Contingent Workforce Archives - The Future of Work Exchange

Workforce Orchestration Unlocked: Elevating Services to Drive Enterprise Value

Contingent Workforce Technology and Innovation by John Yuva on 09/17/2026

The extended workforce has become too important for organizations to manage through disconnected programs and isolated service providers. With contingent talent representing roughly 48% to 49% of the workforce in many industries, organizations increasingly need a more strategic approach to managing how work gets done. The challenge is not simply finding talent, as was pointed out during a recent Future of Work Exchange (FOWX) Podcast, featuring FOWX Managing Director Christopher Dwyer and Atrium’s VP of Enterprise Solutions, Kelly Couto. It’s about understanding where talent is needed, which workforce models make sense, and how different services can work together to create measurable business value.

That is where workforce orchestration is emerging as an important concept.

The modern workforce ecosystem includes a growing range of services, including managed service programs, employer of record and agent of record models, recruitment process outsourcing, embedded recruiting, early talent programs, direct sourcing, and SOW engagements. Rather than viewing these offerings as competing alternatives, Couto said organizations can increasingly treat them as components of a broader workforce strategy.

The starting point, however, should not be the technology or the service. It should be the business objective. As Couto explained, organizations need to begin by defining what success looks like and then identifying where they can create the greatest impact. That could mean examining specific labor categories, expanding into multiple workforce areas, adding embedded recruitment resources, launching an RPO program, strengthening an early talent strategy, or implementing an MSP that brings multiple elements together.

This strategy-first approach matters because every organization arrives with a different workforce environment. Some may already have sophisticated internal technology and established workflows. Others may have adopted new AI tools without fully understanding how those technologies fit into their broader ecosystem.

The role of services is therefore changing, noted Couto. Services can increasingly act as the connective layer between people, process, data, and technology. Rather than simply executing transactions or supplying talent, service providers can help organizations understand their current environment, identify gaps, determine where technology can create value, and build a phased strategy for improvement. That creates a more flexible model for workforce transformation. Couto emphasized that an organization does not necessarily need to overhaul every component of its workforce strategy at once. It can identify a high-impact area, create measurable results, and then expand into adjacent areas as the operating model matures.

This is particularly important as workforce strategies become more complex. Procurement, HR, talent acquisition, and business leaders increasingly need to coordinate around the same workforce objectives. They must understand supplier performance, talent availability, workforce costs, compliance, technology capabilities, and the employee and worker experience. Technology can provide important capabilities, said Couto, but technology alone cannot determine the right operating model.

That is why workforce orchestration is becoming increasingly relevant. The objective is not simply to deploy more tools or add more services. It is to connect the right capabilities around clearly defined business outcomes.

Couto shared that the organizations that make the greatest progress may not be those with the most technology or the largest number of workforce programs. They may be the organizations that understand how their workforce ecosystem fits together and can continuously adjust it as business needs change. The future of workforce management will require more than talent acquisition, staffing, or technology in isolation. It will require orchestration across all three.

The rest of this article is available by subscription only.

Introducing a New Subscription Model

To continue providing valuable insights and resources on the future of work and extended workforce management, we’re transitioning our site to a paid subscription model. While some posts will remain free, subscribing will grant you exclusive access to in-depth analysis, market research, expert interviews, and actionable strategies that will help improve your business. Solution providers and practitioners are invited to join today and gain a competitive edge by tracking the industry’s important innovations, emerging trends, and best practices.

Click here to learn more.

The Future of Contingent Workforce Management Is Orchestration

Artificial Intelligence Contingent Workforce Talent Acquisition Technology and Innovation by John Yuva on 09/10/2026

The contingent workforce has become too important to manage as a collection of isolated transactions. Organizations are balancing fluctuating demand, specialized skills, constrained budgets, supplier relationships, compliance requirements, and growing expectations around workforce flexibility. As a result, contingent workforce leaders are increasingly being asked to do more than fill openings. They are being asked to orchestrate talent, technology, suppliers, and business requirements around broader workforce outcomes.

That shift was a central theme during a recent Future of Work Exchange (FOWX) Podcast, featuring Cristin Monnich, Head of Services for Worksuite. Monnich highlighted a fundamental change in how organizations should think about external talent: not simply as labor to procure when internal capacity falls short, but as a strategic source of skills, relationships, flexibility, and competitive advantage.

