How a Nurse-Well-Being Initiative Drove $4M in Savings

Cone Health’s nurse-well-being initiative demonstrates that targeted workforce investments can generate measurable labor-cost savings, improve quality-linked reimbursement, and strengthen organizational stability, all within a single fiscal year.

A year after launching a systemwide nurse-well-being initiative, Cone Health reports more than $4 million in savings, driven primarily by improved retention, reduced absenteeism, and a more stable, higher-performing nursing workforce.

After speaking with the system’s CNO, CFO, and the RN who created the program, the financial strategy was clear: Nurse well-being is no longer a “soft” investment, but a grounded labor-cost reduction strategy.

Lower Turnover = Lower Labor Premiums

CFO Andy Barrow framed the financial impact bluntly:

 “The financial thesis is largely a cost-avoidance play,” he said. “Lower turnover and lower absenteeism mean lower vacancy, so avoidance of backfilling staff at premium rates, whether that’s overtime or traveler rates.”

Each avoided nurse loss, Barrow noted, represents “tens of thousands of dollars” in costs prevented spanning overtime, traveler utilization, recruitment, and orientation.

Given that roughly 50% of Cone Health’s expenses lie in labor, Barrow emphasized that stabilizing the nursing workforce is one of the few levers that materially moves the margin. Reducing travelling-nurse reliance in particular is a priority.

 “We continue to combat the need for travelers and contract labor in our market,” he said.

Beyond labor savings, Barrow connected nurse well-being to measurable quality and financial outcomes.

 “A stable, healthy workforce… leads to better patient outcomes through reduced fatigue, better monitoring and documentation,” he said.

These quality improvements can generate reimbursement upside where payer contracts reward performance.

 “Where the reimbursement model accounts for that, we can certainly make the correlation to nurse well-being and the culture we’ve created,” he said.

Fast ROI

Vi-Anne Antrum, Cone Health’s CNO, calls the initiative the fastest, most impactful clinical investment the system has made.

The program, created by registered nurse, author, and coach Diane Sieg, takes a ‘train the trainer’ approach to deliver compounding results. The program is set up to train internal coaches to train future generations of ‘champions’ and coaches that empower nursing staff with self-leadership.

Nurses reported improvements not just at work, but at home:.

 “We’ve actually had people… talk about the tremendous impact it’s made for them, not only professionally, but with their families,” Antrum said.

This relief from emotional and mental strain allowed nurses to focus more fully on patient care, an effect Antrum says translated directly into clinical quality gains, which lead to further gains in dollars saved.

Reimbursement & Retention

Antrum highlighted the operational and cultural dividends from the program.

 “You have the benefits of continuity of care—an experienced workforce that you’re not having to perpetually retrain in your policies and procedures,” she said.

The initiative strengthened Cone Health’s employer brand, and now one-third of new orientation cohorts consist of returning nurses. Every returning nurse represents avoided recruitment and onboarding costs, direct savings that accumulate quickly across a large workforce.

Perhaps the most concrete example was a dramatic improvement in pressure injury prevalence.

 “We were at 0.7% as a system and the benchmark is 3.11%,” Antrum said. “So we are top decile on that key metric for PSI-90.”

For CFOs, the significance is immediate: PSI-90 performance is embedded in both commercial upside models and federal pay-for-performance programs.

 “[pressure injury prevalence] hits a bunch of those reimbursement metrics… all of the upside incentives from our private payers, and it’s part of our CMS pay-for-performance programs,” she said.

Antrum emphasized that well-being investments created the conditions for these outcomes by reducing cognitive overload and turnover, two silent drivers of quality variation and cost.

She also noted the investment was paired with a structured retention framework, reinforcing stability and continuity of care, two elements that lower labor costs and reduce quality-related penalties.

Barrow is unequivocal about the financial return of the organization’s nurse well-being initiative. The math, he says, is straightforward: The cost of the program is a fraction of the labor expenses it prevented.

“The cost of the investment is a lot less than the $4 million that we would have spent had we not retained those nurses that we've been able to tie back to the program,” he notes.

 With retention gains tied directly to reduced reliance on travelers, lower turnover, and fewer orientation cycles, the financial effect is clear.

While Barrow says he typically prioritizes strict measurement, he said this is an area where the correlation is undeniable.

 “I’m usually a big advocate for precision, but… the correlation between what we've done with the well-being initiatives and building a culture of well-being is closely enough correlated with the results… that the attribution is pretty easy to me,” he said.

Metrics That Matter for CFOs and CNOs

The well-being initiative highlights the importance of tracking shared metrics that link staff engagement to financial outcomes.

 “We’ve been able to reduce our turnover and improve our retention year over year for nursing since we instituted this program,” Antrim said.

 She also noted that employee engagement survey results, which held steady or slightly increased despite national declines, are a critical indicator of workforce health.

From the CFO perspective, operational and financial metrics provide the clearest signal of return on investment:

 “I keep my eye on retention and turnover rates, overtime usage, contract labor for nursing… and productivity at the department level,” Barrow said. “There’s a benefit when we run more efficiently… I haven’t seen as many areas where we run 110%–115% for multiple pay periods in a row, which speaks to… better retention and less short-staffing.”

Together, these shared data points allow both clinical and financial leaders to monitor the impact of well-being initiatives, linking workforce stability to reduced labor costs and improved efficiency.

Takeaway for CFOs

Cone Health’s experience illustrates that nurse-well-being programs can yield a direct, quantifiable financial return. Cost avoidance from reduced turnover, reduced absenteeism, lower reliance on premium labor, and fewer orientation cycles—plus incremental reimbursement tied to quality—combined to generate more than $4 million in just a 12-month impact.