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March 24, 2021

The Economics of On-Demand Staffing: Can It Work for Healthcare?

Having local, experienced professionals readily available helps staffing offices match the right clinician with the right license to the right patient at the right time. Here’s the scoop.

By Heather Johnson
About the author

Uber and Lyft may have defined the gig economy, but on-demand staffing has grown to include much more than ride-shares. Construction, hospitality, retail, and customer service are just a few industries that use on-demand workers to fill short-notice shifts. 

Healthcare followed this model years before the “gig economy” became a thing. Hospitals and other healthcare providers rely on per-diem physicians and clinicians to fill in when there’s a shortage of regular workers. Providers can call on per-diem staff on short notice or pre-schedule them to cover vacations, maternity leaves, and other planned absences. 

However, until recently, healthcare organizations relied primarily on staffing agencies to supply per-diem talent. For longer-term needs, they relied on travel nurses. Compared to today’s on-demand solutions, agencies are slow and expensive. 

On-demand staffing enabled by mobile technology allows healthcare organizations to fill in gaps in minutes. This ensures healthcare organizations can consistently provide high-quality patient care despite staff shortages or a surprise surge in volume.


The Challenge of Supply and Demand

The COVID-19 public health emergency exposed the problems that result from understaffing. But demand fluctuates all the time, even when we’re not in the middle of a pandemic. Flu season triggers an influx of older adult patients. A multi-car pile-up overwhelms a trauma center. Patient acuity demands a higher ratio of clinicians who can take on complex cases.

To provide the highest quality care at the lowest cost, healthcare organizations must match the right clinician with the right license to the right patient at the right time. This requires an ongoing analysis of individual patient needs and staffing mix. Technology can help healthcare organizations get a holistic view of their staffing situation. However, that’s only part of the puzzle.

When hospitals staff to peak demand with full-time employees, they end up overstaffed during low-volume periods. Overstaffing employees leads to excessive, unnecessary labor costs. Chronic overstaffing in one area will lead to cuts somewhere else to save the bottom line.


clinician overstaffing graph


Understaffing presents an equally expensive problem. Multiple studies show nurse understaffing has a negative impact on patient outcomes. When outcomes worsen, healthcare costs also increase. 


clinician iunderstaffing graph


For understaffed hospitals, simply hiring more nurses isn’t feasible or practical due to cost and because of the ongoing nursing shortage. To find balance, more and more hospitals are turning to a more flexible staffing model, one that involves staffing to 60 percent capacity rather than 90 percent capacity, for example. Per-diem talent fills in the gaps.

This flexible model allows hospitals to maintain proper nurse-to-patient ratios without excessive labor costs. Meanwhile, patients continue to receive high-quality care from physicians and clinicians with the right mix of experience.


Balancing the Load 

Maintaining the right number of healthcare professionals becomes more complex due to high employee turnover. The national average for RN turnover rates in the U.S., year over year, is 17.1 percent.

While hospitals evaluate strategies to reduce turnover and improve retention, they can expect their per-diem talent, available on demand, to come through. But relying more heavily on agencies is not the most cost-effective way to bring in more per-diem.

Technology-enabled, “Uber-like” platforms such as CareRev supply experienced healthcare professionals in a snap—without agency commissions or expensive travel contracts. A growing number of innovative health systems have adopted CareRev as a key component of their flexible staffing models.


carerev staffing graph

Nursing and staffing executives unfamiliar with on-demand staffing solutions like CareRev should take some time to evaluate the platform, its benefits, and how they can use it instead of, or in addition to, traditional agencies. Here, we answer a few common questions about app-based on-demand healthcare staffing.


We’re short three nurses this week. How fast is fast?

person on their mobile phone

When you use CareRev’s platform, you can post a shift in seconds. The professionals in your internal resource pool see that notice instantly. A professional with the experience you need can pick up a shift in seconds with a few taps of the CareRev mobile app.

If you need to look beyond your internal resource pool, you can expand to CareRev’s network of experienced pros. You’ll have access to a local marketplace of qualified RNs, CNAs, and Surgical and Radiologic Technicians. 

These are local professionals who can get to your facility in minutes. Compare that to the time it takes to relay information to your recruiters, or the weeks or months it takes to activate a travel nurse two states away. 

Another note: CareRev takes care of the onboarding. We work with healthcare providers to create online orientation materials that CareRev professionals review on their own time. We streamline the process to get professionals onto the platform quickly so you have access to the broadest talent pool possible.


Are CareRev professionals qualified to work on complex cases?

nurse at screen during surgery

While CareRev is easy to use, it’s not easy to join our network. Our professionals must have more than one year of full-time experience in inpatient or outpatient care, excluding clinicals. Most have more than a year of experience. Almost half (42%) have a full-time job.

Before joining CareRev, professionals go through a rigorous vetting process that includes:

  • Initial interview conducted by a multi-specialty-trained RN.
  • A background check that includes National criminal records, sex offender review, the Office of Inspector General (OIG), and previous employment verification.
  • Immunity records and certifications to make sure candidates have up-to-date vaccines. ACLS, BLS, CNOR, CCRN certifications are also verified if applicable.
  • An in-depth onboarding process that includes orientation to the CareRev app, a self-assessment, and a skills checklist - the results of which end up on the professional’s profile for you to access and review.
  • When needed, the ability to sign up for preceptor shifts and EMR classes and/or an orientation session with facility staff.


We’ve been with our agency for over 10 years. Why switch?

carerev post a shift screenshot

Staffing agencies charge commissions to their clients, which range from 25 to 50 percent. If you’re bringing in a travel nurse, you also have to cover their lodging and meals. Those extra costs can add hundreds to thousands of dollars per day, per clinician. CareRev does charge a fee to its clients, but it’s far less than what you’d spend on agency commissions and travel contracts.

In addition to the financial benefits, app-based staffing is simply the way forward. We believe on-demand staffing is, and will continue to be, a huge component of the future of work. Workers are demanding flexible schedules. Many prefer to pick up gigs via staffing apps and specialized platforms rather than get stuck in a 9-to-5. 

By using app-based technology to find and recruit per-diem talent, you’ll have access to a more diverse talent pool than a traditional agency can provide. Professionals choose CareRev so they can work on their own terms, either part-time or full-time. Our per-diem professionals also enjoy getting to know different hospitals in their area—including yours.

A flexible staffing model that incorporates on-demand staffing is the most cost-effective way to adjust to the daily peaks and valleys in patient care. With the help of technology, healthcare leaders can control costs without compromising quality care.


Ready to implement CareRev in your healthcare organization?

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