Cross Country Healthcare, Inc
Cross Country Healthcare is a U.S.-based workforce solutions company focused on staffing and labor-management services for healthcare and related end markets. Its core business is placing nurses, allied health professionals, physicians, advanced practice providers, and other clinicians into temporary, local, travel, per diem, and permanent roles. The company also sells workforce management software and advisory services through Intellify®, which helps health systems manage internal and contingent labor in one view. In addition to healthcare staffing, Cross Country serves education and PACE programs, giving it exposure to multiple labor-intensive service markets. In 2025, the company agreed to be acquired by Aya Healthcare, which is expected to reshape its strategic and ownership profile.
Fiscal year 2025 · change from previous year
Development 2020–2025
Business
Share of revenueTravel, per diem, local contract, and allied health placements for healthcare facilities.
Locum tenens and temporary physician, CRNA, NP, and PA coverage.
Intellify® cloud-based workforce management, VMS, and labor analytics services.
Teacher, substitute teacher, and other education-related staffing placements.
PACE staffing, retained search, and other outsourcing services including MSP agency work.
Products
Reported · share of revenue- Temporary Staffing Services97.2 %
- Other Services2.8 %
Source: 10-K FY2025, revenue the company reports per product line (SEC XBRL). Shares are of the lines shown and add up to 100 %.
Customers
Cross Country sells primarily to healthcare providers that need flexible clinical labor to cover shortages, seasonal demand, and specialty gaps. Its customer base includes acute care hospitals, health systems, outpatient clinics, ambulatory centers, physician practices, rehabilitation facilities, urgent care centers, managed care providers, and pharmacies. The company also serves PACE programs, schools, correctional facilities, and government facilities, reflecting a broader staffing footprint beyond hospitals. Customers buy from Cross Country to fill open shifts quickly, access screened clinicians, reduce labor-management complexity, and improve continuity of care. Larger customers also use its MSP and VMS capabilities to centralize contingent labor procurement and improve visibility across internal and external staffing.
Buy travel nurses, allied staff, locums, and workforce management tools to cover shortages and manage labor spend.
Use temporary clinicians and local staffing to maintain service continuity across clinics, ambulatory centers, and rehab facilities.
Purchase locum tenens physicians and advanced practice professionals for temporary coverage and specialty access.
Buy staffing and support services to serve elderly participants and meet program operating needs.
Use substitute teachers and other education staffing to fill vacancies and manage staffing volatility.
Strategy
Cross Country’s strategy centers on being a full-spectrum healthcare labor partner rather than only a transactional staffing vendor. The company is pushing its AI-enabled Intellify® platform to give health systems visibility across internal and contingent labor, which strengthens customer stickiness and broadens the relationship beyond fill-rate execution. It is also expanding PACE and other non-hospital offerings to diversify demand and capture policy-supported growth areas. The announced merger with Aya Healthcare is the dominant near-term strategic event and suggests the company is prioritizing transaction completion and integration readiness over standalone expansion. Operationally, management is focused on streamlining costs, addressing workforce challenges, and improving the efficiency of its staffing and managed-service model.
Software and advisory services can deepen customer relationships and reduce reliance on pure staffing volume.
Broader end markets can offset volatility in travel nurse demand and open policy-supported growth avenues.
The transaction is the key corporate event and will determine future ownership and operating structure.
Geography
Cross Country operates nationally across the United States and markets its services on a national, regional, and local basis. The company emphasizes a broad U.S. footprint because healthcare staffing demand is highly local, with different specialty shortages and wage dynamics by market. It also maintains significant back-office operations in India through Cross Country Infotech, which supports information systems, finance, accounting, and administrative processing. That offshore support structure helps scale operations, but it also creates exposure to foreign regulatory, data-security, and currency risks. The company’s 2025 disclosures also highlight state-level expansion in PACE and federal policy changes affecting Medicare Advantage integration and rural access.
Risks
Cross Country is exposed to cyclical demand in healthcare staffing, where hospital census, labor budgets, and bill-rate pressure can change quickly. The company’s results are sensitive to clinician supply, because shortages or burnout can reduce the number of professionals available for assignment and can also raise pay rates faster than bill rates. Intermediary organizations, MSPs, and VMS platforms can compress margins by adding fees and reducing direct customer relationships, especially when competitors win managed-service placements. The company also faces execution and regulatory risk around the pending Aya merger, along with international operating risk from its India-based support functions. More broadly, staffing companies face credit risk, customer concentration, reimbursement pressure, and public-health shocks that can disrupt both demand and supply.
- Intermediary and MSP/VMS margin compressionImpact: HighLikelihood: High
Third-party staffing intermediaries charge fees and can disintermediate Cross Country from end customers.
Exposure: Managed service and agency staffing channels
- Declining staffing demand and rate pressureImpact: HighLikelihood: Medium
Healthcare customers can reduce temporary labor usage when census, budgets, or staffing conditions improve, while pay rates may stay elevated.
Exposure - Aya merger execution and regulatory riskImpact: HighLikelihood: Medium
The pending transaction depends on regulatory approvals and closing conditions; delay or failure could affect business plans and stock price.
Exposure: Corporate transaction and strategic planning
- International operations and data-security riskImpact: MediumLikelihood: Medium
Critical back-office functions are concentrated in India, exposing the company to foreign regulatory, tax, and cybersecurity issues.
Exposure: Infotech support operations
- Credit and collectability riskImpact: MediumLikelihood: Medium
Healthcare customers may delay payment or default, increasing allowance needs and reducing cash conversion.
Exposure: Accounts receivable and MSP arrangements
Accounting
Judgemental itemsContract structure determines whether Cross Country records the full bill rate or only an administrative fee, affecting top-line revenue and gross margin.
Impact: Material for revenue growth and margin analysis
Acquisitions create goodwill and trade names that must be tested for impairment when performance weakens or assumptions change.
Impact: Can create large noncash charges
Staffing receivables depend on customer solvency and billing accuracy, so reserves can move with collections and rate/hour disputes.
Impact: Affects operating income and cash conversion
Fees tied to the Aya transaction are recorded in acquisition and integration-related costs and can obscure underlying operating trends.
Impact: Distorts comparability across periods
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Last updated: 24/09/2026