1. Flexible scheduling is now essential — but systems must balance it with staffing gaps.

Scheduling autonomy is now a primary differentiator for recruitment and retention.¹ Seeking work-life balance, more clinicians are drawn to flexible scheduling or locum tenens work. At the same time, healthcare leaders expressed concern that too much scheduling flexibility hinders their ability to find enough clinicians to fill shifts or keep finances sustainable.

To navigate this tension successfully, leading organizations are building tiered scheduling frameworks that provide different levels of flexibility based on contract type, tenure, and specialty demand. For example, some systems are introducing "core coverage tiers" that guarantee minimum shift commitments while offering floating days or remote options for tenured staff. Other systems are creating pilots that resemble the on-demand shift marketplaces with their own employed physicians, using internal apps that allow part-time, per diem, or float pool providers to claim unfilled shifts — creating a flexible backstop to stabilize coverage.

By categorizing roles and shift types based on clinical urgency and predictability (such as trauma coverage vs. routine outpatient visits), health systems can align autonomy with operational necessity — ensuring flexibility without compromising access or financial performance.

In general, a strategic mix of full-time staff, locums, pool coverage, and tech tools can help systems meet coverage needs while honoring clinician preferences. In some cases, hiring APPs to enable team-based care models can help deepen capacity. Some participants also used AI tools to reduce clinician load by helping with imaging interpretation and some aspects of charting.

Participants have also developed other ways to navigate this tension. For instance, one health system discusses the business impact of seeing fewer patients per day directly with each physician — often showing them an individualized profit and loss statement to show how many patients it would take to cover different levels of compensation.

Connecting the pay structure to patient visits helps clinicians better understand their compensation plan and incentivizes them to see more patients. Some administrators have also enlisted clinician champions to better understand clinician culture and communicate business needs effectively.

2. AI won't replace clinicians or staff, but it will change care team roles.

Healthcare organizations are already using AI to help with everything from reading radiology images to writing appeal letters for denied claims.

But the impact of AI on the healthcare industry is much deeper than automating individual tasks. To understand whether AI fits into organizational goals, leaders must also consider how it changes team dynamics. For example, when a radiology practice struggled to staff enough radiologists to support the volume of patients, they deployed AI to increase capacity by interpreting imaging results.

Radiologists will still review AI results, but their focus will likely shift. These clinicians may spend less time drafting reports and more time focusing on clinical interpretation and confirming results. The practice hopes the AI tool could boost capacity by 30%.

This experience demonstrates how care team roles can change when they deploy AI tools: Clinicians and staff may spend more or less time on certain tasks or perform completely different tasks. New roles may be added. Staff will need to be trained to use AI technologies effectively. And, as patients increasingly access AI-powered tools, clinicians may have to learn to engage with them in a new way.

Finally, healthcare organizations also must consider other factors, such as whether clinicians will buy into the new technology and how they will proactively mitigate AI challenges — including preventing data bias, responding to AI hallucinations, and ensuring data privacy.

3. Telehealth's future depends on integrating telehealth with in-person care.

While the pandemic spurred telehealth adoption, health systems have not always implemented telehealth in primary or specialty care areas. In some cases, they reduced telehealth services they had already implemented — whether due to a lack of clinician buy-in, tight budgets, or limited infrastructure.

Nonetheless, patients want access to both telehealth and in-person care, and we are seeing a resurgence of interest in telehealth after organizations scaled back post-pandemic. Integrating telehealth with in-person care can alleviate care fragmentation and improve care coordination within care teams. For instance, when a telehealth system has an on-ramp to scheduling an in-person appointment, clinicians can more easily direct a patient to come in when necessary.

Integrating telehealth into daily practice also supports agile staffing models by allowing doctors to conduct virtual visits from home on certain days. The expansion of multi-state licensure compacts further enhances this flexibility: When physicians can more easily practice across state lines, there are more opportunities for multi-state telehealth practice.

4. Community partnerships are opening up new revenue models.

Investing in retail healthcare or partnering with non-healthcare organizations — like housing, grocery stores, or schools — can unlock revenue and expand reach. For example, a nonprofit health system restructured to form a for-profit arm, which allowed them to acquire and operate a regional retail pharmacy. Another nonprofit formed an internal traveler agency through their human resources department to outsource clinicians to other organizations in the area. Yet another organization partnered with the local school system to provide school nursing services.

In addition to supplementing organizations financially, these innovations can build relationships with local businesses and organizations, all while influencing the health of the patient population.

When resources are tight, even small investments in community outreach can drive impact. For example, one organization called the local school to talk about engaging sports teams with different aspects of care, such as diet, sports physicals, or behavioral health.

5. Legislative policy uncertainty is reshaping health system planning.

Ongoing federal policy changes are raising questions about health systems’ financial stability and patient access. Participants expressed concern about how changes to Medicare and Medicaid reimbursements would affect smaller and rural hospitals, whether immigration policies will impact staffing strategy and patient care, how market uncertainty might impact cash flow, and whether patients will feel they can get the care they need as language surrounding diversity, equity, and inclusion shifts. For example, one health system with a large Hispanic population reported that many patients have stopped showing up for important appointments.  

Uncertainty makes planning for the future difficult, particularly when it comes to costs. Some leaders are trying to gauge the impact of different legislative scenarios on their health system via modeling tools.

Action steps

Participants at the CHG Health Executive Summit explored a range of nuanced topics — from workforce planning to the impact of AI, to planning for an uncertain legislative future. In light of these discussions, healthcare leaders at other organizations should take the following actions:

For more than 45 years, CHG Healthcare has helped healthcare organizations meet their most pressing staffing needs. As the nation’s largest physician-centered clinical workforce provider, we offer a full spectrum of workforce solutions with permanent placement, locums, telehealth, and advanced practitioners (APs), including nurse practitioners, physician assistants, and nurse anesthetists (CRNAs).

CHG also provides travel and permanent allied health professionals across therapy, lab, pharmacy, and healthcare management specialties. With more than 1,500 expert recruiters covering over 130 specialties, we deliver healthcare professionals with the scale, speed, and quality your organization demands.

Our capabilities go beyond staffing with a suite of innovative technology solutions—including the only physician and AP-centered vendor management system (VMS), credentialing management software, and AI-powered platforms. We partner with healthcare organizations to provide solutions backed by expertise, insight, and data to help optimize workforce strategy, control costs, and drive revenue.

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This article is sponsored by CHG Healthcare, an Advisory Board member organization. Representatives of CHG Healthcare helped select the topics and issues addressed. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

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