The healthcare staffing industry connects medical facilities with skilled professionals to meet temporary and permanent staffing needs across a variety of roles. The sector includes traditional healthcare staffing services like travel nursing, per diem staffing, and locum tenens, but also includes a variety of firms focused on specialty staffing and outsourced niche services. The industry generally plays a critical role in addressing labor shortages, fluctuating patient demand, and regulatory compliance. According to one source, the global healthcare staffing market was valued at $69.3 billion in 2024 and is expected to grow at a compound annual growth rate (CAGR) of 7.8% through 2034. Another source projects an 8.4% CAGR through 2029. However, the industry is notably subject to business cycles that mirror the labor market.
Key Growth Drivers
Key growth drivers for the industry include the following:
Aging Population and Chronic Disease Prevalence: The aging U.S. population continues to drive demand for healthcare services, particularly in geriatrics, oncology, and chronic disease management. This demographic shift increases the need for specialized staffing solutions to address complex care needs.
Healthcare Workforce Shortages: Persistent shortages of healthcare professionals, including nurses and specialists, are a major growth driver. For instance, the U.S. is projected to face a shortfall of over 4 million healthcare workers by 2026. Staffing agencies are critical in filling these gaps.
Technological Advancements: The adoption of artificial intelligence, data analytics, and digital platforms is transforming recruitment processes. These technologies streamline hiring, reduce costs, and enable faster matching of professionals to vacancies, which can both help and hurt staffing firms.
Flexible Work Models: Increasing demand for flexible work arrangements—such as gig roles, per diem shifts, and part-time contracts—has reshaped the industry. These models help attract talent while addressing fluctuating patient volumes, and can be difficult for healthcare providers to implement on their own.
Regulatory Changes: New regulations mandating nurse-to-patient ratios and staffing levels are driving demand for temporary staffing solutions to ensure compliance without long-term employment costs.
Rise of Home Healthcare and Telemedicine: Growth in home healthcare services and telemedicine has expanded the scope of healthcare staffing to include virtual roles like telehealth providers and medical coders. This trend reflects evolving patient care models and technological integration.
Healthcare Staffing M&A Trends
Healthcare staffing M&A, perhaps more than any other healthcare niche, experienced a massive boom during the pandemic corresponding with staffing shortages across the industry and corresponding surges in rates and placements. Announced M&A volumes fell of a cliff (normalized?) in 2023, but are showing signs of a rebound. It's also important to note that the boom/bust primarily occurred in the traditional staffing and travel nursing segment, while the broader "specialty services" staffing category has remained relatively steady from an announced deal volume perspective.
Major acquirers in the specialty services staffing category include radiation physics provider Apex, vascular access and infusion nurse staffing provider Dynamic, and pediatric home therapy staffing provider InHome Therapy. The general staffing and travel nursing category has mostly been dominated by current / formerly publicly-traded firms Aya, AMN, and Cross Country, but there are several large sponsor-backed platforms as well.
Healthcare Staffing EBITDA Multiples
Local Healthcare Staffing Operators (typically revenue under $5M):
These companies usually sell for lower multiples, ranging from 2.5x to 5x EBITDA. The lower multiple is often due to higher operational risk, lower revenue diversification, and limited geographic reach, as well as a heavy reliance on the owner / operator, which can lead to employer contract retention and business continuity concerns. In fact, some smaller staffing agencies may have little to no enterprise value separate from the efforts of the owner / operator.
Larger Regional or Niche Staffing Agencies / Specialty Service Providers (revenue $5M-$50m):
Larger, more established companies with proven profitability and a broad contracted customer base can command higher multiples. These typically range from 5x to 10x EBITDA, depending on size, type, contract terms, growth rate, and the stability of the cash flow.
Large National Agencies:
Large national agencies operating in traditional healthcare staffing markets can command multiples in the 8x to 12x EBITDAÂ range.
High-Growth Niche Service Providers and Technology Platforms:
Specialty staffing and services providers of scale in growth niches with strong, continuing management teams can command multiples in the 10x to 20x EBITDAÂ range, especially if they have elevated, durable margins and demonstrate the ability to grow quickly organically or through M&A.
Soliant Acquired by Vistria for $2.5b
Private equity firm The Vistria Group has recapitalized / acquired / made a strategic investment in Soliant in a deal that implies an enterprise value of roughly $2.5 billion. The deal was announced about four years after middle market buyout fund Olympus Partners bought the business for $612 million from Adecco Group (~11x EBITDA at that time). Soliant operates in two distinct markets, serving both hospitals and schools. Massive growth in Soliant's educational staffing segment (K-12) has overshadowed recent struggles in the travel nursing segment (hospitals). It now serves over 3,000 school districts and more than 700 hospitals across the United States.
