Updated November 12, 2025
Key Takeaways
- Healthcare staffing agencies must carefully evaluate VMS options amid evolving technology and market dynamics.
- Ownership consolidation of VMS/MSP platforms continues to challenge vendor neutrality and fair access.
- Advances in AI and automation are reshaping contingent workforce management in healthcare.
- Regulatory compliance, data security, and DEI initiatives are critical in modern staffing management.
- Emerging digital marketplaces offer new opportunities to counterbalance dominant MSPs.
Healthcare Staffing VMS/MSP in 2025 and 2026
Healthcare staffing remains one of the most complex and critical challenges facing hospitals and facilities today. Contingent labor (temporary nurses, allied health professionals, and support staff) is essential to maintaining patient care amid fluctuating demand and workforce shortages. Vendor Management Systems (VMS) and Managed Service Providers (MSP) have long been central to managing this labor force, offering operational efficiencies and streamlined processes.
However, the landscape in 2025 has evolved significantly. The ownership and control of VMS/MSP platforms by major staffing firms continue to shape market dynamics, raising questions about vendor neutrality and fair access. At the same time, advances in artificial intelligence, regulatory changes, and shifting workforce models are transforming how healthcare staffing is managed.
The Incestuous Nature of VMS/MSP Ownership in Healthcare Staffing
The healthcare staffing market remains dominated by a small group of large staffing firms that also own the VMS and MSPs controlling hospital contingent workforce orders. This ownership structure creates conflicts of interest where agency-owned platforms prioritize their own staffing agencies over competitors. As a result, smaller vendors face limited access to job orders, reducing competition, choice, and pricing transparency for healthcare facilities.
These integrated MSP/VMS providers act as gatekeepers, funneling nearly all staffing requests through their platforms and tightly controlling which agencies see and fill these orders. This control can lead to preferential treatment of their affiliated agencies regardless of cost or efficiency, pushing out smaller independent staffing firms. Regulatory scrutiny is increasing, but consolidation continues with high-profile mergers such as Aya’s acquisition of Cross Country Healthcare, signaling the trend will likely persist.
Vendor neutrality, a principle where MSPs treat all vendors equally, is a growing priority among healthcare organizations tired of reduced market diversity and access limitations. Vendor-neutral platforms enforce consistent standards, transparent pricing, and credential compliance across all suppliers, helping facilities balance quality, cost, and accountability more effectively.
For staffing agencies and healthcare buyers, understanding who owns the VMS/MSP platform remains crucial. Ownership affects access, fairness, and ultimately the diversity and quality of contingent workforce options available. This market dynamic defines many operational and strategic decisions in healthcare staffing today.
How do ownership and consolidation of VMS/MSP platforms affect vendor neutrality and access for staffing agencies?
Ownership by major staffing firms can create conflicts of interest, limiting access and prioritizing affiliated agencies, while vendor-neutral platforms promote fair competition.
Advancements in Technology Transforming Staffing Management
Modern VMS and MSP platforms are no longer just tools for order management; they increasingly rely on artificial intelligence and automation to optimize healthcare staffing. Predictive analytics now help forecast workforce demand based on historical data, seasonal trends, and patient volume, enabling facilities to proactively schedule contingent staff.
Automated credentialing systems have reduced paperwork and delays by verifying licenses, certifications, and compliance requirements in real time, ensuring staff meet regulatory standards before assignment. These platforms also employ advanced matching algorithms that connect the right candidates with the right shifts faster, improving fill rates and reducing operational gaps.
Additionally, many VMS solutions integrate compliance monitoring tools that track labor laws, billing accuracy, and facility-specific rules, minimizing risk for both hospitals and staffing agencies. These innovations enhance efficiency and transparency, offering measurable benefits compared to legacy systems, and are becoming essential in managing increasingly complex healthcare workforce needs.
What modern efficiencies do VMS and MSP systems bring to healthcare staffing, and how have these platforms evolved from older models?
Modern systems automate matching, scheduling, credentialing, and reporting, increasing operational speed and accuracy compared to legacy processes.
