The ASHHRA Podcast

Luke Carignan and ASHHRA CEO Jeremy Sadlier close out October with three costs health systems already pay without naming them. Each one eats margin and morale, and each ends on a decision that sits with HR.

💵 Pay Compression Is a Fairness Problem First

Nurse.org's 2026 salary survey of 3,758 nurses: 93% say pay is not keeping up with inflation and workload, and 23% say they are underpaid compared with new hires. Mercer's 2026 planning data puts healthcare merit increases at 2.9%, tied for the lowest of any industry, while starting wages rise. Jeremy's math: a range moving 5% a year against 3% raises builds 2 points of compression every year.

HR Risk: NSI prices a bedside RN at $60,090 to replace, and 71% of nurses who left last year were past year one. The people leaving are the ones you invested in.

https://nurse.org/news/nurse-salary-survey/

🧠 The EAP Is a Phone Number, Not a Strategy

NAMI and Ipsos found 26% of employees do not know whether their employer offers an EAP at all. The ones who know face the 1-800 number, the provider list, and weeks of calls before a first appointment. Jeremy calls it a culture problem and sets the contracting standard at 24 to 72 hours to a first conversation, with charge nurses as step one, not the only step.

Action: Put guaranteed access time in the EAP contract, embed counselors on units, and tell people it exists.

https://www.nami.org/wp-content/uploads/2026/03/NAMI-Workplace-Mental-Health-Poll-February-2026_Final-PPT.pdf

📉 Budget Season Against a 1.5% Margin

Fitch puts the nonprofit hospital median operating margin at 1.5% for fiscal 2025, up from 1.1%, and calls it a likely brief operational peak before the Medicaid provisions of the One Big Beautiful Bill Act bite in 2027.

Key Takeaway: Price turnover in dollars, not points. "Spend $2 million to recover $18 million" wins where "I need $2 million for retention" loses. Jeremy goes further: workforce programs with a five-year payback belong in the capital budget, not the operating line that gets redlined every bad year.

https://www.fiercehealthcare.com/providers/fitch-2025-likely-brief-operational-peak-nonprofit-hospitals-ahead-obbba-changes

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Luke is on the road, so Bo sits down with ASHHRA Executive Director and CEO Jeremy Sadlier for a different kind of Weekly News Drop: the news is ASHHRA's own. Registration for ASHHRA27 is open, and the two of them walk through what the conference will feel like and how the ASHHRA Preferred Partner Program is built to lower what healthcare HR pays for everything it buys.

🤠 One Campus, Everybody You Meet Is ASHHRA

ASHHRA27 runs May 16-18, 2027 at the JW Marriott San Antonio Hill Country, with sessions, rooms, and restaurants in one place instead of a convention center and a scatter of hotels. Jeremy calls it the nicest venue in his tenure, with rooms still under $300. The Riverwalk is a 30 to 40 minute ride if you add a day.

Key Takeaway: The elevator, the dinner table, the spa, and the TPC course are all full of people who do your job. Nobody is more than an arm's length from a peer.

https://ashhra.org/ashhra27/

🎓 Education by Practitioners, for Practitioners

The committee leaned toward abstracts from working healthcare HR leaders over business partners this year. Expect the Savannah summit conversations on stage: a clinical workforce aging out, benefit costs that are becoming untenable, GLP-1 coverage as a hiring differentiator, and where AI replaces work and how to redeploy the people who did it. The AP3 partners get their own row in the hall, and the puppies are at the end of it.

💲 How AP3 Bends the Cost Curve

Jeremy built the program after watching reimbursement fall while costs like stop-loss rose 20 to 50 percent for some systems. Fifteen vetted partners across ten categories, from contingent labor and medical plan risk to GLP-1 management and workforce wellbeing, offer discounts and incentives that you unlock by mentioning AP3. Membership is not required, and no GPO is coming.

Action: Treat the contracted incentive as your starting point, not your ceiling. The first organization to use the program negotiated down from there and signed.

HR Risk: Bo runs every partner through a six-domain diligence scan, legal, security, corporate and financial, market, healthcare credibility, and workforce culture, before a contract is offered, and again every six months.

https://ap3.info

🔎 This Week's 3 Mission-Critical Moves

Register for ASHHRA27 while the room block is open. Scroll the ten categories on AP3.info before your next vendor renewal. Send Bo or Jeremy the name of a partner you already trust and would recommend to a peer.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Featuring Romy Newman, VP of Talent Ecosystem, CLASP

Disclosure: CLASP is a sponsor of The ASHHRA Podcast.

Bo opens with a question from his Army years. What if every recruit paid for basic training up front and the Army just hoped they stayed? That is close to how the United States trains clinicians. Romy Newman co-founded Fairy Godboss, ran digital ad sales at the Wall Street Journal, and now leads talent ecosystem at CLASP, which connects health systems to clinical students before graduation and ties loan repayment to tenure.

🎓 The Debt Math Nobody Shows the Student

Newman's numbers: a CRNA graduates owing about 1.25 times first-year salary. A physical therapist can owe twice it, roughly $200,000 of debt against an $80,000 first job, with five to ten years to pay it down. Nurses and CRNAs fund an unpaid residency on top. The weight shows up as anxiety at boards time.

Key Takeaway: Surgeries drive hospital revenue, and that is why CRNA demand exploded. The system needs these people and still makes them pay to enter.

💸 Why the Sign-On Bonus Loses

A $50,000 bonus nets about $25,000 after tax, gets spent on a car, and walks out inside a year, leaving the system to claw it back. Loan repayment pays out monthly only while the employee stays, and under Section 127 the first $5,250 a year is tax free. CLASP syncs to the servicer, so the employee never sees a bill, just an email saying the employer paid this month.