The rest of this article is available by subscription only.

Introducing a New Subscription Model

Click here to learn more.

Beyond Traditional Workforce Models: Building a Smarter Total Talent Strategy

Business Leadership General Insights Talent Uncategorized by John Yuva on 05/21/2026

Whether enterprises realize it or not, it is time to approach total talent management as an ecosystem value chain. Like supply chains, which are not linear segments but rather a spiderweb of inputs, the total talent ecosystem has a similar construct. With enterprise talent and strategy at the center hub, the various talent inputs such as FTEs, gig workers, contractors, and external talent serve as spokes that feed into organizational strategic objectives. As an ecosystem, it is about accessing the best talent from an arsenal of channels.

Using a sports analogy, enterprises now have a valuable “bench of players” from whom to select for various projects and initiatives. With total talent intelligence, organizations can tap employees with specific skillsets that may not be core to their current roles. Through the utilization of HR solutions, there should be transparency in the full depth that each employee brings to the enterprise.

The rest of this article is available by subscription only.

Introducing a New Subscription Model from the Future of Work Exchange.

Click here to learn more.

Smarter Talent, Faster Hiring: AI’s Expanding Role in CWM

Contingent Workforce Direct Sourcing Solution Providers Talent Talent Acquisition Technology and Innovation by John Yuva on 05/14/2026

Artificial intelligence is becoming a permanent fixture as part of today’s enterprise operations and talent management approaches, serving as an essential technology for contingent workforce management (CWM) strategies that streamline candidate pairings with operational needs while increasing transparency of available skillsets and workforce contributions. Whether shoring up talent gaps or scaling needs, AI provides external workforce insights invaluable to HR and recruitment professionals and business leaders. The evolution of artificial intelligence will mean the emergence of more CWM opportunities.

Enterprises and HR executives who are not at least exploring the possibilities of AI’s impact on CWM will find themselves at a competitive disadvantage when sourcing talent and executing extended workforce strategies. Beeline stated that the “effects of AI in extended workforce management are just beginning and can be seen shaping how jobs are described, how candidates are evaluated, and how contracts are written. AI will soon be employed for more strategic outcomes like workforce planning, workforce optimization, and total workforce management.”

The rest of this article is available by subscription only.

Introducing a New Subscription Model

Click here to learn more.

AI, Total Talent, and the Road to 2026 — What the Next Generation of Workforce Programs Will Demand

Contingent Workforce Talent Talent Acquisition Technology and Innovation by John Yuva on 01/15/2026

During a recent FOWX podcast, Christopher Dwyer, senior vice president of research and managing director of the Future of Work Exchange for Ardent Partners, spoke to Orli Becker, executive vice president and managing director of contingent workforce solutions for AMS, Orli Becker, on the impact of direct sourcing, the power of skills-based hiring, how AI is transforming extended workforce management, and more

In part three of our three-part series, we highlight the major discussion points and a link to the full event.

As artificial intelligence reshapes nearly every corner of the enterprise, the contingent workforce industry finds itself both energized and challenged by its potential. AI, combined with emerging workforce models like total talent management, will fundamentally redefine how organizations plan, deploy, and manage labor in the years ahead. Yet, despite the excitement, the path forward remains complex.

AI adoption in workforce solutions is accelerating rapidly. Technologies leveraging generative, predictive, and agentic AI are already enhancing sourcing, screening, workforce analytics, and program automation. These tools promise to reduce administrative burden, surface insights faster, and improve decision-making. For service-heavy industries like workforce management, AI has the potential to amplify human expertise rather than replace it, particularly when deployed with a “human-in-the-loop” approach.

AI Fragmentation and Risk Shape AI Adoption

However, the industry remains highly fragmented. Vendor management systems, MSP platforms, direct sourcing tools, freelancer management systems, SOW solutions, and contractor compliance platforms often operate in isolation. There is currently no single AI orchestrator capable of unifying these systems into a seamless user experience. This fragmentation limits AI’s impact, creating friction rather than simplicity for program stakeholders.

At the same time, organizations are approaching AI with caution. Concerns around bias, ethics, data privacy, and regulatory compliance are prompting rigorous scrutiny of AI-enabled solutions. While enterprises want innovation, they also demand assurance that these technologies are safe, transparent, and aligned with evolving legislation. This tension between opportunity and risk will likely shape AI adoption curves well into 2026.