Market Dynamics and Regulatory Landscape
Healthcare staffing is increasingly shaped by new regulations and evolving market forces. Recent legislative efforts, such as the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025, are establishing minimum nurse-to-patient ratios nationwide to improve patient outcomes and reduce medical errors. These laws reflect growing recognition that adequate staffing is essential not only for care quality but also for nurse retention and safety.
Regulatory bodies like The Joint Commission have also made nurse staffing a formal National Performance Goal starting in 2026, requiring hospitals to maintain proper staffing levels and demonstrate compliance. This rise in oversight means healthcare facilities and staffing agencies must work within stricter standards, increasing the demand for VMS/MSP platforms that can ensure regulatory compliance and transparent reporting.
At the same time, market consolidation continues as large staffing firms merge and acquire MSP/VMS providers, influencing pricing, access, and operational control. While regulatory attention on vendor neutrality and transparency is rising, healthcare organizations and staffing agencies must navigate these changes carefully to optimize workforce quality and cost-effectiveness amidst a complex and shifting environment.
How are regulatory requirements (e.g., minimum nurse staffing ratios, compliance rules) influencing the management of contingent labor?
New regulations require higher transparency, robust credential verification, and real-time compliance reporting, all of which VMS/MSP platforms increasingly support.
Addressing Modern Workforce Needs: Hybrid, Remote, and DEI Initiatives
The centralized role of MSP/VMS platforms as gatekeepers in healthcare staffing remains critical today, controlling access between hospitals and staffing agencies. This model helps streamline labor demand by funneling all orders through a single system, which was a core point of the original blog. However, the modern workforce is becoming more complex, requiring platforms that go beyond simple order management.
Hybrid and remote clinical roles are increasingly common, and today’s VMS systems must support flexible scheduling, location tracking, and credentialing across diverse care settings. This adaptability enables facilities to fill shifts more efficiently while accommodating staff preferences and regulatory compliance.
What role do hybrid and remote workforce models now play in healthcare staffing, and how do VMS/MSPs support them?
Hybrid/remote roles are managed through the same platforms, which track credentials, schedules, and assignments across diverse care settings.
In addition, there is rising pressure on healthcare organizations to meet diversity, equity, and inclusion (DEI) goals within contingent labor. Though federal regulations around DEI have changed, the employees and providers you want to attract still value those initiatives. Staying competitive and retaining your workforce means you must acknowledge what they want in a workplace. Modern workforce management platforms have integrated data tracking and reporting functionalities that help organizations monitor DEI metrics and advance equitable hiring practices.
How do today’s platforms help organizations achieve diversity, equity, and inclusion goals in their contingent workforce?
Although federal mandates have slowed formal DEI programs, some private healthcare organizations continue tracking DEI metrics using workforce management software.
This evolution shows that while the centralized aggregation and gatekeeping functions we previously discussed still underpin healthcare staffing, the capabilities required of VMS/MSPs have expanded. Data-driven, flexible, and inclusive workforce management is now necessary to meet today’s operational and strategic demands.
Opportunities in Digital Marketplaces and Alternative Platforms
The traditional model of healthcare staffing dominated by a few large MSP/VMS platforms is being challenged by the rise of digital marketplaces and alternative platforms. These newer solutions leverage technology to increase transparency, broaden access, and empower smaller staffing agencies that historically struggled with limited visibility in legacy MSP-controlled systems.
Unlike the traditional approach where all vendor communications go through a single gatekeeper, digital marketplaces enable more open and simultaneous access to job orders. This model reduces the risk of favoritism and accelerates fulfillment times, addressing key pain points we previously outlined about restricted vendor access and the “incestuous” relationships between industry-giant staffing firms and MSPs.
These platforms also embrace modern features such as AI-driven candidate matching, real-time analytics, and mobile accessibility, providing healthcare facilities with more robust tools to quickly fill contingent labor needs. By democratizing access and enhancing user experience, digital marketplaces represent a strategic shift in how healthcare staffing can be managed, potentially disrupting the entrenched MSP/VMS market dynamics described previously.
For staffing agencies, these innovations offer new pathways to hospital clients, bypassing restrictive vendor hierarchies while maintaining compliance and operational efficiency. This growing ecosystem signals a more competitive and technologically advanced future for healthcare contingent workforce management.
