The healthcare workforce is both a health system’s most valuable asset and its largest cost: a collective $900B industry expense annually. Despite that level of spending, most health systems still can’t see what they’re managing clearly enough to control it. Some people call it the black box at the center of every workforce budget. A few areas are driving that.
Underneath all three sits a visibility problem. Healthcare workforce data is fragmented, biased, or incomplete far more often than it’s whole, scattered across scheduling, HR, finance, compensation, and clinical systems that were never built to talk to each other.
All come back to the same root cause: disconnected systems and reactive decision-making. Adding another point solution to fix one symptom just means one more system to reconcile later. What health systems need for healthcare workforce management is something built to connect and sit above it all.
That’s the idea behind Healthcare’s Workforce Operating System, designed to pair intelligent technology with a team of seasoned operators to help health systems manage their total workforce and its impact on patient care and financial performance more strategically. Instead of replacing what a health system already runs, it connects and augments those systems, giving leaders one real picture of cost, capacity, and incentives to plan and act on.
What that looks like in practice depends on where a health system is starting. Below are four areas where it’s showing up right now.
Flexibility works, but only when it’s backed by real infrastructure. Arnot Health built a structured internal resource pool that grew from 60 nurses to more than 110, driving more than $2.3 million in cost avoidance by reducing reliance on agency labor. Separately, AI-driven bill-rate benchmarking has led to $4 million in savings since implementing Hallmark’s Vendor Management System (VMS). Structure alone wasn’t enough, and neither was visibility. Having both is what delivered the results.
Two-thirds of nurses and 56% of physicians cite staffing shortages as a top driver of burnout (AHA), and flexible staffing is one of the clearest levers available to address it. But flexibility without forecasting just moves the guesswork around. Health systems still planning off spreadsheets and last year’s averages end up overstaffing units with little demand and understaffing the ones that matter, driving up premium labor spend in both directions. Predictive workforce intelligence, built on real-time demand signals rather than historical averages, is what turns a flexible staffing policy into something a health system can actually plan around.
Locum tenens is one use case where this shows up clearly. Health systems have long tolerated slow time-to-fill, opaque agency fees, and no consistent way to measure a temporary clinician’s performance against a permanent one. Those are costs and risks nobody could fully see, let alone manage. Centralizing that spend under a single VMS changes the equation: one source of truth for position data and provider information, rate benchmarking that makes apples-to-apples comparisons possible, and shared accountability for performance across every agency a health system works with. Getting there takes more than new software. It takes an honest readiness assessment of governance, contracting, and spend visibility before the system goes live.
These patterns showed up directly when Hallmark and Becker’s Healthcare brought together workforce leaders from Bryan Health, Mass General Brigham, and Ballad Health Medical Associates for a live conversation on the $900B black box. Jacquelyn Liddell, VP of Talent Acquisition and Workforce Development at Mass General Brigham, put the visibility problem in plain terms: everyone is “seeing a part of the puzzle, but not the full picture,” which is why so much strategic planning takes longer than it should, and organizations end up reacting instead of anticipating.
Bonnie Jensen, Chief Nurse Executive at Bryan Health, described the same fragmentation from the dashboard side. Systems that “don’t always talk well together or play well together in the sandbox,” as she put it, leave leaders managing off partial insight instead of one real-time picture. She also pointed to what closing that gap has meant in practice, calling the Hallmark platform one of the best products she’s used for helping to manage their staffing needs.
Meridith OKeefe, Chief Operations Officer at Ballad Health Medical Associates, framed flexibility differently. Her rule is “tight, loose, tight”: standardize what matters, flex what doesn’t, and design that flexibility at the team level instead of handing down a policy from the top. With Advanced Practice Providers (APPs) now making up more than half of Ballad Health’s professional services workforce, she’s landing on the same conclusion as Jensen and Liddell, just from the physician side. More dashboards won’t fix that. A connected view the whole care team can act on will.
Healthcare workforce management is entering a phase where connected data stops being optional. It’s becoming the only realistic way to manage the industry’s largest expense with any precision. The health systems ahead of this curve are the ones treating workforce as one connected system instead of four separate problems solved four separate ways.
Hallmark’s Flexible Workforce, one of the core suites within Healthcare’s Workforce Operating System, gives organizations the visibility and flexibility to move from reacting to workforce problems to staying ahead of them.
