Balancing Locum Tenens Staffing Costs with Quality Care in Rural and Remote Healthcare Facilities

If you are responsible for ensuring your rural or remote community has access to high-quality healthcare, you likely feel the pressure of doing so while keeping costs in check. While patient volumes can fluctuate in rural and remote locations, oftentimes, with lower patient volumes than urban counterparts, predictable revenue can be challenging to budget. Pair that with reimbursement disparities, infrastructure upkeep, and workforce shortages, which shape a sometimes-dreary forecast of the healthcare landscape. Recent studies indicate that nearly half of America’s rural hospitals are operating at a financial loss. This situation underscores the immense financial pressures healthcare facilities face.

Skilled providers bring immense value to rural healthcare facilities—not just in patient care, but in revenue potential as well. We appreciate the difficulties of securing healthcare providers in rural and remote areas and the fact that there isn’t a simple solution. In this article, we’ll discuss how your healthcare facility can balance locum tenens staffing costs with quality care. If using locum tenens is your best option for getting your community care, we’ll share how we’ve worked with clients to help them strategically place locum tenens providers without derailing budgets.

The Cost Realities of Locum Tenens in Rural Healthcare

In some of the most rural and remote parts of America, attracting highly qualified medical providers for permanent positions can seem impossible. While you may be able to secure a few, you likely will still find holes in your staffing mix, especially if your permanent providers need to take vacations, leave of absence, or just need to avoid being overworked and burned out.

In healthcare, deciding to work with locum tenens may not be seen positively, primarily because of the perceived cost of locum tenens. On paper, working with a staffing agency and using locum tenens seems expensive. Typically, the hourly rates are higher, and you’ll likely be responsible for providing housing and travel for the providers you welcome to your community.

Despite these financial challenges, it’ll often cost your facility and your community far more not to utilize locum tenens if and when you need them. What if a full-time provider unexpectedly leaves? What if they get sick? What if you oversee a solo-provider site and cannot find someone to stay full-time? Not to mention the cost of trying to recruit internally with limited resources. The investment in locum tenens can be worthwhile when managed strategically by ensuring your community can receive uninterrupted care, reduce provider burnout, and maintain patient trust.

What “Quality Care” Really Means in Remote Settings

Using locum tenens, especially when you work through a staffing agency, can help you partner the right provider with the needs of your community. Agencies can access thousands of providers with varying backgrounds, skill sets, and personalities. While no staffing agencies are the same, Wilderness Medical Staffing takes matching providers with healthcare facilities very seriously.

In many of the rural and remote areas we serve, we recruit providers from across the country, so geography doesn’t have to limit your staffing options. (Of course, some of the healthcare facilities we work with prefer local providers, which we do our best to find, but if you’re open to searching outside your local or regional location, it can be easier to find just the right providers for your needs.)

Providers who take on the challenge of rural and remote healthcare often have a mindset and a desire to practice medicine, first and foremost. While compensation is important, we’ve found that many providers are even more drawn to the unique communities they have the opportunity to serve. They get to know their patients in more than 20-minute visit increments. The patients welcome them into the community, especially if they are longer-term or returning providers who create continuity of care. Locum tenens providers can also practice to the full extent of their training and scope of practice, potentially allowing facilities to offer more billable services and better patient care.

When choosing locum tenens, it’s crucial that they possess cultural competency for your community to gain their patients’ trust, especially in areas where the primary populations are Alaska Native or Native American. As a staffing agency, it’s our job to screen the providers who we recommend to you so that they will be an asset to your community overall.

When used strategically, locum tenens providers can do more than just fill staffing gaps—they can help stabilize and even improve the quality of care. Locum providers support clinical teams and patient access by reducing burnout among permanent staff, preventing lapses in coverage, and bringing in specialized skill sets that may not be available. Facilities that re-engage the same locums over time often benefit from greater continuity, improved patient satisfaction, and smoother operations. The key is to move beyond reactive coverage and approach locum staffing as part of a proactive workforce strategy.