Total Talent Management and Hybrid MSP Models Align Talent Strategies

Beyond technology, the future of workforce management will be defined by broader structural shifts. One of the most significant is the growing movement toward total talent management. Long discussed but rarely executed at scale, total talent seeks to unify internal and external workforce strategies under a single framework. This approach enables shared talent pools, consolidated analytics, and holistic workforce planning that spans full-time, contingent, freelance, and project-based labor.

The benefits of total talent are substantial. Organizations gain visibility into skills across the entire workforce, enabling more effective deployment, upskilling, and mobility. Skills-based hiring becomes exponentially more powerful when applied across all worker types, allowing enterprises to focus on capabilities rather than headcount categories. Over time, this creates a more agile and resilient workforce capable of adapting to rapid market change.

Another notable trend is the growing shift toward in-house program management. Dissatisfaction with transactional MSP models is driving many organizations to bring contingent workforce oversight internally. Increasingly, former MSP professionals are joining client-side teams, enabling enterprises to replicate cost-saving tactics without outsourcing execution. However, this does not signal the end of service providers. Instead, hybrid models are emerging, where organizations retain strategic control while leveraging external expertise for design, stabilization, or specialized services.

This evolution reflects a broader mindset shift. Talent is no longer viewed solely as a cost center but as a strategic asset tied directly to revenue, innovation, and risk management. Workforce planning, once an afterthought for contingent labor, is becoming a core discipline. Organizations that succeed in this next phase will be those that align talent strategy with long-term business outcomes rather than short-term savings.

Looking toward 2026, the message is clear. Becker remarked that the future of workforce management will demand integrated thinking, talent-centric design, and thoughtful adoption of technology. AI will play a critical role, but only when paired with human expertise and holistic strategy. Direct sourcing, skills-based hiring, total talent management, and hybrid operating models will define the next generation of programs. For organizations willing to embrace this complexity, the reward will be a workforce built not just for efficiency, but for enduring competitive advantage.

Direct Sourcing and Talent-Centric MSPs — Redefining How Organizations Access Skills

Contingent Workforce Talent Talent Acquisition by John Yuva on 01/08/2026

In part two of our three-part series, we highlight the major discussion points and a link to the full event.

Direct sourcing has long been discussed as the future of contingent workforce strategy, yet only recently has it begun to gain meaningful traction in the U.S. market. This momentum reflects a broader shift in how organizations think about talent, ownership, and workforce engagement. Direct sourcing is no longer just an efficiency play; it is emerging as a foundational pillar of talent-centric workforce models.

For years, direct sourcing struggled to move beyond theory. While organizations recognized the potential of direct sourcing to reduce costs and improve talent quality, adoption remained slow. A key reason was ownership. Contingent workforce programs traditionally sat within procurement, where the primary focus was compliance and cost control. While these priorities are critical, they often leave little room for strategies centered on candidate experience, employer branding, or long-term talent communities.

That dynamic is changing. Increasingly, HR and talent acquisition leaders are becoming influencers (and in many cases owners) of contingent workforce programs. Recent data suggests that more than half of these programs are now human resources- or talent acquisition-led, a dramatic shift from historical norms. This evolution is helping organizations better understand the true value of direct sourcing, not merely as a cost lever, but as a means of accessing higher-quality, more engaged talent.

Staffing-Aligned vs. Vendor-Neutral Direct Sourcing

At its core, direct sourcing enables organizations to leverage their employer brand to build and nurture talent pools aligned to their specific needs. These pools can include former employees, silver-medalist candidates, interns, retirees, referrals, redeployed workers nearing assignment completion, and even candidates initially considered for full-time roles. When curated effectively, these communities create a self-reinforcing talent ecosystem that reduces reliance on third-party suppliers while improving fit and engagement.

However, direct sourcing is frequently misunderstood. Many organizations equate it with simple referral management or pre-identified worker tracking, underestimating the operational complexity involved. Successful direct sourcing requires both enabling technology and experienced recruiting services. Technology alone cannot curate talent pools, nurture relationships, or deploy multi-channel attraction strategies. Without skilled recruiters and sourcers who understand how to activate a brand in the market, programs often stall or underperform. This is where the distinction between staffing-aligned and vendor-neutral direct sourcing providers becomes critical. Staffing-affiliated providers face inherent conflicts of interest, as expanding client-branded talent pools can reduce placements from their own candidate queues. Vendor-neutral models, by contrast, are incentivized to prioritize talent outcomes regardless of source, making them better suited to deliver on the full promise of direct sourcing.

