The Structural Risk in Locums Tenens Staffing
David Durbin
Why Overreliance on a Single Agency Undermines Workforce Strategy
A Common Strategy with Structural Risk
Many healthcare organizations rely heavily on locum tenens providers to maintain clinical continuity. In fact, more than 80% of healthcare systems utilize locums staffing in some capacity.
To simplify operations, it’s common to consolidate that demand with a single agency partner. At first glance, this approach appears efficient with fewer relationships to manage, faster communication, and established trust.
However, this convenience often masks deeper structural issues; not because agencies are falling short, but because the model itself limits visibility and control.
The goal is not disruption, it's structure.
A more structured approach enables healthcare organizations to preserve strong agency partnerships while introducing the transparency, balance, and governance needed to manage workforce risk effectively.
What Is Supplier Concentration in Locums Tenens?
Supplier concentration in locums tenens refers to a model where a healthcare organization relies primarily, or exclusively, on one staffing agency to fulfill contingent physicians or advanced practice providers (APP).
Why it matters:
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Limits access to broader talent pools
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Reduces pricing transparency
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Weakens negotiating leverage
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Introduces operational and compliance risk
The Structural Risks of Relying on a Single Locums Tenens Agency
1. Cost Variability Without Benchmarking
When one agency controls the majority of supply, organizations lose the ability to benchmark rates effectively.
Without competitive pressure:
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Bill rates can gradually increase
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Rate validation becomes difficult
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Budget predictability declines
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Over time, this lack of transparency can erode financial discipline.
2. Compliance and Oversight Gaps
Centralized supplier models create structural blind spots, independent of agency intent or performance, that can limit visibility into:
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Credentialing consistency
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Invoice accuracy
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Contract adherence
Over time, these gaps narrow visibility and quietly expand risk exposure.
3. Coverage Constraints and Limited Talent Access
A single agency can only provide access to its own candidate network.
This creates:
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Slower time-to-fill
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Delayed start dates
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Increased last-minute staffing gaps
In a market where speed and access are critical, limited reach directly impacts patient care continuity.
4. Reduced Negotiation Leverage
Concentrated supply models naturally shift the dynamics and balance of power, not because of vendor behavior, but because limited competition reduces market feedback. This can make it more difficult for organizations to:
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Negotiate rates
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Enforce service expectations
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Drive performance improvements
The goal of diversified sourcing isn't to pressure partners, it's to create a more balanced dynamic that works better for both sides.
Why This Matters Now: The Executive Imperative
Healthcare leaders are increasingly recognizing that workforce strategy is not just an operational concern, it’s a governance priority.
A modern locums tenens strategy must enable organizations to:
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Maintain financial discipline through transparent pricing and auditing
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Expand market reach beyond a single agency’s network
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Ensure consistent compliance across all contingent physicians and advanced practice providers (APP)
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Protect organizational leverage through balanced sourcing
These capabilities are essential for building a resilient and scalable workforce model.
What a More Resilient Locums Tenens Strategy Looks Like
Importantly, this shift is not about replacing trusted agency partners; it’s about creating a more structured environment where those partnerships can perform at their best.
This approach focuses on:
Diversified Supplier Access
Engaging multiple agencies to broaden candidate reach and reduce dependency
Market-Based Pricing Visibility
Using benchmarking to validate rates and control costs
Centralized Governance
Standardizing credentialing, invoicing, and compliance processes
Operational Transparency
Creating clear insight into workforce performance and spend
The goal is not disruption, it’s structure. A system that allows agency partnerships to thrive within a more transparent and competitive ecosystem.
Case Study: Transforming Workforce Governance at Scale
One large not-for-profit U.S. health system faced significant challenges following a merger. Multiple staffing models and vendor relationships created:
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Limited workforce visibility
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Contract complexity
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Operational inefficiencies
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Fragmented multi-vendor model
After implementing a more centralized, vendor-neutral workforce model, the organization achieved:
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Improved vendor relationships through a more competitive marketplace
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Expanded clinician access across multiple supply channels
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Real-time workforce visibility via executive dashboards
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Standardized operations across facilities
Key Takeaways for Healthcare Leaders
Relying on a single locums agency can create four major risks:
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Increased costs due to lack of rate benchmarking
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Reduced compliance visibility and oversight
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Limited access to qualified clinicians
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Decreased negotiating power
A more effective approach is a diversified, vendor-neutral strategy that improves transparency, resilience, and performance.
A senior technology leader noted the impact of partnering with Trio:
“Trio delivered a tightly integrated solution… transforming labor-intensive processes into a streamlined model with zero-touch invoicing and greatly improved visibility and analytics.”
Discover how Trio exceeded this leader's expectations.
Conclusion: From Convenience to Control
Overreliance on a single locums agency may feel efficient, but it introduces risks that compound over time.
Healthcare organizations that prioritize transparency, competition, and governance are better positioned to control costs, improve access, and strengthen workforce resilience.
The goal is not disruption, its structure that enables stronger partnerships, better visibility, and more resilient workforce outcomes.
The question is no longer whether locums are essential, it's whether your sourcing strategy is built to support them effectively.
Want to see how your workforce strategy stacks up? Contact us and talk to a Trio expert for a full assessment.
