AMERICAS RESEARCH REPORT MARKET SIZES AND FORECASTS

GLOBAL RESEARCH REPORT

US Healthcare Staffing Market Growth

Assessment 2025

Crystal Fullilove
Healthcare Staffing Analyst
crystal.fullilove@staffingindustry.com

July 24, 2025

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Author Title
Authoremail@staffingindustry.com

GLOBAL RESEARCH REPORT

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

About the Author

Crystal Fullilove
Healthcare Staffing Analyst

Crystal Fullilove is a healthcare staffing analyst at Staffing Industry Analysts (SIA). Her research coverage
includes all aspects of healthcare staffing and workforce solutions. Crystal graduated summa cum laude from
Southern New Hampshire University with a Bachelor of Science in business administration and minor in
human resource management.
Prior to joining SIA, Crystal worked in human resources and healthcare staffing. She managed clinical
traveler programs as well as managed service providers (MSPs) for large health systems within the United
States.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Table of Contents
KEY FINDINGS .................................................................................................................................................................. 4
ECONOMIC & MACROECONOMIC FACTORS IMPACTING STAFFING DEMAND ................................................................. 5
Healthcare Labor as a Cost Driver and Economic Pressures ............................................................................................................................... 5
Growth in Outpatient Settings, Challenges in Residential Care .......................................................................................................................... 7
Acute Care Hospitals vs. Outpatient and Ambulatory Settings........................................................................................................................... 9
Hospital Bed Capacity and Staffing Shortages .................................................................................................................................................. 10
The Rising Toll of Rural Hospital Closures and Shrinking Care Access .............................................................................................................. 11
REGULATORY AND LEGISLATIVE TRENDS IN HEALTHCARE STAFFING ............................................................................ 12
Impact of the One Big Beautiful Bill Act on Healthcare Staffing ....................................................................................................................... 12
Physician Interstate Medical Licensure Compact Map ..................................................................................................................................... 15
WORKFORCE SUPPLY, DEMAND, AND SHORTAGES ....................................................................................................... 16
Navigating Healthcare’s Supply and Demand Imbalance ................................................................................................................................. 16
Education Pipeline Bottlenecks and Workforce Entry Concerns ...................................................................................................................... 17
Critical Occupational Shortage Areas and Skills Gaps ....................................................................................................................................... 19
Registered Nurse Employment Across the US .................................................................................................................................................. 20
Home Health and Personal Care Aides.............................................................................................................................................................. 21
Structural Labor Constraints Ahead .................................................................................................................................................................. 22
Use of AI and Automation in Sourcing, Credentialing, and Hiring (Front Office Software) .............................................................................. 23
AI Adoption Trends in Travel Nurse and Locum Tenens Staffing ...................................................................................................................... 26
HEALTHCARE EMPLOYMENT BY INDUSTRY GROUP ....................................................................................................... 29
Wage Data: Healthcare Practitioners & Technical Occupations (1/3) .............................................................................................................. 30
Wage Data: Healthcare Practitioners & Technical Occupations (2/3) .............................................................................................................. 31
Wage Data: Healthcare Practitioners & Technical Occupations (3/3) .............................................................................................................. 32

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Wage Data: Healthcare Support Occupations................................................................................................................................................... 33

HEALTHCARE SEGMENT MARKET INTELLIGENCE ........................................................................................................... 34
Ophthalmologists Lead All Surgical Specialties in Projected Growth ............................................................................................................... 35
SECTOR-SPECIFIC TRENDS: TRAVEL NURSING, PER DIEM, LOCUMS, AND ALLIED .......................................................... 37
Temporary Staffing: Healthcare Occupations ................................................................................................................................................... 37
Profitability Paths of AMN Healthcare and Cross Country Healthcare ............................................................................................................. 40
Inflation-adjusted Travel Nurse Bill Rates Remain Slightly Above Pre-Pandemic Levels.................................................................................. 42
Internal Staff Growth and Mix of Roles at Travel Nurse Staffing Firms ............................................................................................................ 43
MSP Travel Nurse Staffing Revenue Dominates, Standalone VMS Grows Slightly ........................................................................................... 44
Allied Health Temp Staffing Tops $2.3B in H1 2024, Led by 'Other' Occupations at 23.6% ............................................................................. 45
Majority of Allied Health Temp Staffing Managed Through MSP or VMS ........................................................................................................ 46
Per Diem as a Flexible, Cost-Effective Alternative to Travel Contracts............................................................................................................. 47
M&A Trends, Market Shifts, and Industry Consolidation (1/2) ........................................................................................................................ 48
M&A Trends, Market Shifts, and Industry Consolidation (2/2) ........................................................................................................................ 49
STAFFING TECHNOLOGY AND OPERATING MODELS ...................................................................................................... 50
Evolving Tech Stacks in Healthcare Staffing ...................................................................................................................................................... 50
Temporary Staffing Platforms: Structural Transformation ............................................................................................................................... 52
Legal and Market Realities in Healthcare Talent Platforms .............................................................................................................................. 53

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Key Findings
Healthcare staffing firms can use this
• Despite some normalization post-COVID, the US healthcare system continues to face record job
report to strategically adapt to market
openings and persistent labor shortages. Projected annual nurse job openings of 200,000 and a
physician shortfall of 86,000 by 2036 underscore continued demand for recruitment services shifts by aligning services, technology,
and contingent clinicians. and engagement models with evolving
• Employment in ambulatory care continues to grow robustly (+2.6% YoY), while hospital client needs and labor trends.
demand remains steady. Staffing firms should prioritize expanding placements in outpatient,
home health, and community-based roles, where flexibility and lower acuity drive clinician
Key opportunities include expanding
migration. per diem and allied health talent pools,
• As travel nurse long-term contracts remain relatively costlier, per diem staffing has emerged as supporting staffing mandates, and
a cost-effective, flexible alternative. App-based platforms are enabling more local gig-style targeting high-demand areas like rural
work and short-term contracts (4–8 weeks), attracting nurses seeking autonomy without hospitals, outpatient clinics, and
relocation.
behavioral health.
• Locum tenens is the only segment experiencing consistent growth (+6% forecast for 2025),
driven by aging physicians, demand for revenue-generating roles, and growing reliance on The report also outlines how AI,
nurse practitioners (+46.3% projected growth in the next decade) and physician assistants automation, and skills-based hiring can
(+28.5%).
modernize operations and improve
• Constraints in education, faculty shortages, immigration backlogs, and high turnover in entry- clinician experiences.
level roles (including CNAs, home health aides) are limiting clinician supply. In 2024 alone, over
65,000 qualified nursing school applicants were turned away. Staffing firms must explore new
pipelines and upskilling strategies.
• The One Big Beautiful Bill Act (OBBBA) preserves tax-free travel nurse stipends and extends key
tax deductions for staffing firms, both wins. However, new Medicaid work requirements may
reduce hospital funding if coverage loss drives up uncompensated care, especially in rural
areas.
• AI and automation are reshaping credentialing, sourcing, and onboarding. Mobile-first
platforms, shift optimization, and automated compliance tools are now vital for efficiency.
• Firms like AMN and Cross Country are pivoting toward diversified, tech-enabled solutions. M&A
activity continues as healthcare staffing firms consolidate and seek greater economies of scale
and network effects. The future belongs to staffing firms that combine tech, workforce
solutions, and a compelling clinician experience.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Economic & Macroeconomic Factors Impacting Staffing Demand

Healthcare Labor as a Cost Driver and Economic Pressures
Healthcare staffing demand is closely tied to 2024 US Hospital Expenses
macroeconomic conditions and hospital finances. Labor is
the single largest expense for healthcare providers, making
up over half of hospital operating costs. According to the 9%
American Hospital Association, in 2024, 56% of hospital
costs were labor related, as hospitals raised wages to attract
13%
and retain staff. These rising labor costs have collided with
broader economic headwinds as outlined below.
Inflation and expenses: General inflation spiked through
2021–2022, raising the cost of supplies and prompting
upward pressure on wages. From 2022 to 2024, general 56%
inflation rose 14.1%, but Medicare hospital payment rates 22%
increased only 5.1% during that period.
This created a reimbursement shortfall, squeezing hospital
margins. Expenses jumped by an estimated $135 billion in
2022 vs 2021, largely due to labor and supply cost increases.
With labor being a variable cost, many health systems
responded by reducing contract staff utilization or closing Drugs Supplies Other Labor
underutilized services to control expenses. Source: American Hospital Association, The Cost of Caring: Challenges Facing
America’s Hospitals in 2025
Hospital financial performance: Many hospitals offered
retention bonuses and pay raises to permanent staff (to mitigate
turnover), while negotiating lower traveler rates or capping agency usage after the peak of 2021 through 2022. Hospital margins
rebounded somewhat in 2023 as patient volumes returned, with a continued uptick in margins through March 2025 (3.3%). Before
the pandemic, hospital operating margins typically ranged from 3% to 4%, with 4% considered the threshold necessary for health
systems to both maintain daily operations and invest in future growth. On a year-to-date basis, hospital performance in the first four
months of 2025 compared favorably to the same time in 2024. Although reassuring, persistently narrow margins suggest that many
are still operating without long-term sustainability.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Medicare Advantage drives longer observation stays: A growing concern is the rise in uncompensated care and the competitive and
constrained labor market. For example, Medicare Advantage (MA) plans (that cover over 33 million people in the US and that have
doubled since 2010) have historically utilized extended “observation stays” as a cost containment strategy, allowing them to avoid
classifying patients as inpatients, and paying hospitals a lower rate. While this approach lowers costs for the plans, it shifts a
significant financial burden onto hospitals. Recent data indicates this trend is worsening. In 2019, MA beneficiaries experienced
observation stays that were 28.6% longer than those under Traditional Medicare; by 2024, the disparity had grown to 36.9%.
A rise in uncompensated care makes hospitals more budget conscious, which is likely to reduce their short-term demand and pricing
flexibility for temporary staffing. Nevertheless, longer patient stays may lead to higher staffing demand, particularly for flexible, short-
duration coverage solutions - a tailwind for healthcare staffing.

Median US hospital operating margin

3.7%

3.3%

2.9%
2.7%

1.9%

1.5% 1.5% 1.5%

1.4% 1.4%
1.3%
1.2%

May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25

Source: Kauffman Hall Operating Margin Index

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Growth in Outpatient Settings, Challenges in Residential Care

The graph to the right reflects employment by industry Percentage change year-over-year for healthcare and major subsectors
sector for 2024 versus 2023 and provides insights about
the performance of various healthcare settings.
4.9%
Ambulatory employment growth remained strong at 4.0% in
2024, only slightly down from 4.2% in 2023. Drivers of growth 4.1% 4.2%
3.9% 4.0%
include the ongoing transition from inpatient to outpatient 3.7%3.8% 3.8%
services which have a more cost-effective care model drawing
interest from both payers and providers. This growth has led
to higher demand for healthcare professionals that provide
preventative and routine care.
Hospitals experienced an uptick in growth from 3.7% in 2023
to 3.8% in 2024. The backlog of deferred care from the
pandemic continues to drive growth in the hospital setting, as
does the aging population and the prevalence of chronic
diseases that require ongoing management and treatment. In
Overall Ambulatory Hospitals Nursing,
areas like Med-Surg, ICU and ER, demand remains critical.
Healthcare Healthcare residential care
Employment growth in the nursing and residential care facilities
setting normalized down from 4.9% in 2023 to 3.8% in 2024.
2023 2024
The deceleration was driven in part by a shortage of
qualified and willing candidates for demanding direct Source: US Bureau of Labor Statistics
care roles, such as nursing assistants and aides. Compounding this issue are low wages, limited benefits, and challenging working
conditions in facilities already struggling with tight budgets and rising labor and supply costs. Many facilities are also reliant on
Medicaid, which limits flexibility in pay and hiring. Travel and per diem roles can be valuable but are more cost-sensitive than in acute
care.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Healthcare staffing firms should consider realigning efforts in 2025/26 to capitalize on growth in ambulatory care while sustaining
hospital staffing pipelines especially for critical care areas. Residential care settings require careful client evaluation, workforce
advocacy, and creative support strategies to remain viable. Staffing firms that specialize in flexibility, tech-enabled matching, and
clinician well-being will have a competitive edge across all sectors.

