North America has become the most important operating base for many of the companies shaping healthcare staffing. But looking only at the size of the regional industry does not explain how these businesses are competing.
A closer look at the companies shows several different strategies developing at the same time. AMN Healthcare is expanding its total-talent and technology capabilities, CHG Healthcare continues to build around physician and locum tenens expertise, Cross Country Healthcare is navigating a period of business normalization, while Aya Healthcare and other technology-oriented providers are pushing staffing toward broader workforce management.
Precedence Research estimates that the U.S. healthcare staffing industry generated approximately USD 21.59 billion in 2025 and is projected to reach USD 42.82 billion by 2035, growing at a CAGR of 7.09% from 2026 to 2035. Travel nurse staffing represented about 45.30% of the U.S. segment in 2025, while hospitals accounted for approximately 42.05% of end-user revenue.
For companies operating across North America, these numbers provide the backdrop. The more interesting story is what individual businesses are doing with that opportunity.
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Why Does AMN Healthcare Remain One of North America’s Most Diversified Players?
AMN Healthcare has one of the broadest company profiles in the North American healthcare staffing space. Its operations extend across nurse and allied staffing, physician and leadership solutions, technology, workforce management, managed services, recruitment process outsourcing, and related talent solutions.
The company’s 2025 financial results provide a useful measure of its scale. AMN reported USD 2.73 billion in consolidated revenue in 2025, compared with USD 2.98 billion in 2024. Nurse and Allied Solutions generated USD 1.647 billion, Physician and Leadership Solutions generated USD 696 million, and Technology and Workforce Solutions contributed USD 387 million.
The composition of that revenue is particularly important. Nurse and allied services represented approximately 60% of consolidated revenue in 2025, physician and leadership solutions represented 26%, and technology and workforce solutions represented 14%.
How Is AMN Changing Its Business Mix?
AMN is increasingly positioning itself as a broader workforce partner instead of relying only on temporary clinician placement.
Its workforce technology offering includes workforce optimization, advisory services, planning, analytics, recruitment process outsourcing, and solutions for managing contingent clinical labor and internal float pools.
The company’s 2025 results also showed a meaningful sequential recovery in parts of its business. Fourth-quarter Nurse and Allied Solutions revenue reached USD 491 million, up 36% sequentially, while travel nurse revenue increased 6% sequentially.
AMN also generated USD 269 million in operating cash flow during 2025 and reduced debt by USD 285 million during the year.
Company insight: AMN’s scale remains a major advantage, but its more important strategic development is the expansion from staffing into workforce technology and managed services.
What Makes CHG Healthcare Different From Large Generalist Providers?
CHG Healthcare has built its North American position around specialization, particularly physician staffing and locum tenens.
The company operates through brands including CompHealth, Weatherby Healthcare, Global Medical Staffing, Locumsmart, and other healthcare workforce businesses.
Rather than attempting to compete primarily through the largest possible staffing portfolio, CHG has developed deep expertise in physician recruitment and temporary physician coverage.
Why Does Physician Specialization Matter?
Physician staffing has a different operating model from nursing staffing.
Recruitment cycles can be longer, credentialing requirements can be more complex, and hospitals may need highly specialized physicians for temporary or permanent coverage.
CHG’s own research found that the median physician search takes approximately 129 days, while an unfilled physician position can represent almost USD 2.6 million in lost revenue for a health system.
CHG also reported that 80% of organizations surveyed expected their use of locum tenens to remain flat or increase, while technology-enabled efficiencies were becoming more important in contingent workforce management.
Company insight: CHG’s competitive strength comes from specialization. Its physician network and locum tenens infrastructure create a position that is difficult to replicate through general recruitment capabilities alone.
How Is Aya Healthcare Changing the Staffing Model?
Aya Healthcare represents another direction in North American company competition.
The company has increasingly positioned itself around the combination of healthcare talent and technology. Its services extend across travel nursing, allied staffing, permanent placement, physician staffing, workforce management, and technology-enabled workforce solutions.
The company’s approach is important because it reflects a broader shift from a staffing-agency model toward a workforce-platform model.