Equally important, direct sourcing reframes how organizations think about ROI. While cost savings are significant (often driven by reduced markups and improved retention) the broader value lies in workforce agility. Candidates sourced directly are typically more engaged, onboard faster, and demonstrate better alignment with organizational culture. Over time, these benefits compound, improving productivity and reducing program leakage. Direct sourcing also serves as a bridge between contingent and full-time hiring strategies. Rather than operating in silos, organizations can leverage shared talent pools to support multiple workforce needs. This convergence sets the stage for more advanced workforce models, including total talent management and skills-based hiring, where the focus shifts from job titles to capabilities.

Ultimately, direct sourcing represents a philosophical shift as much as an operational one. It requires organizations to place talent (not transactions) at the center of their workforce strategy. Those that approach it as merely another cost-cutting tactic will miss its transformative potential. But for organizations willing to invest in the right technology, services, and governance, direct sourcing offers a powerful path toward a more resilient, engaged, and future-ready workforce.

The State of the Contingent Workforce Market — Why Old Models Are Breaking Down

Contingent Workforce Talent Acquisition by John Yuva on 12/18/2025

In part one of our three-part series, we highlight the major discussion points and a link to the full event.

The contingent workforce industry has reached a pivotal inflection point. What was once viewed as a tactical labor solution has evolved into a core component of enterprise workforce strategy, driven by demographic shifts, changing worker preferences, and persistent skills scarcity. As discussed in a recent Future of Work Exchange podcast conversation between Arden Partners’ Christopher Dwyer and AMS EVP Orly Becker, today’s labor market realities are exposing deep cracks in traditional contingent workforce models—particularly long-standing MSP and vendor management approaches that have failed to evolve alongside the workforce itself.

A Labor Market Redefined by Flexibility and Scarcity

At the heart of this disruption is a fundamental change in how workers choose to engage with employers. Stability and long-term tenure, once the gold standard for career success, have given way to flexibility, autonomy, and work-life balance. Younger generations increasingly favor contingent, project-based, or independent work models, while experienced Baby Boomers are exiting the workforce altogether. Compounding this shift are declining global birth rates, which are shrinking the overall labor pool. The result is a persistent imbalance between talent supply and demand, especially for specialized and in-demand skills.

The rest of this article is available by subscription only.

Introducing a New Subscription Model

Click here to learn more.

Why VMS Technology and AI Are Becoming the Strategic Core of Healthcare Workforce Management

Contingent Workforce General Insights Solution Providers by John Yuva on 12/11/2025

Did you miss Ardent Partners’ recent FOWX podcast featuring a discussion with Kelly Rakowski, CEO of Trio Workforce Solutions? The conversation tackled the impact of the extended workforce in healthcare, the pathways ahead for AI in workforce management, and how VMS platforms are serving as “strategic hubs” for contingent workforce management.

In Part Three of this three-part article series, we highlight the major discussion points and a link to the full event.

Why VMS Technology and AI Are Becoming the Strategic Core of Healthcare Workforce Management

Healthcare has reached an inflection point where workforce management, technology, and artificial intelligence are converging to reshape how organizations staff, operate, and care for patients. Vendor management systems (VMS), once viewed as back-office infrastructure for processing contingent labor orders, have now evolved into strategic platforms powering the Future of Work in healthcare. As Trio Workforce Solutions CEO Kelly Rakowski explains, the modern VMS has become a mission-critical hub capable of orchestrating labor strategies across permanent, flexible, and contingent staffing pools, while also harnessing the power of data, automation, and AI to drive smarter, faster decisions.

Traditionally, VMS platforms in the staffing industry emerged to support the operational mechanics of contingent workforce programs: job postings, candidate submittals, credentialing workflows, timekeeping, and invoicing. In healthcare, these functions were vital but insufficient. The sector’s high-stakes requirements including rigorous licensing, clinical credentialing, patient safety standards, and the need for precise experience matching, demanded more specialized technology. Yet for years, VMS adoption in healthcare lagged, and systems were often disconnected from clinical workflows and broader workforce strategy.

