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Q2 2019 Investor Relations Presentation
PROPRIETARY & CONFIDENTIAL 2
This presentation contains forward-looking statements. Statements that are predictive in nature, that depend upon or refer
to future events or conditions or that include words such as “expects”, “anticipates”, “intends”, “plans”, “believes”,
“estimates”, “appears”, “seeks”, “will” and variations of such words and similar expressions are intended to identify
forward-looking statements.
These statements involve known and unknown risks, uncertainties and other factors that may cause our actual results and
performance to be materially different from any future results or performance expressed or implied by these forward-
looking statements. Factors that might cause such differences include, but are not limited to, those discussed in the Risk
Factors section of our Annual Report on Form 10-K for the year ended December 31, 2017, and our other Securities and
Exchange Commission filings made prior to the date hereof.
Although we believe that these statements are based upon reasonable assumptions, we cannot guarantee future results
and readers are cautioned not to place undue reliance on these forward-looking statements, which reflect management’s
opinions only as of the date of this filing. There can be no assurance that (i) we have correctly measured or identified all of
the factors affecting our business or the extent of these factors’ likely impact, (ii) the available information with respect to
these factors on which such analysis is based is complete or accurate, (iii) such analysis is correct or (iv) our strategy, which
is based in part on this analysis, will be successful. The Company undertakes no obligation to update or revise forward-
looking statements.
Forward Looking Statements
PROPRIETARY & CONFIDENTIAL 3
Cross Country Healthcare Today
Where We Are Headed




Marketplace Dynamics and Evolution
Financials
Agenda
PROPRIETARY & CONFIDENTIAL 4
1986 Cross Country Healthcare Founded
Proud History
198
6
1998
1999
1st MSP and 1st Joint Venture
2001 IPO listing on
2013-
2015
Acquisitions to diversify service
offering
2017
Became the largest provider of
Per Diem Staffing in the U.S
2018
Became a market leader in workforce
solutions with record MSP wins
.
• Joint Commission Certified
• Trusted Partner Committed to Quality
• Dedicated Clinical Team of RNs
• Delivering value through TTM offering
PROPRIETARY & CONFIDENTIAL 5
Who We Are
• Full national coverage through our large branch network
• 80+ MSP programs serving more than 3,000 facilities
• More than 30,000 healthcare professionals on assignment at
more than 6,700 facilities in the last 12 months
• Tenured and experienced leadership
Physician Staffing Search
Nurse &
Allied Staffing
$816M
2%
Measurable
Results
Solutions
FINANCIAL
STABILITY
YEARS
33
Comprehensive
Nurse & Allied Physician Staffing Search
88%
10%
PROPRIETARY & CONFIDENTIAL 6
SUPPORTED BY A STRONG FOUNDATION OF INNOVATIVE TECHNOLOGIES
Strategic Solutions Search SolutionsContingent Solutions
How We Go To Market: Total Talent Management Solution
• MSP, IRP, VMS
• Optimization:
 HR & TA Process
 Demand Planning & Scheduling
 Predictive Labor Management
• Outsourcing & Joint Ventures
• Direct Staffing (Per Diem, Travel,
Allied, Locums, AP, NP)
• EMR Staffing
• Educational Staffing
• Retained Search
• Contingent Search
• Executive/Leadership Search
• Recruiter on Demand
• Subscription-based Search
PROPRIETARY & CONFIDENTIAL 7
Delivering Value Across the Landscape
Our
Clients
Our
Candidates
Our
Operations
Our
People
 Coverage
 Capacity
 Effectiveness
 Attraction
 Conversion
 Retention
 Efficiency
 Standardization
 Automation
 Productivity
 Performance
 Accountability
• Drive client engagement and satisfaction with a dedicated
account management and a value-based sales approach
• Capitalize on cross-selling opportunities leveraging the full suite
of value-add services
• Enhance the total candidate experience, leading to higher
placements and renewals
• Expand the pool of healthcare professionals through efficient
and cost-effective sources
• Metrics driven, performance-based culture
• Increase the speed to full-productivity for all revenue producing
employees
• Streamline and improve core processes for efficiency and
scalability
• Improved operating leverage driving higher profitability
Focus Areas Goals
PROPRIETARY & CONFIDENTIAL 8
Continued Expansion of Managed Service Programs (MSP)
Expanding customer relationships represent significant opportunity for growth with increased spend
under management, new cross-selling opportunities and improved capture rates
2,850+ ambulatory care and other
healthcare facilities
9,600+ Healthcare Professionals in 250+ clinical
and non-clinical specialties placed
135,000+ Travel Assignments and
Per Diem Shifts were filled
80+ MSP Clients at 300+ acute
care facilities
Significant growth in number of MSPs
and Spend Under Management
PROPRIETARY & CONFIDENTIAL 9
• Provides platform for winning MSPs
• Supports the growth in ambulatory &
outpatient services
• Trend towards MSP contracting requires
partners with national scale
• National presence increases brand awareness
and enhances appeal to healthcare
professionals
• Provides opportunity for cross-selling
additional capabilities through existing
channels
Strength of a National Footprint
 Cross Country Healthcare Locations
~75 Locations across the U.S.