Setting Growth Outlook Workforce Challenges Profitability Strategic Priority

Ambulatory Care Higher Moderate High Expand placements

Hospitals (Acute) Moderate High (specialties) Moderate to High Maintain & optimize

Risk mitigation &

Nursing/Residential Lower Very High Low
advocacy

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Acute Care Hospitals vs. Outpatient and Ambulatory Settings

A significant trend in healthcare is the ongoing shift from hospitals to outpatient and community-based settings, which is driving new
staffing demands across the continuum of care:
Outpatient Growth Accelerates
Ambulatory care settings such as surgery centers, urgent care, clinics, and diagnostic centers are the fastest-growing areas of
healthcare employment. From 2013 to 2023, they added nearly 2 million jobs (31%), far outpacing hospital growth. The Bureau of
Labor Statistics projects that 71% of new healthcare jobs over the next decade will be in ambulatory care, which also includes the
home healthcare setting.
Impact on Hospitals
Hospitals are leaner, with shorter stays and sicker patients. While some roles have shifted out such as surgeries moving to ambulatory
surgery centers (ASCs), inpatient care now requires more staff per patient due to increased acuity. This has intensified perceived
shortages, even if total RN supply hasn't changed significantly.
Staffing Strains in Outpatient Settings
ASCs and clinics often use part-time or per diem staff, drawing nurses from hospitals with better hours and less stress. This workforce
shift causes retention issues in inpatient settings, while outpatient centers increasingly rely on staffing firms for roles like endoscopy
nurses or clinic nurse practitioners.
Emergency, Urgent Care, and Virtual Staffing
The growth of freestanding emergency departments and urgent care has increased demand for ED nurses and techs. These centers
often recruit hospital staff looking for lower acuity or shorter commutes. Meanwhile, telehealth is expanding, creating new roles like
virtual nurses and remote monitoring staff, with staffing firms now placing virtual clinicians in specialties like tele-ICU and tele-
pharmacy.
Cross-Training and Workforce Flexibility
Health systems are cross-training nurses to work in both inpatient and outpatient settings or transitioning inpatient nurses to
outpatient roles to retain them. For staffing firms, this opens new opportunities across both settings, requiring more flexible staffing
models.
Flexibility, cross-setting support, and tech-enabled deployment will be key to meeting future workforce needs.

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Hospital Bed Capacity and Staffing Shortages

The concept of a “hospital bed shortage” often refers not to a lack of physical beds, but to a shortage of staff to operate them.
According to the National Library of Medicine, persistently elevated hospital occupancy is driven by a 16% reduction in the number of
staffed US hospital beds rather than by a change in the number of hospitalizations. Experts in developed countries have posited that a
national hospital occupancy of 85% constitutes a hospital bed shortage and the US could reach this dangerous threshold as soon as
2032, with post–COVID-19 rates currently at 75.3%.
Higher Occupancy, Less Flexibility
At sustained high occupancy (especially ICUs), patient mortality increases due to delays in care. Without sufficient staff to support this
capacity, hospitals cannot expand services effectively. Staffing shortages become the bottleneck, making it harder to meet rising
demand and putting patient outcomes at risk.
Discharge Bottlenecks
Hospitals across the US continue to face significant discharge delays due to post-acute care staffing shortages especially in skilled
nursing facilities (SNFs) and home health agencies. These delays result in bed blockages, extended lengths of stay, and growing rates
of emergency department boarding.
According to the American Health Care Association, over 191,000 nursing home positions remain unfilled as of early 2024, nearly
matching the peak post-COVID shortages, with over 60% of nursing homes reporting that they have to turn away hospital discharge
referrals due to lack of staff.
Home health aide turnover exceeds 60% nationally, driven by low pay and high workload and although the Bureau of Labor Statistics
projects 21% growth in home health and personal care jobs from 2023 to 2033, wages have not kept pace, making recruitment
difficult. Many home health agencies report waitlists or refusal of new cases due to staffing shortfalls, especially for patients requiring
skilled nursing.
Hospitals have reported record levels of ED boarding in 2024, particularly for patients awaiting skilled nursing facility or home care
placement. According to the American College of Emergency Physicians, patients now spend an average of 8-12 hours boarding in EDs
after admission decisions, with longer stays for complex discharge cases.
Long term Outlook
If staffing improves, closed beds can reopen. But by 2030, population growth may outpace physical hospital capacity unless new
facilities are built. For now, solving the staffing shortage is the most immediate way to restore capacity. Staffing firms and flexible
workforce models remain essential to maintaining hospital readiness and preventing a future crisis.

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The Rising Toll of Rural Hospital Closures and Shrinking Care Access
The accelerating pace of rural hospital closures presents a US rural hospitals vulnerable to closure: 432
growing challenge to healthcare delivery, staffing continuity,
and labor deployment models. Over the past year alone, 18
rural hospitals either closed or transitioned to models
excluding inpatient care. Since 2010, 182 such facilities have
ceased traditional inpatient operations. According to the
Chartis Center for Rural Health, nearly half (46%) of rural
hospitals operate at a loss, with 432 deemed at risk of
closure which is an alarming signal of systemic fragility in
the rural health ecosystem.
The median operating margin for rural hospitals stands at
1.0%, compared to the national average of US hospitals
which was 4.9% in 2024 according to the Advisory Board.
Financial viability is particularly strained in states that have
not expanded Medicaid (10 states as of May 2025), where
rural facilities face steeper economic and care delivery
headwinds.
Conversely, the Affordable Care Act’s Medicaid Expansion expanded Source: Chartis, 2025 Rural Health State of the State
Medicaid coverage to nearly all adults with incomes up to 138% of
the Federal Poverty Level and provided states with an enhanced federal matching rate for their expansion populations. With Medicaid
expansion, more patients become insured which increases hospital admissions and service utilization increasing demand for
temporary, travel, and permanent placement services - who are in a better position to afford contract staffing.
As rural hospitals close or shift to outpatient models, demand for inpatient RNs, hospitalists, and acute care staff may decline in these
areas. Staffing firms dependent on rural inpatient placements, especially travel nurse and locum tenens roles, may face volume
declines. As patients travel farther for care, remaining hospitals (often larger regional centers) see higher patient loads, which can
spike staffing needs in those hubs, resulting in increased demand for contingent staff to meet increased patient volumes.
Meanwhile, the shift to outpatient care is driving demand for ambulatory, home-based, and virtual clinicians. Staffing firms that
adjust to meet evolving care delivery models can explore new avenues for labor deployment including recruitment that prioritizes
advanced practice providers, behavioral health, physical therapy, and other telehealth-ready roles

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Regulatory and Legislative Trends in Healthcare Staffing

Impact of the One Big Beautiful Bill Act on Healthcare Staffing
On July 4th, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law. Healthcare staffing leaders are likely to experience
several direct advantages from this legislation as outlined below.
Tax Relief and Financial Benefits. One of the most impactful provisions in the new legislation for healthcare staffing firms is the
permanent extension of the 20% deduction on pass-through business income, which was set to expire at the end of 2025. Many
healthcare staffing firms are structured as pass-through entities, such as S-corporations or LLCs, and without this extension, these
firms would have faced a substantial tax increase.
Tax-Free Status of Travel Nurse Stipends. A huge win for healthcare staffing firms is what was left out of the final Senate bill which
was a proposed measure to tax per diem stipends for travel healthcare professionals. Earlier drafts of the legislation had considered
eliminating the tax-free treatment of daily allowances for housing, meals, and incidentals which are core components of
compensation packages for travel nurses. Thanks to strong opposition from industry advocates such as the American Staffing
Association, the proposal was removed maintaining a critical financial incentive that supports both the mobility of travel nurses and
the competitiveness of staffing firms.
Medicaid Work Requirements. The new law introduces work requirements for certain Medicaid recipients: specifically, able-bodied
adults without dependents, requiring them to work, train, or volunteer to retain coverage. This law creates a potential upside and risk
to staffing demand. The upside for staffing firms is that the policy could expand the entry-level labor pool, particularly for roles in
lower wage healthcare support services, in which staffing firms may benefit by helping job seekers enter the workforce to maintain
their health coverage. However, a significant downside, and one voiced by the American Hospital Association is that up to 11.8 million
Americans could lose Medicaid coverage, leading to increased uncompensated care. Hospitals, especially in rural and underserved
areas, may respond with budget cuts, service reductions, and staff layoffs. Ultimately, this policy may increase supply while also
threatening hospital financial health. This could result in reduced demand for contingent workers.

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Other Regulatory and Legislative Trends Shaping Healthcare Staffing

Public policy is increasingly influencing the healthcare staffing sector, creating both challenges and opportunities for staffing firms.
Five major forces driving change in healthcare include:
Staffing Ratio Mandates:
States like California and Oregon are enforcing minimum nurse-to-patient ratios (including 1:2 in ICUs and 1:5 in med-surg). These
laws increase demand for clinical staff, often outpacing hospitals’ ability to hire full-time employees. As a result, hospitals turn to
staffing firms to quickly meet compliance deadlines. While beneficial for staffing firms, these laws tighten labor supply and inflate
wages, intensifying competition for talent.
Nursing Home Staffing Rules:
The Centers for Medicare and Medicaid finalized a total nurse staffing standard that requires long term care facilities to provide a
minimum of 3.48 Hours Per Resident Day (HPRD) of total direct nursing care to residents, of which at least 0.55 HPRD of care must be
provided by RNs and 2.45 HPRD of care provided by nurse aides. Facing a steep rise in required staffing levels, many facilities turned
to staffing firms to bridge staffing gaps, to avoid penalty provisions while permanent recruitment efforts increase.
Laws Regulating Temporary Healthcare Staffing Firms:
State legislatures and regulators have introduced laws that in some cases make it harder or more costly for staffing firms to operate.
There are currently 26 states with laws regulating temporary health care staffing agencies (up 2 states from last year - Delaware and
Kansas). While often well-intentioned, aiming to protect patients or prevent excessive markups, these regulations can limit market
flexibility and have prompted some staffing firms to rethink their presence in certain states. Key areas of concern include conversion
fees, reporting requirements, nurse staffing agency licensure, and health care services pool law.
Workforce Development Legislation:
Federal bills to expand residency slots, train more nurses, and support healthcare apprenticeships aim to address long-term
shortages. The Resident Physician Shortage Reduction Act of 2025 aims to increase the number of Medicare-funded residency
positions by 14,000 over seven years to address physician shortages. The Train More Nurses Act seeks to expand RN education by
directing the Department of Health and Human Services and Labor to assess current nursing grant programs and recommend
strategies to boost nursing school faculty particularly in underserved communities. The Department of Labor is committed to
expanding apprenticeship programs, including healthcare roles such as registered nurses and home health aides. These initiatives may
improve domestic supply over the next decade.

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Licensure Portability:
The expansion of the Nurse Licensure Compact (NLC) with 43 jurisdictions currently part of the NLC as shown below reduces
administrative friction for cross-state placements. However, non-compact states like California (no action) and New York (pending
legislation) hinder rapid deployment to these locations. Staffing firms benefit from compacts but must nevertheless maintain strong
compliance when placing clinicians across the country.

Nurse Licensure Compact participation by state

Source: National Council for State Boards of Nursing, July 2025

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Physician Interstate Medical Licensure Compact Map

The Interstate Medical Licensure Interstate Medical Licensure Compact participation by state
Compact (IMLC) is an agreement
among participating US states and
territories to work together to
significantly streamline the licensing
process for physicians who want to
practice in multiple states.
The Compact currently includes 41
states, plus Washington D.C and
Guam. In these jurisdictions,
physicians are licensed by 50
different medical and osteopathic
boards.
Traditional licensing processes can
take weeks or months when
physicians apply to each state
individually. With the IMLC, qualified
physicians can obtain licensure in
multiple states simultaneously
through a centralized process,
cutting processing times significantly
(often within days to weeks).
This accelerates deployment of
physicians to new assignments,
enabling faster fulfillment of client Source: Interstate Medical Licensure Compact, July 2025
needs especially valuable during
surges in demand like flu seasons,
pandemics, or local staffing
shortages.

