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What separates high- and low-performing hospitals in 2025

Hospital finances showed signs of improvement at the end of the second quarter, though notable performance gaps remain between higher- and lower-performing facilities, according to Kaufman Hall’s latest “National Hospital Flash Report,” published Aug. 11.
The median monthly operating margin index rose to 3.7% in June, up from 1.9% in May, though the pace of improvement remains uneven and somewhat unexpected amid recent market turbulence.
Hospitals in the Northeast and Mid-Atlantic reported the largest year-over-year increases in operating margins at 38%, followed by the South and Midwest at 29%. The West and Great Plains saw declines of 13% and 27%, respectively. Smaller and mid-size hospitals generally fared better than large facilities: hospitals with 26 to 299 beds saw margin gains between 17% and 30%, while those with more than 500 beds experienced a 29% decline.
“Higher performing hospitals are nimbler on both the revenue and expense sides,” Erik Swanson, managing director and data and analytics group leader at Kaufman Hall, said in a news release. “They may be expanding their outpatient footprint, diversifying services or managing expenses like purchased services by centralizing some functions. They are also more likely to have value-based care or bundled care arrangements in place.”
In 2025, top-performing hospitals are setting themselves apart from lower-performing facilities through a combination of strategic, operational and financial factors. According to Kaufman Hall and Fitch Ratings, the key differentiators include:
1. Strong market presence in growth regions: Hospitals located in expanding markets — especially in the South, Midwest and Northeast — are benefiting from rising demand, better payer mixes and stronger revenue potential. These organizations are leveraging local demographics and economic growth to drive performance.
2. Workforce recruitment and retention. Talent remains a key differentiator. High performers are more successful in hiring and retaining clinical and nonclinical staff amid national shortages, allowing them to maintain service capacity and quality care while controlling labor costs.
3. Aggressive payer strategy: Top-tier hospitals are skilled at negotiating favorable payer contracts, often using a “mind the gap” approach to keep reimbursement rates at the upper end of the scale. These hospitals maximize market leverage to drive revenue growth.
4. Operational agility: High-performing hospitals are nimble and can adjust quickly to changing conditions. They centralize purchased services, optimize supply chains and adapt care models to improve efficiency.
5. Investment in technology and infrastructure: Successful systems are proactively investing in AI, health IT and data analytics. These investments support care delivery and administrative efficiency and prepare hospitals for value-based care and alternative payment models.
6. Outpatient expansion and service diversification: Expanding outpatient footprints and diversifying service lines allow top hospitals to meet evolving patient demand and offset pressures on inpatient care, particularly in high-cost settings.
7. Proactive real estate and capital management. Strong performers are strategically managing real estate assets to bolster balance sheets and fund growth initiatives, such as facility modernization and digital transformation.
In contrast, lower-performing hospitals, often in rural or underserved regions, struggle with:
- Limited access to capital
- Declining patient volumes or poor payer mixes
- Severe staffing shortages
- High dependency on public reimbursement
- Little room for investment in innovation or infrastructure
Fitch warns that this divergence is becoming a “trifurcation” of hospital performance, with institutions separating into top-tier, middle-tier and lower-tier segments. Without strategic shifts, the financial gap may widen in the years ahead.
Top-performing hospitals will “have a predisposition to maximize that market essentially with annual payer negotiations, in a ‘mind the gap’ mentality that keeps them at the upper end of the payment scale,” Fitch said in a recent report.
Meanwhile, most hospitals are expected to remain in a middle band: operating sustainably but with limited margin growth and persistent staffing challenges. Those at the bottom of the scale face declining volume and payer mix issues and will likely need to rely heavily on outside cash to stabilize, according to Fitch.
The latest hospital financial reports indicate that 2025 performance gains are unevenly distributed, with the gap between top and bottom performers potentially widening as financial pressures persist.

How to Get a High Paying Contract Nursing Job
Contract nursing offers the chance to do meaningful work, gain diverse experience, and earn competitive pay. Whether you’re pursuing contract nursing jobs, per diem nursing positions, or rapid response assignments, the key to maximizing your income is preparation and strategy.
If you’re ready to secure a high-paying contract nursing job, use these proven tips to set yourself apart and negotiate pay that reflects your expertise.
Your resume is your first impression. A clear, polished resume highlights your skills, certifications, and professional accomplishments, and it determines whether you’ll be invited to interview.
Include:
- Your nursing specialties (such as ICU, emergency department, or medical imaging)
- Certifications (like ACLS, BLS, or specialty credentials)
- Details about your experience in different care settings, such as inpatient care, skilled nursing facilities, or acute care staffing
It’s normal to have employment gaps but be ready to confidently explain them during interviews. A well-organized resume positions you as a serious professional ready for high-paying nursing contracts.
Keeping your credentials updated makes you a more attractive candidate and can improve your earning potential.
Make sure to:
- Renew essential licenses and certifications promptly.
- Consider adding specialty certifications that are in demand for travel nursing jobs and contract assignments.
- Stay up to date with immunizations required by hospitals and clinics. Being ready with all documentation can speed up onboarding and help you access crisis response nursing jobs or urgent needs contracts that often pay premium rates.
The more prepared you are, the easier it is for a nurse staffing agency or recruiter to match you with higher-paying positions.
Professional references can be the deciding factor in landing a top-paying assignment.
Employers and recruiters rely on references to verify your:
- Clinical skills
- Professionalism
- Reliability
Choose references who can confidently speak to your work ethic and performance. Positive recommendations can open the door to flexible nursing shifts, per diem contracts, and specialized roles that pay more.
Flexibility is often rewarded in the world of contract nursing.
Consider these options to boost your pay:
- Accepting night shifts or weekends, which usually come with higher hourly rates.
- Taking assignments in locations experiencing shortages, such as rural facilities or emergency department nursing jobs.
- Being open to rapid response contracts or crisis response assignments, which often offer premium compensation.
When you demonstrate a willingness to adapt, you make yourself more valuable to medical staffing agencies and healthcare employers.
In contract nursing, your reputation follows you from one facility to the next. A strong track record makes it easier to secure higher-paying contracts and preferred assignments.
Tips for maintaining a great reputation:
- Be punctual and dependable.
- Communicate clearly with staffing agencies and supervisors.
- Go the extra mile to provide excellent patient care.
Facilities are willing to pay more to bring on nurses with proven reputations for excellence.
Being a contract nurse offers countless benefits, from career variety to premium pay. To make the most of your opportunities:
- Invest time in preparing a strong resume.
- Keep certifications and immunizations current.
- Maintain excellent references.
- Stay flexible with shifts and assignments.
- Build and protect your professional reputation.
When you combine preparation with dedication, you can consistently secure high-paying contract nursing jobs that match your skills and goals.
If you’re looking for your next opportunity, Staff Relief, Inc. is here to help. We partner with hospitals, clinics, and healthcare facilities to connect nurses with the best assignments in Georgia and beyond.
Contact us today to explore available contracts and start earning what you deserve.

Former nurse marks reaching 102 with advice to ‘stay active’
A former nurse, dubbed “inspirational” by care home staff, has celebrated her 102nd birthday with recommendations for a long, happy life.
Diana Creasey, who moved to Woodpeckers care home in the New Forest during 2023 when she was 100, shared her latest birthday with family, friends and staff.
“Stay active, keep going, follow a good diet and make sure to have lots and lots of fresh air”
Diana Creasey
Asked for the secret of her longevity, she said: “Stay active, keep going, follow a good diet and make sure to have lots and lots of fresh air. And a glass of sherry helps!”
Her advice follows a lifelong career in nursing and healthcare, both in paid roles and, following retirement, as a care volunteer for several years at Lymington’s Oakhaven hospice.
After growing up in North Devon in the 1920s and 30s, Ms Creasey trained as a nurse and worked in plastic surgery nursing during the Second World War.
Serving at London hospitals, she cared for many army personnel coming back from the horrors of the frontline.
One memory from of Blitz was nursing in an underground basement hospital with pregnant women on one side of the ward and casualties on the other. “It was a very stressful time,” she recalled.
Woodpeckers companionship team member Sian Harris said Ms Creasey remained very active, taking daily walks around the garden with the help of staff.
“She was an inspiration when she moved to Woodpeckers aged 100,” said Sian. “And she is still inspiring the staff and residents now aged 102.
“The very fact she is this remarkable age and still as active as she is makes her truly very special,” added Ms Harris.
Woodpeckers in Brockenhurst is run by care home provider Colten Care. It operates 21 care homes in Hampshire, Dorset, Wiltshire and West Sussex.

Hiring More Nurses Generates Revenue for Hospitals
Underfunding is driving an acute shortage of trained nurses in hospitals and care facilities in the United States. It is the worst such shortage in more than four decades. One estimate from the American Hospital Association puts the deficit north of one million. Meanwhile, a recent survey by recruitment specialist AMN Healthcare suggests that 900,000 more nurses will drop out of the workforce by 2027.
American nurses are quitting in droves, thanks to low pay and burnout as understaffing increases individual workload. This is bad news for patient outcomes. Nurses are estimated to have eight times more routine contact with patients than physicians. They shoulder the bulk of all responsibility in terms of diagnostic data collection, treatment plans, and clinical reporting. As a result, understaffing is linked to a slew of serious problems, among them increased wait times for patients in care, post-operative infections, readmission rates, and patient mortality—all of which are on the rise across the U.S.
Tackling this crisis is challenging because of how nursing services are reimbursed. Most hospitals operate a payment system where services are paid for separately. Physician services are billed as separate line items, making them a revenue generator for the hospitals that employ them. But under Medicare, nursing services are charged as part of a fixed room and board fee, meaning that hospitals charge the same fee regardless of how many nurses are employed in the patient’s care. In this model, nurses end up on the other side of hospitals’ balance sheets: a labor expense rather than a source of income.
For beleaguered administrators looking to sustain quality of care while minimizing costs (and maximizing profits), hiring and retaining nursing staff has arguably become something of a zero-sum game in the U.S.
But might the balance sheet in fact be skewed in some way? Could there be potential financial losses attached to nurse understaffing that administrators should factor into their hiring and remuneration decisions?
Research by Goizueta Professors Diwas KC and Donald Lee, as well as recent Goizueta PhD graduates Hao Ding 24PhD (Auburn University) and Sokol Tushe 23PhD (Muma College of Business), would suggest there are. Their new peer-reviewed publication* finds that increasing a single nurse’s workload by just one patient creates a 17% service slowdown for all other patients under that nurse’s care. Looking at the data another way, having one additional nurse on duty during the busiest shift (typically between 7am and 7pm) speeds up emergency department work and frees up capacity to treat more patients such that hospitals could be looking at a major increase in revenue. The researchers calculate that this productivity gain could equate to a net increase of $470,000 per 10,000 patient visits—and savings to the tune of $160,000 in lost earnings for the same number of patients as wait times are reduced.
“A lot of the debate around nursing in the U.S. has focused on the loss of quality in care, which is hugely important,” says Diwas KC.
But looking at the crisis through a productivity lens means we’re also able to understand the very real economic value that nurses bring too: the revenue increases that come with capacity gains.Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management
“Our findings challenge the predominant thinking around nursing as a cost,” adds Lee. “What we see is that investing in nursing staff more than pays for itself in downstream financial benefits for hospitals. It is effectively a win-win-win for patients, nurses, and healthcare providers.”
To get to these findings, the researchers analyzed a high-resolution dataset on patient flow through a large U.S. teaching hospital. They looked at the real-time workloads of physicians and nurses working in the emergency department between April 2018 and March 2019, factoring in variables such as patient demographics and severity of complaint or illness. Tracking patients from admission to triage and on to treatment, the researchers were able to tease out the impact that the number of nurses and physicians on duty had on patient throughput. Using a novel machine learning technique developed at Goizueta by Lee, they were able to identify the effect of increasing or reducing the workforce. The contrast between physicians and nursing staff is stark, says Tushe.
“When you have fewer nurses on duty, capacity and patient throughput drops by an order of magnitude—far, far more than when reducing the number of doctors. Our results show that for every additional patient the nurse is responsible for, service speed falls by 17%. That compares to just 1.4% if you add one patient to the workload of an attending physician. In other words, nurses’ impact on productivity in the emergency department is more than eight times greater.”
Adding an additional nurse to the workforce, on the other hand, increases capacity appreciably. And as more patients are treated faster, hospitals can expect a concomitant uptick in revenue, says KC.
“It’s well documented that cutting down wait time equates to more patients treated and more income. Previous research shows that reducing service time by 15 minutes per 30,000 patient visits translates to $1.4 million in extra revenue for a hospital.”
In our study, we calculate that staffing one additional nurse in the 7am to 7pm emergency department shift reduces wait time by 23 minutes, so hospitals could be looking at an increase of $2.33 million per year.Diwas KC
This far eclipses the costs associated with hiring one additional nurse, says Lee.
“According to 2022 U.S. Bureau of Labor Statistics, the average nursing salary in the U.S. is $83,000. Fringe benefits account for an additional 50% of the base salary. The total cost of adding one nurse during the 7am to 7pm shift is $310,000 (for 2.5 full-time employees). When you do the math, it is clear. The net hospital gain is $2 million for the hospital in our study. Or $470,000 per 10,000 patient visits.”
These findings should provide compelling food for thought both to healthcare administrators and U.S. policymakers. For too long, the latter have fixated on the upstream costs, without exploring the downstream benefits of nursing services, say the researchers. Their study, the first to quantify the economic value of nurses in the U.S., asks “better questions,” argues Tushe; exploiting newly available data and analytics to reveal incontrovertible financial benefits that attach to hiring—and compensating—more nurses in American hospitals.
We know that a lot of nurses are leaving the profession not just because of cuts and burnout, but also because of lower pay. We would say to administrators struggling to hire talented nurses to review current wage offers, because our analysis suggests that the economic surplus from hiring more nurses could be readily applied to retention pay rises also.Sokol Tushe 23PhD, Muma College of Business
For state-level decision makers, Lee has additional words of advice.
“In 2004, California mandated minimum nurse-to-patient ratios in hospitals. Since then, six more states have added some form of minimum ratio requirement. The evidence is that this has been beneficial to patient outcomes and nurse job satisfaction. Our research now adds an economic dimension to the list of benefits as well. Ipso facto, policymakers ought to consider wider adoption of minimum nurse-to-patient ratios.”
However, decision makers go about tackling the shortage of nurses in the U.S., they should go about it fast and soon, says KC.
“This is a healthcare crisis that is only set to become more acute in the near future. As our demographics shift and our population starts again out, demand for quality will increase. So too must the supply of care capacity. But what we are seeing is the nursing staffing situation in the U.S. moving in the opposite direction. All of this is manifesting in the emergency department. That’s where wait times are getting longer, mistakes are being made, and overworked nurses are quitting. It is creating a vicious cycle that needs to be broken.”
Goizueta faculty apply their expertise and knowledge to solving problems that society—and the world—face. Learn more about faculty research at Goizueta.
*Ding, Tushe, Kc, Lee: “Frontiers in Operations: Valuing nursing productivity in emergency departments.” Manufacturing & Service Operations Management 26:4:1323-1337 (2024)

