Far from panicking about the staffing industry’s recent downturn, executives of some of the industry’s fastest-growing staffing firms are striking a positive note.

“We know everything is cyclical,” says Katie Macías, VP of strategy and client partnership at Cynet Health. “We have full confidence things are going to bounce back.” For now, the Sterling, Virginia-based company, ranked as No. 3 on SIA’s 2024 Fastest-Growing US Staffing Firms list, is focused on the turnaround to come. It’s spending on top talent while also expanding into new business lines so it’s ready when the overall market picks up again.

“We’re not afraid to invest and to take it to the next level,” Macías says. “That is why we started growing our portfolio with different lines of business such as international nursing, per diem and locums as well as permanent placement.”

Every firm on SIA’s Fastest-Growing US Staffing Firms list has a unique strategy for success. Even so, the number of qualifying firms fell to 145 from last year’s 158 (for the 2024 list, see page 24), demonstrating recent challenges. The list, sponsored by KarmaCheck, is based on data from SIA’s annual staffing firms survey and highlights the year’s top revenue growers. 

Overall, firms had a median compound annual growth rate of 28.1% between 2019 and 2023 based on US staffing revenue. That’s down from last year’s list, which had a median CAGR of 33.8%. The minimum CAGR to qualify was 15%, and firms needed to have at least $1 million in revenue in 2019.

Cynet Health had a CAGR of 131.1% and 2023 revenue of $219.5 million.

Healthcare Focus

Healthcare staffing firms dominated again this year: Nine of the top 10 fastest-growing US staffing firms come from the healthcare field. Of the full list, healthcare represented 43% of all firms on the list. Last year, eight of the top 10 fastest-growing firms were healthcare companies. 

Summit Medical Staffing, the No. 1 firm, had a CAGR of 181.5% and total revenue of $65.8 million.
Based in Fremont, Nebraska, the firm is led by COO Pete Geldes, President Bill Watts and CFO Cheree Watts. All three were staffing industry veterans before they formed Summit Medical Staffing in 2014. Top talent is one of the secrets to the company’s success, they say. 

“It’s all about the right people — whether it’s the right traveler for the right fit at the facility, the right recruiters, the right client management, the right back office,” Cheree Watts says. “Having the right people will also drive culture.”

Relationships matter at Summit.

“We never say, ‘Oh, this person works for us,’” Bill Watts says. “It’s always ‘This person works with us,’ and that’s a big deal to us.”

About a quarter to a third of Summit’s staff is remote. The company engages its staff with weekly meetings on Mondays and hosts a variety of team-building events, from a Facebook campaign to raise funds for St. Jude Children’s Research Hospital to a celebration of National Doughnut Day.

Summit’s headquarters lie about 40 miles north of Omaha, Nebraska, the city that is home to six of the fastest-growing staffing firms, the most of any city.

Revenue Size

A majority of the fastest-growing staffing firms, 81%, had less than $300 million in US staffing revenue in 2023. Only 5% of companies had more than $1 billion. Last year, 72% had less than $300 million in revenue, and 8% of companies had more than $1 billion.

The largest staffing firm on the list is Aya Healthcare. Based in San Diego, the firm sits at the No. 9 spot and had revenue of nearly $8.90 billion in 2023. It had a CAGR of 95.2%.

“We’ve seen a lot of our current customer growth where it’s not through one business line growing, but it’s really through diversification of different lines of business with those customers,” says April Hansen, the group president of Aya Healthcare.

The company takes a holistic approach to its business mix, offering a variety of services beyond travel nursing. One example is providing nonclinical workers, such as IT, environmental and clerical services to healthcare organizations. Aya began an interim leadership division about a year and a half ago. Its subscription-based CoreHire talent marketplace enables clients to hire for permanent positions. Recently, the firm also announced the next generation of its LotusOne VMS product.

Offering a variety of services enables the firm to grow at existing customers by offering more solutions, Hansen says.

Non-Healthcare Firms

Outside of healthcare staffing, IT, industrial and other segments were well represented on the Fastest-Growing Staffing Firms list.

FrankCrum Staffing, No. 16, receives approximately 90% of its revenue from industrial staffing. The Clearwater, Florida-based firm has five branches in Florida, a CAGR of 63.7% and staffing revenue of $25.3 million in 2023. The firm is also known for its PEO business, though PEO revenue is not included in calculations for the Fastest-Growing US Staffing Firms list.

President Haley Crum noted that success in staffing can be a matter of being in the right place at the right time.

“It’s just really getting in front of customers over and over again and making yourself known,” Crum says.
Macroeconomic trends are impacting the market, Crum says, adding that staffing clients and candidates alike are hesitant to make changes. Still, FrankCrum Staffing is meeting uncertainties head on. The firm is focusing on its structure and reaching out to clients to determine what information they need so that FrankCrum can deliver it. The company also released a culture code document for internal workers that describes the company’s culture.

Taking Care of Customers

A laser focus on customers is another tactic the fastest-growing firms are taking to ensure their growth when markets pick up. Michael Jacoutot, the founder of Spire Healthcare, says it’s a matter of finding customers and taking a consultative approach.

“We don’t consider ourselves in the healthcare staffing business,” Jacoutot says. “We’re in the customer business.”

Spire ranked No. 6 on this year’s list with 112.2% CAGR and $35.3 million in 2023 revenue.

The company works with multiple stakeholders within client organizations to solve problems from different perspectives, whether it’s a concern of HR or of a chief nursing officer. The company takes a three-by-three approach where it matches three internal employees to stakeholders at healthcare organizations to identify where the firm can help them.

Jacoutot is optimistic about the healthcare staffing industry, despite the current difficult market. 

“The pendulum has swung far away from agencies and more towards internal staff and sign-on bonuses and internal programs that provide flexibility to the nurse,” he says. “But at the end of the day, those are very unwieldy and expensive for the hospitals to maintain.”

Also given the shortage of nurses and other healthcare workers, clients will again turn to staffing firms to find them.