CompHealth vs AMN Healthcare: Which Locum Agency Is Right for You? 2026

CompHealth and AMN Healthcare are the two largest locum tenens agencies in the country by revenue and facility network. They are also structurally different in ways that matter for physicians — different ownership models, different business priorities, and different negotiating dynamics. This comparison covers what those differences mean in practice, where each agency has a genuine advantage, and how to use both effectively without getting trapped by either.

1. Who Each Company Actually Is

CompHealth is CHG Healthcare’s locum tenens flagship. CHG is privately held, which means no public financial disclosures, no quarterly earnings calls, and no obligation to report margins or revenue to anyone outside its ownership structure. CompHealth operates as a generalist locum agency — broad specialty coverage, nationwide facility network, high assignment volume. It is the agency most physicians encounter first when entering locum tenens, partly because of its scale and partly because of its marketing reach.

AMN Healthcare is a publicly traded enterprise workforce solutions company. Locum tenens placement — conducted through its Staff Care brand — is one division of a larger business that includes travel nursing, allied health staffing, workforce management technology, and permanent physician placement through Merritt Hawkins. AMN’s public company status means quarterly SEC filings, disclosed gross margins, and financial pressures that private companies do not face in the same way. Its 2026 gross margin guidance of 23.5-24% is public record — a data point that physicians negotiating rates with AMN can and should use.

The practical implication: CompHealth is a locum agency that does locum tenens. AMN is a healthcare workforce company that includes locum tenens among its business lines. That distinction shapes everything from recruiter incentives to contract structure to the conflicts of interest each agency carries.

2. The Merritt Hawkins Problem

AMN’s ownership of Merritt Hawkins — the country’s largest permanent physician placement firm — creates a structural conflict of interest that CompHealth does not have. Merritt Hawkins charges hospitals 20-25% of first-year physician compensation for permanent placements, which translates to $80,000-$110,000 in fees for a $400,000 physician role. AMN earns this fee when a locum physician converts to a permanent hire through Merritt Hawkins.

The conflict is straightforward: AMN has a financial incentive to facilitate permanent placement conversions for physicians working locum assignments through Staff Care, because those conversions generate Merritt Hawkins placement fees on top of the locum revenue already earned. This does not mean every AMN recruiter is actively steering physicians toward permanent roles — but it does mean the financial incentive exists at the corporate level, and physicians should understand it before signing any agreement that includes permanent placement or conversion language.

The specific contract risk is a right-of-first-refusal or conversion fee clause that gives AMN or its affiliates a financial interest in any permanent placement that results from a locum assignment. Read any AMN contract carefully for language that connects your locum work to permanent placement fees, and have a physician contract attorney review it before signing if such language is present. CompHealth does not carry this conflict — CHG’s Locumstory.com is a job board, not a permanent placement firm with placement fees at stake.

3. Business Model and MSP Structure

AMN operates as a Managed Service Provider for many of its largest health system clients. In an MSP arrangement, AMN manages the entire contingent workforce for a hospital or health system — including locum placement — and other staffing agencies operate as subcontractors within AMN’s VMS platform. This creates a margin layering problem: AMN takes a management fee at the top, and the subcontracted agency takes its markup, before any rate reaches the physician. Physicians placed through AMN’s MSP accounts are often working through a multi-layer margin structure without knowing it.

CompHealth does not operate as an MSP. It competes for facility contracts directly and places physicians as a primary agency. This means the margin structure is simpler — one agency, one markup, no management fee layer above it. CompHealth’s reported markup range from physician community sources runs approximately 35-45% of bill rate. AMN’s gross margin guidance of 23.5-24% reflects its blended business mix, not locum-specific margins, which may run higher.

For physicians, the practical question is whether a given assignment is an AMN direct placement or an AMN MSP placement with a subcontracted agency beneath it. The answer affects both the rate ceiling and the negotiating leverage available. Ask your recruiter directly: is this a direct placement or a subcontracted assignment through a VMS? The answer will not always be volunteered.

4. Specialty and Geographic Coverage

CompHealth covers a broad range of specialties with particular strength in high-volume generalist categories — hospitalist, family medicine, internal medicine, emergency medicine — and has a nationwide facility network that is among the most extensive in the industry. Its Modio Health credentialing infrastructure, acquired by CHG in 2019, gives CompHealth a speed advantage at facilities that use Modio for credentialing — a meaningful operational benefit for physicians who need fast starts.

AMN through Staff Care covers comparable specialty breadth but with stronger presence in large integrated health system and IDN accounts where its MSP relationships give it preferred or exclusive access. Physicians targeting major health systems — large regional IDNs, academic medical centers with enterprise staffing contracts — may find that AMN has access to assignments that CompHealth cannot reach because of AMN’s MSP position at those accounts.

The geographic coverage difference is less about state presence and more about facility type. CompHealth tends to have stronger reach into community hospitals, rural facilities, and independent health systems. AMN’s MSP model gives it deeper penetration into large integrated systems. Both agencies cover all major geographies — the distinction is which facilities within those geographies each agency can access.

