Stratus Video, LLC (AMN) Earnings Call Transcript & Summary

Ladies and gentlemen, thank you for standing by, and welcome to the AMN Healthcare Stratus Video Acquisition Conference Call. [Operator Instructions] And as a reminder, this conference is being recorded. I would now like to turn the conference over to our host, Mr. Randy Reece, Director of Investor Relations. Please go ahead, sir.

Thank you. Good day, everyone. Welcome to AMN Healthcare's conference call to discuss our definitive agreement to acquire Stratus Video. Today's call may refer to a press release and slide presentation, which are available on our Investor Relations website at amnhealthcare.investorroom.com. Various remarks we make during this call about future expectations, projections, 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 as a result of various factors, including those identified in our most recent Form 10-K and subsequent filings with the SEC. The company does not intend to update any forward-looking statements provided today prior to its next earnings release. This call contains certain non-GAAP financial information. Information regarding and reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are included in the acquisition press release and slide presentation at amnhealthcare.investorroom.com. On the call today are Susan Salka, Chief Executive Officer; Brian Scott, Chief Financial Officer; and Maureen Huber, Chief Operating Officer of Stratus Video. I will now turn the call over to Susan.

Thank you so much, Randy, and thank you, everyone, for joining us today to talk about AMN's acquisition of Stratus Video. I am thrilled to be speaking to you from the Stratus headquarters here in Clearwater, Florida. I will kick things off with a summary of the strategic rationale for the acquisition and then Maureen will provide an overview of the company, and Brian will discuss the financial rationale. After that, we will open up the call for any questions. Over the last decade, AMN Healthcare has pursued a growth strategy that resulted in almost tripling our annual revenue while increasing our company's market capitalization tenfold. Two factors were the main drivers of this phenomenal increase in value. First are the macro and secular trends that provide an opportunity for us to create this value for all of our stakeholders. For example, some of those trends include the arrival of an age demographic wave and other patient characteristics that are continuously increasing the demand for health care services and requiring a more integrated and diverse team approach to patient care. The second driver and one even more within our control is how the AMN team has responded by making internal and external investments to build this company to become the largest and most innovative and integrated talent solutions organization within health care. Without a doubt, the new decade will require a new level of health care transformation. Today, we are here to talk about the latest steps in AMN's evolution as we have agreed to acquire Stratus Video. Based here in Clearwater, Stratus Video is the leading provider of remote video language interpretation services for the health care industry. The company has grown rapidly since its founding in 2012 using organic growth and acquisitions to surpass $100 million in revenue in 2019. Stratus is a comprehensive provider of interpretation services for the health care industry and has extensive capabilities for telephone-based and in-person interpreting, but over 2/3 of their interpretation revenue comes from video remote interpretation, the fastest-growing segment of this market. Stratus was a pioneer in the rapid transition to video interpretation, which has the ability to enhance the patient and the provider experience and improve patient outcomes while also driving costs down for health care providers. We'll now go to the next slide, Randy. We believe that Stratus will make a very strong addition to AMN's talent solutions by providing a compelling strategic and financial addition to the AMN organization. But we'll start first with why Stratus Video is just a great market and a great business to be in and why their financial profile makes it so attractive for AMN. As I mentioned, they are the clear market leader in this very high-growth segment of the interpretation market. They enable providers to improve care through a better patient experience and better communication, while also reducing cost for this overall growing population of patients within health care. Also, as Maureen will explain, health care clients are required to meet certain federal and state mandates in order to make sure that they are providing quality interpretation for their patients. Stratus has a highly scalable platform with proprietary technology that is specifically designed for health care. And this is very important because there are other forms of interpretation and translation out in the market. But as you can expect, there are nuances within health care and patient care delivery that make it important that you have not only the right qualified interpreters, but also the right platforms that can interface with health care providers more seamlessly. The financial profile of the business itself produces high margins, both at the gross and EBITDA margins because of the efficient use of technology and the ability to have their interpreters be remote. They also have recurring revenue through the outsourcing model and the stickiness that's created with their client relationships. They have very, very high customer and employee retention. In fact, their customer retention has been very consistently over 95%, and as we were fortunate to talk with customers and through the satisfaction reviews that they do as well, they have an excellent, excellent reputation through both their delivery and their execution, but also through the people that they provide in the way that they provide not only quality interpretation, but compassionate care through their services. So then let's talk also about why this is a good -- for AMS, it's a great business to begin with, led by a fantastic management team, and they've proven that they can continue to evolve and grow and make the right investments. But this is also a very important addition to the AMN family in our portfolio of solutions. It is very well aligned with our road map and strategy to continue to evolve our total talent solutions portfolio for our clients. We believe that we share common markets, many common clients that we'll be able to leverage, but also new clients that both we can bring to the Stratus organization and in some cases, vice versa. And as our markets that we share continue to evolve and change, we can also find ways to create synergies in coming to those clients cohesively. One example is through our most strategic clients, our MSP clients, where we have contracts and relationships that often span an entire system across multiple facilities and multiple kinds of settings. It's been interesting as we made this announcement to our clients, I've already received messages from clients asking to hear more and want to learn about this great new offering from AMN. So we believe we'll be able to create synergies by bringing our sales teams to be more closely aligned and have an opportunity to bring a more seamless experience to those clients. As Brian will describe, we believe the acquisition will be immediately accretive, nicely accretive to AMN's margins and our earnings. And of course, it provides us with a wonderful opportunity to participate in this fast-growing and increasingly important area of virtual and digital care. They bring not only a particular capability to our clients today, but they also bring tremendous knowledge regarding the virtual health technology that's required and how you integrate that technology both with clients but also with practice professionals and providers. And so we're excited about how this can help us continue to evolve our approach to virtual care and be able to take this offering, but also additional offerings to a new level. So with that, I'm going to introduce one of my soon-to-be new colleagues and leaders, Maureen Huber. Maureen is the COO, CFO and I think she holds many different titles and hats within the Stratus organization as do others. And she works alongside her colleagues, President Dave and also other very important leaders to continue to pioneer and build the organization. She joined Stratus in 2015. And as you can imagine, has been very instrumental in their growth, their strategy and their ability to deliver to clients as well as ultimately touch patients. So with that, I will gladly turn it over to Maureen to continue talking about Stratus.