According to Moody's, the Soliant deal is financed with $1.49 billion of debt at 5.7x leverage, which implies EBITDA of $261 million and a deal multiple of 9.6x, about five times Soliant's 2019 EBITDA of $54 million to tie things back to figures included in the current press reporting. Also according to the Moody's report:
Under the previous private equity owner and following the 2019 separation from Adecco Group AG, the company more than doubled its revenue scale. Moody's expects over $1 billion of revenue in 2024, compared to $392 million in 2020.
The relatively low multiple compared to other large healthcare staffing precedents deals is a little surprising given the steady growth of the much larger educational segment, and may hint at some regulatory risk for a business that is heavily supported by federal and state regulations.
Cross Country Healthcare Acquired by Aya Healthcare for $615m
Cross Country Healthcare announced in December that it agreed to be acquired by Aya Healthcare in a deal that implies an enterprise value of roughly $615 million. According to the fairness opinion prepared in support of the deal, estimated 2024 adjusted EBITDA is ~$51 million, implying a 12.1x EBITDA multiple.
Management projects minimal revenue growth, but pretty significant margin expansion leading to 14% EBITDA CAGR and a year 5 multiple of 6.3x.
Healthcare Staffing EBITDA Multiple Trends
Multiples for larger healthcare staffing firms have mostly trended upwards slightly over the past ten years, outside of a few smaller travel nursing deals with disclosed financial details that were announced shortly after the post-pandemic peak for bill-rates and demand. Without those two deals, the chart below looks quite different.
Current EBITDA Multiples for Small Healthcare Staffing Firms
Small, subscale healthcare staffing firms typically fetch much lower multiples, if they can even be sold, as heavy owner-operator involvement can be difficult to replicate by buyers. According to data from our active listings database, staffing firms with under $1 million EBITDA tend to be marketed in the 2-5x range, while firms with $1-10 million are marketed in the 4-7x range.
Active Healthcare Staffing Listings
The following is a summary of a few actively listed healthcare staffing deals from our active listings database:
(links will break over time)
Nationwide Travel Nurse Staffing: Listed for sale at $31.2m, this company is marketed based on estimated revenue and adjusted EBITDA of $30.3m and $5.2m, respectively, implying multiples of 1.0x revenue and 6.0x EBITDA.
Michigan Nurse Staffing: Listed for sale at $5.6m, this company is marketed based on estimated revenue and cash flow of $17.7m and $1.4m, respectively, implying multiples of 0.3x revenue and 4x cash flow.
Texas Nurse Staffing: Listed for sale at $6.05m, this company is marketed based on estimated revenue and cash flow of $6m and $1.9m, respectively, implying multiples of 1.0x revenue and 3.2x cash flow.
LTC Nurse Staffing: Listed for sale at $7m, this company is marketed based on estimated revenue and adjusted EBITDA of $13m and $1.56m, respectively, implying multiples of 0.5x revenue and 4.5x EBITDA.
Factors Impacting the EBITDA Multiple for Outsourced Healthcare Staffing Providers
Acquisition multiples are a function of perceived risk and growth. Key considerations within the healthcare staffing industry include the following:
Revenue Scale & Growth Rate – Firms with larger revenue bases and strong year-over-year growth attract higher multiples due to their stability and scalability.
Gross & EBITDA Margins – Durably high margins, driven by efficient workforce management, strong pricing power, and cost control, lead to stronger valuations.
Specialization & Niche Focus – Firms specializing in high-demand, high-margin segments tend to receive higher multiples compared to generalist staffing firms.
Client Diversification & Contract Stability – A well-diversified client base with long-term contracts (hospitals, clinics, long-term care facilities) reduces concentration risk and increases valuation.
Recruiting & Retention Capabilities – Firms with strong candidate pipelines, proprietary databases, and high retention rates for clinicians and healthcare professionals are more valuable to buyers.
Regulatory & Compliance Risk – Adherence to healthcare staffing regulations, licensing requirements, and labor laws minimizes risk and increases buyer confidence, positively impacting multiples.
About Scope Research
Scope Research compiles a variety of healthcare M&A databases and provides healthcare valuation services. The Scope Research Healthcare M&A Valuation Database currently has financial details for 105 healthcare staffing and physician contracting deals going back to 2010, 64 of which include reported EBITDA multiples. The healthcare staffing data can be purchased individually, while our affordable annual subscriptions provide access to all of our healthcare M&A databases and segments, updated continuously.
Don't hesitate to reach out to Will Hamilton at will@scoperesearch.co with questions about our healthcare staffing valuation services or healthcare M&A databases.