Table of Contents
Overview
The Per Diem Nurse Staffing Market is projected to reach approximately USD 16.4 billion by 2033, growing from USD 8.7 billion in 2023 at a CAGR of 6.5% between 2024 and 2033. The growth is driven by the persistent global shortage of nurses and the need for flexible workforce management. According to the World Health Organization (WHO), the global nursing workforce reached 29.8 million in 2023, yet a deficit of about 4.5 million nurses is projected by 2030. These shortages lead to unstable shift coverage and create opportunities for per-diem staffing solutions across hospitals and healthcare facilities.
Demographic ageing remains a long-term market driver. The United Nations projects that one in six people will be over 65 years old by 2050, while WHO indicates that the global population aged 60 and above will nearly double between 2015 and 2050. Older populations require more inpatient and long-term care, increasing daily fluctuations in patient volumes. These variations heighten the need for short-notice staffing, where per-diem nurses provide rapid and cost-effective coverage. As health systems adapt to ageing demographics, per-diem staffing ensures continuity of care amid unpredictable demand surges.
Government regulations and staffing mandates are further supporting demand. The Centers for Medicare & Medicaid Services (CMS) in the United States established minimum staffing standards for long-term care in 2024. Such regulations require consistent nurse-to-patient ratios, even during peak demand, compelling providers to maintain per-diem pools. Similar regulations in states like California also reinforce the use of flexible staffing models to ensure compliance. In other regions, tighter quality oversight in skilled nursing facilities is prompting administrators to use per-diem nurses to meet staffing adequacy requirements.
Financial pressures are influencing providers to reduce reliance on expensive external agencies and invest in internal per-diem pools. NHS England has reported declines in agency spending due to stricter rules and price caps while maintaining high levels of internal bank staff usage. This transition enables cost control while ensuring service continuity. Additionally, persistent retention challenges, nurse burnout, and high turnover rates continue to fuel temporary staffing requirements. Per-diem nurses serve as a strategic buffer against absenteeism and ongoing recruitment shortages across global healthcare systems.
The U.S. Bureau of Labor Statistics forecasts about 189,100 registered-nurse openings annually between 2024 and 2034, reinforcing structural replacement needs. Growing oversight of staffing quality and the rise of care delivery in post-acute settings further enhance the adoption of flexible workforce models. The market’s sustained expansion reflects its crucial role in maintaining service reliability, regulatory compliance, and cost efficiency. Overall, demographic shifts, labor shortages, and policy reforms are expected to anchor steady growth in the global per-diem nurse staffing industry through 2033.
Key Takeaways
- The Per Diem Nurse Staffing Market is expected to reach USD 16.4 billion by 2033, expanding at a CAGR of 6.5% from 2024 to 2033.
- Hospitals dominated the market with a 68.3% share in 2023, primarily driven by rising staffing needs in general and specialty hospital facilities.
- Medical-Surgical Nursing accounted for 41.66% of the market in 2023, highlighting the increasing demand for specialized and skilled nursing professionals.
- Rotating shifts held a 53.2% market share in 2023, indicating healthcare providers’ preference for flexible staffing to meet dynamic patient requirements.
- Experienced nurses represented 43.5% of the workforce in 2023, reflecting the healthcare industry’s reliance on skilled professionals for quality care delivery.
- Key market segments include Healthcare Facility Type, Specialty, Shift Timing, and Experience Level, offering diverse staffing solutions across healthcare environments.
- Per diem nurse staffing models can reduce labor expenses by up to 30%, demonstrating significant financial advantages for healthcare institutions.
- About 55% of per diem nurses hold only one license, underlining the regulatory complexities and licensing challenges in the industry.
- The adoption of AI and data analytics is enhancing operational efficiency, with the American Hospital Association emphasizing technology’s role in improving care.
- North America led the global market in 2023 with a 50.8% share, supported by robust healthcare infrastructure and favorable economic conditions.