HR Risk: Refinancing an employee's public loans into private ones kills their PSLF eligibility. Missed payments do too.

🪖 How the ROTC Model Works

Sixty-plus employers commit to hire a student a year before graduation and repay loans over three to five years, mostly with money redirected from bonuses and travel-nurse spend. Repayment runs higher for night shift, med-surg, or rural moves. Rochester Regional Health goes further and shapes the curriculum with its partner school.

Action: Ask CLASP for the ROI analysis. Luke's read: the CFO already lives the $60,000-per-nurse replacement number.

https://www.clasp.com/healthcare

Newman's parting stat, from Covista's September 2026 report: solving the nursing shortage by 2040 saves nearly 100,000 lives.

https://www.businesswire.com/news/home/20260928447812/en/The-Healthcare-Workforce-Gap-Is-Set-to-Nearly-Double-by-2040

ASHHRA27, May 16-18, 2027, San Antonio: https://ashhra.org/ashhra27/

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Featuring Jeff Battinus, VP of Talent Attraction and Selection, ChenMed, and Yaniv Shimoni, Co-Founder, Take2

Disclosure: Take2 is a sponsor of The ASHHRA Podcast.

Twenty-two years in healthcare recruiting, and Jeff Battinus says his career is changing in front of his face. He joins Bo with Take2 co-founder Yaniv Shimoni to separate real agentic AI from the version that is a sticker on an old process.

🤖 Agent or Bumper Sticker

Battinus's test is blunt. Most of the big vendors, he argues, bolted AI onto applicant tracking systems that were already stacked on top of the fax machine and the Rolodex. A real agent executes on your behalf around the clock. A wrapper hands you recommendations and waits.

Action: Peel one layer. Ask a vendor what the agent does without a human starting it.

📊 What the Interview Data Shows

Chicago Booth and Erasmus researchers ran a field experiment with 70,000 applicants. Roughly 78% chose a voice AI interview over a human recruiter, and the AI-screened candidates were likelier to get offers and still be there at 30 days. Take2 reports 57% of the applicants it interviews start outside business hours.

Key Takeaway: Candidates are voting with the clock. Nobody staffs a recruiter at 11pm.

🩺 Where the Savings Land

At Dental Care Alliance, across 141 brands, Battinus says the interview module alone returned seven figures he pushed back toward patient care. His framing throughout is access, not efficiency: unlock the constraint, get a clinician in front of a patient faster.

HR Risk: Systems moving at this pace recruit from your labor pool, and they reach the offer letter first.

⚡ What Comes Next

Take2 is building pre-boarding agents for license verification, background checks, and forms, with a personal agent assigned to each new hire. Battinus predicts recruiting is 90% automated inside five years, with the human kept for the sell and the hiring-manager relationship.

Action: His parting line is the sharpest in the episode. If talent acquisition does not do this, finance will do it for you.

Shimoni's close is the gentler version. Adoption is not required today. Curiosity is.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Bo and Jeremy are back from the ASHHRA Executive Summit in Savannah, Luke held the fort, and the three of them land on one theme: the systems that win are not doing anything magical. They are deciding earlier than everyone else.

💊 The GLP-1 Decision You Cannot Keep Deferring

One in eight American adults is on a GLP-1 right now, per KFF. IFEBP's June 2026 pulse survey puts employer coverage for weight loss at 36%, and 19% of employers have already dropped it. Jeremy's read from the summit: candidates already on a GLP-1 are choosing hospital A over hospital B on this benefit, and the fear holding systems back is the rebound cost when people come off it.

Action: Do the feasibility study on the whole HR spend, not one line. Ask how you are procuring it, through the PBM or a capitated model, before you decide you cannot afford it.

https://www.beckerspayer.com/research-analysis/employer-coverage-of-glp-1s-for-diabetes-weight-loss-remains-steady-at-36-survey/

🧑‍⚕️ Gen Z Is 30% of Your RNs. Are You Managing for Them?

AONL and Laudio's Spring 2026 study of 100,000 RNs: Gen Z is now 30% of inpatient and ED nurses, the only generation still growing, and needs about 2.5 times the manager touchpoints of millennials to get the same retention gain. Five documented interactions in a quarter is worth about 5 points of retention. Most new grads start on nights, where the leaders are not.

Key Takeaway: Luke's point stands. We saw this coming and did not change the management system. Feedback in the moment, not at the annual review.

https://www.aonl.org/system/files/media/file/2026/03/AONL-Laudio-Insights-Engaging-and-Retaining-Gen-Z-Nurses-Spring2026.pdf

📉 Seeing the Resignation Before the Notice

Healthcare built sepsis alerts and readmission models because seeing a bad outcome early lets you intervene. The workforce data for the same move already sits in your HRIS and scheduling software: shift pickup, overtime, PTO patterns, training logins. NSI puts a bedside RN replacement at $60,090 and first-year RN turnover at 22.7%.

HR Risk: Jeremy's counter is the sharper one. The analytics only confirm what good leaders already do. Apply the fixes to everyone now and you need the model less.

https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf

🔎 This Week's 3 Mission-Critical Moves

Put one of the three on your next leadership agenda and answer honestly: do we have a position on this? Jeremy starts with GLP-1 coverage. Luke, running a system over 10,000 employees, starts all three today.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Luke Carignan runs this one solo while Bo and Jeremy are in Savannah for the ASHHRA Executive Summit. One theme ties the week together: your move. Every story lands on a decision that sits in an HR office.