Georgia could see the largest shortage of RNs by 2036
Staffing is one of the biggest issues facing ASCs. A 2023 survey from ORManager found that in the last 12 months, 56% of ASCs reported an increase in volume. Despite this success, 68% of facilities also reported having a more difficult time recruiting experienced operating room nurses.
“I think the biggest threat towards ASCs in 2023 is staffing, especially qualified, experienced staffing in all areas of an ASC, including business office, pre-op, OR (both nursing and surgical technicians), post-anesthesia care unit and recovery nurses. In addition, sterile processing technicians,” Michael Powers, administrator of Knoxville, Tenn.-based Children’s West Surgery Center, told Becker’s. “Each of these areas require a certain set of skills that are acquired and honed over time. There is increased competition, and in fact it is hard to compete with large health systems/hospitals. I am also finding that ASCs are competing in the same region against one another for the available staffing pool.”
The HRSA report highlights nurse workforce projections from 2021 to 2036 generated using the agency’s health workforce simulation.
Here are the five states with the largest projected shortages of registered nurses by 2036, per the report:
1. Georgia: 29% projected shortage
Projected vacancies: 34,800
2. California: 26% projected shortage
Projected vacancies: 106,310
3. Washington: 26% projected shortage
Projected vacancies: 22,700
4. New Jersey: 25% projected shortage
Projected vacancies: 24,450
5. North Carolina: 23% projected shortage
Projected vacancies: 31,350
https://www.beckersasc.com/leadership/5-states-facing-the-biggest-nurse-shortages-by-2036
Breaking News
Feedback tool helps Ascension hit 82% retention
Ascension has reached its highest nurse retention rate in five years — 81.96% — aided by its employee feedback tool Always On Listening, or AOL.
The tool helps address the “pebbles” in people’s shoes, according to Rob Rose, DNP, RN, chief nursing officer and senior vice president of nursing at the St. Louis-based system.
Whether it’s squeaking doors, hallway trash or a service issue, nurses can access the AOL platform by scanning a QR code. After inputting the feedback, the tool routes the issue to the appropriate group leader. For example, a submission about a squeaky door will be sent to Ascension’s internal maintenance and repair group.
The goal is to acknowledge an AOL submission within three days. Ascension averages 2.73 days in response time, and the average time to resolve an issue is 3.84 days.
The system piloted the tool in three states in February 2025. After the pilot’s quick success, Ascension rolled out the feedback platform throughout its network, which spans more than 100 hospitals across 16 states and the District of Columbia.
Dr. Rose told Becker’s the tool helps resolve pain points rather than allowing the problem to grow.
“I think that’s [an] issue we have in healthcare. We identify these issues. Again, I go back to the pebbles in your shoe. The reason why they become more than pebbles is because we don’t fix it. And it’s not any one person’s fault. It’s just, people get busy, right? Or they forget about it,” he said.
The AOL platform also serves as a recognition tool for nurses to praise other team members or departments.
Dr. Rose attributed Ascension’s five-year record-high in nurse retention not only to the AOL platform but several other initiatives, including competitive wages, retention calls with local leaders, tuition assistance programs, and a standardized education platform for onboarding and competency trainings.
For other hospitals looking to retain more of their nurses, his recommendation is simple: Listen to front-line staff, and design efforts based on their feedback.
“Don’t make it hard to do the right thing,” Dr. Rose said. “[Ask,] ‘What barriers can we take out of your day?’ We know nursing is a complex cognitive, heavy burden profession. We want to be able to do things that reduces that.”
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3 policy issues on pharmacy leaders’ radar
Pharmacy leaders are facing high-stakes challenges that could threaten the stability of drug access and affordability across the U.S. Amid this uncertainty, health systems are responding with urgency, with many exploring new ways to gain control over drug pricing, efforts to increased transparency and options for protecting vulnerable populations.
Here are some of the top policy issues facing pharmacy leaders in the coming year:
Preserving the 340B Drug Pricing Program
As shifts continue with the 340B program, pharmacy leaders have emphasized maintaining the original intent of the program, which is to expand access to care for safety-net hospitals.
Jennifer Bair, PharmD, chief pharmacy officer of Greenville, S.C.-based Prisma Health, which has locations in Tennessee and South Carolina, told Becker’s 340B savings have allowed the health system to expand pharmacy access in rural communities where commercial pharmacies have closed. The savings also allowed the system to implement a 24-hour pharmacy.
However, in recent years major drugmakers have sought to limit the use of contract pharmacies to test rebate-based alternatives to traditional discounts. Drugmakers including Johnson & Johnson, Eli Lilly and Sanofi argued the measures will help improve oversight and curb abuse, while hospital groups and the Health Resources and Services Administration have pushed back, saying the rebate models threaten the financial support safety-net hospitals rely on to serve vulnerable populations.
As a result, certain states have stepped in an attempt to protect contract pharmacies from drugmaker restrictions. For example, a Colorado Senate bill aims to prevent drug companies from limiting how covered entities use the contract pharmacies. Arkansas, Maine, Utah and Nebraska are pursuing similar protections.
In April, President Donald Trump signed an executive order that reintroduces and reinforces a policy from his first term that adjusts Medicare outpatient hospital drug payments to reflect 340B drug discounts. The order came amid a Senate investigation led by Sen. Bill Cassidy, MD, into how covered entities are using 340B funding.
Additionally, in June, HHS proposed transferring oversight of the 340B program from the HRSA to CMS. The move would allow the agency to use its in-house drug pricing expertise and streamline oversight, according to HHS. The funding for 340B oversight would be capped at $12 million under the proposal.
One of the most recent concerns for hospitals and hospital groups is the introduction of the 340B pilot, set to be imposed by the HRSA. The program allows drugmakers to submit alternative rebate plans to the agency by Sept. 15 and, if accepted, the plans would go into effect for one year starting Jan. 1.
In response, hospital groups including the American Hospital Association, America’s Essential Hospitals and the American Society of Health-System Pharmacists issued an Aug. 8 letter outlining concerns about the speed and scope of the rollout, urging the agency to extend the deadlines.
The American Medical Group Association also opposed the rebate pilot program, saying the move would undermine the program’s original purpose and threaten access for underserved communities.
PBM transparency
Pharmacy benefit managers also remain a top concern for policymakers and health systems, as mounting criticism continues on opaque pricing practices and their role in inflating drug costs.
PBMs such as CVS Caremark, Express Scripts and Optum Rx control nearly 79% of U.S. prescriptions and are integrated across insurance and pharmacy networks.
In July 2024, a House Committee on Oversight and Accountability investigation found that PBMs steered patients toward higher-cost drugs and affiliated mail-order pharmacies. A 2024 investigation by the Federal Trade Commission also revealed PBM favoritism toward their own pharmacies and vast market control, affecting both medication access and affordability.
In November, Good Rx and PBMs CVS Caremark, Express Scripts, MedImpact and Navitus Health Solutions faced class-action lawsuits accusing them of suppressing reimbursements to independent pharmacies for generic drug prescriptions.
In 2025, states across the U.S. have stepped in to regulate PBMs amid concerns of their pricing practices and impact on independent pharmacy operations. In Iowa, Gov. Kim Reynolds signed Senate Bill 383, preventing PBM practices such as cost sharing that favor large pharmacy chains and mandating reimbursement based on average state or national drug prices.
Alabama Gov. Kay Ivey, meanwhile, signed the Community Pharmacy Relief Act into law April 15. The measure bans PBM steering to affiliate pharmacies and spread pricing practices.
In May, Illinois approved a bill banning PBMs from steering patients to affiliate pharmacies, with the measure requiring the full rebate to be passed down to insurers. The legislation also imposed a per-member fee on PBMs, with up to $25 million annually.
The North Carolina House and Senate passed separate bills, with the House bill aiming to ban spread pricing and requiring minimum reimbursements for pharmacies, and the Senate bill focusing more on transparency and supply chain oversight.
California is advancing a PBM oversight plan in its 2025-2026 budget. It would allow the state Department of Managed Health Care to manage PBMs through the authority to review their contracts and conduct financial audits. In June, the California Senate passed a PBM bill that would prevent spread pricing practices and the steering of patients toward their own pharmacies.
Another model, billionaire entrepreneur Mark Cuban’s Cost Plus Drugs, launched in January 2022, sparking debate in the pharmaceutical space. The company prices 100 medications by a manufacturing fee, a 15% markup along with a shipping and handling fee. The company has rapidly expanded, with more than 2,500 medications available to its customers as of 2024.
Other players, including UnitedHealth, Elevance Health, Express Scripts and CVS, also introduced pharmacy services and models focused on transparency and competitive pricing to meet growing demand.
An emerging strategy for health systems amid ongoing criticisms of PBMs has been to bring PBMs in house. Salt Lake City-based Intermountain Health, through its insurance arm Select Health, rebranded its PBM to Scripius to gain greater control over prescription costs, enhance transparency and eliminate inefficiencies.
Chapel Hill, N.C.-based UNC Health also launched its own pharmacy benefit management platform, offering a transparent model for drug cost management, claiming up to 32% of savings on annual prescription drug costs.
The aim for the in-house PBMs is to allow health systems to design tailored drug management solutions for their patients.
Health systems bracing for tariffs
Tariffs have also emerged as a potential threat for pharmacy leaders, with potential implications for drug costs and shortages.
In April, President Trump imposed a 10% baseline tariff on all foreign imports, along with higher levies for certain countries. The administration also said it was exploring a Section 232 investigation into pharmaceutical imports, which could lead to new tariffs under the Trade Expansion Act.
Renton, Wash.-based Providence estimated costs to increase by around $10 million to $25 million annually after assessing the impact to essential medical equipment.
A May report from the American Society for Health-System Pharmacists flagged tariffs as the top policy concern that could raise drug prices in 2025. This is because injectable generics and other other low-margin drugs, already prone to drug shortages, are at a heightened risk.
Michael Gaino, PharmD, senior director of pharmacy practice and quality at the ASHP, told Becker’s tariff impacts on drug shortages may be difficult to trace because a drug manufacturer could choose not to disclose the reasoning behind a product shortage.
“A lot of these products have very slim profit margins. We’re talking older drugs that are 20 to 30 years old. Especially for injectable medications, there’s a lot of overhead expense and by the time you factor all that in, in a lot of cases these drugs are making very little as far as revenue or margin,” he said. “Now you add on a tariff, and if the price is not allowed to rise — which there are penalties for some of these drugs — if the price rises faster than the rate of inflation, the manufacturer may choose just to stop making the drug, but they may never disclose the reason for discontinuing.”
In September, President Trump signed an executive order modifying the scope of tariffs for certain imports, including certain generic pharmaceuticals and their ingredients. The changes are dependent on the U.S. reaching broader trade agreements, however.
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Mayo Clinic to shutter 6 clinics, consolidate care
Rochester, Minn.-based Mayo Clinic Health System plans to close six clinics across southeastern Minnesota and transition care to other locations by Dec. 10, according to The Minnesota Star Tribune.
The health system cited staffing shortages and declining patient volumes in a Sept. 8 news release shared with Becker’s.
“MCHS is committed to continuing to provide high-quality rural healthcare, and to do so, we must adapt,” said the release. “At times, this requires making difficult but important decisions — such as consolidating clinic services — to maintain patient and staffing volumes, modernize facilities and ensure care remains safe, reliable and sustainable for the future.”
The health system will transition clinic services in Belle Plaine, Caledonia, Montgomery, North Mankato, St. Peter and Wells to nearby, alternate MCHS sites.
Additionally, elective procedures for ophthalmology, orthopedics/podiatry, endoscopy and gynecology will transition from Albert Lea to Austin and Waseca.
Patients will have the option to continue receiving care from their current provider at a different MCHS location or transition to another health system provider, MCHS added.
The health system noted that it is also enhancing scheduling assistance, expanding transportation solutions, advancing virtual care options and ensuring access to essential specialty services.
MCHS said providers and staff affected by the regional changes will receive support to explore their future employment options and navigate the transition.
More information is available here.
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Amazon expands $5 monthly prescription service to Texas
Amazon Pharmacy has expanded its RxPass service to Texas, allowing Amazon Prime members in the state, including those on Medicare, to receive over 50 generic medications for $5 per month through the prescription subscription service.
Medications covered include those to treat diabetes, heart disease, hypertension, anxiety and other common conditions, according to a Sept. 8 news release from the company. The service is now available in 48 states within the U.S.
Prescriptions can be sent to Amazon Pharmacy by healthcare providers, and customers can transfer existing prescriptions, the release said.
The post Amazon expands $5 monthly prescription service to Texas appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Emory Healthcare enlists AI agents for at-home cardiac care
Atlanta-based Emory Healthcare utilized agentic AI to improve its CMS star measuring rating for blood pressure control from 1-star to 4 stars, according to an abstract presented Sept. 7 at the American Heart Association’s 2025 Scientific Sessions.
The study enrolled 2,000 older adults with hypertension, who received calls from AI voice agents to provide recent blood pressure readings or to conduct a live blood pressure measurement during the call.
Here are five notes from the study:
- The voice-based AI agent was able to reach 85% of patients over a 10-week period.
Of those, 67% completed the call and 60% completed a compliant blood pressure reading during the call. Of all the blood pressure readings, 68% met the controlling blood pressure compliance threshold established by CMS.
- Overall, 1,939 controlling blood pressure gaps were closed, marking a 17% improvement.
- Elevated blood pressure readings and symptoms of dizziness, blurred vision or chest pain prompted the AI agent to escalate the call to a licensed nurse or medical assistant.
- Utilizing AI agents reduced the system’s average cost per reading by 88.7%.
- The average patient-reported satisfaction rate after interacting with the AI agent exceeded 9 out of 10, according to a Sept. 7 news release from the American Heart Association.
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Connecticut hospital upgrades, expands EHR
New Britain, Conn.-based Hospital for Special Care has upgraded its EHR to Altera Digital Health’s Sunrise 25.1 and expanded its use of the platform under a renewed agreement that extends through 2032.
The long-term acute care hospital will implement the latest version of the EHR to streamline financial operations and enhance clinical workflows, according to a Sept. 9 news release shared with Becker’s. Sunrise 25.1 includes approximately 700 updates and features, including centralized billing tools, real-time insights and automated provider-level adjustments.
The hospital will also become the first to implement Sunrise Health Record, an intelligent faxing tool integrated into Sunrise’s health information management workflow, according to the news release.
Hospital for Special Care serves patients in New Britain, Hartford and Hebron and is the fourth-largest long-term acute care hospital in the U.S. It has used the Sunrise platform for more than a decade.
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Hypertensive kidney disease death rate up 48%: 5 notes
Mortality from hypertensive kidney disease in the U.S. has grown by 48%, according to an abstract presented Sept. 5 at the American Heart Association’s 2025 Hypertension Scientific Sessions.
Researchers analyzed CDC data from 1999 to 2023 to assess changes and trends in the number of deaths associated with hypertensive renal disease.
Here are five notes from the abstract:
- Between 1999 and 2023, the age-adjusted mortality rate for hypertensive kidney disease grew from 3.3 per 100,000 people to 4.91 per 100,000.
During the study period, 274,667 deaths were attributed to hypertensive kidney disease in individuals aged 15 and older.
- Men had a 4.48 average age-adjusted mortality rate, compared to 3.69 for women.
- Black individuals had the highest average age-adjusted mortality rate at 10.37 per 100,000 people, compared to between 3.33 and 3.90 per 100,000 seen in other populations.
- Washington, D.C., Tennessee and Mississippi had the highest age-adjusted mortality rates at 7.6, 5.9 and 5.83 per 100,000 people, respectively, while the western U.S. was the region with the highest overall age-adjusted mortality rate at 4.59 per 100,000.
- “High blood pressure isn’t just about strokes or heart attacks – it’s also a major cause of kidney disease and death, especially in Black and Hispanic communities,” Joiven Nyongbella, MD, from Detroit-based Wayne State University Henry Ford Rochester Hospital, said in the release. “Despite national efforts to reduce health inequalities, Black individuals still had over three times the death rate compared to other groups of people.”
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Temple Health’s Heart and Vascular Institute reaches specialty milestone
Philadelphia-based Temple University Hospital has achieved twin milestones in the treatment of chronic thromboembolic pulmonary hypertension. Care teams from the Advanced Pulmonary Hypertension, Right Heart Failure and CTEPH program at Temple’s Heart and Vascular Institute have completed their 500th pulmonary thromboendarterectomy and 500th balloon pulmonary angioplasty.
Temple University Hospital is home to the largest CTEPH center in the eastern U.S., with pulmonary thromboendarterectomies only performed at a handful of hospitals across the nation, according to an Aug. 21 news release from the health system.
CTEPH is a potentially fatal form of high blood pressure “in the circulation of the lungs resulting from a blood vessel that has been blocked by a prior pulmonary embolism,” the release said.
Pulmonary thromboendarterectomy involves placing the patient on a heart-lung machine and cooling their body to 65 degrees to periodically pause circulation. Pulmonary angioplasty remains an option for patients who are not eligible for a pulmonary thromboendarterectomy.
Temple University Hospital’s pulmonary thromboendarterectomy survival rate is 95%, according to the release.
Anjali Vaidya, MD, director of the Advanced Pulmonary Hypertension, Right Heart Failure and CTEPH program at Temple University Hospital shared more about the dual achievement with Becker’s.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What do these twin milestones reveal about Temple’s efforts to build a nationally recognized center of excellence?
Dr. Anjali Vaidya: Temple Heart and Vascular has been committed to our goal of providing exceptional care to each individual patient. Our nationally recognized pulmonary hypertension center of excellence is a testament to years of specialized pulmonary hypertension careers with emphasis on advanced clinical care, scholarly innovation and vast educational outreach.
Q: What were the most critical decisions or investments that enabled Temple to become the largest CTEPH center in the Eastern U.S.?
AV: Our team’s commitment to meticulous clinical care with exceptional outcomes, with interdisciplinary collaborations between cardiology and Dr. Yoshiya Toyoda’s [MD, PhD] cardiovascular surgery team.
Q: What has been most important to sustaining the interdisciplinary model at Temple’s pulmonary hypertension program?
AV: Our team works extremely well together across departments, all with a patient-centered approach. We learn from each other and grow our experiences in partnership across cardiology, cardiac surgery, interventional cardiology, anesthesiology, radiology and more. The collaborative model at Temple allows for the best patient experiences and outcomes.
Q: Looking ahead, what innovations or research directions will shape the next phase of the program?
AV: Our team is continuously innovating on the scholarly front, inspired by and building on our clinical experiences and incorporating novel therapeutic techniques. The integration of multimodality treatments for an individual patient’s CTEPH management continues to evolve, and being at the forefront of this with colleagues around the world has been exceptionally rewarding and beneficial for our patients.
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CDC releases measles resource for healthcare settings
Around the time when West Texas declared its measles outbreak over, the CDC published a measles assessment tool for infection control in healthcare settings.
The assessment, rolled out Aug. 18, is intended to aid health departments and healthcare facilities in reviewing their measles prevention and response policies and procedures, as well as guide infection prevention and control practices during a community-based outbreak.
The CDC also released resources on steps to follow during a measles exposure in healthcare settings, a sample script to assess patients and visitors, and a sample measles exposure notification letter.
The resources can be accessed here.
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2 Cedars-Sinai hospitals to roll out AI-driven documentation platform
Los Angeles-based Cedars-Sinai will implement an AI-powered documentation platform from health tech company Regard at two of its hospitals to support clinicians and streamline diagnosis.
The health system began working with Regard in 2017 through its startup accelerator program and later invested in the company’s Series B financing round via Cedars-Sinai Health Ventures. Since then, Cedars-Sinai has licensed the platform to assist physicians, nurses and revenue cycle staff by reducing manual chart review and note writing.
The platform uses artificial intelligence to analyze EHRs, surface diagnostic insights and draft clinical notes ahead of patient visits. Cedars-Sinai said the technology is being rolled out to hospitalists at Cedars-Sinai Medical Center and Cedars-Sinai Marina del Rey Hospital, according to a Sept. 9 news release from Regard.
Regard has launched in more than 150 hospitals across 15 states since 2020. The company said its platform has helped clinicians accept more than 8 million diagnoses, contributed more than $50 million in revenue for customers and delivered a fivefold ROI per user.
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Cleveland Clinic Florida taps vascular services leader
Cleveland Clinic’s Heart, Vascular and Thoracic Institute in Weston, Fla., has appointed Greg Kasper, MD, as director of vascular services and the Len Stuart Distinguished Chair in Vascular Surgery.
Dr. Kasper is a vascular surgeon, and previously served as president and chief medical officer of Toledo, Ohio-based ProMedica’s Jobst Vascular Institute, according to a Sept. 4 news release from Cleveland Clinic.
He held the role of ProMedica’s vice president of medical affairs for five years during the COVID-19 pandemic, the release said.
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Cancer centers, Big Tech unite in AI push honored by Time
Jeff Leek, PhD, vice president and chief data officer at Seattle-based Fred Hutchinson Cancer Center, was named to the 2025 Time100 AI list for his role in launching the Cancer AI Alliance.
The initiative brings together leading cancer centers and technology companies to accelerate research through AI while protecting patient privacy.
“This is really a team effort,” Dr. Leek told Becker’s. “There’s leaders across multiple different organizations, both in the major technology companies that are helping us and the cancer centers who have helped drive this forward. I view this sort of honor as an on-behalf-of-the-team honor.”
The alliance was announced in October 2024 by Fred Hutchinson Cancer Center, Dana-Farber Cancer Institute (Boston), Johns Hopkins Medicine (Baltimore) and Memorial Sloan Kettering Cancer Center (New York City), in collaboration with technology partners such as AWS, Google, Deloitte, Microsoft, and Nvidia. Its goal is to build AI models across patient data without exchanging records between institutions.
“We wanted to be able to build AI for the future while protecting patient privacy and data security,” Dr. Leek said. “We decided that we would try to show a proof of concept one year later, October 1. Usually, these big institutional collaborations can take up to a decade, and we’re trying to do it all in one year.”
That rapid pace has required coordination across legal, privacy, security, technology and research teams.
“There’s been this huge group of hundreds of people that have come together to enable us to build these models, and we’re going to be seeing the results on a very quick time scale,” Dr. Leek said.
A central feature of the Cancer AI Alliance is its ability to operate across multiple institutions and cloud providers.
“The thing that’s been so exciting about [the alliance] is the intersection of all of these different groups that sometimes are competitive with each other,” Dr. Leek said. “But for this project, one of the people that helped us set it up says this great phrase: cancer is nonpartisan. And so people really put their differences and their competition behind.”
The collaboration is already being applied to difficult questions in oncology.
“We’re going to use [the platform] to address big questions that our oncologists have, ranging from, how do bone metastases events happen after a metastasis in your body, to what are the biomarkers that will help us predict inhibitor therapies in brain cancers, to the kinds of problems that are thorny around who should get which immunotherapy,” Dr. Leek said.
The project’s origins stem from conversations between Fred Hutch leaders and board members with strong ties to the technology sector.
“We wanted to do something on a national scale,” Dr. Leek said. “Really, what ended up happening is I called my friends who are chief data officers and data leaders at these cancer centers and said, ‘Do you want to try something like this on this kind of wild ride?’ And then our board members called their friends, who are the CEOs of these major tech companies, and said, ‘Do you want to try this together?’”
Looking ahead, Dr. Leek said he expects the alliance to expand quickly.
“We’ve already had a ton of inbound interest from other technology partners who want to be part of [the Cancer AI Alliance], who can help us build out new components of our technology platform,” he said. “We’ve seen a lot of interest inbound from other cancer centers and health systems who want to join. The federated model is really appealing, because everybody gets to keep their data sovereign.”
The ultimate aim, he said, is to give oncologists new tools to improve patient care.
“This platform and what we’re building is hopefully going to enable a dramatic acceleration of that research across all of the different cancer centers involved,” Dr. Leek said. “Ultimately for us, we want to scale to as many cancer centers as want to be part of the network.”
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RWJUH Somerset appoints chief medical officer
Somerville, N.J.-based Robert Wood Johnson University Hospital Somerset has appointed Anthony Altobelli III, MD, as chief medical officer.
Dr. Altobelli, a practicing cardiologist, has held the role of interim chief medical officer since fall 2024, according to a Sept. 5 news release from West Orange, N.J.-based RWJBarnabas Health.
He previously served as associate chief medical officer and as clinical chief of cardiology at New Brunswick, N.J.-based Robert Wood Johnson University Hospital. He is co-director of sports cardiology for RWJBarnabas Health.
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10 states that vaccinate the most, fewest
Massachusetts vaccinates the most out of any state, according to a WalletHub report published Sept. 9.
To determine which states vaccinate most, the financial services site analyzed data across 16 metrics, which were grouped into three key areas: immunization rates among kids and teenagers; adult and elderly vaccination rates; and uptake disparities and influencing factors. The metrics evaluated range from coverage rates for various diseases to the share of people without insurance.
Each metric was graded on a 100-point scale, with 100 representing the most favorable conditions. Final scores were determined based on a weighted average across all metrics. A full methodology breakdown can be found here.
The new ranking comes as a patchwork of vaccine guidance emerges across the U.S. Limited approvals for updated COVID-19 shots and turmoil at the CDC have prompted a growing number of states to issue their own vaccine guidance, aiming to provide clarity and reduce access hurdles.
Here are the 10 states that vaccinate the most, along with their overall score, per the report (Note: The ranking included Washington, D.C.):
1. Massachusetts — 81.95
2. New Hampshire — 71.26
3. Washington — 70.74
4. Connecticut — 68.67
5. Rhode Island — 68.17
6. Vermont — 68.03
7. Maine — 66.61
8. North Dakota — 61.20
9. Wisconsin — 60.95
10. Iowa — 60.88
10 states that vaccinate the least:
51. Mississippi — 13.25
50. Nevada — 27.90
49. Alabama — 29.94
48. Georgia — 31.40
47. Kentucky — 32.96
46. Oklahoma — 33.71
45. Florida — 34.05
44. Wyoming — 35.65
43. Arizona — 36.41
42. Alaska — 36.90
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Top-paid specialties for nurse practitioners, physician assistants
Compensation for physician assistants and nurse practitioners varies across specialties, according to a survey conducted by consulting firm SullivanCotter
The “2025 Advanced Practice Provider Compensation and Productivity Survey” draws data from more than 785 health systems, hospitals and physician group practices representing more than 155,000 certified anesthesiologist assistants, certified nurse midwives, certified registered nurse anesthetists, nurse practitioners and physician assistants.
Here are the highest-paid specialties for NPs and PAs, according to survey data shared with Becker’s. The specialties are in descending order, based on annual median total cash compensation, which is equal to base salaries plus annual incentive awards.
Editor’s note: The lists do not include additional premium-based compensation.
Nurse practitioners
Emergency medicine: $155,556
Anesthesiology – perioperative medicine: $154,336
Anesthesiology – pain medicine: $154,089
Psychiatry – general: $153,284
Psychiatry – inpatient: $151,386
Cardiovascular surgery: $151,332
Pediatrics – neonatal-perinatal medicine: $150,977
Thoracic surgery: $149,755
Cardiology – invasive – interventional: $149,269
Psychiatry – outpatient: $149,180
Cardiology – electrophysiology: $149,163
Pediatrics – critical care medicine: $148,265
Radiology – diagnostic: $148,103
Cardiothoracic surgery: $147,039
Medical critical care: $146,401
Pediatrics – hospitalist: $145,741
Neurological surgery: $145,074
Pediatrics – general surgery: $144,980
Occupational and environmental medicine: $144,778
Psychiatry – child and adolescent: $144,677
Physician assistants
Cardiovascular surgery: $166,250
Cardiothoracic surgery: $164,035
Psychiatry – general: $161,464
Orthopedic surgery – medical: $158,952
Cardiology – electrophysiology: $158,792
Oncology – medical oncology: $155,056
Radiology – interventional: $154,904
Pediatrics – neonatal-perinatal medicine: $154,622
Urgent care: $154,355
Dermatology: $154,304
Obstetrics/gynecology – gynecologic oncology: $152,705
Emergency medicine: $152,250
Anesthesiology – perioperative medicine: $151,769
Occupational and environmental medicine: $151,222
Pulmonology – critical care medicine: $150,521
Thoracic surgery: $150,410
Medical critical care: $150,377
Surgical oncology – general: $148,549
Anesthesiology – pain medicine: $148,426
Vascular surgery: $148,141
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Disaster preparedness in 2025: Recommendations for healthcare chief executive officers
September is National Preparedness Month, which aims to raise awareness about the importance of preparing for emergencies. The American College of Healthcare Executives advises healthcare executives to actively participate in disaster preparedness for natural and man-made disasters. This advice has never been more relevant as healthcare organizations plan for the 2026 fiscal year. The decreased financial resources from local, state and federal agencies require increased vigilance by healthcare leaders. Due to hospital roles as seminal entities during natural or man-made disasters, our community responsibilities remain fundamental, particularly within growing fiscal limitations. Our preparedness now for the potential of man-made or natural disasters will benefit both our local communities and our workforces as we strive to keep highly reliable and effective operations under all situations.
Five Recommendations for Healthcare CEOs
1. Standardize hospital policy manuals and hospital alert systems across shared health systems. Consider standardization of disaster policies with flexibility to accommodate special considerations by geographies. The National Incident Management System (NIMS) provides consistency within the hospital leadership command through a hospital incident command structure (HICS) during a disaster. However, there is no national standard for hospital alert systems and only 50 percent of U.S. hospitals have standardized codes. Codes Blue, Pink and Silver are no longer standard. Plain language hospital alerts are the industry best practice because they improve clarity, enhance safety and support transparency.
2. Incorporate regional hazards into the hospital Hazard Vulnerability Assessment (HVA) to better inform the NIMS planning cycle. National and regional hazards are often missed in the hospital HVA. Hospitals appropriately direct resources toward the higher-ranking hazards within the HVA. Incorporating state-recognized hazards into hospital planning addresses vulnerabilities in staff training, pharmaceutical availability, specialty materials and personal protective equipment required for the HVA hazards.
3. Ensure all hospital planning includes patients with special needs. Twenty-seven percent of the U.S. population falls into one or more special needs or disability category. Categories of special needs include Alzheimer’s, autism, blindness or limited sight, deaf or diminished hearing, dialysis dependency, homelessness, limited mobility, medically dependent on equipment using refrigeration, oxygen or electricity, mentally disabled, non-English speaking, pregnancy and children. Populations with special needs may have increased vulnerability during a disaster and hospitals need to plan for the varied needs of these populations. Hospitals must also remember to plan for the special needs of first responders, such as the police, fire and emergency medical technicians responding to a disaster.
4. Senior executives and board members should take a visible role during disaster drills. Staff focus mirrors leadership priorities. The time for executives to understand the incident response plan is before the actual event. The chief executive officer (CEO) should designate a senior leader to be accountable for emergency management within the system and hospitals. This senior leader oversees and supports the program before, during and after events. Transparent reporting through the quality structure and discussion at board meetings ensures vulnerabilities and challenges are understood and sufficient resources are allocated to address any problems.
5. Plan to be self-sufficient beyond the 96 hours required by the Joint Commission. While a hospital is not required to continue normal operations during the first 96 hours of a disaster, it must have a plan ensuring resources are managed and services prioritized, specific to the hospital’s size and critical functions. This recommendation is not a supply mandate but rather an attempt to foster awareness. The reality of local, state and federal resource reductions requires CEOs to consider their hospitals’ capabilities and limitations differently, plan for the progressive curtailment of services and identify trigger points for decisions within emergency operations.
Planning now, and following the outlined steps, will help to ensure smooth operations when a hospital is confronted with a crisis.
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2nd former HHS leader joins Mayo Clinic
Sonja Fulmer, PhD, has been named senior director of health policy at Rochester, Minn.-based Mayo Clinic.
