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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
Optimizing Length of Stay with AI: West Tennessee Healthcare Pilots Xsolis’ Dragonfly Navigate
As healthcare systems continue to face challenges around capacity management and discharge planning, one leading regional provider is turning to AI-powered technology to drive efficiency and improve patient outcomes.
West Tennessee Healthcare, a not-for-profit healthcare system, has expanded its partnership with Xsolis, an AI-driven technology company, to pilot the new Dragonfly Navigate workflow solution. Dragonfly Navigate is designed to help hospitals optimize length of stay and streamline discharge planning through predictive analytics and automated tasks.
“We are excited to expand our partnership with Xsolis to pilot the Dragonfly Navigate workflow solution,” said Debbie Ashworth, Executive Director of Care Management at West Tennessee Healthcare. “Dragonfly Navigate provides a seamless workflow that complements clinical expertise and supports more proactive discharge planning, which will give my teams more time to focus on addressing patient needs.”
Building on a proven track record
West Tennessee Healthcare has utilized Xsolis’ proprietary workflow solutions since July 2022 and has six facilities live on Xsolis’ Dragonfly platform, to date. The health system also leverages Xsolis’ Best in KLAS Physician Advisory Services and connects with payer partners on Dragonfly, leveraging Xsolis’ proprietary Care Level Score™ to facilitate Precision Utilization Management (UM). Precision UM is Xsolis’ highest level of collaboration and time savings offered between payers and providers, where appropriate cases are automated based on historically agreed upon thresholds. To optimize length of stay, West Tennessee Healthcare has also had success with Dragonfly Navigate AI, which incorporates Xsolis’ proprietary AI model predictions into the EMR, to help care teams more easily identify discharge priorities and align on discharge plans.
Now, the health system will be the first to pilot the new Dragonfly Navigate offering, the accompanying workflow solution, which builds on Xsolis’ previous products that optimize length of stay – with more performance insights, plus tools that address the root causes of excess days.
Dragonfly Navigate incorporates proprietary AI models that predict discharge date and disposition early in the patient encounter, enabling more proactive discharge planning and improving patient throughput. The solution also includes automated AI-powered tasks that alert users to potential discharge conflicts or opportunities, as well as thoughtful documentation features and standardized data sets designed for efficiency.
Optimizing length of stay for capacity issues, savings
Additionally, Dragonfly Navigate offers bi-directional EMR integration to prevent duplicate documentation and data silos, and facility dashboards with metrics to manage capacity, identify discharge opportunities, and track patients with known barriers. Retrospective dashboards also connect performance trends to the root causes of avoidable delays.
“Length of stay is the next frontier for bringing our customers significant savings,” said Joan Butters, CEO and co-founder of Xsolis. “We have listened to their needs and are excited to deliver a more seamless workflow solution with Dragonfly Navigate, which builds on the success of our previous products to drive length of stay improvements.”
Optimizing length of stay has been identified as a key characteristic of financially high-performing hospitals. According to the latest data from the Kaiser Family Foundation, the average adjusted expenses per inpatient day at U.S. hospitals is $3,025. That means just one patient staying an unnecessary day at the hospital for each of the 365 days per year totals $1.1 million in additional expenses for the hospital.
By leveraging AI-powered predictive analytics and automated workflows, Dragonfly Navigate aims to help hospitals like West Tennessee Healthcare identify and address the root causes of discharge barriers and avoidable delays. This can lead to improved capacity management, care coordination and patient throughput, enabling more efficient utilization of hospital resources.
To learn more about Xsolis’ Dragonfly Navigate, a better way to manage length of stay, visit https://www.xsolis.com/solutions/navigate/.
The post Optimizing Length of Stay with AI: West Tennessee Healthcare Pilots Xsolis’ Dragonfly Navigate appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Federal grant expands telehealth in Texas, Louisiana
Lubbock, Texas-based Texas Tech University Health Sciences Center received a $1.3 million, four-year grant from the Health Resources & Services Administration, an agency of HSS, to expand telehealth services in Texas and Louisiana.
The TexLa Telehealth Resource Center, housed at the center, will receive $325,000 annually through 2029 to strengthen digital health services in rural and underserved communities, according to the Odessa American. The center is one of 14 federally funded telehealth resource centers nationwide.
Ariel Santos, MD, chair of TTUHSC’s department of surgery and principal investigator for the TexLa Telehealth Resource Center, said the funding will support education and training programs, including certifications and telemedicine skill development.
The grant will also back efforts in remote patient monitoring, wearable health devices and artificial intelligence adoption. The center provides technical assistance, training and outreach to help providers integrate telehealth into practice and improve access to care.
The post Federal grant expands telehealth in Texas, Louisiana appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Mercy adds da Vinci 5 robotic system
Mercy Hospital St. Louis (Mo.) became the first facility in the area to offer robotic-assisted surgery with the da Vinci 5 system.
Mercy surgeons have used robotic technology since 2003 and performed more than 16,000 procedures with various versions of the da Vinci system. The latest model, known as DV5, is designed to enhance precision and efficiency for minimally invasive procedures in urology, gynecology, thoracic and general surgery, according to an Aug. 19 news release.
Patients at the hospital have had recovery times reduced by more than a day on average, compared to traditional open surgery, the release said. Since the introduction of robotic surgery in 2003, that reduction has translated to nearly 27,000 fewer days in the hospital for patients.
Hospital leaders said the system’s expansion reflects Mercy’s ongoing commitment to providing technology that improves patient recovery and outcomes.
The post Mercy adds da Vinci 5 robotic system appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
UChicago Medicine debuts cancer network, AdventHealth hospital tapped as 1st affiliate
The University of Chicago Medicine has launched a national cancer network, and has selected AdventHealth Cancer Institute Shawnee Mission in Merriam, Kan., as its first affiliate.
The UChicago Medicine Cancer Network will allow national affiliates to remain independent while aligning with UChicago Medicine’s clinical care, medical education and biomedical research standards, according to an Aug. 20 news release from UChicago Medicine.
Patients receiving care at a network affiliate will have access to UChicago Medicine-sponsored clinical trials and select industry trials, as well as expert second opinions and advanced treatments, the release said.
The post UChicago Medicine debuts cancer network, AdventHealth hospital tapped as 1st affiliate appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Apella launches ambient AI tool for OR scheduling
San Francisco-based Apella launched Apella Horizon on Aug. 20, expanding its real-time AI platform to include surgical scheduling and capacity optimization.
The system integrates predictive algorithms and ambient sensing to improve preoperative planning, real-time OR coordination and retrospective performance analysis. Apella said Horizon unifies real-time OR management, case scheduling forecasts and workflow efficiency data.
Early pilot sites observed 69 fewer delayed minutes per OR on optimized days while maintaining case volume, according to the company. The average share of cases under-scheduled by more than 30 minutes fell from 60 percent to 16 percent. Hospitals using the tool identified enough open time to add two surgical cases per OR per month and recorded a 46-point reduction in late OR days.
“When OR schedules rely on manually entered data, it can lead to inaccurate scheduling, which can impact resources and patients,” said Roberta Schwartz, executive vice president and chief innovation officer at Houston Methodist. “Ambient technology captures real-time, contextual insights, which helps us not only keep ORs running efficiently, but also find new capacity that isn’t obvious when you’re just looking at the block schedule.”
Apella Horizon connects with EHR case data and Apella’s existing OR management tools. It uses machine learning to flag likely over- or under-scheduled procedures, surface high-value open time, and recommend optimal case placement based on contextual factors like surgeon availability.
The post Apella launches ambient AI tool for OR scheduling appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Trump expands 50% steel, aluminum tariffs: 4 things to know
President Donald Trump has expanded the scope of steel and aluminum tariffs, extending the 50% levy to include an additional 407 product categories, according to an Aug. 19 news release from the Commerce Department.
Here are four things to know:
- The expanded tariffs target a range of imports, including auto parts, chemicals, plastics, construction materials, wind turbines and rail cars, CNBC reported Aug. 19. “Basically, if it’s shiny, metallic, or remotely related to steel or aluminum, it’s probably on the list,” Brian Baldwin, vice president of customs at Kuehne and Nagel International AG, wrote on LinkedIn, citing the expansion. “This isn’t just another tariff — it’s a strategic shift in how steel and aluminum derivatives are regulated.”
- The tariffs officially went into effect Aug. 19; however, the product list is available only via 10-digit customs classification codes, making it difficult for individuals to identify which products are affected.
- Jason Miller, PhD, a supply chain management professor at East Lansing-based Michigan State University, said in a LinkedIn post the expanded tariffs could now affect at least $320 billion worth of imports based on 2024 trade values. “This will add more inflationary cost-push pressures to already climbing prices that domestic producers are charging as picked up by July’s PPI data,” he said.
- The move follows President Trump’s announcement in June that he was doubling aluminum and steel tariffs from 25% to 50%. According to the American Hospital Association, tariffs on these imports will affect medical devices including surgical instruments, prosthetics, implants, crutches and wheelchairs, and orthopedic hardware such as plates and screws.
The post Trump expands 50% steel, aluminum tariffs: 4 things to know appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Why a ‘two-tier Medicare system’ may be on the horizon
Physicians treating Medicare patients have seen their real income drop by more than 33% since 2016, fueled by stagnant reimbursement, growing Medicare Advantage enrollment and surging operating costs, according to a report published Aug. 18 by Omniscient Health, a data science, research and consulting firm.
As financial pressure mounts, some health systems are pulling out of Medicare Advantage entirely, and more physicians may soon scale back their Medicare panels or exit the program altogether.
Becker’s spoke with Meade Monger, PhD, CEO of Omniscient Health and coauthor of the report, about what these converging forces could mean for physician sustainability, Medicare access and the broader healthcare system.
Editor’s note: Responses were lightly edited for length and clarity.
Question: With physicians losing more than a third of their Medicare income since 2016, how close are we to a tipping point where treating Medicare patients becomes financially untenable for most practices?
MM: Doctors are caught between a rock and a hard place. Medicare patients make up a large part of many practices. According to KFF,
- There are roughly 67 million Medicare patients;
- Nearly half of the $1 trillion in gross Medicare benefit spending in 2023 (49% or $493 billion) was spent on Part B services;
- Medicare Part B spending accounts for 25% of all national spending for physician and clinical services make up about 20% of all;
- And 54% of all Medicare members are in MA plans.
This is a double-edged sword for healthcare providers. Opting out completely from Medicare would inevitably inflict serious volume reduction issues, but serving Medicare patients causes financial hardships for physicians. To get on stronger financial footing, doctors could drop the MA plans that are their biggest loss-leaders.
We’re already seeing health systems reaching a breaking point. The Healthcare Financial Management Association found that 19% of health systems have stopped accepting at least one MA plan while another 61% planning to do so or actively considering it. Of course, these steps affect the doctors who are treating MA patients.
Nonetheless, if the gap keeps widening between cost and payment, more doctors will be forced to scale back on Medicare patients, shift the practice focus away from seniors and/or reduce their patient panel and cut overhead and other costs accordingly.
Q: If current MA payment and administrative trends persist, could we see a “two-tier” Medicare system emerge, where seniors on Medicare Advantage plans have far fewer provider choices than those on traditional Medicare?
MM: It is unclear how many providers understand how much less they are paid from MA vs traditional Medicare. Naturally, as they develop a better understanding of the cost and payment imbalance and realize the negative impact on their ability to cover their costs by treating MA patients, this could very well lead to more of a two-tier Medicare system. The challenge will be balancing the increasing patient demand for MA vs. the declining physician demand for MA.
Q: Given that commercial insurers often benchmark rates to Medicare, how might this reimbursement decline ripple out to the broader healthcare payment system?
MM: Many commercial payers benchmark to Medicare but set their reimbursements above the Medicare rates. A few years ago, KFF reported that private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies, for physician services.
As Medicare payments to physicians drop — and inflation further erodes their value — private insurers, which often base their rates on Medicare’s, also keep their own payments low. Medicare rate cuts often propagate into commercial fee schedules directly via percent-of-Medicare contracts or indirectly via leverage in negotiations.
As Medicare rates decline and cause profitability challenges, physicians try to make up for this with commercial-based revenue. But success is bound to be limited: If commercial rates also drift down based on Medicare benchmarks, practices face system-wide margin erosion.
Q: What are the potential downstream effects (e.g., on emergency department overcrowding, patient outcomes, healthcare spending, etc.) if seniors increasingly delay or forgo care due to restricted access?
MM: Seniors may face a grim future. If the inadequate reimbursement rates continue, the trend will lead to less patient access to healthcare providers because of a shrinking population of physicians willing to accept Medicare. In turn, it will increase ER visits because of requirements to treat all patients (EMTALA). Deferred diagnoses, treatments and chronic-disease management drive avoidable complications, with worse outcomes including higher mortality and poorer quality of life due to functional decline. At the same time, deferred care will drive higher costs for treating for sicker patients.
Q: If current trends continue, what will the Medicare physician landscape look like in 10 years?
MM: Extrapolating the last 10 years over the next 10 years would not be even financially sustainable for healthcare providers. There would be different impacts based on the types of physicians. Some physicians see more elderly patients than others based on specialty.
Physicians employed by health systems are also directly affected. The American Hospital Association estimates that hospitals have negative 13% margins on Medicare services. Medicare services constitute 25% of hospital care and commercial insurance covers 37%, according to AHA. With payments negatively impacted by declining Medicare rates, a continuation of past trends into the future will essentially wipe out operating margins.
The post Why a ‘two-tier Medicare system’ may be on the horizon appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
Texas surgical hospital evacuates 200 people after burst pipe floods facility
Amarillo, Texas-based Northwest Surgical Hospital evacuated around 200 people on Aug. 19 after a broken pipe flooded the facility, Amarillo Globe-News reported Aug. 20.
Northwest Surgical Hospital is part of Northwest Texas Healthcare System in Amarillo, according to its website. Another medical clinic, owned by BSA Health System and located in the same building as Northwest Surgical, was also impacted.
At 4:09 p.m., the Amarillo Fire Department was dispatched to the scene. Upon arrival eight minutes later, crews found water coming from Northwest Surgical’s entrance, with six inches of standing water across the facility. The flooding also caused ceiling tiles to sag in the facility. Medical equipment was covered with tarps to prevent damage, the publication said.
The flooding was caused by a two-inch line supplying the facility’s fire riser room that had ruptured under the foundation. Due to the location of the flooding, crews were forced to shut down the water by using a separate valve elsewhere on the property.
Around 200 people, mainly employees, were evacuated safely. No injuries were reported, and one post-surgical patient was transferred to Northwest Texas Hospital.
Structural and electrical engineers are scheduled to inspect the building on Aug. 20. Hospital reopening and patient services updates are expected once the assessments are finished.
Becker’s has reached out to Northwest Texas Healthcare System and the Amarillo Fire Department for comment and will update this story should more information become available.
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Judy Faulkner unveils ‘healthcare intelligence’
With AI wrapped around all features of Epic, Judy Faulkner introduced “healthcare intelligence” for her company’s EHR.
“We are combining the intelligence and curiosity of the human being with the investigative capabilities of gen AI,” Ms. Faulkner said Aug. 19 at Epic’s annual Users Group Meeting in Verona, Wis. “And instead of calling it artificial intelligence, we’re calling it healthcare intelligence.”
In front of a packed, 11,400-seat auditorium, the Epic CEO and co-founder revealed to her health system customers the new AI features being incorporated into the EHR.
“For the data, there is the EHR, the patient’s medical record, and, integrated with the patient’s MyChart, the patient’s voice and thoughts,” she said. “Then there is the Health Grid [which connects Epic to nonprovider organizations] plus the learnings from the huge amount of high-quality patient data in Cosmos,” Epic’s research platform.
Cosmos, which nearly two-thirds of Epic’s customers have already joined, contains deidentified data from 300 million unique patients, 16 billion encounters and 1.7 trillion medical events. Health Grid includes payers, standalone specialists, care at home, and medical device manufacturers.
Merging all of these sources, Epic will be able to “predict the future” for patients, Ms. Faulkner said.
Ms. Faulkner also unveiled Epic’s new ambient documentation tool. Clinicians will use Epic’s smartphone and tablet apps — Haiku and Canto — to record patient visits, which Microsoft’s Dragon ambient AI technology will transcribe and “diarize,” as she put it.
“We’ll work to create the best final note using a combination of Microsoft note components and Epic note components,” she said. “You’ll be able to license the AI charting capability from Epic. … Customers can use other third parties to do ambient AI, as they do today.”
The tool will be available in early 2026.
Epic also presented its new AI assistants: Art for clinicians, Emmie for patients and Penny for revenue cycle management. The AI will create what Ms. Faulkner deemed an “intelligent visit,” with note generation, real-time prior authorizations and diagnostic advice. The various AI agents have different release dates.
“Art can look through Cosmos and be a diagnostic advisor for the patient you’re seeing. For example, Art could say: [Of] 24,572 patients like this, 97% of them have diagnosis A and only 5.5% have diagnosis B, which is the one you’ve prescribed. So do you think you should rethink it?” she said. “So Art and Cosmos would be able to predict many things: the probability of disease, the onset of symptoms, diagnosis and treatments, and after the visit, Emmie will help patients understand their test results and answer some of their questions.”