Thank you, Susan. I'm so happy to be here. On behalf of the Stratus Video team, we couldn't be more excited about the pending acquisition and conclusion of the acquisition from AMN Healthcare. As we continue to grow our business, we were founded in 2012 and identifying technology-enabled workforce management solutions to deliver medically qualified interpreters to improve patient outcome has been our mission from day 1. So we're very much aligned in that vision and how we see the improvement of care throughout communication and having the right workforce at the right time. And that's especially important as it's regulated, the Affordable Care Act stipulates that interpretation must be provided to limited English profession as well as the depth in hard of hearing. So there are many regulatory requirements that we help our clients meet. We service more than 1,600 health care clients across both acute as well as clinics and ambulatory surgical centers, and we continue to service that market, that's approximately $1.2 billion. Stratus is the leader of the video segment of that market, and the market is shifting. So the highest growth area within that existing market is in video. And that's really our foundation. That's where we started. Many interpretation companies started in over-the-phone or in-person agency, we were the first to bring the video capability being solely focused in health care as well as our recent acquisition of InDemand from last May, making us the overall market leader in this segment. And so Randy, if we could. Thank you very much. And we think about delivering that medically qualified interpreter across 3 modalities. As I was describing, video is our foundation. And we service 35 languages over video, including American Sign Language; Spanish is as you can imagine, our largest language, but we spread across fast-growing languages that we see in the United States, such as Mandarin, Cantonese and Vietnamese. So having access to that qualified workforce is really helping our clients meet those shifting demographics and improving those patient outcomes. From our unified platform that we've developed our proprietary technology designed for health care, we're able to access an additional 165 languages through a vast network of our independent medically qualified interpreters. So making sure that we're able to meet those needs in those rare languages, those languages have luster diffusions, where an on-site or other capability would not be able to be met. And as we think about that third modality of care, and there are certain care situations where an on-site interpreter may be required. So if you think of physical therapy or end of life, we're really compassionate in patient safety and concerns involved. An on-site interpreter may be appropriate. And so we've developed proprietary geo-location technology with a vast network of on-site interpreters to meet those needs that can be on-demand or scheduled. So again, it's harmonizing the technology with a highly skilled workforce that has enabled us to continue to grow and meet the needs of a very changing demographic within our health care settings today.

