# Cross Country Healthcare, Inc

> Clarifo company profile — qualitative business description generated from
> the company's filings. Financial statements, charts and ratios are
> available on Clarifo (https://www.clarifo.com/en/companies/Cross Country Healthcare, Inc).

## Overview

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.

## Products & services

• Travel nurse and allied healthcare staffing
• Per diem and local short-term staffing
• Physician Staffing and locums coverage
• Intellify® workforce management and VMS
• MSP, RPO, and outsourcing services
• Education staffing and school placements
• PACE program staffing and care support

- **Nurse and Allied Staffing** (72%) — Travel, per diem, local contract, and allied health placements for healthcare facilities.
- **Physician Staffing** (18%) — Locum tenens and temporary physician, CRNA, NP, and PA coverage.
- **Workforce Management Software and Advisory** (5%) — Intellify® cloud-based workforce management, VMS, and labor analytics services.
- **Education Staffing** (3%) — Teacher, substitute teacher, and other education-related staffing placements.
- **PACE and Other Services** (2%) — PACE staffing, retained search, and other outsourcing services including MSP agency work.

- Travel nurse and allied healthcare staffing
- Per diem and local short-term staffing
- Physician Staffing and locums coverage
- Intellify® workforce management and VMS
- MSP, RPO, and outsourcing services
- Education staffing and school placements
- PACE program staffing and care support

## 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.

- **Acute care hospitals and health systems** (primary) — Buy travel nurses, allied staff, locums, and workforce management tools to cover shortages and manage labor spend.
- **Non-acute care and outpatient providers** (primary) — Use temporary clinicians and local staffing to maintain service continuity across clinics, ambulatory centers, and rehab facilities.
- **Physician practices and specialty groups** (secondary) — Purchase locum tenens physicians and advanced practice professionals for temporary coverage and specialty access.
- **PACE programs and senior-care operators** (secondary) — Buy staffing and support services to serve elderly participants and meet program operating needs.
- **Education and public-sector institutions** (secondary) — Use substitute teachers and other education staffing to fill vacancies and manage staffing volatility.

- Hospitals and health systems needing temporary clinical coverage
- Outpatient and ambulatory facilities filling specialty staffing gaps
- Physician practices and locum users needing short-term providers
- PACE programs requiring non-healthcare and care-support staffing
- Schools and education facilities needing teachers and substitutes
- Government, correctional, and underserved-community facilities
- Customers seeking MSP/VMS tools to manage contingent labor

## 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.

- **United States** (95%) — Primary operating and revenue market based on company disclosures.
- **India** (5%) — Back-office and technology support operations through Infotech; not a revenue geography disclosure.

- Revenue is primarily generated in the United States
- Sales and staffing are organized nationally, regionally, and locally
- India hosts key back-office and technology support functions
- PACE expansion is tied to state-level and federal policy changes
- Local labor markets matter because clinician supply and rates vary by region

## 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.

- **Scale Intellify® and integrated workforce solutions** (medium-term) — Software and advisory services can deepen customer relationships and reduce reliance on pure staffing volume.
- **Expand PACE and diversified care settings** (medium-term) — Broader end markets can offset volatility in travel nurse demand and open policy-supported growth avenues.
- **Complete the Aya Healthcare merger** (short-term) — The transaction is the key corporate event and will determine future ownership and operating structure.

- Expand Intellify® as a workforce management and analytics platform
- Sell across the labor continuum, not just temporary staffing
- Grow PACE and other non-hospital service lines
- Use enterprise sales to deepen relationships with health systems
- Streamline operations and address workforce supply constraints
- Prepare for the Aya Healthcare merger and related integration

## 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.

- **Declining staffing demand and rate pressure** [high] — Healthcare customers can reduce temporary labor usage when census, budgets, or staffing conditions improve, while pay rates may stay elevated.
- **Intermediary and MSP/VMS margin compression** [high] — Third-party staffing intermediaries charge fees and can disintermediate Cross Country from end customers.
- **Aya merger execution and regulatory risk** [high] — The pending transaction depends on regulatory approvals and closing conditions; delay or failure could affect business plans and stock price.
- **International operations and data-security risk** [medium] — Critical back-office functions are concentrated in India, exposing the company to foreign regulatory, tax, and cybersecurity issues.
- **Credit and collectability risk** [medium] — Healthcare customers may delay payment or default, increasing allowance needs and reducing cash conversion.

- Travel nurse and allied demand can fall when hospital volumes normalize
- Bill rates may not keep pace with clinician pay rates and wage inflation
- MSP and intermediary fees can reduce margins and customer control
- Aya merger delay or failure could affect valuation and operations
- India-based support functions create regulatory and cybersecurity exposure
- Customer payment delays can increase bad debt and working-capital strain
- Public health crises can disrupt clinician supply and assignment continuity

## Accounting

Cross Country’s accounting is heavily influenced by how staffing contracts are structured, especially whether revenue is recorded on a gross or net basis. Physician Staffing is recognized gross because the company is the principal, while certain MSP arrangements are recorded net after subcontractor liabilities, which can materially change reported revenue and margins. Revenue and operating results can also swing with assignment volume, bill rates, and mix between travel, per diem, and physician staffing, so quarterly comparisons may be volatile. The company’s financial statements also depend on judgmental estimates for goodwill and intangible asset impairment, especially after acquisitions and in a weaker demand environment. Investors should also watch allowances for credit losses, sales allowances, self-insurance accruals, restructuring costs, and merger-related expenses, all of which can affect earnings and cash flow timing.

- **Gross versus net revenue recognition** — Material for revenue growth and margin analysis
- **Goodwill and intangible asset impairment** — Can create large noncash charges
- **Allowance for credit losses and sales allowances** — Affects operating income and cash conversion
- **Merger-related costs** — Distorts comparability across periods

- Gross vs net revenue presentation affects reported revenue and margins
- Physician Staffing is recorded gross; some MSP work is recorded net
- Revenue mix shifts between travel, per diem, and physician staffing drive volatility
- Goodwill and intangible impairment testing can create large noncash charges
- Allowance for credit losses depends on customer payment behavior
- Self-insurance, litigation, and restructuring accruals require judgment
- Merger-related fees and integration costs can distort period comparisons

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*Last updated: 2026-08-11T04:46:27.166511+00:00*