With a “large medical model” trained on Cosmos data, Epic plans to use AI to predict patients’ journeys over their lifetimes — say, the likelihood of when they might have a heart attack — so providers can intervene early. Patients would have as many as 25 potential “timelines” each.
The company has 160 to 200 AI projects in the works, Ms. Faulkner said.
Epic’s Executive Package also allows health systems to compare how they stack up against their peers on AI adoption, she said. Epic’s Launch Pad helps organizations roll out the AI features. The pricing options include a pay-as-you-go option and a new all-inclusive approach with predictable pricing.
The theme for this year’s Users Group Meeting was science fiction.
“A lot of sci-fi predicts a future that comes true. Why do we predict the future? We predict the future so we can prepare for it, and so we can change it,” Ms. Faulkner said. “Epic AI — learning from the electronic health record, MyChart, the Health Grid and the stories of billions of patient encounters is Cosmos, and helping you with each of your patients individually — is sci-fi turning into reality.”
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Tampa General Hospital partners with CLEAR to fight rising cyber threats
Tampa General Hospital has teamed up with identity verification company CLEAR to bolster its cybersecurity defenses and improve digital access for employees.
The partnership integrates CLEAR’s CLEAR1 platform into Tampa General’s identity access management system, PingOne DaVinci. The hospital said in an Aug. 20 news release that the move automates password resets, cutting down on manual help desk calls and provides stronger protection against identity-related threats such as social engineering and impersonation.
CLEAR1 uses biometric multi-factor authentication to verify identity. Team members set up the system once with a government-issued ID and a selfie, creating a reusable identity credential. Tampa General said the process ensures only the rightful user can regain access to systems while reducing downtime for clinical staff.
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28 statistics on hospital financials by state: Moody’s
Hospitals nationwide are showing signs of stronger financial footing, though the pace of recovery varies by region, according to a report from Moody’s.
Rising revenues and moderating expenses are contributing to healthier margins, while liquidity and leverage trends highlight both opportunities and ongoing pressures. At the same time, reliance on government payers continues to shape hospital financial strategies, underscoring the complex environment leaders are navigating in 2024.
Here are 28 statistics based on the Moody’s report on hospital medians released Aug. 14.
Midwest
1. Median operating cash flow margin: 6.1% (up from 5.2% in 2023)
2. Revenue growth rate: 8.5%
3. Expense growth rate: 6.7%
4. Days cash on hand: 216
5. Debt to cash flow: 3.1x
6. Total Medicare patient revenue sources by gross revenue: 48.3%
7. Total Medicaid patient revenue sources by gross revenue: 14.9%
Northeast
8. Median operating cash flow margin: 5.3% (after 2 years of around 4%)
9. Revenue growth rate: 9.2%
10. Expense growth rate: 7.7%
11. Days cash on hand: 148
12. Debt to cash flow: 3.5x
13. Total Medicare patient revenue sources by gross revenue: 48.1%
14. Total Medicaid patient revenue sources by gross revenue: 16.5%
South
15. Median operating cash flow margin: 7.8% (up from 5.7% in 2023)
16. Revenue growth rate: 10%
17. Expense growth rate: 7.4%
18. Days cash on hand: 196
19. Debt to cash flow: 3.0x
20. Total Medicare patient revenue sources by gross revenue: 48.8%
21. Total Medicaid patient revenue sources by gross revenue: 13.7%
West
22. Median operating cash flow margin: 6.3% (up from 5.2% at its low point during the pandemic)
23. Revenue growth rate: 8.8%
24. Expense growth rate: 7.9%
25. Days cash on hand: 187
26. Debt to cash flow: 3.5x
27. Total Medicare patient revenue sources by gross revenue: 44.9%
28. Total Medicaid patient revenue sources by gross revenue: 18.4%
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Missouri hospital staff provides lifesaving care to CEO after heart attack
Bill Bridges, CEO of Texas County Memorial Hospital in Houston, Mo., became a heart patient at work and was saved by the actions of staff.
Mr. Bridges discussed his story in an Aug. 15 hospital news release.
“I had just mowed the grass and was relaxing at home when I started walking down the hallway and noticed that my hands and fingers didn’t feel right,” Mr. Bridges recalled, referring to July 17, when he suffered a heart attack. “I told my wife, Shannon, that I thought something was wrong. Then I passed out and slid down the wall.”
After his wife called 911, Mr. Bridges regained consciousness and collapsed again when trying to get up, but then received care from EMS crew members Travis Mills and Jason Steelman, according to the release. An ECG at his home showed he suffered a severe heart attack, and he was transported to the Texas County Memorial Hospital emergency department.
Once he arrived at the hospital, Jared Emery, DO, the physician on call, ordered a second ECG as well as other testing that confirmed the heart attack, according to the release.
Mr. Bridges received a “clot buster” medication while at Texas County Memorial Hospital and was then transported to Cox Hospital in Springfield, Mo., a level 1 STEMI center.
At Cox Hospital, testing showed Mr. Bridges’ right coronary artery was completely blocked, and he underwent surgery, according to the release. He returned home after a two-night hospital stay and began a 12-week cardiac rehabilitation program at Texas County Memorial Hospital.
“I am proud to share stories about our patient outcomes every chance I get — how we make a difference in people’s lives,” Mr. Bridges said in the release about the hospital he leads. “Now I have my own story. I experienced firsthand the extraordinary care our staff provides. If TCMH hadn’t been here, my outcome could have been very different. I am deeply proud of — and grateful for — every member of our team.”
Texas County Memorial Hospital is a 66-bed, general acute care institution with a main campus in Houston and clinics across Texas and Wright counties in Missouri.
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Vermont hospital halts surgeries amid sterilization issues
Northwestern Medical Center is temporarily pausing surgeries as it investigates small particulate matter found on sterilized surgical trays.
In an Aug. 19 post on its website, the St. Albans, Vt.-based hospital said it is working to address “very small particulates” surgical services team members have found during routine safety checks before surgery.
“This isn’t an issue of sterility with the surgical trays or instruments — our regular testing show that the trays are properly sterilized,” the hospital said. “When particles have been identified, those trays have not been used.”
Northwestern Medical Center is working with Steris, a company that manufactures and services surgical equipment, to investigate and remediate the issue, which may be related to the hospital’s water source. The hospital said it is “looking at each step in the process to isolate the source.” During the surgery pause, the hospital is replacing surgical trays and installing a reverse osmosis system to remove potential water impurities.
Employees are notifying patients whose procedure may be affected by the delays.
“We will bring surgeries back online when we are confident that the solution has been fully implemented and the problem will not recur,” Northwestern Medical Center said.
Other hospitals have faced similar sterilization-related disruptions in recent years, where surgery pauses were triggered by malfunctioning machinery. The issues come as some healthcare facilities grapple with aging infrastructure and a shortage of sterile processing staff.
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3 Florida health systems invest in nurse training facility
Orlando-based University of Central Florida opened a new nurse training facility, made possible in part by financial support from three Florida health systems.
The Dr. Phillips Nursing Pavilion will enable UCF to graduate an additional 150 licensed nurses each year, according to an Aug. 18 news release from the university.
The facility was established through $43 million in funding from the state of Florida and more than $29 million from private donors, the release said.
Altamonte Springs, Fla.-based AdventHealth provided “significant investment toward the new building and student scholarships,” according to an Aug. 18 news release from the health system.
Orlando (Fla.) Health and Jacksonville, Fla.-based Nemours Children’s Health also donated financial support for the new facility, the UCF news release said.
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Mass General Brigham posts 1.3% margin in Q3
Somerville, Mass.-based Mass General Brigham recorded an operating income of $74.4 million (1.3% operating margin) in the third quarter of 2025, up from $47.2 million (0.9% margin) during the same period last year, according to its Aug. 15 financial report.
The system reported total operating revenue of $5.8 billion for the three months ended June 30, a 12% increase year over year. Patient care revenue totaled $3.7 billion, an 8% increase year over year. The system said this reflected a 3% increase in acute care discharges. Premium revenue increased 19% year over year to $671 million.
Operating expenses totaled $5.8 billion in the quarter, a 12% increase year over year. Wages and benefits increased 8% year over year to $2.8 billion, reflecting patient utilization trends and inflationary pressure on wages. Supplies and other expenses increased 21% year over year, reflecting increased costs and use of pharmaceutical and other clinical supplies. Health Plan medical claims increased 19% year over year to $464 million.
Mass General Brigham reported a net income of $1 billion in the quarter, up from $277 million during the same period last year.
In February, Mass General Brigham announced it was eliminating and rescoping a number of management and administrative roles “to better align the rates of expected revenue and expense growth.” The reorganization is expected to save the system $240 million annually.
“Management continues to focus on initiatives that can drive sustained performance improvement, including patient care throughput and labor management efficiencies, and monitoring emerging federal actions and developing action plans to mitigate potential financial impacts,” the system said in the report.
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Hospitals made EHR engagement gains but key gaps remain: 5 notes
Most U.S. hospitals had adopted foundational digital tools that enable patients to access their health information electronically by 2024, according to an August 2025 data brief from the Office of the Assistant Secretary for Technology Policy / Office of the National Coordinator for Health IT.
Five things to know:
1. Nearly all hospitals support foundational patient engagement tools. In 2024, 99% of hospitals enabled patients to view their health information, 96% allowed downloads, 84% allowed transmission to third parties, and 92% offered secure provider messaging, according to an August 2025 data brief from the Office of the Assistant Secretary for Technology Policy.
2. Most hospitals also offered access to clinical notes and apps. The share of hospitals that let patients view clinical notes reached 95%. App-based access was available in 81% of hospitals via APIs, and 70% offered FHIR-enabled app access.
3. Advanced capabilities remain less common. Just 62% of hospitals enabled patients to submit their own health data, and only 56% allowed record imports from external organizations.
4. Adoption has steadily grown since 2021. Hospitals with all foundational capabilities rose from 72% in 2021 to 80% in 2024. Those offering both emerging capabilities (notes and app access) grew from 65% to 85%, and advanced tools (import and patient-generated data) increased from 37% to 45%.
5. Lower-resourced hospitals lag in app-based access. In 2024, FHIR app access was available at 84% of large hospitals but only 66% of small hospitals. Hospitals using the market-leading EHR vendor had higher adoption of app access (92%) than those using other vendors (70%).
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6 recent hospital, health system CEO moves
Becker’s has recently reported on the following hospital and health system CEO moves, including appointments and exits.
Note: This page was created March 19 and updated Aug. 20.
Aug. 13-19
1. Patrick Swindle was named CEO of Longview (Texas) Regional Medical Center, effective Sept. 30.
2. Megan Gillespie, DNP, RN, was appointed CEO of Sacramento, Calif.-based Sutter Medical Center.
3. Nick Arledge was named CEO of Merit Health River Region in Vicksburg, Miss.
4. Scott Avery was appointed CEO of Canyon Vista Medical Center in Sierra Vista, Ariz.
5. Kevin Zachary was named CEO of Jerseyville, Ill.-based JCH Healthcare.
6. Monte Wilson, CEO of Christus St. Frances Cabrini Hospital in Alexandria, La., will also serve as CEO of Ochsner Southwestern Louisiana, which includes two hospitals in Lake Charles.
Aug. 7-13
1. Bernard Leger plans to step down Sept. 5 as CEO of Victoria, Texas-based DeTar Healthcare System.
2. Mark Gregson was appointed interim CEO of Olympic Medical Center in Port Angeles, Wash.
3. Kelly Morgan was named interim president and CEO of Bay Area Hospital in Coos Bay, Ore.
4. Travis Battagler, BSN, was named CEO of Girard (Kan.) Medical Center.
5. Ruth Duling retired as CEO of Girard (Kan.) Medical Center.
6. Kenny Shafer was named CEO of UAB St. Vincent’s Birmingham (Ala.), effective Sept. 2.
7. Jeff Graham plans to retire Sept. 30 as president and CEO of Chillicothe, Ohio-based Adena Health.
8. Katherine Edrington, DNP, was named president and CEO of Chillicothe, Ohio-based Adena Health.
July 30-Aug. 6
1. Jennifer Opsut was named CEO of Carondelet St. Mary’s Hospital in Tucson, Ariz., part of Dallas-based Tenet Healthcare.
2. Tiffany Means, DNP, RN, was appointed CEO of Eureka Springs (Ark.) Hospital.
3. Eric Neal was named CEO of Morton, Wash.-based Arbor Health, effective Aug. 25.
4. Darryl Wolfe stepped down as CEO of Olympic Medical Center in Port Angeles, Wash.
5. David Was was appointed CEO of HCA Florida Highlands Hospital in Sebring.
6. Chase Tikker was named CEO of AdventHealth Lake Nona (Fla.), effective Aug. 10.
July 23-29
1. Jason Barrett was named CEO of The George Washington University Hospital in Washington, D.C., effective Aug. 18.
2. Guy Hudson, MD, was appointed president and CEO of Brewer, Maine-based Northern Light Health, effective in mid-October.
3. Andy Dreesen, CEO of St. Vincent Health in Leadville, Colo, plans to step down in mid-September.
4. Paul Gaden was appointed CEO of Memorial Regional Hospital in Hollywood, Fla.
5. Barbara “Barb” Martin stepped down as CEO of St. Joseph Medical Center in Joliet, Ill.
6. Brian Barta resigned July 15 as CEO of William Newton Hospital in Winfield, Kan.
7. Parker Pridgen, CEO of AdventHealth Apopka (Fla.), plans to step down in August.
8. Tim Hingtgen plans to retire as CEO of Franklin, Tenn.-based Community Health Systems, effective Sept. 30.
9. Kevin Hammons, president and CFO of Franklin, Tenn.-based Community Health Systems, will become interim CEO.
10. David Butler, CEO of McKenzie-Willamette Medical Center in Springfield, Ore., was dismissed from his role.
11. Michael Clark was appointed CEO of Wilkes-Barre (Pa.) General Hospital.
July 17-22
1. Tom Keller was named president and CEO of Bay City, Mich.-based McLaren Bay Region, effective Aug. 11.
2. Nathaniel Beers, MD, was named president and CEO of Blythedale Children’s Hospital in Valhalla, N.Y.
3. Brian Moore resigned as CEO of Bay Area Hospital in Coos Bay, Ore., on July 16.
4. Austin Manning was appointed president and CEO of Mercy San Juan Medical Center in Sacramento, Calif.
5. Kevin Flanigan, MD, CEO of Warm Springs-based Montana State Hospital, is stepping down after about a year in the role.
6. Daniel Bemporad, DO, was named interim CEO of Warm Springs-based Montana State Hospital, effective July 26.
7. Wendy Horton, PharmD, CEO of UVA Health University Medical Center in Charlottesville, Va., will leave the organization in September for a new role.
8. Tom Patrias was named CEO of University Medical Center New Orleans, effective Aug. 1.
July 9-16
1. Andrew Bedi exited his role as CEO of The Medical Center at Russellville (Ky.), and was named COO of HCA Healthcare’s Doctors Hospital of Augusta (Ga.).
2. Callen Weispfennig was appointed CEO of Audubon (Iowa) County Memorial Hospital and Clinics.
3. Jeff Comer, PsyD, stepped down from his role as CEO of Show Low, Ariz.-based Summit Healthcare due to personal health reasons.
4. Billy Gardner, MSN, RN, chief clinical officer of Show Low, Ariz.-based Summit Healthcare, was named interim CEO.
5. Mark Roberts was named CEO of HCA Healthcare’s Alaska Regional Hospital in Anchorage. He stepped into the role in June.
6. Emily Chapman, MD, was appointed president and CEO of Minneapolis-based Children’s Minnesota, effective Aug. 2.
7. Pete Long-Innes was named CEO of TriStar NorthCrest Medical Center, a HCA Healthcare facility in Springfield, Tenn.
8. Craig Moore was appointed CEO of AdventHealth Kissimmee (Fla.), effective July 27.
9. Paari Gopalakrishnan, MD, was named president and CEO of Towson, Md.-based GBMC HealthCare, effective in September.
10. Williams Giles was appointed CEO of Magnolia (Ark.) Regional Medical Center.
11. Sony Sidhu, DNP, RN, was named CEO of Madera (Calif.) Community Hospital.
12. Paul Minardi, MD, executive vice president and CEO of the KP Medical Foundation since 2022, was appointed executive vice president of enterprise clinical integration and growth at Oakland, Calif-based Kaiser Permanente.
13. Mary Beckerle, PhD, plans to step down as CEO of Huntsman Cancer Institute, part of Salt Lake City-based University of Utah Health, effective Sept. 1.
July 3-8
1. John Nickens was named president and CEO of Phoenix Children’s effective no later than Oct. 1.
2. Liz Dunne, president and CEO of Vancouver, Wash.-based PeaceHealth, will retire after a decade at the organization.
3. Sarah Ness, executive vice president and chief administrative officer of PeaceHealth, was appointed president and CEO, effective Jan. 3.
4. Ketul Patel, CEO of Tacoma, Wash.-based Virginia Mason Franciscan Health, will exit his role to become president and CEO of Marietta, Ga.-based Wellstar Health System.