National Presence with Local Expertise
PROPRIETARY & CONFIDENTIAL 10
Healthcare Staffing Market Overview
• Market projected to grow by mid single digits in 2018 and 2019 reaching ~$17.5B by 2019
• CCH enjoys a strong presence in each segment
Source: SIA April 8, 2019
• Size: $5.3B
• Growth: 1%
• Market Share: 7%
• Rank: 3
32%
21%
• Size: $3.5B
• Growth: 2%
• Market Share: 6%
• Rank: 1
24%
• Size: $4.0B
• Growth: 7%
• Market Share: 4%
• Rank: 5
24%
• Size: $4.0B
• Growth: 4%
• Market Share: 2%
• Rank: 6
Per Diem generally represents nurse assignments for individual shifts;
Allied includes healthcare professionals other than doctors or nurses
PROPRIETARY & CONFIDENTIAL 11
Who we serve…
PROPRIETARY & CONFIDENTIAL 12
Market Dynamics
• Tech enabled services and data analytics are gaining adoption
• Gig economy requires agile and mobile solutions
• Increased utilization of systems to attract candidates and interact with
clients
• Predictive Intelligence, Real Time Dashboards, Artificial Intelligence, are
all gaining momentum
• Supply Constrained Environment both nationally and in key markets
• New and emerging roles within hospitals such as care coordinators,
documentation specialists, experience officers and telehealth specialties
• Healthcare staffing buyers are traditionally less “strategic” in their use of
contingent labor reacting to temporary shortages rather than managing
temp labor as part of a broader workforce plan
• Significant cost pressure
• Fee for value environment with higher emphasis on quality care and
patient experience
• Increased Adoption of strategic staffing partnerships such as MSPs on
the rise and favor larger players
• Shift from acute to outpatient and ambulatory care centers
 Expect 16% growth in outpatient volume in next 10 years
 Outpatient care accounts for 60% of hospital revenue
 Lower acuity urgent visits are expected to decline by 2% in the next 5
years, shifting to lower cost facilities
Supply & Demand
General Trends Technology
• 75M baby boomers now over 50 years of age (25% of population), of
which, 80% have at least one Chronic condition
• Americans ≥ 65 years. to grow ~39% by 2020 and consume 3x-4x as
much healthcare
• 1/3 of the current RNs will reach retirement in next 10 years
• 700K physicians in the US under the age of 75
• 30% of workforce comprised of physicians aged 55 to 75
• 70,000 nurses retiring annually
• 73% of baby boomer nurses plan to retire in 3 years or less
Aging Demographics
PROPRIETARY & CONFIDENTIAL 13
Implications for Health Systems and Clinicians
• More technology savvy
• Preference towards high quality care environments
• Require improved experience with service
providers, enabled by latest technology
• Prefer flexible schedules and seek to select
employment based on multiple options
• Seek opportunities that offer competitive
compensation packages with benefits
• Millennials change jobs more frequently and tend
to work less hours than older nurses, creating
unplanned vacancies
• New Delivery Models Shift Risk to Providers
• Redefining Healthcare and Care Coordination
• Retail-Based Model Improving Access & Cost
• Independent Physicians Aligning with
Hospitals/Payors
• Hospitals Taking control of Continuum of Care
• Wellness Programs Gaining Momentum
• Greater Financial Responsibility Shifting to
Consumers
• IT Adoption is Critical for Healthcare Industry
Health Systems Clinicians
PROPRIETARY & CONFIDENTIAL 14
Transforming to a Total Talent Management Solution
• Primary focus on staff
augmentation
• Dominant position in MSP space
• High concentration in traditional
staffing services
• Multi-brand go-to-market
approach
• Aging technology solutions
PAST
• Embrace value-add service environment and
diversify offering
 Consultative/advisory/strategic solutions
 Predictive analytics
 Recrtuitment Process Outsoucting (RPO)
 Internal Resource Pool (IRP)
 Dashoards and Data Intelligence
• Flexible, dynamic technology solutions
 Create best in class experience for our HCPs and Clients
