Travel Nursing Jobs: What you have to know about VMSs and MSPs

There are two ways to get submitted to travel nursing jobs. The first way a travel nurse gets submitted to a job is through Vendor Management Services (VMS). This is becoming more and more common. At the last SIA Healthcare Staffing Summit, they shared that over 70% of travel nursing contracts are submitted through a VMS. The VMS is a relatively new change to the healthcare staffing industry with many implications (good and bad!).

The second way a travel nurse can get submitted to a job is through a direct contract. Knowing how each of these works and how they impact pay and the ability to stand out when applying for a job is very important to travel nurses.

Getting submitted to travel nursing jobs through a Vendor Management Service

The most popular way to be submitted to a job is through a VMS (Vendor Management Service). VMSs are software systems that are typically managed by an MSP (Master Service Provider). So you talk to your recruiter about a job but that recruiter’s agency may have no direct access to speak to the people at the job you want. If you have a question, they would have to talk to the MSP. The MSP is who has direct access to the healthcare facility. The MSP’s job is to streamline communication so that the facility doesn’t have to talk to dozens of different people to get a healthcare traveler working.

By using a Master Service Provider, the facility can receive candidates from any number of staffing agencies, but they only have to talk to the MSP to streamline the communication for them. The facility will also choose a VMS technology system to receive the candidate’s information. That is the way to standardize the data and for hiring managers to quickly receive applications. If it weren’t for VMSs, the staffing agencies would be submitting our information in many different ways, and it would become too unorganized and confusing to be efficient.

Understanding a Vendor Management Service as a healthcare worker

You can relate to VMSs this way: Different healthcare facilities use different documentation systems. All the documentation systems have the same goal. The goal is for the healthcare provider to enter information to get reimbursed from insurances and have a record of the treatment that happened that day. We learn the documentation system that the facility uses to reach this goal. Many travelers end up learning many types of documentation systems through the years. The VMS is the same! Different facilities use different technologies to receive information about travel nurses who want to work at their facility. This means that recruiters and healthcare staffing agencies have to learn how to use many different VMS requirements to submit candidates to travel nursing jobs.

Who picks the VMS system?

The facility picks the Vendor Management System they want to use, not the MSP. The Master Service Provider is a company that helps the facility manage the candidates, contracts, and communication. If the facility does not already have a VMS system in place, the MSP might recommend a VMS system. But at the end of the day, the facility will decide, and the MSP and staffing agencies work with many different vendor management systems.

How do Master Service Providers (MSPs) work?

A Master Service Provider works for the facility, and that is who their main priority is. In the eyes of the facility, they might think the MSP is the one doing all the credentialing, sourcing, hiring, onboarding, time-keeping, and they don’t even know who the staffing agency is. For the facility, they are talking with just the MSP to manage their supplemental staffing.

The MSP, however, is usually outsourcing and using several different staffing agencies to fulfill the needs of the facility. The staffing agencies pay the MSP to have access to that job, and the staffing agency is the one credentialing, onboarding, and finding the candidate.
For example, AMN has an MSP. The facility that uses them will only communicate and see the logo and brand of AMN on all documentation. You, as the traveler, might be working for Delta and not AMN, but Delta is using AMN as their MSP to get access to the travel nursing jobs. The facility will then have no relationship with Delta, and they might not even know that you are a traveler that came from Delta. All they see is AMN.

This leads to a lot of intermediaries and a lot of contracts.

  1. There’s a contract between you, as the travel nurse, and Delta.
  2. There’s a contract between Delta and AMN.
  3. There’s a contract between AMN and the facility.

That is why we often see contradictions between the different contracts and why certain terms or pay provisions can be very frustrating (or not even possible) to get included in our contract as healthcare travelers. There is very little room to negotiate contracts when an MSP is involved. For the most part, you pretty much take it or leave it if you want access to that job.

How do MSPs get paid?

MSPs get paid from the bill rate (just like all of the rest of us do). They can essentially tell the facility that they are a free service because the healthcare facilities are not paying more than they already were to get a traveler. They will still pay the same bill rate and get all the added benefits and organization that a good MSP will provide. Not all MSPs are good at their job, though. Sometimes facilities end up going back to direct communication with staffing agencies because they did not like the experience of having someone else manage their relationships!

Also, MSPs often negotiate standardized rates in favorable terms for the facility, like having unbillable orientation hours or a decreased overtime rate. So sometimes the facility is paying less money than they were before. The players impacted by this will ultimately be the travelers’ pay rate and the staffing agencies’ margins.
Many times the fee is called the MSP or VMS rate. The most common MSP/VMS rates will be 3% on the low-end and 6% on the higher end. They take this amount of money off the top of the bill rate, leaving less money for the staffing agency to work with.

If a bill rate was $70 an hour, and the MSP/VMS is charging 5%, you would take $3.50 off the bill rate, so it functionally becomes a $66.5 bill rate to run a staffing agency with and to make pay packages.