Regional Analysis
In 2023, North America held a leading position in the Per Diem Nurse Staffing Market, accounting for 50.8% of the total market share. The region’s market value reached USD 4.4 billion, supported by strong healthcare infrastructure and advanced medical systems. The growing need for flexible staffing solutions to address variable patient demands significantly boosted the adoption of per diem nurse staffing across hospitals and healthcare facilities, ensuring operational efficiency and consistent patient care delivery.
The region’s regulatory landscape has also influenced market growth. North American healthcare regulations require facilities to maintain specific nurse-to-patient ratios and adhere to quality standards. These regulations drive healthcare organizations to adopt per diem nurse staffing to manage fluctuating workforce demands while maintaining compliance. This approach allows hospitals to meet short-term staffing gaps effectively, ensuring high-quality patient care without overextending permanent staff or compromising regulatory standards.
Demographic trends have further reinforced market expansion. North America’s rapidly aging population has intensified the demand for skilled nursing services, creating favorable conditions for per diem nurse staffing. The flexibility and cost-effectiveness of per diem arrangements allow healthcare facilities to adapt to increasing patient volumes associated with chronic illnesses and elderly care. This demographic-driven demand has positioned per diem staffing as an essential component of the region’s healthcare workforce management strategy.
Economic stability and heightened healthcare investment across North America have created a conducive environment for market growth. Hospitals and clinics increasingly rely on per diem staffing models to optimize operational costs while maintaining service quality. The COVID-19 pandemic further emphasized the importance of a flexible healthcare workforce, accelerating the region’s reliance on per diem nurses during crisis periods. These combined economic, demographic, and policy-driven factors continue to sustain North America’s dominance in the global per diem nurse staffing market.
Segmentation Analysis
In 2023, the Hospitals segment dominated the Per Diem Nurse Staffing Market, accounting for 68.3% of the market share. This segment includes General and Specialty Hospitals, such as Pediatric and Cardiac units. High patient volumes and diverse healthcare demands increased the need for flexible staffing. Per diem nurse solutions proved vital in maintaining continuous healthcare operations. These hospitals relied heavily on adaptable staffing models to handle fluctuating patient needs and ensure uninterrupted medical services across departments.
General Hospitals played a key role within the Hospitals segment, driving overall market dynamics. Their broad service offerings and large patient inflow required consistent staffing flexibility. Per diem nurses became crucial in addressing peak workload periods and ensuring quality care delivery. Specialty Hospitals, including pediatric and cardiac care facilities, further strengthened the market. Their focus on specific treatments required specialized nursing expertise, where per diem staffing models efficiently supported shifts in patient volumes and specialty service demand.
Nursing Homes emerged as an essential segment in the Per Diem Nurse Staffing Market. These facilities provide long-term care for elderly and chronically ill patients. The growing aging population intensified staffing needs, making per diem nurses indispensable. Their adaptable approach matched the evolving healthcare demands in these facilities. Similarly, outpatient clinics and urgent care centers increasingly adopted per diem staffing to manage varying patient loads. This trend highlighted the expanding use of flexible workforce models across diverse healthcare settings.
By specialty, the Medical-Surgical Nursing segment held a dominant position with a 41.66% market share in 2023. The demand for skilled nurses in surgical and general care units drove this growth. Critical Care and Emergency Department Nursing also contributed significantly, addressing urgent and intensive care needs. Pediatric and Oncology Nursing segments showed rising demand, reflecting growing specialization in nursing. Together, these segments enhanced market diversity and met the complex, evolving staffing requirements of healthcare facilities worldwide.
Key Players Analysis
Cross Country Healthcare
Cross Country Healthcare operates in per diem nurse staffing through its local/per-diem platform, offering on-demand shifts for hospitals and clinics. The company reported Q1 2024 revenue of $379.2 million with a 20.4% gross margin, reflecting normalization after pandemic peaks. Fourth-quarter 2024 revenue was $309.9 million. Cross Country promotes fast matching for per-diem roles via its technology and network, positioning per diem as a flexible way to close daily staffing gaps.