Okay. Next slide. Thanks, Maureen. I just want to also welcome you and David and the rest of the Stratus organization to the AMN family, we are really excited to partner with you and help our collective clients improve the lives of patients each and every day. As we noted in the press release yesterday, Stratus was founded in 2012 and just 7 years later, reached $108 million in annual revenue in 2019. In addition to their strong organic growth, Stratus has made 2 key strategic acquisitions over the last several years to accelerate this. On a pro forma basis, including the 2019 acquisition of InDemand Interpreting, Stratus grew revenue 25% in 2018 and 29% in 2019. And the company continued their revenue momentum throughout 2019. And based on their Q4 results, their annualized revenue run rate is at $119 million. As Stratus is able to capitalize on a blended onshore/offshore model, both employed and contract interpreters, they've been able to achieve gross margins of over 45%. And with the technology-enabled delivery platform, they scale their SG&A to expand their EBITDA margins, growing from 20% in 2017 up to 28% in 2019. As we look ahead, we expect the EBITDA margins to remain in that 28% range as we balance the continued leverage opportunities with the platform, with also investing for the long-term growth of the business as well as the transition they're going to make into being part of AMN. With that fourth quarter annualized revenue of $119 million, they've also achieved a run rate adjusted EBITDA of $34 million. Turning to the transaction highlights. We agreed to purchase Stratus for $475 million of cash. We expect to fund these acquisitions through a combination of term loan and revolver borrowings under our existing credit facility for a total of $425 million, and the balance of the purchase price will be funded through $50 million from existing cash on hand. At closing, we anticipate our pro forma debt-to-EBITDA leverage ratio to be 3.3x. And with our strong expected cash flow generation, we intend to aggressively pay down our debt over the next few quarters to reduce our leverage back down to below 3x by the end of this year. So before I hand the call back over to Susan for some closing remarks and questions, I just wanted to make a comment about AMN's financial performance. As you know, our fourth quarter earnings conference call is scheduled for February 13, which is just 2 weeks away. So on today's call, we do not intend to provide any updates regarding our specific fourth quarter results or our first quarter guidance. However, we are reaffirming the fourth quarter guidance that we provided in our third quarter earnings release and conference call at the end of October. And now Susan will share some closing remarks, and we'll open up for questions.

Great. Thanks, Brian. Thanks, Maureen. So we hope that you can see so clearly, why we are extremely excited about the Stratus Video team joining AMN and all that it brings certainly to the organization in ways of talent and knowledge and a platform that we can continue to build upon. But also, certainly, for our clients and ultimately for the patients that are served, it unlocks a new complementary market for us, an area where we do not have a presence today, a growing category, and we are fortunate that a leader in that growing category, the leader is joining the AMN team. And it's a very natural extension of our portfolio of solutions and our technology. It can continue to help strengthen our relationship with our clients, but also with health care providers, such as the physicians and therapists and nurses that will interact with this great solution, and then, of course, ultimately, the patients that they serve. One of the things that really created excitement when we initially met the Stratus Video leadership team is the strong common cultures that we have, a similar management philosophy, common values that we share, and just in general, the talent that they have across the organization will really fortify the AMN team I think at many, many different levels. And then of course, the financial performance of the business, which is additive today, but we believe will give us more opportunity to continue to grow in terms of our margins, but also in terms of our ultimate delivery to our shareholders. And over time, this will continue to drive greater shareholder value as we continue to build and grow the organization. So with that, we would like to open up the call for your questions, and all 3 of us are available.

