New data from the Bureau of Labor Statistics shows that the industry's job market is holding strong for now.
Healthcare continues to add jobs at a consistent pace, even in the face of economic uncertainty and market volatility.
The industry created 50,600 jobs in April, a slight step down from the 53,600 jobs added in March but right around the monthly average of 52,000 jobs gained over the past 12 months, according to a report by the Bureau of Labor Statistics.
Much of the growth for the month came from hospitals and ambulatory healthcare services, which contributed 22,100 and 21,400 jobs, respectively.
Growth in ambulatory healthcare services was largely driven by jobs added in physician offices (8,000) and outpatient care centers (5,400).
Meanwhile, 7,100 jobs were created in nursing and residential care facilities, with a large chunk coming in skilled nursing care facilities (2,900).
Overall, healthcare had 18.14 million workers in April, representing a 3.5% increase from the 17.53 million workers recorded in April 2024.
Across all sectors, the U.S. added 177,000 jobs in April, roughly in line with the average monthly gain of 152,000 over the prior 12 months. The unemployment rate was unchanged at 4.2% and has remained between 4% and 4.2% since May 2024.
Though the consistent job growth in healthcare serves as evidence for the idea that the industry is "recession proof," many hospitals and health systems have implemented jobs cuts to offset rising costs and potential slashes to funding.
Mass General Brigham announced in February that it would conduct the largest layoffs in its history to close a projected $250 million budget gap over the next two years.
Providence, on the other hand, froze nonclinical hiring in April to alleviate financial strain from issues like low reimbursement from payers.
Hospitals big and small, rural and urban, are feeling financial pressure that could be worsened by policy decisions in Washington in the coming months, possibly leading to a bit of a slowdown in the industry's job growth.
The for-profit giant posted solid first quarter results, though leadership highlighted uncertainty around policy reform.
HCA Healthcare remained on track with its earnings in the first quarter, but it's unclear how potential policy changes in Washington could impact the health system going forward.
Along with reporting revenue growth and strong profits for the first quarter, HCA reaffirmed its 2025 guidance range of $5.85 billion to $6.29 billion.
Leadership, meanwhile, stayed away from providing details on how policies like tariffs and Medicaid reform could affect finances in an earnings call with investors.
"We are in a very fluid situation," CEO Sam Hazen said on the call. "While we have a general sense for the new administration's stated priorities, we do not have any specifics. It is unclear how these efforts might be carried out and what effects they may have on our business."
For the first quarter, HCA recorded revenue of $18.32 billion and net income of $1.61 billion, improvements over the $17.34 billion and $1.59 billion, respectively, reported during the same period last year.
Revenue growth was driven by an increase in patient volume, with the health system seeing same facility admissions rise 2.6% year over year, same facility equivalent admissions jump 2.8%, and emergency room visits swell by 4%.
One area of volume that continued to decline was outpatient surgeries, which fell by 2.1% year over year. Hazen attributed to dip in part to 2024 being a leap year with an added day for services.
When asked by investors about policy developments, Hazen stated that HCA is engaged in advocacy efforts.
"Our general approach is to support reasonable reforms," Hazen said. "However, we do not support reforms that harm coverage for families or individuals, nor do we support policies that compromise the ability for hospitals across the country to care for people in their times of utmost need."
On the issue of tariffs, CFO Mike Marks called HCA's level of risk for the year "manageable." The health system has 70% of its supply expense contracted with firm pricing for 2025, and 75% of its supply expense coming from either the United States, Canada, or Mexico, or from products that currently have broad exemption from tariffs, according to Marks.
Still, Hazen again touted the wait-and-see approach he offered following the release of the health system's fourth quarter earnings.
"I know you would like us to size the potential impacts of health policy risks and now tariff risks, but we are not comfortable with providing estimates at this time," Hazen said. "We just do not have enough insight into what might happen."
President and CEO R. Lawrence Moss is striving to create health, not just deliver medical care for children.
As healthcare grapples with a wide array of challenges that pose a threat to the industry's future, improving children's health looms as a potential answer to drive sustainability for the system.
At Nemours Children's Health, president and CEO R. Lawrence Moss, MD, FACS, FAAP, is focused on advocating for the value of investing in childhood prevention, while strategizing for where children's health is heading.