In 2025, the reset continued at a lower run-rate: Q1 2025 revenue was $293.4 million with a 20.0% gross margin and 2.9% adjusted EBITDA margin; revenue per FTE per day reached $348 in Q2 2025. Liquidity remained adequate at year-end 2024, with $146.9 million of ABL availability, supporting investment in per diem recruiting and tech. Cross Country’s blogs emphasize simplified onboarding and rapid shift fill for per-diem staff.
Health Trust Workforce Solutions
HealthTrust Workforce Solutions, an HCA Healthcare affiliate, operates large per diem nurse pools across the U.S., supported by its Go HWS Mobile app that lets clinicians search, book, and confirm shifts in real time. The company promotes flexible scheduling, weekly pay, and bonuses for per diem roles. It reports placing 28,000+ clinicians annually with access to 1,500+ facilities, indicating broad supply capability aligned to hospital needs during 2024–2025.
Rate transparency strengthened in late-2024 and 2025 job releases: critical care RN per diem roles were posted at $57/hour (San Antonio, Oct 2024) and $52–$53/hour in Tennessee and Virginia (Oct–Dec 2024), while a May 2025 posting listed $69/hour for a CVOR First Assist RN in Florida. Industry coverage noted a 2024 shift from travel to per diem to manage labor costs, reinforcing demand into 2025.
Maxim Healthcare Group
Maxim Healthcare Group operates in per diem nurse staffing through its staffing arm, which rebranded to Amergis in April 2024. The firm maintains Joint Commission Health Care Staffing Services certification and states a presence across 32 U.S. states, supporting local and national coverage for same-day and short-term nurse shifts. These credentials position the company to supply hospitals, schools, and government facilities with credentialed per diem RNs and CNAs on short notice.
During 2025, hiring activity indicates sustained scale. On Maxim/Amergis career pages, open roles span multiple categories—e.g., Behavioral (187), Clinical Leadership (63), CNA (47)—signaling ongoing demand for per diem and PRN nursing and support staff across settings. Recognition as a Top Workplace (2024 listing published Jan 10, 2025) further suggests steady employer momentum that aids candidate attraction for flexible shift coverage. These points reflect current operating reach and hiring intensity.
Supplemental Health Care
Supplemental Health Care (SHC) operates nationwide per diem nurse staffing alongside travel, permanent placement, and managed services. Its network is used to place RNs and LPN/LVNs across hospitals and post-acute settings, filling short-notice shifts and census spikes. The model benefits from a large and aging nurse base: 5.64 million active RN licenses and 968,948 LPN/LVN licenses were recorded at the start of 2024, with a median nurse age of 50, underscoring ongoing replacement needs.
Demand conditions in 2024–2025 have stayed supportive. Health care employment grew by an average of 57,000 jobs per month in 2024; in January 2025 alone, the sector added 44,000 jobs. These gains signal steady shift demand that per diem suppliers like SHC help fulfill, especially in hospitals and home health. Per diem flexibility also aligns with nurses’ preference for self-directed schedules and rapid deployment.
Accountable Healthcare Staffing
Accountable Healthcare Staffing operates in the per diem nurse staffing segment across the United States. The firm reports service coverage in all 50 states and placements at nearly 2,000 client facilities, including hospitals, outpatient clinics, rehab, and long-term care sites. Per diem (PRN) shifts and short local contracts are offered; local assignments typically run 4–13 weeks, giving hospitals rapid fill options and nurses flexible schedules. These offerings were highlighted on company pages updated in 2024–2025.
Service quality signals were strong in 2024–2025. Accountable won ClearlyRated’s Best of Staffing awards in both years. In 2024, 80.5% of clients gave scores of 9–10 and the client Net Promoter Score (NPS) reached 75.6%. In 2025, 68% of clients gave 9–10 and the client NPS was 68%. An August 2024 incident was disclosed: a data breach affecting 800+ individuals, prompting compliance focus. These metrics indicate reliable client satisfaction with ongoing risk controls.
Conclusion
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