🩺 The Physician Succession Crisis Nobody Scheduled
New research from MGMA, Jackson Physician Search and LocumTenens.com found 64% of rural administrators expect a physician to retire or cut back within five years, and only 41% have a formal succession plan. Two-thirds of the significant physician vacancies from the past three years are still open searches today.
Action: Name the physicians who are five to ten years out, then start the conversation before anyone gives notice. This is succession planning, and succession planning lives in HR.
https://jacksonhealthcare.com/new-research-from-mgma-jackson-physician-search-and-locumtenens-com-gives-rural-health-leaders-a-strategy-for-sustaining-specialty-care/

🪜 91% Believe It. 64% Build It.
MedCity News reported this summer that 91% of healthcare employers say internal career laddering improves retention, while 64% actually offer it. Pay is table stakes now and it buys transactions, not loyalty. What holds people is knowing there is a next step with their name on it.
Key Takeaway: The gap between 91 and 64 is a decision, not a budget line. Pathways feel like a long-term investment to leaders managing a short-term crisis, and the systems that built them are less short staffed today.
https://medcitynews.com/2026/07/healthcare-retention-depends-on-better-pathways-not-just-better-pay/

📈 The Fragile Recovery Is a Workforce Story
Fitch projects median operating margins of 1% to 2% for nonprofit hospitals in 2026. Thin, but up. The systems recovering fastest got labor costs down by keeping people rather than cutting them, because every nurse who walks costs roughly $60,000 to replace and every travel contract raises cost per hour.
HR Risk: A CHRO who cannot quantify what retention returned to the margin is arguing from feeling in a room that runs on numbers.
https://www.fiercehealthcare.com/providers/nonprofit-hospital-sector-notch-modest-margin-gains-2026-systems-tighten-ahead-medicaid

🔎 This Week's 3 Mission-Critical Moves
Put one physician succession conversation on the calendar. Scope one career ladder in one department. Put a dollar figure on what retention saved you this year.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Featuring Dominiece Hoelyfield, Lead Inclusion and Culture Consultant, Nationwide Children's Hospital

Bo opens with a question worth sitting with. The last time you walked into your workplace, did you feel like you belonged? Not tolerated, not accommodated, not represented in the right percentage on a slide. Dominiece Hoelyfield has spent a decade and a half on the difference, and she answers it as a practitioner rather than a program.

🧭 Serve the People Who Serve the People

Healthy employees deliver better care to families who arrive at their most vulnerable. That is the whole chain, and Hoelyfield puts her work at the front of it. Nationwide Children's just landed on the U.S. News Best Children's Hospitals Honor Roll for the 13th consecutive year.

**Key Takeaway:** In most communities the health system is a top-five employer, which makes its workforce a direct reflection of the community it treats.

🪟 What Belonging Actually Looks Like

New hires decide fast. BambooHR puts the window at 44 days. What fills it is unglamorous: who introduces you to stakeholders, whether policy is fair, whether anyone checks in when you are running at 40% and still expected to give 100%.

**Action:** Audit the first six weeks, not the first day. Onboarding is where belonging is won or lost.

🤫 Reading What Is Not Said

Hoelyfield runs cultural audits by handing the room the driver's seat. The group writes its own ground rules, then she asks questions and listens past the answers. The hesitation, the stutter, the shift in posture. That is where the real answer sits.

**HR Risk:** A leader who takes a call during a one-on-one has told that person they do not matter. Quiet quitting starts there.

⚖️ Discernment Over Reaction

Her closing advice, and the line of the episode: not everything needs to be addressed, but everything requires discernment. In an organization of thousands, one decision ripples, and no single decision represents every employee.

Change is consistent. Growth is optional.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

Our October Sponsors

AP3

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Clasp

This episode is supported by Clasp — the missing link to lasting talent.

You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other started, and was out the door six months later. That bonus is history, and now you're paying agency premiums to re-fill the role. Sound familiar?

Top health systems are done with this cycle. They've partnered with Clasp for loan-linked hiring that helps them reach candidates ahead of competitors, secure the hire with a truly differentiated offer, and retain them for multiple years by investing where it matters most: their student debt.

Clasp — the missing link to lasting talent. Visit https://clasp.com/.

ShiftKey

This episode is brought to you by ShiftKey — empowering hospitals to deliver quality care on demand.

When census swings and acuity spikes, your team needs flexibility — not 12-week contracts, agency minimums, or exclusivity.

ShiftKey is the most powerful marketplace that gives you direct access to local, credentialed independent clinicians who are ready to work. With a presence in more than 430 markets nationwide, ShiftKey connects you with fast, quality coverage when you need it.

Post a shift. Review the professionals who request it. Choose who fits your standards. Get coverage in minutes. No long-term commitments. No hidden fees.

Start posting shifts today at https://shiftkey.com/.

Support the show

Luke Carignan runs this one solo and flips the format. No crisis, no warnings. Three healthcare workforce stories that went right, and three things healthcare HR can act on because of them.

🩺 Ambient AI Moved Burnout in 30 Days

Yale researchers put an ambient AI scribe in front of 263 clinicians across six health systems. Burnout fell from 51.9% to 38.8% in a month. Cognitive load dropped, after-hours charting dropped, and clinicians reported more eye contact with patients.

Action: Find out whether ambient scribing sits on your technology roadmap or in an IT queue as a physician preference item. The data makes it a workforce strategy.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2839542

🏆 165 Organizations Proved Culture Repeats

Modern Healthcare's Best Places to Work list carried 165 honorees across every size and region. Guadalupe Regional Medical Center has made it eight years running, Peterson Health six, Unity Medical Center five. Employees have to say it in an independent survey.

