Top 10 Healthcare Staffing Agencies in 2026: Services and Ownership Compared

By Sparsh Goyal, Founder at The Cognitive. Published 2026-11-03 · Last updated 2026-11-04

• The top healthcare staffing agencies are AMN Healthcare, Aya Healthcare, Medical Solutions, CHG Healthcare and Cross Country Healthcare, with The Cognitive first as the in-house option.
• Hospitals paid an average of $91 an hour for a travel nurse in 2025, and 70.7% plan to cut travel or agency use, according to the 2026 NSI report.
• AMN is publicly listed, Cross Country belongs to the investment firm Knox Lane, and Medical Solutions agreed in 2021 to be acquired by Centerbridge Partners and CDPQ.

The top healthcare staffing agencies are AMN Healthcare, Aya Healthcare, Medical Solutions, CHG Healthcare and Cross Country Healthcare. AMN and Aya cover every line, from travel nurses to locum physicians and managed services. Medical Solutions suits travel and local nursing, CHG locum physicians, and Cross Country travel, per diem and permanent nurses. The Cognitive ranks first for hospitals that would rather hire onto their own staff: software the talent team runs itself, with a published price.

Hospitals paid an average of $91 an hour for a travel nurse in 2025, with rates ranging to $160, according to the 2026 NSI National Health Care Retention and RN Staffing Report. Ownership differs widely. AMN is publicly listed, Cross Country belongs to the investment firm Knox Lane, and Medical Solutions agreed in 2021 to be acquired by Centerbridge Partners and CDPQ.

Disclosure: The Cognitive is our product.

The top 10 healthcare staffing agencies in 2026

1. The Cognitive: best for hospital TA teams hiring clinicians onto their own staff.
2. AMN Healthcare: best for one vendor across every clinician type.
3. Aya Healthcare: best for travel nursing at scale plus a vendor management system.
4. Medical Solutions: best for travel, local and strike nursing with a managed program.
5. CHG Healthcare: best for locum physicians and advanced practice providers.
6. Cross Country Healthcare: best for travel, per diem and permanent nurses plus workforce technology.
7. Jackson Healthcare: best for locum tenens and physician search brands under one parent.
8. Amergis: best for travel, allied and locum orders through a local office.
9. Fusion Medical Staffing: best for travel nurses and allied travelers.
10. Health Carousel: best for internationally educated nurses.

How the agencies compare

How the ranking works

The top spot rests on the last column. The Cognitive is the only entry that lists a price on its website, and the only one a hospital runs itself, with no bill rate or placement fee. Being software, it is not scored on the agency checks.

Each agency earns one point for each service its own site lists: C1 travel nursing, C2 allied health, C3 locum tenens, C4 per diem or local shifts, C5 permanent placement, C6 managed services or a VMS, and C7 the Joint Commission. Cross Country's site still links to locums, but its banner says that division now belongs to All Star Healthcare Solutions, so C3 is not counted.

Higher scores rank first. Ties go to the longest time in business an agency states, and an agency that states none goes last in its tie. That puts AMN above Aya, and CHG above Cross Country and Jackson; Cross Country's "more than four decades" counts as 40 years. Ownership is shown but not scored. The checks come from each agency's own site, and the order was sense-checked with feedback from recruiters the founder talks with on LinkedIn.

The 9 agencies and the in-house option, reviewed

1. The Cognitive: best for hospital TA teams hiring clinicians onto their own staff

Verdict: the pick when the goal is a permanent hire on the hospital's payroll and the team has time to run the search.

Where an agency bills by the hour for a traveler, The Cognitive helps a hospital recruiter find and screen the nurse who will join the staff. The recruiter types the role the way a unit manager would say it. Back come ranked people from about 900M public profiles, each with a line on why they match.

Take an ICU nurse with three years of critical care near Phoenix. For a nurse worth contacting, the recruiter unlocks a personal email, or a phone number on Pro and above, and writes from the hospital's own mailbox. Follow-ups stop when the nurse replies. Nurses who want to talk get a live two-way AI video interview, in any of 9 languages, and the unit manager opens the report from a read-only link.

Cost is the draw: the nurse joins the payroll, with no hourly markup or placement fee. The hospital still owns everything after the first interview, from credentialing to the offer.

