Telehealth Staffing Agencies vs In-House Hiring: What Works Better?

The choice between telehealth staffing agencies and in-house hiring depends on your business needs in 2026. Here’s the quick breakdown:

• Staffing Agencies: Best for speed, flexibility, and handling complex compliance. They can fill roles in as little as 1–3 weeks and manage credentialing across states, but their services come at a higher cost (15–25% of annual salary or a 30–50% hourly markup).
• In-House Hiring: Offers more control, better alignment with company goals, and works well for long-term hiring. However, it requires significant time (66–131 days per hire) and upfront investment in HR resources and tools.

Vacant positions can cost healthcare businesses $8,000 per day in lost revenue. For startups or companies scaling quickly, staffing agencies are often the faster solution. Larger, established organizations may benefit more from building an in-house team for strategic hiring.

Quick Comparison:

For most businesses, a hybrid approach - using agencies for urgent or niche roles and in-house teams for core positions - offers the best balance of speed and control.

What Are Telehealth Staffing Agencies?

Telehealth staffing agencies specialize in recruiting and placing professionals for virtual healthcare roles. They handle everything from sourcing and screening candidates to verifying credentials and managing compliance. These agencies often take care of the initial onboarding process as well, ensuring that all state licensing, hospital privileging, and payer enrollment requirements are met quickly and efficiently.

One of their biggest strengths is speed. By maintaining pre-vetted talent pools, they can fill positions in as little as 1–3 weeks, compared to the average 66 days it typically takes to hire a Registered Nurse (RN). This efficiency is largely due to their streamlined processes for reviewing applications and verifying credentials ^[5].

Modern agencies also evaluate candidates for "digital fluency", which includes skills like navigating electronic medical records, using remote monitoring devices, and maintaining a professional virtual presence. They ensure candidates are proficient with platforms like Epic, Amwell, or Doxy.me, making them well-prepared for telehealth operations ^[2][1][6].

"Poor credentialing is responsible for delays, denials, and even multimillion-dollar penalties in healthcare." – Alpha Apex Group Health ^[2]

By simplifying and accelerating the hiring process, telehealth staffing agencies help healthcare organizations meet a wide range of staffing needs.

Roles Filled by Staffing Agencies

Telehealth staffing agencies place professionals across a variety of roles, depending on their specialization. Clinical providers make up the largest group, including board-certified physicians (MDs/DOs), Nurse Practitioners (NPs), and Physician Assistants (PAs) in fields like primary care, emergency medicine, and neurology ^[2][1].

Behavioral health is another key area. With telepsychiatry and teletherapy on the rise, mental health professionals now account for 39% of all remote care providers. This includes psychiatrists, licensed therapists, psychologists, and social workers ^[6].

Nurses and specialized clinical staff are also in demand for roles like remote patient monitoring and acute care. Agencies place Registered Nurses (RNs), case management nurses, and specialists for high-acuity needs such as tele-ICU or telestroke services. For instance, a hospital using telepsychiatry and telestroke programs in 2025 achieved stroke consultations within 15 minutes and psychiatric evaluations in under an hour, leading to a 30% boost in patient throughput ^[1].

Non-clinical roles are equally critical. These include medical coders, billers, patient schedulers, EHR managers, and medical interpreters. There’s also growing demand for bilingual virtual medical assistants and patient coordinators, especially those fluent in English and Spanish, to better serve the 22% of U.S. residents who speak a language other than English at home ^[1].

Some agencies even focus on leadership and technical roles, placing HealthTech executives, product managers, and engineers for digital health platforms. This reflects the increasing need for both clinical and technical expertise as telehealth continues to expand ^[2][1].

Benefits of Using Staffing Agencies

Telehealth staffing agencies offer several advantages beyond simply filling roles.

Speed is a major benefit. Agencies can reduce hiring times by up to 55%, often filling positions within 55–90 days compared to the industry average of 120 days ^[2]. For example, a behavioral health platform was able to hire 80 clinicians in under six months using a pre-credentialed, multi-state licensed provider network in 2025 ^[2].

Agencies also provide access to global talent, enabling cost-effective placements from regions like Latin America and Europe, while ensuring compatibility with U.S. time zones.

Compliance support is another key advantage. Agencies navigate the complexities of state licensing, often utilizing tools like the Interstate Medical Licensure Compact (IMLC) to streamline cross-state licensing. They also manage credentialing, which is critical given that about 40% of provider roster information is currently inaccurate. This expertise helps avoid costly delays ^[2].