Strategic Considerations for Staffing Agencies and Healthcare Facilities
For staffing agencies, the choice between developing proprietary VMS solutions or partnering with third-party platforms is increasingly strategic. The original blog highlighted how owning or controlling MSP/VMS technology can provide a competitive edge with exclusive access to hospital orders. This remains true today, as platform ownership can directly impact agency market reach, data visibility, and revenue growth.
Healthcare facilities must also weigh the benefits and risks of vendor consolidation. While consolidated MSP/VMS systems can deliver operational efficiencies and financial leverage, they also risk limiting vendor diversity and transparency, a concern raised by the blog’s discussion of “vendor neutrality.” Facilities should evaluate platforms on their ability to fairly manage vendor pools, support regulatory compliance, and adapt to evolving workforce needs.
Both staffing firms and healthcare buyers should prioritize technology that fosters transparency, data security, and compliance while supporting flexible, inclusive workforce management. Strategic platform choice now influences not just operational workflows but also long-term competitiveness in the complex healthcare staffing market. This renewed focus on strategic decision-making echoes the original article’s call for awareness about “who owns whom” in MSP/VMS relationships, underscoring its ongoing relevance.
What strategic considerations must staffing agencies and hospitals weigh when choosing between building their own VMS or using third-party platforms?
Agencies and hospitals must weigh factors like vendor neutrality, control over data and order flow, scalability, regulatory compliance, and operational cost.
The Future of Healthcare Staffing VMS/MSP
The healthcare staffing market in 2025 is experiencing a period of stabilization after several years of rapid growth and heightened demand. Industry forecasts indicate a modest decline in staffing revenues this year, partly due to softening demand and cost pressures, but a gradual rebound is expected in 2026. This reflects a shifting landscape where the temporary and travel nurse surge is leveling off, even as ongoing shortages persist in key clinical roles.
Looking ahead, technology will be the primary driver of change in MSP and VMS platforms. Many MSPs are expanding their offerings with AI-driven services that automate routine tasks such as resume screening, interview scheduling, and credential verification, allowing them to focus on strategic workforce management. Integration of advanced analytics and direct sourcing capabilities enable better alignment of supply and demand across specialties and geographies.
Be careful with what software companies claim is AI versus logical automation. There are risks to providing open-source AI and LLMs your proprietary and competitive business data.
The evolving workforce also calls for expanded hybrid care models, blending in-person and virtual clinicians to optimize resources and expertise. Virtual nursing roles and tele-ICU services increase workforce flexibility, allowing experienced clinicians to continue practicing remotely and reducing onsite burden. Furthermore, systemic efforts to reduce clinician burnout by integrating mental health and wellness resources into workflows will shape staffing strategies.
How Staffing Agencies and Healthcare Facilities Can Adapt
For staffing agencies and healthcare facilities, the future means embracing these technological and operational shifts while maintaining vigilance around vendor neutrality and transparency. Proprietary platform ownership remains a competitive advantage, but new digital marketplaces and integrated software solutions are creating more options, leveling the playing field and empowering smarter workforce management.
What practical steps can facilities and staffing firms take to keep pace with market changes, technology advancements, and new workforce expectations?
Monitor industry regulations, adopt technology that improves efficiency and compliance, and regularly review platform ownership and vendor management policies.
In sum, the future of healthcare MSP and VMS lies in advanced technology adoption, flexible workforce models, data-driven decision-making, and balanced market dynamics that promote efficiency, compliance, and equitable access for all vendors. This evolution continues the themes of control, transparency, and operational efficiency first explored in the original blog while adapting to the demands of 2025 and beyond.
Historical Context of Healthcare Staffing VMS/MSP
March 4, 2021
Managed Service Providers (MSP) utilizing Vendor Management Systems (VMS) or Workforce Management Systems have been a part of U.S. commerce for decades, starting with Ford Motor Company and moving across all market verticals.
These systems can provide operational and financial efficiencies unavailable to firms not deploying their utilization. The need for a MSP can grow when demand for services exceeds supply. The U.S. nursing shortage is case in a single point. The ability to aggregate as many possible vendors for human capital is a great advantage of this system.
