Largest Healthcare Staffing Firms in the United States: 2017 Update

August 3, 2017

Timothy Landhuis, Research Manager | tlandhuis@staffingindustry.com

Maxim Kupfer, Research Associate | mkupfer@staffingindustry.com

Largest healthcare staffing firms in the United States: 2017 update 

Key Findings:

• We estimate that 39 firms generated at least $50 million in US healthcare temporary staffing revenue in 2016. Added together, these firms generated $10.0 billion in such revenue, accounting for 66% of the market, by our estimates. The complete list of firms can be found starting on page four of this report.
• We also estimate that 31 travel nurse firms, 13 per diem nurse firms, 16 locum tenens firms and 27 allied healthcare firms generated at least $25 million in revenue in their respective healthcare skill sub-segments.
• In this market share report, we have ranked companies in order of revenue size, according to industry custom, but this ranking should not be taken to imply that a firm with a higher rank provides better service or more value to its shareholders.
• Staffing firms varied in degree of financial transparency, and even when forthcoming with information, we reserve the right to adjust data for the sake of consistency. Therefore, for all firms in this report, revenue shown should be considered an estimation by Staffing Industry Analysts.
• Market share percentages in this report were based on our market estimate of $15.1 billion for the US healthcare temporary staffing market in 2016. Similarly, market share on our sub-segment rankings used the following market size estimates: travel nurse ($4.6B), per diem nurse ($3.2B), locum tenens ($3.4B) and allied healthcare ($3.9B).
• Overall, we believe that this list is accurate and can be used appropriately to get a big picture reading of the US healthcare temporary staffing industry landscape. However, as transparency and availability of information from staffing companies can vary from one year to the next, this years estimates may not be comparable to those of previous years in all cases. For that reason, we did not display prior year revenue estimates in this report.
• Additional details on the methodology of this report are provided on page 12.

All of the companies included in this report were invited to provide their revenue numbers via online survey in February 2017. For firms that did not participate in the survey, revenue estimates were based on company reports, company websites and other sources. Our market share reports are of strong interest to staffing buyers, and we hope those listed will benefit from the increased buyer awareness. Firms not on this list that feel they should have been included are encouraged to contact Staffing Industry Analysts, as we will be releasing a follow‐up briefing for any late additions. Many thanks to the staffing firms who offered their encouragement and assistance in this year’s report process. 

 

Notes and observations regarding the largest US healthcare staffing firms

• AMN Healthcare retained its place as the largest healthcare staffing firm in the United States, with 11% market share in 2016 by our estimates. AMN Healthcare ranks as the largest travel nurse firm, the largest allied healthcare staffing firm, the third-largest locum tenens firm, and the sixth-largest per diem nurse staffing firm.
• CHG Healthcare ranks as the second-largest healthcare staffing firm by revenue, with 9% market share. CHG Healthcare is the largest locum tenens firm in the US, holding 33% market share in locum tenens by our estimates. CHG also ranks as the eighth largest allied healthcare staffing firm.
• There were five companies that qualified for this years largest healthcare staffing firms ranking that did not appear in last years report: Cirrus Medical Staffing, Emerald Health Services, FlexCare Medical Staffing, Hayes Locums and LiquidAgents Healthcare.
• In the travel nurse segment, there were six companies that qualified for this years ranking that did not appear in last years report: Advanced, Inc., Atlas MedStaff, FlexCare Medical Staffing, Onestaff Medical, Randstad Healthcare and TRS Healthcare.
• In the per diem nurse healthcare segment, there were two companies that qualified this year that did not appear last year: Dedicated Nursing Associates (DNA) and GrapeTree Medical Staffing.
• In the locum tenens segment, there were three companies that qualified for this years ranking that did not appear in last years report: All Star Recruiting Locums, Hayes Locums and Tusk Enterprises.
• In the allied healthcare segment, there were three companies that qualified for this years ranking that did not appear in last years report: Favorite Healthcare Staffing, HealthTrust Workforce Solutions (HCA) and InGenesis.
• We have raised our estimate of the size of the US travel nurse segment in 2016 to $4.6 billion (up from $4.3 billion in our U.S. Staffing Industry Forecast April 2017 Update report) based on data collected as part of the production of this report. Accordingly, our estimate of the US healthcare temporary staffing industry was also increased to $15.1 billion (up from $14.8 billion in our April forecast report).
• Market share is most concentrated in the locum tenens segment, and least concentrated in the allied healthcare segment. The five largest firms in each subsegment hold the following percentage of the market: locum tenens (70%), travel nurse (47%), per diem nurse (26%) and allied healthcare (23%).

Largest Healthcare Staffing Firms in the United States: 2017 Update

Ranked by estimated 2016 US healthcare temporary staffing revenue

Rank	Company	2016 US Healthcare  Temporary Staffing  Revenue ($million)	Market Share
1	AMN Healthcare1	1,626	11%
2	CHG Healthcare Services2	1,355	9%
3	Cross Country Healthcare3	820	5%
4	Jackson Healthcare	765	5%
5	Aureus Medical Group (C&A Industries)	388	3%
6	Medical Solutions	352	2%
7	Aya Healthcare	340	2%
8	HealthTrust Workforce Solutions (HCA)4	330	2%
9	Maxim Healthcare Services	328	2%
10	Supplemental Health Care	314	2%
11	Soliant Health (Adecco)	257	2%
12	HC Staffing Group Holdings, Fastaff & US Nursing	234	2%
12	trustaff	234	2%
14	FlexCare Medical Staffing	180	1%
15	Vista Staffing (Envision Healthcare Holdings)	175	1%
16	Loyal Source	167	1%
17	Medicus Healthcare Solutions	164	1%
18	TekPartners/MedPartners	155	1%
19	Accountable Healthcare Staffing	143	1%
20	InGenesis	140	1%

1. Includes revenue from acquisition of Peak Health Solutions (2Q16).
2. Includes revenue from acquisition of Global Medical Staffing (3Q16).
3. Does not include revenue from acquisition of Advantage RN in 2Q17.
4. Formerly branded as Parallon Workforce Solutions prior to 3Q16.

