Key takeaways:
- SIA’s September forecast has locum tenens growing 4% in both 2026 and 2027, while per diem nursing drops 7% this year. And strike work is the only thing keeping travel nursing in positive territory.
- A firm with all three desks might have one desk carrying the others right now. You can’t rely on market data for the answer.
- Grade each desk against its own segment and strip strike revenue out of your travel baseline. Then put new recruiter hours where your desk beats its market.
If your healthcare division finished the year about flat, it wouldn’t be surprising, since the market is relatively flat too. Staffing Industry Analysts (SIA) expects US healthcare staffing to grow 1% in 2026, to $39.0 billion.
However, breaking it down, locum tenens is forecast to grow 4% this year and 4% again in 2027. Per diem nursing, the weakest domestic segment, is projected to fall 7% in 2026 before leveling off. Travel nursing is on track for 2% growth, but SIA says it would have declined without strike work.
If you’re serving multiple healthcare segments, you should find out if one is carrying the others before planning 2027 headcount. We covered how to split a blended growth rate by desk for staffing overall. But healthcare adds three wrinkles to that method.
1. Credentialing capacity limits how fast your locums desk can grow
A 4% segment forecast doesn’t guarantee a 4% desk. AMN Healthcare, one of the largest locums suppliers, reported Q2 2026 locums revenue of $131 million. That was down 8% from a year earlier. SIA’s July pulse survey put the median locums firm at 2% growth in June, half the forecast pace.
SIA links locums growth to physician shortages in anesthesiology, radiology, cardiology, oncology, and surgery. The Health Resources and Services Administration expects a shortage of 141,160 full-time-equivalent physicians by 2038 and projects anesthesiology supply at just 83% of demand.
The limit is in clinician supply and paperwork. Every new facility needs its own credentialing and privileging file before a provider can start. In a November 2025 MGMA poll, 32% of medical groups said their credentialing files were running late, mostly because of backlogs.
So if your locums desk trails the segment, more sales calls isn’t the solution. Look first at how many providers each recruiter can keep credentialed and current. AI can help with the tracking work, like flagging upcoming expirations and chasing missing items. But keep the documents themselves in a secured system. And licenses still need confirmation from the issuing board; no model can replace that step.
2. Per diem still has a pricing pitch as the market shrinks
Individual firms may fall well above or below the projected 7% decline in per diem. In SIA’s July pulse survey, the median per diem firm grew 3% year over year in June.
SIA also notes that hospitals still see local per diem as a cheaper alternative to travel assignments. So firms can position per diem as the budget option for clients who are trimming travel spend.
If your desk is tracking down from the market, you have a choice to either rework the fee structure so the desk clears margin at lower volume or plan an orderly exit that protects your best client relationships. Avoid adding recruiters to the desk while you decide.
3. Strike revenue is inflating your travel baseline
Strike assignments bill at higher rates than standard travel, and they vanish fast. SIA says record strike staffing lifted travel revenue in 2026, and it anticipates less of that work in 2027.
AMN’s results illustrate how tricky it can get. The company booked $722 million in labor disruption revenue in Q1 2026, then $25 million in Q2. Any firm that plans 2027 from a strike-heavy 2026 will set targets its travel desk can’t achieve.
Margins add pressure. SIA’s travel nurse benchmarking found median gross margins fell from roughly 25% before the pandemic to 19.9% in 2025. Revenue growth alone won’t tell you whether travel is earning its keep.
Tag strike assignments separately in your books. Use the non-strike baseline when building next year’s travel plan, and any new strike work will be an upside.
Find out which desk is funding the other
If you have the last four quarters of revenue and gross profit for each desk, you can compare each desk’s year-over-year change to its segment forecast. Next, divide gross margin by total recruiter hours to prevent a large desk from hiding an inefficient one.
Recognizing performance patterns guides resource allocation. When a locums desk outperforms its segment while per diem declines, locums is carrying the division, warranting a shift of per diem recruiter capacity toward locums sourcing and credentialing.
On the other hand, an outperforming per diem desk might hide market share loss on the locums side. Addressing this imbalance in your core segment is critical before finalizing the 2027 budget.
