AMN Healthcare Services Inc (AMN) 2025 Q3 法說會逐字稿

Good day, and thank you for standing by. Welcome to the AMN Healthcare's third-quarter 2025 earnings call. (Operator Instructions) Please be advised that today's conference is being recorded.

您好，感謝您的耐心等待。歡迎參加 AMN Healthcare 2025 年第三季財報電話會議。（操作人員指示）請注意，今天的會議正在錄音。

I would now like to hand the conference over to your speaker today, Randy Reece, Vice President, Investor Relations. Please go ahead.

現在我謹將會議交給今天的主講人，投資者關係副總裁蘭迪·里斯先生。請繼續。

Good afternoon, everyone. Welcome to AMN Healthcare's third-quarter 2025 earnings call. A replay of this webcast will be available at ir.amnhealthcare.com at the conclusion of this call.

大家下午好。歡迎參加 AMN Healthcare 2025 年第三季財報電話會議。本次網路直播的回放將在本次電話會議結束後在ir.amnhealthcare.com上提供。

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.

我們在本次電話會議中對未來預期、預測、趨勢、計畫、事件或情況所作的評論構成前瞻性陳述。這些聲明反映了公司基於目前所掌握的資訊而形成的觀點。由於各種因素和警示性聲明（包括我們在最近提交的 10-K 和 10-Q 表格、我們的盈利報告以及隨後向美國證券交易委員會提交的文件中確定的因素和聲明），我們的實際結果可能與這些前瞻性聲明所指出的結果存在重大差異。本公司不打算在下次發布財報之前更新今天提供的業績指引或任何前瞻性聲明。

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.

本次電話會議包含某些非GAAP財務資訊。有關這些非GAAP指標及其與最直接可比較的GAAP指標的調節信息，請參閱我們的盈利報告和財務報告頁面（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.

今天和我一起通話的是總裁兼執行長 Cary Grace，以及財務長兼營運長 Brian Scott。

I will now turn the call over to Cary.

現在我將把電話轉給凱瑞。

Thank you, Randy, and welcome to today's conference call. Since our last call, AMN has continued to adapt to changes in the marketplace and position the company to win as our industry transitions from recovery to growth. Third-quarter revenue of $634 million was $9 million above the high end of our guidance range. Consolidated gross margin was near the upper end of guidance, and SG&A expenses were better than expected. Adjusted EBITDA for the third quarter was $57.5 million, which was 9.1% of revenue, 90 basis points above the high end of our guidance range.

謝謝你，蘭迪，歡迎參加今天的電話會議。自上次通話以來，AMN 一直在不斷適應市場變化，並使公司做好準備，在我們行業從復甦向成長過渡的過程中贏得勝利。第三季營收為 6.34 億美元，比我們預期範圍的上限高出 900 萬美元。綜合毛利率接近預期上限，銷售、管理及行政費用優於預期。第三季調整後 EBITDA 為 5,750 萬美元，佔營收的 9.1%，比我們預期範圍的上限高出 90 個基點。

After experiencing demand softness in the second quarter, staffing demand recovered moderately in the third quarter, extension rates rebounded, and Travel Nurse winter orders came in slightly favorable to prior year. At the same time, permanent hiring activity in the healthcare sector fell notably in the third quarter according to a private survey of job openings.

在第二季需求疲軟之後，第三季人員配備需求略有回升，續約率反彈，冬季旅行護理師訂單略好於去年同期。同時，根據一項私人招聘調查，醫療保健行業的永久性招聘活動在第三季顯著下降。

The different directions of contingent and permanent recruiting suggest that employers are beginning to seek more flexibility in their workforce strategies to meet increasing patient utilization. This is an increasingly attractive strategy as we estimate that the spread between Travel Nurse bill rates and fully loaded permanent nurse compensation is at a historical low.

臨時招聘和永久招聘的不同方向表明，雇主開始尋求更靈活的勞動力策略，以滿足不斷增長的患者就診需求。鑑於我們估計旅行護理師的收費標準與全職正式護理師的薪酬之間的差距處於歷史低位，因此這種策略越來越有吸引力。

Bill rates maintained stability through the last nine months, and there are a few indications suggesting that some clients are reconsidering a bill rate strategy, in which rates have not kept up with increased costs. In fact, we expect bill rates for Nurse and Allied Staffing to be up modestly year over year in the fourth quarter for the first time in three years.

過去九個月，帳單費率保持穩定，但有一些跡象表明，一些客戶正在重新考慮帳單費率策略，因為費率未能跟上成本上漲的步伐。事實上，我們預期護理人員及相關人員配備的收費標準將在第四季同比小幅上漲，這將是三年來首次出現這種情況。

Our consolidated outlook for the fourth quarter calls for revenue a little better than $720 million at the midpoint or just over $620 million, excluding labor disruption revenue. Our guidance includes about $5 million extra SG&A expenses in Q4 related to labor disruption support.

我們對第四季的綜合預期是，營收中位數略高於 7.2 億美元，或略高於 6.2 億美元（不包括勞動力中斷收入）。我們的預期包括第四季度與勞動力市場中斷支援相關的約 500 萬美元額外銷售、管理及行政費用。

While conditions for individual business lines vary, we benefit from the diversification among our 20 solutions, which keep us well-positioned to serve clients' evolving needs and desire for strategic partners over the long run. All three business segments beat consensus revenue estimates in the third quarter, led by $12 million upside in Nurse and Allied Solutions.

雖然各個業務線的具體情況有所不同，但我們受益於我們 20 種解決方案的多樣性，這使我們能夠更好地滿足客戶不斷變化的需求，並長期滿足客戶對策略合作夥伴的期望。第三季度，三大業務部門的收入均超出市場普遍預期，其中護理及相關解決方案部門的收入增加了 1,200 萬美元。

Part of the Nurse and Allied beat came from higher-than-expected labor disruption revenue. As projected, lower Q2 demand and extensions flowed through to lower Q3 revenue, though less than we expected. As new demand and extension offers improved in the quarter, our team executed well to capture this demand and set us up for higher Travel Nurse and Allied revenue in Q4. Demand improved modestly through the third quarter into October, including higher winter orders.

護理師及相關產業績效超出預期的部分原因是勞動市場中斷造成的收入高於預期。正如預期的那樣，第二季需求和延期導致第三季收入下降，但下降幅度小於我們的預期。隨著本季新需求和延期優惠的增加，我們的團隊執行得很好，抓住了這些需求，並為我們在第四季度獲得更高的旅行護士和相關人員收入奠定了基礎。第三季到十月份，需求略有改善，包括冬季訂單增加。

For the fourth quarter, we expect about $100 million in labor disruption revenue. Total Nurse and Allied revenue will be up low-single digits year over year or down approximately 6% to 8%, excluding labor disruption. This will be our best year-over-year revenue comparison for the segment in three years.

我們預計第四季勞動力市場中斷造成的收入約為 1 億美元。不計勞動市場中斷的影響，護理師及相關產業的總收入將年增個位數百分比，或年減約 6% 至 8%。這將是該業務板塊三年來最好的年比營收業績。

In our Physician and Leadership Solutions segment, revenue grew 2% sequentially in Locum Tenens and Interim Leadership, while Search revenue was stable. We were pleased to record 3% year-over-year growth in Locum Tenens revenue. The highlight in Locum was days booked for MSP clients, which grew by 15% year over year, including a nice boost from new client wins. For the fourth quarter, Physician and Leadership Solutions revenue is projected to be down sequentially by approximately 6%, due primarily to seasonally lower Locum's volume.

在我們的醫生和領導力解決方案部門，臨時醫生和臨時領導的收入環比增長了 2%，而搜尋收入保持穩定。我們很高興地宣布，臨時醫生收入年增了 3%。臨時工業務的亮點是為 MSP 客戶預訂的天數，年增 15%，其中包括新客戶帶來的良好成長。預計第四季醫生和領導解決方​​案收入將環比下降約 6%，主要原因是季節性臨時醫生數量減少。

For our Technology and Workforce Solutions segment, third-quarter revenue was $7 million lower than the prior quarter. Most of that drop came from the sale of our Smart Square business on July 1. VMS revenue was $2 million lower and Language Services revenue less than $1 million lower.

我們的技術和人力資源解決方案部門第三季營收比上一季減少了 700 萬美元。大部分跌幅來自我們於 7 月 1 日出售的 Smart Square 業務。VMS 收入減少了 200 萬美元，語言服務收入減少了不到 100 萬美元。

In the fourth quarter, we expect Technology and Workforce Solutions revenue to be down mid-single digits compared with the third quarter with seasonally lower language services minutes and the lingering runoff from previously discussed client transitions in our VMS and Language Services businesses.

預計第四季度技術和勞動力解決方案收入將比第三季下降個位數中段，原因是季節性語言服務時長減少，以及先前討論過的VMS和語言服務業務客戶過渡的後續影響。

I want to touch on the subject of gross margins. Our consolidated gross margin has declined this year caused by an unfavorable revenue mix shift and competitive pressures in staffing and language services. As Nurse and Allied demand moves from stability to growth, we expect staffing gross margins to stabilize. We expect improvement in international staffing revenue and other high-margin services to lift our consolidated gross margin in 2026. In a normal demand recovery, we also would expect to see travelers average hours worked increase and placement mix improve, both of which would create margin growth opportunity.

