Workforce challenges continue to be front of mind for health system executives as the industry contends with ongoing staff shortages, nurse retention issues and clinician burnout.
CareRev, a labor marketplace platform, sees opportunities to leverage technology to help health systems effectively meet their workforce needs by tapping into their in-house staffing pool.
The Venice, California-based company, which launched in 2015, initially focused on connecting hospitals and health systems with local, vetted healthcare professionals on demand. CareRev is expanding its focus to now offer a workforce management tool to create flexible staffing within existing healthcare systems.
CareRev's platform continues to support qualified 1099 employees picking up daily shifts in healthcare settings, but its new flexible work software is also designed for a healthcare system’s part-time or full-time W2 employees. When staffing needs aren’t met by the core full-time workforce, the platform allows current employees in this flexible pool to pick up extra shifts, company executives said.
CareRev began building the workforce management technology in 2020 during the COVID-19 pandemic to support hospitals and health systems, independent of the labor that it connects to its marketplace, said Susan Pasley, vice president of clinical solutions at CareRev.
"At the time, the focus wasn't on implementing new technology, it was really focused on getting the caregivers that they needed to provide care at a time when they were very overtaxed by a high census due to the pandemic. And so we kind of put it on the back burner. But we've realized for a long time that our technology can be leveraged in a lot of different ways," Pasley said in an interview.
CareRev initially started as a gig-work, cloud-based platform that enables hospitals and other healthcare facilities to post shifts when they need clinical support, and local, vetted healthcare professionals claim the shifts through their mobile app—eliminating the need for a traditional agency. The company works with more than 70 hospitals and health systems and 540 outpatient centers and skilled nursing facilities in over 32 major metropolitan areas nationwide.
The company banked $50 million in series A financing two years ago backed by Transformation Capital, Industry Ventures and other investors.
Will Patterson, a former trauma nurse, founded CareRev with the goal of connecting hospitals and healthcare professionals through a mobile app and upending the traditional healthcare workforce model. Patterson stepped down from the CEO role in June and the company tapped healthcare and technology executive Brandon Atkinson as its new CEO. Patterson has stayed on with the company in the role of senior adviser to the CEO and member of the board.
CareRev has created what it calls the largest on-demand workforce and a technology platform to build and manage it. Its network has grown to more 22,000 clinical professionals. It recently expanded into Massachusetts, New Hampshire, Hawaii, Kentucky and Delaware, and launched partnerships with several new hospitals and health systems. From 2021 to 2022, CareRev says it increased the number of its partner hospitals by 70%.
The company says it has filled over 477,000 shifts across 770 facilities nationwide. The company believes it can leverage this technical know-how to help health systems more effectively manage their own flexible staffing resources.
Health systems and hospitals are rethinking their workforce development strategies to draw in talent and keep clinicians in the healthcare field. There is a large demand for nurses, certified nursing assistants and other professionals, but in the wake of the pandemic, nurses entering the field prioritize more flexible scheduling.
According to a recent poll, 94 out of 100 senior health system executives described their nursing shortage as “critical,” and just over two-thirds said they don’t have adequate nursing staff to handle a large-scale health crisis. Four in 5 of the responding executives said they’d heard requests for more flexible scheduling from younger nurses, yet only 11% of the respondents said their organization had it on offer.
"Caregivers have options today that they didn't have before and we saw them exercise a lot of that newfound freedom during the pandemic," said Pasley, a registered nurse by training. "You saw that nurses left the bedside as employees in the hospital en masse to go travel as they were taking advantage of an economic opportunity that hadn't presented itself, certainly in my generation. They came onto platforms like CareRev in high numbers because they wanted to be able to take control of when they worked and how they worked."
"We have been a leader in driving that flexibility from the marketplace side. We believe what we can do now is leverage some of that expertise to be able to help health systems build flexible pools of their own," she added.
Health systems are experimenting with different staffing models in a post-pandemic world, Pasley noted, and there are opportunities to mobilize and maximize their internal workforce.
"We've seen just about every hospital in the country reinvigorate their float pools. We've seen them create internal travel agencies to try to combat the expense of the external travel agency. We've also seen them experiment with care models so that they can leverage people's ability to work at the top of their license in a team setting in different ways," she said. "They're searching for ways to meet nurses, CNAs and other caregivers kind of where they're at because they're demanding flexibility today. But they don't have good technology that allows them to have that broad spectrum view across all of the workforce models, all of the caregivers that they currently employ, especially as they're thinking about how do we continue to evolve the models that we put out there to attract new talent into our systems. "
She added, "We believe that we can fill that gap very seamlessly by offering technology that connects all of those different caregiver models together to ensure that people can be deployed efficiently and effectively where they're actually needed within the health system."
When it comes to filling gaps in their workforce schedules, many health systems still rely on rather archaic methods, such as pen and paper and spreadsheets, Pasley said.
CareRev's software provides health systems and hospitals with full visibility and control of their flexible staffing resources and one place to manage, schedule and post shifts in real time or in advance. In-app communications also remove manual, ad hoc and nonselective outreach.
Floating workers can be hired on a specific unit or float through a predetermined area of care, such as women’s health or surgical services. As a result, full-time workers will get the support they need on the floors, the flexible pool can book the schedules they need and the health system doesn't have to resort to expensive outsourcing, like travel nursing, according to CareRev executives.
"We're not replacing their staffing scheduling, where they put out the core schedule every six weeks in advance," Pasley said. "What we're really doing is augmenting that to be able to say, 'How can you easily communicate with the staff that you have to ensure that every patient has the right caregiver team at the bedside at the time that they are needed?'
The company continued to build out new tools for health systems to effectively manage their workforce needs.
In June, the company launched an artificial-intelligence-based shift pricing system to optimize healthcare shift rates. The technology, called Smart Rates, draws from health systems’ economic, performance and market data to automatically adjust wages on demand. This allows health systems to take the guesswork out of shift rates to improve staffing management and fill more shifts in less time, company executives said.
The pool of nurses available for systems to hire appears to have constricted during the pandemic, according to industry surveys and other data. Nearly 100,000 registered nurses were estimated to have left the field during the COVID-19 pandemic and almost 800,000 intend to follow them out by 2027, the National Council of State Boards of Nursing said in April.
Nurses also are experiencing some of the highest rates of burnout.
More flexible work schedules is a key issue among nurses, almost 90% of whom are women.
"If you look at the statistics, women are still typically primary caregivers for children. And, they're oftentimes primary caregivers for parents. We have a lot of nurses that are single mothers in a situation where really, in order to stay engaged in the profession, as well as take care of their kind of personal responsibilities, it requires them to have some flexibility," Pasley said.
"Being able to ensure that we have flexible models that will meet both professional career goals, as well as personal demands and personal needs, is going to be increasingly important, because we've seen, certainly during the pandemic and post-pandemic, that we're no longer just fighting to keep nurses at the bedside or at a particular hospital. We're fighting to keep nurses and women in the industry."