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Workforce Supply, Demand, and Shortages

Navigating Healthcare’s Supply and Demand Imbalance
The US healthcare system continues to face an intense workforce Job openings in healthcare and social assistance (thousands)
shortage, presenting both challenges and opportunities for staffing
firms.
2036
As the spread between job orders and hires continues, as seen on
1787
the graph, a prime opportunity is presented for healthcare staffing
1541 1470
firms. 1434
1272
Record Job Openings. Healthcare job openings surged to over 1.7
million in 2021, far above the pre-pandemic average of 1 million 855 839
775 730 762
according to the Bureau of Labor Statistics. While hiring rose, high 636 655
vacancy rates persisted, especially in nursing and support roles. By 441
2023, hospitals still reported RN vacancies above 10–15%, and long-
term care saw caregiver vacancy rates exceeding 20%. Staffing firms
became essential stopgaps, filling critical roles when internal
2019 2020 2021 2022 2023 2024 2025
recruitment fell behind.
Rising Patient Volumes. Demand rebounded sharply in 2022 Job Openings Hires
through 2023 with the return of elective procedures and an
Source: Bureau of Labor Statistics
aging population driving higher utilization. Healthcare
employment surpassed pre-pandemic levels, and inpatient occupancy rose to 75.3% (up from 64% pre-pandemic), leaving little excess
resources or capacity. This led to intense reliance on contingent workers to meet surges and acuity driven staffing needs.
Persistent Labor Shortages Remain. The Association of American Medical Colleges projects a deficit of 86,000 physicians by 2036 and
the Bureau of Labor Statistics (BLS) projects nearly 200,000 nurse openings annually through 2033. The BLS projects acute shortages
in health and support roles including lab techs, surgical techs, radiology, respiratory therapy, and behavioral health. Home
health/personal care aides are projected to grow by over 820,000 jobs through 2033, the largest of any occupation (more details can
be found on page 22).
Staffing firms operate in a dynamic environment. Demand is high, supply remains constrained, and labor gaps are geographically
uneven. This creates opportunities for firms providing flexible, rapid-deployment models. However, talent competition is intense and
necessitates aggressive recruitment, retention, and strategic workforce deployment to stay competitive.

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Education Pipeline Bottlenecks and Workforce Entry Concerns

The graph to the right shows a notable rise in the
New RN Graduates, 2019-24
number of new RN graduates in the US from 2019 to 250,078
2023, peaking at 250,078 in 2023, followed by a slight 232,754
decline to 232,754 in 2024. Compared to 2019, the
higher graduation volume presents an opportunity for 203,834
191,964
staffing firms to build pipelines of early-career nurses, 183,682 182,611
however, the 2024 decline suggests some volatility as
well.
Ensuring a robust pipeline of new healthcare workers is
the long-term solution to staffing shortages. However,
education and training constraints pose serious threats.
According to the American Association of Colleges of
Nursing (AACN), US nursing schools turned away over
65,000 qualified applicants between 2022 and 2023 due
to faculty shortages, limited clinical sites, and budget
constraints. Graduate nursing programs also rejected 2019 2020 2021 2022 2023 2024
nearly 10,000 qualified candidates, threatening future
supply of nurse practitioners, educators, and leaders. Source: National Council of State Boards of Nursing
Physician shortages are similarly constrained by
outdated Medicare caps on residency slots, leaving thousands of US and international medical graduates unmatched annually.
Allied health roles such as lab and radiology technologists face undersupply due to funding cuts to these institutions which are key in
allied health training and directly shrinks the pipeline. Entry-level support roles like CNAs and home health aides suffer from high
turnover, low pay, and a dwindling talent pipeline.
Immigration has historically helped close some of the workforce gaps, but visa backlogs prevent foreign-trained nurses and physicians
from entering the US. According to the Commission on Graduates of Foreign Nursing Schools (CGFNS) International’s 2024 Nurse
Migration Report, as of 2024, there were approximately 25,000 internationally educated nurses who passed the NCLEX and obtained
VisaScreen certification who were actively waiting for US employment-based visa numbers. While the number of VisaScreen
applications in 2024 declined by 4.6% from 2023’s peak, application levels remain nearly double (up 198%) those seen pre-pandemic.
This suggests there is a high demand for foreign-educated healthcare professionals, including nurses, to pursue international career

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

pathways. Disruptions to the nurse pipeline could significantly deepen workforce shortages, increase patient-to-nurse ratios, and
intensify burnout across the profession.
The faculty shortage is also a key issue as nursing professors are on average, older and lower-paid than their clinical counterparts,
making recruitment into academia difficult. According to the American Association of Colleges of Nursing’s Faculty Vacancy 2024
Report, the national faculty vacancy rate in 2024 was 7.9%, up from 7.8% in 2023, with 31% of positions unfilled for more than a year.
Recruitment barriers include noncompetitive salaries (cited by 93% of schools), limited teaching experience, and lack of faculty with
appropriate specialty mix (generalists and nurse practitioners experiencing the highest vacancy rates).
Education and immigration constraints will continue to support demand for contingent workers. For staffing firms, this presents both
opportunity and cost pressure. When the labor supply is tight, staffing firms must pay workers more, which raises bill rates for
hospitals. In addition to firms sourcing globally, they are tapping into non-traditional labor pools such as retirees willing to return
part-time, or travel nurses transitioning to per diem locally to increase supply.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Critical Occupational Shortage Areas and Skills Gaps

The health care and social assistance sector is Projected Employment Growth of Fastest Growing Occupations: 2023-2033P
projected to add 2.3 million jobs between 2023
and 2033, or over one-third of all new jobs and
Nurse practitioners 46.3%
grow the second fastest of any sector from 2023 to
Physician assistants 28.5%
2033, according to the Bureau of Labor Statistics
Physical therapist assistants 25.4%
(BLS). The two major healthcare occupations
within the healthcare sector include healthcare Occupational therapy assistants 22.3%
practitioners and technical workers and healthcare Home health and personal care aides 20.7%
support workers (more details on these Speech-language pathologists 18.4%
occupations can be found on page 22). Massage therapists 17.7%
Within the broad labor shortfall, certain Psychiatric technicians 17.1%
occupations and skill sets stand out as hot spots of Health information technologists 16.3%
shortage that heavily impact staffing. The graph to Genetic counselors 16.1%
the right is intended to serve as a resource for Orthotists and prosthetists 15.1%
healthcare staffing executives in prioritizing Diagnostic medical sonographers 15.1%
placements based on greatest demand over the Medical assistants 15.0%
decade. Projections for all occupations made by Hearing aid specialists 14.9%
the BLS can be obtained in the Occupational Source: US14.2%
Bureau of Labor Statistics
Physical therapists
Outlook Handbook.
Ophthalmic medical technicians 14.1%
Targeted clinical skill shortages are driving Respiratory therapists 13.1%
sustained demand for staffing firms, especially Athletic trainers 12.7%
those able to recruit in high-need specialties,
support upskilling, or those who can source talent
across disciplines and geographies. However, staffing firms must now Source: US Bureau of Labor Statistics
balance aggressive recruitment with workforce sustainability, as
overreliance on temporary staffing puts a strain on health systems financially. Strategic collaboration and specialty pipeline
development will differentiate firms in a constrained worker environment.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Registered Nurse Employment Across the US

States with the highest employment Employment of registered nurses by state, May 2024
levels of registered nurses are
outlined in the map to the right.
The top 5 states with the highest
levels of employed registered nurses
are:
• California (326,720)
• Texas (261,050)
• Florida (218,100)
• New York (204,120)
• Pennsylvania (146,840)
The top 5 industries with the highest
level of employment for Registered
Nurses:
• General Medical and Surgical
Hospitals (1,843,130) Source: US Bureau of Labor Statistics

• Offices of Physicians (221,620)

• Home Health Care Services
(187,670)
• Outpatient Care Centers (166,840)
• Nursing Care Facilities
(Skilled Nursing Facilities)
(133,240)

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Home Health and Personal Care Aides

Healthcare and social assistance is projected to have the largest growth and be the fastest growing industry sector (+1.0 percent
annually) according to the Bureau of Labor
Statistics. Employment growth in the health care Compound annual rate of change, projected 2023-2033P
and social assistance sector is expected to be
Healthcare and social assistance; private 1.0%
driven by both the aging population and a higher
Professional and business services 0.7%
prevalence of chronic conditions, such as heart
Information 0.7%
disease, cancer, and diabetes.
Utilities 0.6%
Healthcare support occupations and healthcare Transportation and warehousing 0.6%
practitioners and technical occupations are Construction 0.5%
projected to be among the fastest growing of all Leisure and hospitality 0.5%
occupational groups, growing 15.2% and 8.6%, Other services (except public administration) 0.4%
respectively, from 2023 to 2033. Financial activities 0.4%
Within the healthcare support occupations Wholesale trade 0.3% Total, all industries = 0.4%
category, home health aides and personal care Agriculture, forestry, fishing, and hunting 0.1%
aides are projected to experience the largest Manufacturing 0.1%
increase in new jobs - 718,900 openings for these State and local government 0.1%
positions each year, on average, during this period Educational services; private 0.1%
- according to the Bureau of Labor Statistics. Mining, quarrying, and oil & gas extraction 0.0%
Federal government 0.0%
The growing elderly population, which typically has
Retail trade -0.2%
increased healthcare needs compared to younger
groups, will in turn increase demand for caregiving Source: US Bureau of Labor Statistics
and therapy services. Several of the healthcare occupations with the
fastest projected employment growth - such as nurse practitioners and physician assistants - can assist various healthcare providers
with meeting this growing demand. These occupations are key members of team-based healthcare systems and may reduce the cost
of delivery of several healthcare services. More information can be found on page 37.
For healthcare staffing firms, this suggests long-term, consistent demand across a wide range of roles. Firms may wish to consider
investments in scalable recruiting operations and candidate pipelines - spanning technology, partnerships, internal capabilities, and
talent engagement strategies - to meet growing client needs, especially in aging populations and chronic care support.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Structural Labor Constraints Ahead

The US economy is projected to add 6.7 million jobs from Population and labor force levels, 16 years and older, (millions)
2023 to 2033, according to the US Bureau of Labor
Statistics (BLS). As indicated on the previous page, total 283.3
employment is projected to increase to 174.6 million and 266.9
245.7
grow 0.4% annually, which is slower than the 1.3% annual
221.2
growth recorded over the 2013 to 2023 decade.
Projected employment growth is driven by labor force 167.1 173.3
growth, which in turn is constrained by population 146.5 155.4
growth. Employment growth is limited by slowing
population growth. From 2023 to 2033, the US population
age 16+ will grow by 16.4 million to 283.3 million, as
shown on the graph to the right (nearly 5 million fewer
than the previous decade). Most growth will occur in
older age groups with low labor force participation,
driving the overall rate down from 62.6% to 61.2%. Male
2003 2013 2023 2033P
participation will continue its long-term decline, while
female participation will dip below its 1999 peak. 16 yrs and older (millions) Labor force (millions)
The shrinking US labor force driven by aging demographics, Source: US Bureau of Labor Statistics
declining male participation, and slowing population
growth signals a structurally tight labor market. Competition to source and retain clinicians will intensify, pushing up pay and bill
rates, and pressuring margins.
As labor tightens, the role of healthcare staffing firms becomes more critical but also more complex. Healthcare roles, especially those
requiring licensure or technical training, will be disproportionately affected due to high demand and burnout-driven attrition.
Differentiation through technology, candidate experience, and upskilling programs will be essential for long-term resilience.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Use of AI and Automation in Sourcing, Credentialing, and Hiring (Front Office Software)
According to SIA research AI and automation are increasingly transforming sourcing, credentialing, and hiring across the staffing
industry. In the healthcare staffing sector, the application of AI and automation is highly specialized due to the industry's regulatory
complexity, urgent demand patterns, and credentialing intensity. The following is a breakdown of how the technologies are applied
uniquely in this segment:
AI & Automation in Sourcing for Healthcare:
• High-Volume Talent Pools: AI-enabled front office platforms continuously source candidates from job boards, resume
databases, and LinkedIn, then match them against healthcare job requirements based on certifications, shift preferences, and
location.
• Availability Matching: Some platforms use AI to predict which clinicians are likely to be available, factoring in previous shift
history and responsiveness to outreach (BlueSky, Avionté 24/7).
• Mobile-First Platforms: Vendors like WorkN and Symplr focus on mobile-native applications, enabling clinicians to self-
register, update profiles, and receive job alerts in real time.
Credentialing Automation in Healthcare:
• Automated License Checks: Solutions integrate directly with national/state licensing boards to verify RN/LPN credentials in
real time. Ceipal and LaborEdge have launched or expanded healthcare-focused modules to support this.
• Digital Document Handling: Platforms like BlueSky and symplrCTM provide digital upload, automated reminders for expiring
credentials, and approval workflows critical for compliance audits.
• Blockchain Experiments: Bubty and others are beginning to explore blockchain-based credentialing for tamper-proof
validation, still nascent but growing in interest.
Hiring Workflows in Healthcare:
• Auto-Scheduling & Shift Optimization: AI is used to suggest optimized shift rosters and match clinicians to shifts based on
preference, compliance, and availability. Ubeya and Avionté 24/7 offer advanced scheduling capabilities tailored to
healthcare shift complexity.
• Job Ad Personalization: Generative AI creates healthcare-specific job descriptions tailored to roles like ICU nurses, surgical
techs, or radiologists, enhancing candidate engagement.
• AI Chatbots for Candidate Engagement: Used to answer compliance-related questions, confirm availability, or guide clinicians
through onboarding. BlueSky and symplr have deployed such bots within their workflows.