我想談談毛利率這個話題。由於收入結構不利變化以及人員配備和語言服務領域的競爭壓力，我們今年的綜合毛利率有所下降。隨著護理人員及相關人員的需求從穩定轉向成長，我們預期人員配備的毛利率將趨於穩定。我們預期國際人員配備收入和其他高利潤服務的改善將提升我們2026年的合併毛利率。在正常的需求復甦過程中，我們預期旅客的平均工作時間將會增加，工作地點組合也會有所改善，這兩方面都會創造利潤成長的機會。

AMN has differentiated itself in many ways this year, including from a financial perspective. At the end of the third quarter, we had a zero balance on our revolving line of credit, down from $210 million at the end of 2024. In early October, we completed a debt refinancing transaction that strengthened our financial position and improved our corporate debt rating. Our earliest debt expiration was extended out to 2029. Our revolver was downsized to reduce carrying costs and debt leverage covenant increased to give us more operating flexibility.

AMN今年在許多方面都展現了與眾不同的特質，包括財務方面。第三季末，我們的循環信貸額度餘額為零，而 2024 年底的餘額為 2.1 億美元。10月初，我們完成了一項債務再融資交易，這增強了我們的財務狀況，提高了我們的公司債務評級。我們最早的債務到期日已延長至 2029 年。為了降低持有成本，我們縮減了循環信貸額度；為了提高營運彈性，我們提高了債務槓桿。

The next phase of our strategy to gain market share is in view as we see an increasing number of prospects, seeking more complete talent solutions. Our performance on client retention remained strong year to date, and our latest Net Promoter Scores were significantly improved from last year.

隨著越來越多的潛在客戶尋求更全面的人才解決方案，我們正在著手製定下一階段的市場佔有率策略。今年以來，我們在客戶留存方面的表現依然強勁，最新的淨推薦值 (NPS) 也比去年有了顯著提高。

Our aggressive plan to improve technology, processes and customer focus paid off with a 700-basis-point year-over-year improvement in client satisfaction. We continue to expand our number of service lines provided to clients, and we see interest from a number of strategic clients in consolidating their decentralized locum spend.

我們積極推動技術、流程和客戶至上的計畫取得了成效，客戶滿意度較去年同期提高了 700 個基點。我們不斷擴大為客戶提供的服務範圍，並且我們看到許多策略客戶對整合其分散的臨時醫生支出表現出興趣。

We are also making progress on our strategy to fill more of the available demand by improving our speed to fill. For example, over the past 12 months, we doubled our fill rate in our vendor-neutral program.

我們也正在透過提高供貨速度來滿足更多現有需求，從而在滿足更多現有需求方面取得進展。例如，在過去的 12 個月裡，我們在供應商中立計畫的訂單滿足率翻了一番。

Overall, competition for new clients and renewals has seen less motivation from clients to switch vendors as they prioritize other initiatives. However, we remain confident that our client-first approach and industry-leading spectrum of talent solutions will win over the coming quarters and years.

整體而言，由於客戶將重心放在其他項目上，爭取新客戶和續約客戶的動機有所下降，因此更換供應商的意願也降低。然而，我們仍然相信，我們以客戶為先的方針和行業領先的人才解決方案將在未來幾季和幾年內贏得勝利。

Now, I will turn over the call to Brian to give more details on our latest financial results and business outlook.

現在，我將把電話交給布萊恩，讓他詳細介紹我們最新的財務表現和業務前景。

Thank you, Cary, and good afternoon, everyone. Third-quarter consolidated revenue was $634 million, above the high end of our guidance range, driven by outperformance in our Nurse and Allied and Physician and Leadership segments. Revenue was down 8% from the prior year and down 4% sequentially.

謝謝你，凱瑞，大家下午好。第三季綜合收入為 6.34 億美元，高於我們預期範圍的上限，這主要得益於護士及相關人員和醫生及領導部門的出色表現。營收較前一年下降 8%，季減 4%。

Consolidated gross margin for the third quarter was 29.1% at the high end of our guidance range. Gross margin declined 190 basis points year over year and 70 basis points sequentially.

第三季綜合毛利率為 29.1%，處於我們預期範圍的高端。毛利率年減 190 個基點，季減 70 個基點。

Consolidated SG&A expenses were $139 million compared with $150 million in the prior year and $155 million in the previous quarter. Adjusted SG&A, which excludes certain expenses, was $129 million in the third quarter compared with $141 million in the prior year and $140 million in the previous quarter.

合併銷售、管理及行政費用為 1.39 億美元，而去年同期為 1.5 億美元，上一季為 1.55 億美元。經調整的銷售、一般及行政費用（不包括某些費用）第三季為 1.29 億美元，而上年同期為 1.41 億美元，上一季為 1.4 億美元。

The sequential decrease in adjusted SG&A is primarily attributable to a lower bad debt expense and an unfavorable prior quarter professional liability reserve adjustment. Third-quarter Nurse and Allied revenue was $361 million, down 9% from the prior year, though exceeding the high end of our guidance range, driven by higher-than-expected Travel Nurse volume and $12 million of labor disruption revenue. Sequentially, segment revenue was down 5%, primarily due to lower volume.

經調整的銷售、一般及行政費用較上月下降，主要歸因於壞帳支出減少及上一季專業責任準備金調整不利。第三季護理師及相關產業收入為 3.61 億美元，比上年同期下降 9%，但超過了我們預期範圍的上限，這主要得益於旅行護理師數量高於預期以及 1,200 萬美元的勞動力中斷收入。環比來看，該業務部門收入下降了 5%，主要原因是銷量下降。

Year over year, Nurse and Allied segment volume decreased 11% and average rate and average hours work were flat. Sequentially, volume was down 6%, while the average rate was down 1% and hours work were flat.

與前一年相比，護理師及相關人員業務量下降了 11%，平均薪資和平均工時保持不變。環比來看，業務量下降了 6%，平均成長率下降了 1%，工作時長保持不變。

Travel Nurse revenue in the third quarter was $196 million, a decrease of 20% from the prior year period and 6% from the prior quarter. Allied revenue in the quarter was $142 million, up 1% year over year and down 2% sequentially. Nurse and Allied gross margin in the third quarter was 24.1%, a decrease of 90 basis points year over year. Sequentially, gross margin was up 20 basis points.

第三季旅行護理師收入為 1.96 億美元，比上年同期下降 20%，比上一季下降 6%。該季度聯合營收為 1.42 億美元，年增 1%，季減 2%。第三季護理師及相關產業毛利率為 24.1%，較去年同期下降 90 個基點。毛利率較上月上升 20 個基點。

We noted in the earnings release that our lower consolidated Q4 gross margin guidance is partly influenced by labor disruption-related factors. Due in part to timing of activities, labor disruption benefited the Nurse and Allied segment gross margin in Q3 by about 150 basis points, with a nominal drag to the segment gross margin in Q4. We expect the fourth quarter Nurse and Allied segment gross margin to be approximately 21%, with the lower sequential outlook also being driven by seasonally lower average hours works and a modest decline in spreads.

我們在獲利報告中指出，我們下調的第四季綜合毛利率預期部分受到勞工糾紛相關因素的影響。部分原因是由於活動時間安排，勞動力中斷使護士和相關人員部門的毛利率在第三季度提高了約 150 個基點，對第四季度該部門的毛利率造成了輕微拖累。我們預計第四季度護理師及相關人員業務部門的毛利率約為 21%，環比預期下調也是由於季節性平均工時減少和價差略有下降所致。

Moving to the Physician and Leadership Solutions segment. Third-quarter revenue of $178 million was down 1% year over year. Sequentially, revenue was up 2%, mainly driven by Locum Tenens' performance. Locum Tenens' revenue in the quarter was $146 million, up 3% year over year and 2% sequentially.

接下來進入「醫生和領導力解決方案」板塊。第三季營收為1.78億美元，年減1%。環比來看，營收成長了 2%，主要得益於 Locum Tenens 的業績表現。Locum Tenens 本季營收為 1.46 億美元，年增 3%，季增 2%。

Interim leadership revenue of $23 million decreased 20% from the prior-year period, but was up 2% sequentially. Search revenue of $9 million was down 7% year over year and flat sequentially. Gross margin for the Physician and Leadership Solutions segment was 27.2%, down 110 basis points year over year, attributable to a lower bill pay spread in locum tenens and an unfavorable revenue mix shift.

臨時領導層收入為 2,300 萬美元，比上年同期下降 20%，但環比成長 2%。搜尋收入為 900 萬美元，年減 7%，季減。醫生和領導解決方​​案部門的毛利率為 27.2%，年減 110 個基點，這歸因於臨時醫生的帳單支付差額降低以及收入結構不利的變化。

Sequentially, gross margin decreased 100 basis points, and we expect Q4 segment gross margin to remain consistent with Q3. Technology and Workforce Solutions revenue for the third quarter was $95 million, down 12% year over year and 7% sequentially, primarily driven by lower VMS revenue and the sale of Smart Square.

第四季毛利率季減 100 個基點，我們預計第四季分部毛利率將與第三季保持一致。第三季技術和勞動力解決方案收入為 9,500 萬美元，年減 12%，環比下降 7%，主要原因是 VMS 收入下降和 Smart Square 的出售。

Language services revenue for the quarter was $75 million, flat year over year and down 1% sequentially. VMS revenue for the quarter was $17 million, a decrease of 32% year over year and 11% sequentially. Segment gross margin was 51.5%, down 640 basis points from the prior-year period due primarily to a lower revenue mix from VMS, the sale of Smart Square and lower margin in language services. Sequentially, gross margin declined 360 basis points, driven by the same factors.

本季語言服務收入為 7,500 萬美元，與去年同期持平，季減 1%。本季 VMS 營收為 1,700 萬美元，年減 32%，季減 11%。該業務部門毛利率為 51.5%，較上年同期下降 640 個基點，主要原因是 VMS 收入佔比下降、Smart Square 出售以及語言服務利潤率下降。受相同因素影響，毛利率季減 360 個基點。

We anticipate segment gross margin stepping down by about 100 basis points in the fourth quarter, with lower expected VMS revenue along with pricing pressure in language services. Consolidated operating income of $48 million included a $39 million gain on the sale of Smart Square.

