Editor’s Note
The Department of Homeland Security wants to apply a $103,265 fee to H-1B workers already inside the US. That’s a broader version of the entry charge federal courts have already blocked. The message is the same one from last month, but more pronounced for hospitals and locum tenens staffing firms that lean on international medical graduates.
Elsewhere this week, the numbers point toward strain, not relief. A new workforce report projects deepening physician and advanced practice shortages through 2030. A legislative update flags a coming change to how international training visas are structured. Locum searches can also stall for ordinary reasons, including tight requirements, slow feedback, and pay that hasn’t kept pace with the market.
None of this is confined to physician staffing. A separate look at AI scribe adoption found technology alone won’t fix burnout without real governance behind it. A rural health analysis raised a similar concern from another angle. Programs can spend billions without adequate visibility into where the money goes. Planning and transparency emerge as a common thread across these stories.
– The Locumpedia Editorial Team
Lead Story
Trump $103,000 H-1B Charge Tests Bounds of Fee-Setting Authority
August 27, 2026 | Staffing Industry Analysts
The Department of Homeland Security has proposed a new $103,265 fee for employers hiring new specialty occupation H-1B workers. The proposal would reach a broader group of candidates than the administration’s earlier $100,000 proclamation, including recent US graduates who were exempt from that charge. A federal judge in Boston vacated the earlier fee, but the administration’s appeal is pending.
DHS says the fee would offset immigration-related expenses incurred across multiple federal agencies that otherwise would be funded by taxpayers. Attorneys and legal experts interviewed by Bloomberg News question whether DHS has the authority to use H-1B fees to cover costs incurred by other agencies. The proposal will proceed through formal rulemaking but is expected to face legal challenges.
This is the second six-figure visa cost to surface in a year, and the latest proposal reaches candidates the earlier proclamation left out. Healthcare employers that rely on international medical graduates should monitor the proposal as it moves forward and consider how the potential fee could affect their workforce plans.
La Vida Locum
Community Health Centers Mark 60 Years of Expanding Access to Care Across America
August 4, 2026 | Barton Associates
Community health centers are marking six decades of expanding access to primary care in underserved areas, and the milestone is landing at a time when many of these sites face real staffing strain. These centers were built to reach patients regardless of ability to pay and now serve as a frontline safety net in both rural and urban communities. Workforce gaps at these sites can carry outsized consequences, particularly in communities with few nearby alternatives for primary care.
Community health centers represent a distinct client profile since they’re mission-driven and often serve areas where recruiting is difficult. Facilities in this position tend to value consistency and cultural fit as much as speed. Locum tenens agencies that understand these organizations and build relationships early may be better positioned when a shortage becomes urgent.
Why Some Locum Tenens Searches Stall, and How to Fix Them
August 25, 2026 | ConnectHealth
Locum tenens searches rarely lose momentum for only one reason. More often, a handful of small issues pile up at once. For example, feedback may take too long to reach a candidate weighing other options. Licensing and credentialing delays compound the problem further, especially when a provider needs a new state license or the facility runs a long verification process.
The fix starts with a fresh look at the search itself. Healthcare organizations that separate true must-haves from nice-to-haves tend to move faster, as do those that commit to reviewing candidates within a day and name one decision-maker for final approval. Even modest schedule flexibility can turn a stalled search into a filled one, and one day off call can be the difference.
Locum Leaders
- CHG Healthcare named Ryan Solomon as Chief Financial Officer, succeeding Rob Millard, who has held the role since 2018 and will remain in an advisory capacity until his January 1, 2027 retirement.
- OB-GYN-focused locum agency OBStat announced plans to expand its services nationwide.
Hire Power
Healthcare Staffing Projections Through 2030
August 12, 2026 | AMN Healthcare
A new white paper projects that staffing pressures will persist through 2030. The report draws on five years of AMN’s own search data alongside federal labor and health statistics. It points to an aging workforce and rising demand as major pressures on supply. Locum tenens and other flexible staffing models are potential strategies facilities can lean on while permanent pipelines catch up.
The rural gap is one of the most pressing issues identified. A flexible-coverage model works best when agencies have rural-ready candidates in the pipeline, not just an urban bench willing to travel occasionally. Facilities in shortage areas should expect this data to show up in budget conversations soon. Locum staffing firms that can speak to rural fill rates specifically will have a stronger position.
Making the Rounds
What Drives High AI Scribe Utilization Rates?
August 17, 2026 | Healthcare IT News
Health systems are betting on AI scribes to ease clinician burnout and support retention. A new report finds utilization varies widely and depends more on governance and support structures than on the technology itself. One health system’s enterprise-wide rollout was built around vendor partnership and structured support rather than a simple opt-in tool. That rollout achieved notably higher use than typical deployments.
The lesson travels beyond any one technology. Facilities and agencies alike can treat tools, whether AI scribes or staffing platforms, as fixes that work on their own. This report shows that adoption depends on the structure wrapped around the tool.
$50 Billion Rural Health Transformation Program Needs More Transparency, Groups Say
August 27, 2026 | KFF Health News
One year into the five-year, $50 billion Rural Health Transformation Program, advocacy groups say the fund still lacks the transparency needed to track whether money is reaching the rural facilities it was meant to help. States are not required to proactively publish their federal progress reports. Several, including Mississippi and West Virginia, have declined public records requests or held closed-door planning meetings. A handful of states have built their own spending dashboards, but the level of detail varies sharply from one state to the next.
Money earmarked for rural access, including funding for telehealth and other health technology, can be harder to trace once it passes through subcontractors that states aren’t yet required to disclose. Future reports will require states to identify downstream recipients, including subrecipients, vendors, and contractors.
