Cross Country Healthcare, Inc. (‘Cross Country’) operates as a market-leading, tech-enabled workforce solutions and advisory company.
The company helps customers tackle complex labor-related challenges and achieve high-quality outcomes, while reducing complexity and improving visibility through data-driven insights.
Leveraging national and in-market staffing teams, the company places highly qualified healthcare professionals in virtually every specialty on travel and per diem assignments, loca...
Cross Country Healthcare, Inc. (‘Cross Country’) operates as a market-leading, tech-enabled workforce solutions and advisory company.
The company helps customers tackle complex labor-related challenges and achieve high-quality outcomes, while reducing complexity and improving visibility through data-driven insights.
Leveraging national and in-market staffing teams, the company places highly qualified healthcare professionals in virtually every specialty on travel and per diem assignments, local short-term contracts, and permanent positions. The company also places teachers, substitute teachers, and other education specialties at educational facilities, healthcare leaders within nursing, allied, physician, and human resources at healthcare organizations, and non-healthcare providers to participants in Programs of All-Inclusive Care for the Elderly (PACE) programs. The company’s diverse customer base includes both public and private acute care and non-acute care hospitals, outpatient clinics, ambulatory care facilities, single and multi-specialty physician practices, rehabilitation facilities, PACE programs, urgent care centers, local and national healthcare systems, managed care providers, public and charter schools, correctional facilities, government facilities, pharmacies, and many other healthcare providers, including those in underserved communities. By utilizing the solutions that the company offers, customers are able to better plan their personnel needs, optimize their talent acquisition and management processes, strategically flex and balance their workforce, have access to quality healthcare personnel, and provide continuity of care for improved patient outcomes.
Segments
The company offers services to its customers through its two reportable segments, as described below:
Nursing and Allied Staffing: The Nursing and Allied Staffing segment provides traditional staffing, recruiting, and value-added total talent solutions, including temporary and permanent placement of travel and local nurse and allied professionals, and healthcare leaders within nursing, allied, human resources, and finance; vendor-neutral programs and managed service programs (MSPs); education healthcare services; in-home care services; and outsourcing services. The company also serves as a direct-hire talent acquisition partner to healthcare organizations and academic institutions throughout the nation, providing a full suite of prescriptive talent management solutions, including flexible talent delivery models, such as executive search services for healthcare professionals, as well as contingent search and recruitment process outsourcing (RPO) services. The company also offers its Software as a Service (SaaS)-based, proprietary, vendor management technology, Intellify, to facilities to manage all or a portion of their agency services.
A majority of the company’s revenue is generated from staffing registered nurses and allied professionals on travel contract assignments of varying lengths (typically, 13 weeks) at hospitals and health systems. The company staffs registered nurses, licensed practical nurses, certified nurse assistants, advanced practitioners, pharmacists, and more than 100 specialties of allied professionals on local per diem and short-term assignments in a variety of clinical and non-clinical settings. The company also provides clinical and non-clinical professionals on long-term assignments to customers, such as public and private acute care and non-acute care hospitals, government facilities, public and charter schools, academic medical centers, outpatient clinics, ambulatory care facilities, physician practice groups, local and national healthcare plans, managed care providers, PACE programs, correctional facilities, and many other healthcare providers. The company also receives administrative fees from subcontractors at its MSP clients or from those subcontractors who use its Intellify technology solution to staff hospital facilities directly.
Physician Staffing: The company’s Physician Staffing segment provides licensed practitioners across a broad array of specialties, as well as certified registered nurse anesthetists (CRNAs), nurse practitioners (NPs), and physician assistants (PAs) on temporary assignments throughout the United States (U.S.). The diverse list of customers that the company serves includes healthcare facilities, such as acute and non-acute care facilities, medical group practices, government facilities, and managed care organizations. The company recruits these professionals nationally and places them on assignments varying in length from several days up to one year.
