Cash flow generation is highly volatile, as demonstrated by the 2026Q1 free cash flow margin of 40.3% which contrasts sharply with the negative 8.9% margin observed in 2023Q4.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 |
|---|
| Cash from Operations | 739.24M | 269.46M | 320.42M | 372.17M | 653.73M | 305.36M | 256.83M | 224.86M | 226.99M | 115.26M | 131.85M | 57.05M | 27.68M | 58.64M | 60.51M | 19.31M | 8.09M | 98.73M | 63.69M | 79.64M | 54.54M | 44.09M | 39.04M | 65.14M | 56.85M | 1.68M | -1.59M |
| Operating CF Margin % | - | 9.87% | 10.74% | 9.82% | 12.47% | 7.66% | 10.73% | 10.12% | 10.63% | 5.8% | 6.93% | 3.9% | 2.67% | 5.8% | 6.34% | 2.18% | 1.17% | 12.99% | 5.23% | 6.84% | 5.04% | 6.25% | 6.21% | 9.12% | 7.33% | 0.32% | -0.69% |
| Operating CF Growth % | 423.63% | -15.9% | -13.9% | -43.07% | 114.09% | 18.9% | 14.21% | -0.94% | 96.94% | -12.58% | 131.1% | 106.13% | -52.8% | -3.1% | 213.34% | 138.74% | -91.81% | 55.01% | -20.02% | 46.02% | 23.7% | 12.94% | -40.08% | 14.59% | 3286.12% | 205.86% | - |
| Net Income | -32.44M | -95.7M | -146.98M | 210.68M | 444.05M | 327.39M | 70.67M | 113.99M | 141.74M | 132.56M | 105.84M | 81.89M | 33.22M | 32.93M | 15.95M | -26.27M | -51.99M | -122.18M | 34.36M | 36.53M | 35.09M | 22.23M | 17.35M | 37.79M | 52.36M | -4.39M | -5.2M |
| Depreciation & Amortization | 116.74M | 156.6M | 173.78M | 160.93M | 137.11M | 103.7M | 94.19M | 58.52M | 41.24M | 32.28M | 29.62M | 20.95M | 15.99M | 13.54M | 14.15M | 16.42M | 15.08M | 13.81M | 14.44M | 11.67M | 10.32M | 6.18M | 5.84M | 4.82M | 3.84M | 7.71M | 3.3M |
| Stock-Based Compensation | 21.3M | 30.68M | 23.32M | 18.02M | 30.07M | 25.22M | 20.46M | 16.24M | 10.81M | 10.24M | 11.4M | 10.28M | 7.16M | 6.13M | 6.22M | 7.13M | 8.28M | 8.71M | 9.32M | 8.39M | 6.8M | 142K | 16.1K | 874K | 31.88M | 31.88M | 0 |
| Deferred Taxes | -30.6M | -19.55M | -51.07M | -12.93M | -24.61M | -16.29M | -21.63M | 913K | -667K | 5.61M | -9.42M | 12.68M | 11.78M | 3.03M | 6.95M | -1.79M | -10.71M | -51.72M | -3.37M | 1.14M | 18.08M | 19.02M | 4.09M | 6.04M | 7.29M | -8.65M | -9.73M |
| Other Non-Cash Items | 248.33M | 96.39M | 235.46M | 45.6M | 67.68M | 8.84M | 26.01M | 16.22M | 2.25M | 12.85M | 11.12M | 1.58M | 7.14M | 1.84M | 19.51M | 47.67M | 57.98M | 185.6M | 1.76M | 2.13M | -2.74M | 4.48M | 2.44M | 1.6M | -27.58M | 14.28M | 27.02M |
| Working Capital Changes | 478.08M | 101.03M | 85.91M | -50.13M | -558K | -143.49M | 67.13M | 18.98M | 31.61M | -78.27M | -16.7M | -70.33M | -47.61M | 1.16M | -2.27M | -23.84M | -10.56M | 64.51M | 7.18M | 19.77M | -13.01M | -7.96M | 9.32M | 14.02M | -10.94M | -39.16M | -16.98M |
| Change in Receivables | 41.69M | 74.75M | 219.44M | 224.85M | 20.04M | -585.27M | -8.61M | 5.71M | -10.58M | -10.64M | -57.16M | -98.02M | -52.13M | -8.45M | 1.39M | -29.02M | -15.3M | 88.73M | 10.41M | 5.53M | -40.6M | -474K | 0 | -30.15M | -39.48M | -39.48M | 0 |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | -256.12M | -5.56M | -1.93M | 14.56M | -32.63M | -3.34M | -7.34M | -4M | 4.33M | -12.29M | 5.6M | 1.16M | 0 | -6.91M | 8.57M | 23.83M | -106.36M | 0 | -36.48M | -111.42M | -118.81M | 0 |
| Change in Payables | 19.06M | 0 | 0 | 0 | 0 | 256.12M | 5.56M | 1.93M | 17.15M | -7.86M | 17.7M | 29.61M | 6.13M | 4.34M | 2.83M | 3.66M | 8.94M | 0 | 1.94M | 1.72M | 1.18M | -1.2M | 0 | 3.66M | 2.65M | 2.65M | 0 |
| Cash from Investing | 22.84M | 4.3M | -79.94M | -412.49M | -170.71M | -107.4M | -538.17M | -291.82M | -279.34M | -33.45M | -257.36M | -116.83M | -28.23M | -47.9M | 2.96M | -1.98M | -6.85M | -29.25M | -48.25M | -14.63M | -45.68M | -115.33M | -5.06M | -14.01M | 1.45M | -33.78M | -94.14M |