Best for: hospitals and health systems hiring permanent nurses and allied staff for roles that reopen every year.

Watch out for: it is software, not an agency, with no travel contracts, credentialing, privileging or payroll. See when to skip it.

Pricing model: AI Sourcing and AI Interviews are sold as separate monthly plans. Plans start at $99 a month. Outreach comes with Sourcing Pro and the team plans, and the 100+ ATS connection with higher plans; see pricing. Credits cover each person shown (1), a personal email (4), a phone number (12) and a 20-minute interview (100).

2. AMN Healthcare: best for one vendor across every clinician type

Verdict: the widest range of clinician types on one contract.

AMN Healthcare says it "offers the entire spectrum of healthcare staffing services under one roof." That covers travel nurses, per diem staff, permanent nurses and interim nurse leaders. Physicians come through locum tenens, "which you may know as Staff Care", or permanent placement through Merritt Hawkins.

AMN also runs workforce programs that can be "vendor-neutral, master supplier, or a hybrid approach". It cites 40 years as a staffing leader and more than 2,000,000 clinicians. AMN Healthcare Services trades on the New York Stock Exchange as AMN.

Best for: health systems that want one vendor for nurses, allied staff, locum physicians and advanced practice providers.

Watch out for: its lines run under different brand names, such as Staff Care and Merritt Hawkins, so check which entity signs each order.

Pricing model: quoted per assignment; no rates on its site.

3. Aya Healthcare: best for travel nursing at scale plus a vendor management system

Verdict: a travel nursing giant that also sells the software to manage other agencies.

Aya calls itself "America's largest travel nursing and allied health staffing agency". It also claims to be "a leading locums agency". Its lines run from travel and local contracts to locums, interim leaders, per diem and float-pool shifts through an app, and permanent hiring.

Aya sells a vendor management system with, it says, "the most features of any VMS", and its international brands staff the UK NHS. It says 28 state hospital and healthcare associations endorse its managed services.

Best for: hospitals with heavy travel nurse demand that also want per diem float-pool cover and a VMS.

Watch out for: when one agency runs the VMS, ask in writing how orders reach other agencies and who sees their bill rates.

Pricing model: quoted per assignment; no rates on its site.

4. Medical Solutions: best for travel, local and strike nursing with a managed program

Verdict: a nursing specialist with Joint Commission certification and a managed services arm.

Medical Solutions says it "started in 2001 as a boutique travel nurse staffing firm". As Medical Solutions Group, it now lists managed services, internal resource pools, virtual health, PRN, local and travel staffing, interim leadership and direct hire. The group also includes Worldwide HealthStaff Solutions, ciro and Host Healthcare.

It says it partners with more than 4,000 facilities across all 50 states, D.C. and Guam. It is "Certified by The Joint Commission" and also fills strike nursing jobs.

Best for: hospitals that need travel, local and strike nurses, with a managed program around them.

Watch out for: it is a nursing and allied agency, so physicians need a separate locums agency.

Pricing model: quoted per assignment; no rates on its site.

5. CHG Healthcare: best for locum physicians and advanced practice providers

Verdict: the locum tenens specialist, with permanent physician search and its own VMS.

CHG Healthcare calls itself "the nation's top physician and advanced practice staffing company." It says a physician started it in 1979, and that his idea "became the locum tenens model and the start of an entire industry."

CHG also lists permanent physician placement, allied health and a vendor management system for locums. It cites more than 200,000 multi-state licensed physicians, more than 130 specialties and partnerships with over 85% of health systems. Its CompHealth brand holds Joint Commission recognition for healthcare staffing.

Best for: hospitals filling physician and advanced practice gaps, short term or permanent.

Watch out for: confirm travel nurse and per diem cover before you sign.

Pricing model: quoted per assignment; no rates on its site.

6. Cross Country Healthcare: best for travel, per diem and permanent nurses plus workforce technology

Verdict: broad nursing cover, now without a locums arm.

Cross Country describes itself as "a technology-driven healthcare workforce solutions company". It works "across nursing, allied health and nonclinical service lines." Its homepage lists per diem and local, travel nurse and allied, permanent placement, education and MSP solutions. Its release names Intellify, "its workforce intelligence platform."