[Operator Instructions] And we do have something from the line of A.J. Rice with Crédit Suisse.

Interesting acquisition. Can you just maybe step back and give us a sense of how you size this market and list the growth characteristics are? Is the video segment sort of growing as a percent of the total market, if the total market is relatively steady? Or is the overall market in your mind growing?

So I'm going to turn that over to Maureen in just a moment, but I'll say just generally, the way that we look at it is, it is as a total market of $1.2 billion, still very, very fragmented. If you look at the position that even Stratus has as one of the leaders of the overall market and at $118 million, it's still a relatively small piece of the pie. And the video segment, in particular, has been the fastest growing. And so we think, over time, that will become a bigger and bigger piece of the overall pie. That's certainly where clients have been and will continue to be moving. And so having a strength in that category will be very, very important. The actual overall market of $1.2 billion seems to be growing in the single digits. But it's not because there isn't a need, and I'll let Maureen speak more to this because she understands the numbers probably far better. But there's actually a greater need due to the growing demographic of patients coming in, but it is very difficult for clients to be compliant with serving those patients. And so there could be even greater growth over time as they are more attentive to both compliance, but also the benefits of patient care by providing interpretation, but I'll let the experts speak more to this.

Yes, that's right, Susan. The LEP population in the United States is growing at double the U.S. population rate. And so there is this increasing demand to service those clients or those patients. And as our clients are evaluating the access to language services improving, patient outcomes with reduced length of stay, lower readmissions and medication adherence, they're really seeing those improved outcomes, and that's meaningful. And so as we continue to see those trends grow as well as the improvement in compliance regarding the regulations, we're seeing that shift to video because of those nonverbal cues provides a better interpreting experience than what they previously may have had with over-the-phone. So that's supporting that shift to video as well as that nonverbal communication and the importance to really get that acknowledgment. In thinking about a patient who doesn't speak the language, giving that verbal affirmation to his provider of a head nod in understanding, working with their interpreter, it has been very meaningful. We'll continue to see that shift in growth.

Okay. Maybe also just continuing to try to understand the dynamics in the segment. Obviously, in AMN's legacy business, we're focused on bill pay spread. Can you describe a little bit how the billing structure works? I think it might be permitted to have something we can relate to. How -- what kind of revenues per episode or a translation episode or even patient episode, do they typically generate? And then are the new services being provided by permanent employees, contractors, what's the mix on that?

Sure. Great questions. So the -- really over-the-phone was launched out of the telecommunications industry. So its foundation has been in a per minute revenue basis. And that has transformed into also the video into per minute basis. So it's a consumption based on highly repeatable with great visibility to that revenue stream. And on-site interpreting is similar and that's paid in -- like a professional service in an hourly rate. So kind of thinking about it in those 2 different revenue streams and modalities of per minute and then hourly rate for professional services is how those modalities are experienced in health care and specifically. So we think about the growth and the opportunity around that is utilizing our technology and the predictive analytics of that consumption and use to make sure that we're meeting that growing demand and use of our clients.

A couple of things that we found very interesting is the expectation and need for interpreters to be available real time. Now occasionally, if it's in-person and you want to pre schedule, you have more lead time. But in most cases, it's an instant demand, and they need to have interpreters available within seconds, maybe a minute or 2. I think the average response is under a minute, closer to 30 seconds. And so you've got to have a team of interpreters that are available for your highest demand categories. And that's why, of the 3,000 interpreters, some of them are employed, and we need to make sure that we have the capacity, but also the efficiency to keep them fully utilized and delivering care during the time that they're employed, but then the remainder are contractors who are available on demand. So it creates both the ability to ensure we can deliver the right person at the right time, and there's enough predictability to do that, but then also the flexibility to add on additional capabilities as needed. So Maureen, I don't know if there's anything else you want to add to that for a little more color?

No, I think you addressed it appropriately.