She worked at the FDA for the past 11 years, most recently as acting director of the Digital Health Center of Excellence, before leaving the agency in August. She also served as assistant director for digital health policy.
Dr. Fulmer is the second high-ranking HHS official to depart for Mayo Clinic in recent months, joining Micky Tripathi, PhD, the former assistant director for technology policy who now serves as the health system’s chief AI implementation officer.
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Texas Medical Center launches 3rd startup accelerator
Houston-based Texas Medical Center launched its third five-month accelerator program in partnership with Innovate UK, welcoming eight medical device startups to its Innovation Factory on Sept. 8.
The cohort includes companies focused on behavioral health, maternal trauma and drug delivery, emergency monitoring, dementia and other neurological conditions, and precision surgical tools. The program is part of the Innovate UK Global Incubator Programme and the TMC–United Kingdom BioBridge.
TMC said the program will provide startups with access to clinical trial infrastructure, mentorship, and resources to support U.S. market entry and commercialization efforts.
Participating startups include CareLoop Health and Safehinge Primera, which are developing technologies to support behavioral health and risk prevention. PeriPear and Calla Lily are advancing maternal health solutions through wearable and drug delivery devices, while ACT Medical is developing tools to reduce fatal blood loss from knife wounds.
Additional participants are OmniBuds, a device monitoring all five vital signs continuously; Neu Health, a platform for monitoring symptoms in Parkinson’s and dementia patients; and Nami Surgical, which is creating miniaturized ultrasonic scalpels for robotic procedures.
“We are excited to welcome this new cohort and look forward to seeing their innovations make a difference at TMC and beyond,” said Tom Luby, chief innovation officer of the Texas Medical Center. “Since the launch of our first specialized accelerator through our Biobridge partnerships, we’ve seen commitment and ingenuity from entrepreneurs tackling complex medical challenges. They understand first-hand the realities of these conditions, and TMC provides a unique place to brainstorm, bring ideas to life, test, and commercialize solutions for impact here and around the world.”
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Why Judy Faulkner tells employees: ‘Have fun’
Epic founder and CEO Judy Faulkner gives her employees the same message she delivers to her customers (and gave her kids): “Have fun and learn a lot.”
At Epic’s booth at the annual HIMSS health IT conference, she instructs staff: “Have fun. Enjoy being with your customer. See the other booths, say hello, and get a sense of what’s going on in the industry,” she recalled in a Sept. 8 blog post.
Ms. Faulkner remembered what an employee told her after attending a preconference meeting for a vendor partner: “He said that the other vendor’s staff were told, ‘You have all the right hardware. You have all the right software. You have all the right marketing materials. It’s your fault if you don’t sell, sell, sell.’
“I thought, ‘What a difference.’ We were saying, ‘Have fun and learn.’ And they were saying, ‘Sell, sell, sell.’”
At her executive address at Epic’s yearly Users Group Meeting, she also typically ends with the words: “Have fun and learn a lot.”
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BJC Health System taps East Region president
St. Louis-based BJC Health System has appointed Robert Cannon president of its East Region (BJC HealthCare), effective Oct. 1, 2025, according to a Sept. 4 news release shared with Becker’s.
Mr. Cannon will succeed Nick Barto, who is set to become president and CEO of BJC Health System on the same date.
Mr. Cannon most recently served as group president for the East Region, overseeing Barnes-Jewish Hospital, Barnes-Jewish West County Hospital, Christian Hospital, Barnes-Jewish St. Peters Hospital, Progress West Hospital and Goldfarb School of Nursing, according to the release.
BJC Health System operates in two regions with 47,000 employees.
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40 best health systems for tech workers: Forbes
Forty health systems made Forbes’ list of the top employers for tech workers.
The publication partnered with market research firm Statista to survey over 25,000 U.S. tech workers employed at organizations with at least 1,000 employees. The respondents evaluated their employers on such factors as salary, professional development opportunities, workplace flexibility, the ability to express ideas and opinions openly, and being technologically progressive.
Here are the health systems that appear on the Sept. 3 list (and their overall rankings):
7. Cincinnati Children’s
11. Cleveland Clinic
19. Yale New Haven (Conn.) Health
25. Vanderbilt University Medical Center (Nashville, Tenn.)
28. Ochsner Health System (New Orleans)
36. Mayo Clinic (Rochester, Minn.)
37. Mount Sinai Health System (New York)
43. Penn Medicine (Philadelphia)
50. Northwell Health (New Hyde Park, N.Y.)
70. Universal Health Services (King of Prussia, Pa.)
75. Kaiser Permanente (Oakland, Calif.)
80. Nationwide Children’s Hospital (Columbus, Ohio)
87. Christus Health (Irving, Texas)
94. Banner Health (Phoenix)
100. OhioHealth (Columbus, Ohio)
103. AdventHealth (Altamonte Springs, Fla.)
133. Advocate Health (Milwaukee, Wis.)
163. Mass General Brigham (Somerville, Mass.)
164. BJC Health System (St. Louis)
166. Prisma Health (Greenville, S.C.)
168. Emory Healthcare (Atlanta)
170. Tenet Healthcare (Dallas)
174. WellSpan Health (York, Pa.)
175. Indiana University Health (Indianapolis)
182. Community Health Systems (Franklin, Tenn.)
184. Henry Ford Health (Detroit)
185. Baylor Scott & White Health (Dallas)
186. Allina Health (Minneapolis)
203. Sutter Health (Sacramento, Calif.)
205. Ascension (St. Louis)
207. HCA Healthcare (Nashville, Tenn.)
208. Akron Children’s Hospital (Akron, Ohio)
233. Northwestern Medicine (Chicago)
239. CommonSpirit Health (Chicago)
247. Sanford Health (Sioux Falls, S.D.)
249. Adventist Health (Roseville, Calif.)
255. Intermountain Health (Salt Lake City)
273. Novant Health (Winston-Salem, N.C.)
276. RWJBarnabas Health (West Orange, N.J.)
284. UPMC (Pittsburgh)
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Nonprofit hospital CEO pay rose with size, profits: Study
Inflation-adjusted CEO pay in nonprofit hospitals climbed between 2012 and 2019, with higher compensation associated with larger size and profits, according to a new study from Houston-based Rice University’s Baker Institute for Public Policy.
The study, published Aug. 12 in Medical Care, analyzed more than 1,800 health systems and independent hospitals using IRS 990 and Schedule H tax filings to identify CEOs and their total compensation.
Key findings from the study include:
1. CEO average pay climbed 34% between 2012 and 2019, rising from about $1 million to $1.3 million. By comparison, registered nurses’ average salaries grew 2.3% during the same period.
2. Compensation was strongly tied to hospital size and profits. In 2019, CEOs of organizations with at least 500 beds earned 157% more than those leading hospitals with fewer than 100 beds.
3. Pay was modestly linked to lower mortality and readmission rates, but these quality-related associations weakened over time, the researchers said.
Read the full study here.
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WellSpan taps hospital president
York, Pa.-based WellSpan Health has appointed Andrew Cochrane as vice president of the health system and president of WellSpan Chambersburg (Pa.) Hospital, effective Oct. 6.
In his new role, Mr. Cochrane will oversee operations of the 274-bed hospital and hospital-based services in the Chambersburg area, with a focus on aligning systemwide safety, quality and care management efforts.
Mr. Cochrane previously served as president and CEO of The Cochrane Group, an organizational and leadership consulting group. His prior roles include leadership positions at Robbinsdale, Minn.-based North Memorial Health and Maple Grove (Minn.) Hospital, where he oversaw 353-bed and 130-bed hospitals, respectively.
He succeeds John Massimilla, who retired earlier in summer 2025.
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Ochsner Health president and COO to step down after 27 years
Mike Hulefeld, president and COO at New Orleans-based Ochsner Health will step down from the role at the end of 2025 after 27 years with the health system.
Mr. Hulefeld first joined the system as an administrative fellow and has served in a number of roles, including 13 years as president and COO of the system since November 2022, according to an Sept. 8 news release shared with Becker’s. Prior to 2022, he also served as CEO of Ochsner Medical Center–New Orleans for four years.
In his role as president and COO, he was responsible for the daily operations across the health system’s 47 hospitals and over 370 health and urgent care centers. During this time, Mr. Hulefeld also spearheaded the establishment of Ochsner MD Cancer Center with seven locations across New Orleans.
Mr. Hulefeld will remain involved with the health system following the transition, serving as a mentor and educator of Ochsner leaders, the release said.
Ochsner also named Timothy Riddell, MD, executive vice president and COO. Dr. Riddell has served as the chief medical officer for Ochsner’s Northshore, Mississippi Gulf Coast, Baton Rouge, Acadiana and Rush regions since January.
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Mount Sinai taps chief of congenital heart surgery
Christian Pizarro, MD, has joined New York City-based Mount Sinai Health System as chief of congenital heart surgery and director of pediatric cardiovascular surgery.
Dr. Pizarro is an internationally renowned expert in neonatal cardiac surgery and pediatric heart transplantation. He has spent more than 20 years leading complex congenital heart surgeries and pediatric care, according to a Sept. 9 news release. He joins Mount Sinai from Nemours Children’s Hospital in Wilmington, Del., where he served as chief of pediatric cardiothoracic surgery and cardiac transplantation.
At Mount Sinai, Dr. Pizarro will oversee the system’s pediatric heart surgery program, with a special focus on neonatal surgery, transplantation and complex cardiac repairs. He will also work to expand services, including valvular and airway reconstruction.
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How healthcare CFO tenures stack up against other industries | 2025
The average CFO’s tenure is 4.7 years, according to a recent report from Crist Kolder Associates.
The executive recruiting firm examines the backgrounds and measures turnover of C-suite executives in a portfolio of 667 Fortune 500 and S&P 500 companies, 9.7% of which are healthcare organizations. Analysts tracked data from Jan. 1, 2015, through July 31, 2025, to compile this year’s Volatility Report.
Here is the average CFO tenure by industry:
1. Financial – 5.3 years
2. Technology – 5.2 years
3. Services – 5 years
4. Healthcare – 4.8 years
5. Consumer – 4.5 years
6. Energy – 4.3 years
7. Industrial – 4.1 years
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Utah physician group to lay off 177 employees
Provo, Utah-based Revere Health, an independent multispecialty physician group, has shared plans to lay off 177, with a Nov. 3 date of notice, according to a Utah WARN notice.
The notice comes after Revere Health shared plans to partner with Dallas-based IKS Health, a healthcare technology and revenue cycle management firm, The Salt Lake Tribune reported Sept. 9.
Under the partnership, IKS Health will provide tools like machine learning and automated claims processing to manage billing, collections and denial prevention, which will replace staff-performed “traditional manual processes,” according to a news release shared with the Tribune.
Patient care will not be interrupted by the layoffs, the release said.
Revere Health was founded by three physicians in 1969. It comprises more than 200 physicians, over 200 advanced practice clinicians, more than 2,500 total employees, and more than $350 million in annual revenue, according to a fact sheet on its website.
Becker’s has reached out to Revere Health for comment and will update this story should more information become available.
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The path to the healthcare COO role
The healthcare COO role is becoming increasingly complex in today’s healthcare environment. Eighty percent of COOs say their responsibilities have significantly increased over the past three years — but how long are they staying in the role?
Here are six things to know about the makeup of healthcare COOs, according to executive search firm WittKieffer’s analysis of 180 COOs at hospitals and health systems in 2025:
1. The average tenure of COOs is 4.4 years. Nearly 70% were promoted internally, while 33% were hired externally.
2. Sixty-one percent of healthcare COOs are younger than 55. Another 30% are 55 to 64 years old and 9% are 65 or older. The average age is 52.
3. Directly before becoming a hospital COO, 38% were a functional leader in operations, facility services or administration. Twenty-six percent previously served as a hospital COO, 24% were clinical leaders and 12% were general managers, such as CEOs or presidents.
4. Among systemwide COOs, 41% were general managers directly before assuming their current role. Twenty-five percent were COOs at the hospital or health system level, 22% were functional leaders and 12% were clinical leaders.
5. Among hospital and health system COOs, 37% are women and 10% are ethnically diverse.
6. The most common degrees held by COOs within healthcare are Master of Business Administration (50%), Master of Healthcare Administration (30%) and Master of Science in Nursing (13%).
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Tampa General partners with high schools on career pathways
Tampa (Fla.) General Hospital North has launched multi-year partnerships with Citrus and Hernando County school systems to expand healthcare career education and workforce development.
TGH North — which includes TGH Crystal River, TGH Brooksville and TGH Spring Hill — will invest more than $600,000 over three years, according to a Sept. 8 health system news release. It will support the Academy of Health Careers at Crystal River High School, Citrus County Education Foundation, Health Science Academies at Hernando County Schools and the Hernando County Education Foundation.
Support will include scholarship funding, medical equipment, professional attire and clinical experiences for students.
“This initiative is about more than funding — it’s about creating real pathways for students to explore and pursue careers in healthcare,” Jennifer Siem, senior director of strategic growth and governmental affairs at TGH North, said in the release. “By investing in these programs, we’re not only supporting education — we’re building a future-ready workforce that reflects the needs and values of our region.
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The next phase in virtual nursing
The face of a nurse now appears on a television screen in hundreds of rooms at Jackson, Mich.-based Henry Ford Jackson Hospital. From a command center down the hall, the nurse conducts safety checks, reviews charts and helps patients prepare for discharge — all without ever crossing the threshold.
This new model, known as virtual nursing, is not a futuristic experiment so much as a response to an immediate crisis. Michigan is already short as many as 20,000 registered nurses, according to Eric Wallis, DNP, RN, chief nursing officer of Detroit-based Henry Ford Health, and the average nurse in the state is older than 50.
“We know that a lot of that workforce is going to be moving to retirement age,” he told Becker’s. “What I’m excited about is that this gives some of our nurses the opportunity to take on a virtual role, to not have to be on their feet for a 12-hour shift.”
The system began experimenting with the idea in 2024, asking bedside teams which parts of their work could be shifted to the virtual model. Tasks heavy with documentation — admissions, discharges, chart reviews — topped the list.
“Coming out of the pandemic, there was an incredible workload and burden and burnout and stress that was on our nurses,” Dr. Wallis said. “And so we really were trying to think about, you know, what is that next evolution? What is that next model of care? And really, how do we support our teams?”
When the program expanded this summer, its effect was immediate. According to Wallis, in August — the first full month live across Jackson’s acute care units — virtual nurses spent more than 600 hours on patient calls, completed nearly 25,000 tasks and interacted with about 1,350 patients. More than 200 beds at the hospital are now wired for the technology. Wallis said those numbers translated into hundreds of hours of bedside work lifted off floor nurses — time redirected to bedside care.
For nurses on the floor, the change has been welcome.
“The feedback that we get from our nurses over and over and over again was, this is the best thing that you’ve ever done for us,” Wallis said. “It’s really pretty rare that we get almost 100 percent universally positive feedback on something, and so it’s been really, really well received.”
Patients and families have been receptive as well. Hospital leaders say Jackson’s communication and “likelihood to recommend” scores each rose about four percentage points during the pilot, lifting the hospital’s percentile ranking from the teens to above the 80th percentile nationally.
Virtual nurses also intercepted potential lapses in care. In the program’s first week, they caught eight issues before they became problems, Dr. Wallis said.
“Family members really like having the virtual nurse available for their loved one as well,” he said. “They feel like it’s another layer of safety.”
The technology, developed by Care.ai, links with interactive televisions already in patient rooms. A green light signals when a camera is active; when not in use, it angles toward the ceiling. Henry Ford plans to add features such as fall-risk detection and keyword recognition later in 2025.
Outfitting each room and integrating the technology requires significant upfront costs, though Dr. Wallis said the health system expects to recoup the investment in patient safety gains, nurse retention and labor savings. Clinton Township, Mich.-based Macomb Hospital will be the next site to launch later this year, followed by Wyandotte (Mich.) Hospital and West Bloomfield (Mich.) Hospital in 2026.
Dr. Wallis has begun referring to the initiative as “virtual acute care,” a reimagining of hospital staffing he hopes could expand beyond nursing.
“We’re talking with some of our physician service lines right now about how they can use the virtual technology to make their providers more efficient, to make our pharmacists more efficient,” he said. “We’ve already got a list of at least eight other use cases that we’re working on.”
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Alabama hospital taps CFO from Florida
Troy (Ala.) Regional Medical Center has appointed Steven Lisenby as CFO.
Mr. Lisenby brings more than 35 years of hospital finance experience in Alabama, Florida and Texas, according to a Sept. 8 hospital news release.
He most recently served as CFO of Northwest Florida Community Hospital in Chipley, a role he began in 2020, according to his LinkedIn profile.
Mr. Lisenby is responsible for overseeing all financial operations of the organization, including hospital and clinic services. His responsibilities also include patient business services, medical records, materials management and accounting, along with statistical analysis, budgeting, strategy development and contract negotiations.
He succeeded Kathy Hill, who returned to her home in the Dothan, Ala., area. Ms. Hill took on the role following the retirement of Mike Myers.
Troy Regional is a 97-bed hospital.
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Hundreds of California Kaiser workers strike
Hundreds of healthcare workers across multiple Kaiser Permanente facilities in Northern California began a one-day strike Sept. 8.
Here are five things to know:
1. The strike involves more than 600 nurse midwives and nurse anesthetists across more than 20 hospitals. They are negotiating over issues including “unsafe staffing, burnout, and the risk to patient care,” according to a Sept. 8 news release from United Nurses Associations of California/Union of Health Care Professionals.
2. A total of around 1,300 healthcare professionals at Oakland, Calif.-based Kaiser Permanente’s Northern California facilities represented by the union are on strike. This includes UNAC physician assistants and acupuncturists as well as Local 39 engineers, who issued sympathy strike notices to the health system, a Kaiser Permanente spokesperson said in a statement shared with Becker’s.
3. Kaiser Permanente has been negotiating with the Alliance of Health Care Unions on a new national agreement since May, which includes UNAC/UHCP. The current agreement expires Sept. 30.
“The decision to call for a strike is disappointing given Kaiser Permanente is scheduled to continue our negotiations with UNAC/UHCP on multiple dates in September,” the spokesperson said. “We will continue to bargain in good faith to reach an agreement that is good for our employees and allows us to continue providing high-quality care that is affordable for our members and patients.”
4. Hospitals and medical offices will remain open during the strike and there are “robust plans in place to ensure we can continue to deliver the high-quality care and services our members and patients deserve,” the spokesperson said.
“We’re not only fighting for fair treatment at work — we’re demanding the staffing, resources, and respect that make safe, expert care possible,” Charmaine Morales, RN, president of UNAC/UHCP, said in the release.
5. Kaiser Permanente said its staffing levels have met or exceeded California’s mandated nurse-to-patient ratios.
“In 2024, we added more than 6,332 people to our workforce — including 4,695 in care delivery and 1,684 in Alliance-represented roles,” the spokesperson said. “We are proud that about 92% of our employees in Alliance-represented roles choose to stay with Kaiser Permanente, significantly higher than the national healthcare average.”
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Hospital group urges federal probe of drugmakers’ 340B rebate models: 5 notes
The American Hospital Association is calling on federal regulators to launch an antitrust investigation into its claims of drug manufacturers’ actions regarding 340B rebate models.
In a letter sent to the Federal Trade Commission and the Department of Justice, the AHA accused several pharmaceutical giants of undermining the 340B drug pricing program through behavior the association said may violate federal competition laws.
Here are five notes:
- The AHA argued that major drugmakers, including Johnson & Johnson, Eli Lilly, Sanofi, Novartis and Bristol Myers Squibb, have imposed new rebate models that restrict access to 340B drug discounts.
- Under the rebate model, 340B eligible hospitals must pay full price upfront for medications and wait for rebates, a reversal of the program’s initial, upfront discount structure, the letter said. AHA warned the models would result in forcing financially strained safety-net providers to issue interest free loans to wealthy pharmaceutical companies.
- The letter also outlined a timeline of events when drug companies began announcing rebate models in rapid succession, starting with Johnson & Johnson in August 2024 and other drugmakers following suit shortly thereafter. AHA argued the timing showed a “parallel conduct,” raising concerns under antitrust law.
- As a result, the AHA urged the FTC and the Justice Department to launch a formal investigation into what it called a “potential antitrust conspiracy” which could threaten the financial stability of safety-net hospitals serving low-income and rural communities.
- Most recently, the Health Resources and Services Administration launched a rebate model pilot program in August, offering manufacturers the opportunity to propose alternative discounts. In response, hospital groups, including AHA, America’s Essential Hospitals, the American Society of Health-System Pharmacists and others issued an Aug. 8 letter voicing concerns about the speed and scope of the rollout, urging the agency to extend key deadlines.
The American Medical Group Association also recently opposed the 340B rebate model , saying it would undermine the initial program’s intent and jeopardize access to care for millions of vulnerable patients.
“Safety-net providers operate on razor-thin margins. The rebate pilot would destabilize these institutions, directly threatening access to affordable medications for patients,” Jerry Penso, MD, president and CEO of AMGA stated in a Sept. 8 letter. “HHS should withdraw the proposal and strengthen the existing upfront discount model that has successfully supported providers and patients for decades.”
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WHO adds GLP-1s to essential medications list
The World Health Organization has updated its Model Lists of Essential Medicines and Essential Medicines for Children, adding drugs for cancer, diabetes, obesity and other conditions.
Among the additions are GLP-1 receptor agonists semaglutide, dulaglutide and liraglutide, along with tirzepatide, used to treat Type 2 diabetes and obesity, according to a Sept. 5 news release from the WHO.
Twenty medicines were added to the adult list and 15 to the children’s list, bringing the totals to 523 and 374, respectively. The updated lists include treatments for conditions such as cystic fibrosis, hemophilia, psoriasis and various blood disorders.
In cancer care, WHO added immunotherapy drugs including pembrolizumab, atezolizumab and cemiplimab.
A WHO committee focused on medications shown to improve survival by at least four to six months, citing a need to prioritize treatments with a measurable impact, the release said.
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FTC drops appeals of noncompete ban
The Federal Trade Commission on Sept. 5 voted 3-1 to dismiss its appeals in two legal challenges to its 2024 rule banning noncompete agreements in employment contracts.
On Sept. 5, the agency dismissed appeals in Ryan, LLC v. FTC and Properties of the Villages v. FTC and acceded to the vacatur of the noncompete rule, which a Texas federal judge struck down in August 2024. The rule would have invalidated tens of millions of existing noncompete agreements and prohibited employers from entering into or attempting to enforce any new noncompetes.
FTC Chair Andrew Ferguson and Commissioner Melissa Holyoak, who both dissented when the rule was first issued, argued the agency had exceeded its authority, noting the rule would have preempted state laws, voided more than 30 million contracts and redistributed “nearly a half trillion dollars of wealth within the general economy.”
The commission’s decision follows strong opposition from the healthcare sector. The American Hospital Association and the Federation of American Hospitals filed a friend-of-the-court brief earlier in February urging nationwide vacatur of the rule, arguing it would “create significant distortions in the healthcare labor market because the commission lacks the statutory authority to apply the rule to nonprofit hospitals.”
Chip Kahn, president and CEO of the Federation of American Hospitals, previously described the policy as a “double whammy” for hospitals. “The ban makes it more difficult to recruit and retain caregivers to care for patients, while at the same time creating an anticompetitive, unlevel playing field between taxpaying and tax-exempt hospitals,” Mr. Kahn said in April.
“The ban makes it more difficult to recruit and retain caregivers to care for patients, while at the same time creating an anticompetitive, unlevel playing field between taxpaying and tax-exempt hospitals — a result the FTC rule precisely intended to prevent,” Mr. Kahn said in a statement shared with Becker’s. “In a time of constant healthcare workforce shortages, the FTC’s vote today threatens access to high-quality care for millions of patients.”
The AHA also warned that a one-size-fits-all approach across industries would worsen ongoing workforce shortages.
While the FTC’s rule will not take effect, Mr. Ferguson said the commission under current leadership will continue to pursue enforcement actions against what it views as unlawful noncompete agreements through antitrust laws.
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Cleveland Clinic opens pharmacy to fill care gaps
Cleveland Clinic has opened a new community pharmacy at South Pointe Hospital in Warrensville Heights.
The pharmacy, located in the South Pointe Medical Office, aims to address growing concerns over pharmacy access in Cuyahoga County’s eastern suburbs, where many neighborhoods have been designated as pharmacy deserts from widespread closures, according to an Sept. 5 news release from the health system. Ohio lost 219 retail pharmacies in the past year, the Ohio Board of Pharmacy reported.
“This location at South Pointe Hospital helps bridge a gap in care in this region,” Lindsey Amerine, PharmD, chief pharmacy officer for Cleveland Clinic, said in the release.
Cleveland Clinic now operates 27 retail pharmacies across the region.
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Former cardiology chief sues Michigan hospital
Samir Elian, MD, former chief of cardiology at Flint, Mich.-based Hurley Medical Center, has sued the hospital for alleged retaliation after he raised concerns about insufficient care practices and an inadequate quality assurance program.
In a complaint filed in Michigan federal court, Dr. Elian said one patient died in Hurley’s ICU while awaiting transfer for emergency heart surgery and another died after going into cardiac arrest because the unit had only one working mobile cardiac monitor, according to a Sept. 8 report from MLive.
Dr. Elian is seeking compensatory and punitive damages, reinstatement and back pay for the “substantial economic injury, loss of goodwill, harm to his business reputation, loss of esteem and standing in the relevant hospital community, and loss of business opportunities” associated with what he called the hospital’s retaliation, the report said.
Laura Jasso, spokesperson for Hurley Medical Center, told Becker’s that “Dr. Elian’s lawsuit is a collection of false allegations that demonstrate a superficial understanding of cardiac services rather than any semblance of truth. Hurley will aggressively defend his baseless claims and seek sanctions against him for having filed them.”
Read the full MLive report here.
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Kettering Health to build Ohio outpatient center, remodel hospital in over $35M plan
Kettering (Ohio) Health is reversing plans to replace Kettering Health Greene Memorial hospital in Xenia, Ohio. Instead, the system plans to invest further in the Greene Memorial facility and build a separate outpatient facility for a total investment of about $35 million, according to a news release shared with Becker’s.
As of Sept. 4, the system is awaiting approval from the city of Xenia to build a $26 million, 24,000-square-foot outpatient health center. The new campus would offer primary care, on-demand walk-in care, lab services and imaging while over $10 million will go toward renovations at Kettering Health Greene Memorial.
“We remain committed to addressing the local shortage of primary care and specialist physicians in Xenia,” said Ron Connovich, president of Kettering Health Medical Group, in the release.
Just over a year ago, Kettering Health had planned to replace Greene Memorial. However, the system faced pushback from the city for its $44 million replacement plan. Soon afterward, city officials advocated for Greene Memorial hospital to remain open, even proposing to acquire it earlier in 2024.
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OBBBA impact could cost hospitals $25B a year: Report
Hospitals nationwide could see annual revenue losses of up to $25 billion through Medicaid losses stemming from the One Big Beautiful Bill Act, according to a new analysis from Kodiak Solutions.
The law, passed July 4, cuts about $1 trillion from Medicaid over the next decade, making it the largest reduction in the program’s history. The number of uninsured Americans is projected to grow by 14.2 million by 2034, which includes the 10 million newly uninsured estimated by the Congressional Budget Office due to the legislation’s Medicaid and Medicare provisions, plus the 4.2 million that will lose coverage from the expiration of ACA enhanced premium tax credits.
Five things to know:
1. Kodiak modeled the hospital revenue and profit impact of four Medicaid disenrollment scenarios (5%, 10%, 15% and 20% reductions) in which enrollees become uninsured and shift to self-pay. The analysis is based on data from 2,100 hospitals and 300,000 physicians using Kodiak’s revenue cycle platform.
2. Depending on the scenario, the average hospital would lose between 0.4% to 1.4% of its annual net revenue, or $1 million to $4 million. Collectively, hospitals could see a decrease of up to $25 billion in net revenue annually. Net income for the average hospital could decrease by more than 71%, with a 70% drop in operating profit margin.
- 5% Medicaid disenrollment: $1M+ drop in annual net revenue
- 10% disenrollment: $2M+ drop
- 15% disenrollment: $3M+ drop
- 20% disenrollment: Nearly $4M drop
3. Worst-case scenario: For an average hospital with $278M in net revenue and a 2% margin, net income could fall by 71% to $1.6M, while operating profit margins could shrink by 70%, to 0.6% from 2%.
4. Hospitals will see uncompensated care costs increase by more than $63 billion by 2034 if disenrollment accelerates.
5. Hospitals are encouraged to focus on Medicaid enrollment assistance, expand preventive care services for the uninsured, and prepare for cost reductions or increase payer reimbursement elsewhere to offset the revenue declines.
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Hackers leave ransom note after cyberattack at Georgia hospital
Jesup, Ga.-based Wayne Memorial Hospital said it received a ransom note after a June 2024 cyberattack that allowed hackers to access some patient information.
In a Sept. 7 notice filed with the Maine attorney general’s office, the hospital said an unauthorized party gained access to its network, encrypted some files and left a ransom note on June 3, 2024. Wayne Memorial immediately disconnected its network and took systems offline while working to restore them from backups, according to the letter.
A forensic review found the hackers had access to hospital systems between May 30 and June 3, 2024. Files that may have been exposed contained personal and medical information, including names, Social Security numbers, driver’s license numbers, financial account details, Medicare and Medicaid numbers, medical histories, treatment information and lab results.
The hospital reported that 34 Maine residents were among those affected. While there is no evidence the information has been misused, Wayne Memorial said it is offering free credit monitoring and identity theft protection to those impacted.
In August 2024, the hospital posted a public notice of the event on its website. Individual notification letters were sent on Aug. 27, 2025.
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Michigan hospital names chief medical officer
Pontiac, Mich.-based McLaren Oakland appointed Joseph Zajchowski, MD, as its chief medical officer, effective Sept. 8.
Dr. Zajchowski most recently served as CMO of McLaren Lapeer (Mich.) Region, a 222-bed hospital. Trained as an emergency medicine physician, he has previously worked at McLaren Northern Michigan in Petoskey, McLaren Flint (Mich.), Kona Community Hospital in Kailua-Kona, Hawaii, and Mayo Clinic Arizona in Scottsdale, according to a news release shared with Becker’s.
McLaren Oakland is part of McLaren Health Care, a 12-hospital system based in Grand Blanc, Mich.
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FDA greenlights trial for pig kidney transplant
Mass General Brigham, based in Somerville, Mass., and eGenesis have received FDA approval for a clinical trial testing genetically engineered pig kidneys.
The trial will evaluate the safety, tolerability and efficacy of EGEN-2784, a genetically engineered pig kidney, after 24 weeks post-procedure, according to a Sept. 8 news release from eGenesis. Study participants will be patients who have end stage kidney disease, are 50 or older, are dependent on dialysis and are on the kidney transplant waitlist.
Cambridge, Mass.-based eGenesis is a biotech company that researches and develops human-compatible engineered organs. EGEN-2784 is the company’s lead candidate for kidney transplantation, according to the release.
The trial currently includes three patients. The first patient, a 67-year-old man, has surpassed seven months after the transplant, making him the world’s longest-living recipient of a genetically engineered pig kidney. He continues to live dialysis-free, according to the release.
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UCSF Health executive heads to Baptist Health
Jacksonville, Fla.-based Baptist Health has named Sarah Sanders executive vice president and chief consumer officer, effective Sept. 8.
Ms. Sanders will oversee the organization’s marketing, communications, digital strategy, advertising and community engagement, according to a Sept. 8 health system news release.
She most recently served as vice president and chief marketing and communications officer at San Francisco-based UCSF Health, a regional academic health system with seven hospitals. Ms. Sanders previously led marketing and communications strategies for Nemours Children’s Health in Jacksonville.
Baptist Health includes six acute care hospitals and more than 200 ambulatory locations across Northeast Florida and Southeast Georgia.
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ECG Launches Cipher Collective: An AI Partner Network for Health Systems
Boston, MA, September 3, 2025: ECG Management Consultants, a leading healthcare consulting firm to health systems, physicians, and investors, today announced the launch of Cipher Collective, a curated marketplace of AI-enabled health technology partners powered by ECG. This launch is designed to deliver efficiency, scalability, and clarity to health systems navigating the complex landscape of AI solutions.

