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Segment Information
 9 Months Ended
Sep. 30, 2020
Segment Reporting [Abstract]  
SEGMENT INFORMATION 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. Effective March 8, 2020, the Company modified its reportable segments. The Company previously utilized three reportable segments, which it identified as follows: (1) nurse and allied solutions, (2) locum tenens solutions, and (3) other workforce solutions. In light of the Company’s recent acquisitions and organizational changes to better align its organizational structure with its strategy and operations, the Company’s management reorganized its reportable segments to better reflect how the business is evaluated by the chief operating decision maker. Beginning in the first quarter of 2020, the Company has disclosed the following 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, rapid response nurse staffing and labor disruption, allied staffing, local 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 interpretation services, vendor management systems, workforce optimization, recruitment process outsourcing, credentialing, and flex pool management 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, which includes reclassified prior period data to conform to the new segment reporting structure, 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,
 2020201920202019
Revenue
Nurse and allied solutions$382,699 $398,417 $1,251,509 $1,139,883 
Physician and leadership solutions109,116 143,842 355,580 423,368 
Technology and workforce solutions59,816 25,338 155,354 71,964 
$551,631 $567,597 $1,762,443 $1,635,215 
Segment operating income
Nurse and allied solutions$52,923 $52,533 $173,706 $158,841 
Physician and leadership solutions15,538 17,547 45,432 52,280 
Technology and workforce solutions25,680 11,426 62,814 33,145 
94,141 81,506 281,952 244,266 
Unallocated corporate overhead16,490 21,857 76,223 61,093 
Depreciation and amortization26,936 17,085 69,096 41,513 
Depreciation (included in cost of revenue)481 — 981 — 
Share-based compensation3,772 2,825 15,046 11,713 
Interest expense, net, and other12,564 7,830 35,061 19,568 
Income before income taxes$33,898 $31,909 $85,545 $110,379 
The following tables present the Company’s revenue disaggregated by service type. Certain 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, 2020
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Temporary staffing$382,699 $95,648 $— $478,347 
Permanent placement— 13,468 — 13,468 
Outsourced workforce— — 38,159 38,159 
SaaS-based technologies— — 21,657 21,657 
Total revenue$382,699 $109,116 $59,816 $551,631 
Three Months Ended September 30, 2019
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Temporary staffing$398,417 $123,540 $— $521,957 
Permanent placement— 20,302 — 20,302 
Outsourced workforce— — 4,643 4,643 
SaaS-based technologies— — 20,695 20,695 
Total revenue$398,417 $143,842 $25,338 $567,597 
Nine Months Ended September 30, 2020
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Temporary staffing$1,251,509 $310,945 $— $1,562,454 
Permanent placement— 44,635 — 44,635 
Outsourced workforce— — 87,705 87,705 
SaaS-based technologies— — 67,649 67,649 
Total revenue$1,251,509 $355,580 $155,354 $1,762,443 
Nine Months Ended September 30, 2019
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Temporary staffing$1,139,883 $364,551 $— $1,504,434 
Permanent placement— 58,817 — 58,817 
Outsourced workforce— — 12,435 12,435 
SaaS-based technologies— — 59,529 59,529 
Total revenue$1,139,883 $423,368 $71,964 $1,635,215 
In connection with the reorganization of its reportable segments effective March 8, 2020, the Company reassigned the goodwill balances to the reporting units, the composition of which changed under the reorganized reportable segments, using the relative fair value reallocation approach. The Company performed a goodwill impairment test at the reporting unit level both immediately before and after the reorganization. The Company determined the fair values of its reporting units using a combination of the income approach (using discounted future cash flows) and the market valuation approach. Based on the results of this testing, the Company determined that the fair values of its reporting units were each greater than their respective carrying values both before and after the reorganization. Therefore, there was no impairment loss recognized during the nine months ended September 30, 2020.
The following table summarizes the activity related to the carrying value of goodwill by reportable segment:
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Balance, January 1, 2020$344,316 $163,348 $87,887 $595,551 
Goodwill adjustment for Advanced acquisition29 — — 29 
Goodwill adjustment for b4health acquisition— — (66)(66)
Goodwill from Stratus Video acquisition— — 274,427 274,427 
Reallocation due to change in segments(14,600)297 14,303 — 
Balance, September 30, 2020$329,745 $163,645 $376,551 $869,941 
Accumulated impairment loss as of December 31, 2019 and September 30, 2020$154,444 $60,495 $— $214,939