A.J. what I'd add is there's a -- it's close to a 50-50 mix between employed and contractor. But when you look at the actual minutes, the majority are from that employed group because those are the languages where there's the greatest utilization. So they're able to employ Spanish-speaking and others where they can optimize that labor force. And then they'll use contractors where you've got languages that don't have as high utilization and they can kind of tap into that interpreter group when they're needed.

That's right, Brian. If you think of our 35 languages that are offered on video, it's that same employed workforce that's delivering to our clients, and that represents approximately 95% of our total minutes.

Okay. Maybe just one last one, and then I'll yield. Any comments about the seasonality of this business or the cyclicality of it that we should think about?

It's typical in health care around holidays, when there's fewer scheduling around surgeries and those types of scheduled appointments is where we see a little bit of seasonality, if you will. But typically, anywhere in health care, there is a continuous demand in being available 24/7, 365, is very important for our clients.

And I would assume it's countercyclical to some sort of steady as opposed to some of the other staffing-oriented businesses would tend to be a little more volatile in an economic downturn or not? Is that...

We believe that's right, A.J., which was one of the other characteristics that we really liked about the business is the fact that even in a downturn, there's still a need for this kind of service to deliver to patients. And since the move has definitely been to move away from in-person staffed interpreters for our clients and move to either over-the-phone or video, we don't expect that they would be impacted in an economic contraction, either at all or to the extent that our more traditional clinical staffing businesses are just because of the model and the direction that client preferences are moving.

[Operator Instructions] And we do have something from the line of Jeff Silber with BMO Capital Markets.

I'm just wondering if we could just step back and talk about the genesis of this acquisition. Was this an area that you were thinking of getting into? Or were you just looking for something a little bit more complementary to your business and this happened to be an area that just kind of jumped out at you?

Yes. So this fits in actually beautifully in our road map and the strategy that we've been talking about for the last decade, but I'd say even more vocally over the last 5 years, and that is to become this more holistic total talent partner for our clients to help them in their patient care delivery with things that relate to having the right workforce in the right place at the right time. And we've often said that, that would likely include a component of technology since delivering access to that workforce and access to care, increasingly has some sort of technology element to it. So we have our first category that we've talked about, which would be workforce technology solutions, which this clearly fits into. The second category would be adding new staffing and patient care capabilities to our platform, which this absolutely falls into since we weren't providing interpretation previously. The third category is consolidation of existing areas and this wouldn't fall into that category since we didn't have anything to build upon. So in that way, it's a new entry for us, but it very much fits into those key categories that we've been describing for our strategy. So for us, it was a very natural opportunity. Now it's one that is a very particular segment that we weren't as familiar with, to be honest, before we started doing our research and becoming more familiar with the opportunity. And certainly, we're well aware of interpretation, and we're watching from the sidelines, the great progress that Stratus and InDemand and other companies were contributing. But it's really in the last, I'd say, 2 years that we've seen both the demand from clients pick up significantly in the area of video, which made it that much more attractive. I'd say that was a big part of why now, in addition to the fact that they were available now. But why now would be -- we feel that we are still at the early innings of this rapid adoption of video interpretation. And we think it's an opportunity for us to be a part of that, but then also, as I mentioned, to add in some really important knowledge and capabilities around virtual health care delivery, and particularly as it relates to the virtual workforce.

Okay. That's helpful. Yes, it was helpful. I appreciate that. In looking at the slide where you have the company at a glance and if you look across their health care client universe, fairly similar to who you're selling to. I'm just wondering, at those customers, is it a typical -- a similar buyer that you're selling your existing services now? And also, if you can just talk about the go-to-market strategy for this business going forward?