The United States has a massive burden of chronic disease, one that could be significantly lessened by addressing health trajectories in children, according to Moss. That burden is creating problems in several areas, from the $4.5 trillion in annual costs, to the strain on providers' resources to care for patients.
"The biggest issue for me continues to be our opportunity to do a better job demonstrating that children's health is not just about treating sick kids," Moss told HealthLeaders. "Children's health is about the health of our entire country, it's about the health of our economy, and it's about our future.
"One of the things that that I always try to do, that I think the whole children's hospital industry can do a better job of, is demonstrating that children's health is the lever we have to power our society and our economy. I just get out of bed every day thinking about that because if we could do a better job of that, the shiny object challenges of the day would tend to fade away."
For Moss and Nemours, the priority is advancing whole child health models that promote health, development, and wellbeing over the course of a child's life. Those models are influencing how children's health is trending and the type of medical care children's hospitals are emphasizing.
With higher acuity in inpatient settings and more care being administered at home and in outpatient settings, Moss believes the children's hospital of the future will be a giant ICU with only acute care beds. Meanwhile, most of the care that is delivered in the medical-surgical unit today will be delivered at home.
"At Nemours, we're investing very heavily in something that we call advanced pediatric care at home, which is essentially hospital-level care at home, which we are actively testing and moving very rapidly towards becoming a part of the way that we deliver care here," Moss said. "I hope that we're able to demonstrate to other children's health systems around the country that that's the way to go."
Pictured: R. Lawrence Moss, MD, FACS, FAAP, president and CEO, Nemours Children's Health.
Moss is also bullish on new technology allowing for more innovation in children's health.
By leveraging AI to improve care management and care coordination at a sophisticated level, children's hospitals can scale a major hurdle that currently places limitations on providers.
"In the children's healthcare world, our biggest challenge is the subset of kids we call children with medical complexity," Moss said. "Those are the kids with multiple congenital anomalies, complicated cancer, other types of birth defects, the kind of things that that require what only a children's hospital can do. Yet coordinating that care requires multiple specialists in a variety of procedures and it's the thing we do poorly in healthcare, is deliver that in a coordinated, efficient fashion."
Nemours is partnering with a startup company that's looking at ways to create a virtual care coordinator and care manager to give the health system "essentially an unlimited workforce of roles that are really, really hard to fill," according to Moss. That partnership has yet to be officially announced, but Moss is excited by the opportunity and expects it to greatly benefit children's families.
Additionally, Nemours has been active with capital investments in its home states of Delaware and Florida to strengthen care delivery efforts. While Nemours is interested in delivering population health and elevating children's health outside the hospital, it also wants to care for the sickest of kids, Moss pointed out.
"An emphasis on health outside of the hospital and keeping kids out of the hospital is not a de-emphasis on high-end tertiary quaternary care for kids who need that," Moss said.
In December, the health system announced it would spend $130 million in 2025 on projects in Delaware, including a new Maternal and Fetal Health Program and expansion of its neonatology, cancer and cardiology programs.
At its Central Florida campus, Nemours is investing $300 million over the next four years on expanding the pediatric hospital, building a new surgery center, and building a new administrative building.
"We're finding with the increased visibility we've had in the market and with how responsive communities and families have been through our whole child health model, we've seen a big increase in demand for our high-end tertiary quaternary services, so more kids who maybe were going somewhere else are now coming to us for those services and we need to be there to deliver," Moss said.
Taking care of the sick will always be a core function of hospitals, but bettering the health of communities in a meaningful way requires a comprehensive approach.
"Whether we're leaders in healthcare or we're at the front lines taking care of patients, our job is to create health," Moss said.
The for-profit hospital operator made strides in several areas in the quarter to stabilize its bottom line.
Community Health Systems' (CHS) finances are trending in the right direction, though challenges persist which could be shaped by shifts in Washington.
In its first-quarter earnings report, the Franklin, Tennessee-based health system showed revenue growth on higher volumes and improvement on deleveraging its portfolio through divestitures, while contending with increasing medical specialist fees, payer denials, and policy uncertainties under the new presidential administration.
Overall, CHS trimmed its net loss for the first three months of the calendar year down to $13 million, compared to $41 million in 2024's first quarter.
Encouraging results for the period were headlined by operating revenue increasing 0.6% to $3.16 billion and same store operating revenue jumping 3.1%. CHS saw greater patient from the flu season, which contributed to a 4% increase in same store admissions.