 Empower our clients with real time dasbhoards and
businesses intelligence tools
• Focus on Brand Value
• Foster entrepreneurial and innovative
environment
FUTURE
PROPRIETARY & CONFIDENTIAL 15
Top Priorities
Expand and Diversify Offering
Invest in higher margin services
Further penetration of value-add offering
Full adoption of Total Talent Management Solution
Become the Premier
Preferred Staffing
Partner of Choice
Grow Scale and Market Share
Grow Spend Under Management
Ensure high fill rate for our clients
Increase Capture Rate
Improve new customer acquisition
Innovate and modernize
Infuse technology and automate processes
Create an exceptional candidate experience
Strengthen client relationships
Achieve Consistent and Sustainable Growth
Achieve organic top line growth at or above market
Improve operating leverage
Aggressive cost reduction
Strengthen cost control and collection measures
Improve liquidity
PROPRIETARY & CONFIDENTIAL 16
Financial Summary
Financial Summary
($ in millions)
Q2 2019
Actuals
Q3 2019 Guidance
(Low – High)
Revenue $202.8M $200M - $205M
Gross Margin % 25.4% 24.50% - 25.00%
Adj EBITDA $ $6.3M $5.5M - $6.5M
PROPRIETARY & CONFIDENTIAL 17
Liquidity Profile
(a) Net Funded Debt at period end divided by Adj. EBITDA (on TTM basis)
(b) EBITDA less capital expenditures, taxes paid, and restricted payments divided by fixed charges (on TTM basis)
• Targeted Investments
• Debt Repayment
• Strategic Acquisitions
Capital Allocation
Strategy
As of 6/30/19
($ in millions)
Cash Flow form Operations (YTD) $25M
Term Loan Outstanding $71M
Cash & Cash Equivalents $25M
Net Funded Debt $47M
Total Net Leverage Ratio
(a)
~1.9x
Fixed Charge Coverage Ratio
(b)
~1.6x
Appendix
PROPRIETARY & CONFIDENTIAL 19
This presentation references non-GAAP (Generally Accepted Accounting Principles) financial measures. Such non-GAAP financial measures are provided as
additional information and should not be considered substitutes for, or superior to, financial measures calculated in accordance with U.S. GAAP. Such non-
GAAP financial measures are provided for consistency and comparability to prior year results; furthermore, management believes they are useful to
investors when evaluating the Company's performance as they exclude certain items that management believes are not indicative of the Company's
operating performance. Such non-GAAP financial measures may differ materially from the non-GAAP financial measures used by other companies. The
financial statement tables that accompany our press releases include a reconciliation of each non-GAAP financial measure to the most directly comparable
U.S. GAAP financial measure and a more detailed discussion of each financial measure; as such, the financial statement tables should be read in conjunction
with the presentation of these non-GAAP financial measures.
This presentation also references pro-forma information which reflects the impact from acquisitions and divestitures as of the beginning of periods being
presented or compared.
Adjusted EBITDA is defined as net income (loss) attributable to common shareholders before interest expense, income tax expense (benefit), depreciation
and amortization, acquisition-related contingent consideration, acquisition and integration costs, restructuring costs, legal settlement charge, loss on sale of
business, impairment charges, gain on derivative liability, loss on early extinguishment of debt, other income, net, equity compensation, legacy system
replacement costs, and net income attributable to non controlling interest in subsidiary.
Adjusted Earnings Per Diluted Share (EPS) is defined as net income (loss) attributable to common shareholders per diluted share before the diluted EPS
impact of acquisition-related contingent consideration, acquisition and integration costs, restructuring costs, impairment charges, (gain) loss on derivative
liability, loss on early extinguishment of debt, legacy system replacement costs, and nonrecurring income tax adjustments.
