Healthcare RPO Services
United States

US hospitals spent $1.7 billion on travel nurses in 2024. The national RN vacancy rate is 9.6 percent. The average time to recruit a single experienced RN is 83 days. StaffBank builds permanent international nurse and physician pipelines for US hospitals managing NCLEX, VisaScreen, and state licensing from brief to start date. Not another agency. A permanent fix.

Why the Travel Nurse Model Is Making

the Permanent Shortage Worse

US hospitals spent 1.7 billion dollars on travel nurses in 2024 and 70.7 percent of hospital executives say they want to reduce that dependency this year. The same executives said the same thing last year. And the year before. The intent is consistent. The outcome is not changing because travel nurse usage is a symptom of a vacancy problem, not a solution to it. Every dollar spent on a travel nurse premium is a dollar not available for the retention improvements, mentorship infrastructure, and compensation adjustments that would keep permanent nurses in post.

International permanent nurse recruitment is the structural alternative. A permanently placed international nurse, properly supported through NCLEX and VisaScreen, properly onboarded, and genuinely motivated by the US practice environment, has a fundamentally different retention profile from a 13-week travel nurse. The 60,090 dollar cost of replacing a departing domestic RN becomes a 5-year clinical contribution instead.

The US States Where International

Recruitment Is Most Urgent

California 20.3 percent of RNs aged 55 to 64 and 45.4 percent aged 65 and over plan to retire or leave the field between 2024 and 2026 according to Research.com's April 2026 state-by-state nursing shortage analysis. Simultaneous retirement wave and highest patient volume in the country
North-East RN turnover rose 3.3 percentage points in 2025 to reach 17.9 percent the largest single- year jump of any US region according to the NSI National Health Care Retention Report
Rural states Montana, Wyoming, South Dakota, rural Appalachia where the domestic pipeline has never adequately served these communities and international GPs on J1 waivers are the most realistic solution
FQHCs and safety net hospitals federally qualified health centres serving uninsured and Medicaid populations where physician and nursing vacancy rates are highest and locum costs are least sustainable

What StaffBank Manages for

US Placements

CGFNS credential evaluation 3 to 6 months. We initiate at the earliest stage, not after an offer is made
VisaScreen certification mandatory for all internationally trained nurses seeking US employment immigration
NCLEX-RN examination preparation resources specifically calibrated for internationally educated nurses. The national first-time pass rate for IENs varies significantly by preparation quality
State board of nursing applications managed in parallel with NCLEX, not sequentially after it
Nurse Licensure Compact multi-state licence advice for candidates working across compact member states
USMLE, ECFMG, and J1 waiver pathways for physician placements into shortage areas and rural medicine
Alternative state licensure pathways nine states have now enacted legislation allowing IMGs to practise without completing US residency. We advise on which pathway is most accessible for each candidate's qualifications

Frequently Asked Questions

How does a healthcare RPO company in the USA reduce travel nurse costs for hospitals?

A healthcare RPO company in the USA reduces travel nurse costs by building a permanent international clinical pipeline that eliminates the dependency on short-term agency cover. StaffBank manages the complete NCLEX, VisaScreen, and state board licensing process for internationally recruited nurses — delivering permanently placed clinicians who cost significantly less over time than travel nurses at a 30 to 80 percent premium rate. US hospitals spent $1.7 billion on travel nurses in 2024 while permanent vacancy rates continued to rise. The RPO model breaks this cycle by replacing reactive agency use with a proactive permanent pipeline managed on a fixed monthly fee.

How long does it take for an international nurse to get licensed and start working in the USA?

An internationally trained nurse takes 9 to 18 months to complete the US licensing process and start working — covering CGFNS credential evaluation (3 to 6 months), VisaScreen certification, NCLEX-RN examination, state board of nursing application, and visa processing. StaffBank manages the US healthcare staffing licensing pathway by initiating every stage simultaneously rather than sequentially, compressing the total timeline significantly. The realistic cost of this process per nurse ranges from $12,000 to $25,000 — but compared to the $60,090 average cost of replacing a single departing domestic RN, the economics are compelling for any hospital running persistent vacancy rates.

What is the difference between healthcare RPO and contingency staffing agencies in the USA?

Healthcare RPO in the USA means an embedded recruitment partner owns the full clinical hiring outcome from brief to start date on a fixed monthly fee — whereas contingency staffing agencies earn a placement fee per hire (typically 15 to 25 percent of salary) and have no accountability after the clinician starts. StaffBank’s US healthcare RPO model covers physicians, nurses, and allied health, managing NCLEX, VisaScreen, J1 waiver applications, and state licensing as part of the service. For US hospitals filling more than 8 to 10 clinical roles per year, healthcare RPO consistently delivers lower total cost than equivalent contingency fees.

Can a healthcare RPO company help US hospitals recruit physicians for rural and underserved areas?

Yes — healthcare RPO for rural US physician recruitment is one of StaffBank’s most active service areas, managing J1 waiver applications for internationally trained doctors committing to practise in Health Professional Shortage Areas. Nine US states including Tennessee, Florida, and Iowa have now enacted legislation allowing international medical graduates to obtain a temporary licence to practise without completing a US residency — and StaffBank advises healthcare organisations on which state’s pathway is most accessible for each candidate’s qualifications. International medical graduates currently carry a disproportionate share of rural primary care in the US, making international physician recruitment through an experienced healthcare RPO partner the most realistic pipeline for underserved communities.

Have a question not answered here?

StaffBank has delivered international healthcare recruitment at NHS England national programme level supporting the NHS England Global Fellows Programme for Emergency Medicine, the NHS Global Learners Programme for International Nurse Recruitment, and the NHS England International Diagnostic Radiography Recruitment Programme. Alongside these national programmes, StaffBank supported the Devon Alliance for International Recruitment across six NHS Trusts in Devon, where the programme celebrated its 1,000th international nurse arrival in August 2023 and continues to grow. If your organisation is building an international clinical recruitment programme we have delivered this at national scale