Sure. Sometimes, it is a similar buyer if it falls under -- the decision-making around these services falls under the Chief Nurse Executive or Officer, that's quite honestly, where they prefer to be having a dialogue and to be partnering. Sometimes it falls under other decision-makers. Purchasing is more increasingly involved, I would say. But there are other leaders that might be involved or responsible for this particular function as well. As we talked with some of our largest clients, they were, first of all, thrilled to hear that this was an area we're looking into because, in many cases, they are recognizing they need to transform and make a transition away from either in-person, which is very costly and difficult to manage or even trying to elevate from over-the-phone to video. So there was a very enthusiastic reception from our clients. So even if perhaps the decision-maker sat under a different umbrella, they were very keen to bring them into the dialogue and talk about how we could bring it all more together. So how we go to market, Stratus already has a fantastic sales team that has evolved over time. Actually got to meet some of them this morning, which was exciting. And they are, as you would expect, already creating a more segmented approach to their client sales and even delivery, and so that will fit in very, very well with AMN's go-to-market strategy and how we have both direct sales team members that might deal more directly with smaller clients or specialized clients, but then where we have the large enterprise clients, we would, of course, want to come together and have more of a singular voice in a cohesive approach to how we're selling. So we see great opportunity and being able to plug them in pretty immediately to our managed services programs. We also know that our schools' clients have a great need for interpretation. And remember, we're already providing some amount, just small at this point, but some amount of speech therapy through a technology platform, so this could plug in very well with that. But even where it doesn't plug into that, just when you have a speech therapist on-site with a student, having the ability to bring in video interpretation on demand would be extremely helpful. So we see actually several, several opportunities to get this integrated into our existing sales team and strategy.

All right, great. And this one's for Brian. Are you going to be breaking out this segment separately? Or is it going to be within the other workforce solutions area?

Yes. Thanks, Jeff. We're -- as of now, I'd say, we would include it in our other workforce solutions segment, although we are going to take a look at our segment reporting again before we get to the first quarter reporting. But for now, you should assume it will be in our other workforce solutions segment.

And we will go to the line of Mark Marcon with Robert W. Baird.

This seems like a really interesting area. I was wondering, can you just describe, of the 3 different modalities, Maureen, what is the -- what's the mix between video versus over-the-phone versus in-person?

Sure. So our video is the majority of our business. It's just under 70%. And over-the-phone is approximately 23% and then our on-site, which is our in-person technology and other revenues, the remaining portion.

Great. And then from a bill rate perspective, if we think about like average cost per hour, what is the typical metric? What's the range in terms of dollars per minute or dollars per hour?

You know, I -- Mark, I think we might want to -- wait, I'll have Maureen give you a very general range, just so we can sort of put it in context. But obviously...

I don't want to be...

For competitive reasons, we don't necessarily want to put our pricing strategy out there, but I think she can give you some just ballpark figures just put it in context.

Yes. I think the way to think about it is complexity of the languages that are being serviced to a client. So when we think about pricing, decision-making, it's the size of the client and the volume that they would be delivering as well as the complexity of the language is the service because there is rate variability in some of those areas. And so depending on what that mix and need is how we determine pricing. From a permanent perspective, it can -- it does have a range because of those requirements. And similarly, with on-site interpreting, it just depends, quite frankly, on the language that's being serviced.

Yes, I was thinking more like video in Spanish as a more common benchmark.

Yes. Yes. I think the other thing to say is that there is a bit of a premium for video because you are able to improve that patient experience. They've actually found over time that you can -- actually, you can shorten length of stays and even in some cases, that interpretation engagement can be a little bit quicker because you're -- you have a higher level of interaction. And so that's where -- it's one of the more attractive parts as well, not only that they're -- if you look at the market share today, video is still the smallest part of that total $1.2 billion market, but it's growing 20% clip. And so because of the technology enablement and the incremental value that it brings, you can charge a slight premium for that. So it kind of a double benefit. We're in the most attractive part of the market, it's growing more rapidly. And also you see that margin profile that comes in that as well.

Just to give you a general figure, as an example, the average rate for video for a general language might be in the $1.50 per minute range. Some could be less, some could be more, depending upon the complexity. Obviously, volume matters. But if you're just looking for, well, how do I think about how these clients are built and what the overall cost structure might look like, that gives you a general sense.

That's really helpful. And then I'm assuming that the gross costs are basically the costs that go with the people as well as the technology supporting the overall platform.

Yes, cost of sales is predominantly the cost of the interpreters.

Great. And then with regards to -- the Stratus has 1,600 health care clients. What's the overlap with the AMN network of clients?

