Health systems rank their No. 1 priority as recruitment and retention, not improved outcomes

Health systems that may have been tone deaf pre-pandemic to high dissatisfaction levels  among employees are hearing those complaints quite clearly now. As emphasized in a recent Aon consulting survey, “Benefits Survey of Hospitals,” health care organizations are almost laser-focused this year on creating a satisfactory working environment throughout their systems.

The survey sought input from participating benefit plans for more than 2.6 million health system employees at more than 1,200 U.S. hospitals. In a near shocking departure from its 2021 survey, respondents cite recruiting and retention as their top priority, outranking even the mission-focused concern of improving their systems’ health care outcomes.

“Competitive benefits to attract and retain talent” is cited by 91% of respondents as their top priority this year. This was followed closely by addressing burnout among employees, and helping plan members better understand the value of their benefits package.

“For the first time, ‘improving outcomes’ fell to the fifth position as a priority,” the report says. “It is clear that employees’ health and wellbeing is a priority — and certainly an important tactic to retain talent and ensure that employees thrive, in the workplace and out. Cost management has continued to fall in priority over the last two years, while member satisfaction with the health plan has gained increased importance.

With turnover higher than past years for both clinical (79%) and nonclinical positions (66%), health systems are desperate to attract and retain talent.

“Nurses were the most sought after talent in 2022, and in fact nurse staffing firms rank second as competitors to hospitals for talent,” the report says.

But the survey reveals that health systems are more concerned than ever about building a loyal, committed staff from top to bottom, and are willing to seriously address areas such as overall compensation, burnout, employee financial stress, and inclusivity/equity to do that.

Benefits design and understanding

The survey added a new category this year to its “what are you most worried about?” question: “Employees understand value of  the benefits.” Right out of the gate, this question hit a nerve, as 89% of respondents cite it as a concern. That placed it in a tie for second on the worry list, just under “competitive benefits to attract and retain talent” (91%) and tied with “burnout/workforce resilience.” Eight of 10 respondents chose “member satisfaction with the health plan” as a top concern. That was up three places from a year ago.

To understand the significance of these rankings, consider that a year ago “improving health outcomes” ranked No. 1. This year, it fell four places. For health systems, this is a major reversal of priorities. With two of the top three concerns centered on employee benefits, and a third close behind, the survey represents a huge opportunity for benefits consultants who have been successful at designing and explaining package value to plan members.

Burnout

The pandemic exacerbated an already crisis-level burnout factor among health care employees. Because burnout is so closely tied to retention, health systems are searching for strategies to address it.

“Many are enhancing their Employee Assistance Program (EAP), or are looking at virtual care options for mental health support (e.g., therapy, digital self-management tools, texting),” the report says. “There is no simple or single solution to solving burnout, but employers are trying to address emotional wellbeing holistically to support each employee’s needs. This support can come in the form of mental health access, peer to peer support, work/life integration tactics, flexibility, or approaches to improve workflow and administrative efficiency.”

Financial stress

As part of the initiative to retain talent, respondents indicated they are aware of the toll taken by financial stress on their employees – and acutely aware that many of them are worried about paying their own health care bills.

“Hospitals are facing increasing bad debt from patients — including employees — who cannot pay their bills,” the report says. “We continue to observe tactics to address this, such as lower employee contributions and cost share through plan design or an emergency fund, especially for low-wage earners. Increased funding of life insurance, short-term and long-term disability coverage, hospital indemnity, or student loan payment assistance demonstrate a heightened mutual concern among employers and employees around financial wellbeing.”

Read more: Nearly 1 in 10 Americans carry medical debt

The results demonstrated that health system management has a growing awareness of the roles played by social determinants of health, lack of equity throughout their systems, and lack of fiscal knowledge on the part of employees, in causing financial stress. Many want to create benefits packages that are increasingly flexible, with more choices designed to reflect the diversity of their membership and the varying levels of financial expertise within the employee group.

Equity

Once a siloed corporate concern where the term “lip service” unhappily applied all too often, equitable treatment of health systems’ consumers and employees has quickly ascended in importance.

“The pandemic created an urgency as an industry to address health disparities and ensure the health and safety of vulnerable communities,” the report says. “Health care employers can partner with the delivery system in impacting these social determinants of health more directly than other employers. Such factors have traditionally been considered outside of an employer’s control, but the ‘equity’ in a health system’s Diversity, Equity and Inclusion (DEI) tactics can serve patients and workforce alike.”

Indeed, recognizing how a health organization’s employees experience equity can be directly applied to the benefits package and thus to hiring and retention.

“Benefits offerings must be more expansive than ever to meet employees where they are,” the report says. “Modifying benefits to address accessibility (such as through virtual care), affordability (especially for low-wage earners), or family building (such as fertility, adoption, or surrogacy benefits), or creating more inclusive benefits to support the LGBTQ+ population, are clear and common examples.”

Related: Hospitals open child care centers in order to retain nurses and staff

As health systems emerge from a traumatic several years, they have clearly learned that they undervalued their employees in the past. Now, they appear to be determined to correct that behavior.

“This is the year of the employee: priorities are focused on what is most critical to support them, in and outside of work, so that they thrive in the workplace and have a reason to stay,” Aon concludes. “Most organizations attribute compensation tactics to be the most effective. However, it is critical for employers to look at their total rewards strategy.”