brian. Before I open the call for questions, I want to acknowledge the recent passing of AMN's former Chairman, Doug. Doug served on our Board of Directors for 26 years and was the Board's Chairman for 17 years. Doug's legacy lives on in the values he championed, the people he impacted, and the continued impact of AMN on the lives of healthcare professionals and patients across the country. We are grateful for his extraordinary contributions and extend our deepest gratitude to his wife Laura and his entire family. I know I speak for many in saying how deeply he will be missed. Among the many great things about AMN, our people and our culture are the foundation of what makes AMN so special. And we are grateful for the many years Doug was a part of the wonderful AMN team. Operator, you can open the call for questions now.

John Trevor Romeo, Analyst

The first one I had was if you could provide any more color on how your clients are thinking about their contingent labor needs at this point. Cary, you noted the slower decision-making in Q2, followed by some improvement in July. I think there were a few comments you already had on the demand levels, but I would love maybe just more color on how you saw the trends move throughout the quarter and maybe more importantly, what your clients are telling you as far as where their contingent labor needs could go forward with the various uncertainties out there.

Caroline Sullivan Grace, President and CEO

Yes. So let me take demand first, and then I'll maybe more broadly talk about what we're seeing in terms of their needs around workforce solutions. So I mentioned this in the call, but what we really saw as we kicked off the year is a healthy start with year-over-year increases in demand. As we got into the second quarter, we really started to see the uncertainty of some pending policy changes, whether it was around tariffs, around healthcare funding as part of the spending bill and for academic medical centers, potential cuts in research budgets. And so we saw that uncertainty resulted in delays in decision-making throughout the second quarter. What we've seen really starting in July, and we were only a week into August, but we have seen demand stabilize in Nurse. We are seeing demand up in Allied and in locum. And we saw extension rates in July rebound sharply. So we've seen some of the delayed decision-making really start to break free a little bit as we've entered the third quarter. Now what we experienced in the second quarter plays through to what we see in the third quarter. Some of the stabilization or increase in demand is expected to start to come through more in the fourth quarter or towards the end of the year. If I step back and think a little bit about what clients are thinking about contingent labor, we really are at a period where for many clients, they have normalized both their utilization of labor. When we look at where premium contingent cost over a fully loaded permanent cost is, we're down to high single digits. This past quarter, we were more at 9%, which is really at the low end of what you would see historically. We've seen that contingent spend normalize as systems were focused on permanent hiring and building flexibility with internal float pools or other ways. We are very focused on helping them across all of their total talent solutions. Throughout this, we helped them in permanent hiring. We've helped them with building up their internal float pools, and whether we're running that or they're running that, whether they want to do programs or they want to do per diem. We are seeing the start of broader conversations about how to manage and sustain a quality, cost-effective workforce in the future, which includes predictive analytics and more data. We're seeing interest in program management, particularly in historically decentralized areas like locum. We expect these trends to continue, particularly as organizations deal with still increasing patient utilization and a limited supply of clinicians.

John Trevor Romeo, Analyst

Interesting. Yes. That's really helpful color. And then I guess, I also just wanted to ask on your gross margins, particularly in the Nurse and Allied segment. I think they picked up nicely from last quarter. So I was just wondering if you could provide a little more color on the drivers there. I think Brian talked about a favorable mix, but did you actually see kind of underlying spreads improve a bit there or did the competitive activity stabilize? What's your outlook for spreads in the core Nurse and Allied moving forward?

Brian M. Scott, Chief Financial and Operating Officer

Yes. Thanks, Trevor. The underlying spreads in Nurse and Allied have been more stable. We did have a little bit of better gross margin performance from what we guided in both the Nurse and Allied and Physician and Leadership segments. Most of that was really one-time items like sales allowance, we had a payroll tax benefit in the second quarter as well. We also picked up a little bit of additional international perm placement revenue at a very high margin. So there were a couple of good items in the quarter, which helped out. The same goes for Physician and Leadership, where we had a reduction in sales allowance. So our focus right now is actually on trying to drive as much volume as possible. There have been pretty stable bill rates, leading to stable margins, and we would expect to see that as we go into the third and fourth quarter as well.

Kevin Mark Fischbeck, Analyst

Great. I was just wondering if you could provide a little more color on when you think these numbers will have actually bottomed. When you talk about some of the firming in demand that you're seeing, are those comments like seasonally adjusted? I know that oftentimes, timing through the year can change when orders start to rebound or when they would be expected to rebound. So I just wanted to get more color on when you thought you might start to see year-over-year growth again.

