Staffing agency economics healthcare: the operating math for gross margin, speed to submittal, and recruiter capacity

Ben Argeband, Founder & CEO of Heartbeat.ai — Make it spreadsheet-like and non-salesy. This is written for desk leaders who need faster submittals and cleaner gross margin without burning out recruiters.

Who this is for

This hub is for locums and permanent placement agencies that want to run their funnel like an operating system: measurable, coachable, and tied to gross margin, speed to submittal, and ROI.

• Agency owners who need predictable unit economics and fewer surprises.
• Recruiting managers who need throughput without “more activity” as the only lever.
• Ops leaders who need definitions, exports, and a weekly cadence that sticks.

Choose your path

• If you need to justify spend: use the contact data ROI measurement workflow.
• If recruiters are overloaded: use recruiter capacity planning for physician roles.
• If locums speed is the constraint: use the locum tenens sourcing playbook.
• If you want to test reachability quickly: start free search & preview data.

Quick navigation

• Quick Answer
• Framework
• Step-by-step method
• Micro-Asset: ROI Calculator
• Micro-Asset: Diagnostic Table
• Micro-Asset: Weighted Checklist
• Common pitfalls
• How to improve results
• Evidence and trust notes
• FAQs
• Next steps

Quick Answer

Core Answer

Staffing agency economics in healthcare is managing attempts-to-fill efficiency so speed to submittal improves while gross margin stays protected through measurable connects, convos, submits, and fills.

Key Insight

Most “margin problems” are workflow problems: too many low-quality attempts before a qualified conversation, which slows submittals and inflates cost per fill.

Best For

Locums and permanent placement agencies.

Compliance & Safety

This method is for legitimate recruiting outreach only. Always respect candidate privacy, opt-out requests, and local data laws. Heartbeat does not provide medical advice or legal counsel.

Framework: The “Agency Math” Loop: attempts → connects → convos → submits → fills

If you can’t see the conversion chain, you can’t manage it. This loop is the simplest way to connect recruiter activity to outcomes and economics:

• Attempts: total outreach touches counted once per action (e.g., each dial, each email sent, each text sent), using one consistent counting rule across the desk.
• Connects: connected calls (not voicemails).
• Convos: qualified conversations. A conversation counts as qualified when: (1) you confirm specialty/role fit, (2) you confirm reachability for follow-up, and (3) you confirm interest or availability window.
• Submits: submitted/presented to the client.
• Fills: accepted offer / booked assignment / start confirmed (pick one and standardize it).

What actually drives agency economics (in plain terms)

• Labor efficiency: how many attempts and how much recruiter time it takes to produce one fill.
• Speed to submittal: how quickly you can get a qualified candidate in front of the client after intake.
• Conversion quality: connects → convos → submits → fills, by desk and specialty.
• Data hygiene: fewer wrong numbers, fewer bounces, and better suppression so you stop paying for dead ends.
• Client control: feedback speed, interview scheduling, and decision clarity (because delays consume recruiter time and reduce fill probability).

Key takeaways (what to do first)

• Standardize definitions (especially speed-to-submittal and “fill”) before you compare recruiters or desks.
• Run one weekly export with timestamps and counts; don’t build a dashboard you can’t maintain.
• Fix the biggest constraint in the loop (connectability vs packaging vs client control) for one week at a time.
• Protect recruiter capacity by improving placement-per-attempt, not by demanding more attempts.

Step-by-step method

1) Standardize definitions (so your reports aren’t arguments)

These definitions keep your dashboards consistent across locums and perm.

• ROI definition: ROI = (Incremental gross profit − Incremental cost) / Incremental cost. Use incremental values (what changed because of the tool/process), not total desk revenue.
• Speed-to-submittal definition: elapsed time from requisition intake (or job opened) to first qualified submittal. Report median and 75th percentile.
• Placement-per-attempt definition: fills / total attempts for a defined period (week/month). This is your efficiency metric and a proxy for recruiter capacity health.

If you track channel health, use canonical rate definitions with explicit denominators:

• Connect Rate = connected calls / total dials (per 100 dials).
• Answer Rate = human answers / connected calls (per 100 connected calls).
• Deliverability Rate = delivered emails / sent emails (per 100 sent emails).
• Bounce Rate = bounced emails / sent emails (per 100 sent emails).
• Reply Rate = replies / delivered emails (per 100 delivered emails).
• Fill Rate = fills / submits (per 100 submits) for the same period.