Why Is Technology Becoming Central to Aya’s Strategy?
Healthcare organizations increasingly have to coordinate permanent employees, temporary clinicians, travel professionals, per diem workers, and external staffing providers.
A technology platform can bring these workforce categories into a more centralized environment.
Aya’s approach is therefore focused not only on finding clinicians but also on helping healthcare organizations manage workforce supply, recruitment, and staffing relationships more efficiently.
Precedence Research lists Aya Healthcare among the prominent companies operating in the U.S. alongside AMN Healthcare, CHG Healthcare, Cross Country Healthcare, TeamHealth, Maxim Healthcare Group, and other providers.
Company insight: Aya’s positioning demonstrates how technology can become a competitive differentiator when staffing companies move from recruitment toward workforce optimization.
What Does Cross Country Healthcare’s 2025 Performance Tell Us?
Cross Country Healthcare provides one of the clearest examples of how staffing companies are adjusting after the exceptional demand experienced during the earlier part of the decade.
The company generated USD 1.054 billion in revenue in 2025, down 22% from USD 1.344 billion in 2024. Its 2025 net loss attributable to common stockholders was USD 94.9 million, compared with a USD 14.6 million loss in 2024.
The company operates across all 50 U.S. states, with its staffing services and workforce solutions primarily generated in the U.S.
Where Is Cross Country Seeing the Most Pressure?
Its 2025 numbers show that both major staffing segments experienced declines.
Nurse and Allied Staffing revenue was approximately USD 194.2 million in the fourth quarter, down 24% year over year. Average field contract personnel stood at 6,318 full-time equivalents during the quarter, compared with 7,621 a year earlier.
Physician Staffing generated USD 42.5 million in fourth-quarter revenue, down 20% year over year. Total days filled declined to 18,599 from 25,427 in the comparable period.
These figures show that company performance is closely connected to staffing volumes and utilization, not simply the overall number of healthcare vacancies.
Company insight: Cross Country illustrates the importance of operational efficiency and workforce utilization as temporary staffing conditions normalize.
Why Is TeamHealth Competing Through Clinical Partnerships?
TeamHealth follows a significantly different model from traditional staffing providers.
The company focuses on physician-led clinical services and partnerships with healthcare facilities. Its network includes more than 18,000 affiliated physicians, advanced practice clinicians, and integrated operational team members, working across more than 2,400 acute and post-acute care facilities and over 500 communities.
This gives TeamHealth a different type of competitive relationship with healthcare organizations.
How Does TeamHealth’s Model Differ?
A conventional staffing transaction may involve placing a clinician into a specific vacancy.
TeamHealth’s model can involve a broader relationship with a healthcare facility, incorporating physicians, advanced practice clinicians, operational management, clinical leadership, and performance support.
That difference changes the company’s competitive position.
The company is competing not simply for staffing assignments but for longer-term clinical relationships.
Company insight: TeamHealth’s strength lies in the depth of its facility relationships and its ability to combine clinical talent with operational support.
What Makes Maxim Healthcare Different in North America?
Maxim Healthcare Services has developed a more diversified position around home and community-based healthcare.
Its business has a strong connection to nursing and home healthcare, giving it exposure to healthcare delivery outside traditional hospitals.
This is significant from a company perspective because home-based care requires different staffing networks and operating capabilities.
Why Is Maxim’s Home-Based Position Important?
Hospitals are not the only organizations competing for healthcare professionals.
Home healthcare providers, schools, government facilities, correctional institutions, and other organizations also require qualified nurses and clinicians.
Maxim’s service portfolio allows the company to participate across several of these settings.
Precedence Research identifies Maxim Healthcare Group as one of the prominent companies operating in the U.S. healthcare staffing space.
Company insight: Maxim’s differentiation comes from its connection to home and community-based care, rather than relying exclusively on hospital staffing.
How Large Is the Company Competition Across North America?
The scale of North American competition becomes clearer when the companies are viewed together.
Precedence Research estimates that North America accounted for approximately 57.90% of global healthcare staffing revenue in 2025.