我們預計第四季度該業務部門的毛利率將下降約 100 個基點，原因是 VMS 收入預期下降以及語言服務價格面臨壓力。合併營業收入為 4,800 萬美元，其中包括出售 Smart Square 獲得的 3,900 萬美元收益。

Third-quarter consolidated adjusted EBITDA was $58 million, down 22% year over year and 1% sequentially. Adjusted EBITDA margin for the quarter was 9.1%, down 160 basis points from the prior year period and up 20 basis points sequentially. Third-quarter net income was $29 million. This compared with net income of $7 million in the prior-year period and a net loss of $116 million in the prior quarter, which included noncash goodwill and intangible asset impairment charges.

第三季綜合調整後 EBITDA 為 5,800 萬美元，年減 22%，季減 1%。本季調整後 EBITDA 利潤率為 9.1%，較上年同期下降 160 個基點，較上季上升 20 個基點。第三季淨利為2900萬美元。相較之下，上年同期淨收入為 700 萬美元，而上一季淨虧損為 1.16 億美元，其中包括非現金商譽和無形資產減損費用。

Third-quarter GAAP diluted earnings per share was $0.76. Adjusted earnings per share for the quarter was $0.39 compared with $0.61 in the prior year period and $0.30 in the prior quarter. Days sales outstanding for the quarter were 57 days, which was three days lower than a year ago and three days higher sequentially.

第三季GAAP稀釋後每股盈餘為0.76美元。該季度調整後每股收益為0.39美元，而去年同期為0.61美元，上一季為0.30美元。本季應收帳款週轉天數為 57 天，比去年同期減少了 3 天，比上一季增加了 3 天。

Operating cash flow for the third quarter was $23 million and capital expenditures were $8 million. As of September 30, we had cash and equivalents of $53 million and total debt of $850 million. We ended the quarter with a net leverage ratio of 3.3 times to 1.

第三季經營現金流為 2,300 萬美元，資本支出為 800 萬美元。截至9月30日，我們擁有現金及現金等價物5,300萬美元，總債務為8.5億美元。本季末，我們的淨槓桿率為 3.3 倍 1。

In October, we completed the refinancing of $500 million of unsecured notes, due in 2027, with $400 million of new unsecured notes due in 2031. Concurrently, we downsized our revolver capacity to $450 million and increased our maximum leverage ratio covenant. These transactions immediately increased our balance sheet resilience.

10 月份，我們完成了 5 億美元 2027 年到期無擔保票據的再融資，同時發行了 4 億美元 2031 年到期的新無擔保票據。同時，我們將循環信貸額度縮減至 4.5 億美元，並提高了最大槓桿率限制。這些交易立即增強了我們資產負債表的穩健性。

Moving to fourth-quarter guidance. We project consolidated revenue to be in the range of $715 million to $730 million. This revenue guidance includes approximately $100 million related to labor disruption support. Gross margin is projected to be between 25.5% and 26%. Excluding the impact of labor disruption revenue, our gross margin would be higher by about 100 basis points.

接下來公佈第四季業績預期。我們預計合併後的營收將在 7.15 億美元至 7.3 億美元之間。該營收預期包括約 1 億美元與勞工糾紛支持相關的資金。預計毛利率將在 25.5% 至 26% 之間。如果排除勞動市場中斷收入的影響，我們的毛利率將提高約 100 個基點。

Reported SG&A expenses are projected to be approximately 20% to 20.5% of revenue and include about $5 million of additional costs in the quarter to support labor disruption activity. Operating margin is expected to be 0.2% to 0.8% and adjusted EBITDA margin is expected to be 6.8% to 7.3%. Additional fourth-quarter guidance details can be found in today's earnings release.

報告的銷售、一般及行政費用預計約為收入的 20% 至 20.5%，其中包括本季為應對勞工中斷活動而增加的約 500 萬美元額外成本。預計營業利潤率為 0.2% 至 0.8%，調整後 EBITDA 利潤率為 6.8% 至 7.3%。有關第四季度業績指引的更多詳情，請參閱今天發布的財報。

Now, operator, please open up the call for questions.

現在，接線員，請開啟提問環節。

(Operator Instructions) Trevor Romeo, William Blair.

（操作說明）特雷弗·羅密歐，威廉·布萊爾。

First one, I had kind of a -- might be a multipart question on the margin guidance just because I know there are kind of a lot of moving pieces here. So maybe just starting with the gross margins. I think, you're 29% in Q3, 100 basis points of unfavorable from the labor disruption in Q4, but I think, even if you add that back, it's like a 240- to 250-basis-point drop sequentially in gross margin. So could you help us think about, I guess, the individual drivers of that on the consolidated and the magnitude of each one?

第一個問題，我可能有一個關於利潤率指引的多部分問題，因為我知道這裡面有很多變數。所以或許可以先從毛利率著手。我認為，第三季毛利率為 29%，第四季勞動市場中斷導致毛利率下降 100 個基點，但即使加上第四季的勞動市場中斷，毛利率也較上季下降了 240 到 250 個基點。那麼，您能否幫我們思考一下，影響綜合數據的各個驅動因素以及每個因素的影響程度？

Sure. Yeah, Trevor, this is Brian. No problem. Yeah. So I start with also on the third quarter, that the 29% just for the labor disruption event that we supported some of the timing activities, we actually got a benefit to some degree to the margin in the third quarter as well. So that 29% to get that closer to 28% if you'd normalize the third quarter as well. And then we tried to give enough color on the fourth quarter on the guide that if you were to kind of remove the impact as well, you're closer to 27% in the high-26s if you take the midpoint of our range and that 100 basis points.

當然。是的，特雷弗，這位是布萊恩。沒問題。是的。所以，我首先要說的是第三季度，僅因勞動市場中斷事件造成的 29% 的損失，我們採取了一些時間安排措施，實際上，我們在第三季度的利潤率也在一定程度上受益。如果將第三季的數據也正常化，那麼這個比例將從 29% 降至更接近 28%。然後我們試圖在指南中充分說明第四季度的情況，如果你也要消除一些影響，那麼如果你取我們區間的中點和 100 個基點，你就會發現接近 27% 到 26% 的高位。

So you're talking about a little over 100 basis points change sequentially from Q3 to Q4 to kind of remove that from the equation. And there's a couple of factors driving that. One is just revenue mix between the segments. You have a -- if you look at the guidance we gave, you've got some decline in both our Physician and Leadership and Technology Workforce Solutions segments, both of which have a higher margin profile. So those are probably the main things that are driving that.

所以，您指的是從第三季度到第四季度，連續變化略超過 100 個基點，以此來消除這種影響。造成這種情況的原因有二。一是各業務板塊之間的收入構成。如果你看一下我們給的業績指引，你會發現我們的醫生和領導力及技術人才解決方案部門都出現了下滑，而這兩個部門的利潤率都比較高。所以這些可能是造成這種情況的主要原因。

And then to a lesser degree, you have some impact from just seasonality. We mentioned even in Nurse and Allied, where there's usually a little bit lower hours work, and that has a bit of a drag on the margin in the fourth quarter. And kind of the last thing, because you said there's multiple parts here, the third quarter, we did get a little bit of a benefit as well from some favorability on sales reserves in Nurse and Allied. And so that's why you're seeing that larger change from quarter-to-quarter in the margins.

此外，季節性因素也會產生一定影響，但影響較小。我們甚至提到過，在護理師和相關專業人員中，工作時間通常略少一些，這會對第四季度的利潤率造成一定程度的拖累。最後一點，因為你說這裡有多個部分，第三季度，我們也從護理和相關行業的銷售儲備金的一些有利因素中獲得了一些好處。所以這就是為什麼你會看到季度利潤率出現較大變化的原因。

Okay. Brian, that's helpful. Thank you. If I could maybe follow up on, I guess, the EBITDA margin guidance. I think, just if we're trying to isolate, maybe the ex the big labor disruption event, just what's the underlying performance of the business, I guess. If I just take the midpoint of your guidance there, I think, I get about $50 million, $51 million of EBITDA, but you obviously have that big labor disruption event in there. So if we're trying to use that as kind of a guide for modeling going forward, maybe you could just help us think about what the underlying EBITDA would look like and how that could evolve going forward?

好的。布萊恩，這很有幫助。謝謝。我想就 EBITDA 利潤率指引方面再補充一點。我認為，如果我們試圖將大型勞工糾紛事件的影響排除在外，那麼企業的基本績效究竟如何呢？如果我取您給出的指導意見的中點，我認為 EBITDA 大約為 5000 萬美元到 5100 萬美元，但顯然其中包含了那次重大的勞工糾紛事件。所以，如果我們想以此作為未來建模的指導，也許您可以幫助我們思考潛在的 EBITDA 會是什麼樣子，以及它未來會如何發展？

Sure. Yeah. I mean, we tried to give enough of the components there. The margin -- you said there was a large amount of revenue, obviously, in the guide from that event, and that did have a larger -- I mean, a lower -- slightly lower margin profile to it. When you have something of that magnitude, there's a fair amount of what we're billing for that are really just pass-through costs for things like transportation.

當然。是的。我的意思是，我們努力提供了足夠的組件。利潤率——您提到，那次活動的業績指引中顯然有很多收入，而且利潤率也更高——我的意思是，更低——略低一些。當專案規模如此之大時，我們帳單中相當一部分實際上只是運輸等轉嫁成本。

And so that impacts the margin profile when it's of that magnitude and just some of the timing again is between the third and the fourth quarter, but I think, you could probably think about the ex that amount, you're -- we're in the kind of mid-6s EBITDA margin range for the guide if you were to move the impact of the labor disruption in the quarter.