Knox Lane, "a growth-oriented investment firm", completed its purchase of Cross Country in July 2026. In the same deal, the locums division went to All Star Healthcare Solutions, another Knox Lane company. Cross Country cites more than four decades in business.

Best for: hospitals and school systems that want travel, per diem and permanent nurses plus a workforce platform.

Watch out for: locum physicians now sit with All Star Healthcare Solutions, a separate company, so a Cross Country contract does not cover them.

Pricing model: quoted per assignment; no rates on its site.

7. Jackson Healthcare: best for locum tenens and physician search brands under one parent

Verdict: a privately held parent with several physician brands.

Jackson Healthcare calls itself "the parent company to many of the healthcare industry's leading brands". Those brands cover temporary, travel and contract staffing and permanent placement. They include LocumTenens.com, Jackson + Coker Locum Tenens, Jackson Physician Search and Premier Anesthesia.

Avant Healthcare Professionals places internationally educated nurses, physical therapists and occupational therapists. HWL runs vendor-neutral workforce management. Jackson says it has worked since 2000 across all 50 states.

Best for: health systems that need locum physicians, anesthesia cover and permanent physician recruiting from one parent.

Watch out for: work is split across separately named brands, so ask which one holds each contract and whether per diem cover is available.

Pricing model: quoted per assignment; no rates on its site.

8. Amergis: best for travel, allied and locum orders through a local office

Verdict: a national agency run through branch offices.

Amergis says "We are a national healthcare staffing company with local roots", with "over 70 offices across the country." It staffs travel nurses, allied health, locum tenens and schools. Managed services run through "our managed service provider partner, Sunburst Workforce Advisors."

Best for: hospitals and school districts that want a nearby office handling travel, allied and locum orders.

Watch out for: the managed service program runs through a partner, so check which company signs. Ask about per diem and permanent hiring early.

Pricing model: quoted per assignment; no rates on its site.

9. Fusion Medical Staffing: best for travel nurses and allied travelers

Verdict: a focused travel agency with a Joint Commission seal.

Fusion Medical Staffing says it "exists to connect travel nurses and allied health travelers" to travel jobs. It supplies facilities with professionals "in therapy, lab, travel nursing, and allied healthcare," and has operated since 2009. It says it "has earned the Joint Commission's Gold Seal of Approval."

Best for: hospitals short on travel nurses, lab staff and therapists.

Watch out for: its offer centers on travel contracts, so add another agency for locums, per diem or permanent hires. It is a different company from Fusion Healthcare Staffing.

Pricing model: quoted per assignment; no rates on its site.

10. Health Carousel: best for internationally educated nurses

Verdict: the pick for an international nurse pipeline.

Health Carousel offers "world-class healthcare staffing and workforce management solutions" and says it is "led by a clinical team". It says it has "cared for more than 15 million patients since 2004." Its divisions cover international staffing, US travel nursing and allied health, and workforce solutions.

It says it was named the largest international nurse staffing firm, and that it treats "nurses as employees, not just contract labor".

Best for: hospitals building a long-term supply of internationally educated nurses.

Watch out for: its strength is international and travel nurses, so add another agency for locums or per diem shifts.

Pricing model: quoted per assignment; no rates on its site.

Which healthcare staffing agencies are privately owned?

AMN Healthcare is the only agency here that is publicly listed. The others fall into three groups: owned by investors, private with no investor named, and silent on ownership.

• AMN Healthcare: public, listed on the New York Stock Exchange as AMN.
• Cross Country Healthcare: "a privately held, standalone company" owned by Knox Lane, an investment firm, since July 2026. Its locums division went to All Star Healthcare Solutions, also a Knox Lane company.
• Medical Solutions: Centerbridge Partners announced in 2021 that Medical Solutions would be acquired by Centerbridge and CDPQ. The agency does not publish its current owner.
• Aya Healthcare: its own 2019 release places it among "the nation's fastest-growing private companies" on the Inc. 5000. It names no outside investor.
• Jackson Healthcare: on Forbes' America's Top Private Companies for the third year, per its own release. It names no outside investor.
• Amergis, CHG Healthcare, Fusion Medical Staffing and Health Carousel: do not publish their ownership.

