ShiftMed has released its 2026 Open Shift Management Report, highlighting a persistent labor cost imbalance across U.S. healthcare markets and identifying substantial savings potential for health systems. The report outlines a recurring premium pay gap ranging from $15 to more than $30 per hour between agency-based staffing and local on-demand clinicians. This disparity, observed across major cities including Philadelphia, Chicago, New York, and Washington, DC, underscores what the company describes as a structural inefficiency in workforce allocation when scheduling becomes reactive. The findings position Open Shift Management as a key lever for addressing escalating labor costs while maintaining operational continuity.
The report comes as health systems continue to face workforce shortages, reimbursement pressure, and tightening operating margins. According to ShiftMed, open shifts frequently trigger the use of overtime or external agency contracts, leading to unpredictable expenditure and sustained margin pressure. By contrast, local on-demand clinicians consistently command lower hourly rates, creating a measurable gap that, when scaled across large volumes of shifts, translates into significant financial implications. In 2025, health systems using ShiftMed’s platform filled 630,966 shifts, generating $189 million in documented savings by avoiding premium labor channels. The company indicates that this figure represents only a fraction of the broader market opportunity, suggesting that the full potential of Open Shift Management could extend into multi-billion-dollar savings nationwide.
ShiftMed attributes these efficiencies to its embedded workforce intelligence capabilities, which integrate directly into existing scheduling systems. The platform automatically identifies open shifts in real time and routes them to qualified clinicians before escalation to higher-cost staffing options occurs. This enables internal staff, float pools, and local on-demand professionals to self-schedule into available shifts, reducing administrative burden and limiting reliance on agencies. The report also highlights workforce stabilization benefits, noting that 18% of on-demand clinicians transition into permanent roles, thereby strengthening internal hiring pipelines and reducing long-term dependence on premium labor.
Commenting on the findings, Todd Walrath stated, “Reactive staffing models are eroding margins in plain sight. Open Shift Management restores control at the shift level, where labor costs are determined. The premium pay gap is structural. When coverage is routed with discipline, the savings are predictable and scalable.” The report provides health system leaders with localized wage benchmarks, enabling more precise evaluation of cost-saving opportunities and workforce strategies.
