How NYC Health + Hospitals is reining in travel nurse expenses

NYC Health + Hospitals has made progress in decreasing its dependence on travel nurses, though staffing expenditures still exceed the public health system's allocated budget, executives told New York City Council leaders during a preliminary budget hearing March 5. 

The health system has hired 850 permanent registered nurses since July, when the city reached a "historic" contract with the New York State Nurses Association that gives nurses pay parity with the private sector.  

"Because we got that nurse contract signed and achieved nurse parity, we have now been extremely successful in hiring nurses who work for H + H," said Mitchell Katz, MD, president and CEO of the New York City-based system. 

The increase in nurse hiring, driven by the new contract, has allowed the system to gradually shrink its travel nurse workforce. 

"Every week we have fewer registry nurses," Dr. Katz said.

In March 2023, more than 20% of the health system's more than 8,000 nurses were travelers, according to John Ulberg, senior vice president and CFO of NYC Health + Hospitals. About 350 registry nurses have fulfilled their contract and left in the last year, with about 800 to 900 remaining.  

Mr. Ulberg said the system reported $150 million in expenses tied to travel nurses that were not included in its budget during last March's preliminary city budget hearing. He did not share how much the system has spent on travel nurses this year, saying only that it "is a tremendously large number" that is consistently decreasing. 

"It's not that we're saving money," he said. "We're actually bringing spending back down to what the budget affords."

Internally, the health system refers to this transition away from travel nurses as "the glide path," Mr. Ulberg said. Leadership has set targets for each facility to reduce the number of travelers over an 18-month period. 

Natalia Cineas, DNP, RN, senior vice president and chief nurse executive of NYC Health + Hospitals, expressed excitement over the system's progress with nurse hiring and said this effort will remain a priority through the remainder of 2024. 

"We had a lot of best practices in place before the contract to retain our nurses, and I think that the contracted partnership with NYSNA has really helped solidify all of the different facets that we need to have a stronger workforce," she told Becker's on March 7. "I think that element was a critical factor, and now we're able to really see the fruits of our labor — no pun intended."

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