| Capital Expenditures | -32.9M | -35.63M | -80.89M | -103.69M | -75.83M | -53.66M | -39.1M | -36.46M | -36.39M | -26.53M | -21.96M | -27.01M | -19.13M | -9.05M | -5.47M | -4.65M | -4.17M | -3.79M | -8.79M | -9.15M | -9.71M | -3.82M | -5.06M | -13.01M | -4.33M | -4.5M | -2.36M |
| CapEx % of Revenue | 0.96% | 1.3% | 2.71% | 2.74% | 1.45% | 1.35% | 1.63% | 1.64% | 1.7% | 1.33% | 1.15% | 1.85% | 1.85% | 0.89% | 0.57% | 0.52% | 0.6% | 0.5% | 0.72% | 0.79% | 0.9% | 0.54% | 0.8% | 1.82% | 0.56% | 0.87% | 1.02% |
| Acquisitions | -41K | 65.28M | 0 | -292.1M | -69.5M | -41.26M | -476.43M | -247.91M | -217.36M | -1.5M | -218.34M | -85.07M | -14.47M | -39.5M | 0 | 0 | -3.23M | 0 | -30.95M | -5.48M | -35.96M | -111.51M | 0 | -9.53M | -9.53M | -12.97M | -91.79M |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 68.53M | 22K | -6.76M | -26.6M | -26.61M | -8.99M | -7.66M | -13.29M | -10.67M | -8.62M | -5.91M | -3M | 10.38M | 647K | 8.43M | 2.67M | 553K | -25.46M | -8.5M | 0 | 0 | 0 | 0 | -1M | 15.31M | -19.09M | 8K |
| Cash from Financing | -261.82M | -295.89M | -259.45M | 10.73M | -591.87M | -34.9M | 211.49M | 136.6M | 37.51M | -77.19M | 126.29M | 56.2M | -2.1M | -783K | -61.68M | -15.3M | -26.45M | -53.81M | -22.33M | -50.92M | -23.54M | 86.52M | -34.75M | -86.47M | -33.82M | 47.21M | 95.77M |
| Debt Issued (Net) | -250M | -285M | -250M | 459.7M | 0 | -21.88M | 240.54M | 180M | 120M | -44.06M | 149.68M | 57M | 2.23M | -681K | -53.73M | -12.5M | -21.86M | -53.65M | 2.04M | -37.92M | -21.81M | 89.11M | -36.42M | 137.37M | -662K | -128.87M | 45.18M |
| Equity Issued (Net) | -492K | 0 | 0 | -424.74M | -576.77M | -2.69M | -6.93M | -18.7M | -67.01M | -20.16M | -13.26M | 0 | 0 | 0 | 530K | 0 | 0 | 0 | -28.45M | -16.29M | -10.58M | 2.32M | 1.93M | -219.21M | -33.06M | 177.34M | 52M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -492K | 0 | 0 | -424.74M | -576.77M | -2.69M | -6.93M | -18.7M | -67.01M | -20.16M | -13.26M | -11.91M | -4.45M | -2.67M | -1.07M | 0 | 0 | 0 | -28.45M | -18.51M | -37.53M | 0 | -110K | -219.26M | -35.16M | 0 | 0 |
| Other Financing | -11.32M | -10.89M | -9.45M | -24.23M | -15.1M | -10.33M | -22.13M | -24.7M | -15.48M | -12.97M | -10.13M | -796K | -4.33M | 262K | -8.48M | -2.8M | -4.59M | -156K | 4.07M | 3.29M | 8.86M | -4.9M | -258K | -4.63M | -101K | -1.26M | -1.41M |
| Net Change in Cash | 513.81M | -22.13M | -18.97M | -29.6M | -108.84M | 162.72M | -69.97M | 69.64M | -14.57M | 4.53M | 1.05M | -3.5M | -2.51M | 9.9M | 1.72M | 2.08M | -25.17M | 15.74M | -7.18M | 14.07M | -14.69M | 15.2M | -779K | -35.45M | 24.48M | 15.11M | 43K |
| Free Cash Flow | 706.34M | 233.83M | 239.53M | 266.78M | 572.81M | 251.69M | 217.72M | 188.4M | 190.61M | 88.73M | 109.89M | 30.04M | 8.54M | 49.59M | 55.04M | 14.66M | 3.92M | 94.94M | 54.9M | 70.48M | 44.82M | 40.27M | 33.98M | 52.13M | 52.52M | -2.82M | -3.94M |
| FCF Margin % | 20.66% | 8.56% | 8.03% | 7.04% | 10.92% | 6.32% | 9.1% | 8.48% | 8.92% | 4.46% | 5.78% | 2.05% | 0.82% | 4.9% | 5.77% | 1.65% | 0.57% | 12.5% | 4.51% | 6.06% | 4.14% | 5.71% | 5.4% | 7.3% | 6.77% | -0.54% | -1.71% |
| FCF Growth % | 172.74% | -2.38% | -10.21% | -53.43% | 127.58% | 15.6% | 15.56% | -1.16% | 114.81% | -19.26% | 265.79% | 251.63% | -82.77% | -9.9% | 275.34% | 273.99% | -95.87% | 72.94% | -22.11% | 57.25% | 11.3% | 18.53% | -34.83% | -0.75% | 1963.91% | 28.55% | - |
| FCF per Share | 18.06 | 6.07 | 6.27 | 6.78 | 12.77 | 5.24 | 4.57 | 3.96 | 3.92 | 1.80 | 2.23 | 0.62 | 0.18 | 1.04 | 1.18 | 0.32 | 0.11 | 2.91 | 1.62 | 2.02 | 1.30 | 1.25 | 1.08 | 1.31 | 1.12 | -0.09 | -0.18 |
