Healthcare Staffing Report: Aug. 22, 2013

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Four largest healthcare staffing firms hold onto positions

It’s a tough climb to the top, and once you’ve reached the summit it’s best to stick around for a while and enjoy the view. That adage is borne out by our recently released 2013 List of Largest U.S. Healthcare Staffing Firms, in which the top four placeholders held station from last year.

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AMN Healthcare Services once again claimed the top position, with an estimated $912 million in 2012 U.S. temporary staffing revenue, good for a nearly 10 percent share of a total market we peg at $9.5 billion. Maxim Healthcare Services and Medical Staffing Network traded places from the prior year, coming in at 5th and 6th, respectively. Also swapping positions from the 2012 rankings were On Assignment and Team Health, landing in the respective slots of 7 and 9.

Travel nursing is where AMN really flexes its muscle, controlling 25 percent of the market, more than twice as much as next-closest rival Cross Country. Reliant Healthcare moved up two places from 2012 to claim the third slot. Though still a relatively concentrated market, travel nursing has become less so in recent years, as the share captured by the four largest firms has declined to 48 percent in 2012 from 63 percent in 2007.

Maxim remained atop the list of largest per diem staffing firms in the U.S., with Medical Staffing Network unchanged in second position. Next was Parallon Workforce Management Solutions, which generated an estimated $104 million in per diem business in 2012 despite not having appeared on any of last year’s lists. How is this possible, you ask? Parallon was formed in mid-2011 as a unit of healthcare giant HCA, which endowed the new entrant with an array of ready customers. The market share trend in the per diem sub-segment has been largely flat, with the share accounted for by the top five players hovering around one quarter for the last six years.

If per diem is a relatively fragmented market, allied health staffing is even more so. However, allied does show a discernable trend toward consolidation, as the five largest firms controlled 21 percent of the market in 2012, a 5 percent greater portion than they had held five years earlier. Jackson Healthcare narrowly edged out AMN to remain the leader in allied, while Adecco’s Soliant Health unit gained one position from last year to crack the top three.

Like travel nursing, locum tenens staffing is a highly concentrated market in which one company holds a dominant position. CHG Healthcare Services had 2012 locum revenue estimated at more than $600 million, for a 27 percent share of that market. Jackson was just ahead of AMN, in second and third, respectively, the inverse of their 2012 locum rankings.

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