Physician recruiting has never been more competitive. With average vacancies taking six to nine months to fill plus with each provider generating upwards of $100k in monthly revenue, healthcare organizations simply cannot afford gaps in coverage. Locum tenens fills those gaps, protect revenue, preserve continuity of care and support provider wellbeing.
However, not all locum strategies are created equal. Over the last two decades, the industry has evolved into four distinct layers, each offering different levels of visibility, efficiency and cost savings. In a recent webinar, Jerry Limonta, Senior Director of Physician & Advanced Practice Solutions at Qualivis, walked through these four models to help healthcare leaders assess where their organization fits on the locums spectrum — a critical step toward building a smarter, more sustainable workforce strategy.
With the endorsement of 28 state hospital associations, Qualivis partners with healthcare organizations to navigate these layers and determine the best fit, whether that means securing immediate coverage, reducing long-term costs or building greater independence through an internal provider pool.
Layer 1: Direct Locum Tenens
The traditional approach. Hospitals contract directly with locums agencies to fill coverage gaps. While this model offers flexibility and fosters direct relationships, it is, as Jerry Limonta noted, “just a very inefficient way to operate.” Drawbacks include:
- Time-intensive management of multiple agency relationships
- Redundant calls, emails and spreadsheets
- Limited visibility into overall spend
- Missed opportunities to leverage collective buying power
For organizations with small, infrequent needs, direct contracting may suffice. But for most, it quickly becomes unsustainable.
Layer 2: Vendor Management System (VMS)
Technology for visibility and control. A VMS centralizes orders, candidate submissions and invoicing across multiple agencies. This creates efficiency, reduces administrative burden and provides better reporting.
Qualivis’ LotusOne platform goes beyond traditional VMS solutions by offering:
- Streamlined job entry and candidate management
- Credentialing and licensing workflows
- Consolidated invoicing
- Real-time reporting and analytics
“You have the ability to open up an order, view candidate submissions and you can see it all inside the technology,” said Limonta.
The tradeoff: while a VMS reduces complexity, it still requires internal management and with some other models may come with technology costs.
Layer 3: Managed Service Provider (MSP)
Full-service workforce management. An MSP combines technology with dedicated support teams that handle the heavy lift of locum management at no additional cost.
With an MSP, you gain:
- A single agreement that standardizes rates, terms and processes across vendors
- A consolidated invoice for all locums spend
- Centralized credentialing and licensing tracking
- Access to a broader candidate pool through an engaged vendor panel
- Ongoing data insights and market intelligence to guide strategy
The Qualivis MSP model not only reduces administrative burden but also delivers measurable cost savings—on average 8–10%—through rate caps, expense controls and competitive market leverage.
Layer 4: Internal Provider Pool
The ultimate evolution. Forward-thinking organizations are creating their own flexible float pools of physicians and advanced practitioners. These pools allow healthcare organizations to:
- Re-engage retiring physicians who want part-time schedules
- Offer flexibility to providers who prefer shift-based work over long-term contracts
- Reduce overreliance on third-party agencies
- Build a pipeline for future permanent recruitment
“A lot of times, we’ll speak to a provider who just doesn’t want to sign a contract for 20 shifts a month for three years. But they will give you 10 shifts a month consistently for the next year,” said Limonta, “That’s someone you can put into your float pool as a more cost-effective option than third-party locum tenens.”
With LotusOne, providers in your internal pool can view open shifts, accept assignments from their phones and stay connected to your organization. This maximizes control, lowers costs and strengthens retention. You can also extend the float pool to retiring physicians interested in locums work, helping retain their expertise at a lower cost than outside firms.
Choosing the Right Layer for Your Organization
Not every solution fits every organization. Some may find direct contracts or a VMS sufficient, while others will realize the greatest benefit from an MSP or internal pool. Many organizations “graduate” through these layers over time as their needs grow.
That’s where Qualivis comes in. As your true workforce partner, we assess your spend, current vendor mix and your administrative challenges. Then, we recommend the model that delivers the greatest impact while containing costs for your program.
Ultimately, locum tenens isn’t just about filling shifts. It’s about protecting revenue, reducing burnout, supporting recruitment and ensuring patients receive uninterrupted care.