6 Factors Shaping the Healthcare Job Market, and How to Respond

If you run hiring for a hospital, a health system or a care provider, you plan for two things at once: growing demand for care and the people who leave. The market affects how many qualified candidates you can reach, how long vacancies stay open and what pay will compete locally. Your working conditions affect whether the people you hire stay.

This guide sets out six factors shaping the healthcare job market, each with the current figures from the people who publish them: federal agencies, professional bodies and a national hospital survey. For each one it explains what it means for an employer's hiring plan. It then brings the factors together into the decisions you can make: where to recruit, how to keep new hires through their first year, how to set pay and how to staff for the peaks.

DisclosureJake Jorgovan co-founded Alpha Apex Group, which is mentioned in this article.

The figures at a glance

1. Demand keeps growing, led by an aging population

In its projections for 2025 to 2035 (opens in a new tab), published on August 27, 2026, the Bureau of Labor Statistics expects private healthcare and social assistance to add over 2.2 million jobs, more than any other sector and about 37% of all new jobs. The whole economy is projected to grow 3.5% over the same decade; this sector, 9.5%.

The bureau names two drivers: an aging population and the rising prevalence of chronic conditions such as heart disease, cancer and diabetes. The AAMC projects (opens in a new tab) that the US population aged 65 and older will grow 34.1% by 2036, and older patients use more care.

Services for the elderly and persons with disabilities are projected to add 625,400 jobs, the most of any detailed industry, which BLS links partly to demand for home-based care. Home health and personal care aides (opens in a new tab) are projected to grow 18%, about 847,300 jobs. Nurse practitioners are the fastest-growing of all detailed occupations, at 41%, which BLS links to their role in team-based models of care.

Across all healthcare occupations (opens in a new tab), BLS projects about 1.9 million openings a year, from growth and from replacing workers who leave their occupation. Registered nurses show the balance: employment is projected to grow by 194,700 over the decade, about 19,500 a year, yet BLS projects about 180,800 openings every year. Most of these openings replace nurses who move to other occupations or leave the labor force, including through retirement. These national figures do not count nurses changing employers while staying in nursing, so forecast your own replacement hiring from your turnover data.

What it means for your plan: count replacement hiring as well as new positions. A department that is not growing still needs to hire every year.

2. Shortages are uneven by role and by place

A national shortage figure hides where the gaps are. HRSA's National Center for Health Workforce Analysis publishes projections of supply against demand (opens in a new tab) by occupation and geography, and its December 2025 release shows how different the picture is depending on what you hire and where:

• Registered nurses: an 8% national shortage projected for 2028, narrowing to 3% (108,960 full-time equivalents) by 2038, if historical patterns of graduation, attrition and labor force participation hold.
• Rural areas: the RN shortage in nonmetro areas is projected at 11% in 2038, against 2% in metro areas. By state, projections run from a 22% shortage in California to a 79% oversupply in Wyoming.
• Licensed practical nurses: a shortage of 245,950 full-time equivalents in 2038, with supply meeting only 70% of demand.
• Nurse practitioners: supply is projected to exceed demand nationally over the period, with distribution "the most important issue".
• Physicians: HRSA's projections page (opens in a new tab) shows a shortage of 141,160 full-time equivalents in 2038, including 70,610 in primary care, with shortages in 30 of the 35 specialties modeled and a 58% shortage in nonmetro areas against 5% in metro areas.

The AAMC's own model, published in March 2024, projects a physician shortage of up to 86,000 by 2036. Its scenarios assume growth in the number of medical residency positions. The two estimates use different models, years and units, so they cannot be compared directly.

Behavioral health is another pressure point: HRSA projects shortages in 2038 of 99,780 full-time equivalents for mental health counselors and 43,810 for psychiatrists, based on current use of services alone.

What it means for your plan: plan from your own roles and region. A rural hospital hiring LPNs and a metro clinic hiring nurse practitioners face different markets, and the second may have more candidates than the headlines suggest.