Key Takeaway: Community hospitals and specialty providers are on this list, so "we are too small" does not survive contact with the roster.

https://www.beckershospitalreview.com/hospital-management-administration/165-top-places-to-work-in-healthcare-2026/

🔧 Cleveland Clinic Built the Pipeline Instead of Buying It

Registered apprenticeships in pharmacy, EEG, ophthalmology and sleep medicine. Apprentice retention climbed from 75% to 95% in a single year, and the system beat its apprentice hiring goal by 50%. Healthcare apprenticeships are up 43% over five years, near 37,000 nationally.

HR Risk: At roughly $60,000 to replace one bedside RN, every retention point you leave on the table is a budget line.

https://consultqd.clevelandclinic.org/tips-to-bolster-apprenticeship-program-success

🔎 This Week's 3 Mission-Critical Moves

Put ambient scribing into the roadmap conversation. Ask your people what they would actually say in that survey. Name one thin-pipeline specialty and price out an apprenticeship.

Luke's challenge lands harder than any of it. Find one person this week and tell them out loud what they do well.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Featuring Noe Arceo, Vice President of Talent Acquisition & Workforce Development, OhioHealth

Noe Arceo calls the team he joined at OhioHealth a good team with good bones. His first year went into the parts of the hiring process they could control, and time to fill came down 42%. The method behind it fits on a single sheet of paper he has carried since his Baylor Scott & White days.

🎯 The Four Knows

Twenty years of healthcare recruiting compressed into four habits: know the business, know your pipeline, know the players, know your numbers. Miss one and you become an order taker. Run all four and you open the leader meeting with "we ran four interviews this week and three more are queued" instead of asking what's going on.

Key Takeaway: The framework guides your style, it does not replace it.

🧬 Culture DNA at OhioHealth

The strategy OhioHealth calls Mission Mountain points at one North Star: the most trusted, easiest to use health system in the country, grounded in safety. Arceo turns that into empowering staff as moment makers, the Nordstrom and Chick-fil-A standard applied to a patient who could get the same MRI anywhere.

Action: Stop running belonging work off the side of someone's desk. His team launched a Hispanic and Latino business resource group that drew 100+ people to its first event, then hired a dedicated quarterback so the next one runs clean.

🌡️ The 212 Degree Rule

Water at 211 degrees is hot. At 212 it boils. Arceo bought his whole team 212 The Extra Degree by Sam Parker and Mac Anderson because the ask is not more work, it is one more thing. One more candidate touchpoint builds trust. One written offer letter behind the verbal one keeps a start date from slipping.

HR Risk: A candidate who starts late rarely finishes year one strong.

Metrics create anxiety in a healthcare HR team before they create momentum. Arceo's answer borrows from Ted Lasso: staying stuck hurts more than blossoming does.

*Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Eight hundred hospitals, nursing homes, maternal wards, and psychiatric centers have already closed, cut services, or landed at risk. Not projected. Already happened. Three stories this week, and every one of them lands on an HR desk.

🤖 NEJM: AI Grows the Clinical Workforce

Dhruv Khullar of Weill Cornell Medicine published the counter-argument on September 12. Cheaper care means more care, not less work, and one critical failure at any stage still requires a human watching. If he is right, the shortage gets worse, not better. Action: build pipelines now, and stop assuming a four-year degree is the only on-ramp.

https://www.nejm.org/doi/full/10.1056/NEJMp2607831

💸 800 Facilities and the Medicaid Math

The One Big Beautiful Bill Act cut $625 billion from Medicaid over ten years, with 16 million projected to lose coverage. The hardest part has not landed yet. In December 2026, states must implement work requirements, verifying 80 hours a month of qualifying activity every six months. Somebody processes all that paperwork. HR Risk: making workforce decisions on a guess about coverage you cannot confirm. Jeremy's read is to hold steady until the financial hit is real rather than cut ahead of it.

https://www.nbcnews.com/health/health-news/medicaid-cuts-threaten-hundreds-hospitals-new-report-finds-rcna265789

⚙️ 56 Workflows Ready for Agentic AI Right Now

The deployment story is administrative, not clinical. Patient verification, scheduling, prior authorization, documentation, coding, billing. AWS launched a platform aimed straight at them, and more than 80% of healthcare executives expect real value this fiscal year, not in five. Aultman Health System in Ohio moved IT staff into auditor and strategist roles instead of cutting them. Key Takeaway: the same claim-denial logic runs faster with agents, so decide now what empathy looks like in an automated process.

https://www.lisatmiller.com/agentic-health/

🔎 This Week's 3 Mission-Critical Moves

- Ask your team which manual task eats the most of their week. Eight hours is 20% of a job, so five people doing it costs you a full headcount.

- Name your own 56. Find the workflows where the time is spent waiting, not working.

- Decide where the human stays, on purpose, before the workflow decides for you.

The clinical AI story is still coming. The operational one already arrived.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Featuring Kellie Woods, Manager of Talent Acquisition, Franciscan Health

Most people running talent acquisition at a large health system started at a large health system. Kellie Woods didn't. She spent years at two independent community hospitals in Northwest Indiana, watched both get absorbed, and now covers nursing, physician practices, home health and hospice across eleven hospitals with a team of seven. That path shows in how she reads what is coming.

🏥 A Hospital Is a Small Community

The boiler tech, the cook, the housekeeper, all of them move patient outcomes. Talent acquisition sits in that same line. Without hiring, there is no hospital. Key Takeaway: recruiters are not back office, they are the front end of patient care.

