Forecast and Outlook for Healthcare Staffing



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Wednesday, Oct. 17 3:30 pm Ironwood 8 Keynote Panel: Forecast and Outlook for Healthcare Staffing Moderator: Barry Asin, President, Staffing Industry Analysts Panelists: Tony Gregoire, Sr. Research Analyst, Staffing Industry Analysts Jon Osborne, VP, Research & Editorial, Staffing Industry Analysts

Agenda Where We Are Today Heard at the Healthcare Summit Trends and Long Term Outlook Healthcare Staffing Forecast Questions and Answers

Healthcare Industry Job Growth 50 Healthcare Industry Monthly Job Growth (000) 1 40 0.9 0.8 30 0.7 20 10 0.6 0.5 0.4 0 0.3-10 0.2 0.1-20 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 0 Recession Monthly Job Growth 6-month average Source: Bureau of Labor Statistics and Staffing Industry Analysts

Healthcare Quits Rising Again Y/Y % Change in Healthcare Quits 30% 20% 10% 0% 1 0.9 0.8 0.7 0.6 0.5-10% -20% -30% -40% 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 0.4 0.3 0.2 0.1 0 Recession Y/Y change in healthcare quits 3-month moving average Source: Bureau of Labor Statistics, JOLTS data

Pulse Survey Aggregate Revenue Growth Healthcare Staffing 30% 20% 10% 0% -10% J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A 2010 2011 2012-20% -30% -40% Source: Staffing Industry Analysts Monthly Pulse Survey

Largest Healthcare Staffing Firms Top 5 Market Share 2005 = 25% 2011 = 30% Largest healthcare staffing firms in the U.S. Ranked by estimated 2011 U.S. temporary staffing revenue 2011 U.S. Staffing Revenue ($million) Market Share Rank Company 1 AMN Healthcare Services $848 10% 2 CHG Healthcare Services $597 7% 3 Jackson Healthcare $399 5% 4 Cross Country Healthcare $398 5% 5 Medical Staffing Network $302 4% 6 Maxim Healthcare Services $298 3% 7 Team Health $210 2% 8 Supplemental Healthcare $189 2% 9 On Assignment $171 2% 10 Aureus Medical Group (C&A Industries) $151 2% 11 Soliant Health (Adecco) $135 2% 12 CareerStaff (Sun Healthcare Group) $89 1% 13 Favorite Healthcare Staffing $84 1% 14 Kforce $68 1% 15 ATC Healthcare $65 1% 16 The Delta Companies $52 1% 17 Reliant Healthcare $50 1% Total $4,106 48% Source: Staffing Industry Analysts 2012 Book of Lists

Public Company Revenue Growth Source: Company Reports and Staffing Industry Analysts

Public Company Gross Margins Source: Company Reports and Staffing Industry Analysts

Pulse Survey Shows Travel Nursing Growth Steady Source: Staffing Industry Analysts Monthly Pulse Survey

Pulse Shows Per Diem Nursing Growing Slowly Source: Staffing Industry Analysts Monthly Pulse Survey

Allied Benchmark Survey Revenue Mix Over $450M in Annualized Revenue (15% of the market) Source: SIA 2012 Allied Health Benchmarking Analysis

Allied Benchmark Survey Revenue Growth Allied Benchmark Survey 2012 Revenue Growth by Specialty Source: SIA 2012 Allied Health Benchmarking Analysis

Allied Health Growing in High Single Digits in the Pulse Survey Source: Staffing Industry Analysts Monthly Pulse Survey

SIA NALTO Locum Tenens Benchmark Survey Sample Data collected from 16 companies representing nearly $1 billion in annualized revenue (47% of market) Source: Staffing Industry Analysts NALTO 1H12 Locum Tenens Benchmarking Survey

Benchmark Suggests a Broad Distribution of Growth Rates in Locums for 2012 Source: Staffing Industry Analysts NALTO 1H12 Locum Tenens Benchmarking Survey

Locums Results Vary by Segment Source: Staffing Industry Analysts/NALTO 1H 2012 Locum Tenens Benchmark Survey

Agenda Where We Are Today Heard at the Healthcare Summit Trends and Long Term Outlook Healthcare Staffing Forecast Questions and Answers

Heard at the Healthcare Staffing Summit

Agenda Where We Are Today Heard at the Healthcare Summit Trends and Long Term Outlook Healthcare Staffing Forecast Questions and Answers

Healthcare Staffing Trends and Long Term Outlook Ongoing growth in healthcare workforce Changing mix of healthcare skills Health IT Tax challenges and opportunities Evolving management strategies