With the healthcare market saturated by disconnected point solutions and uncertain ROI, many organizations face pressing challenges: legal and regulatory considerations, suboptimal technology deployments, and the need to identify AI use cases and related solutions that align with overall strategic goals. Cipher Collective addresses these obstacles head-on, offering a single point of entry to a fully vetted suite of technologies. Each solution is strategically tied to a specific point along the patient-provider journey and fortified by ECG’s strategic advisory capabilities, operational expertise, and implementation leadership.
“AI adoption in healthcare is at an inflection point,” said Asif Shah Mohammed, Partner and Head of Digital Innovation at ECG. “Our clients are eager to unlock the potential of AI, but they’re overwhelmed by the noise in the market and want to alleviate risks. Cipher Collective brings order to the chaos by offering clear guidance on an organization’s AI roadmap with an ROI-focused pathway forward.”

Each initial network member (Alpha Nodus, Azra AI, Janus Health, Mediktor, OpenBots, Reveal HealthTech, and WellStack) offers a best-in-class solution with the proven ability to support high-impact use cases, from digital triage and virtual care pathways to advanced documentation tools, automation, intelligent workforce management, and revenue cycle optimization. Powered by ECG, the Cipher Collective anticipates providing a differentiated go-to-market offering that will target increased revenue, reduced costs, improved access, and an enhanced experience for patients, providers, and staff.
“Health systems are interested in leveraging AI to improve operational efficiency and patient experience, but it can be difficult to gauge the integrity, impact, and sustainability of each product, and our clients have little room for error considering their thin margins,” said Chris Collins, CEO at ECG. “Cipher Collective is designed to offer our clients a credible hub to examine different solutions through the lens of the health system, not a traditional product transaction.”
About ECG Management Consultants, a Siemens Healthineers Company
With knowledge and expertise built over the course of 50-plus years, ECG is a national consulting firm that is redefining healthcare together with its clients. ECG offers a broad range of strategic, financial, operational, and technology-enabled consulting services. ECG is an industry leader, offering specialized expertise to hospitals, health systems, medical groups, academic medical centers, children’s hospitals, ambulatory surgery centers, investors, and payers/health plans. As an affiliated partner of Siemens Healthineers, ECG’s consultants have established a proven track record of delivering results fueled by a unique combination of top talent and tech-enabled solutions.
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From niche to routine: How genetic testing is reshaping everyday care
Key Takeaways
- Mainstreaming genetics – Testing now guides real-time treatment.
- New care models – Clinicians empowered, workflows optimized.
- Education & coverage – Training gaps and reimbursement hurdles persist.
- AI with oversight – Scales insights but needs human validation.
Genetic testing is rapidly moving genomics from a niche specialty to becoming more integrated into mainstream clinical practice. Once deployed primarily to diagnose rare and inherited conditions after initial clinical evaluations, genetic insights are now shaping real-time treatment decisions across clinical specialties to benefit patients earlier in their healthcare journeys and to promote delivery of personalized care.
During a recent webinar hosted by Becker’s Healthcare, leaders from Providence’s Swedish Cancer Institute in Seattle, Labcorp, and Gene Pool Media shared perspectives on embedding genetics into everyday care and strategies to expand precision medicine at scale.
Here are four key takeaways from their discussion:
1. Transforming cancer care
Genetic testing has moved beyond academic centers to being reflected in clinical guidelines adopted by a growing number of clinicians. Marianne Dubard-Gault, MD, medical director of Cancer Genetics & High-risk Services at Swedish Cancer Institute, routinely offers genetic testing to patients newly diagnosed with breast, ovarian and pancreatic cancer.
The presence of specific biomarkers or variants in a tumor can affect the treatment sequence or type of therapy a patient receives.
“Targeted therapy is possible because we identified the genetic predisposition or the biomarker in the blood or the tumor, and we were able to tailor and prescribe medication developed for that particular thing and really give people outcomes that we haven’t seen in the past,” said. Dr. Dubard-Gault.
Rebecca Previs, MD, director of medical affairs for oncology at Labcorp, agreed and also highlighted the shift from a one-size-fits-all model to personalized care in ovarian cancer, with somatic and complementary germline testing now central to treatment decisions.
“We have this unique ability to understand a patient’s biology within their own tumor,” said Dr. Previs. “For many patients in the oncology space, including ovarian cancer, both germline [inherited] and somatic [tumor/acquired] testing are at the heart of this paradigm shift.”
2. New models of care
Despite growing evidence of its real-time impact on patient’s health, genetic testing is still often underutilized due to a disconnect between established clinical guidelines and broader real-world adoption as noted by Dr. Previs. She also observes that testing is often not ordered due to inconsistent workflows and limited resources.
“Testing doesn’t happen unless providers know to order the test,” Dr. Previs said. “There are a lot of stakeholders involved for physicians and the multidisciplinary healthcare team. That clinical utility piece is so critical and we have to lead with evidence.”
As genetics becomes an integral part of everyday healthcare, it’s essential to evolve care models to seamlessly support and enable genetic testing. Sarah Young, clinical program manager for oncology at Labcorp, pointed to workforce shortages and that there aren’t enough genetics professionals for every patient. Empowering clinicians to order genetic tests, while reserving genetic counselors for complex cases, has proven effective for the teams she works with.
3. Education and reimbursement remain major hurdles
All panelists stressed the importance of provider education. Kira Dineen, CEO of Gene Pool Media and host of the DNA Today podcast noted that physicians receive little genetics training in medical school.
Insurance coverage also lags behind scientific progress. Dr. Dubard-Gault said she spends up to a third of her time on prior authorizations, which can help minimize financial burden to patients but can introduce delays in initiating genetic testing. Ms. Dineen added that reimbursement gaps create frustration.
One positive development is a new 2025 billing code for genetic counseling that covers preparation and documentation time.
“The ROI is so much better than it was last year because of this new billing code,” Ms. Dineen said. “Hiring a genetic counselor might make you money as opposed to losing money that it used to. We’re specialized in genetics. New codes like the one above help payers, providers and patients alike to streamline healthcare delivery.”
4. The future of genetics
The panelists also discussed the role of AI in genetics. Dr. Previs called AI “a future state tool” that could help scale variant interpretation and patient education. But she stressed that human oversight is essential. Clinicians must be empowered to do their jobs more efficiently, not have their clinical judgment replaced by AI.
While AI can be a powerful tool to help clinicians, Dr. Dubard-Gault cautioned that clinicians should not rely solely on automated analysis. A system created with close collaboration between clinicians and AI developers, with clinicians validating outputs, is key to giving patients peace of mind and helping to improve outcomes.
The panelists agreed that genetic testing should no longer be viewed as exceptional. In order to meet a new reality where genetic insights are part of everyday care, education, reimbursement reform and thoughtful use of technology will be critical to scaling access.
“Genetic testing saves lives,” Dr. Dubard-Gault said. “We don’t always see it because when we do it well, we prevent cancer. We identify that common thread in the family and catch the next cancer before it can even start.”
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Allina Health shutters hospital infusion center
Minneapolis-based Allina Health shut down its infusion unit at St. Paul’s United Hospital on Sept. 5, the St. Paul Pioneer Press and FOX 9 KMSP reported.
The closure comes after the system told Becker’s it was shuttering four Allina clinics in November to have more efficient use of space and resources. The news outlets also reported how United Hospital’s pain center closed in July.
“Allina Health has made the decision to consolidate our infusion services on our United Hospital campus,” a spokesperson for Allina Health said in a statement to Becker’s. “Allina Health will help patients transition their care to two remaining infusion centers at our United Hospital campus — Allina Health Cancer Institute or Allina Health United Medical Specialties Clinic Infusion Center — or another Allina Health infusion center in the metro area.”
The system did not respond to questions about how many patients will have to transfer their care and how many employees were impacted.
“We will work with impacted care team members to find other positions within the Allina Health system,” the system said.
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Free CNA training program targets staffing gaps, nurse retention at CHI Health
Omaha, Neb.-based CHI Health is building its own pipeline of clinical support staff through a new program that offers free training, certification and guaranteed employment to aspiring certified nursing assistants.
The goal of the CNA Advance Program is twofold: Develop an internal pipeline of highly skilled CNAs and strengthen support for registered nurses at the bedside, according to Jenny Stachura, MSN, RN, chief nursing officer of CHI Health’s Nebraska and Iowa market, which includes CHI Health St. Elizabeth, where the initiative began.
The three-week training program launched in 2024 and has since graduated more than 50 students. Once participants pass a final exam, they are guaranteed a position at one of five CHI Health in the Omaha metro area.
Becker’s recently spoke with Ms. Stachura, who shared more about the impetus behind the program, how leaders are evaluating its success and plans for expansion.
Question: Can you share a bit about what it took to operationalize the CNA advance program across CHI Health St. Elizabeth, and what lessons have you learned about launching a training-to-employment pipeline within a clinical environment?
JS: Launching the CNA Advance Program at CHI Health St. Elizabeth required significant cross-departmental collaboration and a clear understanding of our workforce needs. We established a dedicated project team, including representatives from nursing leadership, human resources, education and finance, to design and implement the program. A key first step was a comprehensive needs assessment to identify specific clinical areas with high CNA vacancies and to understand the existing skill gaps of new hires.
Recruitment and selection were critical. We targeted individuals with a strong desire to enter healthcare but who might not have had prior clinical experience. This involved community outreach and developing a screening process that assessed interest and commitment.
Lessons learned include the importance of continuous communication and feedback loops between the program team, students and clinical staff. We found that regularly soliciting input helped us refine the curriculum and address any challenges in real-time. Additionally, dedicating sufficient resources for mentorship and providing ongoing professional development for preceptors proved crucial for the program’s success and the retention of our newly trained CNAs. Finally, celebrating milestones and successes, both big and small, has been instrumental in building morale and demonstrating the organization’s commitment to this pipeline.
Q: Beyond graduation numbers, how are you evaluating whether this program is delivering the outcomes the organization needs?
JS: While graduation numbers are a key metric, we evaluate the CNA Advance Program’s success through several other critical outcomes to ensure it aligns with our organizational needs. Primarily, we track retention rates of graduates within our facility, comparing them to the retention of CNAs hired through traditional recruitment channels. This helps us understand the long-term impact of the program on workforce stability.
We also monitor the performance and competency of our CNA Advance graduates. This includes regular feedback from nursing unit managers and preceptors regarding their clinical skills, adherence to protocols, teamwork and overall contribution to patient care.
Furthermore, we analyze the impact of the program on specific unit-vacancy rates and staffing levels. Ultimately, the program’s effectiveness is measured by its ability to create a sustainable pipeline of skilled and engaged CNAs who contribute to high-quality patient care and positively impact our overall operational efficiency.
Q: How does the CNA Advance Program fit into your broader strategy for workforce development and nurse retention?
JS: The CNA Advance Program is a cornerstone of our broader workforce development strategy, particularly in addressing the critical need for qualified nursing support staff. It directly contributes to nurse retention by ensuring that our registered nurses have adequate and competent CNA support, which reduces their workload and allows them to focus on higher-level patient care. This, in turn, can mitigate burnout and improve job satisfaction among our nursing staff.
The program also aligns with our long-term talent management goals by cultivating a dedicated internal talent pool. Many of our CNA Advance graduates express interest in pursuing further education to become [licenced practical nurse or RNs, and we support these aspirations through tuition reimbursement and career laddering initiatives. This creates a sustainable pipeline of healthcare professionals who are already familiar with our organizational culture and values.
By investing in this training-to-employment model, we are building a more stable, skilled and engaged workforce from within, ultimately strengthening our ability to deliver high-quality patient care and adapt to evolving healthcare demands.
Q: Are there any plans to evolve or scale the program in the next year?
JS: Yes, we actually expanded the program this past year to include the five CHI Health campuses within the Omaha metro. By doing so, we have been able to expand the program’s capacity to accommodate more students per cohort, addressing the continued demand for CNAs across the organization.
We also plan to enhance the career laddering component of the program. Our goal is to not only fill immediate CNA vacancies but also to nurture a long-term talent pipeline for all levels of nursing roles within CHI Health. Finally, we are looking into integrating new technologies or simulation-based training methods into the curriculum to further enhance the practical skills and preparedness of our graduates.
The post Free CNA training program targets staffing gaps, nurse retention at CHI Health appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
NYU Langone launches GI cancer center, appoints 2 leaders
New York City-based NYU Langone Health’s Perlmutter Cancer Center has appointed two leaders for its newly established Gastrointestinal Cancer Center.
Anirban Maitra, MD, and Manuel Hidalgo, MD, will serve as co-directors of the center, according to a Sept. 5 news release from the health system.
Dr. Maitra is a gastrointestinal and pancreatic pathologist. He previously served as associate director of translational research and as the inaugural scientific director of the Pancreatic Cancer Research Center at Houston-based University of Texas MD Anderson Cancer Center.
Dr. Hidalgo is a translational researcher and clinical oncologist. He has served in professorial roles at Boston-based Harvard Medical School, Baltimore-based Johns Hopkins University, and New York City-based Weill Cornell Medical College. He also served as faculty and director of the ASCO/AACR Methods in Clinical Cancer Research Workshop from 2019 to 2024.
The post NYU Langone launches GI cancer center, appoints 2 leaders appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
The time is now: building operational resilience for a changing healthcare landscape
Sweeping policy changes are reshaping reimbursement and funding, putting unprecedented pressure on operating margins. Hospitals can no longer afford inefficiency in how they manage costly assets like operating rooms, staffed beds or infusion chairs. The stakes are high: patient access, financial stability, and community trust all hang in the balance. For healthcare leaders, the mandate is clear – build resilience or risk falling behind.
Forward-thinking health systems are already acting. By leveraging AI-powered capacity management, they are shortening length of stay, unlocking beds, optimizing operating room (OR) blocks, leveling infusion workloads and demonstrating measurable ROI in the face of tighter regulation.
On September 16–17, 2025, healthcare executives will gather virtually for Transform Hospital Operations Virtual Summit and Transform Infusion Center Operations Virtual Summit, hosted by LeanTaaS in partnership with Becker’s Healthcare. This free, two-day event will bring together more than 7,000 leaders to exchange strategies and real-world case studies on creating sustainable operations.
Driving resilience with intelligent operations
The Transform Virtual Summits will explore practical solutions to today’s most pressing capacity challenges in healthcare. Sessions will highlight how health systems are:
- Reducing emergency department (ED) boarding by treating inpatient flow as an interconnected system
- Unlocking OR capacity through smarter block management and connected surgical workflows
- Using predictive data and automation to streamline discharges, align staffing, and prevent delays
- Balancing infusion workloads to reduce bottlenecks, improve staff satisfaction, and protect patient access
Speakers from Baptist Health Arkansas, University Health Texas, WVU Medicine, Atrium Health, Vanderbilt University Medical Center, Providence, Inova Health, MultiCare Health System, OhioHealth, NewYork-Presbyterian, Hartford HealthCare and UCSF Health will share how these strategies are driving results across their organizations.
Two tracks, one vision: resilient operations
Transform Hospital Operations Virtual Summit is organized into two focused days. The first day (September 16) tackles inpatient flow challenges and solutions, with strategies to streamline discharges, reduce length of stay and align staffing with patient demand. The second day (September 17) shifts the spotlight to perioperative operations, featuring proven methods to maximize OR utilization, boost throughput and recover lost surgical volume.
Running concurrently on September 17, Transform Infusion Center Operations Virtual Summit offers a dedicated forum for cancer care leaders. Sessions will showcase how infusion centers are applying AI and advanced analytics to balance patient schedules, ease staff burden and sustain growth.
The time to act is now
Rising labor costs, accelerating demand, and outdated manual processes make it essential to rethink how resources are managed. Data-driven solutions and transformation services provide a proven way to safeguard margins and expand access while reducing administrative strain on staff.
LeanTaaS is at the forefront of this transformation. Its iQueue software suite supports nearly 200 health systems and more than 1,200 hospitals nationwide, using predictive models to reveal hidden capacity, expand access, reduce costs and strengthen resilience.
Healthcare executives ready to stay ahead of these pressures are encouraged to join the Transform Virtual Summits – an exclusive opportunity to learn from peers, discover best practices and shape the future of healthcare operations.
Register today: Transform Hospital Operations Virtual Summit / Transform Infusion Center Operations Virtual Summit
The post The time is now: building operational resilience for a changing healthcare landscape appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Health systems navigate Epic’s growing AI portfolio
Health system leaders are evaluating what new AI tools their organizations should integrate into their Epic EHRs, following several announcements at Epic’s annual User Group Meeting in Verona, Wis.
Epic unveiled a range of new features designed to enhance clinical, administrative, and patient experiences. Available now are tools such as AI for self-scheduling, actionable follow-ups for radiology, AI wound measurement, outpatient denials appeals through the AI assistant Penny, and MyChart Central for early adopters.
Looking ahead, Epic plans to roll out AI-generated notes in early 2026, AI charting for patient education, a digital concierge in MyChart, automated claims follow-up, and a digital AI colleague for clinicians by late 2026. Future updates will include voice agents, real-time authorizations, and automated credentialing.
For health system CIOs, the announcements highlight both opportunity and complexity. At Palo Alto, Calif.-based Stanford Health Care, Michael Pfeffer, MD, CIO and associate dean, said the “depth and breadth of Epic’s infusion of AI into many aspects of their EHR platform stood out” as particularly notable.
Stanford is evaluating the tools through a “responsible AI lifecycle” that reviews fairness, usefulness, and reliability while ensuring alignment with strategic and operational plans. Multiple groups and committees at the health system also assess Epic’s AI tools and roadmap to determine their value, timing and prioritization, and alignment with Stanford’s strategic priorities.
“It’s exciting to see Epic embrace AI capabilities to enhance the patient, clinician, and admin experiences,” Dr. Pfeffer told Becker’s. “You’ll see more automation tools in the short term and more augmentation tools in the mid-term that will continue to transform the EHR experience at Stanford Health Care.”
At Tallahassee (Fla.) Memorial HealthCare, Interim CIO Chris Belmont said Epic’s focus on building its own agentic AI tools could help automate repetitive tasks, such as generating letters for insurance denials.
“Its [the tools] more than a shiny object—it’s valuable and relevant to the operations of healthcare organizations.,” Mr. Belmont told Becker’s. “My biggest concern is how we can keep up with it, but that’s a nice problem to have rather than chasing spot solutions.”
TMH is still transitioning from its March Epic go-live, prioritizing adoption, competency, and trust in the data before rolling out AI capabilities. But it is working with Epic’s team to pick AI solutions that are valuable for its different users.
“We have identified a handful that we want to start with and will spread the work out over time to not overwhelm our IT team or end users,” Mr. Belmont said. “As we move further away from Epic being ‘new’ at TMH, we’ll continue to evaluate and add AI capabilities that make sense for our organization.”
Mr. Belmont said in the future, he believes that Epic will continue to grow their portfolio of AI solutions.
“AI is the most exciting thing I’ve seen in my 40+ years in healthcare,” he said. “As AI becomes more familiar to us all, I hope it gets folded into the solution versus being called out individually as AI. The focus should be on the benefits and the outcomes (the why) instead of the underlying tools.”
He said he’s also interested in the cost model moving forward.
“The investments necessary for AI are tremendous, and how Epic will recoup those investments could be significant to some organizations, including TMH,” Mr. Belmont said.
Overall, Mr. Belmont feels TMH is in a great position to adopt the AI solutions.
“Epic undoubtedly plays a role in our future success,” he said. “We aren’t large enough to put AI solutions together on our own, but with Epic’s help, we can get the benefit without all the burden of building it ourselves. I see it as a speed-to-value opportunity.”
With Epic’s AI portfolio expanding rapidly, health system IT leaders are taking a deliberate approach, carefully evaluating which tools align with organizational priorities, establishing governance frameworks, and planning phased adoption.
The post Health systems navigate Epic’s growing AI portfolio appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
‘The Advocate Way’: A new model for systemwide cancer care integration
The 2022 merger of Charlotte, N.C.-based Atrium Health and Advocate Aurora Health, then dually based in Downers Grove, Ill., and Milwaukee, created one of the largest nonprofit health systems in the country in Advocate Health.
“We are poised to push past traditional geographic and care delivery boundaries to create a healthier tomorrow for all,” Charlotte, N.C.-based Advocate Health CEO Eugene Woods said at the time.
Now operating as one entity, the 69-hospital system has more than 162,000 employees and provides care for about 6 million patients across Alabama, Georgia, Illinois, North Carolina, South Carolina and Wisconsin, with Winston-Salem, N.C.-based Wake Forest University School of Medicine serving as the system’s academic core.
Almost three years since the merger, Advocate has tapped two leaders to build a national cancer service line. A daunting task on its own, the service line aims to serve as a replicable care model that establishes a blueprint for providing standardized — and exceptional — specialty care at scale.
Ruben Mesa, MD, and Nike Onifade will lead the Advocate Health Cancer National Service Line as president and senior vice president, respectively. Theirs is a partnership balanced with clinical and administrative experience, with both having spent time at the leadership helm of cancer centers across the U.S.
Dr. Mesa and Ms. Onifade spoke to Becker’s about their plans for the unified cancer service line, the challenges and advantages brought on by such an expansive system footprint, and what it means to create “The Advocate Way.”
The case for a national cancer service line
“What I’ve learned along the way is that cancer is not only healthcare, it is a mission. And cancer has been a strong part of the mission for our institution as it’s come together,” Dr. Mesa said.
Each year, Advocate Health cares for about 50,000 newly diagnosed cancer patients in addition to cancer patients already in the system, “making it a very significant activity and area of focus — from research, practice and education,” he said.
Atrium Health’s Wake Forest Baptist Comprehensive Cancer Center, which Dr. Mesa has led since 2023, is one of only 57 NCI-designated comprehensive cancer centers in the U.S. He carries a wealth of insights from his time as executive director of the Mays Cancer Center at the UT Health San Antonio MD Anderson Cancer Center, and as deputy director and chair of hematology and medical oncology at the Mayo Clinic Comprehensive Cancer Center in Phoenix.
“The origin of the service line is really around the concept of: How do we really work together as one system to decrease the burden of cancer in our communities?” Dr. Mesa said. “And then, how do we bring the innovations, clinical trials and expertise of the system to our patients in a way that is both aligned but also a platform for innovation across the system?”
The answer will be found through what Ms. Onifade calls establishing “The Advocate Way.”
“Fifty-thousand new cancer patients each year, that’s a tremendous number,” Ms. Onifade said. “We feel it’s not just a privilege but also a responsibility for us to align and elevate the way we deliver cancer care across our footprint and the system.”
Ms. Onifade’s administrative background is firmly planted in oncology, having served as division vice president of the oncology service line for both Houston-based St. Luke’s Health, a member of CommonSpirit Health, and the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, also in Houston, as well as senior director of operations at Pittsburgh-based UPMC Hillman Cancer Center.
“Ruben and I have spent a lot of time traveling to the various regions we now oversee, seeing how care is delivered,” she said. “We’re meeting people who are incredibly passionate about their work and about finding the best ways to care for patients. Their passion is unique to their local markets; it is also tied to our enterprise focus.”
Balancing local and national needs
As Dr. Mesa and Ms. Onifade navigate how to standardize “The Advocate Way” across six states with diverse patient populations and geographic considerations, prioritization has emerged as a key classifier.
“When we talk about our size and scale — we’re taking care of patients from the South Side of Chicago, to rural Wisconsin, to suburban Georgia,” Ms. Onifade said.
“While there are very important things for us to align around, [alignment on] other things might be more neutral and [misalignment] on others that might be detrimental,” Dr. Mesa said. “The process of identifying what falls in each bucket is important.”
Dr. Mesa envisions a “team of teams” model, where innovation can occur alongside clinical requirements and expectations. The standards that must remain aligned across the Advocate Health footprint are quality, safety, service and patient experience.
“Whether a patient presents in Green Bay, Wisconsin, or Greensboro, North Carolina, their expectations around receiving a certain therapy for lymphoma should be the same, as should their access to our clinical trials or the best of our supportive care,” he said.
“We want patients to get the highest level of care within their home state or city, without needing to fly to a quaternary hub for more complex care,” Ms. Onifade said. “But we also want to leverage the amazing things happening in the communities and provide care curated to that particular community.”
Developing a national cancer workforce at scale
Patient care metrics, quality and safety are not the only elements Dr. Mesa and Ms. Onifade are aiming to align across the system. They also consider unifying the oncology workforce as a crucial component to establishing “The Advocate Way” across the national service line.
“Right now, our Atrium teams feel very connected, our Advocate teams feel very connected, and our Aurora Cancer teams in Wisconsin feel very connected,” Ms. Onifade said. “Our goal is to bring all of that engagement together under the national service line [and maintain] this community and culture of support.”
Dr. Mesa said he has seen how important it is for organizations to have established engagement structures to maintain the passion and purpose of care teams. He foresees supporting the oncology workforce through training and development opportunities such as tumor boards or specialty councils, as well as initiatives that foster a sense of both local and national community among colleagues.
“It’s incredibly important to leverage the fact that we have very dedicated, passionate people who love caring for patients, and give them the resources and tools to continue being successful in their roles,” Ms. Onifade said.
A mission for all
Unlike a standalone institution, Advocate Health’s national cancer service line has system and primary care integration built into its care model.
Driven by the diversity of its patient population and the system’s overall commitment to clinical innovation, Dr. Mesa and Ms. Onifade said the lessons they learn while establishing the national cancer service line will have broad applicability for other health systems.
“The 50,000 new patients we see, when we compare that with socioeconomic data as well as the types of cancers represented, is a fairly accurate reflection of the national data published by the American Cancer Society,” Dr. Mesa said.
“And there is an element of cancer in every specialty and every disease group,” Ms. Onifade added. “You can have cancer in orthopedics, in cardiology, in pediatrics.”
“[The Advocate Way is] really a ‘for all’ mission,” Dr. Mesa said. “Regardless of our role in that mission, we will bring the same passion and purpose that we would if our loved one were the person experiencing cancer.”
The post ‘The Advocate Way’: A new model for systemwide cancer care integration appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
AtlantiCare appoints chief of women’s oncology
Atlantic City, N.J.-based AtlantiCare has appointed Kay Yoon-Flannery, DO, as chief of women’s oncology at the AtlantiCare Cancer Care Institute in Egg Harbor Township, N.J..
She will lead alignment of breast, gynecologic and genetic cancer services across the system, according to a Sept. 8 news release.
Dr. Yoon-Flannery previously served as director of quality and process improvement, director of physician engagement, and co-director of the Janet Knowles Breast Center at Camden, N.J.-based MD Anderson Cancer Center Cooper, according to her LinkedIn profile.
The post AtlantiCare appoints chief of women’s oncology appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Mississippi system taps chief nurse
Rachel Kemp, DNP, MSN, has been named chief nursing officer of Singing River Health System in Ocean Springs, Miss.
Dr. Kemp joins the system from Memphis, Tenn.-based Regional One Health, where she served as vice president of patient care services. Under her tenure, the level 1 trauma center saw a 20% reduction in harm events and maintained a 4% nurse turnover rate, according to a Sept. 4 news release.
Dr. Kemp brings more than 16 years of experience in healthcare leadership to her new role, including eight in executive-level positions.
Singing River Health System operates three hospitals and a network of outpatient clinics and specialty centers across Mississippi’s Gulf Coast region.
The post Mississippi system taps chief nurse appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Froedtert South launches partnership to boost workforce
Froedtert South and Carthage College, both based in Kenosha, Wis., have partnered to expand the health system’s workforce.
The organizations are offering fully funded certified nurse aide training and guaranteed employment for program graduates, according to a Sept. 5 joint news release.
The Duncan Family CNA Program Scholarship covers the full cost of Carthage’s monthlong CNA training. Each scholarship recipient commits to working at Froedtert Pleasant Prairie (Wis.) Hospital for at least 1,000 hours over a two-year period. Froedtert South hired 13 students from the most recent class.
Since the CNA program launched in January 2024, 182 students have completed training.
The partnership also includes a $5,000 annual scholarship for students in Carthage’s four-year bachelor of science in nursing program. Both scholarships are funded by Tom Duncan, a retired Froedtert South administrator, and Jan Duncan, who served as a speech and language therapist for more than 30 years.
Enrollment remains open for the winter CNA session beginning in January 2026.
The post Froedtert South launches partnership to boost workforce appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