🤝 Give the Hiring Manager Grace

Kellie's team read Let Them together, and it changed how they handle slow approvals. The manager sitting on your interview guide may have just come off a code. Action: assume the best, then follow up anyway. Both things can be true.

📈 Growth Is Back, and This Time It Is a Choice

Q2 2026 healthcare M&A is up 33 percent, and two of every three deals came from systems seeking partners rather than avoiding collapse. UHS paid $835 million for Talkspace. Freestanding EDs keep opening. HR Risk: TA hears about the strategy after the ink dries, then gets asked to staff it. Franciscan is building its own DO program in Crown Point to grow the physicians it cannot hire.

🔁 Never Leave a Candidate on the Table

Twenty-three years in, her best tip is the plainest one. Circle back. Keep a list of the people for whom the timing was wrong. Remember one or two things about them. They remember that you remembered.

The pipeline gets built before the deal is announced, or it does not get built at all.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode .

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Featuring Ivy Singley, Director of Employment Services and Workforce Development, Infirmary Health

Replacing one bedside nurse ran just over $61,000 last year. Every single percentage point of RN turnover swings the average hospital's bottom line by roughly $290,000 a year. Treating that as a pipeline problem misses what happens inside the walls every day, and Ivy Singley has spent almost 30 years in those walls.

🚫 Retire the Word "Resilience"

Naming resilience as a core trait tells candidates they will work in chaos. Boomers hear grit. This generation hears sunup to sundown and passes. HR Risk: your job postings may be screening out the people you most want.

🤖 AI Belongs on the Front End, Not the Final Call

Ivy uses AI for screening, sourcing, and executive summaries that let HR hold its own in a strategy conversation. She draws the line at choosing. A resume written by AI reads beautifully until the candidate cannot explain the procedure they claimed. Key Takeaway: screen with the tool, decide with a human.

⏱️ 95% of the Recruiting Cycle Is Waiting

Luke reverse-engineered a system hiring 10,000 people a year with 20 recruiters. Screening to pre-boarding averages 18 days industry-wide, and only about 5% of that is actual work. The rest is a nurse applying at 10pm Saturday and nobody touching it until Monday. Action: attack the queue, not the headcount. No number of recruiters closes that gap.

👥 Same-Day, Multi-Layer Interviews

Infirmary Health interviews with the hiring manager, runs a tour, and puts the candidate in front of a peer panel, often in one day. Candidates behave for the manager and open up with peers, and the hire becomes a collective decision instead of one manager's guess. Careers: infirmaryhealth.org/careers

You cannot hire your way out of a waiting problem, and you cannot automate your way out of a judgment one.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

Support the show

ChatGPT Is Inside Epic, 40 Mergers in Six Months, and 92% Bracing for Strain

Three stories, one direction. Technology is accelerating, consolidation is accelerating, and the people running health systems have stopped waiting to see how it shakes out.

🤖 ChatGPT Now Reads Epic Charts: 325 Million Patient Records and What Healthcare HR Does Next

On September 1, OpenAI launched ChatGPT for Healthcare with a direct Epic integration. Clinicians pull visit notes, labs, medications and specialist records into ChatGPT without leaving the workflow. Epic holds 325 million patient records across 1,000-plus US hospitals. UCSF Health is already piloting it. Read-only for now, plus a public data plugin wired to nine sources including PubMed and CMS coverage. HR Risk: once it works on the clinical side, the question becomes why it isn't in Workday, your ATS, and the rest of your HR stack.

https://techcrunch.com/2026/09/01/chatgpt-health-adds-epic-integration-for-clinicians-to-import-patient-data/

🏥 40 Hospital Mergers in Six Months: Why 2026 Consolidation Accelerated Past 2025

2025 saw 46 hospital mergers, the fewest in 15 years. The first half of 2026 already produced 40. WVU Health System is putting $800 million into acquiring Independence Health, five nonprofit hospitals in western Pennsylvania. Prisma and Erlanger, Sanford and North Memorial. Two of every three deals came from systems seeking partners, not systems bleeding out. Action: if you get absorbed, your hardest job is protecting community culture while payroll systems, retirement plans and physician contracts all get merged.

https://medcitynews.com/2026/09/hospital-mergers-summer-2026/

📉 FTI Consulting 2026 Survey: 92% of Hospital Leaders Expect a Decade of Financial Strain

FTI Consulting surveyed more than 200 hospital CEOs, CFOs and COOs. 92% expect major or moderate financial strain over the next decade. 86% named physician recruitment. And for the first time, workforce pressure outranked quality of care as the top clinical concern. Key Takeaway: payroll and benefits run 50 to 60 percent of the budget, so leadership is coming to HR first.

https://fticommunications.com/2026-hospital-operations-outlook-survey-report/

🔎 AI, Mergers, and Margin Pressure: The Three Forces Hitting Healthcare HR in 2026

- Ask your CMO or CIO whether your system has evaluated the Epic and ChatGPT integration. If they have not heard of it, you are the one bringing the signal.

- Find a mentor who has run an integration, or be that mentor for someone who has not.

- Put your biggest spend lines on the table before someone else does it for you.

The leaders moving right now decided that waiting was the riskier option.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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70% of Engagement Comes Down to One Thing. Your Boss.

Featuring Burl Stamp, FACHE, President, Stamp and Chase | Author, Becoming a Better Boss

Before we get started, sit with this number: 70%. That is how much of employee engagement is determined not by your comp structure, your benefits package, or your culture initiative. It comes down to one thing. The person they report to.

Bo sits down with Burl Stamp, former hospital CEO, fellow of the American College of Healthcare Executives, and author of the most timely leadership book in healthcare this year. Burl has spent more than two decades studying what separates the leaders people want to follow from the ones they simply tolerate.