We've done the overlap analysis. And I'd say it's a healthy one in that there are certainly some shared clients. Although there could be a shared client where it's a large client for us, and it's a good client for them, but they're not fully penetrated. And if it's a client, let's say, that has multiple facilities across multiple regions, they might be in one of the regions or just some of the facilities. And so with our larger MSP contracts and enterprise relationships, we think we can help them really increase their penetration at those clients that are already existing clients. Likewise, they have some interesting clients that we don't necessarily work so closely with today. But in the same types of settings, so I think there's some nice introductions to be made there, but then also in, say, areas of telehealth. So maybe I'll let Maureen talk a little bit about that because this is an exciting area for them, but also will be for us.

Yes. When we think about those growth opportunities in those new encounters and experiences where there is availability of screens and cameras and microphones and thinking of telehealth, we're uniquely positioned as we have interoperability. So if you think of the leading telehealth providers in the market today, we're able to bring in an interpreter into those virtual care sessions. So this has been an area that's been growing tremendously for us over the past year and will continue to do so. Similarly, as -- home health is starting to begin to adopt technology. In home health, especially, as they're thinking about virtual care, similarly, we can bring that video interpreter into the home health as well. So we're seeing these new areas and segments that we're going to intersect with AMN Healthcare sales team as we kind of explore what our market opportunities are.

Great. And then just with regards to the integration plan, can you just talk about what the preliminary thoughts are around that?

Sure, Mark. I think it will be probably more appropriate to talk about that on our call after we've closed the transaction. We, of course, aren't a singular company today. We can do some planning, but we can't actually do things to become a singular organization but the obvious areas of opportunity are, as we mentioned, within sales and integration to us there means more bringing our teams together through education, through technology, making sure that where we have opportunities to introduce Stratus through our existing relationships or through RFPs that, that's happening very somewhat easily and contemporaneously with RFPs. And then also, where they have opportunities and clients, we will -- as we usually do, we will create a list of the top opportunities that they have to bring to the AMN organization and vice versa. And then we will make sure that we are going after the biggest opportunities first. We'll then, over time, be looking at how we integrate them into our back-office capabilities, things that Maureen and her team have had to deal with historically, like negotiating leases and benefits and legal matters and taxes and things are things our team is superb at handling. And so our shared services corporate model I think will be very advantageous to take those responsibilities away and make sure they have even more time to drive and build the business. So those things will happen over the next year. Since we don't have another interpretation company, they won't be sort of plugged in as maybe in situations where we've had a travel nurse company or allied company that have joined us. So there will be elements that will just continue to run fairly autonomously. And there will be others where we'll, of course, be bringing them together to get the synergies out of the companies coming together.

Yes, Mark, this is not a cost synergy play for us, where we've been extremely impressed with not only the whole management team of Stratus, but really every person we've interacted across the organization. So we are thrilled to be able to bring more of this talent into AMN. We think there's definitely ways to create revenue synergies over time, but it's -- that's how we're going to create more value over time. We don't necessarily see overlapping costs. I'm sure we can find some efficiencies here and there. Working together in the areas that Susan described. But we also, as I mentioned earlier, plan to invest more in the business too. So that's really we're thinking how we can actually make sure that they maintain or accelerate that durability to grow going forward as well.

Thank you. And at this time, we have no further questions or comments in queue. Please go ahead.

Okay. Wonderful. Well, again, we appreciate everyone joining us today with fairly short notice. As I'm sure you can tell, we are extraordinarily excited about Stratus Video and all that they will bring to the company, to our clients, ultimately, to patients, the value that will be created for shareholders. And I personally am looking forward to working with the leadership team and getting to know the broader Stratus Video team because everyone I have met so far is equally as passionate and talented as my other colleagues at AMN. So we look forward to working with you and seeing what impact we can make together. Thanks everybody and have a great day.

Thank you. And ladies and gentlemen, that does conclude our conference for today. Thank you for your participation and for using AT&T Conferencing Services. You may now disconnect.