3. The training pipeline has limits you cannot hire around

More demand does not quickly become more supply, because training capacity is limited. AACN reports (opens in a new tab) that US nursing schools turned away 92,672 qualified applications to baccalaureate and graduate programs in 2025, citing too few faculty, clinical sites, classroom space and clinical preceptors, and budget constraints. Its faculty survey, released in October 2025, found 1,588 full-time vacancies across 1,075 nursing schools, a vacancy rate of 7.2%.

For physicians the timeline is longer still: HRSA notes it can take over a decade of education and residency to prepare one. In March 2024 the AAMC reported that 20% of the clinical physician workforce was 65 or older and another 22% was between 55 and 64, so a significant number would reach retirement age within a decade.

What it means for your plan: clinical placements and preceptors are a constraint on the whole market, and they are something a provider can offer. Employers that host students and train preceptors help create the candidates they later hire.

4. Turnover is highest in the first year

Detailed retention data for hospitals comes from NSI Nursing Solutions' 2026 report (opens in a new tab), a survey of 527 acute-care hospitals in 40 states covering 2025. NSI is a nurse recruitment firm, and its figures exclude agency and travel staff.

• Staff RN turnover averaged 17.6% (14.6% for hospitals that count only full-time and part-time staff). Across 2021 to 2025, the average hospital turned over 102% of its RN workforce.
• 22.7% of newly hired RNs left within a year. Across all hospital employees, 29.5% of new hires left within their first year.
• NSI puts the cost of losing one bedside RN at $60,090, and estimates that each percentage point of RN turnover costs or saves the average hospital $295,000 a year.
• Hospitals reported an average RN vacancy rate of 8.6%, and a third had a rate of 10% or higher. Recruiting an experienced RN took 78 days on average, from 56 to 102 days depending on specialty.

Nurses' own survey answers point the same way. In NCSBN's 2024 National Nursing Workforce Study (opens in a new tab), released in April 2025, 39.9% of RNs and 41.3% of LPNs and vocational nurses said they intended to leave the workforce or retire within five years. Intent is not departure. Among reasons other than retirement, NCSBN lists stress and burnout first, cited by 41.5% of nurses intending to leave, followed by workload, understaffing and inadequate salary.

What it means for your plan: every nurse lost in the first year means hiring the role again. NSI found that 74% of hospitals have a formal retention strategy and that most of those protect newly hired nurses; nurse residency programs are a common approach.

5. Burnout is linked to working conditions an employer controls

Burnout grew across the pandemic years. In a CDC analysis (opens in a new tab) of the national Quality of Worklife survey, the share of health workers who felt burned out very often rose from 11.6% in 2018 to 19.0% in 2022, and 45.6% felt burned out often or very often in 2022. Reports of harassment at work more than doubled, from 6.4% to 13.4%, and the share very likely to look for a new job rose from 11.1% to 16.5%.

The same analysis shows which conditions go with lower burnout. Health workers who trusted management, had help from their supervisors and had enough time to finish their work had markedly lower odds of burnout. Those who were harassed or reported too few staff had much higher odds. The samples are small (325 health workers in 2022) and the data are cross-sectional, so they show associations only.

The Surgeon General's advisory on health worker burnout (opens in a new tab) identifies workplace systems as the cause, including excessive workloads, administrative burdens, limited say in scheduling and lack of organizational support. One respiratory therapist quoted there put the cost plainly:

"The primary concern for burnout is not being able to emotionally take care of each patient individually or uniquely." (Derick S., respiratory therapist, Nevada)

What it means for your plan: supervisor support, enough time to do the work, protection from harassment and a say in scheduling are all within an employer's control. CDC links the first three to lower burnout; the Surgeon General names limited say in scheduling as a cause.

6. Pay and the cost of covering gaps

Pay varies by setting. The May 2025 median wage for registered nurses (opens in a new tab) was $97,550: $100,220 in hospitals, $91,230 in ambulatory care and $84,300 in nursing and residential care facilities. Nurse practitioners (opens in a new tab) had a median of $132,300, and home health and personal care aides $35,800, against $50,980 for all occupations. NCSBN's 2024 study found median pre-tax earnings for RNs and LPNs 10% to 16% higher than in its 2022 study.

