Cross Country was founded in 1986 by a clinician and her family. She used her expertise and years of bedside experience with patients as the foundation the company was built on. In 1992, Cross Country was sold to a private equity firm. By 2001, they had merged with another company called TravCorps, and after this merger, the company went public. 

Cross Country needed to evolve at the same rate technology had been, and in 2019, the board decided to bring back co-founder, Kevin Clark, as CEO. 

The Next Generation

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Kevin sought to revitalize the company, leading with cutting-edge technology to separate Cross Country from competitors. Though this would be somewhat of a new challenge as the company evolved, Kevin knew that this would be a pivotal moment in Cross Country’s future. 

He really aimed for success and knew that this meant starting with the basics. In all of my dealings with Kevin over the years and everywhere else, I've been a software developer at heart. I've always developed my own software – every company I’ve ever joined. So, in 2021, while I was still at Aya Healthcare, Kevin approached me to help build a new ATS and that’s how I joined Cross Country.

I joined with the goal of helping Cross Country become more of a technology company because I thought that if we were going to compete in this market, we would not be able to compete by just being a staffing agency.

I look at staffing a little differently than traditional staffing firms do. I think of it like almost any other business; we’re in a supply chain business. What do we do? We move a product through a supply chain right from the front door to get to your client. 

What makes it different is that we supply people rather than a product. However, it's very analogous to Amazon; practically the same concept. So, what did Jeff Bezos do? He automated the supply chain. He put technology into the supply chain which revolutionized the retail business. And that's what we're doing in healthcare.

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So, we started by asking, “What do we need first?” We knew what we needed first was a Vendor Management System (VMS)  so that we could manage our clients' needs and go beyond their contingency labor.

We asked ourselves, how do we help manage their core staff? So, we built our VMS technology, which is the core of our technology for the client - our bread and butter so to speak.

Our VMS manages a client’s contingent labor, everything from daily shifts to per diem labor. We then built out an app that allows clinicians to pick up a shift at a time, or lets hospitals book a shift at a time. This gives clients more flexibility, transparency, and most importantly - access to people.

We then looked at clients to uncover their pain points and inefficiencies. What we realized was that there are inefficiencies in hospitals that look to use contingent labor first when external labor should be their last choice. These hospitals should be looking internally to say, do we have existing clinicians who can actually work?

This investigation led us to build out our internal resource pool (IRP) technology. This piece of tech allows hospitals to build their internal resource pools for greater efficiency and cost-savings. Utilizing their internal resources first won't cost facilities more money and gives them visibility into the resources they already have at their disposal.

This IRP technology helps hospitals look and see who's the best option available based on price. It then allows teams to choose whether they want to schedule internal team members before automatically outsourcing external clinicians.
For Healthcare Facility Clients:

Building smart technologies to help hospitals manage their core labor was first and foremost when creating this product. We wanted to give clients a streamlined, transparent method of easily managing all of their labor - whether internal or external.

For Healthcare Professionals:

At the same time, we also wanted to create a great experience on the front end for our professionals. Similar to many of the apps you've seen in the shifts market, we built one for travel and, of course, shift and per diem workers.

So, what we did was to build technology that allows us to walk clinicians through every step of the process so that they can go from the door to the floor in a seamless fashion.
With this app, clinicians can do everything from uploading their credentials, applying for an assignment, managing their onboarding processing and everything in between. All while receiving notification reminders for the next step. And that's really where we spent a lot of our time and continue to spend a lot of time on really building those products out.

At the end of the day, Cross Country has come a long way. We have matured from this older staffing company with antiquated technology, to become a modern tech-enabled platform that seamlessly integrates our technology to match professionals to clients and jobs. A true 180 from the company’s first day in operation.  
The Importance of Pay Rate Transparency

When I started looking at how to create value for professionals and clinicians in the travel nurse and healthcare staffing worlds in 2015, many companies came to market that were cold recruiter lists. At this point, they were slowly starting to bring pay transparency to the market, as there was still no pay transparency yet in the travel nurse world.

There would be mention of pay-rate ranges, however, the most common response was,  “Call me to find out what you get paid.” Eventually other organizations began to work on pay transparency and others started to follow. However, it didn't take on very well as people were resistant to these technologies and the companies pushing them. But then COVID hit. And, as we all know, in COVID-19, with travel nurses and the allied world, pay rates sky-rocketed. There were clinicians earning anywhere from $5,000 or $10,000 dollars in a week. At that point, pay rate transparency became incredibly important.

It became table stakes; everyone went for pay rate transparency. But one of the things we realized at Cross Country was that while everyone shifted toward pay transparency, as well as us, no one was really helping the client with bill rate transparency.

Making Bill Rate Data Actionable

One of the big opportunities we saw, and we've really capitalized on over the last year since we launched our new product, Data Aggregation Services (DAS), is how you can look at the market data using some of our own resources plus independent resources to see where the market is trending in terms of bill rates.

Because when you're working with a hospital as your client, the question they care about is: how do I reduce my spending? Hospitals were bleeding money through COVID-19; they had to figure out how to survive. Many of these hospitals were having trouble staying profitable, so they started reducing their use of contingent labor. They also started looking at how to hire more core staff. Seeing these trends, we asked, how can we help them manage internal labor?

The Power of Data in Workforce Management

Facilities will eventually need to outsource contingent labor,and we wanted to make sure that they were empowered to have the tools in front of them when the time came. We wanted hospitals to be able to see where the bill rates were and where they were trending and give them a say in their budget.

With that came the birth of DAS. This tool enables facilities to see a low, a mid, and a high market rate.

DAS gives them the power to say:  “We can test this out, and we can see,” and “We also understand, based upon the data that Cross Country provides or DAS provides, we understand what is going to be the throughput and the acceleration of placements depending upon our rate. And then we can tweak it and play with it.”

And that has been very empowering for clients.

When you look at our technology as we move into a different phase, this question to ask is, going back to the supply chain, how do we make things easier?

So, now we're giving the clients and our professionals a lot of information. We're making their jobs easier, their decision making easier, and now we have to make it even easier for them moving forward.

Most of our technology is around shift work and 13-week contracts. Most of it is travel, usually 13-week contracts or longer, and shift work, which we call per-diem. Then, there’s the core side that's a smaller part of our business because most hospitals are doing that directly themselves. It's an added service that we have, but most of the hospitals are doing that themselves on the RPO side, and we'll do a little bit of the RPO with the technology. So, if they want their staff to pick up their own shifts, they're using our app.

Sure, the biggest opportunity right now and hottest topic is to utilize more machine learning and automation. Right now, we’re using machine learning but not to the extent that we will in the future. Right now, I think it's about more predictive analytics and machine learning as an opportunity for everybody. It's also a risk for everybody. Organizations that don't do that and aren't on that curve of automating more of their processes are going to find themselves in trouble over the next several years.

The travel and allied businesses are becoming commodity-based businesses where margins will be tougher. When margins are tougher, you need to be able to create leverage in your SG&A and that's through automation.

Where this applies more specifically is that you can start predicting where a professional wants to go, right? For instance, you can look at and do predictive analytics by saying a person who went to Cleveland four times in the last five years is likely to go to Cleveland again and you can send that person to that assignment. But when you start looking and layering over marketing data, you start doing personas, and then you start predicting, based upon behaviors overlaid with persona data.

Then, I think we could start talking more about actual machine learning and getting into artificial intelligence. Of course, there are easy ways to utilize artificial intelligence right now. Chatbots are the simplest way. However, the true power of AI emerges as we analyze the questions users ask and the responses they seek. This continuous learning process allows us to develop more sophisticated AI applications.

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