Largest Healthcare Staffing Firms in the US - 2016 Update

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Largest Healthcare Staffing Firmsin the United States: 2016 Update

August 3, 2016Timothy Landhuis, Research [email protected]

North America

Core Skill Sectors & Industry Segments

Largest Healthcare Staffing Firms in the United States: 2016 Update | August 3, 2016


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Largest healthcare staffing firms in the United States: 2016 update

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Key Findings

• We estimate that 36 firms generated at least $50 million in U.S. healthcare temporary staffing revenue in 2015. Added together, these firms generated $8.2 billion in such revenue, accounting for 62% of the market, by our estimates. The complete list of 36 firms can be found starting on page four of this report.

• We also estimate that 25 travel nurse firms, 12 per diem nurse firms, 13 locum tenens firms and 26 allied healthcare firms generated at least $25 million in revenue in their respective healthcare skill subsegments.

• 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, in some cases data provided was adjusted for the sake of consistency. Therefore, for all firms in this report, the revenue figure is estimated by Staffing Industry Analysts.

• Market share percentages in this report were based on our market estimate of $13.1 billion for the U.S. healthcare temporary staffing market in 2015. Similarly, market share on our subsegment list used the following market sizes: travel nurse ($3.4B), per diem nurse ($3.1B), locum tenens ($3.1B) and allied healthcare ($3.5B).

• Overall, we believe that this list is accurate and can be used appropriately to get a “big picture” reading of the U.S. healthcare temporary staffing industry landscape. However, as transparency and availability of information from staffing companies can vary from one year to the next, this year’s 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 13.

All of the companies included in this report were invited to provide their revenue numbers via online survey in February 2016. 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.


Confidential Report – NOT for Distribution | ©2016 by Crain Communications Inc. All rights reserved.Confidential Report – NOT for Distribution | ©2016 by Crain Communications Inc. All rights reserved. 3

Notes and observations regarding the largest U.S. healthcare staffing firms

• AMN Healthcare retained its place as the largest healthcare staffing firm in the United States, with 11% market share in 2015 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 fifth-largest per diem nurse staffing firm.

• CHG Healthcare ranks as the second-largest healthcare staffing firm by revenue, with 8% market share. CHG Healthcare is by far the largest locum tenens firm in the U.S., holding 29% market share by our estimates. We note that CHG Healthcare has achieved significant organic growth over the past decade with revenue growth not aided by acquisitions.

• There were five companies that qualified for this year’s largest healthcare staffing firms ranking that did not appear in last year’s report. The companies are Advanced Medical Personnel Services, Health Carousel, Nightingale Nurses, Travel Nurse across America and Trinity Healthcare Staffing Group.

• In the travel nurse segment, there were four companies that qualified for this year’s ranking that did not appear in last year’s report. The companies are Cirrus Medical Staffing, Health Carousel, LiquidAgents Healthcare and Maxim Healthcare Services.

• In the locum tenens segment, there were three companies that qualified for this year’s ranking that did not appear in last year’s report. The companies are Interim Physicians, Maxim Healthcare Services and Mint Physician Staffing.

• In the allied healthcare segment, there were 10 companies that qualified for this year’s ranking that did not appear in last year’s report. The companies are Addison Group, A-Line Staffing Solutions, CoreMedical Group, Loyal Source, PrideStaff, The Delta Companies, The Execu|Search Group, The Judge Group, Therapy Source and trustaff.

• Travel nurse and locum tenens were the most concentrated markets and per diem nurse staffing was the most fragmented, based on the market share of the 10 largest companies in those subsegments.



Largest healthcare staffing firms in the United States: 2016 update (page 1 of 2)

Ranked by estimated 2015 U.S. healthcare temporary staffing revenue

Rank Company2015 U.S. Healthcare Temporary Staffing Revenue ($million)

Market Share

1 AMN Healthcare Services1 1,379 11%

2 CHG Healthcare Services 1,093 8%

3 Cross Country Healthcare2 759 6%

4 Jackson Healthcare 665 5%

5 Maxim Healthcare Services 339 3%

6 Aureus Medical Group (C&A Industries) 292 2%

7 Supplemental Health Care 285 2%

8 Parallon Workforce Solutions (HCA) 259 2%

9 Aya Healthcare 225 2%

9 Healthcare Staffing Services, Fastaff & US Nursing 225 2%

11 Medical Solutions 217 2%

12 Soliant Health (Adecco) 210 2%

13 trustaff 171 1%

14 Vista Staffing (Envision Healthcare Holdings)3 169 1%

15 Accountable Healthcare Staffing 150 1%

16 Loyal Source 147 1%

17 TekPartners/MedPartners 132 1%

18 InGenesis 123 1%

18 Medicus Healthcare Solutions 123 1%

20 Favorite Healthcare Staffing 100 1%

1. Includes revenue from Onward Healthcare, acquired in 1Q152. Includes revenue from Mediscan, acquired 4Q15.3. Acquired from On Assignment in 1Q15