🧠 The Middle Manager Crisis Has a Second 70% Nobody Quotes
Gallup's landmark research showed that 70% of employee engagement is determined by the manager. The second stat from that same study almost never gets cited: 70% of middle managers said they felt ill-prepared for the challenges they face. That was before the pandemic, in 2018. Today, with span of control reaching 60, 80, and even 100 direct reports in some nursing roles, the white flag is going up.

📋 The TEAM Framework: Four Levers That Actually Work
Burl's framework built from the research: Teach, Empower, Align, Mentor. His top three practical tactics for any middle manager starting today: listen more than you speak in every team interaction, give small doses of immediate feedback consistently rather than saving it for annual reviews, and take care of yourself, because staff can tell when their manager is running on empty and when they are genuinely present.

🔍 Where Leadership Development Fails
Organizations spend enormous energy on learning objectives and workshop design. Then the workshop ends. Burl's direct assessment: worry more about what happens after the workshop than before it. If behaviors are not changing and turnover is not moving, the workshop score does not matter.

📖 Resources

Becoming a Better Boss by Burl Stamp: https://www.amazon.com/Becoming-Better-Boss-leader-tolerate/dp/1971718149/

Connect with Burl: https://www.linkedin.com/in/burlstamp | stampandchase.com

Great leaders are, first and foremost, self-reflective. They are always asking how they lead and how they can lead better.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Why Healthcare HR Tech Fails: It's Never the Software

Featuring Stephanie Wright, Founder, Wright Talent Advisory

Only 43% of HR professionals say their HR technology is effective. Fewer than half. These are organizations that ran vendor selection, sat through demos, built a business case, got budget approved, signed a contract, and went live. Then more than half of them looked at what they bought and said it was not working.

Luke sits down with Stephanie Wright, a healthcare TA implementation specialist who has worked across Workday, Phenom, and other major platforms at health systems including Carilion Clinic. She launched Wright Talent Advisory in Dallas to do full-time what most HR leaders only do once in a career.

🗺️ Process Before Config. But You Can't Fully Avoid the Overlap.
Stephanie's honest answer: organizations that do requirements work ahead of time still end up in design conversations where the configurator is explaining the system in technical jargon while the client tries to map it to their current workflow in real time. The process work helps. It does not eliminate the messy middle. Plan for both.

🔥 The Real Reason Implementations Underdeliver
It is not technical blockers. It is change management treated as a checklist item rather than a work stream. A 30-minute Teams call and a PDF is not change management. Your project team members are your champions, if you actually organize and amplify them. Most organizations do not.

🧪 UAT Gets Compressed. That Is Where Things Break.
User acceptance testing is almost always squeezed because design ran long and executives want to hit the go-live date. Stephanie's fix: get hiring managers into the sandbox early, run them through edge cases, and treat testing as a change management moment, not a technical exercise.

📋 Before You Sign Anything
Know your internal resource gaps before a vendor ever walks in. Assume the projected timeline is optimistic by at least 25%. Ask the vendor what they will need from your team and where they see gaps. That conversation rarely happens, and it costs organizations every time.

Connect with Stephanie: wrighttalentadvisory.com or LinkedIn.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

Support the show

Hospital M&A Is Up 33%, CommonSpirit Has 250 AI Tools Running & UHS Just Bought a Mental Health App

August 31st, 2026. Bo Brabo and Luke Carignan. Three stories, one theme: health systems are making big, deliberate moves. Merging before they have to, deploying AI at scale, and buying digital companies to own the front door to care.

🤝 The Consolidation Wave and Why This Time It's Different

Hospital M&A is up 33% year-over-year in Q2 2026. Sixteen deals, $7.7 billion in total value. Atrium Health is taking control of WakeMed with a pledged $2 billion investment. MultiCare is affiliating with Samaritan Health for a $700 million 10-year commitment, creating an 18-hospital, 33,000-employee system. Chartis puts it plainly: two-thirds of 2026 transactions involve health systems proactively seeking partners before reaching a breaking point. These are not rescue deals. The logic has shifted from survival to strategic positioning.

HR Action: If your board is in partnership discussions, HR should already be at the table. If consolidation arrives as a surprise, that is a different conversation to have with yourself.

🤖 Ambient AI Has Stopped Being a Pilot

CommonSpirit Health now runs 250 active AI tools across 150 hospitals, up from 60 in 2023, generating more than $100 million in annual value. Kaiser Permanente has deployed AI scribes across 40 hospitals in eight states. One major health system reports physicians seeing 15% more patients per hour and spending two to three fewer hours per day on documentation.

HR Action: Find out how many AI tools are actively running at your health system right now. Not piloting. Running. If nobody knows the number, that is your answer. It is also an opportunity.

📱 UHS Bought Talkspace for $835 Million

Universal Health Services, one of the largest hospital operators in the US, acquired Talkspace, offering therapy and psychiatry by text, video, and async messaging. 160 million Americans live in areas with a mental health provider shortage. Mental health conditions account for 20% of all emergency department visits. The digital behavioral health market is projected to reach $17.5 billion by 2030. This is not a tech company buying a clinic. It is a traditional health system buying a digital front door to behavioral health at scale.