5. Aimee Keller-Pickford was appointed CEO of AdventHealth Winter Garden (Fla.).
6. Sheila Rankin was named CEO of AdventHealth Winter Park (Fla.).
7. Cliff Wilson was appointed market president and CEO of Albuquerque, N.M.-based Lovelace Health System, effective Aug. 11.
8. Brian Roland was named CEO of Elkview General Hospital in Hobart, Okla.
9. Wyatt Chocklett was named CEO of Dickson, Tenn.-based TriStar Horizon Medical Center.
10. Anne Gunther, DNP, RN, was appointed CEO of Pomerene Hospital in Millersburg, Ohio.
11. Wyatt Brieser was named CEO of Hammond-Henry Hospital in Geneseo, Ill.
12. Jeff St. Clair, president and CEO of Springhill Medical Center in Mobile, Ala., will retire in August.
13. Dave Ressler, CEO of Aspen (Colo.) Valley Health, plans to retire in 2026.
June 25-July 1
1. Bryan Mills, president and CEO of Indianapolis-based Community Health Network, plans to retire at the end of 2025 after 16 years in the role.
2. Cliff Wilson will step down July 23 as CEO of Georgetown (Ky.) Community Hospital and president of Brentwood, Tenn.-based Lifepoint Health’s Central Kentucky market.
3. Abel Biri was appointed CEO of AdventHealth Orlando (Fla.), the flagship facility of Altamonte Springs, Fla.-based AdventHealth.
4. Ella Goss, MSN, RN, plans to retire Aug. 1 as chief executive of Anchorage-based Providence Alaska.
5. Jita Pandya Buño was named CEO of University of Washington Medical Center in Seattle, effective Sept. 1.
6. Jason Smith, MD, PhD, chief medical officer of Louisville, Ky.-based UofL Health, was appointed interim CEO.
7. Rick Allen retired as CEO of Warren (Pa.) General Hospital after more than a decade.
8. Tom Miller, the inaugural CEO of Louisville, Ky.-based UofL Health, stepped down June 25.
9. Rich Liekweg, CEO of St. Louis-based BJC Health System, plans to retire Oct. 1.
10. Garrett Colglazier, COO of Sabetha (Kan.) Community Hospital, was named CEO.
June 24-25
1. William “Bill” Alley, BSN, RN, was named CEO of Twin County Regional Healthcare, a Duke LifePoint facility in Galax, Va. He stepped into the role June 23.
2. John Herman, CEO of Penn Medicine Lancaster General Health, part of Philadelphia-based University of Pennsylvania Health System, was tapped as president of Tufts Medical Center in Boston, effective in early September.
3. Joseph Impicciche, CEO of St. Louis-based Ascension, will retire at the end of 2025 after leading the health system since 2019.
4. Eduardo Conrado, president of St. Louis-based Ascension, was appointed CEO, effective Jan. 1, 2026.
5. Jeff Johnston was named president and CEO of Tulsa, Okla.-based Hillcrest HealthCare System, effective July 14.
6. Kevin Gross is retiring as president and CEO of Tulsa, Okla.-based Hillcrest HealthCare System.
7. David Theroux was appointed CEO of Hendry Regional Medical Center in Clewiston, Fla. He assumed the role June 16.
8. Jane Russell, PharmD, was named president and CEO of Bath Community Hospital in Hot Springs, Va., effective Aug. 25.
9. Troy Greer resigned as president and CEO of Albuquerque, N.M.-based Lovelace Health System after two years in the role.
10. Michael Kueker, CEO of Lovelace Medical Group, was named interim CEO of Albuquerque, N.M.-based Lovelace Health System.
June 11-19
1. Cyndee McGuire, president and CEO of Monadnock Community Hospital in Peterborough, N.H., plans to retire in early 2026.
2. Nicole Tucker, RN, was named CEO of LewisGale Hospital Alleghany in Low Moor, Va.; it is part of Nashville, Tenn.-based HCA Healthcare.
3. Lori Mazanec, CEO of Box Butte General Hospital in Alliance, Neb., has taken a medical leave of absence.
4. Brian Shelmadine, DO, PhD, chief medical officer of Box Butte General Hospital in Alliance, Neb., was named interim CEO.
5. Chris Pizzi, chief executive of Providence Oregon’s South Division, was appointed COO and CFO of Asante Rogue Regional Medical Center in Medford, Ore.
6. Gary Herbst, CEO of Visalia, Calif.-based Kaweah Health, plans to retire June 30, 2026.
7. Mick Brant, CEO of Gothenburg (Neb.) Health, was placed on administrative leave by the hospital board.
8. Andrew Knust, CFO of Gothenburg (Neb.) Health, was named interim CEO.
9. Cam Patterson, MD, chancellor of Little Rock-based University of Arkansas for Medical Sciences and CEO of UAMS Health, plans to step down due to medical and personal reasons.
June 4-11
1. Megan Ryan, president and CEO of Nassau University Medical Center in East Meadow, N.Y., was placed on administrative leave.
2. Richard Becker, MD, was named interim president and CEO of Nassau University Medical Center in East Meadow, N.Y.
3. Joseph Gleason was named CEO of HCA Florida University Hospital in Davie.
4. Jason Paret will step down as CEO of Avalon, Calif.-based Catalina Island Health on Sept. 30.
5. Justin Birmele was appointed president and CEO of AdventHealth Gordon in Calhoun, Ga., and AdventHealth Murray in Chatsworth, Ga., effective June 15.
6. Abdul Khan, MD, was named CEO of Ochsner River Region, part of New Orleans-based Ochsner Health.
7. Saad Ehtisham was appointed president and CEO of Morristown, N.J.-based Atlantic Health System, effective July 30.
8. Blair Kent has retired as CEO of MemorialCare’s Long Beach (Calif.) Medical Center and Miller Children’s and Women’s Hospital Long Beach.
9. Jennifer Liter, DNP, RN, was named CEO of Carroll County Memorial Hospital in Carrollton, Ky.
May 28-June 3
1. Christy Jordan, BSN, RN, chief legal officer at Brunswick, Ga.-based Southeast Georgia Health System, was appointed president and CEO.
2. Dipen Parekh, MD, was named CEO of the University of Miami Health System and executive vice president for health affairs at the University of Miami.
3. Shaun Phillips, PharmD, resigned as CEO of Canyon Vista Medical Center in Sierra Vista, Ariz.
4. Megan Ryan, president and CEO of Nassau University Medical Center in East Meadow, N.Y., plans to resign July 20 following a state-approved restructuring of the board that oversees the hospital.
5. Rosenda “Rosey” Barrera, MSN, RN, was named interim CEO of Saint Francis Hospital in Evanston, Ill., in addition to her role as chief nursing officer.
6. Lori Morgan, MD, president and CEO of Pasadena, Calif.-based Huntington Health, plans to step down before the end of 2025 to focus on her family.
7. James Leonard, DO, is leaving his position as CEO of Northwest Health-Porter in Valparaiso, Ind.
8. Jon Dingledine, COO and CFO of Coldwater, Ohio-based Mercer Health, was named CEO, effective July 1.
9. Michael Kupferman, MD, was appointed CEO of Hershey, Pa.-based Penn State Health, effective June 23.
May 21-28
1. Hollie Seeley was appointed CEO of Sutter Health’s California Pacific Medical Center in San Francisco, effective June 9.
2. Sudandra Ratnasamy, BSN, was named CEO of Rutherford Regional Health System, a Duke LifePoint facility in Rutherfordton, N.C., effective June 23.
3. Joy Coulston stepped down as CEO of Powell (Wyo.) Valley Healthcare after having served in the role since June 2023.
4. David Brash was appointed CEO of Raleigh General Hospital in Beckley, W.Va., effective July 7.
5. Dave Ramsey plans to retire as president and CEO of Charleston, W.Va.-based Vandalia Health in July 2026.
6. Bart Carter, MD, chief medical officer of Mount Graham Regional Medical Center in Safford, Ariz., was named interim CEO and administrator in charge.
7. Roland Knox, CEO of Mount Graham Regional Medical Center in Safford, Ariz., is taking an extended absence due to a health issue.
8. Rob Deininger, market CEO for the AdventHealth Central Florida Division’s quaternary hub, was named president and CEO of the AdventHealth’s East Florida Division.
9. Kari Vargas, CEO of AdventHealth Winter Garden (Fla.), was appointed CEO of AdventHealth’s Central Florida Division North Market.
10. Doug Harcombe, CEO of AdventHealth Celebration (Fla.), was named CEO of AdventHealth’s Central Florida Division South Market.
May 14-19
1. Jamie Youssef was named CEO of Ascension Texas, effective June 1.
2. Scott Robertson, MD, was named CEO of Dignity Health Foundation and system senior vice president of the Physician Enterprise, California Region, for Chicago-based CommonSpirit Health.
3. Linda Walker was appointed CEO of Llano (Texas) Regional Hospital.
4. Michele Morrison, RN, was named president and chief hospital executive of Hackensack Meridian’s JFK University Medical Center in Edison, N.J.
5. Tamar Kutz was appointed interim president and CEO of Decatur (Ill.) Memorial Hospital, effective May 25.
6. Christian Wallis was named interim CEO of Northern Inyo Healthcare District, which operates a 25-bed critical access hospital in Bishop, Calif.
7. Paula Bell, PharmD, was appointed CEO of West Tennessee Healthcare’s Henry County Hospital in Paris, Tenn.
8. Seleem Choudhury, DNP, RN, was named president and CEO of UChicago Medicine AdventHealth GlenOaks in Glendale Heights, Ill., effective June 15.
9. Carolyn Jackson was named CEO of Encompass Health Rehabilitation Hospital of Braintree (Mass.).
10. John Whitlock resigned as CEO of MetroWest Medical Center in Framingham, Mass., part of Dallas-based Tenet Healthcare.
11. Sean Lally, executive vice president and chief strategy officer of Bayside, N.Y.-based St. Mary’s Healthcare System for Children, has been appointed president and CEO.
12. Edwin Simpser, MD, will retire at the end of June as president and CEO of Bayside, N.Y.-based St. Mary’s Healthcare System for Children.
May 7-14
1. Owen Bailey, CEO of Mobile, Ala.-based USA Health, will retire Aug. 1.
2. Michael Dowling will transition from president and CEO of New Hyde Park, N.Y.-based Northwell Health to become CEO emeritus, effective Oct. 1.
3. Audrey Gregory, PhD, MSN, RN, was named senior executive vice president and CEO of Altamonte Springs, Fla.-based AdventHealth’s multi-division delivery network.
4. Dan Barbee, BSN, was named CEO of University of Toledo Medical Center in Ohio after serving in the role on an interim basis.
5. Sandra Scott, MD, was appointed CEO of New York City-based One Brooklyn Health after serving in the role on an interim basis since January 2024.
6. Misty Robertson, DNP, RN, was named CEO of Blue Mountain Hospital District, which includes a 25-bed hospital in John Day, Ore., and a 40-bed care center in Prairie City, Ore.
7. Ken Stevens was appointed CEO of Medical City Frisco (Texas).
8. Cheryl Cioffi, DNP, RN, was named president and CEO of Frederick (Md.) Health, effective July 1.
April 30-May 7
1. Rachael Prather, BSN, RN, was named CEO of Ferrell Hospital in Eldorado, Ill.
2. Tanner White was appointed CEO of the future Altru Hospital in Devils Lake, N.D., which Altru Health System is in the process of acquiring from Chicago-based CommonSpirit Health.
3. Brian Brennan was named president and CEO of Hospital Sisters Health System’s central Illinois market and HSHS St. John’s Hospital in Springfield, Ill., effective May 27.
4. Wesley (Wes) Taylor was appointed CEO of Memorial Health Meadows Hospital in Vidalia, Ga., part of Nashville, Tenn.-based HCA Healthcare.
5. Cindy Bergmeier was named CEO of TriStar Summit Medical Center in Hermitage, Tenn., part of Nashville, Tenn.-based HCA Healthcare.
6. Steven Webb was named president and CEO of Batesville, Ark.-based White River Health.
7. Jeff Cook was appointed president and CEO of Hattiesburg, Miss.-based Forrest Health after serving in the role on an interim basis.
8. Tony Esposito, former CEO of Crozer Health, was named CEO of Temple Physicians, Philadelphia-based Temple Health’s network of community-based providers. He was also named CFO of Temple Faculty Physicians.
9. Collier Douglas “Doug” Long was named CEO of CHA Hollywood Presbyterian Medical Center in Los Angeles.
10. Dale Neely was appointed CEO of HCA Florida Capital Hospital in Tallahassee, Fla.
11. Amber Deardorff, BSN, RN, was named president and CEO of Mary Greeley Medical Center in Ames, Iowa, effective Aug. 1.
April 23-30
1. Mike Ditoro, PharmD, was named CEO of Desert Regional Medical Center in Palm Springs, Calif.
2. Justin Harris was appointed CEO of Daviess Community Hospital in Washington, Ind., effective July 1.
3. Patrick Conway, MD, was named CEO of Eden Prairie, Minn.-based Optum, effective May 6.
4. Bruce Eady, MSN, RN, was named CEO of Milwaukee Rehabilitation Hospital at Greenfield (Wis.).
5. Julie Covault, COO of Sidney, Ohio-based Wilson Health, was appointed acting CEO.
6. Derek Drake, DNP, RN, CEO of Orange County Global Medical Center in Santa Ana, Calif, will become president of Mercy Hospital of Buffalo (N.Y.) in July.
7. Julie Lacy was appointed CEO of Crete (Neb.) Area Medical Center after serving in the role on an interim basis for six months.
8. Garett May was named president and CEO of West Jefferson Medical Center in Marrero, La.
9. Sue Shugart was appointed CEO of Haywood Regional Medical Center in Clyde, N.C., and market president of two other Duke LifePoint hospitals in the state, effective May 26.
10. Victoria Woodrow will step down July 24 as CEO of Hamilton Memorial Hospital District in McLeansboro, Ill.
11. Justin Epperson, CFO of Hamilton Memorial Hospital District in McLeansboro, Ill., was named interim CEO.
12. Brian Dieter will retire in early August as president and CEO of Mary Greeley Medical Center in Ames, Iowa.
13. John Hennelly stepped down as CEO of Sonoma (Calif.) Valley Hospital on April 22.
14. Ben Armfield, CFO of Sonoma (Calif.) Valley Hospital, was named interim CEO.
April 16-22
1. Wesley Burks, MD, CEO of UNC Health and dean of UNC School of Medicine, will step down from his roles Sept. 1.
2. Kaitlan Baston, MD, was appointed interim CEO of University Hospital in Newark, N.J., effective May 3.
3. Rob Anderson was named CEO of Lakewood Ranch (Fla.) Medical Center.
4. Jodi Coombs, BSN, RN, was appointed interim president and CEO of St. Christopher’s Hospital for Children in Philadelphia.
5. Robert Brooks will exit his role as interim CEO of St. Christopher’s Hospital for Children in Philadelphia, supporting the leadership transition before leaving the organization.
6. Andy Munce, MSN, RN, was appointed president and CEO of Sanford Health’s Sioux Falls, S.D., region after serving in the role on an interim basis.
7. Robert Parker, who was appointed CEO of Columbus, Ga.-based St. Francis Emory Healthcare in March, stepped down from his role later that month for personal reasons.
8. Bill Little was named CEO of Columbus, Ga.-based St. Francis Emory Healthcare, effective April 21.
9. Brian Canfield stepped down as CEO of Quincy, Ill.-based Blessing Health System.
10. Tim Tranor, DNP, RN, BSN, was named COO and interim CEO of Quincy, Ill.-based Blessing Health System.
11. Misty Jones, MSN, RN, was named president and CEO of Stanford Health Care Tri-Valley, effective June 9.
12. Hatch Smith Jr. resigned as CEO of Llano (Texas) Regional Hospital on April 15 for a new role.
April 10-15
1. Brett Kinman will resign as CEO of Magnolia (Ark.) Regional Medical Center, effective July 9.
2. Kerry Ashment was named CEO of Memorial Hospital of Carbon County in Rawlins, Wyo.
3. Gabe Bullaro was appointed CEO of HCA Florida North Florida Hospital in Gainesville, effective April 14.
4. Tony Esposito will step down as CEO of Upland, Pa.-based Crozer Health, effective April 18.
5. Gerald Cayer will retire as CEO of Lowville, N.Y.-based Lewis County Health System, effective Aug. 3, 2026.
6. Julie Freischlag, MD, will retire at the end of 2025 as CEO and chief academic officer of Winston-Salem, N.C.-based Atrium Health Wake Forest Baptist, chief academic officer of Charlotte, N.C.-based Advocate Health, and as executive vice president of health affairs at Wake Forest University in Winston-Salem.
7. Cameron Howard was named CEO of Oviedo (Fla.) Medical Center, part of HCA Florida Healthcare.
8. Kim Needham was appointed CEO of Waukegan, Ill.-based Vista Health System.
9. Kent LaCroix was named interim CEO of Schoolcraft Memorial Hospital in Manistique, Mich.
April 2-9
1. John McDonald was appointed president and CEO of Kerrville, Texas-based Peterson Health, effective in June.
2. Victoria Hanson, PhD, was named regional president and CEO of Avera Sacred Heart Hospital in Yankton, S.D., effective May 3.
