Staffing and Wage Access Get Digital Do-Over as Healthcare Delivery Changes

As healthcare delivery models expand, questions around facility needs, staff demands over shifts, wage access and more are advancing rapidly, and digital platforms are leaning into harmonizing this highly complex set of patient, professional and institutional requirements.

Speaking with PYMNTS’ Karen Webster for the J.P. Morgan Payments Global Innovators in Payments Series, Clipboard Health CEO and Founder Wei Deng outlined the issues, as a nursing shortage, rampant burnout, and tectonic shifts in the healthcare landscape create a delicate balancing act for all involved.

Acknowledging that the pandemic pushed these problems to the fore, Deng said “there’s always been this issue, for decades” around nurses of different skill and certification levels wanting more control over shifts. It’s now being drastically compounded by changes in workforce demands.

COVID-19 dislodged the longtime go-to model of hospitals and facilities using staffing agencies, creating a void in the market for ways to hire and retain staff. Doing so has new challenges.

Fundamentally, the two forces are at odds. Facilities are keen to have their own nurses to fill shifts as they see fit, while a post-COVID nursing population craves scheduling and payment flexibility.

Asked if nurses want full-time jobs as such, Deng said: “The short answer is yes and no.” Nurses and healthcare workers want enough work to equal a full-time income, but “they don’t necessarily want people telling them what hours to work.”

Platforms like Clipboard Health are focusing innovation efforts on bridging this divide.

“We’re working on tools to help them with not just supplementing staff with outside help, but also helping them retain their full-time staff, and helping them with hiring full-time staff as well. That’s something that many facilities have expressed an interest in,” Deng said.

See also: Platforms Step In to Fix Outdated Nurse Staffing and Payments Methods

Competing Priorities

With changes in healthcare delivery coming fast and furious between in-home health, long-term care, medical rehabilitation facilities and hospitals, payments in the time of early wage access is a driver for innovators like Clipboard Health. But it’s not like finding rideshare drivers.

Questions of hourly rates and benefits, skill levels from LVNs to CNAs to licensed registered nurses and nurse practitioners present a tangle of compensation and shift considerations.

Noting that this can come down to plus or minus $2 an hour, Deng said: “People that can get [nurses] paid that same day can overcome the extra $2 an hour because people want access to funds faster. If they are going to get paid an extra $2 or $3 an hour but won’t get paid for two weeks, we see that people would rather get paid a little bit less and get access to funds faster.”

It gets more complicated with the rising trend of in-home health into which Big Tech and Big Retail have stepped, from Amazon to Walmart and others in between. Quality control, HIPAA compliance, and assurance that loved ones are being well cared for all enter the equation.

“We are experimenting, helping with in-home care, not direct to consumer, but working with home care agencies or home health agencies. That is definitely a trend,” Deng said. “If anything, long-term care facilities as an industry will exist, but I think it’s going to be a smaller percentage over time. More care is going to shift home. We want to enable folks to do that.”

Having dealt with this on a personal level, Deng added, “There are going to be a lot more controls that must be put in place to ensure they deliver not just quality care, but that they’re doing the right thing.” She wants to solve this “before we feel comfortable launching full force.”

See also: Clipboard Health Notches $80M at $1.3B Valuation

A Flexible Healthcare Staffing Model Emerges

Webster likened the nursing shortage and post-COVID shift and wage access concerns to staffing in the restaurant industry, notorious for no-shows and payment complexity.

Deng said Clipboard Health helps with those problems.

“What we found is that our platform works, obviously for people on the platform, the users,” she noted. “But we want to bring it to other people who are not using Clipboard to do on-demand work. You have full-time staff who could also benefit from getting paid faster … and with flexibility.”

Serving facilities that range from having five nurses on staff to over a hundred, Clipboard is finding strong interest among those that are not yet able to handle hiring themselves. The platform is building the digital infrastructure to connect facilities with nurses on mutually beneficial terms.

The goal is solving a disconnect between what facilities want — reliable full-time staff — and the reality that turnover is increasing, with a hospital’s “permanent” staff is not permanent in the pre-COVID sense. In today’s workforce model, “they don’t belong to the facility,” Deng said.

Asked if taking on payroll is on Clipboard’s whiteboard, Deng said: “That’s something we’re looking at, because it feels like all of these things are kind of connected.”