HR Action: When your CEO acquires a company with tens of thousands of remote contract clinicians, HR cannot be the last to know. Be in the room before the deal closes.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

NEWS LINKS

Story 1 — Hospital M&A Wave 2026

Chief Healthcare Executive: More Hospital Mergers in First Half of 2026
Healthcare M&A Hit $7.7 Billion in Q2 2026
Chartis: Repositioning, Not Scale
WRAL: Atrium to Take Control of WakeMed — $2B Investment
Modern Healthcare: MultiCare and Samaritan to Combine

Story 2 — Ambient AI at Scale

Becker's: Health Systems Using AI — 50 Examples
Becker's: From Ambient AI to Agentic Workflows — What's Ahead for Healthcare in 2026

Story 3 — UHS Acquires Talkspace

Healthcare Dive / PwC: Health Services M&A Active in 2026
Xtalks: Healthcare M&A in 2026 — A Roundup of Deals

Support the show

96% of Applicants Fall Into the Abyss. Take2 AI Is Pulling Them Back Out.

Featuring Yaniv Shimoni, Co-Founder, Take2 AI | ASHHRA Podcast Sponsor

The average hospital has 43 unfilled nursing positions. It takes up to 102 days to recruit an experienced RN. And your recruiting team is talking to three to four percent of the people who apply. The other 96%? They fall into the abyss. Yaniv Shimoni built a company to fix that — and healthcare was not the plan. The CHROs made it one.

Bo sits down with Yaniv, co-founder of Take2 AI and Stanford GSB alum, to unpack what agentic AI actually means for healthcare talent acquisition and how health systems like CommonSpirit, Temple Health, and the VA are already using it.

🤖 Chatbot vs. Generative AI vs. Agentic AI — Know the Difference
60% of TA leaders can't explain it. Here is the short version: chatbots follow a script. Generative AI creates recommendations — but a human executes. Agentic AI executes on your behalf, end-to-end, while you sleep. Take2's system of agents — AI sourcer, AI interviewer, license verifier, reference checker, and onboarder — integrates bidirectionally with your existing ATS. The ATS stays the system of record. The agents amplify the team around it.

⚡ Five Seconds to First Touch
When a candidate applies, Take2's agent texts them within five seconds — dynamic phone screen, license verification, and calendar scheduling — 24/7. Physicians, NPs, MAs, CNAs. No variance in completion rates between them. 78% of candidates in a University of Chicago study preferred talking to an AI interviewer because of flexibility — nights, weekends, and on their schedule.

🔐 On Candidate Fraud
The fraud is real regardless of whether you adopt AI. What Take2 does: phone number verification, license checks against state boards, background check integration, and real-time photo matching across interview stages. The fight evolves constantly — but doing nothing is not a defense.

🔎 The Right Question Before You Buy Anything
What is the pain I am trying to solve? Time to fill? Capacity? Budget? Define the problem first. Then ask: Is it truly autonomous? Is it trained for healthcare roles? Does it integrate with my ATS? Is it compliant?

Learn more at take2.ai

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AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Four Years Left: The 2030 Staffing Cliff, APRN Expansion & Why 76% of Leaders Can't Execute

August 24th, 2026. Bo Brabo, Luke Carignan, and ASHHRA Executive Director Jeremy Sadlier. Four years to 2030. Three stories. One question underneath all of them: what are you actually doing about it?

📉 The Shortage Isn't Leaving — Here's the Timeline
AMN Healthcare's white paper layered five years of search data against BLS and CDC projections and landed where every independent source has: sustained staffing pressure through at least 2030 across nursing, allied health, physicians, and advanced practitioners. HRSA projects demand for 3.4 million RN equivalents against supply of just over 3 million. Three forces drive this and none resolve on their own — aging patient population, a boomer and early Gen X clinical workforce retiring simultaneously, and a pipeline that cannot outrun the retention leak.
Action: The organizations that come out ahead are making investments now that feel inconvenient — extended orientation, APRN integration, AI-enabled recruiting. If it feels optional today, that is the warning sign.

🩺 27 States Plus DC Now Grant NPs Full Practice Authority
Indiana became the latest, explicitly citing rural physician shortages. Wisconsin's law covering CNPs, CNSs, CNMs, and CRNAs takes effect next month. The NP workforce projects from 157,000 FTEs in 2016 to nearly 400,000 by 2030. Seven states have joined the APRN compact for cross-state practice on a single license.
Action: Don't wait for your state's law to change. Build the care models, onboarding pathways, and integration structures now. Organizations that wait will be 18 months behind when the law does change.

🤖 The Execution Gap Is the Real AI Problem
Incredible Health's executive report: 67% of leaders name retention their top concern. 76% say their organizations cannot implement AI at the required speed. 70% of frontline clinicians aren't using AI daily — while 80% want more training. Only 16% of healthcare recruiters use AI in their own work, managing 70 open roles with capacity to talk to just 10% of applicants. One in three healthcare employers is facing a nursing retirement cliff within five years — at the exact moment the 2030 shortage intensifies.
Action: Pick one thing from this episode — AI in recruiting, APRN integration, orientation length, or nursing succession planning. Just one. Figure out who owns it. If nobody does, that's your answer.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Leadership Is a Verb, Not a Title — and New Hope Treatment Centers Is Proving It

Featuring Tabitha Bramblett, Chief People Officer, New Hope Treatment Centers

Most organizations promote their best performer into a leadership role and then wonder why everything falls apart. Tabitha decided to build the program that changes that — and she did it at a 500-person behavioral health organization serving kids and teens across four states.

Luke and Bo sit down with Tabitha to talk about what leadership development actually looks like when you build it from scratch, why culture isn't a values poster, and what compassion has to do with your bottom line.