Recognizing this trend, the company is continuing on a path of digital transformation and innovation across its business with investments in expanding its technology capabilities both on the customer-facing and candidate engagement fronts. The company has executed multiple initiatives to enhance its position as a leading, consultative, and strategic partner in the healthcare industry. Some key focus areas include personalizing the candidate experience, delivering a superior customer experience, infusing technology enablement to drive efficiencies and increased productivity, and continuing its commitment to clinical excellence. As part of the company’s 2024 IT strategy, the company continued to invest in technologies for both internal and externally facing systems. In 2023, the company released its Internal Resource Pool (IRP) and per diem modules on Intellify.
To successfully execute the company’s business strategy, the company relies on experienced and innovative executive and operational teams.
Business Model
The recruitment and retention of a sufficient number of qualified healthcare professionals to work temporary assignments on its behalf is critical to the success of its business.
Healthcare Professionals.
Nurse and Allied Staffing: The company is well positioned to attract candidates, as clinical professionals routinely seek a wide range of diverse assignments in attractive locations, with competitive compensation and benefit packages, scheduling options, as well as a high level of service. Each of the company’s nurse and allied healthcare professionals is employed by the company and is typically paid an hourly wage and receives other benefits they are entitled to receive during the assignment period. Competitive benefits for the company’s employees generally include professional liability and workers' compensation insurance, a 401(k) plan, health insurance, reimbursed travel, per diem allowances, and housing.
Recruiters are an essential element of the company’s Nurse and Allied Staffing business and are responsible for establishing and maintaining key relationships with candidates for the duration of their assignments. Leveraging the company’s database of clinicians, recruiters match the supply of qualified candidates with the demand for open orders from customers. While word-of-mouth and referrals, especially from current and former healthcare professionals that the company has placed, continue as the leading channel of access to candidates, the company also markets its brands through strategic sourcing initiatives, including programmatic strategic sourcing and extensive utilization of social media and mobile applications, which have become an increasingly important component of its recruitment efforts. In addition to maintaining engaging and intuitive websites to allow potential applicants to obtain information about the company and assignment opportunities, the company further enhanced Cross Country Marketplace, the company’s proprietary mobile on-demand staffing platform, as a one-stop, self-service portal to support candidates throughout their experience with Cross Country. The company’s self-service candidate portal, known as Xperience, provides its travel and allied healthcare professionals with real-time matching to open positions.
Physician Staffing: Cross Country Locums recruits and contracts with physicians and advanced practice professionals to provide medical services for its healthcare customers. The company offers a wide variety of assignments, competitive fees, medical malpractice insurance, and a high level of service. Physicians or advanced practice professionals are independent contractors (unless prohibited by applicable law) and enter into agreements with Cross Country Locums to provide medical services at a particular healthcare facility or physician practice group based on terms and conditions specified by that customer, for assignments ranging from a few days up to a year.
Sales and Marketing: The company takes an enterprise sales approach by marketing its full capabilities across the continuum of care to hospitals, healthcare facilities, schools, PACE programs, and other organizations across the U.S., addressing total talent management needs. The company provides flexible workforce solutions to the healthcare, education, and PACE markets, customizing delivery of diversified offerings to meet the specific needs of each customer.
The company’s delivery brands include Cross Country Nurses, Cross Country Allied, Cross Country Medical Staffing Network, Cross Country Search, Cross Country Locums, Cross Country Workforce Solutions Group, Cross Country Education, Intellify Talent Solutions, and Data Aggregation Services (DAS). The company’s recruiters leverage the company’s extensive databases of clinicians and healthcare professionals, as well as their expertise in their given specialties, to qualify and place healthcare candidates.
Credentialing and Quality Management: The company screens all of its healthcare employees prior to placement through its credentialing departments. The company’s credentialing processes are designed to ensure that professionals have the requisite skill sets required by its customers, as well as the aptitude to meet the day-to-day requirements and challenges they would typically encounter on assignments where they are placed. The credentialing of the company’s nurse and allied healthcare professionals is designed to ensure quality of care and align with the guidelines of The Joint Commission, a national accrediting body.
