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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
____________________
FORM 10-Q
____________________
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2022
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                       to                      
Commission File No.: 001-16753

https://cdn.kscope.io/39597c1a4a29c01b6be1d71f79fa548d-amn-20220930_g1.jpg
AMN HEALTHCARE SERVICES, INC.
(Exact Name of Registrant as Specified in Its Charter)
Delaware
06-1500476
(State or Other Jurisdiction of
Incorporation or Organization)
(I.R.S. Employer
Identification No.)
8840 Cypress Waters BoulevardSuite 300
DallasTexas75019
(Address of Principal Executive Offices)(Zip Code)

Registrant’s Telephone Number, Including Area Code: (866871-8519
____________________

Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading SymbolName of each exchange on which registered
Common Stock, $0.01 par valueAMNNew York Stock Exchange
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes  x  No  o
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes  x No  o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer   Non-accelerated filer
Smaller reporting companyEmerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange
Act).  Yes    No  x
As of November 2, 2022, there were 43,335,911 shares of common stock, $0.01 par value, outstanding.

Auditor Name: KPMG LLP        Auditor Location: San Diego, California        Auditor Firm ID: 185



TABLE OF CONTENTS
 
Item Page
PART I - FINANCIAL INFORMATION
1.
2.
3.
4.
PART II - OTHER INFORMATION
1.
1A.
2.
3.
4.
5.
6.



Table of Contents
PART I - FINANCIAL INFORMATION

Item 1. Condensed Consolidated Financial Statements

AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited and in thousands, except par value)
September 30, 2022December 31, 2021
ASSETS
Current assets:
Cash and cash equivalents$155,723 $180,928 
Accounts receivable, net of allowances of $15,194 and $6,838 at September 30, 2022 and December 31, 2021, respectively
724,966 789,131 
Accounts receivable, subcontractor253,954 239,719 
Prepaid expenses17,019 72,460 
Other current assets54,504 66,830 
Total current assets1,206,166 1,349,068 
Restricted cash, cash equivalents and investments64,883 64,482 
Fixed assets, net of accumulated depreciation of $212,702 and $189,954 at September 30, 2022 and December 31, 2021, respectively
140,995 127,114 
Operating lease right-of-use assets18,505 27,771 
Other assets152,970 156,670 
Goodwill935,675 892,341 
Intangible assets, net of accumulated amortization of $339,092 and $278,249 at September 30, 2022 and December 31, 2021, respectively
499,067 514,460 
Total assets$3,018,261 $3,131,906 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses$459,237 $425,257 
Accrued compensation and benefits338,833 354,381 
Current portion of operating lease liabilities8,226 11,383 
Deferred revenue15,060 15,950 
Other current liabilities69,890 162,419 
Total current liabilities891,246 969,390 
Notes payable, net of unamortized fees and premium843,210 842,322 
Deferred income taxes, net42,159 47,814 
Operating lease liabilities10,785 13,364 
Other long-term liabilities98,228 96,989 
Total liabilities1,885,628 1,969,879 
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at September 30, 2022 and December 31, 2021
  
Common stock, $0.01 par value; 200,000 shares authorized; 50,087 issued and 43,327 outstanding at September 30, 2022 and 49,849 issued and 47,263 outstanding at December 31, 2021
501 498 
Additional paid-in capital497,744 486,709 
Treasury stock, at cost; 6,760 and 2,586 shares at September 30, 2022 and December 31, 2021, respectively
(523,722)(121,831)
Retained earnings1,159,199 796,946 
Accumulated other comprehensive loss(1,089)(295)
Total stockholders’ equity1,132,633 1,162,027 
Total liabilities and stockholders’ equity$3,018,261 $3,131,906 

See accompanying notes to unaudited condensed consolidated financial statements.
1

Table of Contents
AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited and in thousands, except per share amounts)
 
