Cross Country Healthcare, Inc.

Cross Country reported fourth-quarter 2025 revenue of $237 million, down 5% sequentially and 24% year over year. Full-year revenue was $1.05 billion, down 22% year over year. Q4 gross profit was $48 million with a gross margin of 20.3%, down 10 basis points sequentially and up 30 basis points year over year. Adjusted EBITDA was $4 million in Q4 and $27 million for the full year, equal to 1.7% and 2.5% of revenue, respectively. SG&A was $51 million in Q4 and $200 million for the year; excluding nonrecurring severance, SG&A would have been $43 million in Q4 and $186 million for the year. For Q1 2026, the company guided to revenue of $235 million to $240 million, adjusted EBITDA of $4 million to $5 million, adjusted EPS of a loss of $0.04 to $0.06, and gross margin of 19.5% to 20%. Management also said it expects to exit 2026 with fourth-quarter revenue above $250 million and adjusted EBITDA margin of 4% to 5%, and earlier said it expects to exit 2026 with a revenue run rate north of $1 billion.

Kevin Clark framed 2025 as a difficult year marked by merger uncertainty, but said that process is now behind the company and momentum is improving. He emphasized a strategy centered on restoring execution, expanding market share in large health systems, adding new logos, and using technology as a differentiator rather than moving away from staffing. His tone was confident and upbeat, especially around 2026, saying he expects revenue and earnings growth by the end of the year and higher margins in 2027.

Bill Burns focused on the financial reset: lower revenue from normalized contingent labor, but stable gross margins around 20% to 20.4% through the year and lower SG&A after headcount reductions. He said U.S. headcount was down 21% from the start of the year, and that cost savings are being redeployed into revenue producers to support organic growth. He also highlighted $109 million in cash, no outstanding debt, $18 million of operating cash flow in Q4, $48 million for the full year, and share repurchases of more than 800,000 shares for $6.8 million in December plus 486,000 additional shares in Q1 to date.

Analysts focused on how credible management’s 2026 growth and margin targets are, with Kevin Clark and Bill Burns saying the confidence comes from a larger sales pipeline, market stabilization, stronger weekly production, and leverage from technology and offshore operations. Questions also probed M&A, and management said it is being patient, favoring tuck-in deals in home-based staffing and opportunities tied to technology and client footprint rather than buying supply partners. On labor disruption, Burns said Q1 labor-disruption revenue will be in the single millions and is not material to the overall business, and on the market, management said bill rates are stable and they have not seen anything unusual from federal funding changes.