Billing and Payment for Services: The company’s shared service center processes hours worked by field employees in various time and attendance systems, which in turn generate billable transactions to its customers. Hours worked by independent contractor physicians are reported to the company’s Cross Country Locums office. Billing for other services, such as RPO, Search, or Project Management, varies depending on the contract, but typically is invoiced upon the success of achieving agreed-upon milestones or completion of specific deliverables, such as the placement of a candidate. On occasion, the company is able to bill for the reimbursement of certain expenses incurred, such as candidate marketing costs, or set-up fees incurred for certain projects, such as travel costs for internal staff.
Operations: The company’s businesses are operated through a relatively centralized model, servicing all assignment needs of its healthcare professionals, physicians, and customer facilities, as well as support activities, such as coordinating housing, payroll processing, benefits administration, billing and collections, travel reimbursement processing, customer service, and risk management. These activities are performed by a predominantly remote work team, in addition to a few corporate offices.
Information Systems: Various information systems are utilized to run customer relationship management, recruitment, and placement functions based on its different brands. Some of these sophisticated applications are proprietary and are hosted in Tier 1 hosting facilities, while other systems are SaaS-based and hosted by vendor partners. The company’s systems maintain detailed information about customer-required skill sets and status, which assists the company in enabling fulfillment and assignment renewals. The company’s databases contain an extensive pool of existing and potential customers and all related recruitment and sales activity. The company’s financial and human resource systems are housed on enterprise resource planning software suites that manage certain aspects of accounts payable, accounts receivable, general ledger, billing, and human capital management. The company manages its information systems with internal team members located both in the U.S. and in India. Cybersecurity remains a central focus point across the organization, including dedicated resources, iterative training for all employees, and third parties engaged to assist in monitoring and managing systems and devices, detecting cyber threats, and preventing breaches.
Risk Management, Insurance, and Benefits: The company’s risk management program is designed to ensure prompt notification of incidents, educational training to its employees, loss analysis, and timely reporting procedures to reduce its risk of exposure. The company continuously reviews facts and incidents associated with professional liability and workers’ compensation claims in order to identify trends and reduce its risk of loss in the future where possible. The company considers assessments provided by its customers, and works with clinicians and experts from its insurance carriers to determine employment eligibility and potential exposure.
The company provides workers’ compensation insurance coverage, professional liability coverage, and healthcare benefits for its eligible employed professionals.
The company maintains a number of insurance policies, including general liability, workers’ compensation, fidelity, employment practices liability, fiduciary, directors and officers, cyber, property, and professional liability policies. These policies provide coverage for certain liabilities that may arise from its operations, subject to the policy’s terms, conditions, limits of liability, and deductibles.
Services
The company is increasingly called upon by its customers to provide creative and innovative talent sourcing strategies across a continuum of care. Over the past several years, the company’s workforce solutions have evolved into a total talent management approach as its customers focus on maintaining high-quality patient outcomes, while improving their total labor management to address complex financial, compliance, and other challenges within the healthcare industry. As part of this total talent management approach, the company considers the following: solving the immediate and future needs of its customers; enhancing its network of healthcare professionals by improving their experience; expanding service offerings to reduce sensitivity to economic cycles; expanding its expertise with various healthcare solutions in various geographic areas of the U.S.; continuing to diversify its customer base to enhance long-term business prospects; and enhancing and expanding technology to deliver efficient and automated services to customer facilities. The company’s workforce solutions include:
MSP: As healthcare providers continue to adopt centralized, outsourced models for managing contingent labor for both clinical and non-clinical needs, the company offers an MSP in which it manages all or a portion of the customer’s staffing needs. This includes both the placement of its own healthcare professionals and the utilization of other staffing agencies. The benefits to its MSP customers include cost optimization, increased certainty of supply, visibility into labor needs and usage, and market insight from its industry expertise on a broad range of topics. The company has converted close to 100% of its MSPs onto Intellify, its SaaS-based, proprietary, vendor-neutral platform that provides analytics and real-time insights, with industry-leading dashboards and reporting.