That reality has fundamentally changed. The pandemic exposed the limitations of manual processes, fragmented systems, and visibility gaps. Health systems now see contingent labor not as a temporary supplement, but as an essential component of workforce resiliency. Meanwhile, new flexible labor models (e.g., float pools, internal agencies, gig-based marketplaces, and telehealth staffing) require integrated visibility that no spreadsheet or siloed tool can provide.

VMS as a True Command Center

Modern VMS platforms, like Trio’s, have emerged as strategic engines for workforce orchestration. They are no longer passive systems; they are active decision-support platforms that connect supply, demand, credentials, shift data, and financials into a unified ecosystem. According to Rakowski, healthcare organizations increasingly want to manage all workforce modalities (not just contingent talent) within the same platform so they can optimize deployment, minimize premium labor, and make real-time staffing decisions based on predictive needs.

Integration. Integration is at the center of this evolution. Instead of functioning as standalone systems, VMS platforms now interface with HRIS systems, scheduling software, EMRs, payroll systems, and enterprise financial tools. This two-way data flow transforms the VMS into a true command center capable of providing real-time analytics, workforce forecasting, and proactive talent matching. For healthcare leaders, this is invaluable: sudden patient surges, unit-level census shifts, and seasonal fluctuations can be anticipated and addressed before they escalate into staffing crises.

Artificial intelligence. AI amplifies this capability. AI is rapidly becoming the catalyst for the next generation of VMS, offering powerful applications across clinical and staffing workflows. Trio, for example, is deploying AI across three critical domains: candidate submissions, timecard analysis, and contract interpretation.

AI-driven submission evaluation is perhaps the most transformative. Instead of relying solely on manual review, AI agents analyze job requirements, clinician experience, licensure, certifications, and clinical competence to identify the strongest matches instantly. This not only accelerates hiring but increases precision, meaning better fit, reduced turnover, and safer care environments.

Digital workers automating timecard analysis address another chronic pain point in healthcare. Because many health systems still rely on paper timecards or fragmented systems, managers spend hours verifying accuracy and reconciling discrepancies. AI can instantly scan, validate, and flag anomalies, dramatically reducing workload and improving billing accuracy.

Contract analysis. Contract analysis is the third frontier. Physician locum contracts, in particular, are often complex documents with multiple billing rules, travel policies, and compliance clauses. AI can extract, interpret, and operationalize contract language, ensuring accurate billing and preventing costly errors, which are capabilities that were previously impossible at scale.

Despite the growing power of AI, Trio emphasizes a balanced approach: AI is an enabler, not a replacement. Healthcare staffing relies heavily on trust, relationships, and human judgment. Cultural fit, team compatibility, bedside demeanor, and patient-centered communication cannot be evaluated solely by algorithms. AI handles high-volume, repetitive tasks while humans focus on connection, nuance, and clinical alignment.

Looking ahead, the combination of VMS technology and AI will redefine how healthcare organizations build workforce strategies. We will see advances in predictive analytics that forecast staffing shortages months in advance, AI-enabled clinical skill mapping, demand-driven float pool deployment, and fully integrated visibility across permanent and contingent clinicians. For a sector facing nationwide shortages of nurses and physicians, these innovations are not optional — they are essential.

The healthcare workforce ecosystem is becoming more complex, more flexible, and more data-driven. VMS technology, once seen as a transactional tool, is now the strategic backbone of workforce transformation. As organizations navigate rising shortages, cost pressures, and evolving care models, platforms like Trio are shaping a future where AI, data, and human expertise work together to ensure care delivery remains safe, sustainable, and resilient.

Inside Trio Workforce Solutions: A Modern Approach to Healthcare Talent and Workforce Innovation

Contingent Workforce General Insights Solution Providers by John Yuva on 12/04/2025

In Part Two of this three-part article series, we highlight the major discussion points and a link to the full event.

The healthcare labor market is undergoing significant change, and organizations are increasingly seeking innovative partners to navigate the pressures of workforce shortages, rising patient demand, and the need for more strategic labor models. Trio Workforce Solutions represents a reinvention of how healthcare organizations can blend technology, workforce intelligence, and vendor ecosystem management into a unified platform. The story of Trio — its origins, evolution, and rebrand — illustrates how the healthcare staffing industry is modernizing to meet today’s complexity with smarter, more integrated solutions.