 Three Months Ended September 30,Nine Months Ended September 30,
 2022202120222021
Revenue$1,138,586 $877,800 $4,117,731 $2,621,190 
Cost of revenue753,560 571,935 2,776,300 1,745,914 
Gross profit385,026 305,865 1,341,431 875,276 
Operating expenses:
Selling, general and administrative215,419 173,932 717,428 491,773 
Depreciation and amortization (exclusive of depreciation included in cost of revenue)33,239 26,104 96,169 74,098 
Total operating expenses248,658 200,036 813,597 565,871 
Income from operations136,368 105,829 527,834 309,405 
Interest expense, net, and other8,961 5,223 28,630 24,278 
Income before income taxes127,407 100,606 499,204 285,127 
Income tax expense34,962 26,583 136,951 73,956 
Net income$92,445 $74,023 $362,253 $211,171 
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other(219)11 (794)(10)
Other comprehensive income (loss)(219)11 (794)(10)
Comprehensive income$92,226 $74,034 $361,459 $211,161 
Net income per common share:
Basic$2.11 $1.55 $8.04 $4.43 
Diluted$2.10 $1.54 $7.99 $4.40 
Weighted average common shares outstanding:
Basic43,785 47,737 45,056 47,666 
Diluted44,039 48,080 45,332 48,022 
 
See accompanying notes to unaudited condensed consolidated financial statements.

2

Table of Contents
AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(Unaudited and in thousands)
 Common StockAdditional
Paid-in
Capital
Treasury StockRetained EarningsAccumulated Other Comprehensive IncomeTotal
 SharesAmountSharesAmount
Balance, December 31, 202049,614 $496 $468,726 (2,561)$(119,143)$469,558 $40 $819,677 
Equity awards vested, net of shares withheld for taxes132 1 (5,259)— — — — (5,258)
Share-based compensation— — 9,287 — — — — 9,287 
Comprehensive income (loss)— — — — — 70,378 (24)70,354 
Balance, March 31, 202149,746 $497 $472,754 (2,561)$(119,143)$539,936 $16 $894,060 
Equity awards vested, net of shares withheld for taxes78 1 (471)— — — — (470)
Share-based compensation— — 6,019 — — — — 6,019 
Comprehensive income— — — — — 66,770 3 66,773 
Balance, June 30, 202149,824 $498 $478,302 (2,561)$(119,143)$606,706 $19 $966,382 
Equity awards vested, net of shares withheld for taxes12 — (527)— — — — (527)
Share-based compensation— — 2,589 — — — — 2,589 
Comprehensive income— — — — — 74,023 11 74,034 
Balance, September 30, 202149,836 $498 $480,364 (2,561)$(119,143)$680,729 $30 $1,042,478 


 Common StockAdditional
Paid-in
Capital
Treasury StockRetained EarningsAccumulated Other Comprehensive LossTotal
 SharesAmountSharesAmount
Balance, December 31, 202149,849 $498 $486,709 (2,586)$(121,831)$796,946 $(295)$1,162,027 
Repurchase of common stock into treasury— — — (2,298)(228,024)— — (228,024)
Equity awards vested, net of shares withheld for taxes164 2 (9,433)— — — — (9,431)
Share-based compensation— — 11,259 — — — — 11,259 
Comprehensive income (loss)— — — — — 146,008 (907)145,101 
Balance, March 31, 202250,013 $500 $488,535 (4,884)$(349,855)$942,954 $(1,202)$1,080,932 
Repurchase of common stock into treasury— — — (1,876)(173,867)— — (173,867)
Equity awards vested, net of shares withheld for taxes19 — (366)— — — — (366)
Share-based compensation— — 8,513 — — — — 8,513 
Comprehensive income— — — — — 123,800 332 124,132 
Balance, June 30, 202250,032 $500 $496,682 (6,760)$(523,722)$1,066,754 $(870)$1,039,344 
Equity awards vested, net of shares withheld for taxes55 1 (3,836)— — — — (3,835)
Share-based compensation— — 4,898 — — — — 4,898 
Comprehensive income (loss)— — — — — 92,445 (219)92,226 
Balance, September 30, 202250,087 $501 $497,744 (6,760)$(523,722)$1,159,199 $(1,089)$1,132,633 

See accompanying notes to unaudited condensed consolidated financial statements.