Vendor Neutral Program: The company also provides a vendor management system through its Intellify platform, which may also include the placement of its professionals or a menu of various other services. The benefits of its vendor-neutral solution include control over the staffing program and suppliers, cost optimization, and visibility into labor needs and usage.
In-Home Care Services: The company’s Workforce Solutions Group division is a premier provider in clinical and non-clinical staffing for home health and senior care facilities, including Federally Qualified Health Centers (FQHCs), Community Health Centers (CHCs), and PACE centers, allowing aging populations to remain in their homes as long as clinically advisable. The company is a full-service partner, with market expertise and a breadth of services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.
Education Healthcare Services: Through Cross Country Education, the company focuses its knowledge and resources on engaging with and understanding educational organizations, industry trends, and leadership challenges. The company provides a wide range of services to its educational partners to meet their individual needs, including special education providers, substitute teachers, behavioral aides, speech language pathologists, and occupational therapists, among others. The company also fulfills HR-related tasks, alleviating human resource and administrative paperwork so school administrators can focus on student success.
RPO Services: Through the company’s RPO services, the company offers targeted recruitment solutions designed to increase core staff while reducing dependency on contract labor. The company’s RPO program provides support to replace or complement a customer’s existing internal recruitment functions for permanent hiring needs and is delivered to healthcare organizations throughout the country, serving to provide creative, cost- and operationally efficient hiring support and labor optimization, which leads to improvements in quality of care.
Project Management: Periodically, the company’s customers have urgent needs that fall outside the scope of an MSP arrangement and require a more focused effort to place staff within a very short window. For example, as healthcare systems continue to upgrade their electronic medical records or encounter a labor disruption, the company can provide comprehensive project management, deployment of a full staffing plan, and ultimately an organized volume of quality healthcare professionals during the process so that customers may continue to deliver quality care.
Executive and Contingent Search: Similar to RPO, the company seeks to identify and place candidates in full-time roles, across clinical, executive, or administrative functions. These services are offered for specific roles and are contracted on a contingent basis, which has a success fee once placement has occurred.
Other Services: The company offers other value-added services, such as IRP Consulting & Development, Optimal Workforce Solutions (OWS), and DAS. These services seek to augment the company’s customers' capabilities with managing, supplementing, and outsourcing aspects of their internal processes of managing their workforce. DAS provides healthcare systems with bill rate transparency and can be embedded within Intellify or offered on a stand-alone basis.
Geographic Markets and Customer Base
In 2024, the company’s revenue was generated primarily in the U.S., and all of its long-lived assets were located in the U.S. and India. The company provides its staffing services and workforce solutions in all 50 states. During 2024, the largest percentage of its revenue was concentrated in California, New York, and Florida. The company provides services to public and private acute care and non-acute care hospitals, outpatient clinics, ambulatory care facilities, single and multi-specialty physician practices, rehabilitation facilities, PACE programs, urgent care centers, public and charter schools, correctional facilities, government facilities, retailers, and many other healthcare providers.
Competition
Some of the company’s traditional competitors in the workforce solutions, healthcare staffing, and search businesses include: Aya Healthcare, Medical Solutions, AMN Healthcare Services, CHG Healthcare Services, Amergis, Jackson Healthcare, Ingenovis Health, Hallmark Healthcare Staffing, RightSourcing, American Healthcare Services Association, Favorite Staffing, GHR Healthcare, SimpliFi, and HealthTrust Workforce Solutions (HCA).
Certifications
The company’s staffing businesses brands are certified by The Joint Commission under its Health Care Staffing Services Certification Program. In 2024, the company was once again certified by The Joint Commission with no deficiencies.
History
Cross Country Healthcare, Inc. was founded in 1986. The company was incorporated in Delaware in 1999.
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