Non-GAAP Financial Measures
Ccrn q2 2019 investor presentation final

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Ccrn q2 2019 investor presentation final

  • 1. Q2 2019 Investor Relations Presentation
  • 2. PROPRIETARY & CONFIDENTIAL 2 This presentation contains forward-looking statements. Statements that are predictive in nature, that depend upon or refer to future events or conditions or that include words such as “expects”, “anticipates”, “intends”, “plans”, “believes”, “estimates”, “appears”, “seeks”, “will” and variations of such words and similar expressions are intended to identify forward-looking statements. These statements involve known and unknown risks, uncertainties and other factors that may cause our actual results and performance to be materially different from any future results or performance expressed or implied by these forward- looking statements. Factors that might cause such differences include, but are not limited to, those discussed in the Risk Factors section of our Annual Report on Form 10-K for the year ended December 31, 2017, and our other Securities and Exchange Commission filings made prior to the date hereof. Although we believe that these statements are based upon reasonable assumptions, we cannot guarantee future results and readers are cautioned not to place undue reliance on these forward-looking statements, which reflect management’s opinions only as of the date of this filing. There can be no assurance that (i) we have correctly measured or identified all of the factors affecting our business or the extent of these factors’ likely impact, (ii) the available information with respect to these factors on which such analysis is based is complete or accurate, (iii) such analysis is correct or (iv) our strategy, which is based in part on this analysis, will be successful. The Company undertakes no obligation to update or revise forward- looking statements. Forward Looking Statements
  • 3. PROPRIETARY & CONFIDENTIAL 3 Cross Country Healthcare Today Where We Are Headed     Marketplace Dynamics and Evolution Financials Agenda
  • 4. PROPRIETARY & CONFIDENTIAL 4 1986 Cross Country Healthcare Founded Proud History 198 6 1998 1999 1st MSP and 1st Joint Venture 2001 IPO listing on 2013- 2015 Acquisitions to diversify service offering 2017 Became the largest provider of Per Diem Staffing in the U.S 2018 Became a market leader in workforce solutions with record MSP wins . • Joint Commission Certified • Trusted Partner Committed to Quality • Dedicated Clinical Team of RNs • Delivering value through TTM offering
  • 5. PROPRIETARY & CONFIDENTIAL 5 Who We Are • Full national coverage through our large branch network • 80+ MSP programs serving more than 3,000 facilities • More than 30,000 healthcare professionals on assignment at more than 6,700 facilities in the last 12 months • Tenured and experienced leadership Physician Staffing Search Nurse & Allied Staffing $816M 2% Measurable Results Solutions FINANCIAL STABILITY YEARS 33 Comprehensive Nurse & Allied Physician Staffing Search 88% 10%
  • 6. PROPRIETARY & CONFIDENTIAL 6 SUPPORTED BY A STRONG FOUNDATION OF INNOVATIVE TECHNOLOGIES Strategic Solutions Search SolutionsContingent Solutions How We Go To Market: Total Talent Management Solution • MSP, IRP, VMS • Optimization:  HR & TA Process  Demand Planning & Scheduling  Predictive Labor Management • Outsourcing & Joint Ventures • Direct Staffing (Per Diem, Travel, Allied, Locums, AP, NP) • EMR Staffing • Educational Staffing • Retained Search • Contingent Search • Executive/Leadership Search • Recruiter on Demand • Subscription-based Search
  • 7. PROPRIETARY & CONFIDENTIAL 7 Delivering Value Across the Landscape Our Clients Our Candidates Our Operations Our People  Coverage  Capacity  Effectiveness  Attraction  Conversion  Retention  Efficiency  Standardization  Automation  Productivity  Performance  Accountability • Drive client engagement and satisfaction with a dedicated account management and a value-based sales approach • Capitalize on cross-selling opportunities leveraging the full suite of value-add services • Enhance the total candidate experience, leading to higher placements and renewals • Expand the pool of healthcare professionals through efficient and cost-effective sources • Metrics driven, performance-based culture • Increase the speed to full-productivity for all revenue producing employees • Streamline and improve core processes for efficiency and scalability • Improved operating leverage driving higher profitability Focus Areas Goals
