Healthcare Staffing Report: Sept. 18, 2014

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Healthcare staffing firms feature prominently on 2014 lists

Staffing Industry Analyst’s 2014 List of Largest U.S. Healthcare Staffing Firms (based on 2013 revenue) shows little change in the overall order, but a large acquisition within the group suggests a shift in complexion coming for 2015.

AMN Healthcare Services held station atop the list, constituting about 10 percent of a market we estimate at $9.8 billion. In fact, there were no changes in ranking from the prior year among the six largest firms in the healthcare space. We can be fairly certain the same will not hold true a year from now as Cross Country Healthcare, ranked No. 4 on the list, agreed in June to acquire sixth-ranked Medical Staffing Network (MSN). Assuming no other major acquisitions, next year’s list should show AMN, CHG Healthcare and Cross Country as the three largest healthcare staffing firms, with a substantial share of the market. On Assignment, which ranked seventh last year, is now No. 12 after divesting its travel nurse and allied health divisions in 2013, that volume only partially offset by the company’s acquisition of locum tenens firm Whitaker Medical.

Maintaining its dominant position in travel nursing is AMN, with an estimated market share of 25 percent, more than twice that of next-closest rival Cross Country. Medical Solutions jumped into the third slot from sixth last year by virtue of its acquisition of On Assignment’s travel division in the aforementioned deal. Travel nursing continues to be a relatively concentrated industry, with the largest four players controlling half of the overall market.

Continuity characterized the rankings in per diem nurse staffing, with Maxim Healthcare Services as the largest, followed by MSN and Parallon. Cross Country, which ranked No. 12 and is striving to improve fill rates at its MSP accounts, cited the per diem branch network as a primary motivating factor in its purchase of MSN. A far more fragmented market than travel, the largest five firms in per diem make up less than a quarter of total revenue.

Likewise, allied health is a relatively fragmented market, with 21 percent of revenue constituted by its five largest firms. We estimate AMN as the largest in the allied market, with Jackson Healthcare a close second. Adecco’s Soliant Health maintained its third-place ranking.

With an estimated 27 percent market share, CHG Healthcare now dominates the locum tenens sub-segment to an even greater degree than does AMN in travel nurse. On Assignment, after its acquisition of Whitaker Medical, is now fourth largest in locum, behind CHG, Jackson and AMN. The most concentrated field of healthcare staffing, 64 percent of locum tenens revenue is generated by the five largest firms.

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Corporate Members can access the full report here.

Healthcare staffing firms also made a presence on other recently released lists. In our 2014 List of Fastest-growing U.S. Staffing & Talent Engagement Firms (based on organic revenue growth from 2009 to 2013), InGenesis ranked first. In our 2014 List of Companies Looking to Acquire Staffing Firms, 17 percent of respondents noted they were looking to acquire a healthcare staffing company, more than any segment except IT. Finally, in our 2014 List of Largest Staffing and Talent Engagement Firms in the US (based on 2013 revenue), AMN Healthcare, the largest staffing firm with healthcare noted as a top segment, ranked No. 16.

Those three reports can be found here:

2014 List of Fastest-Growing U.S. Staffing & Talent Engagement Firms

2014 List of Companies Looking to Acquire Staffing Firms

2014 Largest Healthcare Staffing Firms in the United States