AHSA and the Evolution of Trio

Trio’s roots date back over 20 years to the formation of American Health Staffing Association (AHSA), a managed services provider (MSP) that initially served healthcare organizations in Michigan before expanding into a national provider. AHSA was distinctive from the start: it specialized exclusively in healthcare and operated a vendor-neutral MSP model, ensuring that clients had access to the broadest, highest-quality supplier network. Its mission centered on standardizing credentialing, elevating candidate quality, improving compliance, and serving as a trusted workforce partner for hospitals and health systems.

As AHSA scaled, the complexity of healthcare workforce needs surged. The organization sought a vendor management system (VMS) that could meet the precision required for clinical staffing — licensure validation, credentialing workflows, skills documentation, and nuanced role requirements. Yet the market lacked a VMS designed specifically for healthcare’s operational and regulatory realities. Instead of adapting generic tools, AHSA made a bold decision: it built its own.

That platform became Trio. Launched in 2018, Trio was intentionally designed around the “three” essential constituencies in the staffing ecosystem: the client, the staffing supplier, and the MSP. The goal was to create an intuitive, healthcare-specific platform that offered a seamless experience for all parties, including clinicians navigating submittals, credentials, and assignments. The company later expanded Trio with specialized locum tenens capabilities, noting that locums staffing lagged behind nursing in digital transformation and required purpose-built functionality.

AHSA and Trio Unite Under One Brand

However, rapid growth created an internal divide. Trio had evolved into a SaaS platform with its own customer base — in some cases independent of the MSP business. Each arm of the company had its own priorities, sometimes competing with one another. Meanwhile, clients were demanding more innovation, more integration, and more ability to manage their entire workforce (not just contingent labor) through a single strategic platform.

Recognizing the shift in market needs, Rakowski and her leadership team united AHSA and Trio under one brand: Trio Workforce Solutions. The rebrand, officially launched in October, reflects a modern, platform-driven organization that integrates technology, data, and services to create a seamless workforce management ecosystem. The goal is not simply to manage contingent staffing, but to power the entire workforce lifecycle — from demand forecasting to talent acquisition, from compliance to analytics, and from labor optimization to supplier performance.

Trio’s platform-centric model allows it to bring innovation to market more quickly while addressing the nuanced needs of healthcare’s workforce environment. The company envisions VMS not as an administrative tool but as a strategic workforce hub. With hospitals increasingly building internal float pools, launching internal travel programs, and assembling their own flexible resource pools, Trio’s platform enables clients to manage these emerging models alongside external contingent labor — within one integrated system. This shift also supports healthcare organizations exploring more self-managed models, giving them control, visibility, and seamless access to their workforce data, even if their partnership model evolves over time.

Preparing for the Complexities of Modern Healthcare

Another key differentiator is Trio’s commitment to the human side of healthcare staffing. Rakowski explained that while technology is essential, healthcare is ultimately a people business. Clinical cultural fit, care team cohesion, patient interaction, and trust remain core criteria for successful placements. To strengthen alignment, Trio has expanded its clinical management team, adding experienced clinicians who help screen candidates, assess fit, and ensure readiness. This enhances matching precision and reduces burden on hiring managers, who historically bore much of the clinical screening responsibility.

As workforce shortages deepen — with expected deficits of up to 15% for registered nurses and more than 100,000 physicians — Trio is positioning itself as an innovation partner prepared for the complexity of modern healthcare. Internal innovation programs, a strong data and AI team, and an integrated services-and-technology model ensure that Trio continues advancing how healthcare systems manage their labor needs at scale.

Trio’s evolution reflects a larger trend in healthcare: the need to bring together multiple workforce solutions into a unified, intelligent platform. The company’s rebrand is more than cosmetic — it symbolizes the future of healthcare workforce management, where technology, human expertise, and trusted partnership converge. As healthcare leaders look ahead, Trio Workforce Solutions stands as an example of how to blend operational precision with modern innovation to support clinical excellence and organizational resilience.

The Transformation of Healthcare Contingent Staffing in a Post-COVID World

Contingent Workforce General Insights Solution Providers by John Yuva on 11/20/2025

In Part One of this three-part article series, we highlight the major discussion points and a link to the full event.