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Other Examples of Process Innovations:

Bullhorn
• Bullhorn’s new "Amplify" initiative enhances AI-driven functionalities across the platform. This enables recruiters to tailor AI
usage (configuring when and where AI should assist in workflows such as candidate matching or screening) which is
particularly valuable in high-volume, compliance-intensive environments like healthcare staffing.
• Bullhorn’s mobile capabilities extend to scheduling, timekeeping, and credential management. Mobile features include
geofencing, push notifications, and digital timesheet approval, important for shift-based healthcare roles. These tools
increase engagement and reduce drop-offs in credentialing pipelines.
1Staff
• 1Staff features an upgraded mobile app for talent that is tightly integrated and administered from the front office. This
provides a streamlined user experience for candidates and allows for on-the-go job search, communication, and credential
management, all critical in healthcare’s high-turnover, shift-based staffing environment.
• Built on Microsoft Dynamics and Azure, 1Staff allows for workflow customization at the job level, enabling staffing firms to
tailor credentialing and hiring workflows to specific healthcare settings or state regulations.
ABD
• A standout feature is a dashboard that offers visibility into real-time mobile app chats from candidates, enhancing recruiter
responsiveness and candidate engagement.
• Responding to increased cloud adoption, ABD has enhanced business forecasting with Tableau-driven alerts and integrated
mobile onboarding with e-sign capabilities, crucial for remote credential and form management.
For staffing firms building their own AI enhanced tools, or using third party software, SIA’s Algorithm Auditing for Staffing Firms report
includes tailored checklists for staffing firms adopting or creating AI-enabled tools, covering legal defensibility, bias detection,
stakeholder communication, and readiness for upcoming regulation.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Key Vendors Active in Healthcare with AI Automation/Capabilities

Vendor Capabilities Notes on Healthcare Relevance

Advanced credentialing, mobile-first UX, shift scheduling, Purpose-built for healthcare; deep specialization in
BlueSky
T&A, AI-driven engagement compliance and credentialing
Automation sequencing, shift fulfillment, mobile worker High adoption in healthcare; 24/7 app supports clinician
Avionté (AviontéBOLD + 24/7)
app, integrated VMS engagement and fast redeployment
AI-driven sourcing, resume parsing, new healthcare- Expanded in 2024 to serve healthcare; includes license
Ceipal
specific product launched and document verification workflows
Credentialing and contingent talent management, Native to healthcare; used by hospitals and agencies for
SymplrCTM
compliance automation workforce oversight and risk mitigation
Front office platform designed for healthcare with Deep domain-specific workflows, real-time compliance
LaborEdge
integrated credentialing alerts
SPaaS model with shift scheduling, mobile-first Strong presence in per diem and nursing segments; used
WorkN / Ubeya
engagement, AI-assisted matching for flexible workforce scheduling
Generalist ATS/CRM used by many healthcare staffing
AI search (Textkernel), automation (Herefish),
Bullhorn firms; healthcare fit depends on partner integrations and
configurable workflows
custom configurations
Full front/mid/back office, credentialing, compliance Generalist system with strong healthcare adoption;
Automated Business Designs (ABD)
alerts, automation supports complex credentialing workflows
Built on Microsoft platform, configurable automations, Generalist platform used in multiple verticals; healthcare
1Staff
credential tracking via partners support via customization and Microsoft ecosystem tools
Salesforce-based, customizable modules, credential Generalist with healthcare use cases; relies on partners
TargetRecruit
management for full vertical functionality
CRM + ATS with built-in automation and compliance Healthcare-capable through customization; often paired
SmartSearch
tools with external credentialing tools

Source: SIA, Global Staffing Front Office Software Landscape 2025 Update, SIA, SPaaS Global Landscape
2024 Update, SIA, 2024 Middle and Back Office Landscape Report

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

AI Adoption Trends in Travel Nurse and Locum Tenens Staffing

In SIA’s May 2025 US Staffing Industry Pulse Survey, we asked participants to estimate the extent of usage of AI products/services by
segment at their staffing companies. In the travel nurse segment, AI is used the most in sales, marketing and IT. In the locum tenens
segment, AI is used the most in recruitment and marketing.
These benchmarks can guide prioritization of investments and set realistic expectations for ROI.

Extent of usage of AI product/service by primary skill segment

Sales & Recruitment/
Executive Finance & Information
AI usage Business Talent Marketing
Team Payroll Technology
Development Acquisition
Little to no
48% 29% 33% 67% 24% 19%
significant use
Healthcare – Travel Modest to
43% 67% 52% 33% 57% 57%
Nursing moderate use
(N = 21) Substantial to
game changing 10% 5% 14% 0% 19% 24%
use
Little to no
58% 50% 36% 92% 50% 58%
significant use
Healthcare – Locum Modest to
42% 33% 55% 8% 50% 42%
Tenens moderate use
(N = 11-12) Substantial to
game changing 0% 17% 9% 0% 0% 0%
use

Source: SIA, US Staffing Industry Pulse Survey Report, May 2025

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Healthcare Worker Expectations in 2025

Healthcare professionals’ priorities have shifted post pandemic and differ based on generation. To attract and retain talent,
employers and staffing firms must adapt to evolving expectations:
Flexibility & Work-Life Balance
Clinicians now prioritize balance over burnout. They want flexible schedules (including self-scheduling, part-time, gig shifts), longer
breaks between contracts, and seasonal roles. Rigid scheduling pushes workers away.
Competitive, Transparent Compensation
Pay must be fair, timely, and competitive. While the COVID-era rates have declined, they still remain higher than pre-pandemic levels
(although modestly when adjusted for inflation). Clinicians now expect sign-on and retention bonuses, shift differentials, student loan
repayment, and instant pay options. Robust benefits, including mental health and wellness support, are also essential.
Growth Opportunities & Respect
Feeling valued matters. Workers want recognition, a voice in decisions, and chances for advancement (including CEUs, tuition
reimbursement, career ladders). Staffing firms and hospitals are responding with development programs and appreciation initiatives.
Safe Work Environments
Clinicians expect protection from unsafe staffing ratios and workplace violence. Hospitals with strong safety measures and adequate
staffing are more attractive. Safety and support are now minimum expectations.
Mental Health & Culture
Burnout prevention and mental well-being are top priorities. Progressive employers offer counseling, mental health days, and
supportive work cultures. Culture now weighs heavily in job decisions even outweighing pay in some cases.
Scheduling Autonomy
Control over work hours is crucial. Nurses want input into their shifts, options for per diem work, and scheduling tools that give them
more autonomy. Flexibility is non-negotiable.
Location & Role Flexibility
Post-pandemic, many clinicians prefer non-traditional roles (such as remote, outpatient) and value geographic freedom. They want
careers that fit their lifestyle not long-term ties to a single hospital.

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Value Alignment
Younger workers want employers that reflect their values such as DEI, ethical leadership, community impact. Word-of-mouth and
online reputation matter, especially around how staff were treated during COVID.
Healthcare workers today demand more flexibility, fairness, and respect. Staffing firms and employers that listen, adapt, and support
their workforce will attract top talent. Those that don’t risk ongoing turnover and shortages.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Healthcare Employment by Industry Group

At a high level, total healthcare employment increased 3.8% from May 2024 to May 2025, according to the Bureau of Labor Statistics.
Employment in the ambulatory setting increased by 2.6% and hospitals increased by 3.4% (Note that hospital employment levels
reflect April Y/Y levels as May 2025 projections were not published as of the time of this report). Nursing and residential care facilities
experienced an increase of 3.3%.

Employment (thousands) seasonally

adjusted
Health Care Industries May. 24 May. 25P % change
Ambulatory 8,748 8,971 2.6%
Offices of Physicians 2,965 3,052 2.9%
Offices of Dentists 1,043 1,052 0.9%
Offices of Other Health Practitioners 1,225 1,284 4.8%
Outpatient Care Facilities 1,115 1,121 0.6%
Medical and Diagnostic Laboratories 309 304 -1.7%
Home Health Care Services 1,734 1,797 3.6%
Other Ambulatory Health Care Services 357 361 1.1%
Hospitals 5,521 5,709 3.4%
General Medical and Surgical Hospitals 5,040 5,222 3.6%
Psychiatric and Substance Abuse Hospitals 166 165 -0.4%
Specialty Hospitals (except Psych and Substance Abuse) 315 320 1.5%
Nursing and Residential Care Facilities 3,306 3,415 3.3%
Skilled Nursing Facilities 1,489 1,544 3.7%
Residential Intellectual and Developmental Disability 668 695 4.0%
Continuing Care Retirement Communities and Assisted Living 985 1,004 1.9%
Other Residential Care Facilities 163 173 6.1%

Source: US Bureau of Labor Statistics

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Wage Data: Healthcare Practitioners & Technical Occupations (1/3)

The supply and demand imbalance for healthcare professionals has resulted in a high degree of volatility in marketplace pay rates for
both temporary and permanent workers. Staffing firms may find it helpful to look at the annual pay rate data shared by the US Bureau
of Labor Statistics. In this case, the most recent data refers to May 2024, which can be viewed as a prior year baseline with respect to
current rates.
May 2024 detailed wage data: Healthcare Practitioners and Technical Occupations (1/3)
Average Percentiles
Occupation (SOC code)
Wage 10% 25% Median 75% 90%
Healthcare Practitioners and Technical Occupations (29-0000) $52.85 $22.85 $31.29 $40.94 $57.59 $85.03
Healthcare Diagnosing or Treating Practitioners (29-1000) $62.75 $32.33 $38.62 $48.48 $64.32 $104.91
Chiropractors (29-1011) $44.01 $21.47 $28.44 $37.87 $50.00 $72.11
Dentists (29-1020) $100.04 $40.64 $61.04 $85.54 * *
Dentists, General (29-1021) $94.33 $40.01 $60.29 $82.97 $105.95 *
Oral and Maxillofacial Surgeons (29-1022) $174.04 $39.89 * * * *
Orthodontists (29-1023) $122.48 $47.34 $66.02 * * *
Prosthodontists (29-1024) $124.80 $46.81 $111.54 * * *
Dentists, All Other Specialists (29-1029) $131.08 $31.04 $78.60 $108.54 * *
Dietitians and Nutritionists (29-1031) $36.49 $24.19 $29.88 $36.09 $41.33 $49.51
Optometrists (29-1041) $67.66 $33.01 $48.87 $63.86 $78.22 $100.00
Pharmacists (29-1051) $71.21 $55.50 $64.39 $72.04 $80.40 $90.77
Physician Assistants (29-1071) $65.62 $45.67 $54.52 $63.86 $76.60 $86.94
Podiatrists (29-1081) $77.31 $26.01 $42.30 $68.17 $102.23 (5) -
Therapists (29-1120) $46.51 $30.54 $37.84 $46.52 $52.71 $62.79
Occupational Therapists (29-1122) $47.97 $34.91 $39.39 $47.69 $53.76 $62.64
Physical Therapists (29-1123) $49.44 $36.25 $40.25 $48.66 $56.51 $63.74
Radiation Therapists (29-1124) $53.38 $37.55 $41.63 $49.01 $57.87 $68.09
Recreational Therapists (29-1125) $30.01 $18.13 $22.60 $27.52 $34.29 $44.97
Respiratory Therapists (29-1126) $40.55 $30.04 $33.27 $38.77 $45.95 $52.07
Speech-Language Pathologists (29-1127) $49.48 $31.87 $39.41 $48.67 $57.94 $66.02
Exercise Physiologists (29-1128) $27.78 $19.43 $23.18 $27.30 $31.24 $36.83
Therapists, All Other (29-1129) $35.19 $18.03 $23.22 $31.22 $40.67 $55.93
Veterinarians (29-1131) * * * * * *