Two essential things to know about MSPs

1. MSPs are many times also large staffing agencies. And because of this, MSPs are not always vendor-neutral. What that means for the traveler is that if you work directly with the MSP staffing agency vs a different one, you could learn about the job days before other travelers. This gives you an advantage in getting hired. Non-vendor-neutral MSPs will provide themselves with time to market the travel position before opening them up to other healthcare staffing agencies.

2. MSPs do not have to pay themselves the MSP fee, and that means they have more bill rate to use. But this does not mean that they pay more money to healthcare professionals. Often it means they keep a higher margin for themselves to help pay for their overhead cost. Some are publicly traded, and they have a fiduciary responsibility to their stockholders to make considerable profits. It is a myth that working directly with the MSP means more money to us as the traveler. You often find the opposite is true! You can make more money if you do not work directly with MSP even after the VMS fee is taken out of the bill rate.

Are MSPs and VMSs good for travel nursing jobs?

MSPs and the VMSs have made very important changes in our travel industry. They have had many implications on pay and on the way healthcare professionals are submitted to jobs. These technologies are not new technologies and many other industries have used them for a very long time. And they are here to stay! So we get to learn how to work with them.

One thing VMSs do that is good for the industry is standardization and organization. While it means there’s not much flexibility in how the healthcare staffing company submits the traveler, it can take away biases. It is supposed to give more fairness for the hiring manager to pick the traveler by looking at the qualifications of the candidates, in the same way, no matter the agency.

Standardization is also good and how we get credentialed as healthcare travelers. One of the most important things a staffing agency does is credential travelers and make sure that we are who we say we are and that we have the skills that we say that we do. Facilities are counting on staffing companies to bring quality healthcare workers to their facility to help them out. However, suppose each staffing agency just decided for themselves how they credentialed us. In that case, there could be many bad travelers with failed background checks or reports against their licensure traveling around the country and seeing patients.

By bringing standardization to the industry, we increase the quality of our industry, the travelers, and the staffing agencies that work inside of it. It also gives a way to increase access to reputable facilities for travelers. This is all good because we want to continue to grow as a respected industry.

Are MSPs and VMSs bad for travel nursing jobs?

The downside of this system is how not-so-great the technology behind it is. It can hurt communication. The hospitals don’t always do a good job communicating what they need. Or the MSPs and VMSs don’t ask and require important details. That means the MSPs or staffing agencies do some educated guessing to fill in the blanks, which doesn’t always make for a great situation. Many little things (like dress code) can be surprisingly challenging to get answers to without direct communication with the facility. This can be very frustrating for travelers who, of course, think that it should be easy to get that information.

MSPs do bring healthy competition and help staffing agencies

Contrary to some people’s belief, the MSPs (even with their fees) are a very valuable resource for newer staffing agencies. It is very difficult to get a direct contract, especially if you’re new and don’t already have relationships inside the industry. But being able to work with an MSP and have access to their travel assignments is a huge win for a new company. They don’t have to hire a sales team and take the time to call facilities around the country to get a contract. Suddenly they have access to thousands of contracts without hiring a single salesperson. The MSPs are well worth their cost for these agencies!

There have been many new (tiny) staffing agencies starting in the travel healthcare industry. These new staffing agencies might not know what they’re doing yet. The MSPs don’t want to waste time with small staffing agencies that are not ready for scale. So lately, it’s getting hard to get approved to be an MSP partner and get access to their travel nursing jobs. Getting access to the MSP’s jobs could require many years of experience as a staffing agency, among other stipulations.

MSPs also don’t give every staffing agency access to every travel assignment they have. This is a big deal for us travelers! Even if two staffing agencies work with the same MSP, they could still have different jobs to offer the travel healthcare worker. The MSPs will open up their best jobs to trusted partners. But travelers do not know which staffing agencies have access to which jobs, which can be a challenge when trying to work in a specific location.

Travel nursing direct contracts

We still have access to many direct contracts in the travel nursing world. Travel nurses and allied health professionals typically work at hospitals. And most hospitals do work with VMSs and MSPs.

Direct contracts mean the healthcare staffing agency gets to talk directly to the facility and have their own contract with them. This also impacts how a traveler is submitted to a job because there will be less standardization. You could get submitted just via an email and not a tech system at all. These contracts are the ones where your résumé matters. With a VMS, your resume is copy and pasted into a standardized system. For direct contracts, many times, they will review your real résumé. Also, it is easier for the recruiter to get answers to some of your questions with these contracts because they can directly email the facility.

PS: See the travel nursing resumé checklist and 6 things to avoid here.

It is crucial for travel nurses to work with multiple staffing agencies

It is absolutely necessary for nurses to work with multiple staffing agencies. I cannot stress enough what a difference it makes in having access to opportunities. You cannot work with just one staffing agency if you want to make the best money and find the best travel positions in this industry. Working with several recruiters is no longer taboo, and if you’re with a recruiter that makes you feel funny about this, get a new recruiter. Your number one goal is to get a great travel nursing job!

Laura Latimer

Laura Latimer

Travel OT and Founder of Nomadicare

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