For growing telehealth companies, scalability is essential. Agencies offer flexible staffing models, such as locum tenens, per diem, contract-to-hire, and permanent placement. This flexibility allows organizations to quickly adapt to patient surges without committing to long-term hires. In one instance, a staffing agency helped a rural provider fill Health Navigator roles within two weeks, achieving a 73% interview-to-offer ratio and a 94% offer-to-acceptance rate ^[1].

Many agencies now use AI-powered sourcing to identify "remote-ready" candidates in as little as 3–5 business days, further reducing hiring delays ^[2][1].

Drawbacks of Staffing Agencies

While staffing agencies offer speed and compliance expertise, they come with certain downsides.

The biggest drawback is cost. Agencies usually charge 15–25% of a candidate's first-year salary for permanent hires. For a physician earning $200,000 annually, this translates to fees of $40,000–$50,000. For temporary or contract roles, agencies often apply a 30–50% markup on the clinician's hourly rate. For instance, a nurse earning $40 per hour might cost the employer $60 per hour ^[4].

These expenses can add up quickly, making agencies less viable for smaller organizations or those with tight budgets.

Another issue is limited control over the hiring process. When using an agency, employers rely on the agency’s screening criteria and candidate pool, which can feel restrictive. This lack of oversight can be frustrating, especially when hiring for highly specialized or culturally specific roles.

There’s also the potential for misaligned incentives. Agencies are motivated to fill roles quickly to earn their fees, which doesn’t always align with finding the best long-term fit. As one report highlights:

"Failed hiring decisions account for 80% of employee turnover, and a lack of process is blamed for 45% of failed hires" ^[3]

Finally, agencies may struggle with niche or emerging roles. For highly specialized positions, such as those in digital therapeutics or cutting-edge telehealth subspecialties, the agency’s talent pool might not be deep enough. In these cases, in-house recruitment might be a better option.

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What Is In-House Hiring for Telehealth?

In-house hiring means handling the entire recruitment process within your organization, using tools like applicant tracking systems (ATS), LinkedIn Recruiter, and background check services to manage the workflow ^[3].

This approach gives you full control over recruiting. Your team decides which platforms to use, how to evaluate candidates, and what qualifications align best with your company’s needs. For telehealth businesses, this often involves assessing candidates for skills like virtual communication and familiarity with digital tools during interviews ^[6].

In-house hiring is particularly effective for long-term planning and aligning with company values. Since your HR team understands your organization deeply, they can better determine if a candidate fits your work environment and mission. This connection is critical - employees are 2.6 times more likely to stay with a company that provides a smooth onboarding experience ^[9]. By managing hiring internally, new employees are immersed in your company's culture from day one.

That said, this approach comes with high upfront costs. You’ll need to cover salaries and benefits for HR staff, pay for recruiting tools, and invest in job advertisements ^[3][2]. In 2016, the average cost per hire in the U.S. was $4,425, and that number has only risen due to increased competition for talent ^[7]. Healthcare roles, in particular, take time to fill - an average Registered Nurse (RN) position takes 66 days, with 70% of that time spent on sourcing candidates ^[5].

Another challenge is managing multi-state compliance and credentialing. Tasks like verifying licenses across states, hospital privileging, and payer enrollment can add 60–90 days to the hiring process when handled manually ^[2][8]. For telehealth companies operating across state lines, these complexities can significantly delay onboarding. This sets the stage for a closer look at the benefits and challenges of building an in-house recruitment strategy.

Benefits of In-House Hiring

In-house hiring gives you unmatched control over the recruitment process. From screening candidates to conducting interviews, your team sets the standards. Telehealth companies often leverage video platforms like Doxy.me or Amwell during interviews to assess candidates’ technical skills and virtual "bedside manner" in real-time ^[6].

Cultural alignment is another key advantage. Your internal team knows your company’s mission, values, and day-to-day operations better than any outside agency. As one industry expert explains:

"In-house hiring guarantees alignment with your healthcare institution's values and goals." – Proactive Healthcare Staffing ^[3]

Additionally, in-house teams excel at internal mobility and planning for the future. They can identify current employees ready for promotions and prioritize them over external candidates ^[9]. This approach fosters loyalty and reduces turnover. For example, internal mobility in healthcare organizations increased by 7% in 2025, showcasing a growing focus on nurturing existing talent ^[5].

For specialized or leadership roles, in-house hiring allows you to customize your search. Whether you’re looking for a Chief Medical Officer with telehealth expertise or a telestroke nurse, your team can tailor the recruitment process instead of relying on an agency’s limited candidate pool.

