Then start moving work down a level and out of the building, deliberately, one pathway at a time. You'll keep more nurses than any retention bonus will ever buy you.The systems that win the next five years won't be the ones who recruited hardest. They'll be the ones who figured out their best nurses were never the constraint. The way they used them was.‍

Twenty-one health systems have terminated Medicare Advantage contracts so far in 2026. Mayo Clinic, Mount Sinai, UNC Health, Memorial Hermann, BayCare, Providence. NewYork-Presbyterian and UnitedHealthcare went out of network on May 1 with no new agreement in place. About 2.9 million MA enrollees, roughly one in ten, are being forced into a new plan this year because their insurer pulled out

The U.S. is short roughly 250,000 nurses and 85,000 physicians, with nearly two thirds of nurses operating at high burnout and a projected 70,000 primary care physician shortfall by 2038. Most health systems are responding by deploying AI on top of broken workflows, which makes burnout more efficient rather than expanding capacity.