  • 8. PROPRIETARY & CONFIDENTIAL 8 Continued Expansion of Managed Service Programs (MSP) Expanding customer relationships represent significant opportunity for growth with increased spend under management, new cross-selling opportunities and improved capture rates 2,850+ ambulatory care and other healthcare facilities 9,600+ Healthcare Professionals in 250+ clinical and non-clinical specialties placed 135,000+ Travel Assignments and Per Diem Shifts were filled 80+ MSP Clients at 300+ acute care facilities Significant growth in number of MSPs and Spend Under Management
  • 9. PROPRIETARY & CONFIDENTIAL 9 • Provides platform for winning MSPs • Supports the growth in ambulatory & outpatient services • Trend towards MSP contracting requires partners with national scale • National presence increases brand awareness and enhances appeal to healthcare professionals • Provides opportunity for cross-selling additional capabilities through existing channels Strength of a National Footprint  Cross Country Healthcare Locations ~75 Locations across the U.S. National Presence with Local Expertise
  • 10. PROPRIETARY & CONFIDENTIAL 10 Healthcare Staffing Market Overview • Market projected to grow by mid single digits in 2018 and 2019 reaching ~$17.5B by 2019 • CCH enjoys a strong presence in each segment Source: SIA April 8, 2019 • Size: $5.3B • Growth: 1% • Market Share: 7% • Rank: 3 32% 21% • Size: $3.5B • Growth: 2% • Market Share: 6% • Rank: 1 24% • Size: $4.0B • Growth: 7% • Market Share: 4% • Rank: 5 24% • Size: $4.0B • Growth: 4% • Market Share: 2% • Rank: 6 Per Diem generally represents nurse assignments for individual shifts; Allied includes healthcare professionals other than doctors or nurses
  • 11. PROPRIETARY & CONFIDENTIAL 11 Who we serve…
  • 12. PROPRIETARY & CONFIDENTIAL 12 Market Dynamics • Tech enabled services and data analytics are gaining adoption • Gig economy requires agile and mobile solutions • Increased utilization of systems to attract candidates and interact with clients • Predictive Intelligence, Real Time Dashboards, Artificial Intelligence, are all gaining momentum • Supply Constrained Environment both nationally and in key markets • New and emerging roles within hospitals such as care coordinators, documentation specialists, experience officers and telehealth specialties • Healthcare staffing buyers are traditionally less “strategic” in their use of contingent labor reacting to temporary shortages rather than managing temp labor as part of a broader workforce plan • Significant cost pressure • Fee for value environment with higher emphasis on quality care and patient experience • Increased Adoption of strategic staffing partnerships such as MSPs on the rise and favor larger players • Shift from acute to outpatient and ambulatory care centers  Expect 16% growth in outpatient volume in next 10 years  Outpatient care accounts for 60% of hospital revenue  Lower acuity urgent visits are expected to decline by 2% in the next 5 years, shifting to lower cost facilities Supply & Demand General Trends Technology • 75M baby boomers now over 50 years of age (25% of population), of which, 80% have at least one Chronic condition • Americans ≥ 65 years. to grow ~39% by 2020 and consume 3x-4x as much healthcare • 1/3 of the current RNs will reach retirement in next 10 years • 700K physicians in the US under the age of 75 • 30% of workforce comprised of physicians aged 55 to 75 • 70,000 nurses retiring annually • 73% of baby boomer nurses plan to retire in 3 years or less Aging Demographics
  • 13. PROPRIETARY & CONFIDENTIAL 13 Implications for Health Systems and Clinicians • More technology savvy • Preference towards high quality care environments • Require improved experience with service providers, enabled by latest technology • Prefer flexible schedules and seek to select employment based on multiple options • Seek opportunities that offer competitive compensation packages with benefits • Millennials change jobs more frequently and tend to work less hours than older nurses, creating unplanned vacancies • New Delivery Models Shift Risk to Providers • Redefining Healthcare and Care Coordination • Retail-Based Model Improving Access & Cost • Independent Physicians Aligning with Hospitals/Payors • Hospitals Taking control of Continuum of Care • Wellness Programs Gaining Momentum • Greater Financial Responsibility Shifting to Consumers • IT Adoption is Critical for Healthcare Industry Health Systems Clinicians