因此，當影響達到如此規模時，就會對利潤率產生影響，而且部分影響時間點在第三季和第四季之間。但我認為，你可以考慮一下，如果將勞動力中斷的影響考慮在本季度，那麼我們的 EBITDA 利潤率預期應該在 6% 左右。

Okay. That's helpful. And then maybe if I could just do one more, if you don't mind. I guess, encouraging definitely to hear about sequential volume growth into Q4. So I guess my question there is, you did talk about winter orders being up, I think, modestly versus last year. I guess, do you get the sense that this is more of a winter phenomenon? Or would you kind of chalk up the sequential volume growth to some kind of underlying improvement in demand, and maybe a shift in the contingent versus permanent staff that, I think, Cary alluded to in the comments?

好的。那很有幫助。如果你不介意的話，也許我可以再做一次。第四季銷量較上月成長，這無疑是個令人鼓舞的消息。所以我想問的是，您確實提到冬季訂單有所增長，我認為與去年相比，增幅不大。我想，你是否覺得這更像是一種冬季現象？或者，您是否會將銷售的持續成長歸因於需求的某種潛在改善，以及臨時工與正式員工比例的變化（我認為 Cary 在評論中也提到過這一點）？

Yeah. So Trevor, we're really looking at it as being both. And so if I kind of give you the shape of demand since our last call, so we talked about in the second quarter, we saw a pause in some decision-making as people really trying to digest potential policy changes. If I take Travel Nurse, so the low point in demand was mid-May, and fast forward to now, we're up about 50% in demand from that low point. We're still a little bit off year over year from where we were last year, but you've seen consistent growth since that low point in May in Travel Nurse.

是的。所以特雷弗，我們實際上是把它看作兩者兼具。因此，如果我大致介紹一下自我們上次通話以來的需求情況，我們在第二季度談到，我們看到一些決策有所停滯，因為人們正在努力消化潛在的政策變化。以旅行護理師為例，需求低谷出現在 5 月中旬，而現在，需求量比低潮時期增加了約 50%。雖然我們與去年同期相比仍有一些差距，但自 5 月旅行護理師業務的低谷以來，我們已經看到了持續成長。

In Allied demand, we're now flat year over year. And in Locums, we've seen growth in Locums Q2 to Q3. We're still mid-single-digit down year over year. But what we're seeing -- and certainly, we had healthy winter orders come in, but we're seeing demand improvement broader than just winter orders. And really, that combination is what's driving what you're seeing Q3 to Q4. And if we even strip out some of the seasonality piece, we're seeing a good growth in the fourth quarter.

就聯合採購需求而言，我們目前與去年同期持平。在臨時工領域，我們看到第二季到第三季臨時工數量有所增加。我們目前的同比降幅仍然在個位數中段。但我們看到的情況是——當然，冬季訂單量很大，但我們看到需求改善的範圍遠不止冬季訂單。而實際上，正是這種組合推動了你們在第三季到第四季看到的情況。即使剔除一些季節性因素，我們也看到第四季實現了良好的成長。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great. Maybe just to go back to the gross margin discussion. I guess in Q3, it looked like all the businesses had year-over-year gross margin compression. Can you just talk a little bit about the outlook for gross margins for next year across the businesses? It sounds like you think that the demand firming in Nurse and Allied is going to provide some stability there, but I guess it wasn't clear to me exactly what you were thinking about the other two businesses.

偉大的。或許我們應該回到毛利率的討論上來。我感覺第三季所有業務的毛利率都出現了同比下降。能否簡要談談明年各業務部門的毛利率前景？聽起來你認為護理及相關行業的需求穩定將為該行業帶來一些穩定性，但我不太清楚你對另外兩個行業的具體看法。

Yeah. Let me maybe pick up on some themes that we see going into next year. And I know we don't give guidance, but I'll give you some transparency about what we see. First, and this has been a negative impact for us the past two-plus years, is we expect to see more favorable revenue mix. That will be coming from international nurse, which we already have seen enough from a visa retrogression this year to have some transparency about those placements next year. We expect International Nurse to be up from a revenue standpoint, 20%-plus, and that's a higher-margin business.

是的。我想談談明年的一些發展趨勢。我知道我們不提供指導，但我會坦誠地告訴你們我們所看到的情況。首先，也是過去兩年多來對我們造成負面影響的一點是，我們期望看到更有利的收入結構。這將來自國際護理師領域，我們今年已經從簽證排期中看到了足夠的情況，因此明年這些崗位的安排需要一些透明度。我們預計國際護理師的收入將成長 20% 以上，而且這是一個利潤率較高的行業。

VMS, we've had a tailwind in VMS predominantly from our Medefis marketplace platform of clients going off. And so we would expect, as we get into 2023, for VMS to turn positive, and that has been a headwind for us. And then we also are seeing healthy demand increases from our leadership and search businesses. And those are the higher-margin businesses, both in PLS, and they're accretive to margin from a consolidated standpoint.

VMS方面，我們主要得益於Medefis市場平台客戶的流失，這為VMS帶來了順風。因此，我們預計，到了 2023 年，VMS 將轉正，而這對我們來說一直是一個不利因素。此外，我們還看到來自領導力和搜尋業務的健康需求成長。這些都是利潤率較高的業務，無論是在PLS或其他方面，從合併的角度來看，它們都能增加利潤率。

So Kevin, first is, we're seeing more tailwinds around some of our higher-margin businesses as we leave this year and go into 2026. We've also been very focused on filling, especially where we have more direct access to demand. So think MSPs, our own VMS platform and direct accounts.

所以凱文，首先，隨著今年即將結束，我們即將進入 2026 年，一些利潤率較高的業務將迎來更多利多。我們也一直非常注重供貨，尤其是在我們能夠更直接地滿足需求的地區。所以想想MSP（託管服務提供者）、我們自己的VMS平台和直接帳戶。

I mentioned this in my opening remarks, year over year, we've doubled our internal capture on our own VMS. So we'll continue to focus on that. And then we're starting to see with some clients, some movement in bill rates. That's really from an industry standpoint.

我在開場白中提到過，我們每年都透過我們自己的視訊管理系統 (VMS) 實現內部捕獲量翻倍。所以我們會繼續關注這一點。然後我們開始看到一些客戶的帳單費率有所變動。這確實是從產業角度來看的。

One of the things we'll be looking for as we get into 2026 is more consistent improvement of bill rates, which would obviously have a strong impact on margins.

展望 2026 年，我們將關注的重點之一是帳單費率的持續改善，這顯然會對利潤率產生重大影響。

Okay. Great. And the VMS improvement that you expect next year, is that tied? Or I guess when, I think, about VMS, I kind of think about it more tied broadly to Nurse demand. Is that happening because you expect Nurse and Allied demand to grow, and therefore, VMS will grow along with that? Or are you seeing --?

好的。偉大的。你們預計明年VMS的改進幅度會是多少？是持平嗎？或者我想，當我思考VMS時，我更多地會把它與護士的需求聯繫起來。這是因為您預期護理師和相關專業人員的需求會成長，因此VMS也會隨之成長嗎？還是你看到了什麼？——？

We're not necessarily assuming strong underlying growth. We just have had post-COVID, some clients who had gone on to this marketplace VMS coming off of it. And that process had a fairly long tail on it that we are at the very end of. And we've also layered in some wins that we've had this year. So the combination of those two things will help us get back to growth on our VMS business in 2026.

我們並非一定假設存在強勁的潛在成長。新冠疫情後，我們有一些客戶從這個市場VMS平台撤出了。這個過程持續了相當長的時間，我們現在正處於它的尾聲。此外，我們也加入了今年取得的一些勝利。因此，這兩件事結合起來將有助於我們在 2026 年恢復 VMS 業務的成長。

Okay. And I guess maybe just talk a little bit about the competitive dynamic, I guess, in the past, you noted that there's been some players who were kind of aggressive. How do you feel broadly about the competitive backdrop right now?

好的。我想或許可以稍微談談競爭動態，我想，過去您曾經提到過一些比較激進的選手。您如何看待當前的競爭格局？

The markets remain competitive, and we're seeing that both in terms of what we see for clients and in our overall pipeline as well as just competition to fill open orders, but we're not seeing competitors be irrational, and so if orders aren't priced at market, you're seeing them stay open.

市場競爭仍然激烈，無論是客戶的需求，還是整體的訂單流程，以及完成未完成訂單的競爭，都反映了這一點。但我們並沒有看到競爭對手出現不理智的行為，因此，如果訂單沒有以市場價格定價，訂單就會一直處於未完成狀態。

So while we're seeing a competitive environment, we also see rationality in that environment. And we feel like the market is really favoring total talent solutions platforms. And so that is a message that's resounding in the marketplace of looking and saying, I'm not coming in just to fill on one type of solution, but I'm coming in and I'm helping you build a sustainable workforce solution. And so we feel like our platform is very well positioned as the market goes into that next phase.

所以，雖然我們看到的是一個競爭激烈的環境，但我們也看到了這個環境的理性。我們感覺市場確實更青睞全方位人才解決方案平台。因此，市場上正在迴響著這樣一個訊息：我不是來填補某種解決方案的空白，而是來幫助你建立可持續的勞動力解決方案。因此，我們感覺隨著市場進入下一階段，我們的平台已經做好了非常充分的準備。

Tobey Sommer, Truist.

Tobey Sommer，Truist。

I want to ask something just kind of out in the future here. If you look at the federal healthcare funding cuts, such as Medicaid, and there are more to a decent list of them. Do you see customers having higher or lower demand for contingent labor because these changes kind of get feathered in over time, independent of the shutdown outcome?

我想問一個關於未來的問題。如果你看看聯邦醫療保健資金削減的情況，例如醫療補助計劃（Medicaid），你會發現還有更多類似的削減項目。您認為客戶對臨時工的需求會增加還是減少，因為這些變化會隨著時間的推移逐漸顯現，而與停工結果無關？

Yeah, you're going to see some variance among systems about both where they are overall financially and kind of where they are in workforce in general, but the two themes that I'd say are predominant across all of our clients is they are focused on revenue growth, and they're simultaneously very focused on cost containment.