2) Instrument the workflow with timestamps you already have

You don’t need a data warehouse. You need a weekly export with the same columns every time:

• Requisition opened (or intake) timestamp
• First outreach attempt timestamp
• First connected call timestamp
• First qualified conversation timestamp
• First submittal timestamp
• Fill/start timestamp (based on your standardized definition)
• Counts: dials, connected calls, emails sent/delivered/bounced, replies

3) Diagnose the constraint (connectability vs process)

Speed to submittal is slow for two reasons:

• Connectability problem: you can’t reach the right clinicians fast enough.
• Process problem: you reach them, but qualification, packaging, or client feedback slows the submit.

Use the loop to pinpoint the leak:

• Attempts high, connects low → fix phone/email quality, timing, and suppression.
• Connects fine, convos low → fix targeting and your first 30 seconds.
• Convos fine, submits low → fix job clarity, rate/comp alignment, and submittal packaging.
• Submits fine, fills low → fix client control, interview scheduling, and close plan.

Time math example (no benchmarks, just your funnel)

Use variables so you can plug in your own numbers. If D is total dials and C is connected calls, then Connect Rate = C/D. If Q is qualified conversations and S is submits, then qualified-convo-to-submit conversion is S/Q. Improving Connect Rate or improving qualified conversations per connected call reduces dials per qualified conversation, which usually improves speed to submittal because you reach “enough qualified yeses” earlier in the week.

4) Protect recruiter capacity by improving placement-per-attempt

Recruiter capacity is not “how many calls someone can make.” It’s how many useful attempts they can make before quality drops. The trade-off is… pushing raw activity can inflate attempts while lowering connects and convos, which slows submittals and increases cost per fill.

Operational levers that usually improve placement-per-attempt:

• Suppression: stop re-hitting records that repeatedly fail (bad numbers, hard bounces, explicit opt-outs).
• Prioritization: call the most reachable candidates first during your best call windows.
• Packaging: reduce back-and-forth so a qualified yes becomes a same-day submittal.
• Segmentation: separate locums availability conversations from perm motivation conversations.

5) Run a weekly cadence that produces decisions (not dashboards)

Run one weekly export by recruiter and by desk (locums vs perm), calculate medians, and choose one constraint to fix for the next 5 business days.

Measure this by… running the same weekly export every Friday and comparing medians week-over-week by desk (locums vs perm) and by recruiter.

1. Export the timestamps and counts listed above for last week’s reqs.
2. Calculate speed-to-submittal (median, 75th percentile) and placement-per-attempt for each desk.
3. Check channel health (Connect Rate, Deliverability Rate, Bounce Rate, Reply Rate) to see if the top of funnel is degrading.
4. Pick one fix (suppression, prioritization, packaging, or client SLA) and implement it for one week.
5. Review what moved and keep only what improved outcomes.

Micro-Asset: ROI Calculator

Use case: decide whether a sourcing/data/process change is worth it for a staffing agency desk without relying on industry averages.

Calculator Card (copy into a spreadsheet)

Uniqueness hook (CALCULATOR): “Speed-to-Submittal Value” worksheet

This is a leading-indicator worksheet that avoids invented dollars. It helps you prove you’re getting faster before fills show up.

Micro-Asset: Diagnostic Table

Use case: identify which lever to pull first (connectability, targeting, packaging, or client control) based on what you can observe in a week.

Micro-Asset: Weighted Checklist

Use case: choose what to fix first when you have limited ops time. Score each item 0–2 (0 = not in place, 1 = partial, 2 = solid). Multiply by weight. Highest weighted total is your first project.

Interpretation: if Measurement and Connectability score low, fix those before you debate sourcing channels. You can’t manage what you can’t see.