Caroline Sullivan Grace, President and CEO

Yes. First off, welcome back. It's nice to hear your voice. A couple of things on demand. If I look at second quarter year-over-year and what's going on with clients, most of the decrease in utilization came from a concentrated number of clients, especially from academic medical centers. We saw the biggest change in utilization from this smaller group of clients. In the remainder of the utilization declines year-over-year, it was concentrated in clients that we have lost in 2023 or 2024. So think of that tail end playing through. If we look at what we're seeing in the early days of Q3, we see academic medical centers in aggregate, their volumes up from what we saw over the past 4 quarters. In terms of where we have seen declines, we're seeing stabilization, and we can expect more normalization as that pattern continues. Looking ahead, we anticipate seeing more winter orders come in over the next 60 days, and we are currently having some conversations with clients about those needs.

Brian M. Scott, Chief Financial and Operating Officer

Yes. Just add that as Cary mentioned at the beginning of the call, the declines we saw in extension rates during the second quarter had nominal impact on Q2, but we expect to feel more of it in the third quarter, which reflects in our guidance. This decline in orders started to arise in April but was most prominent in May and June. We have observed stability in orders over the last couple of months, although still at a lower level than earlier in the year. We're working on booking trends and anticipate an increase in winter orders towards the end of the quarter, following better booking trends, which could indicate more normal buying behavior from clients.

Kevin Mark Fischbeck, Analyst

Okay. I appreciate the commentary around legislative uncertainty, especially among teaching hospitals. However, we also saw sequential declines in growth rates of volumes. To what extent have hospitals been talking to you about that and how it might relate to their need for temporary staffing?

Caroline Sullivan Grace, President and CEO

What we're seeing is that by July and into August, we started to see demand either stabilize in nurse and/or pick up in Allied and in locums. We would typically see, Kevin, and clients have told us to expect similar timing this year. We start to see winter order needs come in at the end of this month and early September. So we view demand in terms of what we've been seeing in base business and expect to see some future orders around winter needs in the upcoming weeks.

Albert J. William Rice, Analyst

Maybe the flip side of these academic medical centers and hospitals generally putting hiring freezes on and being tougher on permanent hires might be a step-up in people being willing to consider Travel Nurse assignments or Allied assignments. Have you seen what's happening with respect to new applicants and so forth?

Caroline Sullivan Grace, President and CEO

We have seen healthy supply, aside from certain specialties or locations. This really is about demand, not about supply. If you have an order priced right, we don't have a challenge filling it. In fact, demand week to week shows that if orders come in priced appropriately, they will get filled immediately. It's not a supply challenge; it's about having attractive packages. This is particularly true in locums where you still see healthy demand for the specialty, and clinicians have options available to them.

Brian M. Scott, Chief Financial and Operating Officer

A.J., it's a good point. We've seen a slowdown in healthcare hiring. They're still hiring, but usually, there's a lag effect. If they continue to slow on permanent hiring and face normal attrition, we might witness a pinch on staffing levels, which could lead to increased demand. However, we haven't seen that yet, but it is historically a trend we've monitored.

Caroline Sullivan Grace, President and CEO

Yes. What we have seen is that coming out of COVID, we saw 2 things regarding programs. Clients weren't happy with outcomes during COVID, so they were open to new models. We've seen normalization of that sentiment recently. There's also been a bias towards vendor-neutral models, but we currently see our pipeline showing a slight bias back to supplier-led. Our strategy has been to serve clients based on their chosen model, and we've had success across various types over the past 18 months, which accounts for our stable market share.

Tobey O'Brien Sommer, Analyst

I want to start out with just a question on the guidance. How do we square the revenue below and gross margin down, but SG&A better? What are the moving pieces? Bonus accruals came to mind, but perhaps there are other moving pieces you could illustrate for us?

Brian M. Scott, Chief Financial and Operating Officer

Tobey. I'll start on the SG&A. We've done good work managing costs effectively, and that reflects in the second quarter. However, we also faced actuarial adjustments and slightly higher bad debt, which together contributed to an increase in SG&A. Adjusted SG&A is sitting in the low 130s. The Smart Square sale will result in a $2 million reduction in SG&A starting in Q3. The guidance reflects adjustments related to those factors.

Caroline Sullivan Grace, President and CEO

We are utilizing our strike support for both our MSP and VMS clients, with strong interest from both groups. Our developed technology enables us to support strikes effectively without disrupting core business. We've built a healthy pipeline for the second half of the year, backing clients in negotiating large collective bargaining agreements. The differentiating capabilities we now possess provide value to clients, which we had difficulty supporting previously. Let me tell you a bit about Language Services. We love this business as it is crucial in acute and non-acute settings. In the last quarter, we had mid-single-digit growth in utilization, but faced significant pricing pressure which limited our growth. We expect to see these trends persist, and we have built a strong pipeline to help us achieve stronger top-line growth by year-end, transitioning into next year.

