Inside HCA’s Plan to Tackle the Healthcare Workforce Retention Crisis
Healthcare organizations in 2025 face significant workforce challenges. Talent shortages, burnout, and rapid digital transformation are reshaping the talent landscape, and healthcare workforce retention rates have declined.
However, one of the nation’s largest health systems, HCA Healthcare, is pioneering strategies to retain and engage its workforce. Here, we’ll explore how HCA Healthcare’s HR leaders are navigating current trends, sharing insights and best practices that can help other organizations address similar challenges.
The State of Healthcare Workforce Retention in 2025
Healthcare workforce retention is now critical to maintaining standards of care. The youngest of the Baby Boomers, one of the largest generations in human history, are already 61 years old.
A Global Healthcare Workforce Shortage Looms
According to a report by McKinsey, there will be a global healthcare worker shortage of at least 10 million by 2030. Although the United States is considered a "worker-advantaged country” due to its relatively high number of healthcare workers, "a shortage of clinical training positions and skilled educators is a major barrier to expanding the healthcare workforce.”
Furthermore, the American Hospital Association reported in its 2025 Health Care Workforce Scan that most U.S. hospitals view workforce shortages as their top concern in 2025. Not only will 42 out of 50 states see nursing shortages by 2030, but there will also be a nationwide shortage of 86,000 physicians by 2036.
Leaders Discussed Workforce Challenges at HR Healthcare 2024
Challenges relating to hiring, career development, and healthcare workforce retention were already on leaders’ minds in 2024.
Human resources leaders from hospitals, clinics, and healthcare companies met in Boston for HR Healthcare 2024, and they discussed some of the most innovative staffing strategies in the healthcare industry. HR Healthcare Insights analyzed sessions from the event and found that workforce shortages, infrastructure limitations, and digital transformation challenges are the most pressing concerns for healthcare HR professionals in 2025.
Leading Causes of Low Healthcare Workforce Retention
Although there are many causes of low rates of healthcare workforce retention, the most common are burnout, technology skill gaps, and the changing expectations of employees.
Burnout
The ongoing shortage of nurses, physicians, and allied health professionals is exacerbated by high rates of burnout. A 2025 study published in the Journal of Nursing Regulation found that over 40% of nurses considered leaving their jobs in the past year, primarily due to stress, workload, and lack of support.
"While healthcare employers continue to prioritize investments in mental health and other support services for nurses, structural issues, such as short staffing and the accompanying high workloads, that predated the pandemic remain a source of concern for the long-term stability of the nursing workforce,” the report said.
Burnout is not just a personal issue. It impacts patient outcomes, organizational culture, and financial performance.
Create Mentorship Programs
Mentorship programs can play a significant role in reducing burnout and improving engagement. A mentorship initiative at a community hospital led to significant improvements in professional accomplishment and engagement, even in resource-limited settings.
Digital Transformation and Skills Gaps
Rapid adoption of digital health tools, electronic health records, and AI-driven systems is transforming healthcare delivery. However, many employees feel unprepared for these changes.
Employees who haven’t been properly trained and familiarized with these systems may struggle to keep pace with their day-to-day work. This can lead to burnout and frustration, causing the employee to consider working elsewhere.
Leverage AI for Knowledge Transfer and Training
At HR Healthcare 2024, Sebastien Girard, Senior Vice President and Chief People Belonging Officer at Novant Health, said he intends on "learning more about talent mobility and how we’re leveraging AI to prepare the next generation of workers for a more digital environment.”
Health systems, hospitals, clinics, and other organizations can use AI-powered tools for training and knowledge sharing purposes. For example, when attached to a knowledge base, generative AI programs can help employees obtain detailed instructions on how to use systems.
Changing Employee Expectations
Today’s healthcare workforce expects more than just competitive pay. Flexibility, career development, and a supportive culture are increasingly important.
According to a report by HealthLeaders Media, one analysis found that worker engagement is declining overall, and disengaged employees are 1.7 times more likely to leave their roles.
Invest in Employee Growth
Organizations that invest in employee well-being and professional growth tend to see higher retention rates and improved patient care outcomes. Employee well-being can take the form of on-site mental health assistance, flexible schedules, paid time off for family needs, and more.