Largest Healthcare Staffing Firms in the United States: 2017 Update

Ranked by estimated 2016 US healthcare temporary staffing revenue

Rank	Company	2016 US Healthcare  Temporary Staffing  Revenue ($million)	Market Share
21	Advanced, Inc.5	127	1%
21	Favorite Healthcare Staffing	127	1%
23	Travel Nurse Across America6	115	1%
24	Advantage RN7	104	1%
25	The Delta Companies	101	1%
26	Medix	99	1%
27	CareerStaff Unlimited (Genesis HealthCare)	96	1%
28	Trinity Healthcare Staffing Group8	86	1%
29	ATC Healthcare	80	1%
29	D&Y (TeamHealth)	80	1%
31	CoreMedical Group	78	1%
32	Health Carousel	73	<1%
33	Emerald Health Services	65	<1%
33	HealthCare Support	65	<1%
35	Nightingale Nurses	60	<1%
36	Interim HealthCare	55	<1%
36	LiquidAgents Healthcare	55	<1%
38	Hayes Locums	54	<1%
39	Cirrus Medical Staffing	52	<1%
Total		10,039	66%

1. Includes revenue from acquisition of Rise Medical Staffing (2Q16) and IPI Travel Nursing (3Q16). Legacy business includes Advanced Medical Personnel Services.
2. Does not include revenue from acquisition of Trinity Healthcare Staffing Group in 1Q17.
3. Acquired by Cross Country Healthcare in 2Q17.
4. Acquired by Travel Nurse Across America in 1Q17.

Largest Per Diem Nurse Staffing Firms in the United States: 2017 Update

Ranked by estimated 2016 US per diem nurse temporary staffing revenue

Rank	Company	2016 US  Per Diem Nurse  Staffing Revenue ($million)	Market Share
1	Cross Country Healthcare1	239	7%
2	HealthTrust Workforce Solutions (HCA)2	201	6%
3	Maxim Healthcare Services	196	6%
4	Supplemental Health Care	106	3%
5	Accountable Healthcare Staffing	81	3%
6	AMN Healthcare	77	2%
7	ATC Healthcare	63	2%
8	InGenesis	54	2%
9	Favorite Healthcare Staffing	51	2%
10	Interim HealthCare	49	2%
11	CareerStaff Unlimited (Genesis HealthCare)	41	1%
12	GrapeTree Medical Staffing	36	1%
13	Dedicated Nursing Associates (DNA)	27	1%
Total		1,221	38%

1. Does not include revenue from the acquisition of Advantage RN in 2Q17.
2. Formerly branded as Parallon Workforce Solutions prior to 3Q16.

Additional notes and explanation of methodology

• For the purposes of this report, we define temporary staffing revenue as revenue generated from the provision of temporary workers to business clients. Direct hire, retained search, and temp-to-hire conversion revenue is not included. We also exclude revenue generated from other services offered by staffing companies: consulting services where billing is based on deliverables; process outsourcing (MSP, RPO, HRO); PEO and payrolling; outplacement; VMS; online staffing and human cloud services.
• We define healthcare temporary staffing as the furnishing of temporary workers in healthcare occupations. Travel nurse staffing typically involves relocation for work assignments typically 13 weeks in length. Per diem nurse staffing typically involves filling assignments of less than two weeks. Locum tenens (latin for holding the place) involves temporary staffing of physicians, dentists and advanced practitioners. Allied staffing refers to all other healthcare professionals, with prominent examples being physical, occupational, and speech therapy, imaging technicians, phlebotomists and pharmacists.
• To the extent that we are able, the 2016 staffing revenue estimates shown in this report include the full-year (pro forma) 2016 revenue of any staffing companies acquired during 2016. We do this to more accurately reflect annual market share of the acquiring firm moving forward.
• Revenue estimates reflect the calendar year 2016 and include gross staffing revenue generated by franchises.
• Due to the complexity involved with producing the staffing revenue estimates in this report, the presence of acquisition revenue, and variability from one year to the next in the transparency and availability of revenue data from staffing companies, comparisons of revenue estimates from last years report and this years report do not necessarily provide a reliable measure of revenue growth at a particular company or for a particular segment. For insight on revenue growth trends in the US staffing industry, we recommend our US Staffing Industry Forecast reports.
• Regarding the data sources used for this report, we invited staffing firms in February to complete a detailed Excel-based application form indicating 2016 staffing revenue by country and occupational segment. A majority of the companies appearing in this report supplied revenue information via the application form, which was then validated by comparison with other publicly available data. For companies that chose not to supply revenue information, we made staffing revenue estimates based on publicly available information and our industry knowledge. Revenue estimates were sent to company management for review, and in many cases feedback received resulted in more accurate final estimates.