The “fill rate”, or ability to reduce hospital vacancies assists the hospital in revenue generation, adequate staffing ratios, and relief from some of the “fixed-costs” associated with full-time employees. When supply is scarce and demand is high, aggregating as many vendors as possible with uniform terms and conditions is the most effective model.
Without such systems in place, the time required to manage, pay, and orchestrate labor demands while working independently with a large vendor pool is expensive and inefficient. This is where operational efficiencies of MSPs are most valuable. Leveraging multiple vendors on one side of the MSP, but communicating singularly on the other side for hospital management. The larger number of vendors funneled through the MSP mathematically increases the odds of meeting the high demand of healthcare workers.
Financial leverage can be realized as contract talks can be standardized across all vendors. Standardizing rates simplifies financial planning for the client. Spreading demand across multiple vendors provides pricing leverage that can’t be realized working with one supplier at a time.
Examples of the Incestuous Nature in Healthcare Staffing VMS/MSP
The healthcare industry has been a late adopter of human capital managed services, but has long used Group Purchasing Organizations (GPOs) for supplies such as durable medical equipment.
One of the first start-ups to engage the contract labor spend of hospitals in the US was Shiftwise. Shiftwise was created in 2003 in Portland, Oregon and was originally known as Origin, Inc, acquired by AMN Healthcare (an industry dominant MSP) in 2013.
A later player to the game was Hospital Corporation of America, a for-profit system. HCA has long known the value of managed services and has utilized HealthTrust purchasing group since 1999. In 2011, HCA launched Parallon, another subsidiary designed to offer workforce management solutions throughout its expansive network of hospitals. In 2016, Parallon rebranded its workforce management solution to better identify with HCA’s original GPO subsidiary, and is now known as HealthTrust Workforce Solutions.
FocusOne Solutions is another provider in the VMS/MSP space serving hospitals for several years. FocusOne Solutions is a sister-company to Aureus Medical Group, one of the nation’s largest healthcare staffing firms with more than 30 years of experience.
Medefis, yet another provider of hospital vendor management solutions, also founded in 2003, owns significant market share.
Although there are several other vendors for vendor management and workforce solutions, the companies listed above comprise over half the agreements in the healthcare staffing world.
What is the “incestuous nature” of these companies? To explain, it is important to understand in simple terms the relationship a VMS/MSP provider has with the hospital.
- The VMS/MSP is the sole gatekeeper for any agency that wishes to do business with the hospital.
- The hospital is typically forbidden to work with individual vendors; as such vendors must only work through the VMS/MSP provider.
- Every staffing firm is 100% dependent on the VMS/MSP to provide their services.
- The VMS/MSP is repository for all staffing orders, and is the first to receive all orders for labor across the system.
The recent spate of acquisitions of VMS/MSP vendors by staffing firms presents an interesting question. Why would a healthcare staffing firm have a desire to get into the VMS software business? A review of the aforesaid four items holds the key and prompts further questioning. Who owns whom? What does vendor neutrality mean?
Let’s take a closer look at the companies we’ve previously mentioned.
HealthTrust Workforce Solutions – If you are a staffing agency wanting to provide services to a HCA hospital, get ready to go through HealthTrust. HCA brilliantly put this together in-house as a cost reduction and operations reduction play.
Shiftwise – As one of the early software solutions in the Healthcare space, Shiftwise accumulated hundreds of contracts with hospitals across the country. In a brilliant move, AMN purchased them in late 2013.
It’s just as wise to bear in mind the owning entities when choosing a software to manage your contingent workforce.
Medefis – This company was founded in 2003 and had acquired many contracts, specifically in the healthcare staffing space. As such, Medefis became a strategic target of AMN and was purchased in 2015.
FocusOne Solutions – This Omaha Nebraska firm is also a VMS/MSP driving contracts in the healthcare staffing space. They are a sister company to Aureus Medical Group, one of the nation’s largest healthcare staffing firms.