Largest healthcare staffing firms in the United States: 2016 update (page 2 of 2)

Ranked by estimated 2015 U.S. healthcare temporary staffing revenue

Rank Company2015 U.S. Healthcare Temporary Staffing Revenue ($million)

Market Share

21 CareerStaff Unlimited (Genesis HealthCare) 97 1%

22 Medix 89 1%

23 Travel Nurse across America 85 1%

24 Advantage RN 83 1%

24 The Delta Companies 83 1%

26 D&Y (Team Health) 80 1%

27 CoreMedical Group 74 1%

28 ATC Healthcare 71 1%

29 Trinity Healthcare Staffing Group 63 <1%

30 Interim HealthCare 60 <1%

31 Kelly Services 59 <1%

32 Advanced Medical Personnel Services 58 <1%

33 Health Carousel 56 <1%

34 Nightingale Nurses 55 <1%

35 HealthCare Support 54 <1%

36 All Medical Personnel 50 <1%

Total 8,180 62%



Largest travel nurse staffing firms in the United States: 2016 update (page 1 of 2)

Ranked by estimated 2015 U.S. travel nurse temporary staffing revenue

1. Includes revenue from Onward Healthcare, acquired in 1Q15

Rank Company2015 U.S. Travel Nurse Staffing

Revenue ($million)

Market Share

1 AMN Healthcare Services1 701 21%

2 Cross Country Healthcare 323 10%

3 Aya Healthcare 225 7%

3 Healthcare Staffing Services, Fastaff & US Nursing 225 7%

5 Medical Solutions 212 6%


7 Trustaff 130 4%

8 CHG Healthcare Services 117 3%



11 Travel Nurse across America 85 3%



14 Advantage RN 71 2%

15 Parallon Workforce Management Solutions (HCA) 70 2%


17 Trinity Healthcare Staffing Group 60 2%

18 Nightingale Nurses 55 2%

19 Emerald Health Services 48 1%




Largest travel nurse staffing firms in the United States: 2016 update (page 2 of 2)

Ranked by estimated 2015 U.S. travel nurse temporary staffing revenue

Rank Company2015 U.S. Travel Nurse Staffing

Revenue ($million)

Market Share


22 Cirrus Medical Staffing 35 1%


22 LiquidAgents Healthcare 35 1%

25 Health Carousel 33 1%

Total 3,101 91%



Largest per diem nurse staffing firms in the United States: 2016 update

Ranked by estimated 2015 U.S. per diem nurse temporary staffing revenue

1. Includes revenue from Mediscan, acquired 4Q15.2. Includes revenue from Onward Healthcare, acquired in 1Q15

Rank Company2015 U.S. Per Diem Nurse

Temporary Staffing Revenue ($million)

Market Share



3 Parallon Workforce Solutions (HCA) 162 5%



6 InGenesis 63 2%

7 Interim HealthCare 57 2%

8 ATC Healthcare 50 2%



11 ACCESS Healthcare Services 35 1%


Total 1,114 36%



Largest locum tenens staffing firms in the United States: 2016 update

Ranked by estimated 2015 U.S. locum tenens temporary staffing revenue

1. Includes revenue from Locum Leaders (Onward Healthcare), acquired in 1Q152. Acquired from On Assignment in 1Q15

Rank Company2015 U.S. Locum Tenens Revenue

($million)

Market Share




4 Vista Staffing (Envision Healthcare Holdings)2 169 5%

5 Medicus Healthcare Solutions 123 4%

6 Cross Country Healthcare 115 4%

7 D&Y (Team Health) 80 3%


9 InGenesis 48 2%



12 Interim Physicians 30 1%

13 Mint Physician Staffing 26 1%

Total 2,450 79%



Largest allied healthcare staffing firms in the U.S.: 2016 update (page 1 of 2)

Ranked by estimated 2015 U.S. allied healthcare temporary staffing revenue

1. Includes revenue from Onward Healthcare, acquired in 1Q152. Includes revenue from Mediscan, acquired 4Q15.

Rank Company

2015 U.S. Allied Healthcare Temporary

Staffing Revenue ($million)

