'It can be a hardship': How Trinity Health hopes to reduce worker stress with daily pay option

Amid workforce shortages and recruitment and retention challenges, Livonia, Mich.-based Trinity Health set out to discuss ways to alleviate stress in employees' lives. An interprofessional team across the health system began those talks about a year ago. One of the results was a new pay option for workers under which they can access their money by the day.

"We know they've been stressed by the pandemic and needing greater flexibility. More and more people are needing to [care for] children or parents, or both, outside of the work setting," Gay Landstrom, PhD, RN, Trinity Health senior vice president and chief nursing officer, told Becker's.

Dr. Landstrom said the health system considered several options to alleviate that stress, draw people to the organization and keep workers there. The interprofessional team asked questions including, "What is it that our colleagues need?" and "What could we do differently than we've ever done before for them?" Among the efforts Trinity Health decided to implement was an experiment with paying its employees by the day.

Nicole Shelton, chief human resources officer, system office clinical and continuing care for Trinity Health, told Becker's initial testing started with continuing care ministries, all three of which have a national footprint. This affected about 6,000 employees and launched at the beginning of the summer.

Ms. Shelton said Trinity Health spent 90 days assessing the program. This involved looking at the daily pay option's functionality as well as gathering feedback from colleagues on whether it had the effect the health system expected.

"It actually went over wonderfully with our colleagues," Ms. Shelton said. "We got very positive feedback and created an expansion plan [for the initiative]."

Trinity Health will initially expand the daily pay option to 17 health systems across multiple states with more to come in 2023, via a partnership with financial services company DailyPay. DailyPay will provide earned wage access to workers.

Dr. Landstrom said workers "need access to their funds, but it can be a hardship to wait two weeks for your paycheck to come. And this allows them to have access to their own money [on a daily basis]."

Workers can access their pay for a day of work on the next day for free, although employees must pay $2.99 to gain instant access.

Trinity Health expects to eventually expand the daily pay option across the organization, which includes more than 120,000 employees working at 88 hospitals, 135 continuing care locations and other locations across 26 states. The initiative is already launched at most continuing care locations.

For now, the main challenges Trinity Health has experienced with the daily pay option were more technical and easily mitigated during the pilot, according to Ms. Shelton.

"We built an integration so that if a colleague chooses to use daily pay, they can use it immediately. And they don't have to go through kind of a big process to get signed up," she said.

Ms. Shelton added that she sees that as "part of the beauty of the program. It is easy [for workers]. They have an app, they have a portal. … And we've anecdotally had colleagues use it day to day to buy food or transit. And then, some colleagues who've had some real emergent needs that had that money not been available, they really would have been in a tough situation."

The pay model is available for all pay scales, except for executives and the highest earners.

Dr. Landstrom said she initially thought the daily pay option would be desired most among lower wage earners. However, "a lot of colleagues at all kinds of pay levels really found this to be beneficial, because everybody can have surprises," she said.

Dr. Landstrom recommended that hospitals and health systems continue to focus on new approaches when it comes to staff recruitment and retention.

"Colleagues today, potential employees or actual employees have some different needs. And they have different expectations than they did in the past," she said. "So we did focus groups. We really sought to understand what people wanted and needed. … [Workers] need flexibility, and rigidity from their employer is not desirable for them. As leaders, we have got to understand that the employees are changing, and what they need and want and expect is changing. And we have to be flexible and creative and try and meet their needs where they are."

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