Jack Garner Slevin, Analyst

You've got Jack Slevin on. Just wanted to maybe turn a little more broadly to the competitive environment. I appreciate your comments on holding share with the latest SIA data, but are there opportunities to potentially win share? There's chatter that some private competition is under pressure. What are you observing in terms of competitive actions and pricing?

Caroline Sullivan Grace, President and CEO

In terms of winning share dynamics, our goal is to gain share. We've successfully stabilized and even grown our market share this year. We aim to build net new client relationships and enhance our fill rates while offering better solutions that can differentiate us from competitors. The challenges that some competitors are facing will create opportunities for us to extend our offerings and win more clients. We expect a continuing trend of consolidation in the coming years. Regarding international nursing, we expect to return to growth in the fourth quarter, albeit modestly. We anticipate achieving double-digit growth in revenue and EBITDA by 2026, based on updated assumptions. Despite uncertainty, we have a solid demand pipeline. Our expectation for continued support from the healthcare community remains optimistic as client needs for clinical staff grow.

Brian M. Scott, Chief Financial and Operating Officer

The peak revenue we witnessed on the international nursing side was around $225 million. Currently, we are running near $125 million. We believe reaching the mid-200s mark is a reasonable target for recovery, accompanied by a higher EBITDA margin exceeding 30%.

Caroline Sullivan Grace, President and CEO

For labor disruption, we have line of sight to $5 million for the third quarter, reflecting expected contracted work. We monitor potential upside from large collective bargaining agreements in the fourth quarter, which may exceed our guidance and provide further revenue opportunities.

Brian M. Scott, Chief Financial and Operating Officer

While there is no anticipated negative impact from other competitors struggling, pricing remains stable across the board. We are witnessing continued stability in bill rates, particularly in the nursing business. Future price developments will likely depend on increasing fill rates in response to the ongoing wage growth seen in the industry.

Caroline Sullivan Grace, President and CEO

As for the sale of Smart Square, we are not anticipating any further divestitures. This decision allows us to focus our capital expenditures on areas with stronger growth potential and enhances our partnerships across scheduling systems without any competitive friction.

Mark Steven Marcon, Analyst

Most of my questions have been asked, but I wanted to dig a little deeper on some of them. Regarding Visa retrogression, can you remind us what the peak revenue on the international nursing side was? Where is it currently so that we have a base level to build from?

Caroline Sullivan Grace, President and CEO

As a reminder, we've come down by about $100 million from the peak in 2023. We were at about $225 million of revenue in 2023, and we're running closer to $125 million now. This puts our target at approximately $100 million for recovery, with strong future growth potential.

Mark Steven Marcon, Analyst

And on the labor disruption side, we did $16 million last quarter and are building in $5 million for this quarter. However, it sounds like there are a lot of collective bargaining agreements. Is that $5 million a really conservative number?

Brian M. Scott, Chief Financial and Operating Officer

We have good visibility to the $5 million projection for Q3, but there is potential upside based on collective bargaining agreements. We view larger revenue opportunities coming in the fourth quarter and possibly into the first quarter of next year. The guidance reflects what we know, and we see reasonable conservativeness in it.

Mark Steven Marcon, Analyst

Okay. Great. And regarding the competitive environment, do you see any negative impacts from pricing perspectives as competitors struggle? Is pricing currently stable?

Caroline Sullivan Grace, President and CEO

Current pricing remains stable. We've seen relative stability in bill rates in nursing and increasing revenue per day in locum management. Looking ahead, we anticipate sustaining our pricing strategy, regardless of our competitors' financial positions.

Mark Steven Marcon, Analyst

I know you called out some wins in MSP. I wondered if you could step back. What are you seeing now? Are you seeing more activity, and is that creating opportunities? How does that influence your ability to capture incremental share?

Caroline Sullivan Grace, President and CEO

We've seen a willingness from clients to explore new models and return to traditional processes especially when considering outcomes during COVID. We're seeing a little normalization in sentiment and transition back to vendor-neutral models from where we had biases prior. Our success spans across the various types of staffing arrangements, so we're operating and serving clients in the model they prefer.

Jack Garner Slevin, Analyst

If I could sneak one in, I would like to ask about international nursing and growth expectations moving forward. Could you share insights into what checks we should monitor to ensure we're on track?

Caroline Sullivan Grace, President and CEO

We expect the shift in international nursing to show modest growth in Q4, especially following a two-year headwind due to retrogression. Starting in 2026, even under conservative estimates, we anticipate double-digit growth rates, highlighting expected recovery accompanied by a supportive legislative backdrop as logistical challenges to clinical supply are alleviated. Thank you for joining our second quarter earnings call. Our entire team appreciates your interest in AMN Healthcare.