Source: US Bureau of Labor Statistics

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Wage Data: Healthcare Practitioners & Technical Occupations (2/3)

May 2024 detailed wage data: Healthcare Practitioners and Technical Occupations (2/3)
Average Percentiles
Occupation (SOC code)
Wage 10% 25% Median 75% 90%
Registered Nurses (29-1141) $47.21 $32.17 $37.92 $44.79 $51.33 $64.14
Nurse Anesthetists (29-1151) $112.09 $70.01 $90.72 $107.45 * *
Nurse Midwives (29-1161) $61.93 $35.90 $50.49 $62.08 $71.02 $86.18
Nurse Practitioners (29-1171) $63.70 $47.36 $52.88 $62.18 $72.14 $81.71
Audiologists (29-1181) $45.81 $29.91 $36.89 $44.95 $52.79 $62.15
Physicians (29-1210) $133.01 $35.32 $67.30 * * *
Anesthesiologists (29-1211) $163.21 $63.79 $89.75 * * *
Cardiologists (29-1212) $211.06 $59.13 (5) - * * *
Dermatologists (29-1213) $170.36 $59.66 $85.95 * * *
Emergency Medicine Physicians (29-1214) $156.10 $60.33 $97.71 * * *
Family Medicine Physicians (29-1215) $124.57 $40.40 $81.44 * * *
General Internal Medicine Physicians (29-1216) $125.86 $36.29 $70.66 * * *
Neurologists (29-1217) $138.46 $40.86 $68.96 * * *
Obstetricians and Gynecologists (29-1218) $136.83 $47.35 $93.18 * * *
Pediatricians, General (29-1221) $107.74 $48.74 $77.79 $101.03 * *
Physicians, Pathologists (29-1222) $132.99 $46.13 $79.78 * * *
Psychiatrists (29-1223) $131.58 $37.59 $65.96 * * *
Radiologists (29-1224) $176.61 $40.55 $103.37 * * *
Physicians, All Other (29-1229) $123.16 $31.76 $41.11 $113.30 * *
Surgeons (29-1240) $173.15 $40.87 $96.15 * * *
Ophthalmologists, Except Pediatric (29-1241) $146.01 $51.80 $91.96 * * *
Orthopedic Surgeons, Except Pediatric (29-1242) $177.12 $43.28 $103.37 * * *
Pediatric Surgeons (29-1243) $217.20 $97.62 * * * *
Surgeons, All Other (29-1249) $182.77 $38.99 $84.53 * * *
Miscellaneous Healthcare Diagnosing Practitioners (29-1290) $45.85 $31.00 $38.31 $45.29 $49.60 $58.60
Acupuncturists (29-1291) $41.57 $20.11 $25.92 $37.39 $49.23 $68.77
Dental Hygienists (29-1292) $45.20 $32.20 $38.53 $45.37 $49.48 $57.83
Health Technologists and Technicians (29-2000) $30.03 $18.09 $22.12 $28.61 $36.40 $44.98
Clinical Laboratory Technologists and Technicians (29-2010) $31.38 $18.21 $22.30 $30.01 $38.50 $46.97
Diagnostic Related Technologists and Technicians (29-2030) $40.10 $24.34 $31.00 $38.69 $47.54 $56.46

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Wage Data: Healthcare Practitioners & Technical Occupations (3/3)

May 2024 detailed wage data: Healthcare Practitioners and Technical Occupations (3/3)
Average Percentiles
Occupation (SOC code)
Wage 10% 25% Median 75% 90%
Cardiovascular Technologists and Technicians (29-2031) $34.99 $18.21 $22.26 $32.34 $43.86 $52.20
Diagnostic Medical Sonographers (29-2032) $44.50 $31.22 $37.58 $42.95 $49.79 $59.18
Nuclear Medicine Technologists (29-2033) $47.98 $36.33 $39.88 $46.78 $52.14 $61.48
Radiologic Technologists and Technicians (29-2034) $37.96 $25.12 $30.16 $37.17 $44.26 $50.78
Magnetic Resonance Imaging Technologists (29-2035) $43.84 $31.66 $37.63 $42.52 $49.25 $58.15
Medical Dosimetrists (29-2036) $69.49 $52.90 $61.13 $67.31 $76.16 $84.69
Emergency Medical Technicians and Paramedics (29-2040) $23.26 $16.38 $18.25 $21.89 $27.09 $32.14
Emergency Medical Technicians (29-2042) $20.81 $15.25 $17.68 $19.53 $22.67 $27.52
Paramedics (29-2043) $28.30 $19.58 $23.21 $27.96 $31.35 $37.74
Health Practitioner Support Technologists and Technicians (29-2050) $24.81 $17.00 $18.79 $23.00 $29.09 $36.51
Dietetic Technicians (29-2051) $18.98 $13.62 $15.80 $17.89 $21.28 $25.21
Pharmacy Technicians (29-2052) $25.44 $18.69 $21.44 $23.72 $28.82 $35.04
Psychiatric Technicians (29-2053) $21.34 $15.92 $17.88 $20.13 $23.34 $28.12
Surgical Technologists (29-2055) $31.54 $21.00 $24.99 $30.21 $37.00 $42.99
Veterinary Technologists and Technicians (29-2056) $24.67 $19.43 $19.93 $22.97 $29.60 $30.88
Ophthalmic Medical Technicians (29-2057) $21.85 $16.65 $17.94 $21.36 $23.91 $29.17
Licensed Practical and Licensed Vocational Nurses (29-2061) $30.59 $23.15 $26.53 $29.80 $34.80 $38.20
Medical Records Specialists (29-2072) $26.05 $16.98 $19.30 $23.41 $29.92 $38.00
Opticians, Dispensing (29-2081) $22.59 $16.72 $18.13 $21.91 $26.43 $30.08
Miscellaneous Health Technologists and Technicians (29-2090) $26.97 $17.89 $19.47 $23.32 $29.72 $38.78
Orthotists and Prosthetists (29-2091) $37.33 $22.22 $26.83 $35.91 $46.49 $54.02
Hearing Aid Specialists (29-2092) $28.98 $17.00 $20.71 $28.09 $37.27 $38.72
Health Technologists and Technicians, All Other (29-2099) $26.66 $17.88 $19.38 $23.19 $29.34 $38.20
Other Healthcare Practitioners and Technical Occupations (29-9000) $32.71 $18.65 $23.02 $29.36 $39.32 $50.21
Health Information Technologists and Medical Registrars (29-9021) $33.54 $18.61 $22.37 $30.12 $41.89 $51.34
Miscellaneous Health Practitioners and Technical Workers (29-9090) $32.35 $18.67 $23.27 $29.08 $38.45 $49.43
Athletic Trainers (29-9091) * * * * * *
Genetic Counselors (29-9092) $49.85 $38.10 $42.13 $47.70 $55.54 $66.35
Surgical Assistants (29-9093) $32.16 $19.01 $23.60 $28.99 $38.65 $49.13
Healthcare Practitioners and Technical Workers, All Other (29-9099) $32.48 $17.54 $20.51 $28.72 $39.76 $52.28

Source: US Bureau of Labor Statistics

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Wage Data: Healthcare Support Occupations

May 2024 detailed wage data: Healthcare Support Occupations
Average Percentiles
Occupation (SOC code)
Wage 10% 25% Median 75% 90%
Healthcare Support Occupations (31-0000) $18.82 $13.37 $16.00 $17.78 $21.31 $24.08
Nursing Assistants, Orderlies, and Psychiatric Aides (31-1100) $17.49 $12.97 $15.20 $17.25 $19.04 $22.10
Home Health and Personal Care Aides (31-1120) $16.75 $12.29 $14.57 $16.73 $18.22 $21.12
Nursing Assistants, Orderlies, and Psychiatric Aides (31-1130) $19.64 $15.07 $17.37 $18.81 $21.97 $23.68
Nursing Assistants (31-1131) $19.63 $15.06 $17.39 $18.82 $21.97 $23.60
Orderlies (31-1132) $19.18 $15.18 $16.76 $18.10 $20.67 $23.65
Psychiatric Aides (31-1133) $20.88 $15.21 $17.48 $20.15 $23.14 $26.90
Occupational and Physical Therapist Assistants and Aides (31-2000) $28.86 $15.00 $19.61 $29.70 $36.16 $39.96
Occupational Therapy Assistants and Aides (31-2010) $31.96 $18.70 $28.00 $32.07 $37.02 $41.29
Occupational Therapy Assistants (31-2011) $33.32 $24.24 $29.20 $33.49 $37.33 $42.16
Occupational Therapy Aides (31-2012) $19.76 $13.33 $16.69 $17.81 $20.73 $30.75
Physical Therapist Assistants and Aides (31-2020) $27.85 $14.34 $17.74 $28.87 $35.73 $39.63
Physical Therapist Assistants (31-2021) $32.29 $22.28 $28.03 $31.50 $37.15 $42.07
Physical Therapist Aides (31-2022) $16.98 $11.97 $14.20 $16.53 $18.24 $22.46
Other Healthcare Support Occupations (31-9000) $22.29 $16.91 $18.24 $21.78 $23.98 $28.96
Massage Therapists (31-9011) $32.45 $17.67 $23.33 $30.29 $39.29 $47.13
Miscellaneous Healthcare Support Occupations (31-9090) $22.06 $16.90 $18.22 $21.72 $23.78 $28.68
Dental Assistants (31-9091) $23.42 $17.39 $18.94 $22.72 $27.31 $29.65
Medical Assistants (31-9092) $21.40 $16.82 $18.05 $21.19 $23.09 $27.61
Medical Equipment Preparers (31-9093) $23.50 $17.19 $18.73 $22.35 $26.81 $31.77
Medical Transcriptionists (31-9094) $20.98 $15.44 $17.62 $20.76 $23.20 $27.27
Pharmacy Aides (31-9095) $27.04 $17.79 $19.87 $26.49 $33.90 $36.36
Veterinary Assistants and Laboratory Animal Caretakers (31-9096) $25.20 $18.69 $20.18 $23.25 $29.08 $33.15
Phlebotomists (31-9097) $21.30 $16.77 $18.06 $20.99 $23.15 $27.72
Healthcare Support Workers, All Other (31-9099) $22.18 $15.13 $17.52 $20.77 $24.96 $30.90

Source: US Bureau of Labor Statistics

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Healthcare Segment Market Intelligence

Visible and Understated Forces Driving Locum Tenens Expansion
The growth of locum tenens staffing in the US is strongly influenced by demographic and structural changes in the healthcare
landscape. Well known primary drivers include the aging population and increased incidence of chronic diseases, however, some less
discussed major factors fueling demand include provider burnout, Medicaid expansion and insurance and telehealth integration.
According to the Bureau of Labor Statistics, family medicine physicians are expected to experience the greatest demand, with an
absolute change of 6.0 over the decade. As generalists, family medicine physicians have a broad scope that allows them to manage
care across all ages and conditions, especially valuable in underserved communities.
The least demand is expected for pathologists with an absolute change of 0.5 over the decade. The low demand for pathologists is
multifaceted, stemming from the increasing use of AI to automate image analysis in pathology, the outsourcing of pathology services
to large labs centralizing operations and the relative stability of the pathology workforce with no large-scale retirement waves
compared to other specialties like primary care or OB/GYN.

