Cross Country Healthcare (NASDAQ:CCRN) executives told investors the company entered 2026 with improving momentum after what CEO Kevin Clark described as a “challenging year” in 2025, citing uncertainty created by a pending merger that was later terminated. Clark, who recently returned to the CEO role, said his focus is to “restore momentum, sharpen execution, and position the company to grow faster than the market again,” emphasizing market share gains in large health systems, new client wins, operational efficiency, and technology-led differentiation.
Management sees travel staffing stabilizing, with focus shifting to speed-to-fill
Clark said Cross Country believes the healthcare staffing market—particularly travel—has stabilized and is “poised for growth in 2026.” He pointed to stability in demand and bill rates, and said clients are increasingly prioritizing speed-to-fill rather than reducing contingent labor. He said weekly production since the start of the year has outpaced the fourth quarter, and for the first time in more than three years the company expects travel to be flat to slightly up sequentially, with Travelers On Assignment projected to grow each month into the second quarter.
Fourth-quarter revenue fell; impairment and merger-related items drove notable below-EBITDA impacts
Burns said fourth-quarter 2025 revenue was $237 million, down 5% sequentially and 24% year over year. Full-year revenue was $1.05 billion, down 22% from the prior year, which he attributed largely to clients’ “normalizing” contingent utilization in the core Nurse and Allied businesses, especially Travel Nurse and Allied.
Fourth-quarter gross profit was $48 million, representing a 20.3% gross margin. Burns said gross margin was down 10 basis points sequentially but up 30 basis points from the prior year, and remained relatively stable through 2025 in a 20% to 20.4% range, with mix shifts partially offsetting continued margin pressure in travel.
SG&A was $51 million in the quarter (up 9% sequentially and down 8% year over year), and $200 million for the full year (down 14% from the prior year). Burns said SG&A included non-recurring severance costs tied to the CEO change; excluding those, SG&A would have been $43 million in the quarter and $186 million for the full year. He said the company reduced U.S. headcount by 21% from the start of the year and continues to pursue cost savings, including through technology and its center of excellence in India.
Adjusted EBITDA was $4.0 million for the fourth quarter and $27 million for the full year, with margins of 1.7% and 2.5%, respectively, as revenue declined and bill-pay spread compression persisted, especially in travel.
Burns also highlighted several notable items below Adjusted EBITDA. The company recorded $78 million in non-cash impairment charges, which he said were driven by a share-price decline following the merger termination and were principally related to indefinite-lived assets such as goodwill and the abandonment of certain trade names. Acquisition integration charges were a net credit of $16 million for the quarter and $3 million for the year due to the $20 million merger termination payment. The company reported net interest income of $300,000 for the quarter and $1 million for the year, reflecting its cash position and lack of debt beyond letters of credit.
Segment performance: travel down, home-based grew, education rebounded seasonally
In Nurse and Allied, fourth-quarter revenue was $194 million, down 4% sequentially and 24% year over year. Burns said Travel—the largest business within Nurse and Allied—declined 9% sequentially and 30% year over year, driven by fewer travelers on assignment.
Local/per diem revenue was $19 million, down 8% sequentially. Burns described the business as roughly an $80 million annual business that serves urgent, shift-level needs and operates with a gross margin close to the consolidated average, “several hundred basis points higher” than the travel business.
Education staffing revenue was $18 million, up 48% sequentially as schools returned from summer recess. Year over year, the business declined about 7% due to several large clients insourcing roles. For the full year, education revenue was $71 million with an approximate gross margin of 28%, and Burns said the company believes the business will return to growth in 2026. In the Q&A, Burns characterized education as run-rating about $75 million annually.
Home-based staffing posted fourth-quarter revenue of $34 million, up 34% year over year. Burns said he expects that growth trajectory to continue, and later said the business was running at north of $140 million annualized.
Physician Staffing revenue was $43 million, down 12% sequentially and 20% year over year. Burns attributed the decline to fewer billable days in top specialties including hospitalists, anesthesia, and CRNAs, while revenue per day filled increased 10% year over year due to modest bill-rate increases and favorable mix.
Technology and operating leverage central to strategy; company outlines 2026 financial targets
Clark emphasized Cross Country’s technology portfolio, anchored by Intellify, a workforce intelligence platform that supports many MSP and vendor-neutral programs. He described Intellify as a scalable VMS capable of managing multiple staffing categories, and said the company is seeing interest from other staffing organizations to leverage the platform. Management said it plans to expand Intellify into home-based and education staffing markets in 2026. The company also highlighted Xperience, a mobile platform used by healthcare professionals to find opportunities and manage careers.
Executives also pointed to enterprise automation and AI initiatives, as well as the rollout of middle-office functionality within the company’s ERP system, as means to increase recruiter productivity and back-office efficiency. In response to investor questions, Clark said the company is infusing AI across the enterprise, including in delivery and recruitment and in locums credentialing.
On profitability, Burns told investors gross margin expansion is not expected to be the primary lever given a “hyper-competitive” travel market and continued tight bill-pay spreads. Instead, management cited operating leverage from higher revenue, mix improvement from higher-margin businesses, offshoring additional work to India, and automation.
The company’s balance sheet remained a focal point. Burns said Cross Country ended the quarter with $109 million in cash and no debt. The company repurchased more than 800,000 shares in December for $6.8 million (about 2.5% of shares outstanding) and bought an additional 486,000 shares in the first quarter of 2026 under a Rule 10b5-1 plan. Burns said the company believes its stock does not reflect underlying value and anticipates further repurchases.
For the first quarter of 2026, Cross Country guided to revenue of $235 million to $240 million, driven by growth in Travelers On Assignment and a “small amount” of labor disruption revenue. Burns said labor disruption revenue would be in the single millions and not material overall. The company guided to Adjusted EBITDA of $4 million to $5 million (about a 2% margin) and Adjusted EPS of a loss of $0.04 to $0.06 on an average share count of about 31.5 million shares, noting payroll taxes are expected to negatively impact the quarter by approximately $2 million.
Looking further ahead, management reiterated its goal to exit 2026 with a revenue run rate above $1 billion and an Adjusted EBITDA margin of 4% to 5%, and Burns said the company is targeting year-over-year revenue growth by the back half of 2026, with Q3 as the target but “close” between Q3 and Q4.
About Cross Country Healthcare (NASDAQ:CCRN)
Cross Country Healthcare, Inc, headquartered in Boca Raton, Florida, is a leading provider of healthcare workforce solutions in the United States. The company specializes in the recruitment, placement and management of nursing and allied health professionals on both a travel and permanent basis. Through its integrated platform, Cross Country Healthcare serves hospitals, health systems, and long-term care facilities by matching qualified clinical talent with patient care needs across diverse care settings.
The company’s core service offerings include travel nurse and allied health staffing, per diem staffing, permanent placement services, and managed services programs.