Common pitfalls

• Managing activity instead of throughput. If you only manage dials/emails, you can increase attempts while convos and submits stay flat.
• Inconsistent definitions across desks. If one team defines “fill” as offer accepted and another uses start date, placement-per-attempt becomes noise.
• No suppression loop. Re-hitting bad numbers and bouncing emails inflates attempts and wastes recruiter capacity.
• Attribution inflation. If you credit every fill to a tool, ROI becomes a story instead of a decision metric.
• Letting packaging be ad hoc. Slow submittals are often a missing packet, missing fields, or unclear client must-haves.

How to improve results

Use a one-week improvement cycle. Don’t change five things at once; you won’t know what worked.

Weekly measurement instructions (minimum viable)

1. Export last week’s reqs and candidate activity: dials, connected calls, emails sent/delivered/bounced, replies, first qualified convo date, first submittal date, fill/start date.
2. Calculate by desk and recruiter:
   • Connect Rate = connected calls / total dials (per 100 dials)
   • Deliverability Rate = delivered emails / sent emails (per 100 sent emails)
   • Bounce Rate = bounced emails / sent emails (per 100 sent emails)
   • Reply Rate = replies / delivered emails (per 100 delivered emails)
   • Speed-to-submittal = time from req intake/open to first qualified submittal (median; 75th percentile)
   • Placement-per-attempt = fills / total attempts (same period)
3. Pick one constraint from the Agency Math Loop and run a one-week fix (suppression, prioritization, packaging, or client SLA).
4. Keep only the change that improves outcomes; revert the rest.

High-leverage improvements that usually show up fast

• Prioritize reachability. Put your best call windows against the most reachable candidates first.
• Reduce dead ends. Fewer wrong numbers and fewer bounces improves placement-per-attempt and protects recruiter capacity.
• Standardize submittals. A consistent packet reduces back-and-forth and improves speed to submittal.
• Segment by intent. Locums availability and perm motivations are different; qualify and message accordingly.

Legal and ethical use

Use legitimate recruiting outreach only. Respect opt-outs, keep suppression lists, and follow applicable privacy and communications laws where you operate. Keep access controls tight and avoid sensitive inferences about clinicians.

If you’re unsure about a specific outreach practice, get counsel. This page is operational guidance, not legal advice.

Evidence and trust notes

This hub avoids unsupported industry “averages” on purpose. Agencies win by measuring their own funnel and improving constraints. For how Heartbeat.ai approaches data quality, verification, and trust, see: Trust methodology and data quality approach.

Deep dives referenced in this hub:

• How to measure contact data ROI
• Recruiter capacity planning for physician roles
• Locum tenens sourcing playbook

FAQs

What is the simplest way to manage staffing agency economics in healthcare?

Run the Agency Math Loop weekly: attempts → connects → convos → submits → fills. Track speed to submittal and placement-per-attempt, then fix the biggest constraint first.

How do I define ROI for a recruiting workflow change?

ROI = (Incremental gross profit − Incremental cost) / Incremental cost. Use incremental fills and incremental costs attributable to the change, and keep attribution conservative.

What should I track to protect gross margin without relying on industry benchmarks?

Track your own placement-per-attempt and speed to submittal by desk and specialty. When placement-per-attempt improves, recruiter time per fill typically drops, which supports gross margin.

How do I measure speed to submittal in a way that’s fair across recruiters?

Define it as elapsed time from req intake/open to first qualified submittal, then report median and 75th percentile by desk. Use the same definition everywhere.

Where should a locums agency start if they need faster submittals?

Start with connectability and packaging: improve Connect Rate (connected calls / total dials) and enforce a same-day submittal packet once you have a qualified yes. Then refine targeting.

Next steps

• Implement the weekly export: follow the ROI measurement workflow and standardize your definitions.
• Fix capacity constraints: use capacity planning for physician roles to rebalance pods and protect calling blocks.
• Move faster on locums: use the locums sourcing playbook to tighten targeting and packaging.
• Test reachability now: start free search & preview data.

Must-use phrase: This page is about staffing agency economics in healthcare, managed with your own funnel math.

About the Author

Ben Argeband is the Founder and CEO of Swordfish.ai and Heartbeat.ai. With deep expertise in data and SaaS, he has built two successful platforms trusted by over 50,000 sales and recruitment professionals. Ben’s mission is to help teams find direct contact information for hard-to-reach professionals and decision-makers, providing the shortest route to their next win. Connect with Ben on LinkedIn.