Employment projections data for physicians, (thousands), 2023-2033P

Employment % Employment
Occupation Employment 2023 Employment 2033P
Change, 2023-2033 Change
Physicians 644.9 676.8 4.9% 31.9
Anesthesiologists Occupation 33.0 2023 34.5 Employment
4.4% % Employment
1.5
Employment Employment 2033P
Change, 2023-2033P Change
Cardiologists 15.0 15.8 5.6% 0.8
Dermatologists
Physicians 12.0
644.9 13.0
676.8 7.8%
4.9% 1.0
31.9
Emergency medicine
Anesthesiologists physicians 34.2
33.0 35.6
34.5 4.0%
4.4% 1.41.5
Family medicine physicians 109.5 115.5 5.4% 6.0
Cardiologists 15.0 15.8 5.6% 0.8
General internal medicine physicians 60.9 63.3 4.0% 2.4
Dermatologists 12.0 13.0 7.8% 1.0
Neurologists 9.0 9.7 7.5% 0.7
Emergency medicine physicians
Obstetricians and gynecologists 34.2
19.8 35.6
20.5 4.0%
3.9% 0.71.4
Family medicine
Pediatricians, physicians
general 109.5
34.3 115.5
35.2 5.4%
2.4% 0.96.0
General internal
Physicians, medicine physicians
pathologists 60.9
9.7 63.3
10.2 4.0%
6.0% 0.52.4
Neurologists
Psychiatrists 9.0
21.4 9.7
23.3 7.5%
9.1% 1.90.7
Obstetricians
Radiologists and gynecologists 19.8
31.2 20.5
32.5 3.9%
4.1% 1.30.7
Physicians, all general
Pediatricians, other 254.8
34.3 267.7
35.2 5.0%
2.4% 12.90.9
Physicians, pathologists 9.7 10.2 US Bureau of Labor Statistics,
Source: 6.0% 0.5
Employment Projections Program
Psychiatrists 21.4 23.3 9.1% 1.9
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Radiologists 31.2 32.5 4.1% 1.3
 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Ophthalmologists Lead All Surgical Specialties in Projected Growth

Excluding pediatric surgeons, all surgeons are projected to experience increased demand through 2033, according to the Bureau of
Labor Statistics (BLS). The “surgeons, all other” occupation is a catch-all classification for specialized surgical roles that do not fall into
the more commonly defined surgeon categories (such as cardiothoracic and vascular surgeons) and is projected to experience the
greatest demand with an absolute change of 1.3.
Orthopedic surgeons are projected to experience increased demand through 2033 with an absolute change of 0.7. Demand stems
from age-related degeneration (hip fractures, osteoarthritis), a rise in youth and adult sport injuries such as ACL tears and rotator cuff
injuries, as well as being one of the main specialties driving the shift toward outpatient surgery, creating new demand outside
traditional hospitals.
Ophthalmologists are projected to experience an absolute change of 0.6 through 2033 due to a unique convergence of high-volume
outpatient surgeries, new imaging tools (fundus photography, AI-assisted diagnostics) allowing for earlier detection and steady
demand for procedures like LASIK and cosmetic eyelid surgery, as well as the potential shortfall of eye surgeons with one-third of
ophthalmologists aged 60 or above and nearing retirement.
More details on demand for temporary physicians can be found in SIA’s Locum Tenens Market Growth Assessment.

Employment projections data for surgeons, (thousands), 2023-2033P

Employment % Employment
Employment projections data for surgeons, (thousands),
Occupation 2023-2033
Employment 2023 Employment 2033P
Change, 2023-2033 Change

Surgeons 53.2 55.8 5.0% 2.6

Ophthalmologists, except pediatric 11.5 12.1 5.2% 0.6
Orthopedic surgeons, except pediatric 14.9 15.6 4.9% 0.7
Pediatric surgeons 1.2 1.2 2.6% 0.0
Surgeons, all other 25.6 26.9 5.0% 1.3

Source: Bureau of Labor Statistics, Employment Projections Program

Source: Bureau of Labor Statistics, Employment Projections Program

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Nurse Practitioners and Physician Assistants Lead Workforce Growth Through 2033
There has been rapid growth in supply of nurse practitioners Percent change in employment, projected 2023-2033P
(NPs) and physician assistants (PAs) over the past 20 years.
Both groups have experienced accelerated growth in
workforce size, clinical authority, and patient demand. Percent change in employment, projected 2023-33
Employment of NPs is projected to grow 46.3% from 2023 to
2033, making it one of the fastest-growing occupations in
the US. Employment of PAs is projected to grow 28.5% from Nurse
46.3%
practitioners
2023 to 2033, according to BLS data.
Nurse practitioners and physician assistants can diagnose,
treat, prescribe, and perform many of the same functions
as physicians. Their training allows them to work across
multiple specialties and settings, from primary care clinics
to intensive care units, and they cost less than a physician
while still offering high quality patient care. Health
systems have increased their reliance on these Physician
28.5%
professionals to expand capacity without proportionately assistants
increasing overhead.
With continued support from policymakers, educational
institutions, and healthcare systems, these clinicians are
expected to play an even larger role in meeting provider Source: Bureau of Labor Statistics, Employment Projections Program
shortages, expanding access, and improving care coordination
over the next decade.
Source: Bureau of Labor Statistics, Employment Projections Program

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Sector-Specific Trends: Travel Nursing, Per Diem, Locums, and Allied

Temporary Staffing: Healthcare Occupations
Despite periodic optimism in 2024, travel nurse staffing continued to decline, with volumes and bill rates falling steadily, down an
estimated 37% according to SIA’s March 2025 US Staffing Industry Forecast, as health systems reduced contingent spend. Some bill
rates dropped below market levels, leading to unfilled orders. Per Diem Nurse and Allied Health staffing also declined by 17% and
15%, respectively. In contrast, locum tenens staffing grew 15%, fueled by demand for revenue-generating roles and the rapid
expansion of the advanced practitioner workforce.
The travel nurse segment remains strained, with stable demand in select specialties (Med-Surg/Telemetry, ER, ICU), but no sustained
growth. Low bill rates, talent shortages, regulatory constraints, and tight margins amid high competition are major challenges. While
some executives are optimistic, SIA projects a 12% decline in 2025, followed by a modest 3% recovery in 2026.
Per Diem Nurse staffing shows stable bill rates but continued margin pressure. A slight rebound is projected: 1% growth in 2025, and
3% in 2026, partly driven by increased demand in acute and home care.
Locum tenens continues to expand, with steady bill rates and rising demand for physicians and APPs (nurse practitioners, physician
assistants). As the physician workforce ages, APPs are filling gaps. SIA forecasts 6% growth in 2025 and 5% in 2026, driven by
demographic trends and procedural demand.
Allied healthcare staffing fell 15% in 2024, though some specialties (such as imaging and therapy) experienced growth. Demand is
rising due to aging populations and increasing health needs. However, reimbursement challenges persist. SIA forecasts a 7% decline in
2025 and a 1% increase in 2026, reflecting mixed trends across specialties.
US healthcare temporary staffing market sizes (2019-2026P) and year over year growth can be found on the following page.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

US healthcare temporary staffing market size ($billion) and y/y

growth
2019 2020 2021 2022 2023 2024 2025P 2026P

USTravel
healthcare
nurse temporary staffing market
8.7 size ($billion)
11.4 and y/y
29.9 44.6 28.6 18.0 15.8 16.3
growth
Year-over-year chg. 15% 32% 162% 49% -36% -37% -12% 3%
Per diem nurse 4.4 4.7 6.8 7.9 6.2 5.1 5.2 5.3
Year-over-year chg. 3% 7% 43% 17% -22% -17% 1% 3%
Locum tenens & AP 5.2 4.7 5.4 6.8 7.9 9.1 9.6 10.1
Year-over-year chg. 7% -8% 14% 25% 17% 15% 6% 5%
Allied 5.2 5.7 8.4 12.3 12.6 10.7 9.9 10.0
Year-over-year chg. 7% 8% 49% 46% 2% -15% -7% 1%
Total Healthcare 23.5 26.6 50.6 71.6 55.2 42.9 40.6 41.8
Year-over-year chg. 9% 13% 90% 42% -23% -22% -5% 3%

Source: SIA, US Staffing Industry Forecast, March 2025

Source: SIA, US Staffing Industry Forecast, March 2025

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Revenue Trends and Strategic Shifts at AMN Healthcare and Cross Country Healthcare
The table below displays the revenue and year-over-year growth figures for the two publicly traded healthcare staffing companies
from 1Q2023 to 1Q2025: AMN Healthcare Services and Cross Country Healthcare. SIA corporate members can access the Workforce
Solutions Ecosystem Valuation Comparison Database for a comprehensive view of publicly traded companies that SIA tracks.
In looking at the last 4 quarters (2Q2024 through 1Q2025), AMN Healthcare navigated a difficult market with falling revenues across
most segments particularly in travel nurse staffing yet found strength in locum tenens, labor disruption events, and workforce
technology. The shift toward comprehensive, tech-enabled workforce solutions is a strategic pivot that’s showing early signs of
traction. For healthcare staffing firms, the future lies in offering diversified solutions, building technological differentiation, and
preparing for a sustained lower demand environment in traditional travel nurse staffing.
In looking at the last 4 quarters (2Q2024 through 1Q2025), Cross Country Healthcare faced sharp revenue declines in its core nurse
and allied business due to reduced demand and lower volumes, but stabilized margins and returned to profitability in some quarters.
Physician staffing emerged as a consistent growth engine, while homecare and education added diversification. The pending merger
with Aya Healthcare may accelerate innovation and drive scale. For the broader healthcare staffing industry, diversifying beyond
travel nurse staffing, investing in technology, and aligning with evolving client needs to navigate the post-pandemic market may prove
beneficial.

Public healthcare staffing firms revenue and year-over-year percent change, 1Q2023-1Q2025

2023 2024 2025

Public healthcare staffing firms revenue and year-over-year percent change, 1Q2023-1Q2025
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1

AMN Healthcare Revenue 1,126,223 991,299 853,500 818,269 820,878 740,685 687,509 734,709 689,533

Y/Y Growth -27.5% -30.5% -25.0% -27.3% -27.1% -25.3% -19.4% -10.2% -16.0%

Cross Country Healthcare Revenue 622,707 540,695 442,297 414,035 379,174 339,771 315,119 309,940 293,408

Y/Y Growth -21.0% -28.2% -30.5% -34.1% -39.1% -37.2% -28.8% -25.1% -22.6%

Source: Public company reports and earnings calls

Source: Public company reports and earnings calls

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Profitability Paths of AMN Healthcare and Cross Country Healthcare

The graph below displays the gross margin percentage trends for the two publicly traded healthcare staffing companies: AMN
Healthcare Services and Cross Country Healthcare. For a deeper dive into the full competitive landscape, SIA corporate members can
read the Largest Healthcare Staffing Firms in the US 2025 report.
Sustained Margin Leadership by AMN Healthcare
AMN’s gross margins consistently remained higher than Cross Country’s, starting at 32.8% in 1Q23 and ending at 28.7% in 1Q25.
Despite a clear declining trend, AMN preserved a 9-11 percentage point premium over Cross Country throughout the period. The
decline accelerated modestly post-3Q23, aligning with revenue softness, especially in travel nursing.
The higher margins suggest a greater mix of higher-margin services, such as locum tenens and workforce technology, operational
efficiency and scale advantages, and more effective use of technology and predictive tools to optimize staffing and pricing. However,
the declining trend implies margin erosion from falling travel nurse demand and bill rates, and possibly more exposure to labor
disruption events, which are lower margin despite revenue boosts.
Cross Country’s Flatter, Lower Margin Profile
Cross Country’s gross margin started at 22.4% in 1Q23 and fell to 20.0% by 1Q25, a narrower 2.4 percentage point drop over two
years. The margin profile appears more stable but consistently lower, indicating either higher direct labor costs or less pricing power.
The consistently lower margins suggest heavier reliance on lower-margin core nurse staffing, less benefit from tech-enabled
diversification (although Cross Country is investing in automation and system upgrades). Margin stabilization around 20% from 2Q24
onward may reflect cost optimization through AI automation and offshoring to India as well as a gradual shift toward physician
staffing and homecare, which offer steadier returns.
Public healthcare staffing firms revenue and year-over-year percent change, 1Q2023-1Q2025

32.8% 33.3% 33.9% 31.9% 31.4% 31.0% 31.0% 29.8% 28.7%

Public healthcare staffing firms revenue and year-over-year percent change, 1Q2023-1Q2025
22.4% 22.8% 22.0% 21.9% 20.4% 20.8% 20.4% 20.0% 20.0%

1Q23 2Q23 3Q23 4Q23 1Q24 2Q24 3Q24 4Q24 1Q25

AMN Healthcare Cross Country Healthcare

Source: Public company reports and earnings calls
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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Travel Nurse Revenue Drops 37% in 2024 as Market Normalizes