Lastly, in-house hiring supports employer branding. Your team can create content like "day-in-the-life" videos of remote employees, share patient success stories, and highlight career development opportunities to attract top talent ^[6].

Drawbacks of In-House Hiring

While in-house hiring has its advantages, it also comes with notable challenges.

One of the biggest hurdles is time. Building a candidate pipeline can take weeks or even months. For example, filling an RN position often takes up to 66 days, and every day a role remains vacant can cost a company around $8,000 in lost revenue ^[5][2].

Another challenge is the high upfront costs. You’ll need to budget for HR team salaries, ATS subscriptions, job board fees, and background check services ^[3][2]. These expenses can be especially burdensome for smaller telehealth startups or companies scaling quickly.

In-house teams also face resource limitations. Managing the entire recruitment process - from sourcing to credentialing - demands time, expertise, and dedicated staff. If your HR team is small or stretched thin, keeping up with hiring demands can be difficult. Nearly half (47%) of healthcare HR teams report challenges in sourcing specialized talent for telehealth and remote care roles ^[1].

Credentialing delays are another common issue. Verifying licenses across multiple states, managing hospital privileging, and handling payer enrollment can take 60–90 days when done manually ^[2]. Without specialized tools or expertise, these processes can create significant bottlenecks.

Finally, in-house hiring may lack the speed and flexibility needed during periods of rapid growth. If patient demand spikes or your company is scaling quickly, your internal team might struggle to fill roles fast enough. In such cases, staffing agencies - with their pre-vetted talent pools - can provide a quicker solution.

Side-by-Side Comparison: Staffing Agencies vs. In-House Hiring

Let’s break down the key differences between staffing agencies and in-house hiring, focusing on speed, cost, and compliance.

Speed is a major factor. Staffing agencies often have pre-screened candidates ready to go, which means they can fill roles in as little as 72 hours for urgent needs [2,5]. For specialized roles, the timeline is typically 43–90 days. In contrast, in-house hiring takes significantly longer - averaging 66 to over 131 days [2,5,8]. These extended timelines can create bottlenecks, especially in fast-paced industries like healthcare.

Costs also vary widely. In-house hiring comes with fixed expenses like recruiter salaries, benefits, and the cost of recruiting tools [5,6]. On the other hand, staffing agencies operate on a variable pricing model. For permanent hires, agencies charge 15–25% of the candidate’s first-year salary. For temporary positions, they apply a 50% hourly markup [5,7]. The financial impact of delays is worth noting too - a vacant healthcare position, for example, can cost an organization around $8,000 per day in lost revenue ^[2].

Compliance and credentialing are other critical areas of difference. In-house teams have to manage complex tasks like multi-state licensing, hospital privileging, and payer enrollment themselves. These processes can add 60–90 days to onboarding ^[2]. Staffing agencies, however, handle these tasks as part of their service, often streamlining credentialing across all 50 states. This expertise is vital, considering that 85% of unspecialized credentialing applications contain errors, leading to delays ^[2]. The risks of non-compliance are real - one radiology group faced a $3.1 million settlement due to credentialing failures ^[2].

Here’s how these differences stack up:

This comparison highlights the trade-offs between the two approaches, helping organizations decide which model aligns best with their hiring goals.

Which Option Is Right for Your Business?

The best hiring strategy for your telehealth business depends on your current growth stage and operational needs. Key factors like speed, cost, compliance, and scalability play a significant role in determining the right approach. A small five-person startup, for instance, will have vastly different hiring requirements compared to a well-established provider with 200 employees.

When to Use a Staffing Agency

Staffing agencies are ideal when you need to move fast and scale flexibly without being tied down by long-term commitments. If you’re expanding into a new state, growing quickly, or need to fill multiple roles in a matter of weeks, agencies can deliver the speed and efficiency you need. They’re particularly helpful if your business lacks an internal HR team or if you’re hiring across multiple regions, such as Latin America or Europe.

Take this example: In 2025, a behavioral health platform successfully scaled its provider network by hiring over 80 clinicians in under six months ^[2]. For startups without dedicated compliance resources, this kind of support can be a game-changer.

Staffing agencies also shine in managing complex compliance requirements. Tasks like multi-state licensing, payer enrollment, and credentialing can overwhelm smaller HR teams, but specialized agencies handle these processes from start to finish. With 47% of healthcare HR teams citing challenges in sourcing specialized talent ^[1], outsourcing these responsibilities can be a practical choice.