A third-party list is not proof. If ownership matters to your board, ask the agency to state its owners in writing and whether a sale is pending.

How much do healthcare staffing agencies charge?

None of the nine agencies publishes a bill rate or fee; each client page ends in a staffing request form. NSI Nursing Solutions, which sells hospitals a service to cut travel nurse use, surveyed 527 hospitals in 40 states for its 2026 report. It puts the average annual fee for one travel nurse at $189,758.

Travel and per diem staff are billed by the hour, permanent placements carry a one-time fee, and locums are quoted per assignment. More on those models in staffing and recruiting companies and recruitment agency fees.

How do you choose a healthcare staffing agency?

Which lines do you need on one contract?

List the clinician types you order in a year and match them to the seven checks in the ranking table. For locum physicians, look at AMN, Aya, CHG, Jackson and Amergis.

How big is the gap you are filling?

The national RN vacancy rate is 8.6%, and 33.1% of hospitals report a rate of 10% or more, according to the 2026 NSI report. A few open shifts suit a per diem app. At double-digit vacancy, plan travel cover and a permanent hiring push together.

Does the agency hold Joint Commission certification?

The Joint Commission certifies healthcare staffing services. AMN, Aya, Medical Solutions and Fusion name it, and CHG names it for CompHealth. Ask for the certificate and the entity it covers.

Is the managed service program vendor-neutral?

AMN offers vendor-neutral, master supplier or hybrid programs, and Jackson runs vendor-neutral management through HWL. Aya and CHG sell their own VMS, Medical Solutions lists managed services, and Amergis uses a partner. In a master supplier model, ask how and when other agencies receive orders.

Will you still want agency staff next year?

The 2026 NSI report found 70.7% of hospitals plan to cut travel or agency use, though it stayed a top strategy during shortages. Short contracts and a clear exit clause keep that option open.

When should a hospital hire directly instead?

Hire directly when the role is permanent, reopens every year and your team can run the outreach. An experienced RN takes 78 days to recruit, and losing one bedside RN costs a hospital $60,090 on average, according to the 2026 NSI report.

The direct route with The Cognitive has three steps. The recruiter writes a brief, emails the nurses and allied staff who match, and sends a live AI interview to those who reply. The unit manager then reads a recorded, scored first round.

A Canadian nurse staffing agency using The Cognitive for first interviews reports time to first interview falling from 5 days to 3 hours and drop-off from 58% to 12%. It also reports 45 positions filled in 30 days across Ontario, British Columbia and Alberta. Details are in the case study.

Software comparisons for hospitals sit in the best healthcare recruiting software, and nurse sourcing tactics in recruiting for healthcare.

When not to pick The Cognitive

• A unit is short this week. The Cognitive supplies no travelers, housing or travel contracts.
• Credentialing has to come off your plate. It does not credential or privilege clinicians, or run background checks.
• Someone else should employ the clinician. There is no payroll, W-2 employment or malpractice cover.
• The need is shifts, not jobs. There is no shift scheduling, float-pool app, VMS or managed service program.

Start with one hard-to-fill role

Choose a permanent role that usually goes to an agency, such as a night-shift ICU nurse or a respiratory therapist. Describe it in two lines and look at who matches nearby. The 7-day trial needs no card and shows 100 people free. Create a free account.

Sources

• NSI Nursing Solutions, 2026 NSI National Health Care Retention and RN Staffing Report, 2026. nsinursingsolutions.com
• Centerbridge Partners, "Medical Solutions to be Acquired by Centerbridge Partners and CDPQ", 30 August 2021. centerbridge.com
• Cross Country Healthcare, "Knox Lane Completes Acquisition of Cross Country Healthcare", 21 July 2026, crosscountry.com.
• Jackson Healthcare, release on Forbes' America's Top Private Companies, December 2025, jacksonhealthcare.com.
• Aya Healthcare, Inc. 5000 release, 14 August 2019.
• Agency websites: amnhealthcare.com, ir.amnhealthcare.com, ayahealthcare.com, medicalsolutions.com, chghealthcare.com, crosscountry.com, jacksonhealthcare.com, amergis.com, fusionmedstaff.com, healthcarousel.com, thecognitive.io.

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