Results from the 2025 SIA NATHO Travel Nurse
2024 revenue and volume change
Benchmarking Survey found that aggregate revenue
decreased 37.1% in 2024, primarily driven by a 25.3% Aggregate 25th Median 75th
decrease in volume (hours billed) which is reflective of 2024 revenue and volume change
continued normalization following the surge in
demand during the pandemic.
The median revenue decline of 41.3% indicates most
firms experienced losses greater than the average. -15.7%
Even top-performing firms (75th percentile) saw a
-25.3% -24.5%
24.5% drop, signaling market-wide contraction, not
just isolated underperformance. This variability implies -31.7%
that smaller/niche firms may be disproportionately -37.1%
-39.7% -41.3%
impacted, while larger firms may be weathering the
storm better due to broader client bases or diversified -49.2%
offerings (such as per diem, allied, or locum tenens).
Despite the sharp 2024 decline in both revenue and
Revenue Volume
hours worked in the travel nursing segment, the market
remains above pre-pandemic levels (although further Source: SIA NATHO Travel Nurse Benchmarking Survey, 2025
details on inflation adjusted bill rates are detailed on
the following page).
Source: SIA NATHO Travel Nurse Benchmarking Survey, 2025
Healthcare staffing firms face a new reality where demand has normalized but remains structurally elevated. To thrive, firms should
consider operating leaner, embracing technology, and pivoting to broader or more flexible staffing models while closely managing
bill/pay rate spreads to protect profitability.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Inflation-adjusted Travel Nurse Bill Rates Remain Slightly Above Pre-Pandemic Levels
The average travel nurse bill rate declined substantially, from Travel nurse hourly bill rates ($), 2019-2024
$101.57 in 2023 to $88.83 in 2024, according to the 2025 SIA
NATHO Travel Nurse Benchmarking Survey. The decline primarily 130.73
124.72
reflected continued normalization after a surge in bill rates during Travel nurse hourly bill rates ($), 2019-2024
the pandemic. After substantial bill rate declines in 2024 and 2023,
101.57
the aggregate bill rate remains only slightly above pre-pandemic
88.83
levels, when adjusted for inflation.
77.15
The table below shows revenue, costs and EBITDA as a percentage of 69.34
revenue. As a portion of the bill rate, travel nurse wages decreased
from 48.5% in 2023 to 44.9% in 2024. Under normal circumstances a
lower pay rate might suggest improved margin potential, but this
was negated by increases in other cost categories. For example,
housing and meals and incidentals as a percentage of the bill rate
increased from 26.4% in 2023 to 31.3% in 2024 - likely reflecting
increased living costs or expanded stipends to remain competitive in 2019 2020 2021 2022 2023 2024
attracting travel nurses.
SG&A costs also increased as a percentage of the bill rate which may be related to investments in recruitment, technology,
compliance, or general inflationary pressure on overhead. Higher SG&A, combined with increased stipends, has eroded gross margin
and EBITDA, resulting in less profitability per placement.

Components of travel nurse pay rate as % of bill rate

Percentage of Bill Rate (%) 2019 2020 2021 2022 2023 2024
Hourly wages,ofbonuses,
Components payroll
travel nurse paytaxes
rate as % of bill rate 38.0% 41.7% 50.3% 52.3% 48.5% 44.9%
Housing and meals & incidentals reimbursement (non-taxable) 33.3% 29.7% 21.4% 20.7% 26.4% 31.3%
Gross margin 24.8% 24.6% 24.2% 23.3% 20.5% 19.3%
Sales, general and administration expense 13.9% 12.3% 8.8% 8.6% 11.2% 13.6%
Earnings before interest taxes depreciation and amortization 10.9% 12.4% 15.4% 14.7% 9.3% 5.8%
Source: SIA NATHO Travel Nurse Benchmarking Surveys, 2021-2024

Source: SIA NATHO Travel Nurse Benchmarking Surveys, 2021-2024

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Internal Staff Growth and Mix of Roles at Travel Nurse Staffing Firms
The top table shows the change in internal headcount in 2024. In aggregate, total full-time equivalents (FTEs) declined 25.4%, roughly
consistent with the large declines in travel nurse volume in 2024. This contraction reflects broad-based cost optimization efforts and
reduced demand in the travel nursing segment.
The contraction suggests that firms are Y/Y change in internal headcount, 2024 vs. 2023
rightsizing their internal operations to Aggregate 25th Median 75th
align with post-COVID normalization and Recruiter FTEs for Travel Nurse -23.5% -36.9% -23.3% -11.2%
ongoing margin pressures. This could also Y/Y change in internal headcount, 2024 vs. 2023
Recruiter Support FTEs for Travel Nurse -31.3% -50.0% -16.6% 16.7%
reflect automation and digital efficiencies Account Manager FTEs for Travel Nurse -28.4% -37.4% -25.9% -6.3%
reducing the need for back-office or Account Manager Support FTEs for Travel Nurse -42.8% -55.4% -38.5% -20.5%
administrative personnel. All Other FTEs for Travel Nurse -24.8% -51.1% -25.0% -15.8%
Total FTEs for Travel Nurse -25.4% -39.8% -29.9% -18.6%
The bottom table shows the mix of internal
staff. Recruiters constituted 29.5% of internal FTEs in 2024, a slight uptick from 2023.
This relative increase in recruiter proportion, despite absolute staff declines, signals a strategic focus on maintaining sourcing
capabilities amid constrained supply and competitive talent acquisition dynamics. The emphasis on preserving recruiter headcount
suggests that staffing firms still view talent acquisition as mission-critical, especially as market dynamics shift and competition for
quality clinicians remains high.
Healthcare staffing firms are navigating a leaner operational model while strategically preserving core functions like recruiting,
anticipating future demand rebound or competitive differentiation via talent access.

Y/Y change in internal headcount, 2024 vs. 2023

2024 2023
Y/Y change in internal headcount, 2024 vs. 2023Aggregate 25th Median 75th Aggregate 25th Median 75th
Recruiter FTEs for Travel Nurse 29.5% 27.1% 40.0% 53.0% 28.8% 29.0% 38.5% 54.2%
Recruiter Support FTEs for Travel Nurse 7.6% 1.9% 7.3% 13.2% 8.2% 2.2% 7.3% 12.8%
Account Manager FTEs for Travel Nurse 5.3% 4.6% 7.7% 10.6% 5.6% 4.3% 6.8% 8.8%
Account Manager Support FTEs for Travel Nurse 3.5% 2.3% 3.5% 5.4% 4.6% 2.0% 4.2% 7.9%
All Other FTEs for Travel Nurse 53.3% 5.1% 36.8% 50.7% 52.9% 7.8% 38.8% 52.9%
Total FTEs for Travel Nurse 100.0% 100.0%
Source: SIA NATHO Travel Nurse Benchmarking Survey, 2025

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Source: SIA NATHO Travel Nurse Benchmarking Survey, 2025
 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

MSP Travel Nurse Staffing Revenue Dominates, Standalone VMS Grows Slightly
The share of travel nurse revenue generated via the use Share of revenue generated through an MSP
of an MSP in 2024 was 73.2% in aggregate, up from
87.5%
68.9% in 2023. This was revenue either generated via a 81.6%
staffing firm’s own MSP program or by acting as a 73.2%
Share of68.9%
revenue generated through an75.6%
71.0% MSP
supplier to another staffing firm’s MSP program.
51.3%
The aggregate percentage of revenue generated 50.5%
through a standalone VMS among survey participants
was 7.1%, up slightly from 7.0% in 2023. By standalone
VMS, we mean revenue passing through a VMS only.
(Any revenue passing through both a VMS and an MSP
would be accounted for in the top graph).
Aggregate 25th Median 75th
Adding the 73.2% of revenue through an MSP and the
7.1% of revenue through a standalone VMS gives a 2024 2023
combined 80.3% of revenue that passes through either
an MSP, a VMS or both. The remaining 19.7% of revenue Share of revenue generated through a VMS
is not associated with either an MSP or a VMS.
19.5%
Share of revenue generated through a VMS
14.4%

9.5%
7.1%7.0%
5.0%

0.0%0.0%

Aggregate 25th Median 75th

2024 2023

Source: SIA NATHO Travel Nurse Benchmarking Survey, 2025

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Allied Health Temp Staffing Tops $2.3B in H1 2024, Led by 'Other' Occupations at 23.6%
The pie chart below illustrates the market share of each allied health occupation accounting for $2.3 billion in allied health temporary
staffing revenue for the first half of 2024 ($4.6 billion on an annualized basis), according to SIA’s US Allied Health Benchmarking
Survey. An updated report will be published by SIA in the fall of 2025.
“Other allied health” held the largest market share for the second year in a row, at 23.6% in 2024. “Other allied health” includes
phlebotomist, medical assistants, PT and OT assistant, pharmacy assistant, pharmacist, and social worker, along with other
occupations. Aside from the “other” category, the occupations with the largest staffing market sizes were radiological/MRI/CT
technologists (18.2%), surgical technologists (13.2%), and respiratory therapists (10.1%). All remaining occupations that we track
increased in market share from last year’s report except for medical assistants and pharmacy technicians.

Share of 1H24 reported allied healthcare revenue by occupation

Share of 1H24 reported allied healthcare revenue by occupation

Radiological/MRI/CT technologists
18.2%
23.6% Surgical technologists
Respiratory therapists
Physical therapists (PT)
Clinical lab technicians/Medical technologists
1.0% 13.2% Sonographers/Ultrasound/Cardiotechnologists
2.5%
Catheter lab technicians
3.0%
Occupational therapists (OT)
5.2%
Speech therapists/Speech pathologists
10.1%
Behavioral Health
7.3%
Other allied health
7.8% 8.2%

Source: SIA US Allied Health Benchmarking Survey, 2024

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Majority of Allied Health Temp Staffing Managed Through MSP or VMS

In the allied health survey, SIA asked respondents
Share of revenue generated through an MSP
how much of their allied health temporary staffing
revenue was associated with a managed service 80.0% 79.5%
provider (MSP) and with a standalone vendor Share of revenue generated through an MSP
60.0%
management system (VMS). An MSP is a company 56.9%
that manages a client’s contingent workforce 48.0%49.0%
program on behalf of the client. A VMS is the
technology used to manage such a program, whether 25.5%
24.8%
managed by an MSP or internally by the client.
Of the 1H24 allied health staffing revenue reported
in the survey, 60.0% was noted as associated with an
MSP, up from 56.9% in 1H23. The survey found that
Aggregate 25th Median 75th
13.5% of revenue in 1H24 was associated with a
standalone VMS (standalone meaning that a VMS 1H24 1H23
was used in an internal program without the use of
an MSP), up from 12.1% in 1H23.
Combining the 60.0% of staffing revenue from an Share of revenue generated through a VMS
MSP with the 13.5% of revenue from a VMS, the
30.0%
survey indicated that 73.5% of allied health staffing 27.8%
revenue was associated with an MSP, a VMS, or both Share of revenue generated through a VMS
(up from 62.7% in last year’s survey).
13.5%
12.1% 10.5% 9.0%

1.5% 0.8%

Aggregate 25th Median 75th

1H24 1H23

Source: SIA US Allied Health Benchmarking Survey, 2024

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Source: SIA US Allied Health Benchmarking Survey, 2024
 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Per Diem as a Flexible, Cost-Effective Alternative to Travel Contracts

Per diem nurses who work day-to-day or on short notice at facilities have gained popularity as a cost-effective and flexible alternative
to longer term contracts like travel nurses (typically averaging 13 weeks). Trends in this space include:
Gig Apps Power On-Demand Staffing
App-based platforms have transformed per diem staffing, allowing nurses to pick up local shifts across multiple hospitals without
long-term commitment. These gig-style shifts appeal to nurses seeking flexibility and supplemental income. Staffing firms are now
focusing on local markets, where onboarding is easier and housing costs are avoided. More details can be found on page 53.
Growth of Local Short-Term Contracts. Firms now offer short contract (4–8 weeks) roles for nurses willing to commute within their
state. These fill mid-length gaps like maternity leaves and are cheaper than national travelers.
Expansion Beyond Nursing. Per diem usage has extended to allied health and tech roles like respiratory therapists and MRI techs.
Hospitals use on-call techs or float pools to avoid service disruptions and revenue loss when staff call out.
Strategic Staffing Benefits. Per diem staffing reduces overtime strain on full time employees and keeps traveler usage limited to true
gaps. Hospitals are embracing a tiered model: full-time staff, a layer of per diem nurses, and travelers only when necessary. This
approach cuts labor costs and improves morale.
Nurses Prefer Local Flexibility. As travel pay normalizes, many nurses prefer local work if pay and conditions are reasonable. Per diem
roles appeal to working parents, semi-retired nurses, and students needing flexibility.
Market Momentum and Outlook. Though less publicized than travel, per diem staffing surged during the pandemic and remains vital.
There is continued strength in per diem demand, even as travel orders slow. The lines are blurring between travel and per diem,
reflecting a shift toward a flexible nursing workforce model.
Per diem provides a scalable, cost-efficient model and gives nurses the freedom of gig work without the burden of relocation.
Hospitals are also investing in internal capabilities while partnering with tech-enabled staffing platforms to tap into local talent on
demand.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

M&A Trends, Market Shifts, and Industry Consolidation (1/2)

The COVID boom fueled record M&A activity, with 120 healthcare staffing deals between 2021 and 2024, according to SIA’s Staffing
and Workforce Solutions Mergers and Acquisitions Database. 2021 was the peak with 34 deals, followed by slight contraction (25
deals) in 2022, before continuing the decline in 2023 (17). In 2024, there were 19 M&A deals in the Americas, specific to healthcare
staffing (as seen in the table below) up from 17 in 2019, signaling a potential post-pandemic market normalization. This uptick
suggests renewed investor confidence and strategic repositioning as the industry adapts to long-term structural shifts, such as rising
demand for healthcare workers, staffing shortages, and increased interest in technology-enabled workforce solutions. It may also
indicate a rebound in deal-making following the volatility and valuation uncertainty seen in recent years.