是的，你會發現各個系統在整體財務狀況和員工隊伍方面都存在一些差異，但我認為我們所有客戶都普遍存在的兩個主題是：他們都專注於收入成長，同時也非常注重成本控制。

So the more prevalent sentiment that we hear is pretty consistent with what you've heard from some of the public company health systems, who have reported over the past couple of weeks, which is they're still expecting to have low-single-digit increases in patient utilization.

因此，我們聽到的更普遍的觀點與過去幾週一些上市醫療系統公司所報告的觀點相當一致，即他們仍然預計患者使用率將出現個位數低增長。

They're focused on how do we ensure that we're able to meet those demands, but also do it from a workforce standpoint in an affordable way, knowing that labor has been increasing higher than reimbursement rates. So there is a lot of focus on sustainability of solutions, which gets a little bit back to my point around total talent solutions platform.

他們關注的是如何確保我們能夠滿足這些需求，同時也要從勞動力角度出發，以可負擔的方式實現這些需求，因為他們知道勞動成本的成長速度已經超過了薪資報銷速度。因此，我們非常關註解決方案的可持續性，這多少也回到了我之前提到的全面人才解決方案平台的觀點。

And the other piece, Tobey, that's really more recent, we actually heard this at a healthcare conference this week is there's growing recognition about the affordability of contingent labor relative to permanent labor, and particularly by finance executives. So if you look at where we are on a premium of contingent labor to fully loaded permanent costs, you're under 10%.

托比，還有一點，這其實是最近才有的，我們本週在一個醫療保健會議上聽到了，那就是人們越來越認識到臨時工相對於正式工的成本優勢，尤其是財務主管們。因此，如果我們看一下臨時工成本與完全固定成本之間的溢價，就會發現不到 10%。

And so when you look at this past quarter, permanent hiring in healthcare was down the most we've seen in several years. You've also seen this increase in demand since the second quarter for contingent, and a growing recognition about the affordability of contingent and the role it can play in creating a flexible workforce.

因此，回顧上個季度，醫療保健行業的永久性招聘人數出現了近幾年來的最大降幅。自第二季以來，人們對臨時工的需求也有所增加，並且越來越認識到臨時工的成本優勢及其在打造靈活勞動力方面所能發揮的作用。

Well, having finance professionals be advocates would be a reversal and probably just what the doctor ordered, so to speak. Within Nurse and Allied, could you talk about from a bill rate, pay rate and spread perspective, do you think bill rates can rise enough so that you can pass on at least the elements that seem to be empirically with a decent amount of inflation, I'm thinking of per diems and housing specifically.

嗯，讓金融專業人士擔任倡導者將是一種逆轉，而且可能正是我們所需要的。在護理師及相關領域，您能否從計費率、支付率和差額的角度談談，您認為計費率能否上漲到足以將至少那些在經驗上似乎與相當程度的通貨膨脹相關的要素（我具體指的是每日津貼和住房補貼）轉嫁出去？

I think, we have been talking about stabilization of bill rates for some time period. And as I mentioned, for Nurse and Allied, we're going to see in the fourth quarter, a very slight increase in bill rates for the first time in three years. We need to see that more consistently, Tobey.

我認為，我們已經討論穩定帳單費率一段時間了。正如我之前提到的，對於護理人員和相關人員來說，我們將在第四季度看到帳單費率出現非常小幅的成長，這將是三年來的首次成長。托比，我們需要看到你更穩定地做到這一點。

So you just look at it from an underlying labor cost standpoint, you really do need to, as an industry, get to increasing bill rates. We're seeing clients who've had open orders out there for some time period that aren't priced to market. We saw that even today, a client changed some bill rates. So we are starting to see that gradually happen. You just need to see it more consistently as we get into 2026.

所以，從根本的勞動成本角度來看，作為一個產業，你確實需要提高收費標準。我們發現有些客戶已經下了一段時間的未完成訂單，但這些訂單的價格並未反映在市場價格上。我們發現，即使在今天，也有客戶更改了一些帳單費率。所以我們開始看到這種情況逐漸發生。隨著我們進入2026年，你只需要更持續地關注它。

Yeah. So I'd just add, I think, for the more near term, our -- the rate increases that we think are needed are really to be more attractive when you look at what the compensation packages need to be just to entice a nurse to take an assignment. So we're not necessarily focused on using that as a way to expand margins near term. That's really about how do we drive more volume.

是的。所以我想補充一點，我認為，就近期而言，我們認為必要的加薪幅度，實際上應該更具吸引力，因為要吸引護理人員接受工作安排，就需要提供相應的薪酬方案。因此，我們並不一定會在短期內將其作為擴大利潤率的手段。這其實就是我們要如何提高銷量的問題。

When we have clients that have open orders sitting there for a period of time, they're recognizing that they probably -- they pressure tested rates long enough to know that they're not going to get filled. And if they have that need, particularly as they're maybe not doing as much permanent hiring, they're looking at that cost equation. So we're -- I think, we're more excited about these potential rate increases being utilized to fill more orders. That will allow us to drive more volume. We'll get operating leverage on that. We've got -- this business can support a larger amount of volume that we have today, and we'll gain a lot of operating leverage on that. So that's kind of goal number one for us.

當客戶有未完成的訂單長時間處於擱置狀態時，他們意識到他們可能已經對價格進行了足夠長時間的壓力測試，知道這些訂單不會被成交。如果他們有這方面的需求，尤其是在他們可能沒有進行太多永久性招聘的情況下，他們會考慮成本問題。所以，我認為，我們更興奮的是，這些潛在的利率上漲能夠被用來完成更多的訂單。這將使我們能夠提高銷量。我們將從中獲得經營槓桿效應。我們有—這項業務可以支援比我們目前更大的業務量，我們將從中獲得大量的營運槓桿。所以，這算是我們的首要目標。

The other thing that will typically follow that, as Karen mentioned earlier, is if there is that greater need and urgency to get their orders filled, we'll also continue to educate on utilizing the travelers that have an assignment more.

正如凱倫之前提到的，接下來通常的情況是，如果客戶更需要、更迫切地需要完成訂單，我們也會繼續教育客戶如何更多地利用有任務在身的旅行者。

And so as you see the average hours increase, that's where you start to see some of that pull-through that you're talking about because some of those costs like per diems are more fixed in nature, but -- and that will allow kind of a win for both sides. The client already has people on the ground that can do more work for them, and that has some margin benefit for us as well.

因此，隨著平均工時的增加，你會開始看到你所說的這種拉動效應，因為像每日津貼這樣的一些成本本質上是固定的，但這將使雙方都有利。客戶已經在當地有人員可以為他們做更多的工作，這對我們來說也帶來了一些利潤優勢。

And Tobey, what I would say is if you think about this from a market standpoint, we see -- we don't have a problem with supply if you have an order that is priced right. And so that is going to be the factor that we will continue to be monitoring around clients, not only the demand increasing, but are you seeing a recognition of places, where if you need to get the order filled, you increase bill rates.

托比，我想說的是，如果你從市場角度考慮這個問題，我們會發現——只要訂單價格合適，我們就不會面臨供應問題。因此，這將是我們繼續關注客戶的一個因素，不僅要關注需求的成長，還要關注客戶是否意識到，如果需要完成訂單，就應該提高收費標準。

I'm going to sneak in one last one, if I could. Your only public competitor has got due to potentially be acquired here in the next month. Is that a good thing or a bad thing for AMN and the industry if that goes through or does not?

如果可以的話，我想偷偷加最後一個進去。你唯一的公開競爭對手可能在下個月被收購。如果這項提議獲得通過或未能通過，對AMN和整個產業來說是好事還是壞事？

It doesn't change our strategy or what we're going to do. So we do think in the intermediate and long term, this industry needs to consolidate. So I think, that is a direction that we think will happen. For this particular deal, it doesn't change what we would do in 2026 or our strategy.

這不會改變我們的策略或我們要做的事情。因此，我們認為從中長期來看，這個產業需要整合。所以我認為，這就是我們認為會發生的發展方向。就這筆交易而言，它不會改變我們在 2026 年的行動或策略。

A.J. Rice, UBS.

A.J. Rice，瑞銀集團。

Can you just maybe give us some update on what you're seeing on the clinician side, the supply of clinicians re-upping for additional assignments, new people applying, et cetera? Can you give us any flavor for how you're seeing that developed and expectations around rate increases that you need to get to get people to -- incremental people to sign up for travel assignments?

您能否向我們介紹一下您在臨床醫生方面觀察到的情況，例如臨床醫生續約接受額外任務的情況、新申請人數等等？您能否簡要介紹您目前對這一發展趨勢的看法，以及為了吸引更多人報名參加旅行任務，您需要對費率上漲做出哪些預期？

Yeah. Overall, we are still seeing a healthy supply now in certain locations or certain specialties, you may be more constrained. I'd say overall in Locums, you see more supply challenges than you do in Nurse and Allied more broadly.

是的。總體而言，目前某些地區或某些專科的供應仍然充足，但您可能面臨供應緊張的情況。我認為總體而言，在臨時醫護人員領域，人員供應方面面臨的挑戰比在更廣泛的護理人員和輔助醫療領域要大得多。

What we are seeing is if an order is priced right, then we can fill that order. And so that is the dynamic that we've been spending a lot of time with clients on is, A.J., how do we get them to a point where we can actually fill that order.

