Healthcare staffing went through its largest “cyclical reset” in history, AMN Healthcare Services Inc. (NYSE: AMN) reported in its fourth-quarter earnings announcement.

“Our healthcare professionals and corporate team members were resilient in 2023, working through the largest cyclical reset of staffing demand in industry history,” AMN President and CEO Cary Grace said in a press release.

Fourth-quarter revenue at the healthcare staffing firm fell 27.3% year over year to $818.3 million.

The decline was most pronounced in AMN’s nurse and allied solutions segment, where revenue fell 34.8% year over year. The company also saw revenue decline 15.6% in its technology and workforce solutions segment. On the other hand, revenue edged up 0.3% in its physician and leadership solutions operations.

Grace said AMN worked with clients to help them rebuild sustainable workforces during the quarter and worked to accelerate innovation.

“We invested heavily in our growth opportunities with more than $100 million of capex while rigorously managing financial discipline in operations,” she said. “We are consolidating our businesses under our One AMN branding and platform initiative and building a unified, client-centric sales and service organization.”

The company also acquired MSDR in the fourth quarter.

MSDR added $13 million in revenue to the company’s physician and leadership solutions segment during the quarter. AMN also noted locum tenens revenue — included in this segment — rose 7% on an organic basis. However, interim leadership revenue fell 35% year over year and search revenue fell by 20%.

In AMN’s nurse and allied solutions segment, travel nurse revenue fell 40% year over year, while allied revenue was down 16%.

AMN’s technology and workforce solutions segment saw vendor management system revenue fall 45% year over year to $31 million. However, language services revenue rose 18% year over year to $68 million.

SIA forecast healthcare staffing revenue to contract in 2023 after seeing a large expansion amid the Covid-19 pandemic.

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Guidance

AMN forecast first-quarter revenue to be down 26% to 28% year over year.

Its nurse and allied solutions segment revenue is expected to be down between 36% and 38%, while the technology and workforce solutions segment revenue is expected to be down 18% to 20% year over year.

Revenue is expected to increase by between 11% and 14% in its physician and leadership solutions segment.