  • 14. PROPRIETARY & CONFIDENTIAL 14 Transforming to a Total Talent Management Solution • Primary focus on staff augmentation • Dominant position in MSP space • High concentration in traditional staffing services • Multi-brand go-to-market approach • Aging technology solutions PAST • Embrace value-add service environment and diversify offering  Consultative/advisory/strategic solutions  Predictive analytics  Recrtuitment Process Outsoucting (RPO)  Internal Resource Pool (IRP)  Dashoards and Data Intelligence • Flexible, dynamic technology solutions  Create best in class experience for our HCPs and Clients  Empower our clients with real time dasbhoards and businesses intelligence tools • Focus on Brand Value • Foster entrepreneurial and innovative environment FUTURE
  • 15. PROPRIETARY & CONFIDENTIAL 15 Top Priorities Expand and Diversify Offering Invest in higher margin services Further penetration of value-add offering Full adoption of Total Talent Management Solution Become the Premier Preferred Staffing Partner of Choice Grow Scale and Market Share Grow Spend Under Management Ensure high fill rate for our clients Increase Capture Rate Improve new customer acquisition Innovate and modernize Infuse technology and automate processes Create an exceptional candidate experience Strengthen client relationships Achieve Consistent and Sustainable Growth Achieve organic top line growth at or above market Improve operating leverage Aggressive cost reduction Strengthen cost control and collection measures Improve liquidity
  • 16. PROPRIETARY & CONFIDENTIAL 16 Financial Summary Financial Summary ($ in millions) Q2 2019 Actuals Q3 2019 Guidance (Low – High) Revenue $202.8M $200M - $205M Gross Margin % 25.4% 24.50% - 25.00% Adj EBITDA $ $6.3M $5.5M - $6.5M
  • 17. PROPRIETARY & CONFIDENTIAL 17 Liquidity Profile (a) Net Funded Debt at period end divided by Adj. EBITDA (on TTM basis) (b) EBITDA less capital expenditures, taxes paid, and restricted payments divided by fixed charges (on TTM basis) • Targeted Investments • Debt Repayment • Strategic Acquisitions Capital Allocation Strategy As of 6/30/19 ($ in millions) Cash Flow form Operations (YTD) $25M Term Loan Outstanding $71M Cash & Cash Equivalents $25M Net Funded Debt $47M Total Net Leverage Ratio (a) ~1.9x Fixed Charge Coverage Ratio (b) ~1.6x
  • 19. PROPRIETARY & CONFIDENTIAL 19 This presentation references non-GAAP (Generally Accepted Accounting Principles) financial measures. Such non-GAAP financial measures are provided as additional information and should not be considered substitutes for, or superior to, financial measures calculated in accordance with U.S. GAAP. Such non- GAAP financial measures are provided for consistency and comparability to prior year results; furthermore, management believes they are useful to investors when evaluating the Company's performance as they exclude certain items that management believes are not indicative of the Company's operating performance. Such non-GAAP financial measures may differ materially from the non-GAAP financial measures used by other companies. The financial statement tables that accompany our press releases include a reconciliation of each non-GAAP financial measure to the most directly comparable U.S. GAAP financial measure and a more detailed discussion of each financial measure; as such, the financial statement tables should be read in conjunction with the presentation of these non-GAAP financial measures. This presentation also references pro-forma information which reflects the impact from acquisitions and divestitures as of the beginning of periods being presented or compared. Adjusted EBITDA is defined as net income (loss) attributable to common shareholders before interest expense, income tax expense (benefit), depreciation and amortization, acquisition-related contingent consideration, acquisition and integration costs, restructuring costs, legal settlement charge, loss on sale of business, impairment charges, gain on derivative liability, loss on early extinguishment of debt, other income, net, equity compensation, legacy system replacement costs, and net income attributable to non controlling interest in subsidiary. Adjusted Earnings Per Diluted Share (EPS) is defined as net income (loss) attributable to common shareholders per diluted share before the diluted EPS impact of acquisition-related contingent consideration, acquisition and integration costs, restructuring costs, impairment charges, (gain) loss on derivative liability, loss on early extinguishment of debt, legacy system replacement costs, and nonrecurring income tax adjustments. Non-GAAP Financial Measures