What to Expect When Working for a Nurse Staffing Agency
Starting a new nursing job in metro Atlanta—or anywhere in Georgia, South Carolina, Alabama, Florida or beyond —can feel overwhelming, even when you know it’s the right move. Working for a nurse staffing agency opens the door to exciting opportunities like travel nursing jobs, per diem nursing positions, and flexible contract nursing assignments, but for many nurses, the process can seem mysterious.
Here’s what to expect and how to prepare so you can start your journey with confidence.
Whether you’re interested in contract nursing jobs, per diem, or full-time placements, the process of joining a nursing agency is straightforward.
- Explore Open Positions
Start by browsing our current healthcare staffing opportunities, including travel nurse contracts and per diem RN jobs across Georgia. You can view all available positions [here]. - Apply and Submit Your Resume
Once you find a role that matches your skills and interests—like emergency department nursing jobs, radiology technologist positions, or ICU contract assignments—submit your application. Our recruitment team reviews your resume to ensure a great fit. - Complete Skills Assessments
After initial screening, you’ll complete online assessments to evaluate your clinical expertise. - Interview and Client Screening
Next, you’ll interview with a recruiter from Staff Relief. Some positions require additional interviews with the hiring facility, especially for rapid response nursing or specialized roles.
The good news? This process typically moves fast—most candidates receive an offer within 9 days of applying.
More Earning Potential
One of the biggest reasons nurses choose agencies like Staff Relief is the pay. Per diem and contract nursing jobs can pay up to 50% more than traditional staff positions. You’ll also have access to the same premium assignments available with leading partners such as Aya Healthcare, AMN Healthcare, and Medical Solutions.
More Flexibility and Freedom
When you work with a nurse staffing agency, you decide when and where you want to work. Whether you prefer travel nurse assignments across the Southeast or local shifts around Georgia, you have control over your schedule.
More Responsibility and Professional Growth
As a contract or per diem nurse, you’ll take on additional responsibilities like tracking time and attendance. While this requires organization, it also builds valuable skills in accountability and independence.
More Variety and Travel
You won’t be tied to one facility. With travel nursing jobs, you can explore new cities, gain diverse experience, and enjoy housing assistance coordinated through agency partnerships.
More Security and Benefits
Even though you’re working flexible assignments, you still receive comprehensive benefits. Staff Relief provides health insurance and other perks so you can feel secure in your role.
If you’re a nurse who thrives in a fast-paced, dynamic environment and values more freedom, higher pay, and a variety of assignments, agency work could be your ideal career path.
Staff Relief partners with major healthcare staffing leaders to offer you access to top contracts and exclusive opportunities. Ready to get started?Contact Staff Relief today to learn more about our per diem nursing jobs, travel nurse assignments, and allied health contracts in Georgia. Let the best nurse staffing agency in Geogia find the perfect fit for your skills and goals.

Travel Nurse Pay in Georgia – Updated
Working as a contract nurse or per diem nurse in Georgia opens doors to flexibility, premium pay rates, and the chance to grow your experience across different healthcare settings. Whether you’re comparing travel nursing jobs, exploring remote RN jobs, or looking into per diem nursing positions, it’s essential to understand the factors that impact your earnings so you can make informed decisions and advocate for fair compensation.
Below, you’ll find everything you need to know about travel nurse pay in Georgia, average hourly rates, and how variables like specialty and location shape your paycheck.
When you partner with a nursing staffing agency or medical staffing agency, you’ll likely choose between contract assignments and per diem shifts:
- Contract Nursing Jobs: You’ll sign an agreement to work a set number of hours over a defined period, such as 8–13 weeks. Many contract nursing jobs offer guaranteed hours, premium rates for urgent needs, and stipends for housing and travel.
- Per Diem Nursing Jobs: “Per diem” means “per day.” These shifts are typically scheduled a week at a time, providing maximum flexibility for nurses who prefer short-term or occasional work. Per diem nurses often receive higher hourly rates to compensate for the lack of long-term commitment and benefits.
Whether you’re drawn to the stability of a contract or the freedom of per diem nursing shifts, you’ll be paid hourly, with rates that can fluctuate based on demand and specialty.
No two assignments are exactly the same. Here are the main factors that determine what you’ll earn as a travel nurse or per diem nurse in Georgia:
1. Location
Urban areas like Metro Atlanta and Savannah typically offer higher compensation compared to rural hospitals and clinics. Travel nurse jobs in Atlanta often pay a premium to attract experienced RNs to high-volume facilities.
2. Specialty
Your area of expertise makes a significant difference. Roles in the emergency department, ICU, operating room, and critical care nursing often command the highest hourly rates. Specialized skills like medical imaging, radiology technologist jobs, or dialysis RN contracts can further boost your earning potential.
3. Experience and Credentials
More years in the field—and specialty certifications—qualify you for higher-paying assignments. Rapid response nursing jobs and crisis response contracts also tend to pay more due to urgency and complexity.
4. Facility Type
Pay can vary depending on whether you’re working in an acute care hospital, skilled nursing facility, outpatient clinic, or rehab center. Some settings offer incentives like retention bonuses or completion bonuses.
5. Travel Requirements
Assignments requiring you to commute 50+ miles often include additional stipends or elevated pay rates to offset costs and time away from home.
While rates fluctuate weekly based on demand and season, here’s what you can generally expect in Georgia:
- General RN: $40–$46 per hour
- General RN (Metro Atlanta): $48–$55 per hour
- Specialty RN (ICU, OR, ED): $55–$75+ per hour, depending on urgency and shortage areas
- Licensed Practical Nurse (LPN): $25–$40 per hour
- LPN (Metro Atlanta): $30–$45 per hour
These figures often include travel stipends and housing allowances. For high-paying travel nursing companies or crisis response contracts, rates can exceed $80 per hour in peak demand.
Some agencies bundle housing and travel reimbursements, while others pay a higher hourly rate without stipends.
Before accepting a contract, review details carefully:
- Hourly base pay
- Housing allowance or provided housing
- Meal and incidentals stipends
- Travel reimbursements
- Completion and referral bonuses
If you’re unsure whether a pay package is competitive, compare it with similar contract nursing jobs.
- Get certified in high-demand specialties like emergency room nurse staffing, ICU nursing, or radiology technologist work.
- Consider rapid response nursing or ICU contract nurse positions for premium rates.
- Pick up flexible options like weekend nursing contracts or extra per diem shifts to maximize income.
- Keep your licenses and certifications current to qualify for the broadest range of assignments.
If you’re ready to explore per diem nursing jobs in Georgia or secure a travel nurse contract with competitive pay and benefits, Staff Relief, Inc. is here to help.
Contact us today to learn more about available contracts and start earning what you deserve.

The Ultimate Guide to Per Diem and Travel Nursing Jobs in the Southeast
If you’re an RN exploring your next career move, you’re not alone. Demand for per diem nursing jobs, travel nursing assignments, and contract nursing positions continues to rise across the Southeast—including Georgia, Florida, Alabama, and North Carolina.
At Staff Relief, we specialize in connecting nurses with flexible, rewarding opportunities at top healthcare facilities. Whether you’re searching for remote RN jobs, weekend nursing contracts, or emergency department nursing careers, this guide will help you understand your options and how to get started.
Per diem nursing offers unmatched flexibility. You can pick up shifts on your schedule—ideal for maintaining work-life balance or supplementing your income. Contract nursing jobs, meanwhile, provide stability for a set duration, often with higher pay rates and benefits.
- Flexible nursing shifts that fit your lifestyle
- The ability to work in acute care, skilled nursing facilities, or inpatient care units
- Opportunities to gain experience in critical care, emergency departments, or medical imaging
- Access to rapid response nursing jobs and crisis response travel nurse contracts that offer premium compensation
- The chance to build your resume with respected employers like Aya Healthcare, AMN Healthcare, and Medical Solutions
Many nurses are drawn to the Southeast for its competitive pay and growing healthcare networks. Here are some popular areas to consider:
- Georgia: From Atlanta to Savannah, per diem nursing jobs in Georgia are in high demand. If you’re wondering how to become a travel nurse in Georgia, Staff Relief can guide you through licensing and onboarding.
- Florida: Coastal communities and urban hospitals alike need RNs for contract nursing jobs in Florida, especially in ICU, OR, and emergency room nurse staffing.
- North Carolina: Explore travel nurse assignments in North Carolina, including rapid response nursing and critical care contracts.
- Alabama: More facilities are offering remote RN jobs in Alabama and local contracts to address staffing shortages.
You have more options than ever to search for your next role. While many nurses and allied health professionals look on popular platforms like Indeed and Vivian, applying through multiple agencies can be time-consuming and repetitive.
Staff Relief makes it simpler. Our job board and mobile app put thousands of opportunities in one place. You can browse, compare, and apply to positions without juggling multiple applications or credentialing processes.
Here are a few resources to explore:
- Staff Relief Job Board & Mobile App – Your all-in-one hub for per diem, travel, and contract jobs, with a streamlined application process and dedicated support.
- Indeed – Search a wide range of listings for nursing and allied health jobs.
- Vivian Healthcare Jobs – Compare pay packages and contract details across agencies.
Ready to save time and find your next assignment faster? Start with Staff Relief’s platform for the most efficient experience
Aya Healthcare, AMN Healthcare, and Medical Solutions are some of the most respected companies in the industry offering extensive travel nursing, per diem, and rapid response assignments nationwide. As a partner, Staff Relief has access to some of the same contracts and exclusive opportunities available through Aya, AMN, and Medical Solutions. You can explore top-paying positions without having to apply separately to multiple agencies. Whether you’re interested in Aya Healthcare contracts, AMN Healthcare rapid response nursing jobs, or Medical Solutions travel nurse assignments, our team can help you compare options and secure the role that fits you best.
Choosing the right nursing agency is essential. Whether you’re evaluating Aya Healthcare reviews, AMN Healthcare pay packages, or Medical Solutions job openings, here are factors to consider:
- Transparent pay packages and benefits
- Support with licensing and credentialing
- Access to crisis response contracts and rapid response nursing jobs
- A reputation for placing nurses in top paying travel nursing companies
- Ongoing support and career development resources
Staff Relief partners with major systems and local facilities to deliver healthcare staffing solutions that prioritize both the nurse and the patient.
If you’re searching for flexible RN shifts, contract nursing jobs, or remote nursing positions, we’re here to help. From emergency department nurse jobs to radiology technologist staffing, our team can match you with assignments that fit your goals.
Connect with Staff Relief today to get personalized recommendations, compare contracts, and start your next chapter with confidence.

Pros and Cons for Working for a Nurse Staffing Agency
In today’s fast-changing healthcare landscape, more nurses are exploring flexible career paths, including per diem nursing jobs, travel nursing contracts, and remote RN positions. Whether you’re a seasoned nurse searching for higher pay or a new grad eager to explore diverse settings, working with a nursing staffing agency can be a rewarding option. But like any career move, it’s important to weigh the benefits and challenges before deciding.
Below, we break down the main pros and cons of working with a medical staffing agency in Georgia and across the Southeast, so you can make the best choice for your lifestyle and goals.
One of the top reasons nurses choose per diem nursing positions or local contract nursing is the freedom to control their schedule. Unlike full-time hospital roles, contract assignments and per diem shifts let you decide when and where you work. This flexibility is ideal if you have family commitments, are pursuing further education, or simply want more autonomy in your day-to-day life.
Agencies like Aya Healthcare, AMN Healthcare, and Medical Solutions often post weekend nursing contracts, PRN RN positions, and rapid response nursing jobs you can pick up on your terms.
If maximizing your earnings is a priority, you’ll be glad to know that contract nursing jobs and per diem shifts typically pay higher hourly rates compared to permanent staff roles. These assignments often include stipends for meals, lodging, and travel—especially for travel nurse jobs in Atlanta, Savannah, and the Florida Panhandle. Many nurses find that with smart budgeting; they can work fewer shifts while maintaining or even increasing their income.
Plus, expenses related to travel nursing—like transportation and temporary housing—are often tax-deductible, creating additional financial benefits.
For nurses who thrive on change, working with a healthcare staffing agency provides a steady stream of new experiences. You’ll build your skills across different units, such as emergency departments, inpatient care, and even specialized areas like radiology technologist jobs or diagnostic imaging. This variety not only helps you stay engaged but also makes your resume stand out to future employers.
While flexible shifts are a major perk, it’s important to recognize that per diem nursing jobs don’t always guarantee steady hours. You may have weeks packed with back-to-back assignments, followed by slower periods. In some cases, last-minute schedule changes can impact your plans. If you prefer consistency, consider long-term contract nursing jobs, which often range from 6 to 17 weeks and offer more predictable schedules.
Contract and travel nurses frequently rotate among facilities, from skilled nursing facilities to acute care hospitals. Each location has its own protocols, electronic health records, and workplace culture. While you’ll eventually become comfortable in new settings, the learning curve can feel steep, especially when starting out. Nurses who value long-term relationships with coworkers and patients may find this aspect challenging.
If you’re adaptable, resourceful, and excited by the idea of working in diverse environments, you’re well-positioned to succeed. Many RNs say contract work rekindled their passion for patient care, exposed them to innovative treatments, and expanded their professional networks.
Whether you’re interested in remote nursing jobs in Alabama, ICU travel nurse assignments in Georgia, or emergency room contracts throughout the Southeast, there’s no shortage of options through reputable agencies like Aya Healthcare, AMN Healthcare, and Medical Solutions.
Ready to explore per diem nursing positions or contract opportunities? Here are a few steps to begin:
- Research Top Agencies: Read reviews and compare pay packages, benefits, and housing support.
- Set Your Priorities: Decide what matters most—schedule flexibility, pay rate, location, or specialty.
- Prepare Documentation: Update your licenses, certifications, and resume.
- Search Nursing Jobs Online: Use platforms like Indeed, Vivian Health, and agency job boards to find assignments that match your goals.
- Ask Questions: Speak with recruiters to understand expectations, cancellation policies, and support resources.
Working with a nursing staffing agency can be an empowering way to build a flexible, well-paid, and fulfilling career. If you’re considering making a change, take time to explore your options and connect with agencies committed to supporting nurses at every step.
Explore current per diem and contract openings with Staff Relief today and discover how flexible nursing can work for you.

How to Get a High Paying Contract Nursing Job
Contract nursing offers the chance to do meaningful work, gain diverse experience, and earn competitive pay. Whether you’re pursuing contract nursing jobs, per diem nursing positions, or rapid response assignments, the key to maximizing your income is preparation and strategy.
If you’re ready to secure a high-paying contract nursing job, use these proven tips to set yourself apart and negotiate pay that reflects your expertise.
Your resume is your first impression. A clear, polished resume highlights your skills, certifications, and professional accomplishments, and it determines whether you’ll be invited to interview.
Include:
- Your nursing specialties (such as ICU, emergency department, or medical imaging)
- Certifications (like ACLS, BLS, or specialty credentials)
- Details about your experience in different care settings, such as inpatient care, skilled nursing facilities, or acute care staffing
It’s normal to have employment gaps but be ready to confidently explain them during interviews. A well-organized resume positions you as a serious professional ready for high-paying nursing contracts.
Keeping your credentials updated makes you a more attractive candidate and can improve your earning potential.
Make sure to:
- Renew essential licenses and certifications promptly.
- Consider adding specialty certifications that are in demand for travel nursing jobs and contract assignments.
- Stay up to date with immunizations required by hospitals and clinics. Being ready with all documentation can speed up onboarding and help you access crisis response nursing jobs or urgent needs contracts that often pay premium rates.
The more prepared you are, the easier it is for a nurse staffing agency or recruiter to match you with higher-paying positions.
Professional references can be the deciding factor in landing a top-paying assignment.
Employers and recruiters rely on references to verify your:
- Clinical skills
- Professionalism
- Reliability
Choose references who can confidently speak to your work ethic and performance. Positive recommendations can open the door to flexible nursing shifts, per diem contracts, and specialized roles that pay more.
Flexibility is often rewarded in the world of contract nursing.
Consider these options to boost your pay:
- Accepting night shifts or weekends, which usually come with higher hourly rates.
- Taking assignments in locations experiencing shortages, such as rural facilities or emergency department nursing jobs.
- Being open to rapid response contracts or crisis response assignments, which often offer premium compensation.
When you demonstrate a willingness to adapt, you make yourself more valuable to medical staffing agencies and healthcare employers.
In contract nursing, your reputation follows you from one facility to the next. A strong track record makes it easier to secure higher-paying contracts and preferred assignments.
Tips for maintaining a great reputation:
- Be punctual and dependable.
- Communicate clearly with staffing agencies and supervisors.
- Go the extra mile to provide excellent patient care.
Facilities are willing to pay more to bring on nurses with proven reputations for excellence.
Being a contract nurse offers countless benefits, from career variety to premium pay. To make the most of your opportunities:
- Invest time in preparing a strong resume.
- Keep certifications and immunizations current.
- Maintain excellent references.
- Stay flexible with shifts and assignments.
- Build and protect your professional reputation.
When you combine preparation with dedication, you can consistently secure high-paying contract nursing jobs that match your skills and goals.
If you’re looking for your next opportunity, Staff Relief, Inc. is here to help. We partner with hospitals, clinics, and healthcare facilities to connect nurses with the best assignments in Georgia and beyond.
Contact us today to explore available contracts and start earning what you deserve.

How to Find the Best Nursing and Allied Health Jobs in 2025
If you’re thinking about a career change this year, you’re not alone. Thousands of nurses and allied health professionals are exploring contract nursing, per diem shifts, and even remote RN jobs to gain more flexibility, better pay, and fresh experiences.
But with so many options and so many staffing agencies—how do you know where to start?
This guide will walk you through:
✅ Why more professionals are choosing contract and per diem work
✅ How to evaluate agencies and read nursing agency reviews
✅ Where to find the best nursing jobs in 2025
✅ Tips for comparing assignments and getting hired faster
The days of sticking to one hospital job for your entire career are long gone. Today’s nurses are building more dynamic, customized careers—often combining contract assignments with per diem shifts.
The benefits of contract nursing are clear:
- Higher pay compared to permanent staff roles
- Housing and travel stipends
- Bonuses for completing assignments
- The chance to build experience in specialized areas like ICU, ER, and diagnostic imaging
- Flexibility to take time off between contracts
Meanwhile, per diem nursing jobs offer even more control over your schedule. You can pick up shifts when you want—whether that means extra weekends or just a few days a month.
If you’re drawn to this flexibility, you’re in good company. Contract and per diem work have become the fastest-growing segments of healthcare employment.
Once you decide to make a change, your next step is choosing a partner to help you find assignments. But not all agencies are the same.
Before you commit, take time to read nursing agency reviews. Here’s what to look for:
- Transparency in pay packages and benefits
- Support with licensing, credentialing, and onboarding
- Access to rapid response nursing jobs and high-demand contracts
- A track record of placing candidates in the highest paying travel nursing companies
- Clear communication and responsive recruiters
At Staff Relief, we know that trust matters. As a partner of Aya Healthcare, AMN Healthcare, and Medical Solutions, we can give you access to exclusive contracts without the hassle of applying to multiple platforms.
There are dozens of websites that list healthcare jobs, but it’s easy to get overwhelmed. To save time, start with the best nursing job sites for 2025:
- Staff Relief Job Board & Mobile App – Your one-stop platform to see per diem, contract, and travel nursing jobs nationwide, including remote RN jobs and medical imaging positions.
While many agencies focus on nursing alone, allied health roles are booming, too. If you’re a technologist or imaging specialist, consider exploring:
- Radiology technologist jobs in hospitals and outpatient centers
- Diagnostic imaging careers in high-demand specialties
- Medical imaging staffing agencies that can connect you to flexible contracts
- Radiographer employment for mobile imaging services or large health systems
Staff Relief supports professionals across disciplines and can help you find medical imaging jobs near you with excellent pay and benefits.
Ready to pick up extra shifts or transition into per diem work full-time? Here are tips to get per diem nursing jobs faster:
- Keep your credentials and health records updated.
- Sign up with an agency that has real-time job listings.
- Use the Staff Relief app to get instant alerts when new shifts are posted.
- Be proactive—per diem openings often fill quickly.
Whether you want the best remote nursing jobs for RNs, the stability of contract work, or the variety of per diem assignments, 2025 is the perfect year to take control of your career.
At Staff Relief, we make it easy to:
- Access the highest paying travel nursing companies
- Compare contracts side by side
- Read verified nursing agency reviews
- Secure opportunities in radiology, imaging, and allied health
- Apply once and explore thousands of jobs nationwide
Connect with Staff Relief today, and let’s build your path forward together.

