Travel Nurses Cost Less Than You Think. The Credentialing Delay Is What’s Expensive.

A KPMG study released in January 2026, commissioned by the National Association of Travel Healthcare Organizations (NATHO), landed a number that challenges a decade of assumptions about travel staffing costs. On a fully loaded basis, travel nurses average $89 per hour. Permanent nurses average $94 per hour. When you factor in benefits, PTO, retirement contributions, risk management, recruitment, and training, the travel nurse is the cheaper option.

That finding changes the conversation for CFOs and VP-level operations leaders who have resisted travel staffing on cost grounds. But it also exposes a different problem. The cost advantage only holds if the travel nurse is credentialed and billing on time. Every day of delay wipes out the savings and then some.

According to Merritt Hawkins data, a single day of provider onboarding delay costs a medical group $10,122 in lost revenue. MGMA reports that credentialing takes 90 to 180 days on average and that delays cost new providers up to 25% of their first-year earnings. For travel placements specifically, those timelines are supposed to be compressed into days or weeks, not months. When they aren’t, the financial model falls apart.

Travel nurse credentialing delays don’t just slow down revenue. They undermine the entire economic argument for flexible staffing. And in 2026, with Joint Commission NPG 12 tying credentialing directly to accreditation, the stakes are higher than a line item on a P&L.

The Real Cost Picture: What KPMG Found

The 2026 NATHO/KPMG Cost of Labor Study surveyed 100 healthcare executives, including CEOs, COOs, CFOs, and directors of HR and nursing leadership, across acute care hospitals, specialty hospitals, and outpatient facilities. The methodology looked beyond base wages to capture the full cost of employing a nurse, whether permanent or temporary.

For permanent nurses, the base wage of $45 per hour represents just 48% of the total labor cost. The remaining 52% comes from benefits and insurance, PTO and holiday pay, retirement contributions, bonuses and overtime, malpractice coverage, workers’ compensation, recruitment expenses, training, and nonproductive time spent on continuing education and administrative tasks.

For travel nurses, the base wage represents roughly 80% of the all-in cost. Nonproductive costs come in at $9 per hour. The staffing agency absorbs the overhead that hospitals carry for permanent employees: benefits administration, recruitment, retention, and training infrastructure.

The pattern held across disciplines. Travel allied health staff averaged $59.10 per hour versus $64.80 for permanent staff. Travel therapy professionals came in at $60.70 versus $69.60. Across every category KPMG examined, the fully loaded cost of travel staff was lower than permanent employees.

NATHO Executive Director Holly Bass put it directly: the assumption breaks down when you look at the fully loaded costs. For healthcare executives who have been making staffing decisions based on hourly rate comparisons alone, the KPMG data demands a recalculation.

Where the Cost Advantage Disappears

The KPMG numbers assume the travel nurse is working. Billing. Generating revenue from day one of the assignment. The moment credentialing delays push back a start date, the math changes.

The Revenue Gap Is Permanent

Unlike billing delays that resolve once a claim is processed, revenue lost during credentialing is often unrecoverable. Most payers will not pay for services rendered before the provider’s effective enrollment date. A travel nurse who starts seeing patients before credentialing is complete generates claims that get denied, and those denials typically cannot be recovered through appeals or retroactive billing.

MGMA data shows more than half of medical practices reported increases in credentialing-related denials, with some payers taking 100 days to provide an effective date for a new provider. For travel assignments that are supposed to last 13 weeks, losing even 30 days to credentialing delays means the nurse is unbillable for nearly a third of the contract.

The Compounding Effect at Scale

A single delayed travel placement is a problem. Ten delayed placements in a quarter is a financial crisis. Industry research from 2026 shows that more than half of hospitals and provider groups now report material financial losses from credentialing delays, with many organizations losing over $1 million annually.

Consider a 200-bed hospital that uses 75 travel nurses per year. If the average credentialing delay adds 15 days to each placement, and each day of delay costs roughly $10,000 in lost revenue, the annual impact exceeds $11 million. That dwarfs any savings from the $5-per-hour all-in cost advantage KPMG identified.

The Hidden Administrative Costs

Travel nurse credentialing delays also consume staff time that doesn’t show up in the KPMG hourly cost comparison. Medical staff services teams spend an average of 20 hours per credentialing file when the process runs smoothly. Delays add follow-up calls with payers, resubmission of expired documents, verification of licenses that have renewed since the original application, and coordination with staffing agencies on updated documentation. MGMA reports the average cost to rework and appeal a denied claim is $118 per claim. Multiply that across every denied claim from an uncredentialed provider, and the administrative burden becomes substantial.

Why Travel Nurse Credentialing Delays Happen Differently

Permanent provider credentialing follows a predictable cadence. The hire is planned months in advance, the credentialing team begins primary source verification early, and the timeline accommodates the 90 to 120-day industry average.

Travel placements operate on a different clock. A hospital identifies a coverage gap, contacts an agency, reviews candidates, and expects the nurse on the floor within two to four weeks. The credentialing workflow that works for permanent staff collapses under that pressure.