3. Mitch Leckelt will retire June 1 after more than 11 years as CEO of UP Health System-Bell in Ishpeming, Mich.
4. Tonya Darner, CEO of UP Health System-Marquette (Mich.), will assume an expanded role as market CEO for UP Health System-Marquette and UP Health System-Bell in Ishpeming, Mich., effective June 1.
5. Timothy Dentry, president and CEO of Brewer, Maine-based Northern Light Health, plans to retire in 2025.
6. Richard Allen will retire June 30 as CEO of Erie, Pa.-based Warren General Hospital.
7. Dan Grolemund was named CEO of Erie, Pa.-based Warren General Hospital, effective July 1.
8. Hannah McRae, CFO of Cody (Wyo.) Regional Health, was appointed CEO.
9. Harry Wiggins was named CEO of Encompass Health Rehabilitation Hospital in Peterburg, Va.
10. Mallik Chowdary Yenigella was named CEO of Scenic Mountain Medical Center, a 146-bed acute care hospital in Big Spring, Texas.
11. Karen Pinsky was appointed permanent CEO of Penn Medicine’s Chester County Hospital in West Chester, Pa.
12. Charles Briscoe submitted his resignation as president and CEO of Warner Robins, Ga.-based Houston Healthcare.
13. Pierre Monice was appointed president and CEO of Fort Lauderdale, Fla.-based Holy Cross Health, effective May 11.
14. Gina Melby was named CEO of Alan B. Miller Medical Center, a 156-bed acute care hospital slated to open in spring 2026 in Palm Beach Gardens, Fla.
15. Brad Griffin was named CEO of HCA Healthcare’s Fairview Park Hospital in Dublin, Ga.
16. Thomas Klemond, MD, was appointed interim CEO of Minneapolis-based Hennepin Healthcare, effective April 11.
17. David Banks was named president and CEO of Altamonte Springs, Fla.-based AdventHealth.
18. Michelle Waller, MSN, RN, was named CEO of Gateway Regional Medical Center in Granite City, Ill.
March 26-April 2
1. Benjamin Hughes was named CEO of Moberly (Mo.) Regional Medical Center, part of Franklin, Tenn.-based Community Health Systems, effective June 2.
2. Sean Patterson was appointed CEO of Portsmouth (N.H.) Regional Hospital, part of Nashville, Tenn.-based HCA Healthcare.
3. James Longabaugh, DO, will step down in mid-summer as CEO of Sabetha (Kan.) Community Hospital.
4. Alec Kimmelman, MD, PhD, was selected as the next CEO of New York City-based NYU Langone Health and dean of NYU Grossman School of Medicine, effective Sept. 1.
5. Kathy Vancampen was named CEO and market president of Fleming County Hospital in Flemingsburg, Ky., and Meadowview Regional Medical Center in Maysville, Ky., effective April 7.
6. Cecil Miller III was appointed president and CEO of UHS Chenango Memorial Hospital in Norwich, N.Y.
7. Drake Lamen, MD, will retire in mid-April after 18 years as president and CEO of UHS Chenango Memorial Hospital in Norwich, N.Y.
8. Bill Waechter was named market CEO of San Antonio-based Baptist Health System, part of Dallas-based Tenet Healthcare.
9. Tina Eden, RN, was appointed CEO of Virginia Gay Hospital in Vinton, Iowa.
10. Marissa Kiefer, senior vice president and CEO of Children’s Memorial Hermann Hospital in Houston, was named president of UH Rainbow Babies & Children’s and UH MacDonald Women’s hospitals, both in Cleveland, effective June 1.
11. Jennifer DeCubellis will step down May 10 as CEO of Minneapolis-based Hennepin Healthcare System after five years in the role.
12. Reba Celsor, RN, was appointed CEO of Murray-Calloway County Hospital in Murray, Ky.
13. Kelly Haynie was named CEO of Ochsner Medical Center-West Bank Campus in Gretna, La., effective June 1.
14. Stephen DelRossi resigned as CEO of Bishop, Calif.-based Northern Inyo Healthcare District.
15. Allison Partridge, MSN, RN, chief nursing officer and COO of Bishop, Calif.-based Northern Inyo Healthcare District, was appointed acting CEO.
March 19-25
1. Russ Johnson plans to retire in August after having served as president and CEO of Lawrence, Kan.-based LMH Health since 2016.
2. Darlene Stromstad, president and CEO of Utica, N.Y.-based Mohawk Valley Health System, plans to retire in late 2025.
3. Ed Curtis, CEO of Springfield, Ill.-based Memorial Health, plans to retire March 31.
4. Diana Richardson was appointed interim president and CEO of Lawrence (Mass.) General Hospital and Holy Family Hospitals, effective April 14.
5. Dan Hernandez was named CEO of the Emerus WellSpan Health Market, part of York, Pa.-based WellSpan Health.
6. Mary Jo Cagle, MD, will step down May 31 as president and CEO of Greensboro, N.C.-based Cone Health due to a serious family health matter.
March 12-19
1. Nathan Worley was appointed CEO of The Hospitals of Providence-Transmountain Campus in El Paso, Texas, part of Dallas-based Tenet Healthcare.
2. Raymond Moreno, MD, was named chief executive of Providence St. Vincent Medical Center in Portland and Providence Oregon’s west service area.
3. Felix “Drew” Bigby was appointed CEO of Lower Keys Medical Center in Key West, Fla., effective April 28.
4. Jim Heckert, CEO of Christus Southern New Mexico in Alamogordo, will retire March 31.
5. Dave Henry will retire April 1 as CEO of Havre-based Northern Montana Health Care.
6. Kevin Harada, MD, was named CEO of Northern Montana Health Care.
7. Neil Meltzer plans to retire as president and CEO of Baltimore-based LifeBridge Health after more than 12 years in the role.
8. Cole Stockton was appointed CEO of Highpoint Health-Riverview in Carthage, Tenn., and Highpoint Health-Trousdale in Hartsville, Tenn.
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$30M gift fuels new Sutter Health cancer center
Sacramento, Calif.-based Sutter Health has received a $30 million gift to establish a new cancer center in Santa Cruz, Calif.
The Jean and E. Floyd Kvamme Advanced Cancer Center, expected to open in 2030, is part of a larger $50 million effort to “revolutionize cancer care and research” for Sutter Health’s community, according to an Aug. 14 news release from the health system.
Sutter Health is planning to open additional cancer centers across Northern California, in Santa Rosa, Modesto, Yuba City, and the Silicon Valley and East Bay regions, the release said.
The $30 million gift was from the Jean and E. Floyd Kvamme Foundation in honor of Jean Kvamme, who died in 2020 after battling cancer.
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Unemployment among new workers reaches 37-year high
The share of unemployed Americans with no prior work experience reached 13.4% in July — its highest level since April 1988, according to the Bureau of Labor Statistics.
One possible driver is uncertainty around trade policies, which research shows can dampen hiring, according to an Aug. 12 analysis from the Federal Reserve Bank of Richmond.
July’s overall unemployment rate was 4.2%, consistent with levels since May 2024.
The challenges extend beyond Generation Z, the youngest generation currently in the workforce. Long-term unemployment — defined as being jobless for at least 27 weeks — now accounts for 25.2% of all unemployed workers, its highest share since February 2022. The long-term unemployment rate has been rising since spring 2023, an increase unprecedented outside of recessions.
The dual pressure on both the least experienced workers and the long-term unemployed point to “dumbbell-shaped” labor market concerns, according to the report.
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FDA hurdles put drug used to treat rare disorder in limbo
A treatment for Barth syndrome, a rare and often fatal genetic disorder, faces unexpected FDA-related hurdles, NBC News reported Aug. 18.
Approximately 150 people in the U.S. have Barth syndrome, a condition that can cause heart failure. Some with the disorder die before their 5th birthday; two infant deaths were reported recently, according to NBC News.
Some have benefited from an experimental drug called elamipretide. However, the drug has not been approved for full market use, and its manufacturer, Stealth BioTherapeutics, recently was required to resubmit a new drug application.
After more than a decade of development, elamipretide appeared to be close to receiving approval. An FDA advisory committee voted in favor of the medication in October, citing how it improved heart function and muscle strength in clinical trials. But in May, the FDA rejected the drug without explanation.
Rep. Buddy Carter of Georgia has called on the FDA for clarity, saying elamipretide is “really the only drug that we know of that works,” NBC News reported.
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Is Keck Medicine’s chief post-acute officer the 1st of his kind?
In September, CMS selected 741 hospitals to participate in a new reimbursement framework, the Transforming Episode Accountability Model.
Under TEAM, participating hospitals are responsible for the cost and quality of care associated with five surgical procedures — lower extremity joint replacement, hip femur fracture treatment, spinal fusion, coronary artery bypass graft and major bowel procedures — for 30 days after patient discharge. CMS said it aims to “motivate health care providers to better coordinate care and improve the quality of care” with a payment structure that replaces the fee-for-service model.
As health systems prepare for the TEAM’s implementation in 2026, one industry leader whom they might want to call is Felipe Osorno, chief post-acute care officer at Los Angeles-based Keck Medicine of USC.
“I joke that sometimes I feel like I’m the only chief post-acute care officer in the country, because I haven’t found another one,” he told Becker’s. “There are VPs and other continuum of care staff within health systems that worry about this, but as a dedicated role it’s a little bit unique.”
Keck Medicine created the chief post-acute care officer role two years ago, though Mr. Osorno has been with the health system for more than a decade. He holds a dual-chief role, also serving as the system’s chief of staff.
He previously led continuum of care operations at the Keck Medical Center of USC, the system’s flagship academic medical center, where he began to notice how both pre-arrival and post-acute case management lacked operational strategy.
“We’re a tertiary, quaternary center. We focus on the sickest of the sick,” he said. “Being an organization that takes in a limited number of fully capitated risk patients, [post-acute case management was] something we didn’t have to think about too much.”
Mr. Osorno said his role was created to establish a post-acute strategy that would become an integrated part of the health system. Keck Medicine’s focus is not to own post-acute care, but to build partnerships and programs that enhance care transitions and support its primary focus of tertiary and quaternary care.
“We know that to continue to grow, having a pathway to get patients to the right setting at the right time is really important,” he said. “Just throwing a post-acute referral into the ether and hoping someone will take the patient is not a sustainable strategy.”
One of the first moves Keck made was to place its own faculty within six skilled nursing facilities, allowing patients to continue being cared for by Keck hospitalists. Handpicked by the system, Keck worked closely with the facilities to be sure their visions of quality are aligned through education and upskilling.
“We’re hoping that by transmitting some of these skills we can work on problems together, but also that they can build some capability and have the tools to improve the care too,” Mr. Osorno said.
Keck will also ensure continuous care quality through its newly established Keck Academy for Continuous Improvement, the pilot of which begins in September. Through the academy, Keck will train staff members from its post-acute care partners on internal process improvement.
“We’ve seen a dramatic improvement in readmissions and mortality, mostly because we can continue the protocols we started inpatient,” Mr. Osorno said. “Instead of just [handing over] a bunch of discharge orders, we truly see this as: We’re going to continue taking care of the patient.”
Beyond skilled nursing facilities, Keck has started to establish partnerships with home health agencies, hospice providers and long-term care hospitals, where they have started to see care improve through shared accountability, Mr. Osorno said.
Many of these partnerships are made possible by communication dashboards, remote patient monitoring and telehealth. Each facility partner operates at “different levels of sophistication and technology,” which requires some level of flexibility, he added.
“Having one point of contact for escalation makes a huge difference — very low-tech — but we created one phone number for SNFs,” he said. “Of course, we can layer on real-time interoperability of EMRs and AI and telehealth, but sometimes something very simple like one phone number makes a difference.”
Mr. Osorno said he sees tremendous opportunity in the post-acute space for technological entrepreneurship. While he gets pinged by a new vendor every day, he said the current landscape lacks integration.
“One vendor that will do the connection with SNFs, then a different vendor does the connection with home health and a different vendor for something else,” he said. “I would love it if there was one vendor that would help me manage all my needs, but we haven’t found that.”
Despite the many avenues of opportunities, Mr. Osorno said there are still barriers to ensuring seamless post-acute care coordination, one of the most prominent being reimbursement. Payment models for post-acute facilities are not aligned with or equal to the payment models for hospitals.
“If a patient has any needs outside of what a SNF can provide with the basic resources, they’ll lose money,” Mr. Osorno said. “Some patients are basically unplaceable, because folks know that no one’s going to pay for this. How do we build financial models where the money can be spent in the right place?”
As the federal government’s priorities and payment rules shift, Mr. Osorno stressed how important it is for hospital and health system leaders to prioritize effective post-acute care strategies.
“The big pressure we have as a country is to reduce how much we spend in healthcare, and post-acute care will have to be more integrated as part of your strategy,” he said. “People need to think more and more about the beginning-to-end. For us, [patients in post-acute care] might not be in our four walls, but they are still our patients.”
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Key 2026 growth drivers, per 9 hospital, system CEOs
Hospital and health system CEOs are eyeing multiple initiatives to spur growth in 2026. At the forefront of their efforts is expanding access to care, strengthening services and investing in partnerships.
Here, CEOs at healthcare organizations across the U.S. identify the biggest drivers of their growth in 2026.
Editor’s note: Responses have been lightly edited for length and clarity.
Wayne Gillis. CEO of Rehoboth McKinley Christian Health Care Services (Gallup, N.M.): The biggest driver of RMCHCS’ growth in 2026 will be our ability to restore trust and confidence in our community by demonstrating operational excellence, clinical quality and patient-centered care every single day. Growth will not come from a single initiative, but rather from disciplined execution across three areas:
- Expanding access and services: Meeting community needs by strengthening core service lines, investing in behavioral health and primary care, and addressing the gaps that force patients to leave the region for care.
- Workforce engagement: Our staff are the foundation of growth. By building a culture of accountability, continuous improvement and professional development, we create a place where people want to work — and where patients want to receive care.
- Partnerships and innovation: Growth will also come through strategic collaborations — with payers, regional providers, and community organizations — that improve care coordination, reduce duplication, and extend our reach.
At the end of the day, RMCHCS’ growth in 2026 will be driven by the community choosing us as their trusted healthcare partner. If we stay focused on safety, quality and service, growth will be the natural outcome.
Scott Kashman. President and CEO of Ascension St. Vincent’s Riverside (Jacksonville, Fla.): In 2026, our growth will come from a seamless care ecosystem — expanding access close to home, strengthening high-acuity services that draw patients regionally and investing in trusted community partnerships. By balancing advanced clinical capabilities with convenient outpatient care, we’ll meet both regional demand and local needs.
Kelly Macken-Marble. CEO of Osceola (Wis.) Medical Center: With the many headwinds right now facing healthcare, we are focused on ensuring we are meeting the care needs in our region. Population-based data provides us with the primary drivers of growth, which includes improving access to primary care, specialty care and mental health services. We are planning to add intensive outpatient, or IOP, services to our substance use program and will be expanding our campus to support the addition of several new primary care and specialty physicians to meet the needs of the community.
Michelle Majerus. President and CEO of Avera Holy Family Hospital (Estherville, Iowa): The aging population in Estherville, Iowa, and the surrounding area is Avera Holy Family’s biggest driver for growth in 2026. In an effort to become the primary choice for age-friendly care, Avera Holy Family offers a multitude of active aging services and is committed to our journey in advancing our reliable practice of evidence-based interventions for older adults through the 4Ms Framework — What Matters, Medications, Mentation and Mobility. Our compassionate team is committed to moving health forward by keeping care local as we assist patients, family members, caretakers and our community with identifying, achieving and sustaining their quality-of-life indicators to facilitate active aging.
Barb Martin, BSN. CEO of St. Joseph Medical Center (Joliet, Ill.): The biggest drivers of growth is continued growth in the emergency departments through efficient timely management of patients both as inpatients and outpatients. Also, growth will be critically dependent on the recruitment of primary care physicians who drive referrals to the specialist.
Andrew Molosky. President and CEO of Chapters Health System (Temple Terrace, Fla.): The biggest driver of growth in our 2026 plan will be the acquisition plan as a well diversified system. As organizations that have put all their efforts into one or just a select number of endeavors face the headwinds being experienced with the current economic and political environment, we are a natural partner for them. While we will be judicious with our selections and pursuits, the time is ripe for us to celebrate our diversified strategies and the value it brings to the growth marketplace.
Tom Scott. CEO of CentraState Healthcare System (Freehold, N.J.): The oncology service line will continue to drive significant growth. The incidence rate of cancer in the state of New Jersey is higher than the national rate, with over 59,000 new cancer diagnoses estimated this year.
By adding services, specialists, treatments and technology typically only found at large metropolitan cancer centers, CentraState has achieved 71% growth in oncology patient volume in recent years and is successfully delivering comprehensive, multidisciplinary and compassionate care.
To expand access to high-quality cancer care in communities that we serve, we have attracted top clinical and surgical talent and integrated CentraState’s cancer program with Atlantic Health. Close coordination with leading cancer experts from across the system means patients have access to cutting-edge treatments, procedures and groundbreaking research trials close to home. A new state-of-the-art patient care unit and a co-located medical oncology office and infusion suite have expanded clinical capacity. For instance, the number of patients receiving chemotherapy has grown 150% from 2024.
