The Future of Nurse Staffing Success
Rising clinical labor costs and widespread burnout have created an unsustainable staffing crisis in healthcare. Traditional outsourcing methods—such as relying on travel nurses or staffing agencies—often drive costs up without solving the root issues. During our recent webinar, “Don’t Just Outsource, Insource: The Future of Healthcare Staffing Success,” Hallmark CEO Bruce Cerullo and Regional SVP Matt Dane, DNP, MBA, RN explored a better way forward.
This session unpacked emerging workforce trends, including insights from a nationwide survey of 1,200+ healthcare leaders, and highlighted how a Contingent Labor Platform with an Internal Resource Pool (IRP) and Vendor Management Solution (VMS) can help health systems reduce costs, improve fill rates, and create a more resilient workforce.
The Never-Ending Staffing Crisis
The discussion began with an overview of the systemic challenges health systems face:
- Supply-Demand Imbalance: Hospitals continue to struggle to staff shifts adequately.
- Burnout & Declining Morale: The rigidity of traditional staffing models is driving nurses away from full-time roles.
- Unsustainable Costs: Over 89% of surveyed leaders said they feel pressured to cut labor expenses, but agency markups range from 20% to 50%, making outsourcing a costly band-aid solution.
A New Approach: Insourcing Contingent Labor
Instead of relying on external staffing agencies, health systems can take control of their workforce strategy by insourcing contingent labor. Key components of this model include:
- Building an Internal Resource Pool (IRP): This allows systems to prioritize filling shifts internally before turning to external staffing solutions.
- Leveraging a Vendor Management Solution (VMS): When external labor is needed, a competitive marketplace approach ensures better rates and a broader talent pool.
- Technology-Enabled Flexibility: A centralized platform enables real-time matching of shifts to available nurses, increasing efficiency and reducing burnout.
How a Southeast Health System Insourced Nurse Staffing and Cut Costs
Dane shared how a 24-hospital system across Arkansas, Mississippi, and Tennessee transformed its staffing approach by implementing an IRP.
Results included:
- Tripling the size of their float pool in just three months
- Filling 416 shifts and 5,000+ hours per month
- Eliminating thousands of overtime and agency premium pay hours, resulting in millions in annual savings
Key Survey Findings: The Workforce (and Leaders) Want Flexibility
A survey of 1,200+ healthcare leaders confirmed that traditional staffing models aren’t meeting today’s workforce needs:
- 98% reported an increased demand for gig-style work in the past two years.
- 67% cited burnout due to lack of flexibility as a critical issue.
- 96% believe gig-style work will play a major role in their staffing strategy over the next five years.
- 94% are exploring alternative staffing models, such as flexible schedules and local float pools.
Top Nurse Staffing Questions Answered: How Insourcing Solves Workforce Challenges
Speakers wrapped up with audience questions, addressing real-world implementation challenges and best practices. Advice they gave:
- I’ve read a report that 65% of RNs would consider getting out of the profession, why is that in your opinion?
For years, healthcare leaders have faced mounting challenges with the cost, engagement, and availability of skilled clinical staff. Labor costs remain stubbornly high, fueled by staff turnover and skill-mix shortages. Overworked teams and shifting generational expectations have led to a disengaged workforce, jeopardizing patient safety, care quality, and experience outcomes.Veteran clinicians are leaving the profession in alarming numbers, with the average bedside nurse staying just three years. Meanwhile, aspiring nurses are choosing not to enter the traditional healthcare workforce—they see the burnout and know they don’t want to work under those conditions.
A key driver behind this shift is the rise of staffing agencies, which offer nurses greater flexibility. Instead of joining health system teams directly, many nurses are choosing agency work—only for those same health systems to buy back their labor at a 20-50% markup. This not only inflates costs but also diminishes workforce engagement since these nurses lack long-term allegiance to the organization.
The solution? Offering flexibility, competitive compensation, and a better work-life balance—so nurses don’t feel compelled to leave the profession or rely on agencies for the conditions they need. - How is your Internal Resource Pool (IRP) different from a per diem pool or what agencies offer in-house?
Many organizations claim to have float pool capabilities, but in reality, they’re often just repackaged per diem pools or DIY solutions that fail to meet real workforce needs. A true Internal Resource Pool does much more. It:- Reduces reliance on external staffing agencies by filling more gaps with trusted, internal contingent talent.
- Attracts, retains, and upskills clinicians by offering the flexibility they want while keeping them engaged with the health system.
- Creates an employer-of-choice environment that draws more job-seeking clinicians to your organization.
Unlike a per diem pool that simply fills last-minute shifts, an effective IRP should support both short- and long-term assignments, allow health systems to set their own pay rates, and ensure that participating clinicians are employed directly by the organization—not an agency or MSP.
- Can a float pool be implemented to support other types of clinicians? I.e. allied professionals, OT/PT/ST or neonatal intensive care?
Yes—if you have the right system in place. A well-designed float pool should be adaptable to various clinical roles, ensuring that workforce flexibility extends beyond just nursing. Because these are your employees that you’ve pre-screened, onboarded and accepted, this type of program design can be employed in highly specialized areas, even the OR or neonatal intensive care.There’s no risk in quality, because they know your standards, have been trained by your teams, and are equivalent to your FTEs.
- What cost savings and operational efficiencies have health systems seen by shifting from outsourced travel nurses to an internal contingent labor strategy?
Health systems that have implemented strong Internal Resource Pools and optimized their contingent labor programs have seen significant results. Examples:
By reducing agency dependence, hospitals can reinvest savings into their workforce—improving retention, reducing burnout, and ultimately enhancing patient care.
- How can a float pool or VMS address or meet client-specific union / collective bargaining agreement requirements for staffing? I.e. (scheduling, prioritizing who can take shifts, who can be flexed/floated, etc.)?
With the right partner, your IRP can be fully customized to align with union agreements and staffing policies.- You can designate specific locations, employee groups, or job roles that can participate.
- If you need to limit participation to non-union employees or contractors, the system can be configured accordingly.
- Alternatively, if union employees are included, you can ensure they only see and apply for shifts that comply with their bargaining agreements.
A flexible, well-structured IRP isn’t just about technology—it should come with expert guidance from a team that understands the complexities of healthcare staffing and union compliance inside and out.
The Takeaway: Don’t Just Outsource. Insource.
As healthcare leaders seek sustainable staffing solutions, insourcing contingent labor is proving to be a cost-effective, flexible, and nurse-friendly alternative. By adopting this model, health systems can reduce agency reliance, empower their workforce, and improve patient outcomes.
In laymen’s terms: next time your system is experiencing nurse burnout and staffing shortages, don’t just outsource. Insource.
Interested in learning more? Download the full survey report, or check out this page to learn more about the importance and benefits of insourcing contingent labor. Or reach out to explore how Hallmark can help your organization insource staffing success.