Agencies are especially useful for filling hard-to-source positions like telepsychiatry, telestroke, or tele-ICU roles. These specialized positions often demand niche expertise and can remain vacant for extended periods. The variable cost structure - typically 15–25% placement fees or hourly markups - makes agencies a cost-effective solution when you’re not ready to take on the fixed expenses of a full HR team.

When to Build In-House Hiring

If you’re no longer focused solely on rapid scaling, building an in-house hiring team might be the better option. This approach works well when your hiring volume justifies the investment and you have the infrastructure to support long-term recruitment. For example, if you frequently hire for leadership roles, have a dedicated People or Talent team, and use tools like an ATS (Applicant Tracking System), an internal team can offer more control over hiring processes.

Internal recruiters bring valuable organizational knowledge over time. They understand your company’s values, communicate your mission effectively, and can identify candidates who are more likely to stay for the long haul. This is critical, considering that 80% of employee turnover stems from poor hiring decisions, and 45% of failed hires result from the lack of a formal hiring process ^[3].

While maintaining an in-house HR team may cost $8,000–$20,000 or more per month (including salaries, benefits, and tools), the investment pays off when you’re making dozens of hires annually. In contrast, the per-placement fees charged by agencies can add up quickly at higher volumes. An in-house team is ideal when you’re focused on retention, need to fill specialized roles that require thorough vetting, or want full control over the candidate experience.

Using Both: The Hybrid Approach

For many businesses, a hybrid approach - combining the strengths of both staffing agencies and in-house hiring - provides the best of both worlds. This strategy allows you to tap into the speed and flexibility of agencies while maintaining the control and consistency of an internal team. Agencies can handle rapid scaling, seasonal hiring spikes, or hard-to-fill positions, while your in-house team focuses on core leadership and permanent roles.

One effective hybrid strategy is the contract-to-hire model, which lets you "test-drive" clinicians through short-term assignments (e.g., 13 weeks) before committing to permanent roles. This reduces the risk of turnover. Agencies often offer discounted conversion fees - around 50% of the initial placement fee - when transitioning contractors to full-time employees ^[4].

Another option is Recruitment Process Outsourcing (RPO), where agency recruiters work directly with your internal HR team. This creates a seamless recruitment process without the long-term costs of a full-time hiring staff. It’s particularly useful for scaling new departments or expanding into new geographic areas.

The hybrid model allows you to allocate resources strategically based on urgency and role specialization. For instance, Alina TeleHealth successfully deployed board-certified clinicians through a HIPAA-compliant system that ensured telestroke consultations within 15 minutes and telepsychiatry evaluations in under 1 hour ^[1]. Meanwhile, their in-house team focused on building long-term leadership and operational staff.

This approach is especially effective for startups in rapid growth phases. You can scale quickly with agency support while gradually developing your internal capabilities to handle stable, long-term hiring needs as your business matures.

Pricing and Timeline Breakdown (2026 Estimates)

Let’s dive into the pricing models and timelines for staffing agencies versus in-house hiring.

Staffing agencies usually charge a percentage of the candidate's first-year salary for permanent placements - typically between 15–25%. For instance, hiring a physician with a $200,000 salary could mean paying $40,000–$50,000 in agency fees ^[2]. For temporary roles, agencies often use a markup model, adding around 50% to the candidate's hourly wage. So, if a nurse earns $40 per hour, the agency might bill you $60 per hour ^[4]. Some agencies also offer retainer-based pricing, where you pay an upfront fee (e.g., $2,000) and a success fee (e.g., $10,000) upon placement ^[4].

On the other hand, in-house hiring comes with fixed monthly costs that range from $8,000 to $20,000+ depending on your setup. These costs cover salaries, benefits, job board subscriptions, applicant tracking systems (ATS), and background checks ^[2]. While this model can save money if you're hiring at scale, it might feel expensive when your recruitment needs are minimal or sporadic.

Timelines vary significantly between the two approaches. Staffing agencies are known for speed, often presenting candidate profiles within 3–5 business days and completing placements in 15–90 days ^[1]. In contrast, in-house teams take longer. For example, filling a Registered Nurse position takes an average of 66 days, while revenue-generating roles can take over 131 days, with 70% of that time spent on sourcing ^[5]. For specialized roles like physicians or Advanced Practice Providers, in-house hiring averages 120 days, whereas agencies can deliver in 55–90 days ^[2].

The cost of a vacant position is another critical factor. Every day a role remains unfilled can result in approximately $8,000 in lost revenue ^[2].

"A vacant role loses revenue (~US$8,000/day in healthcare). You can delay that loss with an agency's help faster."

