Why locum tenens is becoming a strategic imperative for rural health

Rural hospitals and clinics operate at the intersection of some of health care’s most persistent challenges. Chronic staffing shortages, limited recruitment pipelines, long credentialing timelines, and high provider burnout all converge in communities that already face significant barriers to care.

It’s no coincidence that the locum tenens industry itself was born out of these pressures — originally created to give overstretched rural physicians a way to step away from their practices without leaving patients unsupported. However, what started as a practical solution for rural continuity of care soon revealed a deeper, systemwide need across the health care industry.

The 2025 CHG Healthcare State of Locum Tenens Report provides a timely examination of how health care organizations are addressing these challenges today, including the implications for expanding access to health care in rural areas.

Locum tenens has become a strategic workforce lever

One of the most important takeaways from the CHG report is the steady, intentional rise in locum usage across the country. This year, 80 percent of health care organizations reported that they expect their use of locums to stay the same or increase.

This shift reflects a broader industry recognition that staffing shortages are not temporary disruptions; they are a structural problem. Even large, well-resourced health systems now rely on locums as part of their longer-term staffing strategies, not just for emergency coverage.

For rural organizations, this underscores the reality that traditional recruitment models alone can’t keep pace with market demand. Rural administrators have long been forced to innovate out of necessity. The national trend aligns the rest of the industry with the approach rural facilities have already embraced: Flexibility is essential, and locums are central to achieving it.

Rural communities remain a core destination for locum providers

The report highlights that rural communities continue to represent a substantial share of locum physician demand, accounting for 27 percent of assignments in 2025. While this represents a shift from the 34 percent reported in 2024, the more meaningful trend is the broader movement away from metro-heavy assignment patterns as the population ages and care needs deepen outside urban centers.

This steady demand reflects not only the staffing realities facing rural facilities but also speaks to the enduring appeal of rural assignments for many providers — clinicians who value mission-driven work, broader clinical scope, and the chance to make a tangible impact in underserved communities.

APPs are reshaping the rural primary care workforce

Another major trend from the CHG report involves the rapid rise of advanced practice provider (APP) use in locums. These professions are growing at nearly twice the rate of their physician counterparts. Over a third (39 percent) of health care facilities say they plan to increase their usage of APP locums in the coming year, and CRNAs have become the most requested specialty in the Locumsmart vendor management system.

Nurse practitioners, physician assistants, and other advanced clinicians are increasingly central to rural health care delivery. APPs are projected to make up the majority of the primary care workforce in non-metro areas by 2031. These roles offer faster availability and lower costs for healthcare facilities, particularly in the areas of primary care and anesthesia, where physician shortages remain a challenge.

The growing role of APPs reflects a broader redesign of the rural primary care workforce — one that blends physician leadership with the expanded capabilities of highly trained advanced practice providers.

Technology is improving rural staffing efficiency

The report also highlights the growing role of technology in addressing workforce challenges. When asked what specific workforce-related pain points they believed technology could potentially help solve, health care leaders highlighted credentialing delays (49 percent), scheduling conflicts (44 percent), and inefficient processes (43 percent). These challenges carry even greater weight for rural organizations where administrative teams are small and stretched thin.

Modern staffing and vendor management platforms now automate key parts of the credentialing process, streamline documentation collection, and reduce time-to-fill for critical positions.

Telehealth expands what locums can deliver for rural communities

Telehealth represents a fast-emerging frontier for locum tenens, and physician interest is strong. Nearly half of locum physicians (47 percent) say they are very or extremely interested in taking on telehealth locum assignments, yet only one in five (20 percent) had access to such opportunities in the past year.

While the report highlights this gap between interest and demand, it also reveals some of the most creative and forward-looking applications of telehealth currently in use. One striking example is a telehealth program delivering care to communities north of the Arctic Circle. This model demonstrates how virtual care has matured well beyond low-acuity visits or supplemental support for urban systems. It shows what is possible when telehealth is treated as an essential workforce extender—especially for rural and remote regions.

For rural health care leaders, the implications are significant. Telehealth enables locum providers to support remote communities virtually when full-time recruitment is unrealistic or when on-site coverage cannot meet the full scope of patient needs.

When combined with on-site locum coverage, telehealth creates a hybrid staffing model that strengthens access, preserves local care options, and reduces unnecessary transfers. It gives rural hospitals and clinics a way to deliver more consistent, comprehensive care without relying solely on local workforce availability.

A new workforce reality for rural health care

The CHG Healthcare State of Locum Tenens Report ultimately underscores a new workforce reality for rural hospitals and clinics: Locum tenens has become a strategic pillar in maintaining access and supporting care continuity.

With consistent provider interest in rural locum assignments, a rapidly growing APP presence, enhanced staffing technology, and expanded telehealth capabilities, the rural health care workforce is evolving into a more adaptable and resilient model.

For rural health care leaders committed to sustaining services and strengthening health care access, the findings offer both reassurance and direction. Locum tenens is not just a temporary solution; it is a strategic advantage in ensuring high-quality care for the communities that need it most.

CHG Healthcare’s team of rural health care experts can help you leverage locums more strategically in your facility.

NRHA adapted the above piece from CHG Healthcare, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 

Melinda Giese has redefined the industry through innovation and strategic growth with over 30 years of expertise in health care as senior vice president of enterprise client solutions at CHG Healthcare. She has spent her career partnering with clients on strategic and innovative strategies that stabilize and grow their business. With experience representing payors, providers, health care organizations, and government entities, she is able to see health care from every angle.