In addition to cancer treatment, we have also expanded cancer prevention and early detection, including a robust genetics program to help patients understand their risk for certain cancers, such as a high-risk breast cancer program, as well as expanded our research capacity with a clinical trials program that will double or more this year in the number of patients enrolled.
CentraState is strongly poised to advance cancer care in the state and meet the growing need for cancer services.
Deborah Visconi. President and CEO of Bergen New Bridge Medical Center (Paramus, N.J.): In 2026, our growth will be driven by strategic investments that expand access, strengthen integration and improve the patient experience — led by our new state-of-the-art emergency department, our implementation of Epic and the continued expansion of our behavioral health and specialty medical services. These initiatives, combined with deeper community partnerships, telehealth expansion and a focus on addressing social determinants of health, will create a seamless continuum of care that meets the needs of an increasingly diverse and complex patient population. Together, they position Bergen New Bridge Medical Center as the region’s trusted destination for high-quality, compassionate and comprehensive care.
By aligning care delivery with social determinants, leveraging technology and investing in talent development, we will continue to be the health care destination where people find not only treatment, but also hope, stability, and connection. This integrated model is not just the future of Bergen New Bridge — it’s the future of healthcare.
Kenneth Waller. CEO of Norwalk (Conn.) Community Health Center: Healthcare medical service delivery organizations can employ a myriad of strategies to increase their market share and broaden their organization scope of healthcare services. Norwalk Community Health Center will launch a strategic map illustrating a clear, market growth action plan to expand access and to meet its overarching mission. We will achieve this through the implementation of a systematic process of continuous market assessment of our service area to identify service growth opportunities which will align with our medical consumers’ demands.
This would include an intentional integration into our community safety-net ecosystem where we would design unique service models, expand access and offer innovative medical care: like socioeconomic and other related services to facilitate, enhance and improve the comprehensive care outcomes of our targeted patient community.
This will be the foundation of how NCHC will begin to cultivate its 2026 organizational service growth objectives and goals. Our core healthcare service strategic imperatives will incorporate payor mix diversification. This would include NCHC adding more offerings to its current medical service mix. We will strengthen and increase community engagement service collaboration to expand patient access and growth, and improve economies of scale.
Lastly, infusing technology to drive medical service delivery predictability and to improve overall organizationwide productivity and operational efficiency. These are the elements we are aiming to attain to drive our delivery service growth moving forward in this volatile, uncertain, complex and ambiguous healthcare industry environment.
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New York children’s hospital to be renamed after $50M gift
Buffalo, N.Y.-based Kaleida Health and John R. Oishei Children’s Hospital will rename the facility Golisano Children’s Hospital of Buffalo after receiving a $50 million donation from entrepreneur and philanthropist B. Thomas Golisano.
The hospital said it will officially adopt the new name in January 2026 to honor the gift, which supports advanced pediatric care at New York state’s only standalone children’s hospital, according to an Aug. 19 Kaleida Health news release.
The renaming announcement follows the John R. Oishei Foundation’s decision to relinquish its naming rights. The foundation previously donated $10 million during the hospital’s capital campaign, which led to the opening of its new facility in November 2018.
Mr. Golisano is the founder of Paychex and one of the nation’s largest foundations supporting programs for people with intellectual disabilities.
The hospital will begin using its new logo early next year, the release said.
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North Carolina to cut Medicaid provider reimbursement rates by 3%
North Carolina Medicaid providers will see at least a 3% cut in reimbursement rates beginning Oct. 1, with services like long-term behavioral healthcare, hospital care, nursing homes and physicians seeing 8% to 10% in cuts.
The cuts come after state lawmakers passed a stopgap “mini budget” spending plan, which leaves Medicaid with a $319 million shortfall, despite allocating $600 million for Medicaid oversight fund and rebase.
“More than 3 million people in North Carolina depend on Medicaid for comprehensive care that is life-changing and in many cases lifesaving,” North Carolina Department of Health and Human Services Secretary Dev Sangvai said in an Aug. 6 news release. “Underfunding NC Medicaid now, after years of building a nationally recognized program that delivers real outcomes for the people we serve, is a serious setback.”
The reductions could force some providers to stop accepting Medicaid patients, a spokesperson for the department said in an Aug. 19 statement shared with Becker’s.
“Additionally, NC Medicaid will no longer be able to offer GLP-1 coverage for weight loss, and we will pull back financial funding for the integrated care for kids pilot, which will end early,” the statement said. “These changes will take effect on Oct. 1, 2025.”
NCDHHS said the cuts are structured to be reversible, should additional funding be approved.
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Mayo Clinic posts 7.1% margin in Q2
Rochester, Minn.-based Mayo Clinic recorded an income from current activities of $380 million (7.1% margin) in the second quarter of 2025 quarter, down from $449 million (8.9% margin) during the same period last year, according to its Aug. 18 financial report.
Total operating revenue was $5.3 billion for the three months ended June 30, up from $5 billion during the same period last year. Mayo’s net patient service revenue was $4.5 billion, an 8.6% increase year over year. The system attributed the growth to strong outpatient, surgical and hospital volumes, as well as increased service demand.
Contributions available for operating activities was $73 million in the quarter, down from $115 million during the same period last year. Mayo Clinic attributed the decrease to a greater portion of total giving being directed to nonoperating activities, such as endowments and capital projects.
Total operating expenses were $5 billion in the quarter, up from $4.6 billion during the same period last year. Salaries and benefits — totaling $2.8 billion — increased 7.5% year over year and accounted for 56.3% of total expense. Supply and service expenses were $1.8 billion, a 10.8% increase year over year.
As of June 30, Mayo Clinic had 361 days cash on hand, compared to 362 on Dec. 31. The system had a long-term debt of $4.3 billion as of the end of the second quarter, up from $4 billion on Dec. 31.
Mayo Clinic reported a net income of $1.1 billion in the second quarter, up from $613 million during the same period last year.
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Epic releases new AI tools
Epic Systems introduced two new AI tools aimed at easing communication and reducing administrative work in healthcare.
The tools — named Emmie and Art — are designed for patients and clinicians, respectively, according to an Aug. 19 LinkedIn post from Epic. Emmie is built to help patients interpret test results, receive health guidance, and manage ongoing care between visits. Epic said the assistant draws from patients’ medical records and connected devices to provide information in “easy-to-understand terms” and support open-ended conversations about health.
Art, meanwhile, is designed to help physicians prepare for visits by generating summaries, collecting information from patient interactions with Emmie, and drafting documentation. The assistant can also complete certain administrative tasks, such as verifying prior authorizations and placing orders, according to Epic.
Epic did not disclose when or where the tools would first become available.
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Digital innovations driving supply chain resilience in health systems
As supply chain leaders continue to face unprecedented disruptions, leaders are increasingly turning to AI, automation and real-time data tools to stay ahead. Among the steps they are taking: shifting to a “data lake” concept, employing centralized data platforms and integrating EHR data for more supply visibility.
Here are responses from five supply chain leaders who were asked: What technologies or analytical tools are helping your health system to respond more effectively to supply chain challenges?
Note: Responses have been lightly edited for length and clarity.
Derrick Billups. Vice President of Supply Chain and Support Services at UC Health (Cincinnati): Our approach has centered on using technology and data to boost visibility, agility and continuity. One solution for us is an automated system which replaces back-ordered supplies with pre-approved alternatives through our distributor, helping us avoid delays and keep care delivery on track.
In addition, our ERP, inventory and RFID platforms give us detailed insights into key metrics like days on hand, consumption rates, and lead times — especially for critical SKUs — which helps us make faster, more informed decisions. With this, we are working on sharing demand data with suppliers so inventory can better match patient volumes and precise procedural case type needs, which should lead to more accurate forecasting and enhanced fulfillment. Technology is a powerful enabler, but it is our team’s flexibility, skill and ability to adapt that make the biggest difference which meets today’s supply chain challenges.
Moving forward we are exploring tools like AI, expanded RFID tracking and predictive analytics to improve demand planning and get a clearer, real-time view of inventory movement. Together, these initiatives support a present and long-term vision for a supply chain that can adapt quickly, respond intelligently and sustain high-quality care under any circumstances.
Joseph Dudas. Division Chair of Supply Chain Management at Mayo Clinic (Rochester, Minn.): In 2018, Mayo set out to transform our healthcare supply chain with an initiative called Digital Supply Chain. The objective was to utilize lessons learned from digital leaders such as Uber, eBay, Airbnb, etc., with a goal to accelerate savings and productivity. We pivoted from an ERP-centric vision of rigid “best practice” process management to that of a more agile and “data centered” approach. As a result, we shifted our attention to modernization of our data platform. The change moved us away from the concept of a data warehouse, where we were heavily dependent on IT, to that of a data lake, with new state-of-the-art, self-service data tools. Soon after came the pandemic, and it was fortuitous that we had started this effort as the advancements helped us manage through COVID-19 and the aftermath. With leading indicators in place, we were able to sense the crisis before it happened and mobilize quickly with procurement, inventory management, conservation and visibility solutions.
Wind the clock forward and we continue to do relatively well managing through continuous supply disruptions while also delivering value. That said, in 2025 we felt compelled to revisit our technology strategy again. What we recognized was that DSC was functionally rich, but that certain features had not been delivered as was envisioned, and while the ERP system was no longer a bottleneck, the complexity, cost and agility barriers associated with our approach were new areas for improvement.
DSC 2.0 seeks to advance the Mayo supply chain by addressing complexity, cost and agility constraints while also fully leveraging advancements in artificial intelligence and robotics. While the strategy lays out a high-level plan to converge technologies and simplify our platforms, it more specifically prioritizes new investments and partnerships. Two projects will lead the way as far as our plan is concerned with significant investments already approved to move them forward. They are as follows:
- S2P and ops convergence. A program to move our operating platform to Oracle (P2P was moved to Oracle as part of DSC 1.0) as well as refresh our product information management tools.
- Laboratory supply chain (FALCON). A custom build solution to manage the complexity of the laboratory supply chain. While custom development over the last 10 years has been largely in decline, there is no solution in the marketplace to be purchased, and state-of-the-art development tools have advanced significantly.
- AI platform: A new partnership with Surgence (an AI platform built on Palantir) to a) extend our visibility beyond our own supply chain and b) fully advantage new and quickly evolving artificial intelligence solutions.
DSC 2.0 establishes a clear long-range strategy that sets the direction for sustained leadership and the ability for enablement. It addresses the most immediate concerns of complexity, agility and visibility as well as encourages continued advancement of technology and AI through our center of enablement (as opposed to “center of excellence”).
Adrian Jucja. Vice President of Data Management and Analytics at RWJ Barnabas Health (West Orange, N.J.): RWJ Barnabas has leveraged advanced supply chain analytics for over eight years. We have implemented and use a centralized data analytics tower to manage all supply chain analytics and navigate ongoing strategic and operational supply challenges more effectively. Almost real-time inventory tracking systems have been implemented to provide visibility across all facilities, enabling proactive identification of shortages before they impact patient care. Predictive demand forecasting, powered by the centralized analytics tower are in current development and plans to use machine learning have been identified. We will use historical usage patterns, seasonal trends, and EHR Scheduling to anticipate needs more accurately. These tools will help optimize order quantities, prevent overstocking and reduce waste while ensuring critical items remain available. Snowflake serves as a centralized data tower, seamlessly integrating data from our ERP, EHR, HR and third-party systems, enabling cross-functional insights that connect supply needs to patient volumes, staffing levels and operational trends. Integration with supplier data feeds also allows for quicker adaptation to disruptions, such as delayed shipments or product recalls.
Additionally, business intelligence dashboards and scenario-planning tools have empowered our leadership to make faster, more data-driven decisions. By consolidating procurement, logistics and usage data into Snowflake alongside ERP, EHR and HR inputs, stakeholders can quickly identify bottlenecks, assess vendor performance and explore alternative sourcing options.
Another success story has been the implantation of robotics by using UiPath alongside the analytical platform. During the IV solution shortage this was a key to success where robots were placing orders based on historical trends and available inventory across all 12 hospitals. This combination of Snowflake’s unified data environment, advanced analytics, and robotics has strengthened our ability to respond to challenges with agility, ensuring that front-line clinicians have the resources they need to deliver uninterrupted, high-quality care.
John Mikesic. Executive Director of Supply Chain at University of Missouri Health Care (Columbia): Power BI has become a critical tool for us, integrating data from our warehouse, nursing unit par levels and surgical case usage to create real-time visibility from loading dock to point of care. We’re also using ChatGPT to streamline contract reviews, draft RFPs,and summarize complex datasets. This fall we go live with Agiloft for deeper contract lifecycle integration.
Andrea Poulopoulos. Senior Vice President of Supply Chain at Corewell Health (Grand Rapids and Southfield, Mich.): By leveraging value analysis software, our supply chain team collaborates closely with our clinical teams to evaluate which supplies are best suited to accelerate sourcing strategies, reduce care variation, realize savings and maintain the highest levels of care for our patients. The tool helps to establish a streamlined workflow, rooted in data and clinical evidence, while quantifying the related expense and/or savings of the decision to the organization.
Technology leveraged in our purchasing process takes the tedious task of tracking down orders not received on time and instead simultaneously monitors hundreds of expected deliveries at once by producing a report that captures all purchase orders requiring follow-up. It also sends a follow-up email to request status of the delayed supply, versus a team member having to do so, creating space and time for more meaningful work to be done.
In addition to the technology and analytics we’ve adopted to keep our supply chain well oiled, on a regular basis, we employ risk-modeling solutions that help us gain insight related to the impact of unexpected risks such as government mandates, weather, etc., and to ensure the best return on investment on behalf of the patients we serve.
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Ascension St. John names chief clinical officer
Tulsa, Okla.-based Ascension St. John Medical Center has appointed Dean Kindler, MD, chief clinical officer.
Dr. Kindler, a vascular neurologist, brings more than 20 years of clinical leadership experience to the position, where he will oversee clinical operations across the level 1 trauma center and collaborate with clinicians to expand services and improve patient outcomes, according to an Aug. 19 news release.
He joins Oklahoma from Ascension Michigan, where he served in several leadership roles over the past few years, including as chief medical officer of the Southwest Region and regional CEO.
In July, Ascension St. John Medical Center became the first and only verified level 1 trauma center in Tulsa. It is the largest inpatient facility within the St. Louis-based Ascension health system.
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Rhode Island’s longest hospital strike ends as Care New England workers ink deal
Members of SEIU 1199NE at Care New England’s Butler Hospital in Providence, R.I., have ratified a new four-year labor contract, ending Rhode Island’s longest hospital strike, both parties confirmed in statements shared with Becker’s.
The news came after the hospital and union reached a tentative agreement earlier in August.
“After the [union] members’ bargaining committee approved a tentative agreement this weekend, it was presented to members this morning who voted overwhelmingly to ratify the agreement,” both parties said on Aug. 18. “This contract ends the strike and, most importantly, ensures that caregivers can return to their patients. While this has been a long and challenging process, both sides worked hard throughout negotiations to reach this resolution, and we are grateful for the assistance of the Federal Mediation and Conciliation Service.”
According to SEIU 1199NE, the agreement includes:
- A wage increase of at least $6,000 in the first year of the contract for full-time employees. By the end of the four-year deal, all employees will earn at least $20 an hour.
- Financial support for employees injured by workplace violence.
- Educational benefit worth $600,000 over the life of the agreement, administered by the SEIU 1199NE Training and Upgrading Fund.
Union members ratified the contract more than three months after hundreds of staff members at the hospital, including registered nurses, mental health workers, clerical, environmental service and dietary staff, began an open-ended strike May 15. SEIU 1199NE and the hospital began negotiating a new labor contract in March.
During the walkout, the hospital closed three units, pointing to the strike when announcing the closures.
On Aug. 18, both parties said they now look forward to restoring the services and that details about the hospital’s return-to-work plans will be forthcoming.
“Both sides are proud to move forward with an agreement that recognizes and affirms the value of all workers and advances the mission of Butler Hospital,” they added.
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How an “EHR Tune-Up” Can Help Align Clinical Performance and Technology Optimization
Many hospitals and health systems are not maximizing the value of their core electronic health record (EHR) investments. Conducting regular “EHR tune-ups” can be a quick win to help your organization close the gap between clinical performance and technology optimization.
Many Healthcare Delivery Organizations Are Not Using EHRs to Their Full Capacity
Hospitals and health systems continue to face significant changes, primarily centered around technology and automation, both of which are costly. Whether you enhance performance and then augment operations with technology – or advance technology as a forcing function to drive performance change – successfully closing the gap between clinical performance and technology optimization is required to make the most out of your enterprise EHR investment.
However, many health systems still do not utilize their core EHR to its full potential, including leveraging built-in AI functionality. Manual processes and workarounds that circumvent core capabilities are often prevalent. Team members may frequently turn to niche third-party solutions or “bolt-ons” to address problems without first considering the EHR capabilities right at their fingertips.
Several factors contribute to these issues, including alert fatigue, a lack of standard definitions, and inadequate visual cues to support adoption.