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AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited and in thousands)
 
Nine Months Ended September 30,
 
20222021
Cash flows from operating activities:
Net income$362,253 $211,171 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)99,087 75,871 
Non-cash interest expense and other1,427 (4,541)
Write-off of fees on credit facilities and senior notes 158 
Change in fair value of contingent consideration(1,190) 
Increase in allowance for credit losses and sales credits22,199 2,103 
Provision for deferred income taxes(5,364)(4,328)
Share-based compensation24,670 17,895 
Loss on disposal or sale of fixed assets571 386 
Net loss (gain) on investments in available-for-sale securities652 (41)
Net loss (gain) on deferred compensation balances(1,324)96 
Non-cash lease expense4,818 (257)
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable44,532 (196,342)
Accounts receivable, subcontractor(14,235)(67,641)
Income taxes receivable(1,426)5,472 
Prepaid expenses55,495 (5,695)
Other current assets12,399 3,411 
Other assets(608)780 
Accounts payable and accrued expenses31,855 112,183 
Accrued compensation and benefits2,937 96,666 
Other liabilities(99,534)(26,268)
Deferred revenue(809)6,276 
Restricted investments balance 16 
Net cash provided by operating activities538,405 227,371 
Cash flows from investing activities:
Purchase and development of fixed assets(51,229)(38,710)
Purchase of investments(13,152)(32,437)
Proceeds from sale and maturity of investments12,549 40,000 
Purchase of equity investment (500)
Proceeds from sale of equity investment68 78 
Payments to fund deferred compensation plan(21,411)(6,094)
Cash paid for acquisitions, net of cash and restricted cash received(69,801)(41,264)
Cash paid for other intangibles(5,091)(90)
Net cash used in investing activities(148,067)(79,017)
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Nine Months Ended September 30,
 
20222021
Cash flows from financing activities:
Payments on term loans (21,875)
Payments on revolving credit facility (70,000)
Proceeds from revolving credit facility 70,000 
Repurchase of common stock(401,891) 
Earn-out payments to settle contingent consideration liabilities for prior acquisitions (3,100)
Cash paid for shares withheld for taxes(13,632)(6,255)
Net cash used in financing activities(415,523)(31,230)
Effect of exchange rate changes on cash (10)
Net increase (decrease) in cash, cash equivalents and restricted cash(25,185)117,114 
Cash, cash equivalents and restricted cash at beginning of period246,714 83,990 
Cash, cash equivalents and restricted cash at end of period$221,529 $201,104 
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities$10,700 $35,066 
Cash paid for interest (net of $452 and $248 capitalized for the nine months ended September 30, 2022 and 2021, respectively)
$18,950 $19,301 
Cash paid for income taxes$164,757 $72,863 
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash and restricted cash received$2,731 $1,906 
Goodwill43,301 28,135 
Intangible assets40,200 12,440 
Liabilities assumed(8,431)(1,217)
Contingent consideration liabilities(8,000) 
Net cash paid for acquisitions$69,801 $41,264 
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses$5,187 $5,080 

See accompanying notes to unaudited condensed consolidated financial statements.
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AMN HEALTHCARE SERVICES, INC.
 
NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(in thousands, except per share amounts)
 
1. BASIS OF PRESENTATION
The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions have been eliminated in consolidation. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period.
The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States (“U.S. GAAP”). Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2021, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2021, filed with the Securities and Exchange Commission on February 24, 2022 (the “2021 Annual Report”).
The preparation of financial statements in conformity with U.S. GAAP requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, contingent consideration liabilities associated with acquisitions, and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Cash, Cash Equivalents and Restricted Cash
The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (6), “Fair Value Measurement” for additional information.
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows.
 September 30, 2022December 31, 2021
Cash and cash equivalents$155,723 $180,928 
Restricted cash and cash equivalents (included in other current assets)27,764 29,262 
Restricted cash, cash equivalents and investments64,883 64,482 
Total cash, cash equivalents and restricted cash and investments248,370 274,672 
Less restricted investments(26,841)(27,958)
Total cash, cash equivalents and restricted cash$221,529 $246,714 
Accounts Receivable