Everything You Need to Know About Travel Nurse Credentialing
Every hospital, clinic, and long-term care facility has its own standards for verifying a clinician’s qualifications and readiness to practice. Even if you’ve worked at a similar facility before, you can’t automatically carry over your credentials. Each assignment requires you to complete a credentialing and onboarding process to ensure patient safety and compliance with regulations.
Credentialing typically includes:
- Drug screening
- Health assessments
- Proof of licensure and certifications
- Background checks and reference verifications
- Competency exams
- Facility-specific training and onboarding
Many nurse managers or department leaders will schedule a phone or video call to review workflows, discuss expectations, and confirm you’ve completed all requirements before your start date.
Preparation is key. Keeping all your essential documents organized will save you time and stress whenever you accept a new assignment. Here’s what you’ll need to have ready:
- Copies of your professional license(s) and any specialty certifications (such as BLS, ACLS, PALS)
- Two valid forms of identification (e.g., driver’s license and passport)
- A record of your annual physical exam (valid for one year)
- TB test results (valid for one year)
- Drug screen results
- Immunization and titer records (MMR, Varicella, Hepatitis B, and others)
- Proof of flu vaccination (especially if starting in the fall or winter)
- COVID vaccination records if required by the facility
- Payroll forms and direct deposit information
- References and verified work history
- Competency test results (if applicable)
If you want to avoid delays, consider getting your TB test, physical, and immunizations updated while you’re applying for contracts. Staying current helps you move quickly when the right opportunity arises.
Most healthcare facilities require online assessments to verify your competency in your specialty. These assessments might include:
- Skills checklists
- Clinical scenario testing
- Electronic medical record (EMR) training modules
Once you pass these evaluations, you’ll typically complete one to two days of orientation to get familiar with the facility’s policies, documentation standards, and workflows. This process helps ensure you can provide safe, effective care from day one.
If you work in in-demand roles such as ER RN, PCU RN, CT Technologist, RRT, Surgical Tech, Mammo Tech, Home Health RN, or M/S RN, expect additional verifications and specialty-specific assessments. Facilities often have strict guidelines for these positions due to the complexity of care and the need for current certifications.
Staff Relief’s credentialing team can walk you through these specialty requirements step by step so you feel confident and prepared.
Large national agencies often have more rigid, self-directed credentialing processes. Working with a regional partner like Staff Relief provides you with hands-on support. Our team will:
- Help you track deadlines for documents and assessments
- Coordinate background checks and health screenings
- Connect you with local resources for TB testing and physicals
- Answer your questions about compliance and onboarding
This personal guidance ensures nothing falls through the cracks—and you’re always ready to step into your next assignment.
Credentialing isn’t a one-time process. Here are a few habits that can help you stay organized:
- Keep a digital folder with scanned copies of your documents
- Mark your calendar with expiration dates for your TB test, physical, and certifications
- Get your annual flu shot early if you expect to start an assignment in the fall
- Check whether your next facility requires a COVID vaccine or booster
- Keep your immunizations up to date to avoid delays
Being proactive makes you more competitive for premium travel contracts and quick-start assignments.
Navigating credentialing can feel like a lot to manage, especially if you’re juggling multiple offers. That’s why choosing the right staffing partner is so important.
Staff Relief has years of experience supporting clinicians across Georgia, Alabama, Florida, and the Carolinas. Whether you’re a first-time traveler or a seasoned professional, you’ll have a dedicated team behind you to make credentialing smooth, transparent, and stress-free.
If you’re exploring travel nursing jobs or allied health contracts in the Southeast, our team is here to help you navigate credentialing and start your next adventure with confidence. Contact Staff Relief today to learn about current opportunities and get expert support every step of the way.

Addressing Georgia’s Critical Nursing Shortage
The nursing shortage in Georgia has reached critical levels in 2025, with nearly every county—urban and rural—struggling to recruit and retain qualified healthcare professionals. This crisis isn’t just about open positions; it’s about ensuring patients receive safe, timely, and compassionate care when they need it most.
From major hospitals to long-term care facilities, healthcare organizations are urgently seeking skilled nurses, surgical techs, and allied health professionals who can step into high-demand roles and make an impact.
Several factors continue to drive Georgia’s nursing shortage:
- Rising demand for healthcare services: The state’s aging population and expanded access to care have increased the need for RNs, LPNs, and allied health professionals.
- Burnout and workforce attrition: The lingering effects of the pandemic, combined with long hours and emotional stress, are pushing many clinicians to reduce hours, retire early, or leave the field altogether.
- Education and training bottlenecks: Limited capacity in nursing schools and faculty shortages continue to constrain the pipeline of new graduates.
- Rural disparities: Non-metro counties face even steeper challenges recruiting clinicians, leaving communities with limited access to primary and specialty care.
As a result, many hospitals and clinics are leaning heavily on travel contracts, per diem staff, and flexible assignments to keep up with patient needs.
The staffing shortage has ripple effects throughout Georgia’s healthcare infrastructure:
- Hospitals are relying on travel clinicians—especially in specialties like ER RNs, PCU RNs, and Surgical Techs—to fill critical gaps.
- Skilled professionals such as CT Technologists, RRTs, Mammo Techs, and Home Health RNs remain in high demand, driving up competition and pay rates.
- Burnout among the remaining workforce leads to higher turnover, further deepening shortages.
- Patients experience longer wait times, delayed procedures, and uneven access to care, particularly in rural and underserved areas.
The result is a cycle of strain that requires strategic intervention.
While the challenges are significant, Georgia’s healthcare leaders are adopting innovative strategies to rebuild the workforce and improve retention:
1. Expanding Educational Pathways
- New state investments in nursing schools and allied health programs are increasing enrollment capacity.
- Fast-track bridge programs are helping LPNs and paramedics advance to RN licensure more efficiently.
2. Financial Incentives and Career Support
- Loan repayment and tuition reimbursement programs are helping attract graduates to high-need areas.
- Retention bonuses and flexible scheduling are becoming standard in many contracts.
3. Investing in Burnout Prevention
- More facilities are offering mental health resources and dedicated time off to protect clinician well-being.
- AI-supported scheduling tools are helping balance workloads and reduce last-minute staffing gaps.
4. Expanding Telehealth and Remote Care
- Telehealth adoption continues to grow in 2025, allowing clinicians to manage certain care remotely.
- Hybrid care models are easing staffing pressures in rural counties.
5. Embracing Flexible Staffing Models
- Short-term contracts, rapid response assignments, and per diem shifts give clinicians more options to work on their terms.
- Many clinicians are finding that a mix of travel and local assignments offers better work-life balance.
Healthcare facilities across Georgia and the Southeast increasingly rely on experienced staffing agencies to fill urgent and specialized positions. When you partner with a staffing agency that understands the local landscape, you gain access to:
- Skilled clinicians ready to step into critical roles—whether it’s an ER RN, PCU RN, CT Tech, RRT, or Mammo Tech.
- Flexible workforce solutions to manage seasonal demand and unexpected absences.
- Streamlined credentialing and onboarding to get staff in place faster.
- Insights into regional pay trends and incentives.
Staff Relief, for example, has built long-standing partnerships with hospitals, outpatient centers, and home health agencies across Georgia, Florida, Alabama, and the Carolinas, making it easier to adapt to changing needs.
If you’re considering your next step in nursing or allied health, there has never been a better time to explore opportunities in Georgia. Clinicians with experience in specialties like emergency nursing, progressive care, surgical services, medical-surgical units, and diagnostic imaging are in especially high demand.
With flexible contracts, competitive compensation, and support from experienced recruiters, you can build a career that aligns with your goals and helps meet a pressing need.
Georgia’s nursing shortage is a complex, urgent issue—but progress is happening. By investing in education, supporting the workforce, embracing innovation, and building strong partnerships, the state is working to rebuild its healthcare capacity.
If you’re a healthcare professional ready to make an impact—or a facility seeking experienced clinicians—this is the moment to take action.
Ready to explore the latest opportunities or learn how strategic staffing can help? Contact Staff Relief today and join the effort to strengthen Georgia’s healthcare system for everyone.

10 Tips for Travel Nurses
Travel healthcare is more than just an assignment, it’s an opportunity to expand your skills, explore new places, and make an impact where it matters most. Whether you’re a seasoned travel nurse, a respiratory therapist, or a surgical technologist, knowing how to navigate contracts and maximize your experience is key to success.
Here are ten essential tips every travel healthcare professional should keep in mind.
1. The Demand for Your Skills is Higher Than Ever
In 2025, healthcare facilities across the Southeast in Georgia, Alabama, Florida, and the Carolinas are experiencing critical staffing shortages. High-demand specialties like CT Tech, ER RN, Surgical Tech, RRT, PCU RN, Mammo Tech, Home Health RN, and M/S RN are seeing unprecedented opportunities.
Travel nursing jobs and allied health contracts are plentiful, but competition can be fierce for the best assignments. Staying flexible and proactive will help you secure roles that match your expertise and goals.
2. Understand Tax Implications of Travel Assignments
Many clinicians overlook how travel pay affects their taxes. Housing stipends, travel reimbursements, and per diem allowances can all impact your taxable income. It’s wise to consult a tax professional who understands healthcare contracts to ensure you’re planning ahead and taking advantage of eligible deductions.
3. Credentialing and Compliance Take Preparation
Every state has different licensure and credentialing requirements. Georgia, Florida, and the Carolinas all have their own rules around background checks and health records.
Be prepared to provide:
- A TB test (valid for 1 year)
- A current physical exam (valid for 1 year)
- Titers and immunization records
- A background check
- A drug screen
It’s smart to get your TB test, physical, and immunizations done while you’re applying so you’re ready as soon as you receive an offer. Keep your immunizations updated, including your flu shot in the fall and COVID vaccinations where required. This will prevent delays when it’s time to start your contract.
Working with a healthcare staffing agency like Staff Relief ensures you’ll have help coordinating these documents and understanding what’s required for each facility.
4. Housing Options Vary by Assignment
Some contracts include housing stipends, while others offer pre-arranged accommodations. It’s critical to understand:
- What your stipend covers
- Whether you’ll be responsible for utilities, deposits, or furniture
- How your housing affects your taxable income
If you prefer to find your own place, Staff Relief can help source local housing options and connect you to reputable providers in your assignment area.
5. Your Reputation Will Follow You
Healthcare facilities often work with the same staffing partners across regions. Showing up on time, being adaptable, and maintaining professionalism will build your reputation and make it easier to secure future assignments.
Positive references can help you access competitive roles in specialties like ER, PCU, and surgical services.
6. Flexibility is Your Superpower
The most successful travel clinicians are those who can pivot quickly. Being open to night shifts, rural contracts, or high-demand specialties often results in higher pay and priority placement.
If you’re willing to work in critical areas, you’ll find more opportunities and stronger negotiating power.
7. Pay Packages Can Be Complex
Your compensation may include:
- Base hourly pay
- Travel stipends
- Housing allowances
- Completion bonuses
Make sure you understand the full picture, not just the hourly rate. This is essential so that you can budget effectively. A reputable healthcare staffing agency will always be transparent about how your pay is structured.
8. Burnout is Real so Take Care of Yourself
Long shifts and adapting to new teams can be stressful. Protect your mental health by:
- Scheduling regular downtime between contracts
- Accessing telehealth services offered through Staff Relief for confidential support
- Staying connected to your support network
Prioritizing self-care helps you bring your best to every assignment.
9. Smaller Agencies Can Get You Into Hidden-Gem Facilities
Smaller agencies can often place clinicians into smaller community hospitals and rural facilities where patient loads are more manageable, but pay rates remain competitive. These positions are available through Staff Relief in Georgia, Alabama, and South Carolina. Only Staff Relief and one or two other boutique firms serve these facilities, so you won’t find these assignments through large national agencies like Aya, Medical Solutions, or AMN Healthcare.
10. Choosing the Right Staffing Partner Matters
Your agency isn’t just your employer, it’s your advocate. The best healthcare staffing partners:
- Have deep relationships with respected hospitals and clinics
- Offer personal support before, during, and after your assignment
Staff Relief has decades of experience supporting clinicians across the Southeast, combining local expertise with a commitment to transparency and respect.
If you’re exploring travel nursing jobs or allied health contracts in Georgia and beyond, now is the time to take the next step. With the right support and preparation, your travel career can be rewarding, sustainable, and full of growth. Contact Staff Relief today to learn about current opportunities and find the right fit for your skills and goals.

How to Choosing the Right Medical Staffing Agency
Choosing the right medical staffing agency isn’t just about finding a job—it’s about building a career with the support, transparency, and opportunities you deserve. Whether you’re looking for contract nursing jobs, travel assignments, or allied health positions, partnering with the right agency helps you feel confident every step of the way.
As a regional leader in the Southeast serving Georgia, the Carolinas, Alabama, and Florida, Staff Relief specializes in high-demand roles and offers deep local expertise to help you succeed.
Here are six essential tips to guide your search for a medical staffing agency you can trust.
1. Work with a Partner Who Knows the Region
When you’re working in states across the Southeast, you want an agency that understands the unique dynamics of each market. Regional experience matters because:
- Different states have varying credentialing and compliance requirements
- Compensation rates shift between urban and rural facilities
- Each area has its own demand for specialties, including CT Tech, ER RN, Surgical Tech, RRT, PCU RN, Mammo Tech, Home Health RN, and M/S RN assignments
Staff Relief’s recruiters have years of experience placing clinicians throughout Georgia, Alabama, Florida, and the Carolinas. This local knowledge ensures you’re matched with facilities that fit your skills, preferences, and professional goals.
2. Evaluate the Agency’s Reputation and Track Record
A medical staffing agency’s history is a strong indicator of what you can expect. Take time to:
- Explore the agency’s website to see testimonials from nurses, surgical techs, respiratory therapists, and imaging professionals
- Review social media and online platforms for authentic feedback
- Look for examples of long-term partnerships with respected hospitals, outpatient centers, and home health organizations across the Southeast
When you choose an agency that has established relationships and a reputation for consistency, you gain peace of mind that your career is in capable hands.
3. Expect Clear Communication About Pay
Transparency around compensation is crucial. Medical staffing pay packages can include:
- Base hourly rates
- Travel and housing stipends
- Bonuses
Without clarity, it’s easy to feel uncertain about what you’ll actually earn. A trustworthy agency will explain exactly how your pay is structured, whether you’re taking on a rapid response ER RN contract, a CT Tech travel assignment, or a Mammo Tech position.
At Staff Relief, we prioritize transparent communication so you can make informed decisions and feel confident in your earnings.
4. Assess Benefits and Support
The right staffing agency offers more than just placements. Look for a partner that provides:
- Credentialing and compliance support
- Guidance navigating state requirements if you’re crossing from Georgia into Florida, Alabama, or the Carolinas
- Professional development resources and scheduling assistance
Staff Relief is committed to offering comprehensive support, so you can focus on providing excellent patient care, whether you’re working in PCU, ER, surgical services, or home health.
5. Look for Joint Commission Certification
When an agency is Health Care Staffing certified by The Joint Commission, it demonstrates a commitment to quality and safety. Certification means the agency has:
- Passed rigorous evaluations of processes, compliance, and clinical standards
- Demonstrated consistent excellence in recruiting and supporting healthcare professionals
This recognition shows you’re working with an organization that meets the highest standards. This is something you can expect when partnering with Staff Relief.
6. Find the Right Fit for Your Working Style
Every agency operates differently. Some rely on automated platforms and self-service tools, while others offer more personal, one-on-one support.
Ask yourself:
- Do you want direct access to a recruiter who knows you by name?
- Would you rather work with an agency that manages credentialing and logistics for you?
- Do you prefer a more high-touch approach over an impersonal online process?
Choosing an agency that fits your communication style and values makes every assignment more rewarding. Staff Relief’s approach is personal, responsive, and focused on helping you thrive in the role that’s right for you.
When you work in specialized, high-demand fields like CT Tech, ER RN, Surgical Tech, RRT, Mammo Tech, PCU RN, Home Health RN, and M/S RN. You deserve a staffing partner who understands your expertise and advocates for your success.
The right agency combines:
- Regional knowledge of healthcare employers throughout Georgia, Alabama, Florida, and the Carolinas
- Transparent, competitive pay structures
- Robust support and credentialing assistance
- A proven reputation with hospitals and clinics across the Southeast
- Certification that demonstrates credibility
- A commitment to personal service and professional respect
With the right support you’re not just taking a job, you’re building a sustainable career.
If you’re exploring your next contract or travel assignment in the Southeast, Staff Relief is here to help. Our partnerships with respected healthcare facilities and our experience placing clinicians in high-demand specialties mean you can feel confident you’re making the best move for your future.
Contact us today to learn more about available positions and start your search with a staffing agency that puts you first.

The Cost of Nurse Turnover: A Breakdown
Poor nurse retention is a major issue for healthcare facilities, with the national registered nurse (RN) turnover rate standing at nearly 20%. According to the 2024 NSI National Healthcare Retention and RN Staffing Report, the average cost of nurse turnover is estimated to be $56,300 per every RN who leaves their job. For the average hospital, this can equate to roughly $3.9 to $5.8 million in losses per year.
Beyond the financial impacts, high turnover can also have rippling effects on company culture and patient care. In this article, we’ll break down all the costs of nurse turnover and outline strategies that can help you mitigate this issue at your facility.
Nurse turnover occurs when nursing professionals leave their jobs or the profession altogether. This can include instances in which staff are involuntarily terminated from their positions, enter retirement, or choose to leave their roles for other reasons. Some of the most common reasons why nursing professionals willingly leave their jobs include burnout, feeling underappreciated, and a lack of peer support.
Before we break down the cost of nursing turnover, it’s important to note that national nurse turnover and cost estimates often only account for RNs. While it’s difficult to estimate a turnover rate that is representative of all levels of nursing, let’s take a look at how turnover rates and costs have been reported for other types of roles:
- The cost of nurse practitioner turnover is estimated to be $85,832 to $114,919 per episode, with the average turnover rate standing at roughly 10%.
- The cost of nurse managerturnover is estimated to be between $132,00 to $228,000 per episode, with some hospitals reporting that 50% of their nurse leaders intend to leave their jobs within 5 years.
- The indirect costs of replacing one certified nursing assistant (CNA) can range from $3,000 to $6,000, with turnover rates averaging as high as 50% in nursing homes alone.
From these statistics, it’s clear that turnover costs can add up quickly if nursing professionals keep leaving their positions. But how exactly does turnover amount to millions of dollars per year? Here’s a rundown of what can contribute to both the economic and non-economic costs.
There are several ways in which frequent turnover can lead to increased operational costs for facilities. We’ll review and summarize these costs below.
Costs of Vacancies
When a nurse leaves their position, facilities must spend excess money to compensate for vacancies and understaffing. This includes the costs of advertising the opening, hiring temporary staff, and paying existing staff for overtime. Facilities may even need to close beds and defer patients, which leads to diminishing returns.
Several studies have found that these factors combined can contribute to significant losses, accounting for anywhere between 44% to 83% of turnover costs. These costs also continue to rise the longer a position stays open.
Costs of Training
Each time a facility hires a new nurse, additional resources must be spent for onboarding and training. Research has suggested that training can account for roughly 7% to 9% of turnover costs, as preceptors are often given temporary salary raises to orient new nurses.
Facilities that invest in new nurse residency programs are also estimated to incur an additional training cost of roughly $2,041 per resident. Residency programs are often used as a strategy to improve new nurse retention. But if turnover remains high for other reasons, these programs can have a lower return on investment.
Costs of Productivity Loss
Studies have also shown that initial reductions in productivity can contribute to a large proportion of losses, accounting for roughly 45% to 88% of turnover costs. This is because facilities are essentially paying two nurses to do the work of one during training periods — with some preceptorships lasting months at a time.
Additionally, there can be variations in skill level when facilities use a mix of temporary staff. This means that managers may need to spend more time overseeing care, which also contributes to reduced productivity at the leadership level.
High turnover can also impact the overall workflow and culture at a facility. These non-economic costs are important to consider since they can, conversely, lead to more turnover and create a cyclical issue over time.
Poor Teamwork
High turnover means that the entire nursing team must frequently adapt to new personalities and workstyles. Studies have shown that this can worsen communication and collaboration, impacting the overall cohesiveness of the unit. This can also make it more difficult to retain new hires, since teams may come across as unsupportive.
Lower Quality of Care
When existing staff take on increased workloads to compensate for gaps in staffing, quality of care can go down. Some studies have even shown that high turnover can significantly increase the rate of medical errors, mortality, pressure ulcers, and length of stay.
Reduced Employee Morale
The fragmented communication and increased stress resulting from high turnover can also lower staff morale. This may contribute to burnout, which can cause even more nurses to leave their jobs if staff retention and job satisfaction aren’t made a priority.
While there are many different causes of nurse turnover, studies have shown that nurses are four times more likely to voluntarily leave their positions than to get involuntarily terminated. This means that comprehensive measures at the institutional level are needed to retain staff and keep them satisfied in their roles.
Fundamentally, it’s important to engage your staff in conversations and identify the root causes of turnover at your facility. From there, you can apply more meaningful solutions that help your staff feel supported. This may include:
- Using sustainable staffing alternatives that allow for manageable workloads.
- Empowering nurses by giving them more control over their schedules and work.
- Creating a healthy work environment to prevent staff burnout.
- Providing transparent, consistent, and objective leadership.
The cost of nurse turnover can impact the operations, care quality, and culture at your facility. Need solutions that will stabilize your workforce in the long run? Get dozens of free, expert-written facility management tips and insights delivered straight to your inbox.
https://www.intelycare.com/facilities/resources/the-cost-of-nurse-turnover-a-breakdown/
KPMG’s 2017 U.S. Hospital Nursing: Labor Costs Study
This study identifies several trends and benchmarks in relation to hospital nursing labor costs in the United States. Some of the key findings are summarized below. When all costs are considered, traveling nurses appear to cost less than permanent nurses on an hourly basis. Cost data provided by hospitals indicates that the hourly, all-in cost for a full-time, permanent nurse is approximately $89. This hourly cost is higher than traveling nurses that cost approximately $83 per hour. Key costs that are after captured in this all-in measure are overtime pay, paid time off, retirement, insurance, recruiting, and payroll taxes – and these costs vary by nurse type. Additionally, the survey finds a quantifiable “hidden” cost associated with permanent nurses that is the result of non-productive labor hours, and an unquantified “hidden” cost associated with attrition and time required to fill a permanent direct care registered nurse position. Respondents to the survey indicated that traveling nurses are widely used today, representing approximately 11 % of respondent’s nursing staffs. Also, these hospitals indicated their use of traveling nurses will likely continue to grow in the future. Primary factors for this upward trend are local nursing shortages and facility growth. In all, traveling nurses appear to be a cost effective source of labor tor hospitals, and hospitals are forecasting higher usage of these nurses in the future.

2025 NSI National Health Care Retention & RN Staffing Report
With people living longer, the subsequent rise in chronic conditions and the fact that all Baby Boomers will reach retirement age by 2030, recruiting and retaining quality staff will continue to be a top healthcare issue for years to come. Last year, hospitals increased staff by adding ~304,000 employees, a 5.4% add rate. Of this, ~98,000 RNs were hired which represents a 5.6% RN add rate.
Hospital and RN turnover continue to fall but both remain slightly elevated. Nationally, the hospital turnover rate stands at 18.3%, a 2.4% decrease from CY23, and RN turnover is recorded at 16.4%, a 2.0% decrease. Registered Nurses working in pediatrics, women’s health, and surgical services reported the lowest turnover rate, while nurses working in behavior health, step down and emergency services experienced the highest.
The cost of turnover can have a profound impact on diminishing hospital margins and needs to be managed. According to the survey, the average cost of turnover for a bedside RN is $61,110, an 8.6% increase, resulting in the average hospital losing between $3.9m – $5.7m. Each percent change in RN turnover will cost/save the average hospital an additional $289,000/yr.
The RN vacancy rate also remains elevated at 9.6% nationally. While 0.3% lower than last year, over forty percent (41.8%) reported a vacancy rate of ten percent or more. The RN Recruitment Difficulty Index decreased three (3) days to an average of 83 days. In essence, it takes approximately 3 months to recruit an experienced RN, with step down and med/surg presenting the greatest challenges. Feeling financial stress, hospitals will continue to focus on controlling the high cost of labor with contract labor being a top strategy to navigate a staffing shortage. The greatest potential to offset margin compression is in the top budget line item (labor expense). Every RN hired saves $79,100. An NSI contract to replace 20 travel nurses could save your institution $1,582,000.

2024 Employer Health Benefits Survey
Employer-sponsored insurance covers 154 million nonelderly people. To provide a current snapshot of employer sponsored health benefits, KFF conducts an annual survey of private and non-federal public employers with three or more workers. This is the 26th Employer Health Benefits Survey (EHBS) and reflects employer-sponsored health benefits in 2024.