Healthcare Occupation Categories Among Top 3 Fastest Projected Growing Over the Next Decade Employment Change, 2010-20 2010 2020 New jobs Percent Healthcare Support Occupations 4,190 5,634 1,444 35% Personal Care and Service Occupations 4,995 6,331 1,337 27% Healthcare Practitioners and Technical Occupations 7,799 9,819 2,020 26% Community and Social Service Occupations 2,403 2,985 582 24% Construction and Extraction Occupations 6,328 7,735 1,407 22% Computer and Mathematical Occupations 3,543 4,321 778 22% Business and Financial Operations Occupations 6,789 7,962 1,173 17% Life, Physical, and Social Science Occupations 1,229 1,420 191 16% Education, Training, and Library Occupations 9,194 10,597 1,404 15% Transportation and Material Moving Occupations 9,005 10,333 1,329 15% Installation, Maintenance, and Repair Occupations 5,429 6,229 800 15% Arts, Design, Entertainment, Sports, and Media Occupations 2,709 3,051 343 13% Sales and Related Occupations 14,916 16,785 1,869 13% Building and Grounds Cleaning and Maintenance Occupations 5,499 6,163 664 12% Protective Service Occupations 3,303 3,667 365 11% Legal Occupations 1,212 1,343 131 11% Architecture and Engineering Occupations 2,433 2,686 253 10% Office and Administrative Support Occupations 22,603 24,938 2,336 10% Food Preparation and Serving Related Occupations 11,150 12,243 1,093 10% Management Occupations 8,776 9,392 616 7% Production Occupations 8,594 8,951 357 4% Farming, Fishing, and Forestry Occupations 972 953-19 -2% Total, All Occupations 143,068 163,537 20,469 14% Source: Employment Projections Program, U.S. Department of Labor, U.S. Bureau of Labor Statistics

8 of Top 30 Occupations With Most Job Growth are Projected in Healthcare Employment Change, 2010-20 Rank Occupation 2010 2020 New jobs Percent 1 Registered Nurses 2,737.4 3,449.3 711.9 26.0 3 Home Health Aides 1,017.7 1,723.9 706.3 69.4 4 Personal Care Aides 861.0 1,468.0 607.0 70.5 11 Nursing Aides, Orderlies 1,505.3 1,807.2 302.0 20.1 21 Medical Secretaries 508.7 718.9 210.2 41.3 28 LPN and Licensed Vocational Nurses 752.3 920.8 168.5 22.4 29 Physicians and Surgeons 691.0 859.3 168.3 24.4 30 Medical Assistants 527.6 690.4 162.9 30.9 Source: Employment Projections Program, U.S. Department of Labor, U.S. Bureau of Labor Statistics

Most Healthcare Workers Outside of Hospital Setting Healthcare Employment % by Setting Source: Bureau of Labor Statistics September 2012

Ambulatory Continues to Dominate Healthcare Job Growth Source: Bureau of Labor Statistics September 2012

Locums and Allied Now a Majority of Healthcare Staffing Industry Revenue Source: Staffing Industry Analysts Forecast September 2012

Health IT

Tax Challenges and Opportunities Travel Reimbursements/Tax-Advantage Plans Independent Contractor Status Independent Contractor Compliance

Management Strategies Used by Healthcare Staffing Buyers Source: Staffing Industry Analysts 2012 Healthcare Buyer Survey

Healthcare Suppliers Most Averse to VMS and MSP Source: Staffing Industry Analysts 2012 VMS/MSP Customer Experience Report

Agenda Where We Are Today Heard at the Healthcare Summit Trends and Long Term Outlook Healthcare Staffing Forecast Questions and Answers

Healthcare Staffing Revenue Growth Forecast 13% 9% 8% 2010 (E) 2011 (E) 2012 (P) 2013 (P) -7% Source: Staffing Industry Analysts September 2012 Forecast

Segment Growth Forecast Source: Staffing Industry Analysts September 2012 Forecast

Questions?

Save the Date! Healthcare Staffing Summit 2013 October 23 25, 2013 Fairmont Millennium Park Chicago, IL

Wednesday, Oct. 17 3:30 pm Ironwood 8 Keynote Panel: Forecast and Outlook for Healthcare Staffing Moderator: Barry Asin, President, Staffing Industry Analysts Panelists: Tony Gregoire, Sr. Research Analyst, Staffing Industry Analysts Jon Osborne, VP, Research & Editorial, Staffing Industry Analysts