The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for expected credit losses based on the Company’s historical write-off experience, an assessment of its customers’ financial conditions and available information that is relevant to assessing the collectability of cash flows, which includes current conditions and forecasts about future economic conditions.
The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable:
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20222021
Balance as of January 1,$6,838 $7,043 
Provision for expected credit losses10,129 325 
Amounts written off charged against the allowance(1,773)(1,220)
Balance as of September 30,$15,194 $6,148 

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2. ACQUISITIONS
As set forth below, the Company completed two acquisitions during the period of January 1, 2021 through September 30, 2022, which were accounted for using the acquisition method of accounting. Accordingly, the Company recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the applicable date of acquisition. Since the applicable date of acquisition, the Company has revised the allocation of the purchase price to the tangible and intangible assets acquired and liabilities assumed based on analysis of information that has been made available through September 30, 2022. The allocations will continue to be updated through the measurement period, if necessary. The goodwill recognized for these acquisitions is attributable to expected growth as the Company leverages its brand and diversifies its services offered to clients, including potential revenue growth and margin expansion. For each acquisition, the Company did not incur any material acquisition-related costs.
Connetics Acquisition
On May 13, 2022, the Company completed its acquisition of Connetics Communications, LLC (“Connetics”), which specializes in the direct hire recruitment and permanent placement of international nurse and allied health professionals with healthcare facilities in the United States. The initial purchase price of $78,764 included (1) $70,764 cash consideration paid upon acquisition, funded through cash on hand, and (2) contingent consideration (earn-out payment) of up to $12,500 with an estimated fair value of $8,000 as of the acquisition date. The contingent earn-out payment is based on the operating results of Connetics for the twelve months ending May 31, 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition.
The preliminary allocation of the $78,764 consisted of (1) $3,694 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,431 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $43,301 of goodwill, of which $35,317 is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately thirteen years. The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date:
Fair ValueUseful Life
(in years)
Identifiable intangible assets
Customer relationships$32,800 15
Staffing database4,200 5
Tradenames and trademarks3,200 5
$40,200 
Synzi and SnapMD Acquisition
On April 7, 2021, the Company completed its acquisition of Synzi Holdings, Inc. (“Synzi”) and its wholly-owned subsidiary, SnapMD, LLC (“SnapMD”). Synzi is a virtual care communication platform that enables organizations to conduct virtual visits and use secure messaging, text, and email for clinician-to-patient and clinician-to-clinician communications. SnapMD is a full-service virtual care management company, specializing in providing software to enable healthcare providers to better engage with their patients. The initial purchase price of $42,240 consisted entirely of cash consideration paid upon acquisition. The acquisition was funded primarily through borrowings under the Company’s $400,000 senior secured revolving credit facility (the “Senior Credit Facility”). See additional information regarding the Senior Credit Facility in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2021 Annual Report. The results of Synzi and SnapMD have been included in the Company’s technology and workforce solutions segment since the date of acquisition. During the second quarter of 2021, $92 was returned to the Company in respect of the final working capital settlement.
The allocation of the $42,148 purchase price, which was reduced by the final working capital settlement and was finalized during the second quarter of 2022, consisted of (1) $2,757 of fair value of tangible assets acquired, which included $884 cash received, (2) $275 of liabilities assumed, (3) $12,440 of identified intangible assets, and (4) $27,226 of goodwill, of which $6,044 is deductible for tax purposes. The fair value of intangible assets primarily includes $10,890 of developed technology and $1,220 of trademarks with a weighted average useful life of approximately seven years.