Performing Regular “EHR Tune-Ups” Can Be a Quick Win
An “EHR tune-up” can help ensure your organization gets the most out of your technology investment while minimizing manual processes or workarounds. The concept of a “tune-up” is not a one-time effort, though. There are actions that every health system needs to take regularly.
1. Check in with your core EHR vendor every 6-12 months about new capabilities, including those related to AI
Monitoring emerging niche third-party solutions related to AI and other rapidly evolving areas is critical; however, these efforts cannot come at the expense of failing to maximize the value of what you have already purchased. AI capabilities, in particular those from core vendors, continue to evolve rapidly. Every 6-12 months, check in with your enterprise EHR vendor to understand their new capabilities and their near-term product roadmap, and how that functionality can benefit your organization if effectively integrated into workflows and fully adopted by clinicians.
Routine check-ins provide your organization with valuable insights into future technology advancements and enhancements that may become available soon. Additionally, sharing your challenges enables your EHR vendor to consider future improvements. Key questions to ask include:
- What types of programmatic enhancements are coming in the near future?
- What types of artificial intelligence (AI), machine learning (ML), natural language processing (NLP), or predictive analytics capabilities are available today? What will be available in the future – and when?
- How can my organization use cognitive models to enhance performance?
2. Regularly evaluate the EHR capabilities your organization is underutilizing, and redefine process workflows accordingly
Technology must drive informed decision-making throughout the enterprise. However, that hinges on clinicians making the most of existing EHR capabilities. Be sure to understand the core technology your organization is underutilizing and why. Is there a technical or integration issue? Is the technology not sufficiently complementing the workflow?
Following that evaluation, it is crucial to redefine process workflows. For example, as part of a recent engagement, Impact Advisors carefully examined underutilized EHR capabilities across defined focus areas, including case management, bed placement, registration, and transportation. We worked with the client to assess the practice or performance indicators that would also need to change if we improved adoption of those related capabilities. As we introduced technology, we also included training on performance and clinical optimization. The marrying of the two processes helped drive results.
For instance, within the existing EHR, we enhanced visual cues that alerted the clinical team when a patient exceeded the length of stay (LOS) goal. The cues were made available to multiple members of the clinical team, allowing all members to focus on initiating change. This helped reduce LOS and freed up needed capacity for patients in the community.
3. Work with the right partner
Getting the most from regular enterprise technology “tune-ups” requires finding a partner with deep clinical, EHR, and AI expertise. The right partner will bring together experts accustomed to enhancing EHR functionality while coupling this with process improvement. The integration of IT workflow and process workflow closes the gap in inefficiency, allowing your organization to achieve optimal outcomes. Additionally, your partner should be making rapid strides in working with their clients to implement AI that is both safe and effective in hospitals and health systems.
The Bottom Line
Regular “EHR tune-ups” can be a quick win to help your organization maximize your technology investment while minimizing manual processes and workarounds. Success requires checking in with your core vendor every 6-12 months to discuss new capabilities, regularly evaluating the EHR capabilities your organization is underutilizing, and working with a partner that has deep clinical, EHR, and AI expertise.
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How the ‘most beautiful hospitals’ are rethinking patient flow
Twenty hospitals were named to healthcare staffing firm Soliant’s 2025 Most Beautiful Hospitals list, which recognizes both architectural beauty and quality of care.
Leaders from eight of the hospitals shared with Becker’s how redesigned spaces have improved patient flow in the past year.
Note: Responses have been lightly edited for length and clarity.
Mary Beckerle, PhD. CEO of Huntsman Cancer Institute at the University of Utah (Salt Lake City): At Huntsman Cancer Institute, we are committed to being on the leading edge to deliver an exceptional patient experience. As one recent example, we updated our radiation oncology and radiology check-in areas to serve more patients simultaneously, significantly reducing wait times. This builds on our previous efforts in 2023 when we opened more dedicated consultation rooms and waiting room spaces in our new hospital, and four state-of-the-art surgical suites, enhancing the ability to perform sophisticated cancer surgeries.
Chris Clark, DO. President of AHN Saint Vincent Hospital (Erie, Pa.): Our clinical decision unit was another important investment in Allegheny Health Network’s ongoing efforts to improve the patient experience and throughput at every touchpoint of the care journey. Saint Vincent has one of the state’s busiest emergency departments, and those high volumes can create long wait times for patients and their families. This beautiful new CDU has meaningfully helped to minimize those long stays in the ED and enable us to care for patients more effectively and efficiently. It perfectly aligns with our organization’s Living Health model and goal of providing remarkable, high-quality health experiences and outcomes for those we serve.
Anne Hubling, DNP, RN. President and Chief Nurse Executive of Northwestern Medicine Marianjoy Rehabilitation Hospital (Wheaton, Ill.): At Northwestern Medicine Marianjoy Rehabilitation Hospital, our priority is to create a healing and therapeutic environment. Over the past year, we renovated our outpatient therapy gyms to enhance patient care and improve workflow for therapists. The new design not only optimizes treatment space but also facilitates better access for patient services. Moreover, we have integrated our beautiful campus gardens and natural surroundings into the therapeutic experience, featuring improved outdoor spaces that can be incorporated into treatment programs.
Cynthia McGuire. President and CEO of Monadnock Community Hospital (Peterborough, N.H.): In the past year, our medical-surgical unit underwent a major renovation to improve patient flow, safety and independence. Key updates include a new therapy team office and on-unit gym for faster, more personalized rehabilitation, an expanded nurses’ station with enhanced monitoring and communication tools, and ADA-accessible shower and tub room that support safe practices before discharge. These changes have streamlined care delivery, strengthened collaboration and created a more efficient, patient-centered healing environment.
Clint Miller, BSN, RN. Chief Nursing Officer at Spooner (Wis.) Health: We recently repurposed part of our facility to better support our rehabilitation services department, adding a second gym space to provide greater privacy during treatment sessions. We’re committed to continually enhancing our services with a focus on improving the patient experience.
Bill Phillips. COO of University Health (San Antonio): The University Health Women’s & Children’s Hospital has only been open 18 months, and our original design was done with optimal patient flow in mind, in front- and back-of-house layout, OR and elevator placement. Our NICU has private rooms but also high-visibility rooms for multiples and the highest-risk infants. We see these elements working well, along with increased infant protection design on all floors to make sure access is limited to those who have guest bands for each floor. The human element of design is also crucial: We have increased the number of ambassadors who can assist with access questions and ensure families get where they need to go quickly. And in what has been proven to ease anxiety and reduce tension, our SaludArte healing arts program creates comfortable and beautiful spaces — both public and private — clinically proven to encourage healing for patients and peace of mind for the team.
Rolla Sweis, PharmD. President and CEO of La Rabida Children’s Hospital (Chicago): Our newly expanded and improved inpatient unit represents a significant milestone in La Rabida’s commitment to providing critical medical services to children with complex medical conditions, chronic illnesses and rehabilitation needs. This redesign has allowed us to meet the growing demands we’re seeing in the community and underscores our dedication to ensuring that every child receives the highest quality of care in a compassionate and family-friendly environment, regardless of the family’s ability to pay.
1. We’ve designated the entire second floor as one inpatient space, including additional patient rooms (we like to call them cabins). Additionally, every room on the unit has been updated with integrated technology and equipment, making it easier to provide bedside care.
2. The redesign also provides more opportunities for patients to be out of their rooms, including a dedicated inpatient playroom that was precisely designed to accommodate the healthcare and developmental needs of our patient population. This in-unit play space provides easy access to play and therapy space to all patients on the unit with complexities that may prevent them from visiting our first-floor playroom.
3. We’ve also redesigned how the inpatient unit is accessed: through a central welcome area. Now, all visitors pass through this area before entering the actual patient care space, a best practice for safety and security.
Monte Wilson. CEO of Christus St. Frances Cabrini Hospital (Alexandria, La.): Being named one of the most beautiful hospitals in the U.S. is a reflection of our commitment to innovation and healing-centered design. Our newly redesigned simulation center — with smart functionality and cutting-edge technology — has transformed how we train caregivers and optimize patient flow, bringing education into the 21st century.
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Advocating for IV Compounding Policy Change
Sterile compounding has long been recognized as a high-risk area of health system pharmacy. Traditional manual IV compounding techniques can be prone to human error, leading to incorrect ingredients and volumes, contamination, and mislabeling. And while advancements in IV compounding automation are delivering proven clinical and operational outcomes, barriers to adoption continue.
In the 2025 State of Pharmacy Compounding (SOPC) survey conducted by Pharmacy Purchasing & Products, 91% of respondents indicated plans to increase or maintain their in-house sterile compounding volumes over the next three years.1 With persisting labor and supply challenges, IV automation will be essential to safely supporting these growing volumes.
How can we help to drive awareness and acceptance of this important pharmacy technology?
During Omnicell’s recent IV TRUST Summit (Transforming IV Robotics for Unifying Safety and Technology), Tim Perrin, Senior Policy Advisor, at Polsinelli PC, shared progress on advocacy initiatives that are bolstering the sterile compounding community to help drive IV compounding policy change.
Working closely with industry advocates, the hope is to amend federal policies to incentivize adoption of state-of-the-art automated IV drug compounding technology in two key ways:
- Calling on the FDA to update its policies that govern health system drug compounding for patients
- Advocating for legislation that would leverage the Medicare program to promote the use of transformative technologies to treat patients
The Drug Quality & Security Act (DQSA) was enacted 12 years ago yet still has not been fully implemented. Over the years, the FDA has released guidance documents, many bearing labels like draft, interim, revised, nonbinding recommendations, and even ones marked “final,” which are not truly final policy. This has led to regulatory ambiguity – at both the federal and state level – that complicates strategic planning and decision making. Urging federal policymakers to provide clear regulations will empower hospitals to treat their patients with the highest quality care.
In parallel, efforts are underway to educate members of the U.S. House of Representatives and the U.S. Senate to drive Congressional oversight of FDA guidance, as well as enact legislation that will help to incentivize adoption of sterile compounding technology. The Safer Compounding in Hospitals Act was first introduced by a bipartisan duo of House Members in 2020 and is expected to be reintroduced in the House during this session of Congress, while outreach continues to secure Senate champions. This important legislation and advocacy work has been endorsed by ASHP and the THRIV Coalition, and continues to gain support across the industry, including recently from the Emily Jerry Foundation.
A critical component of this advocacy strategy is the support of health systems weighing in with their elected representatives in Congress. Joined together, these stories and voices, as constituents, make a compelling case for policy change.
Watch the IV TRUST Summit replay to hear more about driving IV compounding policy change and the latest updates on the Safer Compounding in Hospitals Act from Tim Perrin, Senior Policy Advisor, at Polsinelli PC.
1Survey Respondents. State of Pharmacy Compounding. Pharm Purch Prod. 2025;4:S6.
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Walgreens expands specialty pharmacy offerings
Walgreens Specialty Pharmacy, which earned $25.9 billion last year from U.S. prescription revenue, has expanded its limited distribution drug portfolio to 265 medications, the company said Aug. 19.
Limited distribution drugs are specialty medications that have complex regimens, high costs and/or special handling requirements. Therapies for chronic diseases and cancers are typically administered at specialty pharmacies. These medications account for about 75% of drugs in development, according to Walgreens.
The company’s specialty pharmacy added leukemia drug Imkeldi (imatinib), HIV preventive Yeztugo (lenacapavir) and chronic skin condition treatment Imkeldi (imatinib) to its network.
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TriStar Health hospital taps new CFO
Baylor Breckenridge has been named CFO of TriStar NorthCrest Medical Center in Springfield, Tenn., according to an Aug. 18 LinkedIn post.
Prior to his new role, Mr. Breckenridge served as assistant CFO of HCA Florida Fort Walton-Destin Hospital, according to his LinkedIn page.
He also served as controller for Pensacola, Fla.-based HCA Florida West Hospital.
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How Yale New Haven Health uses eCART to support clinicians and patients
Yale New Haven (Conn.) Health has implemented an AI-powered clinical deterioration tool, eCART, across its seven hospitals — a move leaders say has both improved patient safety and reduced strain on clinicians.
The health system evaluated six different tools — three traditional and three AI-enhanced — on nearly 400,000 patients over three years before selecting eCART, Deborah Rhodes, MD, senior vice president of care signature and associate chief medical officer at Yale New Haven Health told Becker’s. She said the tool continuously monitors 97 clinical variables for every inpatient outside the ICU, identifying not just abnormal values but patterns and interactions that can signal a patient’s decline hours before it becomes critical.
“Most tools are set to fire around fixed parameters, so they over-alert on stable patients who just run low or high,” said Dr. Rhodes. “By being able to identify patterns in individual patients that signal a change or interaction, eCART is able to have this higher level of precision relative to other tools.”
Dr. Rhodes noted that one of the tool’s biggest advantages is the lead time it provides. On average, eCART identifies signs of patient deterioration about four hours before a critical event, giving clinicians time to intervene. She said that advance notice has become central to how the system is learning to improve its response to patient decline.
“We are saving lives, and we have the data to show that,” Dr. Rhodes said.
Since going live systemwide more than a year ago, Yale New Haven Health has reported a 13% relative decrease in mortality — a 1.2% absolute reduction — with especially notable gains in sepsis-related deaths.
Unlike some predictive tools that overwhelm clinicians with alerts, eCART typically flags no more than 20 to 30 patients at a time in even the largest hospital. When a patient’s score rises, nurses follow a structured pathway beginning with rechecking vital signs and, if needed, calling in a rapid response team. Each unit receives weekly feedback on how quickly staff respond and complete the pathway, which Dr. Rhodes said has helped standardize care across the system.
“Most new things you ask teams to do are met with resistance because they’re already overwhelmed. What we’ve found with eCART is the opposite — rather than adding to their burden, it helps them focus on the patients who most need attention. The nurses have just embraced this,” she said.
Dr. Rhodes credits not only the technology but the system built around it.
“AI is the heightened signal. Augmented intelligence is when we build the right processes, structures and teamwork around the tool to really take it to its full potential,” she said. “The tool itself is only step one. It’s the steps we built around it that got us to this state.”
Looking ahead, Yale New Haven Health is preparing to expand eCART into its children’s hospital for patients ages 2 to 18. While FDA approval covers only adult populations, the health system’s internal data showed statistically significant performance in pediatric patients as well.
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Avera to expand virtual nursing across rural sites
Sioux Falls, S.D.-based Avera will use $1 million in federal funding to expand its virtual nursing program.
The U.S. Department of Agriculture’s distance learning and telemedicine program awarded Avera $1,017,126 over three years to enhance access to virtual patient care at 28 rural healthcare sites in South Dakota, Minnesota, Nebraska and Iowa, according to an Aug. 19 news release shared with Becker’s.
Avera said it will use the funds to deploy virtual nursing models that assign remote staff to nonhands-on tasks, such as patient education, admissions, discharges and safety surveillance. The approach aims to ease staffing shortages by allowing bedside nurses to focus on direct care.
Avera began piloting the model two years ago at Avera McKennan Hospital & University Health Center in Sioux Falls and Avera St. Mary’s Hospital in Pierre, S.D. The funding will also support additional sites and cover purchases of AI-powered mobile carts, surveillance cameras, Artisight Connect TV Sticks and audiovisual communication tools.
The health system has received 23 USDA grants over the past 15 years to support rural care initiatives. The latest funding extends through August 2027.
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The ‘well-oiled machine’ behind VUMC’s record-breaking heart transplant program
In 2024, Nashville-based Vanderbilt University Medical Center’s heart transplant team set a world record by performing 174 heart transplants.
One of the leaders behind the record is Kelly Schlendorf, MD. She serves as medical director of Vanderbilt’s adult transplant program alongside Ashish Shah, MD, who serves as the heart transplant program’s surgical director and the Alfred Blalock Endowed Director and chair of the department of cardiac surgery.
Dr. Schlendorf, who is also section chief for heart failure and transplantation, said the health system’s heart transplant success reflects a number of moving parts fitting together seamlessly to drive the program forward.
“In order to achieve the volumes that we have over the past few years, there’s really no one person or operation or innovation that makes that happen,” she told Becker’s. “There are individual leaders and thoughtful strategies and innovative technologies that help to make it happen, but it’s really only those things combined with everything else — and ‘everything else’ is a lot — that has allowed for our success.”
Dr. Schlendorf and Dr. Shah oversee a multidisciplinary team of about 150 people per transplant, spanning physicians and surgeons, pharmacists and social workers, financial and organ procurement coordinators, and nursing and operating room staff.
Dr. Schlendorf told Becker’s maintaining a shared vision and purpose, “which is ultimately just to do right by our patients and by the donors and their families who have chosen to give the gift of life,” has allowed the team to be successful.
In fiscal 2025 — July 2024 to the end of June 2025 — the Vanderbilt team performed 184 heart transplants.
Those kinds of numbers, Dr. Schlendorf said, are not the result of one star surgeon or one piece of technology.
“I spend a lot of my time reminding people that there’s a lot more to [transplant programs] than surgery,” she said. “My fantastic surgical colleagues get and deserve a lot of credit, but there are so many other people involved who are deserving of credit, and sometimes I think those people get under-recognized.”