🏗️ Building Leaders Before They Have the Title
New Hope launched a formal emerging leaders program in partnership with CoEffX — an application and nomination process that gives aspiring leaders a chance to learn what leadership is and isn't before they're ever promoted. Graduates move into structured leadership cohorts with peer surveys built in. The result: people who don't actually want to lead opt out early, before a mismatched promotion creates a broken team and a gilded cage no one asked for.
Action: If you have no program at all, Tabitha's first two steps — hire a learning and development coordinator and find a program partner — are the place to start. You don't have to build it from scratch. CoEffX (coeff-ex.com) is worth a look.

❤️ Compassion as an Operational Strategy
New Hope built its entire culture framework — EPIC values: Excellence, Professionalism, Integrity, Compassion — around a single question: what if we started every interaction, with residents and teammates alike, with compassion? They operationalized it with loving-kindness meditations at shift start and major meetings. Their CEO modeled it personally during Tabitha's health challenges.
Tabitha's direct line: turnover, vacancy rates, and time-to-fill are all downstream of how people feel about each other at work.

🎯 The Recruiting Insight No One Talks About
Tabitha still reads resumes intentionally — not because AI can't filter, but because people are more than buzzwords on a page. The interview isn't a checklist. It's a conversation. And the question isn't whether the candidate can do the job — it's whether they share the vision.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

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Nurses Tripled AI Use Without You, 170K New Grads Can't Fix 40% Turnover & CHROs Think They've Won

August 17th, 2026. All three: Bo Brabo, Luke Carignan, and ASHHRA Executive Director Jeremy Sadlier — plus a first for the Monday News Drop: a special field correspondent. Three stories, one thread: is your workforce moving faster than your strategy?

🚨 Field Report: Candidate Fraud Is Already at Scale
Casey Marquette, CEO of Covenant HR and AP3 partner, joins as the show's first field correspondent. 22 North Korean operatives submitted 167,000 applications, completed 21,000 interviews, and secured 76 US jobs using stolen identities and AI-assisted interviewing. Covenant HR's platform flags 20% of candidates as suspicious. Gartner projects one in four candidates will be fraudulent by 2028. Healthcare is uniquely exposed: credential complexity is enormous and the stakes of a bad hire include patient harm and data breach — not just a bad fit. Only 31% of HR leaders report strong fraud prevention controls. The fix is identity verification built as a continuous layer from application through onboarding, with real-time photo matching across every interview stage.
Action: Visit ap3diligence.info to learn more about Covenant HR.

🤖 44% of Nurses Are Using AI. Only 4% of Healthcare Employers Are.
Incredible Health's 2026 State of Nursing Report (2,200 nurses, 1.5M platform records): nurse AI adoption went from 15% to 44% in 12 months — without employer strategy, training, or mandates. Only 8% of nurses report a clear AI strategy from their organization. But nurses with employer-guided training save 24+ minutes daily versus 16 for those without. Only 20% of nurses say pay is the top reason they'd stay. Three in four have considered leaving in the past three years.
Action: Ask your team what AI tools they're already using. That's your strategy's starting point.

💧 The Pipeline Isn't the Problem. The Leak Is.
US nursing schools graduated 170–190K new RNs this year. The national vacancy rate is still 8.6% and turnover rose to 17.6% — up from 16.4% two years ago. Some facilities are replacing 40% of their nursing staff annually. Nurses who left their first job had orientations nearly two weeks shorter than those who stayed. The minimum at some facilities: six and a half days.

Action: Review your orientation length and your 30-60-90-day touch point cadence. If structure disappears at 90 days, so will your nurses.

Enjoying the show? Subscribe to The ASHHRA Podcast on your favorite podcast platform so you never miss an episode.

AP3 Sponsor Read

This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit https://www.ap3.info/ to learn more and get connected with a partner.

Take2 Sponsor Read

This episode is brought to you by Take2 — the AI recruiting platform built specifically for healthcare.

Hiring in healthcare is harder than ever — high-volume openings, hard-to-fill clinical roles, and recruiting teams stretched thin. Take2 changes that.

Take2's AI agents automate the work that slows recruiters down — sourcing candidates, running outreach, screening and vetting applicants, scheduling interviews, and verifying licenses and certifications. It works around the clock, syncs directly into your ATS, and gives your recruiters hours back every week so they can focus on the people, not the process. From CNAs and EVS to RNs, APPs, and physicians, Take2 helps you hire faster across every role.

Vetted through AP3. Built for healthcare. Proven to perform.

Visit https://take2.ai/ashhra to learn more and get started.

NEWS LINKS

Story 1 — Incredible Health: 2026 State of Nursing Report

• Incredible Health: 2026 Annual State of Nursing Report — AI Adoption Trends and Future Implications for Retention
• Incredible Health: The Workforce Moved First — Inside Our 2026 State of Nursing Report
• Distilinfo: Nurse AI Adoption Surpasses Hospital Strategies, Report Finds (July 8, 2026)
• Healthcare IT News: Nurses Are Fearing AI Less — And Using It More

Story 2 — RegisteredNursing.org: The Nurse Staffing Pipeline Paradox

• RegisteredNursing.org: The Nurse Staffing Pipeline Paradox — Why Graduating More Nurses Isn't Enough (August 10, 2026)
• RegisteredNursing.org: Nursing Program Expansion — State Investments & Pipeline 2026 (August 8, 2026)
• NSI: 2026 National Health Care Retention & RN Staffing Report
• Becker's: Hospital Nurse Turnover and Vacancy Rates by Year

Story 3 — HMA CHRO Priorities + Becker's Compensation

• The Health Management Academy: 2026 CHRO Priorities Snapshot
• Becker's: Where Health System Compensation Dollars Are Going in 2026 (March 27, 2026)
• Becker's: 140 Hospital and Health System CHROs and Chief People Officers to Know — 2026

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