3. REVENUE RECOGNITION
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Revenue primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders (clinical and operational). The Company also generates revenue from technology-enabled services, including language interpretation and vendor management systems, and talent planning and acquisition services, including recruitment process outsourcing. The Company recognizes revenue when control of its services is transferred to its customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those services. Revenue from temporary staffing services is recognized as the services are rendered by clinical and non-clinical healthcare professionals. Under the Company’s managed services program (“MSP”) arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals along with those of third-party subcontractors. Revenue and the related direct costs under MSP arrangements are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. When the Company uses subcontractors and acts as an agent, revenue is recorded net of the related subcontractor’s expense. Revenue from permanent placement and recruitment process outsourcing services is recognized as the services are rendered. Depending on the arrangement, the Company’s technology-enabled service revenue is recognized either as the services are rendered or ratably over the applicable arrangement’s service period.
The Company’s customers are primarily billed as services are rendered. Any fees billed in advance of being earned are recorded as deferred revenue. While payment terms vary by the type of customer and the services rendered, the term between invoicing and when payment is due is not significant.
The Company has elected to apply the following practical expedients and optional exemptions related to contract costs and revenue recognition:
Recognize incremental costs of obtaining a contract with amortization periods of one year or less as expense when incurred. These costs are recorded within selling, general and administrative expenses.
Recognize revenue in the amount of consideration that the Company has a right to invoice the customer if that amount corresponds directly with the value to the customer of the Company’s services completed to date.
Exemptions from disclosing the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less, (ii) contracts for which revenue is recognized in the amount of consideration that the Company has a right to invoice for services performed and (iii) contracts for which variable consideration is allocated entirely to a wholly unsatisfied performance obligation or to a wholly unsatisfied promise to transfer a distinct service that forms part of a single performance obligation.
See Note (5), “Segment Information,” for additional information regarding the Company’s revenue disaggregated by service type.

4. NET INCOME PER COMMON SHARE
Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share:
 Three Months Ended September 30,Nine Months Ended September 30,
 2022202120222021
Net income$92,445 $74,023 $362,253 $211,171 
Net income per common share - basic $2.11 $1.55 $8.04 $4.43 
Net income per common share - diluted $2.10 $1.54 $7.99 $4.40 
Weighted average common shares outstanding - basic43,785 47,737 45,056 47,666 
Plus dilutive effect of potential common shares254 343 276 356 
Weighted average common shares outstanding - diluted44,039 48,080 45,332 48,022 
Share-based awards to purchase 14 and 15 shares of common stock were not included in the above calculation of diluted net income per common share for the three and nine months ended September 30, 2022, respectively, because the effect of these instruments was anti-dilutive. Share-based awards to purchase 21 and 26 shares of common stock were not included in the above calculation of diluted net income per common share for the three and nine months ended September 30, 2021, respectively, because the effect of these instruments was anti-dilutive.

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5. SEGMENT INFORMATION
The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. The Company has three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse staffing (including international nurse staffing and rapid response nurse staffing), labor disruption staffing, local staffing, international nurse and allied permanent placement, allied staffing and revenue cycle solutions businesses. The physician and leadership solutions segment includes the Company’s locum tenens staffing, healthcare interim leadership staffing, executive search, and physician permanent placement businesses. The technology and workforce solutions segment includes the Company’s language services, vendor management systems, workforce optimization, virtual care, credentialing solutions, and outsourced solutions businesses.
The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.

The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:
 Three Months Ended September 30,Nine Months Ended September 30,
 2022202120222021
Revenue
Nurse and allied solutions$828,317 $627,049 $3,157,834 $1,908,195 
Physician and leadership solutions175,152 150,663 530,355 430,523 
Technology and workforce solutions135,117 100,088 429,542 282,472 
$1,138,586 $877,800 $4,117,731 $2,621,190 
Segment operating income
Nurse and allied solutions$115,182 $92,564 $471,141 $283,768 
Physician and leadership solutions23,904 19,301 64,280 62,366 
Technology and workforce solutions71,145 47,210 232,526 131,952 
210,231 159,075 767,947 478,086 
Unallocated corporate overhead34,635 23,867 116,356 74,915 
Depreciation and amortization33,239 26,104 96,169 74,098 
Depreciation (included in cost of revenue)1,091 686 2,918 1,773 
Share-based compensation4,898 2,589 24,670 17,895 
Interest expense, net, and other8,961 5,223 28,630 24,278 
Income before income taxes$127,407 $100,606 $499,204 $285,127 

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The following tables present the Company’s revenue disaggregated by service type. Prior period amounts have been reclassified to conform with current period presentation. These reclassifications have no impact on total revenue by reportable segment.
Three Months Ended September 30, 2022
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$583,463 $ $ $583,463 
Labor disruption services19,479   19,479 
Local staffing31,814   31,814