When posts stay open, hospitals still have to cover the shifts. The most common strategies in NSI's survey include flexing part-time or per diem employees, overtime, recruitment incentives, critical staffing pay, travel or agency nurses and an internal staffing pool. The gap between options is wide: NSI puts the average travel nurse fee at $91.23 an hour, ranging to $160, against $59.46 for an employed staff RN including benefits. Most hospitals (70.7%) said they want to rely less on travel and agency staff, yet only 26.7% expected to increase their recruitment budget.

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NSI’s 2026 report gives average hourly costs of $59.46 for an employed RN, including a 25.8% benefits allowance, and $91.23 for a travel RN. These are report benchmarks, not a quote for a particular hospital.

What it means for your plan: benchmark pay by setting and region, not against the national median, and compare the cost of a raise with the cost of the overtime and agency hours it would replace.

What to do about it: building a healthcare hiring plan

The six factors point to a small number of decisions. These steps turn them into a plan.

1. 1

   Forecast replacement hiring by role and location

   Start from your own turnover by role, unit and length of service (how to calculate it so it compares with published rates), then add projected growth. Compare each role with the federal projections for your state and setting before you set targets, and where they show a shortage, as for LPNs and rural RNs, allow a longer lead time and a wider search.

2. 2

   Protect the first year

   Assign every new nurse a trained preceptor, consider a residency program for new graduates, and check in at 30, 60 and 90 days. Track first-year turnover separately from the rest.

3. 3

   Fix the conditions linked to burnout

   Train managers to support their teams and spot burnout early, give staff a say in scheduling (self-scheduling and shift swaps where the unit allows), act on harassment, and set up a channel for staff to raise concerns, from surveys to meetings with leaders, then report back what changed.

4. 4

   Benchmark pay and review it every year

   Use BLS data for your state and setting, and review pay and benefits at least yearly, including for experienced staff. Set the cost of a raise beside your own cost of a departure; NSI's estimate for one bedside RN is $60,090.

5. 5

   Build a flexible layer you own

   Keep a core of employed staff and add a pool you control: per diem staff, part-time nurses who can pick up shifts and an internal float pool. Use agency and travel staff for peaks and specialist gaps, and if recruiting volume outgrows your team, consider recruitment process outsourcing for part of it.

6. 6

   Grow your own pipeline

   Host clinical placements, support faculty and preceptor roles with nearby schools, and offer career paths, tuition support and mentoring, so current staff can move into hard-to-fill roles.

Of these, the flexible layer is the one I have built myself, in a different industry. In a May 2025 interview (opens in a new tab) I described the structure we built at my company after two rounds of layoffs: a full-time core with everyone else working hourly, designed so that a drop in revenue could be met by reducing hourly work instead of laying people off. For a hospital, I'd consider an employed core supported by a per diem and internal float pool. Size the core to steady demand, and size the pool around unit demand, patient acuity, the skills each unit needs and the shifts its nurses can reliably cover. The plan still has to provide safe clinical coverage when demand rises.

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The approach described in this article, shown as a visual guide.

Use these questions when you review the plan:

Common questions about the healthcare job market

Which healthcare jobs are growing fastest?

In the BLS 2025 to 2035 projections, nurse practitioners are the fastest-growing of all detailed occupations (41%). Physical therapist assistants, occupational therapy assistants, psychiatric technicians and ophthalmic medical technicians are also among the ten fastest-growing occupations. Home health and personal care aides add the most jobs among the occupations covered here, about 847,300.

Is there a nurse shortage?

HRSA projects national shortages of registered and licensed practical nurses, with large differences by role and place. Its projections, set out in factor 2, show a national RN shortage that narrows by 2038, much larger gaps in rural areas and some states, and a larger LPN shortage. For nurse practitioners, HRSA projects national supply above demand.

Why is turnover so high in healthcare?

Among reasons other than retirement, nurses planning to leave most often cite stress and burnout, followed by workload, understaffing and inadequate salary (NCSBN). Hospitals report personal issues, relocation, retirement, career advancement and scheduling conflicts as the top reasons RNs resigned (NSI). First-year leavers were 29% of all RN separations in NSI's survey.

How long does it take to hire a nurse?

In NSI's 2026 survey, hospitals took 78 days on average to recruit an experienced RN, ranging from 56 to 102 days by specialty.