我們發現，如果訂單定價合適，我們就可以完成訂單。因此，我們花了很多時間與客戶探討的問題是，A.J.，我們如何讓他們達到我們能夠真正完成訂單的程度。

Yeah. I mean, we're (inaudible) the investments we're making in our cash flow, we talked about in previous calls, the ability to engage with clinicians more directly, get opportunities in front of them with more speed and more frequent touch points. We think that's what we're going to continue to make more differentiation so that we can attract more supply to AMN. And then for those orders that have rates, we'll get them filled, but we have a lot of -- we put a lot of work around how do we improve that clinician experience so that we are thought of as the employer of choice. At this time, we've had some really good success in the investments we've made there.

是的。我的意思是，我們正在（聽不清楚）投資我們的現金流，我們在之前的電話會議中談到過，能夠更直接地與臨床醫生互動，更快地將機會呈現給他們，並增加接觸點。我們認為，我們將繼續努力實現差異化，以便吸引更多供應商加入AMN。然後對於那些有費率的訂單，我們會完成它們，但是我們投入了大量精力來改善臨床醫生的體驗，以便我們被視為首選雇主。目前，我們在那裡的投資已經取得了非常好的成功。

And A.J., as an example. We have something called PreCheck, where we can outline the type of role that's going to be interesting to you that we can automatically fill. And we can get a sense from different clinicians about what type of pay package they would need to be able to take jobs.

以A.J.為例。我們有一個叫做「預檢」的功能，我們可以幫您列出您感興趣的職位類型，並自動為您安排合適的人選。我們可以向不同的臨床醫生了解他們需要什麼樣的薪資待遇才能接受這份工作。

So we're getting even better at predictive analytics to be able to help our clients understand where supply is, what their expectations are -- and that, combined with a lot of data that we have, and we've put on our Workwise platform around going market rates, we think that's going to become increasingly helpful to them in 2026 to be able to get the type of contingent staff that they need.

因此，我們在預測分析方面做得越來越好，以便能夠幫助我們的客戶了解供應情況、他們的期望——結合我們擁有的大量數據，以及我們圍繞市場價格在 Workwise 平台上發布的數據，我們認為這將在 2026 年對他們越來越有幫助，使他們能夠獲得所需的臨時員工。

Interesting. When you think about the Allied business or maybe even Locums, I know, there's different specialties that come and go in demand. Are you seeing any changes in the demand, underlying demand for certain types of clinicians in either of those categories, or easing of demand for people in any of those categories?

有趣的。當你想到輔助醫療產業，或甚至是臨時醫生產業時，我知道，不同的專業領域的需求會隨著時間而改變。您是否觀察到上述任何類別中某些類型臨床醫生的需求變化，或者對這些類別中任何人群的需求是否有所緩解？

But I would -- so for Locums, if you look year-over-year, 8 of our 10 specialties grew. So there was broad-based demand of Locum across the specialties. If you looked at it more recently, the specialty demand really was driven at a higher level by surgery, hospitalist, dentistry, and anesthesia.

但我會——所以對於臨時醫生來說，如果你看看每年的情況，我們 10 個專業中有 8 個專業有所增長。因此，各專科領域對臨時醫師的需求都很廣泛。如果你觀察最近的情況，你會發現專科醫生的需求實際上是由外科、住院醫師、牙科和麻醉科等更高層次的專科醫生推動的。

So Locums, we're seeing broad-based demand. I'd say the four that I just mentioned, we're seeing strong demand, particularly over the past quarter.

所以，我們看到臨時醫護人員的需求非常廣泛。我認為我剛才提到的這四種產品，尤其是上個季度，需求都很強勁。

From an Allied standpoint, therapy and imaging were the top. And I would also say, because in our Allied business, we have a schools business that grew very healthy this year, and we would expect that to continue into 2026.

從聯合醫療的角度來看，治療和影像檢查是最重要的。我還要補充一點，因為在我們的聯合業務中，我們的學校業務今年發展非常健康，我們預計這種情況會持續到 2026 年。

And maybe just a final question on new business opportunities. Are you seeing more opportunities? There's turnover in MSPs? Are you seeing more opportunities in just traditional non-MSP clients? Any way to characterize where the new business opportunities are concentrated?

或許還可以問最後一個關於新商機的問題。你覺得機會更多了嗎？MSP（託管服務提供者）人員流動率高嗎？您是否發現只有傳統的非MSP客戶才有更多機會？有什麼方法可以確定新的商業機會集中在哪些領域？

Yeah. So a couple of things. One, if you look at our pipeline, our pipeline actually grew very nicely quarter-over-quarter. Underneath it, between MSP and VMS, there is a bias towards MSP in the pipeline. We had been trending post-COVID where the pipeline had a bias towards VMS. Now, both grew quarter over quarter, but we do see a bias in MSP.

是的。有兩件事。第一，如果你看一下我們的銷售管道，你會發現我們的銷售管道實際上每季都實現了非常好的成長。在 MSP 和 VMS 之間，本質上存在著對 MSP 的偏好。新冠疫情後，我們的發展趨勢是管線建設偏向VMS（可變材料管理系統）。現在，兩者的季度環比均有所增長，但我們確實看到 MSP 存在一定的偏差。

The other two themes that we see from a sales standpoint is we have momentum in extensions. And so that has been a focus for us to do more with our current clients. And so we are seeing momentum in expansions with clients. A focus has been on how we put Locums in there, language services.

從銷售角度來看，另外兩個主題是：我們在擴展程序方面勢頭強勁。因此，我們一直致力於為現有客戶提供更多服務。因此，我們看到與客戶的業務拓展勢頭強勁。我們一直關注的是如何將臨時工和語言服務納入其中。

And then I'd say the last theme that we're seeing from a sales standpoint is, if we lose in a pipeline, we are increasingly losing to the incumbent and to inertia. And so again, we think we have a differentiated platform around total talent solutions as we go into 2026 that we'll be able to combat some of that.

最後，從銷售的角度來看，我們看到的最後一個主題是，如果我們在銷售管道中失敗，我們越來越傾向於輸給現有企業和慣性思維。因此，我們認為，到 2026 年，我們將擁有一個圍繞全面人才解決方案的差異化平台，這將使我們能夠應對其中的一些挑戰。

Mark Marcon, Robert W. Baird.

馬克馬爾孔，羅伯特W貝爾德。

Good afternoon. Thanks for taking my questions. Cary, Brian, you mentioned that if orders are priced right, we can get the clinicians. When you talked about the orders trending up, are you talking about only the orders that you would consider to be priced right? Or is that inclusive of orders that potentially aren't really fillable?

午安.謝謝您回答我的問題。Cary，Brian，你們提到過，如果訂單價格合適，我們就能找到臨床醫生。您之前提到訂單量呈上升趨勢，您指的是那些您認為定價合理的訂單嗎？或者，這是否也包括那些可能無法真正完成的訂單？

It's inclusive of all orders. But what I would say underneath that is if we look at more kind of aged open orders, there's been a very slight uptick, but not meaningfully.

包含所有訂單。但我想說的是，如果我們看一下更久遠的未成交訂單，會發現訂單量略有上升，但並不顯著。

Yeah. And as we've talked about the trends in the last few months, Mark, the winter order, more of those are typically priced at the rate we fill. And that's why you saw that the third quarter, although we saw a sequential decline as we expected, we beat the guidance we gave. And it's -- as we started getting more of those orders in, the team did a great job of filling them quickly.

是的。正如我們過去幾個月討論的趨勢一樣，馬克，冬季訂單通常會根據我們的供貨量定價。所以你會看到，儘管第三季度我們如預期般出現了環比下滑，但我們仍然超過了我們給出的預期。而且——隨著訂單越來越多，團隊在快速完成訂單方面做得非常出色。

And some of that -- and even in the extension rates when they came back, we're able to keep more on assignment. So that impacts the third quarter, but even more so, the sequential increase that we're going to see in the fourth quarter is driven by that.

而且其中一些——甚至在他們回歸後的續約率方面，我們能夠留住更多人繼續執行任務。因此，這會影響第三季度，但更重要的是，我們將在第四季度看到的環比成長正是由這種情況所推動的。

And then for those other ones, some of these orders that have lower rates, it's not that none of them get filled. It's just that a much lower percentage. So as they're posting those, the team will work, but the fill rates and the time to fill is lower overall. And so Cary mentioned we had a client today that on some of those orders have been sitting there, they increased the rate because they're recognizing they need to get them filled.

至於其他一些訂單，也就是那些費率較低的訂單，並不是說這些訂單一個都沒完成。只是這個比例低很多。所以，當他們發布這些職位時，團隊會繼續工作，但總體而言，職位填補率和填補時間都會降低。凱瑞提到，我們今天有一位客戶，由於一些訂單積壓已久，他們提高了價格，因為他們意識到需要盡快完成這些訂單。

And so that's taking an existing order and getting a better rate, where the team will be able to act on it immediately and get the majority of those filled as well. So it's -- when we look at the order trends, we've always kind of included everything, but as that mix changes towards more of them having rates that are priced appropriately, we know we can convert more of them to placements.

因此，這相當於接受現有訂單並爭取更優惠的價格，這樣團隊就可以立即採取行動，並完成大部分訂單的交付。所以，當我們觀察訂單趨勢時，我們總是把所有東西都包括在內，但隨著訂單組合向價格合理的訂單方向轉變，我們知道我們可以將更多的訂單轉化為實際投放。

Great. That's encouraging. And then can you talk a little bit more about what you're seeing in terms of demand trends out of rural hospitals and particularly the ones that have been impacted by Medicaid cuts. We're starting to hear a little bit about how some of those facilities might be trending more towards travel nursing to an even greater extent than they already did, partially because if they're uncertain about their financial outlook, they'd rather turn to the travelers. Is that true? Does that resonate? What are you seeing from that perspective?