Americas 2024 M&A deals, Target Segment: Healthcare Staffing

HQ- HQ-
Quarter Target
Region Acquirer/Investor Acquirer Target Target Price
(YYQQ)
Share of 1H24 reported allied healthcare revenue Segment
(State) by occupation (State)
Health Advocates Healthcare
24Q4 Americas FL Staff America Medical Staffing FL Not disclosed
Network Staffing
Healthcare
24Q4 Americas Dynamic Infusion TX Solution Nursing MD Not disclosed
Staffing
Health Advocates Healthcare
24Q4 Americas FL Medical Temps LA Not disclosed
Network Staffing
Healthcare USD 615
24Q4* Americas Aya Healthcare CA Cross Country Healthcare (NASDAQ: CCRN) FL
Staffing million
Health Advocates Healthcare
24Q4 Americas FL DiagnosTemps TX Not disclosed
Network Staffing
LiquidAgents Travel nurse and allied health business of Healthcare
24Q4 Americas TX TX Not disclosed
Healthcare Republic Healthcare Staffing
Advanced Care Healthcare
24Q4 Americas N/A 3D Medical Staffing UT Not disclosed
Group Staffing
Health Advocates Healthcare
24Q4 Americas FL WorkSquare Healthcare Staffing Solutions FL Not disclosed
Network Staffing
Healthcare
24Q3 Americas Triage NE RTG Medical NE Not disclosed
Staffing
Healthcare
24Q3 Americas Elite365 FL Critical Connection MD Not disclosed
Staffing
Footnote: * Deal is pending regulatory approval. Source: SIA, Staffing and Workforce Solutions Mergers and
Acquisitions Database
Confidential Report – NOT for Distribution | ©Crain Communications Inc. All rights reserved. 48
Source: SIA US Allied Health Benchmarking Survey, 2024
 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

M&A Trends, Market Shifts, and Industry Consolidation (2/2)

Americas 2024 M&A deals, Target Segment: Healthcare Staffing

HQ- HQ-
Quarter
Region Acquirer/Investor Acquirer Target Target Target Segment Price
Share of 1H24 reported allied healthcare revenue by occupation
(YYQQ)
(State) (State)
The Vistria Group Healthcare
24Q3 Americas IL Soliant GA not disclosed
(investment firm) Staffing
TheraEx Staffing + SVC Group of Healthcare
24Q3 Americas Merger CA NV not disclosed
Companies Staffing
Healthcare
24Q3 Americas SVC Group of Companies NV OCal Solutions OH not disclosed
Staffing
Healthcare
24Q3 Americas GQR TX Uniti Med NE not disclosed
Staffing
Healthcare
24Q2 Americas GHR Healthcare PA United Anesthesia NC not disclosed
Staffing
Healthcare
24Q2 Americas MedSource Travelers FL Onyx Health Care Staffing TX not disclosed
Staffing
Coastal Clinical & Management Healthcare
24Q2 Americas Luke Holdings FL PA not disclosed
Services Staffing
Knox Lane (private equity Healthcare
24Q2 Americas CA All Star Healthcare Solutions FL not disclosed
firm) Staffing
Healthcare
24Q2 Americas ShiftMed VA CareerStaff Unlimited TX not disclosed
Staffing
Source: SIA, Staffing and Workforce Solutions Mergers and Acquisitions Database
Database

Source: SIA US Allied Health Benchmarking Survey, 2024

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Staffing Technology and Operating Models

Evolving Tech Stacks in Healthcare Staffing
Decisions about technology stacks are at the core of healthcare staffing firm strategy and operations. Key trends in the staffing
company tech stack for US healthcare staffing firms are shaped by the sector’s specialized demands, persistent talent shortages, and
compliance-intensive environment. Below are the defining themes across front, middle, and back office systems:
Specialized Healthcare Functionality in Front Office
Systems
Vendors are enhancing front office systems with
capabilities purpose-built for healthcare staffing, such as:
• Credentialing automation to manage licenses,
certifications, and compliance checks.
• Detailed tracking of licensure across states and
expiry alerts.
• Workforce management modules including shift
scheduling and time & attendance with geofencing
and mobile access for clinicians.
Convergence of Front Office and SPaaS
Healthcare staffing firms increasingly deploy Staffing
Platforms as a Service (SPaaS) to support high-volume, on-
demand, mobile-first delivery models. Notable trends
include:
• Native mobile apps for clinicians to self-select shifts, manage credentials, and receive instant pay.
• Integration of client and candidate portals for real-time job matching, T&A, and communication.
Middle & Back Office Evolution Focused on Compliance and Integration
Middle and back office systems supporting healthcare staffing are investing in:
• Robust time & attendance with support for biometric and geofencing features, especially critical in clinical environments.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

• Modern payroll systems ensuring regulatory compliance across multiple states and jurisdictions.
• API-first design and support for iPaaS platforms to facilitate better interoperability across complex tech stacks.
AI Adoption Across the Stack
AI is maturing but remains unevenly deployed. In healthcare:
• Front office systems use AI in search & match, candidate scoring, and document parsing.
• SPaaS platforms deploy AI in engagement messaging, job matching, and workforce planning.
• Back office AI use cases are limited but evolving in areas like anomaly detection in payroll and fraud prevention.
Shift Toward Modular, Cloud-Native, Platform-Based Ecosystems
Healthcare staffing tech stacks are moving from unified tools to modular ecosystems featuring:
• SaaS delivery with continuous deployment.
• Salesforce and Microsoft-based solutions enabling plug-and-play extensibility.
• Growing preference for buy-and-build strategies over bespoke development.
For more insight into the importance of building a tech stack that can cater to a changing marketplace, SIA corporate members can
read the 2024 Staffing Company Tech Stack report.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Temporary Staffing Platforms: Structural Transformation

Temporary staffing platforms automate recruiting by US healthcare temporary staffing by model ($billion); percentages
allowing workers to independently select work assignments, reflect platform share of market
using algorithms to optimize the most appropriate jobs for
the most relevant workers. This is just one technology driven 22%
solution for increasing efficiency and streamlining US healthcare temporary staffing by model ($billion); percentages
operations. reflect platform share of market 22%
17% 15.9
Staffing platforms are a segment of the staffing industry
where automated/online and self-service processes replace 21%
many of the tasks that were formerly performed by recruiters 12.0
8.5
via a traditional staffing model. A fundamental difference
9% 9.1
between staffing platforms and traditional staffing is that
matching is conducted within the digital platform by the
2.1 55.7
clients themselves rather than by the staffing firm.
42.1 43.2
The chart shows that the platform share of the US healthcare 33.8
temporary staffing market has remained tightly rangebound 24.5
from 2022 through 2024 at about 21% to 22%. However, the
segment has been anything but stable. Most notably there has
been a mix shift with platforms in the travel nurse sector 2020 2021 2022 2023 2024
gaining share in 2024 (34% versus 28% in 2023) and per diem
losing a little share (20% versus 23% in 2023). Traditional Staffing Staffing Platform
Source: SIA, Temporary Staffing Platform Update: 2025
The dynamic is largely explained by the individual performance of
the largest staffing platform in the world, across all sectors, Aya Healthcare. Aya’s travel nurse business contracted materially less
than the overall market, driving this share gain. On the other hand, several platform companies on the
Source: SIA, per diem side
Temporary underperformed
Staffing Platform Update: 2025
the market, based on SIA estimates.
Ultimately, rising margin pressures in healthcare staffing may further stimulate the transformation of healthcare staffing to platforms
due to greater operating efficiencies. To stay competitive, travel nurse firms should consider integrating platform technology or
differentiate through high-touch, specialized services.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

Legal and Market Realities in Healthcare Talent Platforms

SIA defines “Talent Platforms” as digital, two-sided US talent platform market composition, $ billions; percentages
marketplaces that connect freelancers with work, often (but represent healthcare share of US talent platform market
not always) on an independent contractor basis.
20%
The healthcare talent platform segment contracted by 23% 17%
US talent platform market composition, $ billions; percentages
year-over-year in 2023, a stark contrast to the broader B2B
represent healthcare share of US talent platform market
talent platform market, which fell by only 5% overall. This 1.7
13%
decline dragged down global platform growth by 2 4% 1.3
percentage points.
<1% 0.2 0.8
Healthcare platforms had previously been a strong growth
engine but became a growth headwind in 2023. Healthcare
0.1
talent platform activity is almost entirely US-based and is
concentrated in a few vertical platforms such as ShiftKey,
6.9 6.6
Clipboard Health, CareRev, and Nursa. For this reason, SIA
5.5 5.4
breaks out US healthcare talent platform trends in the 4.6
chart to the right.
Examples of non-US healthcare staffing platforms are rare
but include Florence (UK), eHCA and HealthcareLink
(Australia). US-based Aya Healthcare expanded to the UK 2019 2020 2021 2022 2023
via its acquisition of ID Medical.
All Other Categories Healthcare Skills
Displacement in Sector Ranking
Source: SIA, Talent Platform Update: 2024
Healthcare, once among the top three spend categories, has
now been overtaken by office/clerical work as the third-largest category in talent platform GSV.
Source: SIA, Talent Platform Update: 2024
Worker Classification Scrutiny
Talent platforms in healthcare are under legal pressure to classify workers as employees rather than independent contractors. A
coalition of healthcare staffing firms petitioned the US Department of Labor (DOL) to weigh in on misclassification, prompting concern
across the industry.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

New Federal Rule (2024)

In March 2024, the DOL issued a final rule using a "multifactor economic reality test" that tightens the definition of independent
contractors. This rule is not specific to healthcare but aligns with concerns over IC misclassification of nurses.
Legal Precedents
Qwick, a hospitality-focused platform, reached a settlement with San Francisco in 2024 to reclassify all California workers as
employees, pay $1.5M in restitution, and implement additional worker benefits. The legal environment may pressure healthcare
talent platforms to adopt staffing firm models to ensure compliance.
Platform Convergence with Staffing
Talent platforms are increasingly integrating services typically associated with traditional staffing firms like vetting, background
checks, and human-assisted matching. Many are offering or planning managed services and Statement of Work (SOW) support,
further blurring the lines between platforms and staffing models.
Enterprise Integration & Expansion
Despite setbacks, enterprise buyers continue to show interest in talent platforms, including in healthcare. Adoption is tempered by
compliance risks, but integration with MSPs/VMS is expanding this trend will be key for healthcare platforms scaling into enterprise
healthcare systems.
For an in-depth look at the Talent Platform landscape and business model, SIA corporate members can read the Talent Platform
Update 2024 report.

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 SIA | US Healthcare Staffing Market Growth Assessment | July 24, 2025

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