The healthcare workforce has undergone a remarkable transformation over the past decade, shaped by shifting patient demands, structural workforce shortages, new care delivery models, and the seismic shock of the COVID-19 pandemic. Few industries were as deeply affected as healthcare, where contingent labor (particularly travel nurses and locum tenens physicians) became an essential strategic lever for maintaining operations and protecting patient care. As Kelly Rakowski, CEO of Trio Workforce Solutions, explains, the story of healthcare staffing today cannot be told without understanding the forces that converged before, during, and after the pandemic.

Fragility of the Healthcare Workforce

Even before COVID-19, the use of contingent staffing had been steadily increasing. Healthcare has always faced unpredictable demand, shaped by seasonality, regional demographics, and emergent public health needs. Volume spikes in respiratory illnesses during winter months, fluctuating elective procedure schedules, and migration patterns in states like Florida or Arizona create inherent variability in staffing needs. Rather than staff for the highest-demand peaks (an approach that would be financially unsustainable), health systems historically staffed to the median and relied on contingent clinicians to smooth the variability. Travel nursing emerged as the dominant mechanism for filling these short-term shortages, structured around the familiar 13-week assignment model that historically aligned to maternity leaves and later became the staffing industry standard.

However, a more complex challenge was simultaneously brewing: a widening gap between the supply and demand for clinical talent. Retirements among physicians and nurses were increasing, and post-graduate medical education slots (controlled by federal regulation) limited the influx of new physicians. Nursing schools faced their own bottlenecks, primarily a shortage of qualified faculty. This created structural workforce fragility well before COVID-19 accelerated the crisis.

When the pandemic hit, contingent staffing became a national lifeline. Historic surges in patient acuity required tens of thousands of travel nurses and locum clinicians to rapidly shift to hotspots across the country. At the same time, clinicians were contracting COVID-19 themselves or quarantining, further widening staffing gaps. Utilization skyrocketed, and so did compensation rates, reflecting the risk environment and dire need. Health systems confronted unprecedented expenses while also suspending elective procedures, which is their primary revenue engine.

External Workforce Prioritization

As the pandemic receded, several powerful dynamics persisted. First, burnout skyrocketed. Many clinicians retired early or left the profession entirely, cementing long-term shortages. Second, permanent staff began demanding flexibility similar to the rest of the labor market, catalyzing internal travel programs, float pools, and hybrid workforce models. Third, the visibility of contingent labor costs dramatically increased. Boards of directors and senior executives, many of whom were never historically involved in staffing decisions, now saw workforce resilience as a top organizational priority. Industry surveys of healthcare CEOs repeatedly place workforce challenges at the very top of strategic concerns.

Today, while bill rates have normalized to pre-pandemic levels (adjusted for inflation and new compensation baselines), utilization remains elevated, registering roughly 50% higher than before COVID-19. Health systems are incorporating contingent labor into long-term workforce strategies rather than treating it as a temporary emergency tool. Innovation has accelerated: internal staffing agencies are emerging within large systems, local gig-based marketplaces are gaining traction, and multi-skilled float pools are helping improve flexibility without over-extending permanent staff.

Yet complexity remains exceptionally high. Credentialing, licensure, compliance standards, and cultural fit are all vital, especially because clinical roles involve life-or-death responsibility. Technology is increasingly relied upon to support precision matching, skills verification, experience alignment, and predictive staffing needs. The rise of AI-enhanced tools is helping heal long-standing inefficiencies that were once managed manually across spreadsheets, fragmented systems, and siloed operational teams.

A New Era for Healthcare Staffing

Healthcare’s contingent workforce is no longer a secondary staffing strategy; it is a cornerstone of workforce resilience. As Rakowski emphasizes, the industry must now focus on optimizing the entire workforce, including permanent, local flexible, and contingent, through smarter models, stronger technology, and a more human-centered approach. The pandemic accelerated what was already inevitable: healthcare staffing has entered a new era defined by adaptability, strategic workforce planning, and a commitment to ensuring safe, high-quality care despite ongoing shortages.

The future will belong to organizations that understand how to integrate flexibility with operational excellence — and how to support clinicians with the tools, data, and environments they need to thrive.