Several factors compound the problem. Multi-state license verification across 43 Nurse Licensure Compact jurisdictions and the remaining non-compact states adds complexity that permanent local hires don’t face. CAQH profile attestation lapses create bottlenecks: if a travel nurse’s CAQH profile hasn’t been re-attested within 120 days, it goes inactive, and every payer relying on it hits a wall. Primary source verification requests stack up when multiple facilities are trying to credential the same nurse simultaneously. And competency documentation requirements that vary by hospital and unit mean agencies are collecting different paperwork for every placement.

The result is a credentialing process designed for a 120-day timeline being forced into a 14-day window. Something breaks every time.

Fixing the Bottleneck: What Operationally Sharp Teams Do

Pre-Credentialing Before the Assignment Exists

Organizations with the fastest travel nurse onboarding times don’t wait for a placement to start the credentialing process. They work with preferred agency partners to pre-credential travel nurses in their system before a specific assignment is confirmed. When a coverage gap opens, the credentialed pool is already verified, and the nurse can start immediately.

Pre-credentialing requires investment in systems that can maintain active credential files for a larger pool than you’ll use at any given time. But the revenue math justifies it. Pre-credentialing 50 nurses to fill 30 slots means every placement starts on time instead of 15 days late.

Automated Expiration Tracking Across the Entire Pool

A travel nurse’s credential file is a moving target. Licenses renew, certifications expire, CAQH profiles need re-attestation, and state-specific requirements shift. Manual tracking in spreadsheets works until you hit 30 or 40 active files, and then things start falling through. Automated systems that flag expirations 30, 60, and 90 days out keep files current without requiring constant manual review. When a placement request comes in, the nurse’s credentials are already verified and audit-ready.

Parallel Processing Instead of Sequential

Traditional credentialing workflows run sequentially: collect documents, then verify licenses, then check references, then submit to committee. Each step waits for the last to finish. Faster operations run these in parallel. License verification starts the same day the application is received. Reference checks run concurrently with primary source verification. Committee review is scheduled proactively based on expected completion dates rather than waiting for a complete packet. Parallel processing can compress a 90-day timeline to 30 to 45 days without cutting any verification steps.

Connecting Credentialing to Staffing and Finance

When credentialing, staffing, and finance operate in separate systems, nobody sees the full picture. The staffing director knows there’s a gap. The credentialing team knows the file is incomplete. The CFO knows revenue is below forecast. But nobody connects the delay in credentialing to the revenue shortfall. Organizations that link these systems can quantify the cost of every credentialing delay in real time, which creates the urgency to fix bottlenecks before they accumulate into a material financial problem.

Turning the KPMG Data into an Operational Reality

The NATHO/KPMG study proves travel nurses are cost-effective. The question is whether your credentialing process lets you capture that advantage or burns it up in delays.

Platforms like Credentially are built for this problem. Automated primary source verification compresses credentialing cycles from 120 days to 45. Real-time license tracking across all 43 NLC states and non-compact jurisdictions keeps credential files current without manual chasing. Expiration alerts give medical staff coordinators weeks of lead time instead of last-minute scrambles. And because the platform connects credentialing data to operational workflows, organizations can see the revenue impact of every day saved.

For travel-heavy operations, the numbers are specific. Organizations using automated credentialing report 60 to 70% reductions in cycle time and measurable drops in administrative hours per file. At the scale of 75 travel placements per year, cutting 15 days off each credentialing cycle recovers millions in revenue that would otherwise be lost to delays.

The Argument Has Changed

For years, the debate about travel nurses centered on whether the hourly premium was justified. The KPMG data settles that question: on a fully loaded basis, travel staff cost less than permanent employees across nursing, allied health, and therapy roles.

The new question is operational. Can your credentialing process move fast enough to capture the cost advantage? Every day of travel nurse credentialing delay converts a cheaper staffing option into a more expensive one. Organizations that treat credentialing speed as a financial priority, not just an administrative task, will be the ones that actually realize the savings the KPMG data describes.

The staffing model works. The cost structure works. What doesn’t work is a credentialing process built for 120-day timelines in a workforce that needs to be billing within two weeks.

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Sources

1. NATHO/KPMG – 2026 Cost of Labor Study: travel nurses $89/hr vs permanent $94/hr (prnewswire.com, January 2026)

2. Staffing Industry Analysts – NATHO cost study coverage with allied health and therapy breakdowns (staffingindustry.com)

3. MGMA – Credentialing-related denials data, 90-180 day average credentialing time, $118 per denied claim rework cost (mgma.com)

4. Merritt Hawkins – $10,122 per day provider onboarding delay cost (via MGMA)

5. MGMA – Credentialing delays cost new providers up to 25% of first-year earnings

6. NCSBN/Nurse Licensure Compact – 43 jurisdictions, CAQH 120-day re-attestation requirement

7. Nurse.org – KPMG study methodology and permanent nurse base wage breakdown ($45/hr base, 48% of total cost)

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