Market Share





5 TekPartners/MedPartners 123 4%


7 Medix 89 3%



10 Kelly Services 59 2%


12 HealthCare Support 54 2%

13 Advanced Medical Personnel Services 50 1%

14 All Medical Personnel 41 1%

15 Ardor Health Solutions 37 1%


17 The Execu|Search Group 33 1%


19 Addison Group 30 1%

20 A-Line Staffing Solutions 29 1%

20 trustaff 29 1%



Largest allied healthcare staffing firms in the U.S.: 2016 update (page 2 of 2)

Ranked by estimated 2015 U.S. allied healthcare temporary staffing revenue

Rank Company2015 U.S. Allied Healthcare

Temporary Staffing Revenue ($million)

Market Share

22 The Judge Group 28 1%

22 Yoh 28 1%


25 PrideStaff 26 1%

26 Therapy Source 25 1%

Total 1,736 50%



Market share held by the largest healthcare staffing firms on the rise

• The chart at right shows the combined market share of the five largest and ten largest healthcare staffing firms from 2007 to 2015, according to our annual reports.

• The market share captured by the five largest and ten largest healthcare staffing firms remained roughly the same from 2007 to 2012.

• However, the market share increased during the period from 2013 to 2015. We note that this trend of consolidation was aided in 2014 by Cross Country Healthcare’s acquisition of Medical Staffing Network (the fourth-largest firm acquiring the sixth-largest firm, by 2013 healthcare staffing revenue).

• During 2015, the largest healthcare staffing firms maintained their market share aided in part by strong organic growth as well as AMN Healthcare’s acquisition of Onward Healthcare and Cross Country Healthcare’s acquisition of Mediscan.

27% 27% 27% 28% 28% 28% 29%32% 32%

39% 40% 40% 40% 39% 39% 40% 41% 42%

2007 2008 2009 2010 2011 2012 2013 2014 2015

5 Largest 10 Largest

Combined market share of the 5 largest and 10 largest U.S. healthcare staffing firms, 2007 to 2015



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 revenue is not included. Also excluded is MSP fee revenue and revenue generated from services where fixed payments are received in exchange for defined deliverables, rather than staffing revenue that is typically billed based on hours worked by a temporary employee supplied by a staffing firm.

• 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.

• The definition of healthcare temporary staffing revenue used in this report exactly matches the definition used for our market size estimates that we produced in our most recent U.S. Staffing Industry Forecast report, published in April 2016. This allows us tocalculate the market share for each company listed in this report by dividing its staffing revenue by our 2015 U.S. healthcare temporary staffing market size estimate of $13.1 billion. Similarly, we used the following estimates for the travel nurse ($3.4B), per diem nurse ($3.1B), locum tenens ($3.1B) and allied healthcare ($3.5B) staffing market size in 2015.

• To the extent that we are able, the 2015 staffing revenue estimates shown in this report include the full-year (“pro forma”) 2015 revenue of any staffing companies acquired during 2015. We do this to more accurately reflect annual market share of the acquiring firm moving forward. We call out noteworthy staffing firm acquisitions in the footnotes of this report.

• Revenue estimates reflect calendar year 2015 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 year’s report and this year’s report do not necessarily provide a reliable measure of organic revenue growth at a particular company or for a particular segment. For better insight on organic revenue growth trends in the U.S. staffing industry, we recommend our U.S. 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 2015 staffing revenue by skill segment. A substantial 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. Revenueestimates were sent to company management for review, and in many cases feedback received resulted in more accurate estimates.



About Staffing Industry AnalystsFounded in 1989, Staffing Industry Analysts is the global advisor on staffing and workforce solutions. Our proprietary research covers all categories of employed and non-employed work including temporary staffing, independent contracting and other types of contingent labor. SIA’s independent and objective analysis provides insights into the services and suppliers operating in the workforce solutions ecosystem including staffing firms, managed service providers, recruitment process outsourcers, payrolling/ compliance firms and talent acquisition technology specialists such as vendor management systems, online staffing platforms, crowdsourcing and online work services. We also provide training and accreditation with our unique Certified Contingent Workforce Professional (CCWP) program.

Known for our award-winning content, data, support tools, publications, executive conferences and events, we help both suppliers and buyers of workforce solutions make better-informed decisions that improve business results and minimize risk. As a division of the international business media company, Crain Communications Inc., SIA is headquartered in Mountain View, California, with offices in London, England.

For more information: www.staffingindustry.com

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Largest Healthcare Staffing Firms in the US - 2016 Update

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