It also helps considerably to keep employees engaged with the higher purpose of their work, such as caring for patients and improving patient health outcomes. Factors like the patient experience and improvements to patient-centric metrics can sometimes get lost in the day-to-day shuffle of work.
"Hospital leaders need to look beyond compensation to improve retention and focus on drivers of engagement, like trust, respect, and belonging,” the HealthLeaders Media report said.
HCA’s Healthcare Workforce Retention Strategy
HCA Healthcare has emerged as a leader in developing innovative strategies to improve healthcare workforce retention. By combining cultural leadership, educational investments, and operational support tools, the organization has reduced turnover rates and fostered long-term career loyalty. Two pillars of this strategy stand out: leadership-driven cultural alignment and targeted workforce development programs.
Active Leadership and Engaged Teams
At the core of HCA’s retention success is a leadership philosophy that prioritizes visibility, communication, and empathy.
In a report by Becker’s Hospital Review, Scott Davis, former CEO of HCA Houston Healthcare Northwest and current CEO of Swedish Medical Center, emphasizes that "culture drives the organization” and starts with leaders who actively engage teams. Under his leadership, facilities achieved turnover rates below 8% by creating "an environment of collaboration and multiple communication pathways”.
Davis credits this to practices like leader rounding-where executives and managers regularly interact with frontline staff-and structured feedback loops through employee advisory groups.
Values-Driven Work and Educational Partnerships
This approach aligns with HCA’s broader cultural framework, which integrates the organization’s values into daily operations.
According to an article in HCA Healthcare Magazine, Laura DeMotte, American Group Vice President of Human Resources, notes that the organization is "uniquely positioned to offer a career of a lifetime” through investments in academic partnerships and colleague support systems.
By empowering leaders to model transparency and care, HCA creates environments where employees feel valued. This is a critical factor in healthcare workforce retention.
Employee Initiatives and Investments
HCA’s key initiatives that drive retention include:
- Tuition reimbursement and direct-billing partnerships with Galen College of Nursing, which trains 20% of U.S. nursing graduates annually.
- Leadership Institute programs, which have graduated 21,275+ colleagues since 2014, correlate with 11% higher engagement scores among participants.
- Mental health resources, including free counseling and the Hope Fund, which provided $11.4M in financial assistance to colleagues in 2023 (2024 Annual Impact Report. (2024 Annual Impact Report)
These programs address both immediate pain points and long-term career growth, ensuring employees see HCA as a partner in their professional journeys. As DeMotte states, "We’re strategic in how we leverage education assistance to strengthen the healthcare workforce and pour into our colleagues”.
Community and Career Development Investments
The impact of HCA Healthcare’s investments in people and communities is outlined in its 2025 Annual Impact Report, which shows the following employee and community impacts from the previous year:
- $31.2 billion in payroll and benefits
- $48.5 million in giving to community organizations
- $4.4 billion (estimated) in charity care and uninsured discounts
This reflects its commitment to addressing the needs of not only its employees but also their surrounding communities.
By intertwining cultural leadership with systemic support, HCA Healthcare demonstrates that healthcare workforce retention is not a single initiative but a holistic ecosystem. The results speak for themselves: reduced turnover, higher engagement, and a pipeline of homegrown leaders. All are proof that investing in people remains the most sustainable retention strategy in modern healthcare.
The Road Ahead for Healthcare Workforce Retention
Looking forward, the healthcare workforce will continue to evolve. HR leaders must remain agile to continue to retain their workforces and address talent shortages. This will require them to adapt to challenges like AI integration, regulatory changes, and shifting patient needs.
HCA Healthcare’s experience demonstrates that a holistic strategy—combining engagement, mentorship, technology, education, and well-being—can drive meaningful improvements in retention and organizational performance. The lessons learned in 2025 will shape the future of healthcare HR.
To learn more about how your organization can improve healthcare workforce retention rates, don’t miss HR Healthcare 2025. It takes place from October 5th to 7th at The Westin Copy Place in Boston, Massachusetts.
Get tickets and download the agenda today.