Evaluating Vendor Neutrality
Now, back to “vendor neutrality.” When the VMS/MSP providers have no affiliation with staffing firms, their sole responsibility is to provide seamless transactions between the hospital client and all subcontracted vendors. Now that the largest staffing firms have acquired these popular systems they in essence “own” every order that is generated by the hospital client. There is speculation, but no proof that these staffing firms are taking advantage of having total access to every order before any other company “sees” these opportunities. True transparency would be the simultaneous release of all orders to all vendors including the staffing firm that owns the VMS/MSP.
It is an interesting exercise to review how revenues have grown or diminished since the largest healthcare staffing firm in the United States, AMN, has made their acquisitions.
According to Harris Williams & Co., a research and M & A firm, the healthcare staffing industry was expected to finish 2016 with approximately 7% in growth year over year. This follows several prior years of single digit growth.
Considering single digit growth in the industry AMN healthcare has provided the following staffing revenue increases, both prior to, and then after VMS/MSP purchases.
| Year | Revenue (USD) | Percent Increase |
|---|---|---|
| 2011 | 887,500,000 | – |
| 2012 | 954,000,000 | 7.5% |
| 2013 (AMN acquires Shiftwise) | 1,010,000,000 | 5.9% |
| 2014 | 1,040,000,000 | 3.0% |
| 2015 (AMN acquires The MHA Group [including Merritt Hawkins] and B.E. Smith) | 1,460,000,000 | 40.4% |
| 2016 | 1,900,000,000 | 30.1% |
| 2017 (AMN acquires Phillips DiPisa and Leaders For Today) | 1,990,000,000 | 4.7% |
| 2018 (AMN acquires MedPartners) | 2,140,000,000 | 7.5% |
| 2019 (AMN acquires Silversheet and Stratus Video) | 2,220,000,000 | 3.7% |
| 2020 | 2,390,000,000 | 7.7% |
| 2021 | 3,980,000,000 | 66.5% |
| 2022 | 5,240,000,000 | 31.7% |
| 2023 (AMN acquires Medical Search International and DRW Healthcare Staffing) | 3,790,000,000 | −27.7% |
| 2024 | 2,980,000,000 | −21.4% |
| 2025 | 2,610,000,000 | −12.4% |
- Medfinders: Provider of clinical workforce managed services, travel nurse and allied health staffing, locum tenens, permanent physician search, and home healthcare.
- ShiftWise: Developer of vendor-neutral vendor management systems (VMS) technology for healthcare staffing, powering managed service programs (MSPs).
- The MHA Group (including Merritt Hawkins): Leading physician and advanced practitioner search and recruitment firm, also providing locum tenens services.
- B.E. Smith: Premier healthcare executive search and interim leadership placement firm, serving hospitals and other healthcare facilities.
- Phillips DiPisa: Executive search firm focused on placement of physician leaders, healthcare executives, and C-suite roles within hospitals and health systems.
- Leaders For Today: Provider of interim leadership and executive staffing solutions for hospitals and healthcare organizations.
- MedPartners: Provider of mid-revenue cycle solutions, including case management, clinical documentation improvement, medical coding, and registry services.
- Silversheet: SaaS platform for credentialing management and healthcare administration aimed at streamlining onboarding and compliance.
- Stratus Video: Provider of video remote interpretation and language access services in healthcare settings.
- MSDR (Medical Search International and DRW Healthcare Staffing): Firms specializing in locum tenens and advanced practice staffing solutions.
If the entire market is growing at around 7%, and AMN is growing at 30% to 40%, it might be inferred that the pie is getting smaller for all other staffing agencies in this space. An argument can be made that this growth can be attributed to acquisitions, or sheer management superiority. The reader will have to be the judge.
| Period | AMN Growth | Industry Growth | AMN vs Industry |
|---|---|---|---|
| 2011-2012 | +7.5% | ~7% | Slightly Outpaced |
| 2014-2016 | +30-40% | ~5-7% | Significantly Outpaced |
| 2021-2022 | +31% to +66% | ~7% | Dramatically Outpaced |
| 2023-2025 | −12% to −28% decline | ~7% | Underperformed |
The good news is that staffing firms that have been “blocked” from direct access to these clients can now present their own VMS/MSP solutions to compete head to head with the largest in the industry. A sea change is coming in this industry, and it will be driven by technology.