Hiring More Nurses Generates Revenue for Hospitals
Underfunding is driving an acute shortage of trained nurses in hospitals and care facilities in the United States. It is the worst such shortage in more than four decades. One estimate from the American Hospital Association puts the deficit north of one million. Meanwhile, a recent survey by recruitment specialist AMN Healthcare suggests that 900,000 more nurses will drop out of the workforce by 2027.
American nurses are quitting in droves, thanks to low pay and burnout as understaffing increases individual workload. This is bad news for patient outcomes. Nurses are estimated to have eight times more routine contact with patients than physicians. They shoulder the bulk of all responsibility in terms of diagnostic data collection, treatment plans, and clinical reporting. As a result, understaffing is linked to a slew of serious problems, among them increased wait times for patients in care, post-operative infections, readmission rates, and patient mortality—all of which are on the rise across the U.S.
Tackling this crisis is challenging because of how nursing services are reimbursed. Most hospitals operate a payment system where services are paid for separately. Physician services are billed as separate line items, making them a revenue generator for the hospitals that employ them. But under Medicare, nursing services are charged as part of a fixed room and board fee, meaning that hospitals charge the same fee regardless of how many nurses are employed in the patient’s care. In this model, nurses end up on the other side of hospitals’ balance sheets: a labor expense rather than a source of income.
For beleaguered administrators looking to sustain quality of care while minimizing costs (and maximizing profits), hiring and retaining nursing staff has arguably become something of a zero-sum game in the U.S.
But might the balance sheet in fact be skewed in some way? Could there be potential financial losses attached to nurse understaffing that administrators should factor into their hiring and remuneration decisions?
Research by Goizueta Professors Diwas KC and Donald Lee, as well as recent Goizueta PhD graduates Hao Ding 24PhD (Auburn University) and Sokol Tushe 23PhD (Muma College of Business), would suggest there are. Their new peer-reviewed publication* finds that increasing a single nurse’s workload by just one patient creates a 17% service slowdown for all other patients under that nurse’s care. Looking at the data another way, having one additional nurse on duty during the busiest shift (typically between 7am and 7pm) speeds up emergency department work and frees up capacity to treat more patients such that hospitals could be looking at a major increase in revenue. The researchers calculate that this productivity gain could equate to a net increase of $470,000 per 10,000 patient visits—and savings to the tune of $160,000 in lost earnings for the same number of patients as wait times are reduced.
“A lot of the debate around nursing in the U.S. has focused on the loss of quality in care, which is hugely important,” says Diwas KC.
But looking at the crisis through a productivity lens means we’re also able to understand the very real economic value that nurses bring too: the revenue increases that come with capacity gains.Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management
“Our findings challenge the predominant thinking around nursing as a cost,” adds Lee. “What we see is that investing in nursing staff more than pays for itself in downstream financial benefits for hospitals. It is effectively a win-win-win for patients, nurses, and healthcare providers.”
To get to these findings, the researchers analyzed a high-resolution dataset on patient flow through a large U.S. teaching hospital. They looked at the real-time workloads of physicians and nurses working in the emergency department between April 2018 and March 2019, factoring in variables such as patient demographics and severity of complaint or illness. Tracking patients from admission to triage and on to treatment, the researchers were able to tease out the impact that the number of nurses and physicians on duty had on patient throughput. Using a novel machine learning technique developed at Goizueta by Lee, they were able to identify the effect of increasing or reducing the workforce. The contrast between physicians and nursing staff is stark, says Tushe.
“When you have fewer nurses on duty, capacity and patient throughput drops by an order of magnitude—far, far more than when reducing the number of doctors. Our results show that for every additional patient the nurse is responsible for, service speed falls by 17%. That compares to just 1.4% if you add one patient to the workload of an attending physician. In other words, nurses’ impact on productivity in the emergency department is more than eight times greater.”
Adding an additional nurse to the workforce, on the other hand, increases capacity appreciably. And as more patients are treated faster, hospitals can expect a concomitant uptick in revenue, says KC.
“It’s well documented that cutting down wait time equates to more patients treated and more income. Previous research shows that reducing service time by 15 minutes per 30,000 patient visits translates to $1.4 million in extra revenue for a hospital.”
In our study, we calculate that staffing one additional nurse in the 7am to 7pm emergency department shift reduces wait time by 23 minutes, so hospitals could be looking at an increase of $2.33 million per year.Diwas KC
This far eclipses the costs associated with hiring one additional nurse, says Lee.
“According to 2022 U.S. Bureau of Labor Statistics, the average nursing salary in the U.S. is $83,000. Fringe benefits account for an additional 50% of the base salary. The total cost of adding one nurse during the 7am to 7pm shift is $310,000 (for 2.5 full-time employees). When you do the math, it is clear. The net hospital gain is $2 million for the hospital in our study. Or $470,000 per 10,000 patient visits.”
These findings should provide compelling food for thought both to healthcare administrators and U.S. policymakers. For too long, the latter have fixated on the upstream costs, without exploring the downstream benefits of nursing services, say the researchers. Their study, the first to quantify the economic value of nurses in the U.S., asks “better questions,” argues Tushe; exploiting newly available data and analytics to reveal incontrovertible financial benefits that attach to hiring—and compensating—more nurses in American hospitals.
We know that a lot of nurses are leaving the profession not just because of cuts and burnout, but also because of lower pay. We would say to administrators struggling to hire talented nurses to review current wage offers, because our analysis suggests that the economic surplus from hiring more nurses could be readily applied to retention pay rises also.Sokol Tushe 23PhD, Muma College of Business
For state-level decision makers, Lee has additional words of advice.
“In 2004, California mandated minimum nurse-to-patient ratios in hospitals. Since then, six more states have added some form of minimum ratio requirement. The evidence is that this has been beneficial to patient outcomes and nurse job satisfaction. Our research now adds an economic dimension to the list of benefits as well. Ipso facto, policymakers ought to consider wider adoption of minimum nurse-to-patient ratios.”
However, decision makers go about tackling the shortage of nurses in the U.S., they should go about it fast and soon, says KC.
“This is a healthcare crisis that is only set to become more acute in the near future. As our demographics shift and our population starts again out, demand for quality will increase. So too must the supply of care capacity. But what we are seeing is the nursing staffing situation in the U.S. moving in the opposite direction. All of this is manifesting in the emergency department. That’s where wait times are getting longer, mistakes are being made, and overworked nurses are quitting. It is creating a vicious cycle that needs to be broken.”
Goizueta faculty apply their expertise and knowledge to solving problems that society—and the world—face. Learn more about faculty research at Goizueta.
*Ding, Tushe, Kc, Lee: “Frontiers in Operations: Valuing nursing productivity in emergency departments.” Manufacturing & Service Operations Management 26:4:1323-1337 (2024)

Georgia could see the largest shortage of RNs by 2036
Staffing is one of the biggest issues facing ASCs. A 2023 survey from ORManager found that in the last 12 months, 56% of ASCs reported an increase in volume. Despite this success, 68% of facilities also reported having a more difficult time recruiting experienced operating room nurses.
“I think the biggest threat towards ASCs in 2023 is staffing, especially qualified, experienced staffing in all areas of an ASC, including business office, pre-op, OR (both nursing and surgical technicians), post-anesthesia care unit and recovery nurses. In addition, sterile processing technicians,” Michael Powers, administrator of Knoxville, Tenn.-based Children’s West Surgery Center, told Becker’s. “Each of these areas require a certain set of skills that are acquired and honed over time. There is increased competition, and in fact it is hard to compete with large health systems/hospitals. I am also finding that ASCs are competing in the same region against one another for the available staffing pool.”
The HRSA report highlights nurse workforce projections from 2021 to 2036 generated using the agency’s health workforce simulation.
Here are the five states with the largest projected shortages of registered nurses by 2036, per the report:
1. Georgia: 29% projected shortage
Projected vacancies: 34,800
2. California: 26% projected shortage
Projected vacancies: 106,310
3. Washington: 26% projected shortage
Projected vacancies: 22,700
4. New Jersey: 25% projected shortage
Projected vacancies: 24,450
5. North Carolina: 23% projected shortage
Projected vacancies: 31,350
https://www.beckersasc.com/leadership/5-states-facing-the-biggest-nurse-shortages-by-2036

Nursing Shortage Fact Sheet
The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage.
For more information including below, see attached PDF:
- Current and Projected Shortage Indicators
- Contributing Factors Impacting the Nursing Shortage
- Impact of Nurse Staffing on Patient Care
- Efforts to Address the Nursing Shortage

The cost of nurse turnover in 24 numbers
The 2024 NSI National Health Care Retention & RN Staffing Report features input from 400 hospitals in 36 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies.
It found the average cost of turnover for one staff RN grew from January through December 2023 to $56,300, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare’s most challenging labor disruptions.
Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here.
1. The turnover rate for staff RNs decreased by 4.6% in 2023, resulting in a national average of 18.4%. Given varying bed size, RN turnover can range from 5.6% to 38.8%.
2. The average cost of turnover for a staff RN increased by 7.5% in the past year to $56,300, with a range of $45,100 to $67,500. This is up from the average cost of turnover for an RN in 2022, which was $52,350.
3. Each percent change in RN turnover stands to cost or save the average hospital $262,500 per year.
4. The RN vacancy rate sits at 9.9% nationally. This marks an improvement, as hospitals hired an additional 153,000 RNs in 2023 and lowered the vacancy rate by 5.8%.
5. The average time to recruit an experienced RN ranges from 59 to 109 days, with the average for 2023 sitting at 86 days — nine days quicker than the year prior.
7. Every region represented in the 2024 report recorded a decrease to RN turnover, ranging from -1% to -5.1%. The South Central region saw the high end of this range while the North Central region saw the low end.
8. Over the past five years, RNs in step down, emergency services, and telemetry were most mobile with a cumulative turnover rate between 112% and 119%. “Essentially, these departments will turn over their entire RN staff in less than four and a half years,” the report states.
9. RNs in pediatrics, surgical services, and women’s health were less mobile, with 2023 turnover rates of 13.3%, 15.4% and 16.3%, respectively.
https://www.beckershospitalreview.com/finance/the-cost-of-nurse-turnover-in-24-numbers-2024

Costs and cost-effectiveness of improved nurse staffing levels and skill mix in acute hospitals
Extensive research shows associations between increased nurse staffing levels, skill mix and patient outcomes. However, showing that improved staffing levels are linked to improved outcomes is not sufficient to provide a case for increasing them. This review of economic studies in acute hospitals aims to identify costs and consequences associated with different nurse staffing configurations in hospitals.
Although more evidence on cost-effectiveness is still needed, increases in absolute or relative numbers of registered nurses in general medical and surgical wards have the potential to be highly cost-effective. The preponderance of the evidence suggests that increasing the proportion of registered nurses is associated with improved outcomes and, potentially, reduced net cost. Conversely, policies that lead to a reduction in the proportion of registered nurses in nursing teams could give worse outcomes at increased costs and there is no evidence that such approaches are cost-effective. In an era of registered nurse scarcity, these results favour investment in registered nurse supply as opposed to using lesser qualified staff as substitutes, especially where baseline nurse staffing and skill mix are low.
https://www.sciencedirect.com/science/article/pii/S0020748923001669

American Hospital Association Health Care Workforce Scan
The pandemic exacerbated existing shortages of health care workers in all roles, from clinicians to environmental and food services to admissions and scheduling. These shortages will persist well beyond the pandemic given today’s highly competitive labor market.
Record numbers of people are leaving their current jobs for new ones, new fields or new pursuits outside the job market altogether.
Despite all the difficulties, trauma and challenges they have faced, millions continue to show up and believe in their ability to make a difference in patients’ lives. Their mental and physical well-being requires tangible help and support from their leaders, and respect from the communities they serve.
The incredible challenges have also created unique opportunities to accelerate change and improve the way care is delivered, whether through technology, new care delivery approaches or multidisciplinary team models.
Ensuring the health and safety of the health care workforce – and the health and safety of the patients they care for – requires commitment at the individual, organizational and community level.

The Real Costs of Healthcare Staff Turnover
Staffing tops the list of healthcare industry challenges heading into 2023, according to polling data from healthcare advocacy group MGMA. It’s no wonder: Hospital staff turnover rates climbed as high as 26% in 2021 as workers retired due to burnout or went to work for organizations offering higher pay or better work-life balance.
For healthcare organizations, high employee turnover rates are a burden on finances and resources. Turnover costs include the expense of recruiting, hiring, and training new employees, as well as the cost of temporarily filling staffing gaps with expensive contract workers. There’s also the cost of reduced productivity as managers shift much of their attention to hiring and as new hires get up to speed. A less tangible—but still significant—turnover cost is lower employee morale as those who remain work harder to fill gaps for less pay than contract workers hired to provide temporary coverage.
Employee turnover refers to the total number of workers who leave a company over a specific period of time. Companies measure involuntary departures (layoffs and firings) and voluntary turnover (resignations) as well as the cost of replacing a given type of employee. Considering turnover can provide opportunities to replace underperformers, many employers also calculate the ideal turnover rate for their organization so managers can set specific employee retention goals. Every company has employee turnover—farsighted companies take the time to understand their turnover rate, the factors driving turnover, and what they can do to build and retain a workforce that will help achieve their organizational goals.
Key Takeaways
- Even before COVID-19, more than half of doctors and nurses reported symptoms of burnout, defined by physical and/or emotional exhaustion due to the rigors of the profession. But the pandemic shifted burnout into overdrive. During the pandemic, 93% of health workers reported experiencing stress.
- The average cost of turnover for a regular position is between six and nine months of an employee’s salary. Replacing a highly specialized healthcare professional can cost as much as 200% of the employee’s yearly salary.
- Patients notice high turnover rates when they see the impact of poor patient-to-staff ratios. They lose confidence in their healthcare provider when they don’t believe they’re receiving the best care, which can cause reputational damage.
In 2022, turnover rates for segments of the healthcare industry ranged from 19.5% at hospitals to 65% for at-home care providers to 94% at nursing homes.
This level of turnover puts a huge financial and logistical burden on healthcare providers. While COVID-19 put additional stress on the healthcare labor force, and the industry will likely feel the effects of COVID for years to come, the healthcare staffing crisis existed long before the pandemic. The following factors are also contributing to today’s healthcare worker exodus:
Inflexible, demanding schedules
Healthcare jobs are notorious for long hours and erratic schedules, and many are considered “deskless” jobs, meaning workers spend much of their time on the move. In fact, it’s estimated that nurses in hospitals walk about five miles a day.
Excessive administrative work
Fictional doctors and nurses are often depicted standing by a patient’s bedside, developing personal relationships and providing hands-on care. In reality, providers no longer have sufficient time to spend one-on-one with patients and other caregivers. Instead, they’re burdened by documentation, charting, and other administrative tasks. In 2021 doctors reported spending, on average, 15.6 hours per week on paperwork and other administrative tasks. First-year medical residents spend only about 10% of their work time face-to-face with patients, according to a study from Penn Medicine and Johns Hopkins University.
Heavy workloads
Even before COVID-19, more than half of nurses and physicians reported symptoms of burnout, according to the U.S. Department of Health and Human Services, and burnout rates have worsened over the past several years due to heavy workloads and related job stress. (A person experiencing burnout suffers from emotional exhaustion, depersonalization—a sense of detachment from oneself—and a reduced sense of personal accomplishment.) During the pandemic, researchers found that 93% of health workers were experiencing stress, 86% had anxiety, and 76% reported exhaustion.
Disconnection from managers
Healthcare workers who don’t work in a single location, such as nurses, medical assistants, and respiratory therapists, may miss out on opportunities to interact with their managers in person. Cut off from these critical personal connections, they can feel underappreciated and unseen, which makes it more likely they’ll look for a job elsewhere.
Relatively low pay
Many nurses feel they aren’t getting the pay they deserve. Even with a median annual salary of US$77,600, 66% of nurses describe pay as their No. 1 consideration when planning their next career move, according to a survey by Vivian, a healthcare hiring platform.
The direct costs of high employee turnover—the costs of recruiting, onboarding, and training new people and the costs of hiring contract staff to fill empty positions—are relatively easy to measure. The indirect costs are less quantifiable but just as burdensome; they include reduced patient satisfaction and lower employee morale. Consider these costs as you assess the impact of employee turnover on your organization.
1. Separation costs
These include severance pay, costs associated with unemployment insurance claims, payments for any ongoing benefits, and the costs associated with exit interviews and removing employees from all internal systems and directories.
2. Hiring costs
Turnover costs an organization much more than money. There’s the cost of reduced productivity when an employee leaves, and the hiring process itself can be expensive and resource intensive. It costs an employer an average of between six and nine months of an employee’s annual salary to replace them, according to the Society for Human Resource Management, and it can cost as much as 200% of the employee’s annual pay to replace a specialized healthcare professional.
3. Training costs
Even highly skilled and experienced employees need time to adapt to a new job. The healthcare industry has mandatory training and certification requirements that don’t exist in other industries. Unfortunately, many healthcare employees don’t feel they’re getting the right skills training for their rapidly changing roles, and managers and healthcare HR teams struggle to track and enforce training requirements.
4. Contingent labor costs
Understaffed healthcare organizations often resort to hiring travel or contract staff to fill workforce gaps. Unfamiliar with a facility’s policies, staff, and even its geography, contract workers can reduce overall productivity and burden full-time employees.
5. Substandard patient care
High employee turnover can lead to unsafe staff-to-patient ratios that make it hard to provide the best care. With too many patients to monitor, nurses and aides can overlook issues that slow recovery times and endanger patients. A study by the US National Institutes of Health showed that patients can lose confidence in their healthcare provider when they don’t believe they’re receiving the best care, which can tarnish the provider’s reputation.
6. Lower morale
The US healthcare industry lost more than 500,000 employees each month in 2022, according to the U.S. Bureau of Labor Statistics, and those left behind are dispirited about the future. In 2021, nearly three quarters of healthcare employees surveyed by Vivian, a healthcare hiring platform, said that workplace morale had gotten worse over the previous 12 months, and only 20% said they’re optimistic about the future of healthcare in the US. This lack of employee engagement is likely to increase employee turnover rates and reduce patient care levels, negatively impacting a healthcare organization’s reputation and financial health.
To reduce healthcare staff turnover (PDF), organizations must first improve employee well-being. People want to be compensated fairly, but beyond that, they want to be surrounded by coworkers and managers they respect. They want to feel ownership of their work lives and find work-life balance. They want systems and processes that are easy to navigate so they can focus on what matters—patient care. Here are some steps healthcare organizations can take to reduce turnover.
Managers who practice intentional hiring take the time to develop a clear job description for an open role and a clear plan for finding the right set of candidates. It may feel like this preparation lengthens the hiring process, but in the long run, it will pay off for the organization and for the candidates’ coworkers.
There are complications inherent in managing any 24/7 workforce, but these complications are compounded in healthcare by the need to have people with specific education, training, and certifications present at all times. The latest cloud-based human capital management (HCM) systems give managers visibility into staffing needs and availability and allow them to anticipate and cover surges.
Giving new employees the right tools at the start allows them to get a clear sense of the organization’s training goals and how they can fit training requirements into their workday. Dashboards that show employees what training they need, and when they need it, can improve compliance numbers while showing HR staff who’s falling behind. Cloud-based HCM systems let employees set their own training pace and measure their progress, which is especially valuable in busy workplaces where staff may have limited time to devote to training.
Healthcare professionals look for organizations that offer professional development programs beyond what’s required by law, including courses in management, communications, and ethics.
The stress of logging long hours in challenging situations is compounded by having to use inflexible, out-of-date, unconnected systems. Prospect Medical Holdings, which operates 17 hospitals and 165 medical care clinics across five states, at one time had 37 different HCM systems before successfully centralizing operations on a single cloud platform. A cloud HCM system enables employees to choose flexible schedules, sends workers notifications when it’s time to take a break, and allows management to send out regular communications that make workers feel more connected to the organization.
Healthcare-specific recruiting features in Oracle Fusion Cloud HCM help hospitals and other providers attract the best doctors, nurses, physician assistants, therapists, technicians, and support staff while giving them the tools they need to retain their accreditations and grow their expertise.
Oracle Cloud HCM’s workforce management capability enables staff to manage their schedules, sign up for shifts on their mobile devices, and block off time when they’re not available—giving them the ability to manage when and where they work. Healthcare providers can also use the cloud application’s dashboards to stay informed about patient counts and resource requirements so they can make shift changes as needed. Additionally, Oracle Cloud HCM’s employee experience platform makes it easy for hospital leaders to keep employees informed about significant organizational news and initiatives and, through pulse surveys, learn about employee concerns and needs.
Technology alone will never solve the healthcare industry’s employee turnover problem. That will take concerted efforts by healthcare organizations to focus on staff well-being, open up lines of communication, and improve the workday experience. But the right technology—easy to use, mobile friendly, and able to take on the most monotonous administrative tasks—can make a huge difference, allowing staff to focus on more complex and rewarding work: caring for patients.
Learn how the Oracle ME platform can help your organization improve the employee experience.
What is the cost of employee turnover generally?
Employee turnover costs US companies an average of $50,000 per worker, not factoring in the heavy burden on the employees who stay.
How is the cost of employee turnover calculated?
To calculate turnover costs, dig into the numbers. Calculate the cost to hire contract fill-ins for the vacant position and the cost to recruit and hire the new employee (including job postings, managerial and HR time, and background screenings). Also factor in onboarding and training costs, as well as productivity costs as the new hire ramps up. The latter is usually calculated as the cost of a new hire’s salary and benefits during their first 30 to 90 days, when they’re doing more training than work.
What is the cost of nurse turnover?
The average cost of turnover for a staff registered nurse in the US is $46,100, with an average range of $33,900 to $58,300, according to the 2022 NSI National Health Care Retention and RN Staffing Report from Nursing Solutions Inc., a national nurse recruitment agency. The average time needed to replace a nurse is about 87 days. Nurses in some fields, including emergency services and behavioral health, are leaving at accelerating rates, with cumulative turnover rates that exceed 100%. (This happens when jobs need to be filled over and over—for example, an organization with 100 employees may have 50 positions that are filled by employees who stay long term and 50 positions where lots of turnover is the norm. Each terminated employee is part of the organization’s overall turnover rate.)
https://www.oracle.com/human-capital-management/cost-employee-turnover-healthcare

The Relationship Between Nurse Staffing, Quality, And Financial Performance In Hospitals
Little evidence exists on the relationship of nurse staffing and quality with financial performance in hospitals. This study aimed to measure the relationship between nurse staffing, quality of care, and
profitability in hospitals. This study used longitudinal panel datasets from 2006 to 2010, drawn from various datasets including the American Hospital Association Annual Survey Database, Medicare Cost Report, and Hospital Compare Data. This study used the random-effects linear regression model to measure the relationship between nurse staffing, quality, and profitability. In addition, we tested a mediating effect of quality on the relationship between nurse staffing and profitability. This study found nurse staffing’s significant association with quality and profitability in hospitals. First, compared to hospitals in the lowest quintile of RNs per 1,000 inpatient days, hospitals in the higher quintiles had lower pneumonia readmission rates, and higher total profit margins, operating margins, and cash flow margins. In addition, hospitals with lower pneumonia readmission rates were found to have higher total profit margins and cash flow margins. Lastly, the current study found that the positive relationship between RNs per 1,000 inpatient days and total profit margin and cash flow margin was partially mediated by pneumonia readmission rates. In conclusion, our finding that nurse staffing is positively associated with both quality of care and profitability in hospitals suggests that the idea of hospitals responding to financial pressures by cutting RN resources with a goal of greater profitability should be called into question. The influence of lower RN staffing levels on higher profitability for hospitals is uncertain, while it is possible that RN staff reductions may compromise the quality of patient care. Keywords: nurse staffing, registered nurse, quality of care, readmission rate, profitability, total profit margin, operating margin, cash flow margin, hospital.
On a practical level, the findings on the relationship between nurse staffing, and the quality and financial outcomes in hospitals can assist nurse managers and chief executive officers in identifying the optimal RN staffing level. These findings suggest that RN staffing level may be a strong predictor of quality and profitability and that the quality may mediate the relationship between RN staffing level and profitability in hospitals. This could be of particular interest to current hospital managers because of the payment reductions for excessive readmissions embedded in the ACA, which might have significantly affected the average profitability of some service lines in their hospitals. A lesson that can be learned from the past is that hospitals may attempt staff reductions in response to increased financial pressures as a result of payment reforms. However, as the findings in this research and the literature suggest, the reduction of nursing staffs may be related to an increase in adverse effect on the quality of patient care. The analysis results of this study demonstrated that a higher RN staffing level was associated with a lower pneumonia readmission rate, while the medium level of RN staffing level (≈ 7.7 RNs per inpatient day) had the highest profitability among general and acute care, non-federal government hospitals. Staffing decisions involve balancing between labor costs and the level of care required to fulfill healthcare needs of patients (Blegen, Vaughn, & Vojir, 2008). It is a matter of choice to hospital managers to decide what would be the most effective nurse staffing strategy for their hospitals in response to the HRRP.
https://journals.scholarpublishing.org/index.php/ABR/article/view/8745

The Effects of Nurse Staffing on Hospital Financial Performance: Competitive Versus Less Competitive Markets
Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets
In this study we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida.
By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals.
Nurse staffing levels had a positive association with financial performance (β=3.3; p=0.02) in competitive hospital markets, but no significant association was found in less competitive hospital markets.