Strategies to Balance Cost and Quality

Use Data to Plan Smart Coverage

Use prior data to forecast demand based on seasonality, utilization rates, and staff PTO patterns. When did you find the most significant need for providers? Do you need to utilize locum tenens consistently, or can you use them as a backup to fill in gaps in existing staff?

Last-minute placements can drive up the cost of using locum tenens. Travel will typically be more expensive than planning further ahead of time, and your choice of providers may also be limited. The more providers you can add to your provider pool three to six months ahead of needing them, the more flexibility you have in credentialing, onboarding, and scheduling. While agencies may vary in how and when they invoice for the work that locum tenens do, most agencies, including us, will not charge you unless a provider has come to your facility to work. Planning ahead and getting your staffing agency up to speed on your needs isn’t only smart, it’s often risk-free, especially from a financial perspective.

Build Relationships with a Core Pool of Providers

Implementing proactive staffing strategies, such as establishing a core pool of locum tenens providers, can enhance continuity of care and reduce onboarding costs. Facilities that have adopted this approach report improved patient satisfaction and more predictable staffing expenses. Many clients we work with who have the most success utilizing locum tenens create a “provider pool.” They will credential and onboard several providers and create rotating schedules for their organization. This helps in a variety of ways:

• The returning locum tenens are familiar with the patient population and the facility.
• Return providers reduce onboarding time vs. constantly onboarding new providers.
• Continuity of care for the patients increases.
• It helps the facility to build community rapport with consistent providers.
• The facility saves money on credentialing and retraining.

Prioritize Cultural and Regional Fit

In rural communities and tribal health areas, the personality fit of a provider matters just as much as skill. The providers placed on assignment must have mutual respect and awareness of cultural differences while being open to learning and adapting.

Mismatched providers can lead to lower patient trust and provider turnover when cultural fit isn’t prioritized. While we do our best to screen providers and educate them on the communities where they will work, we also rely on our clients to give us any information that might help ensure that providers seamlessly integrate into their community.

Prioritizing the fit of providers in the beginning stages of selecting which locum tenens will work with your organization can save money since the cost of a failed placement outweighs the upfront investment of a successful one.

Negotiate Transparent, Predictable Agreements

Understanding how you’ll be billed and your rates when working with a staffing agency and locum tenens providers should be clearly outlined prior to any assignment’s start date. You can work with your agency to negotiate rates for the different types of schedules your intended providers may work, such as call, call-back, or hourly vs. daily rates.

Working with a staffing agency further offsets administrative costs that may be otherwise needed due to agencies having access to extensive provider networks. At Wilderness Medical Staffing, you also get support with travel coordination, marketing, and payroll processing for every assignment.

Keep in mind that your rates will typically include the following: the provider’s pay, the services from the staffing agency, additional fees such as travel or housing expenses, and reimbursable expenses or per diem. Because locum tenens are independent contractors, you will not need to pay taxes on them. Additionally, we will include malpractice insurance within our rates, although inclusion of malpractice insurance may vary if working with other staffing agencies.

When negotiating rates, avoid open-ended agreements or reactive pricing. Understanding rates, how you’ll typically schedule providers, and what types of providers you’ll use can help you budget locum tenens and save you money. You can also talk to your staffing agency about how frequently providers return to assignments to better gauge how many locum tenens you’ll likely need to staff.

Final Thoughts: What Success Looks Like

Balanced staffing doesn’t always mean the lowest cost; it means a solution to provide healthcare to rural and remote communities. To help you offset staffing costs, thinking through your locum strategy is essential. You’ll have more predictable costs, fewer coverage gaps, better patient experiences, and lower staff burnout. Locum tenens should be part of a long-term workforce strategy, not just a stopgap in staffing.

With adequate planning and positive partnerships with a locum tenens staffing agency, the value added that locum tenens can bring will far outweigh the costs.

If you’re already working with us, let’s connect about how we can further optimize your staffing strategy.

If we haven’t worked together yet, we’d be glad to learn more about your community’s needs and share what’s worked for others like you or share insights from the hundreds of rural facilities we’ve worked with. You can also see what our clients say about working with us in our testimonials.