• Alpha Apex Group Health ^[2]

When you consider this opportunity cost, the speed of staffing agencies often makes their fees worthwhile - particularly for revenue-generating roles that directly affect your bottom line.

Final Recommendation: What Works Better in 2026?

There’s no universal answer here - the best hiring strategy depends entirely on where your telehealth business stands right now.

If you’re a startup or a fast-growing clinic, staffing agencies can offer a critical advantage in speed. Whether you’re expanding into multiple states or trying to manage a sudden influx of patients, waiting 120 days to fill a role simply isn’t an option. Agencies provide quick placements and handle compliance efficiently. Plus, they tap into extensive global talent pools. While the upfront cost - 15–25% of the first-year salary - might seem steep, it’s worth considering that every unfilled position could cost your business about $8,000 a day in lost revenue ^[2].

On the other hand, mature organizations with established HR teams often benefit from in-house hiring, especially for leadership roles or positions requiring strong alignment with the company’s values. An internal team ensures a consistent brand voice and a tailored hiring process. That said, agencies can still be a valuable resource for filling specialized roles or addressing short-term gaps.

A hybrid approach is gaining traction as a flexible solution. Use your in-house team to build a stable, long-term core, while leveraging staffing agencies for short-term needs, such as seasonal demand, niche specialties like telepsychiatry, or contract-to-hire arrangements. This model offers the best of both worlds: the control and personalization of in-house hiring combined with the speed and scalability of agency support - without the overhead costs of maintaining a large recruitment team.

With the telehealth market expected to reach $175.5 billion by 2026 ^[6], the ability to hire quickly, efficiently, and cost-effectively will be a key factor in staying competitive. The right hiring strategy isn’t about where you want to be in the future - it’s about aligning your approach with your current stage of growth.

FAQs

How can a hybrid hiring approach enhance my telehealth recruitment strategy?

A hybrid hiring strategy blends the efficiency and global accessibility of telehealth staffing agencies with the personalized touch and cost management of an in-house recruitment team. Staffing agencies shine when it comes to quickly filling high-demand or specialized roles, such as virtual nurses or bilingual patient support staff. They can often place candidates within just 1–3 weeks while handling critical tasks like compliance, background checks, and licensing. This allows your internal team to concentrate on leadership roles or niche positions that require a more tailored cultural fit.

As the telehealth industry continues to expand rapidly, this hybrid approach also simplifies the challenges of hiring across multiple states and regions. Agencies can manage complex issues like multistate licensure and data privacy regulations, while your in-house team focuses on strengthening your employer brand and fine-tuning recruitment processes. This model provides the agility to scale quickly in growing markets, such as LATAM or Europe, without overburdening your internal resources. It’s a practical way to achieve sustainable growth while maintaining flexibility.

What are the biggest compliance challenges when hiring telehealth professionals in-house?

Hiring telehealth professionals in-house presents a unique set of compliance hurdles that go well beyond typical recruitment challenges. One major factor is the need for multi-state licensure verification, as telehealth often involves providing care across state lines. For instance, physicians might need to secure licenses through the Interstate Medical Licensure Compact (IMLC), while nurses may require credentials under the Nurse Licensure Compact (NLC). With each state enforcing its own set of rules, navigating this process can quickly become intricate.

Another critical consideration is ensuring HIPAA compliance. Remote work setups demand secure systems, including encrypted communication tools, protected networks, and stringent access controls, to safeguard sensitive patient information. Beyond that, companies must also comply with state-specific telehealth laws, which cover areas like patient consent, prescribing practices, and billing protocols. Overlooking these regulations during hiring or onboarding could lead to significant legal issues.

Lastly, HR compliance across multiple states adds yet another layer of complexity. Things like employee classification, payroll tax requirements, overtime policies, and workers' compensation laws differ from one jurisdiction to another. Mistakes in these areas can lead to costly penalties. Successfully navigating these challenges calls for a combination of strong legal expertise, well-structured compliance workflows, and advanced technology solutions to keep everything on track.

Why can staffing agencies be a more cost-effective option despite their fees?

Staffing agencies charge higher fees, but they often make up for it by simplifying the hiring process and cutting overall expenses. They remove the need for a dedicated in-house recruiting team, drastically reduce the time it takes to fill positions - sometimes from weeks to just days - and include key services like compliance checks, candidate screening, and onboarding in their packages.

By managing these tasks effectively, staffing agencies help lower administrative costs and provide quicker hiring solutions, which can be an economical option for many healthcare organizations.

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