5. Contract Terms and Red Flags

Malpractice coverage: Both CompHealth and AMN provide malpractice coverage for locum assignments. Confirm whether your specific assignment carries occurrence or claims-made coverage, and whether tail coverage is included if claims-made. Do not assume — get the coverage type confirmed in writing before your first clinical day. See the LPG malpractice guide for the full framework.

Non-compete and non-solicitation: Both agencies include non-solicitation language restricting direct contact with facilities after an assignment ends. Review the scope, duration, and geographic reach of any such clause with a physician contract attorney. Non-solicitation provisions are generally more enforceable than broad non-competes — understand what you are agreeing to before signing.

Cancellation provisions: Both agencies include cancellation clauses that define notice requirements and financial consequences for early assignment termination — by either party. Read these carefully. A facility-initiated cancellation with short notice can leave a physician without income and with housing costs already committed. Negotiate notice periods and cancellation protections explicitly before accepting any assignment.

AMN-specific: Permanent placement language: As noted above, review any AMN contract for language connecting your locum work to Merritt Hawkins placement fees or conversion rights. This is the most AMN-specific contract risk and warrants explicit attention. See the full AMN Healthcare review for a complete breakdown.

6. Pay and Transparency

Neither CompHealth nor AMN discloses bill rates as standard practice. At both agencies, asking directly is the only mechanism that might produce bill rate information — and even then, disclosure is not guaranteed. The difference is that AMN’s public company status provides macroeconomic transparency that CompHealth’s private structure does not: gross margin targets, segment revenue, and workforce metrics are disclosed quarterly in SEC filings. Physicians negotiating with AMN can use public financial data to contextualize rate offers in a way that is not available with CompHealth.

CompHealth’s reported markup range from physician community sources runs approximately 35-45% of bill rate. This is consistent with CHG’s private company positioning — strong margins without public accountability for them. The Modio Health credentialing advantage does not reduce the markup; it reduces the time to first paycheck, which is a different value proposition.

On pay transparency, both agencies operate from the same fundamental position: the bill rate is their information, not yours, and they will not share it unless competitive pressure or direct negotiation forces the issue. The most effective counterpressure at both agencies is identical — parallel recruiter conversations that make the competitive landscape visible and create rate pressure from outside the single-agency relationship.

7. Recruiter Experience

CompHealth recruiter feedback from the physician community is variable — a function of scale more than agency-specific culture. Positive accounts cite breadth of assignment access and logistics support. Negative accounts cite poor communication, mismatched assignments, and last-minute cancellations. Recruiter quality varies significantly by specialty focus and individual recruiter tenure. The most consistent CompHealth-specific feedback pattern involves logistics and credentialing support quality — the Modio infrastructure is a genuine operational asset when it works, and a source of frustration when it does not.

AMN’s enterprise model produces the most institutional recruiter experience of any major locum agency — more relationship manager than dedicated physician advocate in many cases. The company’s focus on large health system MSP contracts means some recruiters prioritize institutional account management over individual physician placement optimization. Pay discrepancies and payroll delays are the most specific recurring complaint in physician feedback about AMN — a pattern worth noting before committing to a long assignment.

The physician community consistently rates specialty boutique agencies above both CompHealth and AMN on recruiter expertise and relationship quality in hard-to-fill subspecialties. For generalist specialties where volume and assignment access matter more than recruiter depth, CompHealth’s scale is a genuine advantage over most boutiques. AMN’s advantage is access — specific large-system assignments that only AMN’s MSP position can reach.

8. Who Each Agency Is Best For

CompHealth is best for: Physicians entering locum tenens for the first time who need maximum assignment access across specialties and geographies. Generalist specialties — hospitalist, family medicine, internal medicine, EM — where volume and assignment breadth matter more than recruiter depth. Physicians targeting community hospitals, rural markets, and independent health systems where CompHealth’s direct placement model has stronger reach than AMN’s MSP-focused approach. Physicians who want fast credentialing through Modio Health infrastructure.

AMN is best for: Physicians specifically targeting large integrated health systems and IDNs where AMN’s MSP relationships give it preferred or exclusive access. Broad-demand specialties where large system assignment volume outweighs the need for specialty-specific recruiter expertise. Physicians comfortable with enterprise complexity and the contract discipline required to navigate MSP structures, multi-layer margins, and the Merritt Hawkins conflict explicitly.

Neither agency is the right single-agency strategy. The physicians who extract the most value from the locum market run multiple agency relationships simultaneously — using each for what it does best while maintaining competitive rate pressure through parallel conversations. CompHealth for community hospital breadth and credentialing speed; AMN for large system access where its MSP position gives it unique reach; a specialty boutique for rate negotiation leverage in competitive subspecialty markets. See the LPG agency evaluation guide for a framework on managing multiple agency relationships.

The full independent reviews of each agency are available here: CompHealth Review 2026 | AMN Healthcare Review 2026 | CompHealth vs Weatherby vs AMN: Three-Way Comparison