Optimizing the Role of Nursing Staff to Enhance Physician Productivity: One Physician’s Journey
After completing my family medicine residency a few years ago, I immediately joined a private group practice with eight family physicians and two nurse practitioners and inherited a nearly full patient panel from a retiring family physician. I naively assumed that transitioning from residency to private practice would decrease my workload and increase my quality of life, but after a hectic first year, I knew that something had to change for my professional life to be sustainable. I was spending way too much time working and could see that the complexity of practicing medicine would continue to increase in the years ahead.
I began to look for ways to cope and came across an article in Family Practice Management by Peter Anderson, MD, and Marc D. Halley, MBA.1 The article described a new model in which a physician works simultaneously with two clinical assistants – a registered nurse (RN), a licensed practical nurse (LPN), or even a capable medical assistant (MA) – allowing them to assume more responsibility for each patient encounter so the physician can focus on the patient and medical decision-making. The additional nurse responsibilities include gathering an initial history (including the history of present illness, HPI; review of systems; past medical, social, and family history, PSFH; and health habits) and then staying in the exam room to document the physician encounter, order needed tests, print handouts, send prescriptions to the pharmacy, and complete the note including the assessment and plan. By shifting many of the ancillary physician tasks to well-trained clinical assistants, the physician can focus on what he or she is uniquely trained to do – provide high-quality acute, chronic, and preventive care in the context of a therapeutic relationship. After discussing this idea with my nurse (an LPN) and practice manager, we decided to try this new model.
My nurse and I started slowly, selecting several days where we would see fewer patients, thereby allowing additional time to learn our new process. It was a significant adjustment for both of us. She was now in charge of the documentation (and thus the computer), and it became necessary for me to clearly verbalize every aspect of the visit, including the physical exam, the assessment, and the plan for treatment or additional workup (labs, imaging, medications, referrals, etc.). We used Anderson and Halley’s model as our starting point, but soon our process evolved based on our own skills and strengths, the needs of our patients, and the limitations of our office space, schedule, and electronic health record (EHR). After experimenting for a month, we were both convinced that we were ready to fully commit to this new model and decided to hire a second nurse. Because we had spent significant time fine-tuning our system, the training process for our second nurse (also an LPN) was relatively smooth, and my original nurse was able to do the bulk of the teaching.
Every new process requires some experimentation and modification in the early stages, and for our practice key adjustments occurred in the following areas:
Communication with nurses. When we first began, I would handwrite my assessment and plan for each patient encounter to ensure accuracy. Quickly, my nurses let me know that this was a waste of time. Instead, they suggested that I clearly explain each diagnosis and associated plan to the patient, and they would capture the information as I spoke. The nurses have also demonstrated that they can capture patient instructions as we discuss them, and they now typically print those instructions at the conclusion of each visit. Today it is unusual for me to type or handwrite anything during an office visit.
Access to patient data. Each of our exam rooms has a desktop computer that we use to navigate the EHR. Lab and imaging results import electronically into the EHR, as do many of our consult notes. With my nurse in the room using the computer during the office visit, I lost the ability to peruse the chart during the visit, so I began to use an iPad with our wireless Internet connection to view a read-only version of the chart. The iPad also allows me to review the history related to each problem, the problem list, and current medications without pulling my nurse away from her documentation responsibilities.
Chart review. As we progressed with our new model, I continued to gradually shift more responsibility onto my nurses’ capable shoulders. They assumed responsibility for immunization status (checking status for adults and children, administering needed vaccines, creating catchup schedules, etc.), preventive care, and even some basic chronic disease management (confirming annual diabetic eye exams and referring as needed, ordering annual lipid panels when appropriate, etc.). The nurses found that in opening a visit note, they were essentially doing a thorough chart review including reviewing, updating, and sorting the problem list; reviewing preventive care needs; sorting the medication list; reviewing and reorganizing the PFSH and health habits; starting the HPI by searching the chart for any prior tests or visits related to the chief complaint (as recorded by the front desk staff when scheduling the visit); and even starting the assessment and plan portion of the note by listing the relevant diagnoses. It was not possible to accurately complete such a chart review between patients, so my nurses agreed to arrive about an hour before our first patient each day to allow additional time for this work.
Patient check-in form. We have continually worked to implement processes that improve patient flow and efficiency during office visits. One of our more successful processes involves using a patient check-in form. Early on, it became apparent that the rooming process was a bottleneck in our patient flow because of the need to confirm problems, medications, allergies, social history, family history, habits, etc. I had asked my nurses to attempt to quickly update these at each office visit, and it turned into a time-consuming process, particularly for complex patients on multiple medications. To expedite the process, we worked with our EHR support staff to create a one-page document that lists a patient’s medications, allergies, family history, social history, health habits/risk factors, pharmacy of choice, and advance directives. These forms are printed directly from the EHR during the morning chart review and are given to the front desk staff to pass out to patients when they arrive. This allows patients to review much of their history while sitting in the waiting room and allows the nurses to address only changes that need to be made. As an added benefit, patients appreciate that we put time into prepping for their arrival rather than handing them a blank form to complete.
Patient privacy. I was concerned that having a nurse present in the exam room might be a distraction for patients or make them uncomfortable sharing sensitive information. While we did receive several questions initially about the nurse being in the room, I have been pleasantly surprised by how many patients don’t even seem to notice. There are occasional instances when it is evident that a patient would be more comfortable without a nurse present during the visit, and the nurses can usually ascertain this while rooming the patient. Overall, feedback has been amazingly positive. Rather than viewing the nurses as an intrusion, patients appreciate the additional resources that my nurses have become. They also seem to recognize that the nurses’ presence allows me to be fully focused on them, rather than trying to manage charting, test orders, referrals, and refills while providing their care.
Space, workflow, and scheduling issues. Because my colleagues were not implementing the same practice model that I was, I was careful to limit the impact on them. To create a new workspace for my second nurse, I cleared some supplies from an unused desk, purchased a new computer, purchased a new office chair, and moved an unused phone. I typically have access to only two or three exam rooms while seeing patients (the Anderson and Halley model suggests three to five exam rooms), but I have not asked for more. I have found that even with two exam rooms I am considerably more efficient under this model.
While both of my nurses participate in patient visits throughout the day, they typically have short breaks between patients and can use this time to manage phone calls, medication refills, and other peripheral nursing issues. Because of this, we have not needed to schedule additional time for the nurses to manage these tasks, although we have utilized our group’s two full-time triage nurses for support on our most hectic days.
The transition to our new model has probably been most difficult for our office manager and our group’s lead nurse. A new process was required to schedule my nurses, and it can be tedious to manage schedules when I am out or one of my nurses is out. I have just recently started training some of our other office nurses in the new model, but previously I would have to resort to my old single-nurse system if one of my two nurses was out of the office.
Ongoing improvement. To fully implement this system requires nurses who are motivated and willing to assume more ownership over each patient encounter. The nurses’ knowledge of each patient and their overall medical knowledge has grown as a result of their active participation in each visit, and they have learned by watching how I make decisions and conduct the medical workup. I also continue to teach them in a more formal manner by using interesting cases that we see, and I have learned this model requires an ongoing commitment to training. I started out meeting with my nurses for one hour each week, and even though I have been using this system for almost two years, I continue to meet with them at least twice per month. During these meetings I elicit feedback about problems or inefficiencies, provide feedback on recent chart notes, and provide teaching about changing medical standards of care. My nurses are now often the ones to identify problems and suggest appropriate changes to improve our model and the care we provide. These routine meetings have created a culture of teamwork and a continual focus on innovation – traits that will likely serve us well in the ever-changing world of medicine.
Two years into the model, we can report positive results.
Patient care statistics. The organization I work for monitors patient care data, generating physician report cards for preventive care and chronic disease management. Since implementing this new practice model, I have seen an improvement in most of my report card measures, particularly those that rely more on my nurses to complete. For example, the table below shows improvements in virtually every category of diabetes care, with a particularly large jump in the percentage of diabetes patients who have received foot exams, a task I have completely turned over to my nurses.
Since implementing my new practice model, in which nurses take greater responsibility for certain aspects of the patient visit, I have seen improvements in most of my report card measures, including those for diabetes care, shown here.
Percentage of diabetes patients | |||
---|---|---|---|
Diabetes measures | Goal | Old system | New system |
A1C > 9% | < 15% | 5% | 0% |
A1C < 7% | > 40% | 53% | 64% |
Blood pressure > 140/90 mm Hg | < 35% | 22% | 7% |
Blood pressure < 130/80 mm Hg | > 25% | 53% | 64% |
Eye examination completed | > 60% | 47% | 48% |
Smoking status and cessation advice or treatment provided | > 80% | 98% | 98% |
LDL > than 130 mg/dl | < 37% | 15% | 9% |
LDL < 100 mg/dl | > 36% | 58% | 62% |
Nephropathy assessment completed | > 80% | 95% | 95% |
Foot examination completed | > 80% | 60% | 79% |
Finances and productivity. The costs incurred with this new model can be divided into two categories: initial startup costs and ongoing costs. I estimate that my initial startup costs were in the range of $15,000. This includes the fairly nominal cost of additional office equipment (computer, office chair, etc.) and the more significant cost of slowing down my days as I brought both nurses up to speed on the new system. The only significant ongoing cost is paying the salary and benefits of my second LPN, approximately $8,000 per quarter. This is less than you might expect because four months after transitioning to this new model, I made a personal decision to decrease my full-time equivalent (FTE) status from 1.0 to 0.75. Thus, I am not responsible for the full salary of my second nurse. The remainder of her time is allocated to other parts of the practice.
My FTE change makes it nearly impossible to calculate how my practice change has affected revenue, but I can say that my office productivity has increased. We measure productivity in terms of patient visits per half-day and average charge per patient visit, which we track based on work relative value units (RVUs). Since moving to this new system, I have seen my patient visits per half-day increase by 15 percent and my average charge (work RVU) per office visit increase by 10 percent (see the graph below). Because some of our practice costs are divided based on productivity, this increase in my productivity has led to a relatively minor, but ongoing, increase in those costs.
Under my new practice model, patient visits per half-day have increased 15 percent and work relative value units (RVUs) have increased 10 percent. These numbers reflect an eight-month average before and after changing to the new model.

Although this new model has certainly brought an increase in expenses, I have seen a much greater increase in productivity and revenue, which has allowed me to maintain an annual income above the national median of $160,000 for a full-time family physician, despite having decreased my FTE status to 0.75.
Nurse and patient satisfaction. During this transition I have regularly asked my nurses for feedback regarding their satisfaction with our change, and when there have been frustrations or difficulties, I have done my best to work creatively with them to correct those. At this point, I am happy to report that my nurses are both very pleased with our current system. My original nurse reports that “Overall, I am very happy with the two nurse system. My favorite thing about it would be that I get to see from start to finish the entire diagnostic and treatment process. It allows me to become educated on each patient’s history and treatment plan, which in turn allows me to provide appropriate care and to be a better advocate for that patient. While working so closely together, I’ve been able to gain an understanding of how Dr. Anderson practices, and I have become more confident in myself and my own skills. Our care as a team has become significantly more thorough, and we are able to focus now on providing comprehensive care to each individual.”
Although we have not conducted a formal patient survey, the feedback we have received from patients has been almost universally positive. Patients are happy to have my undivided attention while in the exam room, they appreciate getting so much done with each office visit, and they are grateful that my increased efficiency has allowed me to be more available for same-day appointments.
This journey in restructuring my practice model has led me to a place where I am able to focus more on my patients, provide higher quality care, be more productive, and have happier employees. As physicians, we should not view ourselves as beholden to old models of care. Instead, we ought to view ourselves as empowered to institute fundamental changes to our work. The practice of family medicine is likely to get more demanding in the years ahead, and it is our opportunity and responsibility to build innovative practices that meet these demands while enabling excellent patient care, employee satisfaction, and a sustainable and meaningful personal life.

10 Best Practices for Increasing Hospital Profitability
Industry experts say that hospitals wishing to increase their profitability can focus on two key areas — reducing costs and increasing reimbursement. Here are 10 best practices for increasing hospital profitability by reducing costs and increasing revenue and reimbursement.
Because labor is the largest single expense for hospitals, it is critical that hospitals are not over- or under- staffing their facilities.
Hospitals leaders can cosider the use of flexible staffing, such as part-time or hourly employees, and adjust staffing based on patient census data. Leaders should also monitor the efficiency of this staffing by continuously reviewing benchmarking data such as hours worked per case.
Amy Floria, CFO of Goshen (Ind.) Health System, says that her facility monitors patient volume on a daily basis and adjusts staffing accordingly. “We adjust our nursing staffing every eight hours after looking at our inpatient volume and expected discharges and admits,” she says.
Kevin Burchill, a director at Beacon Partners, a healthcare management consulting firm, agrees that staffing must be adjusted daily. “The easiest thing that a hospital can do to improve profitability is for the senior management team to assume responsibility for the day-to-day performance of an organization and look at the organization’s performance in real time,” he says. “You must shift to an emphasis on the day-to-day, not pay-period to pay-period or month-to-month.”
It is important that concerns regarding efficient staffing are communicated throughout the organization and that hospital leaders work in collaboration with physicians. Donna Worsham, COO of National Surgical Hospitals, suggests that hospital leaders share staffing efficiency benchmarking data with unit managers and provide feedback regarding the productivity of the unit.
Flexible staffing is especially useful for OR nursing staff. OR managers should review clock-in times versus surgery-start times and determine if their staff is consistently arriving before a surgery actually begins. If this is the case, mangers can utilize flexible staffing to allow nursing staff to arrive later so that when surgeries run over, no overtime expenses are incurred, says Ms. Worsham.
Other facilities are saving in staffing costs by reducing benefits for full-time staff. Goshen Health System, for example, deferred merit increases, reduced paid vacation time and suspended its retirement matching program in response to the current economy, according to Goshen’s CEO, Jim Dague. Goshen reduced employee dissatisfaction in response to these cuts by soliciting employee feedback on which benefits to reduce, thereby building organizational support for the changes. In addition, Goshen’s executives took a voluntary 20 percent cut in order to help sustain the system through the recession.
Joe Freudenberger, CEO of OakBend Regional Medical Center in Richmond, Texas, agrees that staff must buy in to any reductions in hours and shifts worked that will personally affect them in order for the hospital to remain successful. He says that hospital leaders must communicate the reasoning for these changes to the staff before making them. “If we call off staff, they see it as personally hurting their income when we need to help them understand that it is actually preserving their income by maintaining the financial viability of the hospital,” he says. “It may be obvious to us that we’re calling them off because we have a significant reduction in patient volume, but we need to communicate that to them for them to understand the financial realties we face.”
Although some staffing cuts may be necessary, hospitals should be careful not to take a blanket approach to layoffs or cuts in services. Hospital leaders must take a close look at their business before making cuts.
“Don’t make the same mistake everyone else does — don’t look at bottom line, determine that you need to cut $1 million, for example, and then cut 10 percent across the board. Doing so will trim some fat but will cut meat and bone in other areas,” says Mr. Burchill.
He suggests that hospitals assess each program individually and determine which ones are what are winners and losers. “You do not want to cut areas that you should be doing more of or that are already profitable,” says Mr. Burchill.
Hospital leaders can reduce supply costs by working with vendors to improve contracts and encouraging physicians to make fiscally responsible supply decisions.
“When it comes to supply costs, you must drive this expense or the vendor will drive it for you,” says Ms. Worsham.
Hospital leaders should not shy away from approaching vendors for discounts. Goshen’s IT director recently requested a discount on the health system’s contract for IT maintenance due to current economic conditions and successfully received a discount that saved the hospital 15 percent on this contract, according to Ms. Floria.
Hospitals can also reduce supply costs be reducing the number of vendors. Goshen, for example, is in the process of reducing the number of vendors in its surgical suite and aims to eventually scale the vendors down to 4-6 companies. “This action is expected to save us at least a million dollars in supply costs,” says Mr. Dague.
Another way in which hospitals may reduce supply costs is by requiring vendors to submit purchase orders for any equipment or implants that are not included in a negotiated, written agreement with the facility. “All of our vendors sign agreements that any purchase orders must be submitted at least 24 hours before a procedure and must be approved by the materials manager or the CEO, or it’s free,” says Ms. Worsham. “If you don’t require this, vendors will drop off the invoice for a pricey piece of equipment or implant after the procedure has already taken place and walk out the back door, which can greatly hurt your profitability.”
All hospitals can benefit from tightening up the efficiency of their operating rooms, but it is especially critical that less busy facilities ensure that their ORs are used as efficiently as possible.
“Hospitals need to review block time utilization,” says Ms. Worsham. “Physicians who are assigned more time than they are using are hurting your profitability.”
Ms. Worsham suggests that hospital OR managers work directly with physicians to make OR utilization more efficient.
“When physicians’ schedules create gaps in the OR schedule, it effects a hospital’s ability to staff effectively, which can create significant labor costs for the hospital,” says Ms. Worsham.
Hospitals should work to encourage physicians to become more concerned about the costs of supplies and other activities, such as unnecessary tests and inefficient coding processes that may drive up hospital costs.
“Hospitals today have a unique opportunity to leverage physicians’ interest in having hospitals help to stabilize their incomes with the hospitals’ needs to involve physicians in cutting costs and improving quality,” says Nathan Kaufman, managing director of Kaufman Strategic Advisors, a hospital consulting firm.
Hospitals can encourage the use of products from vendors that are cost-effective, but still high quality, especially in areas such as orthopedic implants, which can be considerably costly for hospitals. In addition, experts say the use of protocol-based care can reduce costs associated with unnecessary tests or treatments.
Mr. Freudenberger says that one of the biggest mistakes hospitals make is not engaging medical staff in profitability. “Physicians have a huge role in maintaining hospital profitability, but unless you give them a reason to be concerned with a hospital’s profitability, they will make choices in what and to whom they refer services that will not consider the implications to the hospital,” says Mr. Freudenberger. “Hospital leaders should work to help medical staff understand the connection of their referrals to the hospital’s viability so that their referral decisions reflect the value they place on the hospital.”
During tough economic times, some hospitals may benefit from outsourcing or partnering with other organizations for certain services, such as food and laundry services, and even, in some cases, clinical services.
“Some hospitals see these economic times as an opportunity to outsource unprofitable services,” says Mr. Burchill.
By outsourcing certain services to more efficient providers, hospitals can share the savings with the service provider. However, hospitals must be sure to select truly efficient providers.
“Outsourcing is clearly a smart thing to do if an organization can gain greater efficiency through finding a larger-scale operation; however the provider must be more efficient than the hospital,” says Kevin Haeberle, executive vice president, HR capital, for Integrated Healthcare Strategies.
Oftentimes, hospitals outsource services such as laundry, food and nutrition, information technology or human resources because they do not have the capital to invest in the equipment upgrades or training that is needed to increase the efficiency of their internal service. In these cases, the decision to outsource may not directly be related to profitability but instead the “lacking of funds for the investment required to make current services viable,” says Mr. Haeberle. However, this decision can improve profitability in the long-run by allowing hospitals to use funds for more profitable services.
Some hospitals have also begun to outsource clinical services such as emergency room staffing and anesthesiology in an attempt to become more efficient. Because these staffing groups employ a large number of specialty physicians, they may be able to provide more efficient services, especially in clinical areas that require around-the-clock coverage where the demand for services is high.
Mike Mikhail, MD, vice president of client services for Emergency Physicians Medical Group, says that hiring an emergency department management company can help to improve the profitability of hospitals whose demand for emergency services exceeds its emergency treatment capabilities. “An emergency management group can help make the emergency department more efficient by introducing management oversight and best practices, allowing more patients to be seen and keeping others from leaving to find another hospital,” he says. “Because a majority of hospital admits come from emergency walk-ins, driving more patients through an ER will create more admits, and therefore more profit for the hospital.”
An increasing number of hospitals are joint venturing with local physicians and surgery center management companies to offer outpatient services through the development of a surgery center.
According to Clete Walker, vice president of development for Surgical Care Affiliates, hospitals are beginning to focus on the need for a comprehensive outpatient strategy and recognizing the need to partner with doctors to effectively execute on this strategy. Mr. Walker reports that he has seen an increased interest from hospitals in joint venture arrangements for outpatient services.
“More and more hospitals are realizing that their core competency is providing inpatient care; their outpatient cases are more costly per case and take up more of the physician’s and patient’s time than they do at an ASC,” he says. “As a result, hospitals are competing with physicians for outpatient cases. Hospitals with joint-venture agreements, however, do not have to compete with the physicians.”
Hospitals can leverage their standing in the community to partner with local physicians to share the revenue generated by efficient outpatient cases.
“We are in lean times, and lean times call for us to rethink our strategies,” says Mr. Walker. “It’s better for physicians, hospitals and other groups to work together to provide an efficient delivery system for patient care than for the groups to compete.”
Identifying and attracting additional physicians to bring cases to your hospital is another way that hospital leaders can increase profits. Physician-owned hospitals can bring in additional physicians as partners, while other types of facilities can recruit new physicians who are willing to perform cases at their hospitals.
“New physicians will bring in more cases and grow your profits,” says Ms. Worsham.
Ms. Worsham suggests polling your medical staff for names of local physicians to target and inviting them into the facility. During the visit, Ms. Worsham recommends that hospitals work to “wow” the target physician. “We work tirelessly to promote the services we can offer them,” she says.
When a new physician begins performing cases at one of Ms. Worsham’s facilities, that physician is assigned a concierge. “We have strong internal programs in place for this first day. A concierge is assigned to each new physician who provides them with a tour facility and walks them through every aspect of their day,” says Ms. Worsham.
Hospitals may also be able to grow case volume and profits by adding new service lines. However, hospitals need to be careful to do their homework on the expected profitability and ROI for any new lines added, especially in a market where access to the funds required to invest in new service lines may be tight.
“You have to look at what the market needs are and where you’re going to get the referrals from,” says Ms. Worsham. “Meet with local physicians and interview them about their needs and the number of cases they see that could utilize a new service.”
Hospitals should also be sure to examine the competitive landscape for any new service line.
Ms. Worsham reports that her facilities have had great success from adding a hyperbaric service line because few competitor hospitals were offering this service.
Hospitals that use hospitalists to care for patients can benefit from the more efficient care and better documentation that specialized hospitalists can potentially provide.
“A protocol-based hospitalist program can increase efficiency and help to reduce the length of stay for patients, which can increase case volume without the need for additional beds,” says Mr. Kaufman.
Hospitals should consider employing these specialists as a means to improving care and enhancing their bottom lines, according to Mr. Kaufman.
Stephen Houff, MD, president and CEO of Hospitalists Management Group, says that hospitalist groups can provide effective care to patients and possibly increase reimbursement. “Hospitalists may be the most reliable and cost-effective means available for hospital leaders to transform medical delivery in their health system,” he says. “Through shared vision, an effective hospitalist team partners with hospital leadership to improve patient safety and access, streamline care, improve patient and family satisfaction, enhance reimbursement via improved clinical documentation and provide seamless transition to post-discharge care.”
One of the most important ways that hospitals can improve their profitability is by continually evaluating and renegotiating their managed care contracts.
“Hospitals must demand their fair share of premiums from third-party payors in order to subsidize the underpayment of Medicare and Medicaid,” says Mr. Kaufman. “Hospitals need to focus on reducing their cost structure as much as possible to approach breaking even with Medicare reimbursement rates, but that only goes so far.”
Mr. Kaufman recommends that hospitals only agree to contracts that reimburse at 130-140 percent of cost. “If a facility is not big enough or strong enough to get these rates, then they should look at merging with a larger facility,” says Mr. Kaufman.
Ms. Worsham suggests that hospitals perform a profitability analysis by payor and by procedure in order to determine where a facility is losing money and identify any trends. She also suggests that hospitals evaluate older contracts due to changes in severity-based DRGs and carve out the reimbursement of implants in order to ensure they are reimbursed appropriately for the costs associated with these.
Ms. Worsham also suggests that hospitals evaluate contracts on a quarterly basis, even if the contract is not near expiring. She suggests that hospital leaders examine the contracts with the following questions in mind:
• Is revenue where we thought it would be given reimbursement rates and volume of policy holders?
• Are we being paid as agreed upon in the contract?
• Are we being paid in a timely manner?
Contracts that are determined to be “high risk” should be renegotiated. Make sure your contracts contains a material harm clause, which will allow you to readdress terms of contracts that have become financially harmful to the facility, according to Ms. Worsham. Renegotiating contracts can be very valuable — one hospital Ms. Worsham advises will gain $500,000 this year due to renegotiations.
Hospitals that focus on enacting these best practices are likely to see improvements in their profitability; however, hospitals can also benefit by using today’s economic conditions as an opportunity to improve their overarching approach to business, creating a more sustainable organization in the future.
“When profits were high, hospitals had the luxury of being sloppy in some areas; now we must run a tighter ship,” says Ms. Floria. “This will benefit the industry in the long-run.”
Hospitals can also use this opportunity to find creative solutions to problems that plague their facilities.
Goshen Health System, for example, recently enacted a program in which the hospital pays the premium required to sustain Cobra benefits for recently laid-off patients seeking care. “We are willing to be creative with our patients,” says Ms. Floria. “We pay for benefits when certain patients cannot. The revenue we receive from caring for these patients recoups this cost and provides us with additional cash flows that likely would have been uncollected or written off to charity care or bad debt.”
This idea, which was enacted during lean times to improve profitability, will continue to benefit the hospital’s bottom line, even when profitable times return.
Contact Lindsey Dunn at lindsey@beckersasc.com.