偉大的。這令人鼓舞。那麼，您能否再詳細談談您觀察到的鄉村醫院的需求趨勢，特別是那些受到醫療補助削減影響的醫院的需求趨勢？我們開始聽到一些消息，說有些醫療機構可能會比以前更傾向於聘用旅行護士，部分原因是如果他們對自己的財務前景不確定，他們寧願求助於旅行護士。是真的嗎？這是否引起了你的共鳴？從這個角度你看到了什麼？

We haven't seen any discernible trends or differences in rural hospitals. What I will say that has existed for some time is international nurses are typically a very good solution, broadly speaking, for a number of health systems, but in particular, for rural systems. It's attractive for the clinician coming over and bringing their family over. It's a very cost-effective way for these systems to be able to put in a longer-term clinician in there. So the international dimension is typically, marginally more important to rural hospitals than you would see elsewhere, but we haven't seen any real noticeable difference in rural hospitals versus others.

我們沒有發現農村醫院有任何明顯的趨勢或差異。我想說的是，國際護理師通常是一個非常好的解決方案，總的來說，對於許多醫療系統而言，尤其是對於農村醫療系統而言，這一點已經存在了一段時間。這對前來就診的臨床醫生及其家人來說很有吸引力。對於這些系統來說，這是一種非常經濟高效的方式，可以安排一名長期臨床醫生在系統中工作。因此，國際因素對農村醫院來說通常比在其他地方更重要一些，但我們還沒有看到農村醫院與其他醫院之間有任何真正的明顯差異。

But I think that decision-making that is what we're seeing as you've got more CFOs and finance folks involved in some of the buying decisions is that there is uncertainty and so wanting that flexibility as they pull back on some of their permanent hiring and recognizing that the incremental cost for bringing in contract labor is about as low as it's ever been. And so I think, that not only in the rural areas, maybe they don't have access otherwise or they want that flexibility, that same type of dynamic we're seeing with certain clients in different settings as well.

但我認為，隨著越來越多的財務長和財務人員參與到一些採購決策中，我們看到的決策過程是，存在不確定性，因此他們希望保持靈活性，減少一些永久性招聘，並意識到引入合約工的增量成本已經達到了前所未有的低水平。因此我認為，不僅在農村地區，他們可能沒有其他途徑獲得這種服務，或者他們想要這種靈活性，我們在不同的環境中也看到某些客戶存在著同樣的這種動態。

Great. And then, can you -- just in terms of normal seasonality, if we strip out the labor disruption revenue from the fourth quarter, how should we think about the normal seasonality in terms of Q4 and Q1? Typically, we see the winter orders staying through Q1, but wondering if there's anything that would change that dynamic this year?

偉大的。那麼，就正常的季節性而言，如果我們從第四季度剔除勞動力中斷收入，我們應該如何看待第四季和第一季的正常季節性？通常情況下，冬季訂單會持續到第一季度，但我想知道今年是否有任何因素會改變這種情況？

No, I don't think anything that would change that dynamic. Those assignments, some of them do carry into the first quarter. So it wouldn't be unreasonable to expect that we'd see nominal growth from Q4 to Q1 in nursing. We still have work to do to fill in that quarter. But with the demand trends, especially as we saw more of a decline during the third quarter, and then as that's picked up through the fourth quarter, that should carry through into the first quarter as well.

不，我不認為有什麼能改變這種局面。這些作業中有些會延續到第一季。因此，我們有理由預期，從第四季度到第一季度，護理業會出現名義上的成長。我們還有一些工作要做才能完成那個季度的任務。但就需求趨勢而言，尤其是在第三季出現更大幅度的下降，然後在第四季有所回升，這種情況應該也會延續到第一季。

We'll also, as Cary mentioned, that we've had a real strong year with schools business. So that should be -- that will carry through into that first quarter for Allied as well. And then seasonally, we're lower in our Locums business and even search entered some degree. And so as that bounces back in the first quarter as well, those are -- that will be a sequential growth is what we've seen historically, and we would expect to see this year as well.

正如凱瑞所提到的那樣，我們今年的學校業務也取得了非常強勁的成績。所以，這種情況應該也會延續到盟軍的第一季。然後，季節性因素會導致我們的臨時工業務減少，甚至搜尋業務也會受到一定程度的影響。因此，隨著第一季經濟的反彈，這些——正如我們從歷史上看到的那樣，這將是一個連續增長，我們也預計今年也會看到這種情況。

Constantine Davides, Citizens.

康斯坦丁·達維德斯，公民。

Cary, in your prepared remarks, you highlighted the Locum days book strength for your MSP clients. Can you expand upon exactly what you're doing to better leverage your MSP relationships for Locum starting with what transpired in the third quarter? And then I guess as a follow-up to that, is there a structural reason why the percentage of revenue from MSPs for Locums has kind of stayed pretty steady in the high teens level versus what you see typically in Nurse and Allied?

Cary，你在事先準備好的演講稿中重點強調了你的 MSP 客戶的臨時醫生預約量。能否詳細說明一下，從第三季發生的事情開始，您正在採取哪些措施來更好地利用您與MSP的關係來開展臨時醫療服務？那麼，作為後續問題，是否有結構性原因導致臨時工的 MSP 收入百分比一直穩定在 10% 以上，而護理師和輔助醫療人員的收入百分比通常則要高得多？

Yeah. So a couple of things about what we're doing in Locum. One is, we have made very intentional moves over the past 18 months to structurally be able to support our Locums MSPs. That includes in our ShiftWise Flex platform, having capabilities that we rolled out at the end of last year to extend what we had done for Nurse and Allied into Locums. We also added our Locums clinicians onto Passport earlier this year. So we have more AMN platform integration of our Locums business into core technology that we have built to support our Nurse and Allied business.

是的。關於我們在 Locum 所做的工作，有幾點需要說明。一方面，在過去的 18 個月裡，我們採取了非常有針對性的措施，從結構上支持我們的臨時醫療服務提供者 (MSP)。這包括我們的 ShiftWise Flex 平台，該平台具備我們在去年年底推出的功能，旨在將我們為護理人員和輔助人員所做的工作擴展到臨時工領域。今年早些時候，我們也把我們的臨時執業醫生加入了Passport系統中。因此，我們將 AMN 平台與我們為支援護理師和輔助醫療業務而構建的核心技術進行了更多整合，使我們的臨時工業務更加融入其中。

Second is, we have been proactively selling to our current clients, Locum's capabilities. In a number of cases, one of the trends that you're seeing broadly is a desire, particularly for regional national systems to centralize pretty decentralized Locum spend. Oftentimes, that will happen with the same program leaders that lead Nurse and Allied. So we've been doing those two things.

其次，我們一直在積極向現有客戶推銷臨時工的能力。在許多情況下，你普遍看到的一個趨勢是，特別是對於區域性國家醫療系統而言，人們希望將相當分散的臨時醫療支出集中起來。這種情況經常發生在領導護士和輔助醫療人員的同一批計畫負責人身上。所以我們一直在做這兩件事。

And then the third very important piece is that if you look at year over year, our fill rates in Locums, you have seen one of the biggest increases of our fill rates in our MSPs. So we're not only prioritizing continuing to expand our Locums MSP clients and the platform that we have underneath it, but we have a world-class Locums MSP team that has increased our fill rate on those platforms year over year.

第三點非常重要，如果你看我們每年的臨時工招募率，你會發現我們MSP的招募率增幅最大。因此，我們不僅優先考慮繼續擴大我們的 Locums MSP 客戶和我們基於此平台的業務，而且我們還擁有一支世界一流的 Locums MSP 團隊，該團隊逐年提高了我們在這些平台上的招聘完成率。

Thanks for the color there. And then just a few moving pieces with labor disruption in the third quarter and fourth quarter, but overall, a pretty strong year for that part of your business. And as you look ahead to 2026, and I know forecasting this activity is probably an imprecise science, but at a high level, how is 2026 shaping up from a collective bargaining standpoint across the client base?

謝謝你帶來的色彩。第三季和第四季由於勞動力市場波動，出現了一些小問題，但總體而言，貴公司這部分業務今年表現相當強勁。展望 2026 年，我知道預測這一年的發展趨勢可能並不精確，但從整體來看，從客戶群的集體談判角度來看，2026 年的發展前景如何？

Yeah. So a couple of things. If you just look at statistically across what has happened in collective bargaining agreements, broadly, you are seeing more strikes than you had seen historically. So that is one trend that we follow. We have a healthy pipeline of strikes that our clients have asked us to engage in over the next 12 months.

是的。有兩件事。如果從統計數據來看，從整體來看，集體談判協議中發生的罷工比歷史上任何時候都要多。這是我們正在關注的趨勢。未來 12 個月內，我們的客戶要求我們參與一系列罷工行動，目前我們已儲備了大量此類行動。

Strike -- our strike solution set is a very important one for clients that have unionized populations, and we only support strikes of our clients, but we are seeing continued strong activity there. And so we would expect our strike business to continue to be active over the next 12 months.

罷工－我們的罷工解決方案對於擁有工會成員的客戶來說非常重要，我們只支持客戶的罷工，但我們看到那裡的罷工活動持續活躍。因此，我們預計未來 12 個月內，我們的罷工業務將繼續保持活躍。

Great. And then if I could just sneak one last one in. The language services part of the business, can you just expand a little bit on the sort of the demand there, the level of price compression you're seeing? And I guess just your longer-term thoughts on the business, just given how quickly technology in that area seems to be evolving.

偉大的。如果我能再偷偷加一個就好了。關於語言服務業務，您能否詳細介紹一下這方面的需求狀況，以及目前看到的價格壓縮程度？我想問您對這項業務的長期規劃，畢竟該領域的技術發展日新月異。

Let me start first on the long term. This business is really important to us, not just in terms of what it can do to support our clients and to support them in providing really strong patient care. It's incredibly important around access. So this is a business that we like. We have seen growth moderate throughout the year. That has coincided as others in the industry have seen as well with tougher immigration policies.

