Providence is investing $220 million to fill open positions and give bonuses to current employees, the Renton, Wash.-based system announced Sept. 3.
The health system is giving a $1,000 bonus to every caregiver who has been with the organization for at least 90 days. The bonuses, which will be given to workers up to and including the director level, will be paid in two installments in September and December.
Providence is also making investments to rapidly fill 17,000 job openings. The system said it is offering sign-on bonuses to front-line workers with the goal of filling positions quickly and alleviating the stress and burnout many clinicians are experiencing. Current employees are eligible for referral bonuses of between $1,000 and $7,500.
“Our caregivers are the core of who we are, and we have been committed to supporting their health and well-being throughout the pandemic,” Providence President and CEO Rod Hochman, MD, said in a news release. “Now, as we enter month 21 of our COVID-19 response, it’s even more imperative to continue to care for and bolster those who make our mission possible.”
The US now has more job openings than any time in history—and the mismatch in workforce supply and demand in the broader economy is even more acute in the healthcare sector. While the industry saw significant job losses in April 2020, employment in many healthcare subsectors quickly rebounded to slightly below pre-pandemic levels, according to data from the Bureau of Labor Statistics.
While ambulatory and hospital employment has mostly recovered, employment in nursing and residential care facilities has continued to decline.
Healthcare’s sluggish return to pre-pandemic employment levels is not for lack of demand. The number of job listings has grown nearly 30 percent since the second quarter of 2020, to nearly 4.5M openings, while new hires have flatlined, resulting in over half of healthcare job listings remaining unfilled as of Q2 2021.
In a recent McKinsey & Company survey of over 100 large US hospitals, health system executives ranked workforce shortages among nurses and clinical staff as their greatest barrier to increasing capacity.
Amid the current COVID surge, many systems are offering sizeable bonuses to attract new employees. These strategies will be critical across the next year, as systems look to reduce spending on costly travel nurses, manage COVID surges while continuing to offer elective care, and forestall further burnout.
But longer term, rethinking job functions, integrating new technology and finding ways to educate and upskill critical clinical talent will be key to winning the war for talent.
The hourly mean wage for registered nurses in the U.S. is $38.47, according to the U.S. Bureau of Labor Statistics’ latest occupational employment and wage statistics survey.
Among 10 metropolitan areas with the highest employment level in registered nurses, registered nurses have the highest hourly mean wage in the Los Angeles area and the lowest in the Miami area.
Ten hourly mean wages for RNs by metropolitan area, in descending order:
While CFOs, on the whole, remain optimistic about an economic rebound this year, they’re concerned about labor availability and accompanying cost pressures,according to a quarterly survey by Duke University’s Fuqua School of Business and the Federal Reserve Banks of Richmond and Atlanta.
Over 75% of CFOs included in the survey said their companies faced challenges in finding workers. More than half of that group also said worker shortage reduced their revenue—especially for small businesses. The survey panel includes 969 CFOs across the U.S.
“CFOs expect revenue and employment to rise notably through the rest of 2021,” Sonya Ravindranath Waddell, VP and economist at the Federal Reserve Bank of Richmond said. “[But] over a third of firms anticipated worker shortages to reduce revenue potential in the year.”
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As many companies struggle to find employees and meet renewed product demand, it’s unsurprising CFOs anticipate both cost and price increases, Waddell said.
About four out of five CFO respondents reported larger-than-normal cost increases at their firms, which they expect will last for several more months. They anticipate the bulk of these cost increases will be passed along to the consumer, translating into higher-priced services.
Despite labor concerns, CFOs are reporting higher optimism than last quarter, ranking their optimism at 74.9 on a scale of zero to 100, a 1.7 jump. They rated their optimism towards the overall U.S. economy at an average of 69 out of 100, a 1.3 increase over last quarter.
For many CFOs, revenue has dipped below 2019 levels due to worker shortage, and in some cases, material shortages, Waddell told Fortune last week. Even so, spending is on the rise, which respondents chalked up to a reopening economy.