That makes the region particularly important for companies such as AMN Healthcare, CHG Healthcare, Aya Healthcare, Cross Country Healthcare, TeamHealth, Maxim Healthcare Group, and other staffing providers.
The U.S. alone had approximately 2,927 healthcare staffing businesses, according to Precedence Research.
This is an important company statistic because it shows that the competitive environment is not dominated exclusively by a handful of national providers.
Thousands of smaller and regional businesses continue to compete through local relationships, specialized talent pools, niche clinical categories, and geographic expertise.
What Company Trends Are Emerging Across North America?
The most important trends become clearer when they are viewed through company strategies rather than general industry statistics.
Why Are Staffing Companies Investing in Technology?
The traditional staffing process depends heavily on recruiters, databases, credentialing teams, and manual communication.
Large companies are increasingly adding technology to these processes.
AMN has expanded workforce optimization and analytics capabilities, while Aya has built technology into its workforce platform. CHG’s research also points toward growing interest in technology-enabled contingent workforce management.
The objective is relatively straightforward: companies want to identify available clinicians faster, reduce administrative work, improve workforce visibility, and help healthcare organizations manage multiple staffing channels.
Why Are Companies Expanding Beyond Temporary Staffing?
Another clear trend is service diversification.
AMN combines nurse staffing with physician services, technology, managed services, and recruitment process outsourcing.
CHG combines physician staffing with locum tenens technology and related workforce solutions.
Aya combines staffing with workforce management technology.
TeamHealth combines clinicians with facility-level clinical operations.
Maxim combines staffing with home-based care.
This suggests that the leading companies are gradually moving toward broader workforce relationships.
How Is Consolidation Affecting North American Companies?
Mergers and acquisitions remain another important company-level trend.
Precedence Research highlights recent developments involving companies such as StaffDNA, Kevala, Travel Nurse Across America, and TotalMed, showing continued activity around staffing capabilities and candidate networks.
Cross Country Healthcare also provides a useful example. Its proposed combination with Aya Healthcare was ultimately terminated in December 2025, while Cross Country received a USD 20 million termination fee.
The development demonstrates that consolidation remains strategically attractive but can involve significant regulatory, financial, and execution considerations.
What Do the Numbers Say About the Next Stage of Competition?
The company data points toward a more selective competitive environment.
AMN remains substantially larger by revenue than Cross Country, with 2025 revenue of USD 2.73 billion versus approximately USD 1.05 billion for Cross Country. But size alone does not explain competitive strength.
CHG’s physician specialization, Aya’s technology orientation, TeamHealth’s facility relationships, and Maxim’s home-care capabilities demonstrate that companies can build defensible positions through specialization.
The future therefore appears to favor companies that can combine at least three elements:
Talent depth: Access to qualified healthcare professionals.
Technology: Tools that improve recruitment, workforce management, and operational efficiency.
Specialization: Expertise in particular professions, healthcare settings, or staffing models.
What Does North America’s Company Landscape Look Like Going Forward?
The North American healthcare staffing landscape is becoming more sophisticated.
The region’s strong revenue position gives large companies room to expand, but the presence of thousands of staffing businesses means competition will remain fragmented.
The companies most likely to stand out will not necessarily be those with the largest recruiter network. Instead, competitive strength will increasingly come from the ability to combine healthcare expertise with technology, specialized talent pools, strong client relationships, and efficient workforce management.
AMN Healthcare is moving toward total talent solutions.
CHG Healthcare continues to leverage physician and locum tenens expertise.
Aya Healthcare is pushing technology-enabled workforce management.
Cross Country Healthcare is adapting to a normalized staffing environment.
TeamHealth is strengthening facility-based clinical relationships.
Maxim Healthcare continues to benefit from its position across home and community-based care.
Together, these companies illustrate how different strategies can coexist within the same North American healthcare staffing ecosystem.
The most useful way to understand the region is therefore not simply to ask how large the industry is, but to examine how individual companies are building scale, where they are investing, and what capabilities they are using to differentiate themselves.
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