She highlighted the operational commitment required to coordinate each patient’s care as key to the VUMC heart transplant program’s success.
“One of the things people often forget is that in order to perform a lot of transplants, you have to have patients on your wait list,” she said. “One of the things that we’ve done very successfully on the operational front — which is maybe not so innovative, but rather just speaks to our operational successes — has been developing a really well-oiled machine that we’ve tweaked over and over again during the years to make sure that we: one, identify as many patients as possible with advanced heart failure who need transplant, including patients who live very far from Nashville, Tennessee; two, put them through a pretty exhaustive evaluation as expeditiously as possible to ensure that they’re well enough to undergo transplant and that they’ll be good stewards of a scarce resource; and then finally, most importantly, take care of them during this process, because most of these patients have very advanced heart failure and some of them really are on death’s doorstep.”
That “well-oiled machine” enables Vanderbilt surgeons to develop innovative techniques and organ preservation methods that allow for an expanded donor pool. One method — rapid recovery with extended ultra-oxygenated preservation — flushes the donor heart with a cold oxygenated preservation solution, preserving it for more than four hours and to as many as eight.
The team began using the preservation method in November 2024 and has seen success rates “similar to, if not better than, the existing techniques,” according to a July 17 news release from VUMC.
“As a program, we’re always looking forward and remaining curious,” Dr. Schlendorf said. “Our goal is to continue to innovate, to push the envelope a little bit, and also just to refuse to accept that just because something has always been done a certain way, that it’s the only way or that it’s the best way.”
The team’s innovation and growth move forward alongside an intensive reflection process, ensuring patient safety and outcomes, which Dr. Schlendorf said the team spends “a lot of time” reviewing and learning from.
“We try to translate those lessons into action items or improvements in the way that we do things going forward,” she said. “As in any growth setting, we’re looking for ways to be more efficient, but always with patient safety first and foremost in our minds.”
Dr. Schlendorf said her biggest piece of advice for health systems looking to grow their transplant programs is to seek guidance from and visit large-volume centers. She recalls spending a few days with the transplant team at Los Angeles-based Cedars-Sinai being “hugely helpful.” Years later, Vanderbilt now hosts groups in the same vein.
Despite the well-oiled operational machine and the dedication to innovation, Dr. Schlendorf said the VUMC heart transplant team was still surprised when it broke the heart transplant world record in 2024, a mark she said the team may surpass in 2025.
“I think Ash and I would both agree that we’ve just been incredibly lucky in bringing together this amazing group of individuals and a very supportive health system,” she said. “It’s amazing what can happen when you bring together the right group of people with a unified vision. It’s been pretty incredible to be a part of. Of all the hats I wear at Vanderbilt, this is certainly the most rewarding.”
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RN median hourly pay, by state
Median hourly base pay for registered nurses varies across states, with RNs in California earning the most, according to SullivanCotter’s “2025 Health Care Staff Compensation Survey Report.”
The survey, released in July, covers nearly 2.5 million healthcare employees across over 2,660 participating organizations, including more than 800,000 individual RNs, licensed practical nurses and nursing managers.
Here is the median per-hour base pay for RNs, by state, according to survey data shared with Becker’s:
Note: States are listed in descending order of pay. Seven states — Alaska, Connecticut, Hawaii, North Dakota, Vermont, West Virginia and Wyoming — were excluded due to insufficient data.
California — $66.00
Washington — $60.59
Oregon — $57.09
New York — $56.65
Massachusetts — $54.90
New Jersey — $52.69
New Hampshire — $49.57
Rhode Island — $49.34
Idaho — $49.23
Nevada — $47.79
Maine — $47.27
Minnesota — $47.16
Maryland — $46.54
Delaware — $46.43
Arizona — $46.35
Colorado — $46.34
Pennsylvania — $46.32
Illinois — $44.18
Georgia — $44.12
Wisconsin — $43.36
North Carolina — $43.35
New Mexico — $43.19
Missouri — $43.16
Montana — $43.03
Michigan — $42.95
Texas — $42.61
Florida — $42.17
Indiana — $41.68
Utah — $41.45
Ohio — $41.17
Nebraska — $41.13
South Dakota — $40.66
Oklahoma — $40.65
Virginia — $40.59
South Carolina — $39.56
Arkansas — $39.37
Louisiana — $39.30
Kansas — $39.28
Kentucky — $39.24
Tennessee — $38.54
Iowa — $38.00
Alabama — $37.65
Mississippi — $36.92
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CEO to exit 1 Texas hospital for another
Patrick Swindle has been appointed CEO of Longview (Texas) Regional Medical Center, effective Sept. 30, according to an Aug. 19 Facebook post from the hospital.
Mr. Swindle has served as CEO of Seton Medical Center Harker Heights (Texas) since 2020 and previously held hospital CEO roles within Tyler-based UT Health East Texas, according to his LinkedIn profile.
Under his leadership at Seton Medical Center, the hospital earned a four-star rating from CMS and “A” grades from The Leapfrog Group, CBS 19 reported Aug. 18.
He will succeed COO Brett Maxfield, who has been serving as interim CEO.
Longview Regional is a 224-bed facility.
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West Texas measles outbreak ends
The Texas Department of State Health Services has declared the state’s measles outbreak over, marking more than 42 days since the last reported case in any affected county in West Texas.
Since late January, Texas has confirmed 762 measles cases, the majority of which were children, and reported 99 hospitalizations and two deaths of school-age children who were unvaccinated, according to an Aug. 18 news release from Texas DSHS.
A third outbreak-related death also occurred in neighboring New Mexico, where a resident of Lea County tested positive for measles after death and had not sought medical care.
Texas accounted for the most measles cases in the U.S. this year. As of early July, the CDC reported 1,267 measles cases linked to 27 separate outbreaks, nearly five times more than cases reported in 2024.
Hospitals across the country struggled with managing potential exposure events as unvaccinated individuals with measles sought care. In March, hundreds were potentially exposed at UC Davis Medical Center in Sacramento after a child visited the emergency department. Additionally, similar exposure incidents occurred in multiple Michigan facilities, prompting urgent contact tracing and public alerts.
Texas DSHS urged healthcare providers to continue to remain vigilant with outbreaks, citing the global circulation of the virus and noted that additional cases may still appear in the state this year, the release said.
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$50B rural health fund not a cure-all for hospitals: Bloomberg
The $50 billion rural hospital transformation program that is part of the recently passed One Big Beautiful Bill Act might aim to support rural healthcare, but an Aug. 19 Bloomberg editorial said it amounts to “something of a slush fund.”
The funds, which will allocate the $50 billion over five years to rural healthcare, go toward state grants and not hospitals.
The opinion piece, written by Bloomberg’s editorial board, said although half the funds will go to states that submit a rural healthcare “transformation” plan, the rest will be distributed at the federal government’s discretion. By not requiring funds to go directly to hospitals, the program opens the door for subsidies to instead flow to technology vendors and other health-related projects at a time when rural healthcare is particularly vulnerable.
“Although grants are required to support ‘health-related activities,’ everything from ‘technology-driven solutions for the prevention and management of chronic disease’ to ‘remote monitoring robotics’ and ‘technical assistance’ can qualify,” the editorial board said. “The law includes no provision for the Centers for Medicare and Medicaid Services to publish their rationale for distributing grants.”
Around 200 rural hospitals have closed since 2005, with smaller facilities most at risk. While urban hospitals are also at risk of closure, net rural facility closures outpace them 4-to-1. Rural hospitals also face mounting challenges such as low patient volumes, high fixed costs and lower Medicaid reimbursement rates.
Medicaid covers about one-quarter of rural patients, outpacing the rates seen in urban areas. Looming Medicaid cuts from the One Big Beautiful Bill Act could worsen already thin margins.
“Providing costly services to fewer patients wouldn’t be a problem if such hospitals were well compensated,” the editorial board said. “But with Medicaid paying 88 cents on the dollar, reimbursement is a challenge and the BBB cuts will make things worse.”
While the rural hospital transformation program might not be the savior many struggling facilities need, Congress did introduce the “rural emergency hospital” designation in 2020, which gives lump-sum payments to offset fixed costs. REH designation participation has been limited due to restrictions on inpatient services and eligibility for other federal programs, but it has picked up speed in certain areas across the country.
In late July, Greenville, N.C.-based ECU Health signed a nonbinding letter of intent with Martin County (N.C.) to tackle rural healthcare challenges in the area. The news came after ECU Health shared plans in late May to reopen Williamston, N.C.-based Martin General Hospital as the state’s first REH.
“We’re advocating for investment from the state in terms of capital and changes to how the rural emergency hospital is reimbursed for Medicaid,” ECU Health CFO Andy Zukowski said during a “Becker’s CFO + Revenue Cycle Podcast” episode. “This rural emergency hospital will [also] be part of a broader system of care that includes a proposed expansion of a hospital and close proximity that would allow us to have inpatient capacity to transfer patients from the rural emergency hospital when needed.”
The Bloomberg editorial board argued that moving forward, unless the rural hospital transformation program is reserved for the most at-risk facilities and paired with structural reforms, it risks becoming a loosely defined initiative rather than a rural care access lifeline.
“Now that Congress has appropriated the $50 billion, taxpayers’ best hope is that CMS spends it wisely,” the editorial board said. “Directing assistance to the hospitals that need it — and imposing reforms that address the reasons they’re failing — would be a good place to start.”
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Healthcare billing fraud: 10 recent cases
Here are 10 healthcare billing fraud cases that Becker’s has reported since July 17:
1. A Maryland physician and his practice were ordered to pay $1.4 million for fraudulently billing Medicare.
2. A Houston physician agreed to pay more than $2 million to resolve allegations that he submitted fraudulent claims to federally funded healthcare programs for implantation of neurostimulator electrodes.
3. Two individuals pleaded guilty to a multi-year fraud scheme that used data stolen from hospital patients to file false claims for pandemic-related relief funds.
4. The CEO and medical director of Fast Lab Technologies were charged with allegedly orchestrating a $500 million scheme to defraud Medicare, Medicaid, TriCare and other insurers by billing for COVID-19 testing services that were never provided.
5. Two individuals, the former CEO of two El Paso, Texas-based long-term acute care hospitals and the owner of one of them, voluntarily surrendered to the FBI after they were formally indicted on charges of wire fraud involving healthcare billing.
6. A federal jury convicted a nurse practitioner for her role in a $12.1 scheme to defraud Medicare by ordering medically unnecessary cancer genetic tests for hundreds of patients she never met or examined.
7. A Florida man was sentenced to 17½ years in prison for his role in a fraud scheme that submitted more than $10.8 million in fraudulent claims for durable medical equipment to Medicare.
8. A physician in Kingsport, Tenn.,was accused of healthcare benefit fraud, making false statements and unlawfully distributing controlled substances
9. An internist in Fair Lawn, N.J., was charged with unlawfully distributing opioids, soliciting sexual favors from patients and defrauding New Jersey Medicaid.
10. A Las Vegas nurse practitioner pleaded guilty to participating in a healthcare fraud scheme involving medically unnecessary amniotic wound allografts in exchange for kickbacks
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Fairview’s $600M financial turnaround, explained
St. Paul, Minn.-based Fairview Health Services reported its first operating profit in six years last year, solidifying a $600 million turnaround in two years. How did they do it?
“We’ve really focused on building a culture of resiliency,” said Joe Gaylord, executive vice president and CFO of Fairview, in a recent episode of the “Becker’s Healthcare Podcast.” “We’ve built the engines within organizationally, we have a transformation office that’s incredibly effective, and we know how to identify those key levers, those key projects that have the biggest impact, whether that be on patients or the community or our financials. We feel great about our ability to adjust and react to whatever might come our way and respond.”
Nearly every business unit across the health system contributed to the financial turnaround, which didn’t come at the expense of patient care. During the same period, Fairview improved quality, patient experience and employee engagement scores. And they’re just getting started.
“We’re continuing our turnaround and building a great workforce that can respond to all the changes coming our way,” said Mr. Gaylord. “We are maintaining our work, operational discipline and workforce discipline. We’ve seen our nursing vacancies go down 83%, turnover’s down 36%, and those key things are really what help drive us forward.”
The stable workforce is important for the health system to continue its turnaround. When the organization has consistent full-time team members, they rely less on the transitory workforce, which can be expensive and challenging for hospital culture.
“Patients are having a more consistent experience, and we’re delivering better outcomes,” said Mr. Gaylord. “That’s critical to us and it doesn’t happen by accident. The focus on our staff and identifying key areas where we need to recruit, shortening the time for onboarding, making sure we’re plugging into things that matter to our employees to improve retention have all contributed to the financial turnaround.”
With the workforce stabilizing, Mr. Gaylord and his team can turn to patient access and capacity management. He said the organization is looking at programs to “keep the precious hospital beds available for folks that need it most.” Hospitals across the nation are leveraging technology, data analytics and remote patient monitoring to ensure patients have a safe recovery space while reserving inpatient beds for the sickest patients.
“[These efforts] also extend to access to specialty clinics or primary care clinics, and making sure wait times are as short as they can be, and that experience is terrific for folks,” said Mr. Gaylord. “In addition to that, we have a big focus on our specialty pharmacy business.”
Fairview created a separate business unit, Fairview Pharmacy Solutions, to integrate whole-care delivery, which has had a “tremendous impact” on the system’s success, said Mr. Gaylord. The Fairview pharmacists play an active role in patient care, ensuring access to medications for better outcomes and lower costs. Payers have noticed those results as well, and Fairview is beginning to help other systems build similar programs.
The innovation doesn’t stop there. Fairview designed an empath unit to serve patients who arrive at the emergency department while going through a mental health crisis.
“They can go to a much more conducive setting and get the care they need,” said Mr. Gaylord. “This keeps them out of the ED and inpatient admissions, and we have a better outcome for them throughout.”
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The clinical workflows CNIOs say are overdue for tech change
Clinical workflows continue to be a major source of inefficiency and frustration for nurses. Documentation, admissions, and medication reconciliation often remain manual, time-consuming and prone to error, even as technology advances in other parts of care delivery. Chief nursing informatics officers told Becker’s that rethinking these processes with tools such as AI, automation and ambient listening could reduce administrative burden, improve accuracy and give time back to the bedside.
Becker’s asked chief nursing informatics officers: What’s one clinical workflow you believe is overdue for a tech-enabled overhaul?
Aruna Jagdeo, BSN, RN. Chief Nursing Informatics Officer, Johns Hopkins All Children’s Hospital (St. Petersburg, Fla.): Patient education documentation needs a complete overhaul. Having staff go to a separate area to chart outside of their normal workflow is challenging when they must prioritize what needs to get done. In the ideal world, AI could assist with educational documentation, taking a lot of burden and regulatory risks off the RN. Education happens throughout the shift, and I’m hoping ambient listening technology can eventually capture and document this on behalf of the nurse.
Amanda Klopp, DNP,, RN. Associate CIO and CNIO, TMC Health (Tucson, Ariz.): Medication reconciliation in most organizations is still a clunky, error-prone, semi-manual process. Even with integrated pharmacy refill history, med rec is far from solved — fill data doesn’t equal patient usage, there are data gaps and delays, and inaccuracies like duplicates and outdated doses. A tech-enabled version that pulls all possible sources of medication data, automatically flags discrepancies, uses AI-powered prompts to detect omissions, and generates a clean list for verification could turn a 20- to 30-minute, high-error-rate process into a five-minute, high-accuracy one. Other workflows overdue for development include discharge education, follow-up, and nursing supply and equipment requests.
Cathy Patterson, MSN, RN. Executive Director and CNIO, Banner Health (Phoenix): The shift report is long overdue for a tech-enabled overhaul. Imagine if AI could generate automated summaries that detail the care delivered, highlight care still needed, and identify barriers to discharge. It could also flag missed care that is crucial for harm prevention — like overlooked fall risk assessments or delayed pain checks. Predictive insights could support discharge readiness and resource planning, streamlining handoffs and improving care coordination.
R. Jared Houck, RN. CNIO, Roper St. Francis Healthcare(Charleston, S.C.): Many hospitals still rely on manual sampling for audits like hand hygiene or central line care, which provides only a partial view of compliance. Video- and sensor-based AI can move us to continuous, 100% observation while shifting compliance from a punitive process to a real-time performance-support tool. Immediate prompts, transparent trend data, and workflow integration can help staff self-correct in the moment, improving safety and sustaining compliance without eroding trust. Nursing care plans are also long overdue for a tech-enabled overhaul. In most organizations, they’ve become disconnected end-of-shift documentation with limited clinical value. Integrated, dynamic, AI-enabled tools could transform them into living resources that guide actions, support collaboration, and improve patient outcomes.
Anita Harris-Brown, DNP,, RN. Vice President, IS Clinical Applications & CNIO, Cincinnati Children’s Hospital (Ohio): Medication reconciliation is a critical process in ensuring patient safety, but it can be tedious and time-consuming. Current manual methods are prone to errors, and the lack of a streamlined, tech-enabled solution often leads to discrepancies and inefficiencies. Imagine a system where medication information is automatically updated and reconciled across all platforms — from the pharmacy to the hospital to the patient’s electronic health record. This would reduce the burden on healthcare professionals and significantly improve outcomes.
