Healthcare’s workforce shortage has crossed a threshold. This is a full-scale patient care quality crisis, according to new research from Covista.

U.S. employers posted 8.4 million open healthcare jobs over the past year. That’s roughly 702,000 vacancies a month. The pool of unemployed healthcare workers available to fill them: about 306,000. For every person looking for work in healthcare, more than two jobs sit empty. Fifty percent of healthcare executives say they’ve had to scale back patient care as a direct result. Only 18% believe there’s enough talent to meet current needs, and that number drops to 14% looking five years out.

Those numbers should alarm anyone who runs a healthcare facility. They alarm us.

The gap is structural

This research confirms what we hear from facility partners every day: the workforce shortage is a structural imbalance, and traditional recruitment can’t solve it. Many organizations are advertising higher pay right now. In fact, Covista’s data shows a 48% pay premium on advertised roles relative to median wages. Unfortunately, higher pay doesn’t create new clinicians, it only moves the same finite pool of professionals around.

Rural and underserved communities bear the heaviest burden. Covista found that 85% of executives in rural and less urban settings cite a lack of local talent as a major hiring barrier, compared to 45% in major cities. In those communities, reduced staffing capacity means delayed treatment, longer wait times, and care that moves out of reach entirely.

The education pipeline matters for the long term, but healthcare facilities can’t wait a decade for new graduates while a gap sits open right now, this shift, this quarter.

What health systems can do now

The organizations we work with that navigate this environment most effectively share a trait: they stopped treating contingent labor as a last resort and started building it as a deliberate, layered strategy.

The staffing waterfall model sequences core staff, float pool, per diem, travel, and agency under a single platform, routing demand to the least expensive appropriate source before escalating. Done well, it replaces reactive scrambling with predictable cost management and steadier patient coverage.

We’ve watched this play out in measurable ways. Facilities that build a preferred roster of per diem clinicians cut their exposure to last-minute coverage gaps and premium agency rates. AI-integrated platforms now handle in hours what once took scheduling teams days: credential verification, compliance checks, shift matching, vendor coordination, predictive demand forecasting. We covered this in our workforce orchestration playbook.

Medely cut average credentialing time by 95%, from roughly 14 days to under 24 hours. That speed matters most when a unit is short-staffed and every hour of coverage delay raises patient risk.

The real cost of an unfilled shift

Healthcare executives track labor cost closely. Fewer track the downstream cost of care quality degradation. When 50% of executives report scaling back care due to staffing shortages, the financial exposure doesn’t stop at the unfilled shift rate. It reaches patient outcomes, regulatory exposure, burnout among remaining staff, and retention risk.

One in five Americans now believe the U.S. healthcare system is in a state of crisis, the highest level of public concern in 30 years, according to West Health and Gallup.

ASCs feel this acutely. Hospitals are pulling FTEs away from ASC talent pools, and competition for skilled surgical and perioperative staff has sharpened fast. Facilities without a proactive staffing strategy don’t just face inconvenience, they risk closing ORs or canceling cases.

We hear this directly from facility leaders. Hunterdon Center for Surgery, which runs 4 ORs with over 60 surgeons, told us they would have had to close operating rooms without Medely coverage. Natalie at Lincoln Glen, a skilled nursing facility, described Medely as “the easiest and fastest way to get staff” and credited the platform’s favorites feature with giving her a reliable bench of known, quality clinicians who know her residents.

Build the bench before the crisis hits

The facilities in the strongest position built their contingent infrastructure before they needed it, not after a callout at 11 p.m. or a failed agency fill on a holiday weekend.

Building a bench means identifying and nurturing relationships with flexible clinicians during stable periods. It means using a platform that lets you invite favorites first, track performance, and maintain continuity across shifts. It means treating per diem staffing as a proactive strategy, not a reactive emergency spend.

One of our sales leaders put it this way: facilities that build a flexible workforce now will end up in a fundamentally different position than those that wait. The talent pool is finite. Clinicians who are flexible and willing to work per diem are already choosing where to build those relationships. Facilities that offer reliability, fast onboarding, and a good experience are the ones that attract and keep them.

The takeaway for facility leaders

The Covista research is clear about the scope of the problem. Education pipelines, expanded campus access, and investment in early healthcare career pathways matter for the long term. But the workforce gap exists today. Sixty-nine percent of healthcare executives say education pipeline partnerships are the most effective strategy for meeting workforce needs, while only 22% invest in them significantly.

That gap between belief and investment tells you something: most organizations know what needs to happen and haven’t made the structural commitment to do it.

For facility leaders, the work runs two tracks at once: advocate for and invest in education pipeline development for the long term, and build a proactive, technology-enabled contingent workforce strategy for right now.