| FCF Conversion (FCF/Net Income) | -21.77x | -2.82x | -2.18x | 1.77x | 1.47x | 0.93x | 3.63x | 1.97x | 1.60x | 0.87x | 1.25x | 0.70x | 0.83x | 1.78x | 3.53x | -0.74x | -0.16x | -0.81x | 1.85x | 2.18x | 1.55x | 1.98x | 2.25x | 1.72x | 1.09x | -0.38x | 0.31x |
| Interest Paid | 42.17M | 45.11M | 61.03M | 48.1M | 37.52M | 38.09M | 22.65M | 23.73M | 21.28M | 17.94M | 8.06M | -5.81M | 4.6M | 7.41M | 13.7M | 19.67M | 16.43M | 7.39M | 9.6M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 8.61M | 7.85M | 28.15M | 78.26M | 213.81M | 106.38M | 46.26M | 37.75M | 30.59M | 73.75M | 73.37M | -33.13M | 17.88M | 18.86M | 1.86M | 388K | 84K | 5.61M | 32.95M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Cyclical demand normalization
As reported in recent financial filings, AMN's operating cash flow frequently diverges from net income, with the 2025Q1 OCF/NI ratio reaching an extreme -84.86, suggesting that GAAP earnings are heavily distorted by non-cash charges and do not serve as a reliable proxy for underlying cash generation.
The persistent gap between net income and operating cash flow indicates that the company's bottom line is heavily impacted by non-cash items, likely related to impairment charges and amortization from past acquisitions. Investors should monitor this divergence closely, as it suggests that the company's reported profitability is significantly more volatile than its actual cash-generating capacity.
Based on quarterly cash flow data, AMN's free cash flow trajectory remains inconsistent, with margins fluctuating from a negative 8.9% in 2023Q4 to a peak of 40.3% in 2026Q1, reflecting the inherent instability of a business model currently struggling to align costs with contracting demand.
While the 2026Q1 spike in FCF appears impressive, it is largely driven by working capital releases rather than sustainable operational improvements. The underlying trend suggests that without significant revenue stabilization, the company's ability to generate consistent free cash flow remains highly sensitive to the cyclical nature of healthcare staffing.
According to historical cash flow statements, AMN maintains a disciplined approach to capital expenditure, with CapEx/Revenue ratios consistently below 4%, suggesting that the business model does not require heavy reinvestment in physical assets to maintain its current service-oriented operations.
The low capital intensity is a positive feature, as it allows the company to preserve liquidity during periods of revenue contraction. However, investors should investigate whether this level of spending is sufficient to support the long-term technological integration required for the company's VMS and workforce solutions strategy.
As evidenced by the 2026Q1 data, where working capital changes contributed $409.4M to cash flow, AMN's liquidity is heavily dependent on the timing of receivables and payables, which may indicate significant volatility in the company's ability to collect from hospital clients facing their own financial pressures.
The reliance on working capital fluctuations to bolster cash flow suggests that the company's operational cash cycle is susceptible to external shocks in the healthcare sector. A reversal in these trends could rapidly tighten liquidity, warranting further investigation into the credit quality of the company's primary hospital client base.
Quick answers to the most common questions about buying AMN stock.
AMN Healthcare Services, Inc. (AMN) generated $269.5M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
AMN Healthcare Services, Inc. (AMN) generated $233.8M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
AMN Healthcare Services, Inc. (AMN) spent $35.6M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.