Karen Hunter, DNP, RN. CNIO, Adventist Health (Roseville, Calif.): One workflow overdue for a tech-enabled overhaul is capturing and integrating vital signs in acute care. Even today, readings are often delayed or manually entered, creating risk for error. Emerging technologies can now capture vitals without touching the patient — using computer vision, radar, or thermal imaging — and send them straight to the EHR in real time. This would reduce cognitive burden, speed decisions, and help clinicians act sooner on signs of deterioration.
Marc Perkins-Carrillo, MSN, RN. CNIO, Moffitt Cancer Center (Tampa, Fla.): Nursing documentation remains one of the most significant contributors to clinician burnout. The current EHR-driven process forces nurses into a rigid, click-heavy environment that detracts from patient care. Ambient listening technology could capture real-time conversations and care activities, then structure that data into compliant documentation. This would reduce the burden and enhance accuracy and timeliness, allowing nurses to focus on patient care.
Michelle Charles, DNP, RN-BC. SVP, CNIO and Virtual Care, Parkview Health (Fort Wayne, Ind.): Revolutionizing patient admissions and clinical documentation is long overdue. Digitizing admissions with integrated EHRs and an AI-driven chatbot could normalize data collection and reduce errors. Augmenting documentation with voice recognition AI tools could also eliminate administrative burden and enable providers to focus more on patient care.
Erin Langmead, MSN, RN-BC. CNIO, Eisenhower Health (Rancho Mirage, Calif.):
Nursing documentation represents a critical workflow overdue for transformation, as it consumes disproportionate time and detracts from direct patient care. AI-powered ambient documentation systems with voice recognition technology could reduce manual entry and enable real-time capture, even across third-party technologies. This would decrease burden while allowing nurses to focus on patients.
Lisa Stephenson, MSN, RN. CNIO, Cedars-Sinai (Los Angeles): I am motivated by the current, rapid infusion of technology into nursing workflows that decrease documentation burden. One area I’d love to see focus on is nursing care plans, which can drive interventions across the continuum of care. Incorporating patient-centered goals and social drivers of health would bring this information together in a meaningful way, telling the patient’s story and impacting outcomes.
Nancy J. Beale, PhD, RN. Vice President, Clinical Informatics and CNIO, Catholic Health (Buffalo, N.Y.): If I had to identify a single workflow with room for improvement, it’s IV smart pump interoperability with the EHR. There is great complexity and variation in pump operation and how it integrates with records. When a nurse is caring for highly complex patients with multiple IV lines, this interoperability must be as streamlined and bulletproof as possible.
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The C-suite’s AI learning curve: Why some CEOs are playing catch-up
While many CEOs are mandating artificial intelligence use across their organizations, some executives have yet to integrate the tools into their daily work, The New York Times reported Aug. 16.
Younger employees tend to have greater comfort with AI and new technologies. Those early in their career typically do more tasks that are well-suited for automation, while senior executives’ schedules are dominated by meetings and approvals, often making them slower to experiment, the Times reported.
Some CEOs are pushing peers to close the gap. For example, CEOs have encouraged senior executives to use Google’s Gemini before defaulting to a standard Google search, according to the Times.
Seventy-seven percent of CEOs view AI as transformative for business, but only 44% said their chief information officers are equipped to navigate the digital landscape, according to a survey of 456 CEOs released in May. An April survey of 400 healthcare executives found 95% expect generative AI to transform the industry.
At hospitals and health systems, CEOs are integrating AI into administrative workflows, including revenue cycle and supply chain, while creating standards to ensure it does not replace critical thinking in leadership.
“Either be afraid and paralyzed by the pace of AI growth, or they can lean into it and be very disciplined about what they use and what they don’t use,” Bob Riney, president and CEO of Detroit-based Henry Ford Health, told Becker’s of the decision organizations must make regarding AI adoption. “But then make sure, once they’re using something and it’s working well, it becomes the standard — as opposed to a whole disparate approach.”
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Sutter Medical Center taps nurse CEO
Megan Gillespie, DNP, RN, has been named CEO of Sacramento, Calif.-based Sutter Medical Center.
Dr. Gillespie has spent nearly 25 years in healthcare leadership roles, most recently as CEO of Sutter Santa Rosa (Calif.) Regional Hospital. She stepped into that position in October 2023, where she led measurable improvements in patient satisfaction and safety outcomes.
At the helm of Santa Rosa Regional, Dr. Gillespie championed initiatives to enhance care access by partnering closely with physicians and frontline teams to identify bottlenecks and improve service lines such as women’s health and emergency care, she said in a 2023 interview with Becker’s.
Prior to joining Sacramento-based Sutter Health, she served as vice president and chief nurse at Advocate Health Lutheran General Hospital in Park Ridge, Ill.
In her new role, Dr. Gillespie will work closely with Sutter Medical Center’s chief medical executive, Phillip Yu, MD, on efforts to advance patient care, according to an Aug. 18 LinkedIn post announcing her appointment.
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Tech giants accelerate push into healthcare with AI
Tech companies are accelerating their push into healthcare, unveiling new AI tools aimed at everything from documenting patient visits to supporting medical care in space.
Here’s a look at recent moves by tech giants expanding their footprint in healthcare AI:
- Google and NASA are collaborating on a new AI-powered tool aimed at enabling autonomous medical care for astronauts during extended space missions, including future journeys to the Moon and Mars.
- OpenAI on Aug. 7 released GPT-5, its latest AI model, which the company said offers major improvements in answering health-related questions. The model outperformed previous versions on HealthBench, a benchmark that uses real-world scenarios and physician-defined criteria. OpenAI said GPT-5 is designed to act as a thought partner, helping users understand their health, ask informed questions and prepare for conversations with medical providers. The tool can also tailor responses based on a user’s context, knowledge level and location, according to the company.
- Microsoft chair and CEO Satya Nadella stated that the company had a “breakout” fiscal 2025 for the use of its Dragon Copilot (aka DAX), which ambiently listens to patient visits and drafts clinical notes for the EHR. According to the company, healthcare customers employed the tool to document over 13 million patient encounters.
- Google Cloud worked with Nashville, Tenn.-based HCA Healthcare to develop a tool called Nurse Handoff. The tool integrates with EHRs and uses Google’s MedLM models to generate concise, AI-assisted shift summaries. It is currently being tested in five hospitals within the HCA system.
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Pediatrics group breaks with CDC on COVID vaccine guidance
In a departure from the CDC’s recommendations, the American Academy of Pediatrics said all children between 6 months and 2 years old should receive a COVID-19 vaccine for the 2025-26 virus season.
The AAP released the recommendations Aug. 19. They differ from the CDC’s guidance published in May, which advises “shared clinical decision-making” between the clinician and parent or patient who is not immunocompromised and is 6 months to 17 years old. The AAP also recommends children ages 2-18 who are in certain risk groups receive the vaccine.
Since 1995, the AAP has synced its guidance with the CDC, with minor differences emerging occasionally, such as starting age recommendations for the HPV vaccine. This year’s guidance is the first substantial departure from the CDC’s vaccine recommendations in the last 30 years, according to ABC News.
The AAP also recommends thimerosal be included in flu vaccines, a preservative the CDC has voted to remove in vaccine formulations.
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AstraZeneca launches 1st at-home flu vaccine
AstraZeneca has issued its flu vaccine nasal spray for at-home use.
The nasal spray is authorized for use by adults ages 18-49 and for caregiver use with children ages 2-17, according to an Aug. 15 news release from the drugmaker. FluMist was initially approved by the FDA in 2003 and is the first seasonal influenza vaccine authorized for at-home use, the company said.
Ordering FluMist online begins with a medical screening questionnaire reviewed by a licensed healthcare provider, and the service is covered by most commercial insurance plans with a shipping fee of $8.99, CNN reported Aug. 15.
The CDC reported that the most recent flu season was the most severe since the 2009 H1N1 pandemic, and the new at-home option is intended to increase vaccine accessibility, the release said.
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Epic to roll out MyChart Central
Epic is rolling out MyChart Central, a new patient-focused login system enabling individuals to access health records from multiple participating providers using a single Epic ID.
Epic made the announcement via its official X account on Aug. 15.
“One way we’re simplifying patient access to health information goes live this week, starting with four organizations: MyChart Central. With it, patients will get a single login to access their health information from providers they’ve visited. MyChart Central also makes it easy for patients to share their records with different health apps, too,” the EHR vendor wrote on X.
According to Epic’s website, MyChart Central serves as a patient-centered hub that allows users to manage care across multiple organizations under one login—an Epic ID. That credential grants centralized access to their MyChart portal accounts across different health systems.
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Parkview Health launches AI-powered backup system for patient records
Fort Wayne, Ind.-based Parkview Health rolled out its “Virtual Single Patient Record” system, an isolated recovery environment developed with health tech company CareEvolution. The platform enables clinicians to access a read-only patient record when the primary electronic medical record or hospital network is offline.
The fully isolated system was designed to provide digital resilience without the high costs typically associated with high-availability infrastructure, according to an Aug. 18 Parkview news release. The cloud-based repository includes full patient history and near real-time data synchronization from Epic, hosted in an independent FISMA-moderate environment.
The system works across devices, including smartphones over LTE, and relies on a serverless, cloud-native model that can scale instantly or hibernate when idle. Ron Double, CIO of Parkview Health, said the tool allows clinicians to retrieve patient information “even if the unthinkable happens and most systems are down.”
The investment aligns with research estimating that a single hospital cyberattack can cost $11 million, while prolonged EHR downtime has been linked to a 20% increase in 30-day mortality rates for some patients, according to the release. The system is now active across all Parkview Health locations.
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Epic launch contributes to Memorial Sloan Kettering’s $113M shortfall
New York City-based Memorial Sloan Kettering Cancer Center reported an operating loss of $113.2 million for the first half of 2025, citing rising expenses and one-time costs related to its Epic EHR implementation.
The center said in an Aug. 15 news release that its operating cash flow margin was 1.4%. The organization attributed the shortfall to higher medical supply and pharmaceutical expenses, along with investments tied to the Feb. 1 Epic go-live.
Memorial Sloan Kettering described Epic as a “cornerstone” of its digital modernization strategy, expected to improve patient satisfaction, operational efficiency and revenue cycle performance. As with other hospitals adopting new EHR systems, the cancer center saw a temporary decline in patient activity in February and March following the launch.
Despite the costs, operating revenue grew 5.2% year-over-year, including a 3.9% increase in patient revenue. Patient activity rebounded in the second quarter, with growth across key service areas, according to the release.
Operating expenses climbed 9.7%, partly due to Epic-related costs. The institution said it continues to seek efficiency measures while focusing on access, discipline and its mission-driven programs.
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UNC Health names revenue cycle VP from CHS
Chapel Hill, N.C.-based UNC Health has named Christina Slemp system vice president of revenue cycle – financial services, according to a post on her LinkedIn page.
Ms. Slemp joins from Franklin, Tenn.-based Community Health Systems, where she served as vice president of revenue cycle.
“Over the course of my career, I’ve been fortunate to work alongside incredible teams, tackle complex challenges, and make a meaningful impact in healthcare operations,” Ms. Slemp said in the post. “This next step with UNC Health represents not only a new role, but also an opportunity to contribute to an organization whose mission and values align deeply with my own.”
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21 health systems with boosted outlooks
Here are 21 health systems that recently had their outlooks upgraded by Fitch Ratings or Moody’s Investors Service in 2025.
Note: This is not an exhaustive list. Health systems were compiled from credit rating reports.
Boston Children’s Hospital’s outlook was revised to stable from negative by Moody’s. The revision reflects a modest improvement in operating performance and the likelihood that margins will continue to strengthen to roughly 4%-6% in fiscal 2025, Moody’s said. Boston Children’s has an “Aa2” rating with the agency.
Broward Health’s outlook was revised to positive from stable by Fitch. The revision highlights the Fort Lauderdale, Fla.-based system’s strategic initiatives to expand service lines and improve access via outpatient sites, Fitch said. Broward has an “A+” rating with the agency.
Butler (Pa.) Health System’s outlook was revised to stable from negative by Moody’s. The revision reflects Moody’s assessment that Butler’s parent company, Independence Health System, will continue on a path of improved operating performance and maintain sufficient days of cash on hand. It also reflects that Butler will meet its covenant requirements. The system has a “Baa3” rating with Moody’s.
Cooper University Health Care’s outlook was revised to positive from stable by Moody’s. The revision reflects the Camden, N.J.-based system’s maintenance of high single-digit operating cash flow margins and strong liquidity, despite significantly increased capital spending, Moody’s said. Cooper has an “A3” rating with the agency.
DCH Health Care’s outlook was revised to stable from negative by Moody’s. The revision reflects the likelihood that the Tuscaloosa, Ala.-based system’s recent operating improvements are sustainable, Moody’s said. DCH Health Care has a “Baa1” rating with the agency.
Essentia Health’s outlook was revised to positive from stable by Fitch. The revision reflects the Duluth, Minn.-based system’s operational improvement in fiscal 2024 and 2025 following periods of margin compression, Fitch said. Essentia has an “A-” rating with the agency.
EvergreenHealth’s outlook was revised to stable from negative by Moody’s. The revision reflects the Kirkland, Wash.-based system’s reduced enterprise risk as hospital operations continue to strengthen, Moody’s said. EvergreenHealth has an “Aa3” rating with Moody’s.
Hunterdon Medical Center’s outlook was revised to stable from negative by Fitch. The revision is based on the Flemington, N.J.-based system’s improved cash flow that reflects strategic growth initiatives and operating efficiencies that have been implemented in recent years, Fitch said. Hunterdon has an “A+” rating with Fitch.
Hutchinson (Kan.) Regional Medical Center’s outlook was revised to stable from negative by Moody’s. The revision reflects improving financial performance, with break-even to slightly positive cash flow expected in fiscal 2025, Moody’s said. Hutchinson has a “Baa2” rating with the agency.
Hurley Medical Center’s outlook was upgraded to positive from stable by Moody’s. The revision reflects Flint, Mich.-based medical center’s stronger volumes and favorable changes to Michigan’s Medicaid-directed payment program, Moody’s said. Hurley has a “Ba1” rating with the agency.
Kettering (Ohio) Health’s outlook was upgraded to positive from stable by Moody’s. The revision reflects the likelihood that the system will maintain strong liquidity as it increases capital spending, backed by high single-digit operating cash flow margins, Moody’s said. Kettering has an “A2” rating with the agency.
Mary Washington Healthcare’s outlook was revised to positive from stable by Fitch. The revision reflects Fitch’s view that the Fredericksburg, Va.-based system is well positioned to generate robust cash flow, absorb additional debt and build unrestricted cash and investments. Mary Washington has an “A” rating with the agency.
Miami Jewish Health Systems’ outlook was revised to stable from negative by Fitch. The revision reflects the system’s improved performance over the last two years, which has enabled MJHS to meet its debt service coverage and days cash on hand covenants in fiscal 2024, Fitch said. Miami Jewish has a “BB+” rating with the agency.
Nuvance Health’s outlook was revised to stable from negative by Moody’s. The revision reflects the Danbury, Conn.-based system’s improved financial performance, which Moody’s believes will be sustainable. Nuvance’s merger with New Hyde Park, N.Y.-based Northwell Health will provide additional financial resources to expand its market capture, Moody’s said. The system has a “Baa3” rating with the agency.
Phoenix Children’s Hospital’s rating was upgraded to positive from stable by Moody’s. The revision reflects the likelihood that the system’s expansion strategies will continue to drive good cashflow and liquidity growth, Moody’s said. Phoenix Children’s has an “A1” rating with Moody’s.
Rex Healthcare’s outlook was upgraded to positive from stable by Fitch. The revision reflects Fitch’s expectation that the Raleigh, N.C.-based system’s operating performance will continue to improve over the medium term. Rex has an “A+” rating with the agency.
San Antonio Regional Hospital’s outlook was revised to positive from stable by Moody’s. The revision reflects that the Upland, Calif.-based hospital has maintained strong operating cash flow of around 8%, Moody’s said. The hospital has a “Baa1” rating with Moody’s.
Tampa (Fla.) General Hospital’s outlook was upgraded to positive from stable by Moody’s. The revision reflects the health system’s integration of three new hospitals in 2024 while meeting budget, Moody’s said. Tampa General Hospital has a “Baa1” rating with the agency.
Texas Medical Center’s outlook was revised to positive from stable by Moody’s. The revision reflects the Houston-based system’s continued exceptional operating performance and liquidity relative to operations, Moody’s said. Texas Medical Center has an “A1” rating with the agency.
UC Health’s outlook was upgraded to positive from stable by Moody’s. The revision reflects the Cincinnati-based system’s growing cash flow and liquidity from improvement initiatives, bond proceeds and strong management execution, Moody’s said. UC Health has a “Baa3” rating with the agency.
Wayne Healthcare’s outlook was revised to positive from stable by Fitch. The revision reflects the Greenville, Ohio-based hospital’s June 2024 conversion to a critical access hospital, Fitch said. Wayne Healthcare has a “BB+” rating with the agency.
The post 21 health systems with boosted outlooks 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.