“Our calculations indicate that, if we extrapolate from the CFO survey results, the labor shortage has reduced revenues across the country by 2.1%,” Waddell added. “In 2019, we didn’t face [the] conundrum of nine million vacancies combined with nine million unemployed workers.”
Consumer prices have jumped 5.4% over the past year, a U.S. Department of Labor report from last week found; a Fortune report found that to be the largest 12-month inflation spike since the Great Recession in 2008.
To reduce the need for labor amid the shortage, many companies will be “surviving with just some compressed margins for a while, or turning to automation,” Waddell said.
That’s the question business leaders are facing after Colorado lawmakers passed a bill requiring companies to post salary ranges for open or remote work positions in the state. California, Connecticut, Maryland, and Washington already have laws on the books mandating companies provide pay ranges to candidates who specifically ask for them or during an offer. The Colorado law takes it one step further by making companies proactively disclose the minimum and maximum salary as part of the job posting.
Though Colorado is the first state to make salary ranges available to any applicant, it won’t be the last, says Benjamin Frost, a solutions architect in Korn Ferry’s Products business. “The wind is clearly blowing in the direction of this becoming commonplace,” he says. Investors and employees want more transparency from companies, particularly around diversity, equity, and inclusion. Moreover, supporters argue providing salary ranges up front can help companies better match candidates to positions, making the hiring process more efficient.
But some companies, already under increasing wage pressure brought on by the hiring boom, apparently don’t see it that way: some recent job listings have specifically excluded candidates who live in Colorado from certain open positions. Frost says the move is less about Colorado’s talent pool and more about losing negotiating power with talent overall. “Excluding Colorado workers seems like a decent price to pay for not needing to disclose salary ranges at the moment,” he says. By contrast, he says, if and when a state like New York or California takes the step toward proactive disclosure, it will be a much bigger deal: “It is about talent pools and where companies can and can’t afford to close off access.”
Human resources leaders also argue that proactively providing pay ranges will actually make the recruiting process less, rather than more, efficient. For one, designating a salary range is tricky business. “You don’t want to limit the talent you get to look at,” says Andy De Marco, Korn Ferry’s vice president of human resources for the Americas. At the time, the range can be so broad that it could become arbitrary. A span of $100,000, for instance, expands the candidate pool and skills spectrum so much that it could slow down recruiting and, by extension, operations.
Excluding applicants from Colorado for now might give companies more time to clean up their pay practices, says Tom McMullen, a Korn Ferry senior client partner and a leader in the firm’s Total Rewards practice. He notes that posting pay ranges could expose internal inequities leaders aren’t yet prepared to deal with. For instance, suppose a company posts a range of $80,000 to $100,000 for a role, but an existing employee is still earning the minimum number after five years with the firm. “How upset will that employee be after seeing this posted range?” asks McMullen.
To be sure, optics are a huge part of the disclosure calculus for leaders. McMullen says companies are running out of time to institute fairer pay practices on their own before regulators push them to do so. “Employees will give their leaders credit for making these changes proactively,” he says.
A recently retired health system CEO pointed us to a working paper from the National Bureau of Economic Research, which indicates that leading an organization through an industry downturn takes a year and a half off a CEO’s lifespan.
It’s not surprising, he said, thatgiven the stress of the past year, we will face a big wave of retirements of tenured health system CEOs as their organizations exit the COVID crisis. Part of the turnover is generational, with many Baby Boomers nearing retirement age, and some having delayed their exits to mitigate disruption during the pandemic.
As they look toward the next few years and decide when to exit, many are also contemplating their legacies. One shared, “COVID was enormously challenging, but we are coming out of it with great pride, and a sense of accomplishment that we did things we never thought possible.
Do I want to leave on that note, or after three more years of cost cutting?” All agreed that a different skill set will be required for the next generation of leaders. The next-generation CEOs must build diverse teams capable of succeeding in a disruptive marketplace, and think differently about the role of the health system.
“I’m glad I’m retiring soon,” one executive noted. “I’m not sure I have the experience to face what’s coming. You won’t succeed by just being better at running the old playbook.” Compelling candidates exist in many systems, and assessing who performed best under the “stress test” of COVID should prove a helpful way to identify them.
HENRY KOTULA 