讓我先從長遠角度談起。這項業務對我們來說非常重要，不僅因為它能夠為我們的客戶提供支持，幫助他們提供真正強大的患者護理。這對於獲取醫療資源而言至關重要。所以，我們很喜歡這家公司。今年以來，我們看到成長速度有所放緩。這與業內其他人士所經歷的情況不謀而合，因為移民政策正在收緊。

And so a bit of what you've seen, Constantine, in the second quarter, and you saw it again this quarter is if you've seen some modest growth in minutes, you've seen that offset by pricing pressure. And so we saw that this quarter, we would expect to see that again next quarter. We do expect there's some changes that we are going to make to our operating model in terms of -- that will improve our cost to serve that we would expect you to start seeing the benefit of that in 2026, but we do think that growth will be more modest than you may have seen 18 months ago, but we still think that this is a growth business and that we are well-positioned to be able to win in it.

所以，康斯坦丁，你在第二季度看到的一些情況，以及你在本季度再次看到的，是即使你看到分鐘數出現了一些小幅增長，你也看到這被價格壓力抵消了。因此，我們看到本季出現了這種情況，預計下個季度也會如此。我們預計我們的營運模式將會發生一些變化，這將降低我們的服務成本，我們預計您將在 2026 年開始看到這些變化帶來的好處，但我們認為成長速度會比 18 個月前更為溫和，但我們仍然認為這是一個成長型業務，並且我們已做好充分準備，能夠在這個行業中取得成功。

Jack Slevin, Jefferies.

傑克‧斯萊文，傑富瑞集團。

Hey, thanks for taking my questions. I'm going to apologize in advance, but I want to go back over some of the strike margin stuff. So if you'll just bear with me, what I'm getting is the 10-basis-point gross margin impact that you called out in the $5 million of G&A. But Brian, I thought, I also heard a mid-6s comment on EBITDA margin ex strike. So on my math, it's a little below 6%, if you plug those other two pieces. I just want to make sure I heard that commentary right.

嘿，謝謝你回答我的問題。我先道個歉，但我想再回顧一下關於擊球差的一些內容。所以，請容我解釋一下，我得到的結果是，您在 500 萬美元的 G&A 費用中提到的 10 個基點的毛利率影響。但是布萊恩，我想，我還聽到有人評論 EBITDA 利潤率（不包括罷工）在 6 點左右。所以以我的計算，如果把另外兩部分代入，結果是略低於 6%。我只是想確認一下我沒聽錯。

And then the second piece of the question on that front. I think I heard some commentary that maybe made it sound like the labor disruption trends ultimately benefited 3Q based on some of the stuff that's happening now. Did I hear that correctly, or just trying to understand on the strike front sort of how to take the balance, a few comments on that?

接下來是關於這方面的第二個問題。我好像聽到一些評論，根據目前發生的一些事情來看，勞動力市場動盪的趨勢最終可能對第三季有利。我聽得對嗎？或者我只是想了解罷工方面的情況，如何權衡利弊？對此您有幾點看法？

Yeah, I'll take those in reverse order. So yeah, you did hear right. So hear that the -- just by some of the -- the way the services were rolled out for the event, we got a margin benefit in the third quarter. So call it, somewhere to the range of 100 basis points gross margin on the consolidated and for Q3.

好的，我會以相反的順序來。沒錯，你沒聽錯。因此，據了解，由於部分服務是為活動推出的，我們在第三季獲得了利潤率收益。所以，可以這樣估計，第三季合併毛利率在 100 個基點左右。

And then for Q4, we kind of called out because we have this large amount of revenue in Nurse and Allied, which has a large -- a lower margin profile that, that dragged the consolidated margin down in our guidance.

然後，對於第四季度，我們特別指出，因為護士和相關業務的收入很大，但利潤率較低，這拉低了我們預期的合併利潤率。

And so if you were to add that back and even maybe just take like a small amount of like what we said kind of normalized, you'd end up somewhere closer to 27%. So 29% becomes 28% and then the guide we give with that adjustment is more like 27%. So there's about 100 basis points change in the margin from Q3 to Q4 on that adjusted basis.

所以，如果你把那部分加回去，甚至只是取一小部分我們剛才提到的標準化值，最終結果會接近 27%。所以 29% 變成了 28%，然後我們根據這項調整給出的指導值更像是 27%。因此，以調整後的數據計算，第三季到第四季的利潤率變化約為 100 個基點。

Does that help?

這樣有幫助嗎？

Yeah, I think that's helpful. Yes. No, no, I appreciate it.

是的，我覺得這很有幫助。是的。不，不，我很感激。

You did hear correct. I was trying to say, if you were to take our guidance for revenue and remove all or most of the -- that strike revenue number we gave that you should be able to take the inputs we gave and you'd end up somewhere in the kind of mid-6s range for adjusted EBITDA margin in the quarter.

你沒聽錯。我當時想說的是，如果你按照我們對收入的預期，去掉我們給出的那個罷工收入數字（也就是我們給出的那個數字），那麼你應該能夠根據我們提供的輸入數據，得出本季度調整後的 EBITDA 利潤率在 6% 左右的區間。

Okay. Got it. That's really helpful. And then second one on this front. I mean, I think, what it sounds like to me, I'm hearing a lot of things that might trend positively when you talk about VMS, return on international, the schools points you brought up and then just overall having a bill rate environment that has been pretty stable to now possibly trending up into '26.

好的。知道了。這真的很有幫助。然後是這方面的第二個。我的意思是，我覺得，聽起來，你談到VMS、國際回報、你提到的學校要點，以及目前相當穩定的賬單費率環境，這些都可能朝著積極的方向發展，而且這種趨勢可能會持續到2026年。

If you look at the ex strike margins in 4Q and appreciating there's a little bit of seasonality there. But if you look at the ex strike margins in 4Q, is that a decent way to think about a floor on where margins can go going forward? Or can you just help me piece together sort of how we go from that margin level forward? Thank you.

如果你看一下第四季的除權價差，你會發現其中存在一些季節性因素。但如果你看一下第四季的除權利潤率，這是否是判斷未來利潤率下限的合理方法？或者您能幫我理清一下，我們如何從目前的利潤水準繼續前進？謝謝。

Yeah. The short answer is yes. We look at that as probably a floor again. If you take it somewhere in the -- if you took the guidance we gave and you get at the 100 basis points, you're looking at 26.5% to 27%. And again, if you assume though some normalized amount of labor restructuring activity, you're somewhere in that 27% range. And that, I think, is a reasonable floor. And then you can kind of build from the components that Terry mentioned earlier in terms of the opportunities we see heading into '26, some of which we have clear line of sight to like with the volume increase we expect to see in international starting in Q1 and others that we'll be aggressively working through during the year.

是的。簡而言之，答案是肯定的。我們認為這可能又是一次底部考驗。如果你按照我們給的指導方針來計算，得到 100 個基點，那麼收益率大概在 26.5% 到 27% 之間。再說一遍，如果你假設一定程度的勞動力重組活動是正常的，那麼結果大概在 27% 的範圍內。我認為，這是一個合理的底線。然後，你可以從 Terry 之前提到的各個組成部分入手，來構建我們看到的 2026 年的機遇，其中一些我們已經有了清晰的展望，例如我們預計從第一季度開始國際業務量將會增加；而另一些則是我們將在年內積極推進的。

Jeff Silber, BMO Capital Markets.

Jeff Silber，BMO資本市場。

I know it's late. I'll just ask one. I think, last quarter, you talked about some of the weakness in academic medical centers considering what was going on with funding, et cetera. Can we get an update on that? Has that changed at all?

我知道現在很晚了。我就問一個吧。我認為，上個季度，您談到了學術醫療中心的一些弱點，考慮到資金等方面的情況。可否提供一下最新進展？情況有改變嗎？

Yeah. Trend remains the same. So if we look at where academic medical centers are year-over-year, they are still lagging our non-academic medical care systems, but we are getting closer to them being stabilized. And I would expect that as we really start, kind of, 2026, that they would be, if not stabilized, very close to stabilized.

是的。趨勢依舊。因此，如果我們看一下學術醫療中心每年的發展狀況，它們仍然落後於我們的非學術醫療體系，但我們正在朝著穩定發展的方向邁進。我預計，到了 2026 年左右，即使不能完全穩定，也應該非常接近穩定。

And can you just remind me what percentage of the business that is?

可以提醒我一下，這部分業務占公司總業務的百分比是多少嗎？

I'm pulling it up from last quarter.

我從上個季度把它調出來了。

20%.

20%。

Yes.

是的。

Thank you. I'm showing no further questions. I'd like to turn it back to Cary Grace for closing remarks.

謝謝。我不再提問。現在請凱瑞·格雷斯作總結發言。

Thank you. As we focus on a strong finish to the year and look forward to 2026, I want to thank our AMN team members who have worked tirelessly to deliver industry-leading total talent solutions to healthcare providers to enable them to provide high-quality and uninterrupted patient care. We are who we are because of the dedication of our AMN team.

謝謝。在我們專注於為今年畫上圓滿句號並展望 2026 年之際，我要感謝 AMN 團隊的成員們，他們孜孜不倦地為醫療保健提供者提供行業領先的全面人才解決方案，使他們能夠提供高質量和不間斷的患者護理。我們之所以能達到今天的成就，全賴於AMN團隊的奉獻。

We appreciate your interest in AMN Healthcare and look forward to talking to you next quarter.

感謝您對AMN Healthcare的關注，期待下季與您洽談。

Thank you, operator.

謝謝接線生。

This concludes today's conference call. Thank you for participating, and you may now disconnect.

今天的電話會議到此結束。感謝您的參與，您現在可以斷開連接了。