The Leverage Test
Why Healthcare Staffing Is Asking the Wrong Question About Every Investment It Makes
Key Takeaways
Healthcare staffing has been evaluating investments through the wrong frame. The question "What does this add?" made sense in a pandemic-era growth market. In a normalizing market, the correct question is "What does this multiply?" Those two questions produce entirely different decisions about technology, headcount, and leadership.
Nomad Health's pivot from staffing to software is the clearest current example of what it looks like to apply the leverage test and commit to the answer. Rather than adding another feature or competing for the same travel nursing supply, the company identified a different value proposition: more placements from the same database, more TOA from the same recruiter, and more files from the same credentialing specialist. That is not addition. That is leverage.
The leverage test applies equally to technology decisions and to leadership decisions. A platform that multiplies recruiter throughput per dollar is a fundamentally different investment than one that adds a feature checklist. A VP of Sales who multiplies the commercial performance of the team that already exists is a fundamentally different hire than one who simply fills a vacancy.
The companies that will define the next market cycle are applying the leverage test before every significant investment. The ones that do not are adding overhead in a market that punishes addition and rewards multiplication.
Healthcare staffing has been asking the wrong question.
For most of the past five years, the evaluation framework for any significant investment -- technology, headcount, or platform -- has been built around one concept: addition. What does this add to our capacity? What headcount does this bring? What feature does this platform include that our current one does not?
The addition frame made sense in a growth environment. When the travel nursing market was expanding at pandemic rates, adding was the right strategic response. More recruiters meant more placements. More technology features meant more client conversations. More Joint Commission certifications meant more contract opportunities. In a rising market, addition compounds.
The market that exists in 2026 is not that market. And the companies still evaluating investments through an addition frame are making systematically wrong decisions.
The Question Nomad Finally Got Right
Tommy Hickey, CEO of Nomad Health recently put into words the correct frame that the industry should study carefully.
As Nomad closes its chapter as a staffing firm and opens a new one as a software company, Hickey described what the company has actually built: not an ATS, not a CRM, not a VMS, but something that delivers a specific kind of value: more placements from the same database, more TOA from the same recruiter, and more files from the same credentialing specialist.
If demonstrably accurate, that is not an addition value proposition. That is leverage.
Leverage is multiplication applied to existing resources. It does not ask what you can add to the system. It asks what you can get more of from what the system already contains. And as Hickey noted, the early mistake in Nomad's software pivot was allowing client conversations to anchor on the existing product categories of ATS, CRM, and VMS, rather than on the multiplication question: what does this do to your output per recruiter?
The shift from addition to leverage is not a naming exercise. It is a fundamentally different logic for evaluating whether an investment is worth making.
Applying the Leverage Test to Technology
The leverage test is not a framework invented for software companies. It is the right evaluation lens for every technology investment a healthcare staffing company makes in the current market.
A VMS that adds features is not the same investment as a VMS that measurably increases fill rate per recruiter per week. A credentialing platform that adds a document management module is not the same investment as one that reduces average time-to-clear by 30% without adding headcount. An ATS that adds integrations is not the same investment as one that increases active submissions per recruiter per day.
The distinction is not subtle. But most technology procurement in healthcare staffing is still evaluated on the addition axis: feature checklists, integration lists, and capability matrices, rather than on the multiplication axis.
The companies applying the leverage test are running different RFPs. They are asking vendors not what the platform includes, but what it multiplies. They are building internal benchmarks for recruiter throughput, credentialing cycle time, and fill rate per FTE, and they are evaluating technology against those multipliers rather than against feature lists. They select platforms that change those numbers, not ones that add to the interface.
This also reframes the VMS commoditization problem that every major healthcare staffing company is facing right now. If the evaluation question is "which VMS has the best features," parity across platforms produces a stalemate. If the question is "which platform multiplies recruiter output more per dollar," that is a question with a measurable, differentiating answer.
Applying the Leverage Test to Leadership
The same test applies to executive search, and it is where the leverage frame changes the nature of the hire most dramatically.
A Chief Revenue Officer who fills a vacancy is not the same hire as one who multiplies the commercial performance of the team that already exists. A VP of Sales who manages a territory is not the same hire as one who rewires how the existing sales organization identifies and closes enterprise accounts. The addition hire adds a quota line. The leverage hire changes the performance ceiling of the entire commercial structure.
In a contracting market, the distinction matters enormously. An “addition” hire at the CRO level costs base salary, bonus, and search fee and delivers an incremental contribution. But a “leverage” hire at the same level and at the same cost changes what every existing member of the commercial team can achieve. The multiplication effect reaches across the organization rather than adding one more contributor to it.
Leverage is harder to identify in a candidate because it is not visible on a resume. A leader who multiplied their previous team's performance may look similar on paper to one who simply added their own output to the revenue line. The distinction only becomes visible when you examine the team around them: whether it improved, whether close rates changed, or whether average deal size moved, alongside their individual metrics.
Healthcare staffing companies should be applying the leverage test to their internal leadership hires: asking different questions in the interview process, checking different references, and looking for evidence of multiplication rather than just performance. We must be identifying leaders who made the people around them better, not just leaders who performed well individually.
The Frame That Changes the Decision
The companies that will define the next phase of the healthcare staffing market are not the ones that added the most during the pandemic. They are the ones that identified what to multiply during the contraction.
The Leverage Test is a single question applied before every significant investment: Does this make what we already have more productive, or does it add a new line item to the cost structure? In a market that punishes addition and rewards multiplication, the answer to that question should precede every technology purchase, every platform decision, and every executive search.
Morgan Taylor Executive Search places the leaders who multiply: commercial executives who raise the performance ceiling of the teams around them, not just contributors who add to the revenue line. If you are evaluating your next senior leadership hire through the leverage lens, we should talk.