Meanwhile, the system sold several assets that will allow it to reach its goal of hitting over $1 billion in divestiture proceeds, CHS leadership highlighted on an earnings call with investors. Divestitures of Shore Point Health System in Florida and Lake Norman Regional Medical Center in North Carolina were completed in the quarter, along with the sale of 50% ownership interest in Merit Health Biloxi in Mississippi. CHS also recently announced an agreement to sell 80% ownership in Cedar Park Regional Medical Center in Texas, expected to close later this year.
"These transactions will further reduce the company's net leverage, improve our maturity profile, and enhance shareholder value while not meaningfully affecting free cash flow," CHS CFO Kevin Hammons said on the call. "Furthermore, we're getting all of this done despite the recent dislocation in the capital markets."
CHS' operating expenses for the quarter were $2.85 billion, a slight decrease from the $2.9 billion reported over the same period last year. The system reduced contract labor spend by $8 million year-over-year, but dealt with medical specialist fees increasing 9% to $163 million. Hammons stated that the system expects to continue feeling pressure from rising medical specialist fees in 2025, though at more manageable levels than those seen from 2022 to 2023.
Investors asked CHS leadership about their handling of potential policy changes as well. Between tariffs and possible funding cuts to Medicaid, health systems are reckoning with market volatility.
"I want to acknowledge the fact that healthcare providers are currently facing a number of uncertainties," CHS CEO Tim Hingtgen said. "Navigating any potential changes that may come out of Washington in the weeks and months ahead makes planning more challenging. But our team is closely following these developments and advocating for policies that maintain and strengthen our health systems and all health care delivery systems."
Regarding tariffs, Hammons pointed to CHS purchasing over 70% of its supplies through HealthTrust Purchasing Group, a group purchasing organization that comes with fixed pricing. Less than 5% of the system's purchases are from China.
On Medicaid, CHS leadership said they've not included directed payment program reimbursement for Tennessee or New Mexico due to those programs not receiving approval by the administration yet. However, CHS expects those programs to be eventually approved, which would contribute $100 million to $125 million annually to the system's EBITDA.
The academic medical center is the latest health system to eliminate nonclinical jobs in pursuit of efficiency.
The University of New Mexico (UNM) Hospital has restructured its workforce at the leadership level as it contends with financial challenges.
Potential federal funding cuts influenced the academic medical center to drop 53 executive positions, according to a spokesperson for UNM Hospital. Health systems everywhere are taking action in anticipation of the Trump administration reducing spending on medical research funding and Medicaid.
An internal email provided to the Albuquerque Journal revealed that elimination of roles at UNM Hospital include the president, CFO, and chief human resources officer of Sandoval Regional Medical Center in Rio Rancho.
"In order to be sure we are operating as efficiently as possible, and are as prepared as possible for federal funding changes which may lie ahead, we have implemented a number of financial improvement initiatives," the spokesperson said in a statement.
In addition to the job cuts, UNM Hospital is undertaking other cost saving initiatives, such as reviewing expenses on contract labor and assessing workflows to improve efficiency.
"By taking these steps now, UNM Hospital is positioning itself to balance its current and future budgets. UNM Hospital remains committed to what is most important — providing health care for New Mexicans, in New Mexico," the spokesperson said.
Growing trend
Several health systems have taken similar approaches to streamlining their workforce in an effort to curb spending and get ahead of funding cuts.
Mass General Brigham announced in February that it would conduct the largest layoffs in its history by slashing hundreds of nonclinical workers to bridge a budget gap of $250 million over the next two years.
One month later, Yale New Haven Health said it would restructure its management and administration teams, with up to 38 people potentially being laid off.
Providence, meanwhile, recently implemented a freeze on nonclinical hires as CEO Erik Wexler cited financial strain from rising costs and reduced reimbursement.
Though there is unpredictability surrounding the current administration, health systems have little choice but to put themselves in a position where they can weather headwinds.
One rural hospital leader shares his multi-pronged approach to replenishing provider talent.
Rural hospitals face their own unique set of challenges when it comes to building and maintaining a sustainable workforce.
When these organizations struggle to attract and keep clinical talent, it can lead to services being reduced or even cut altogether, jeopardizing access to care for patients in these communities.
That makes recruitment and retention of providers the top priority for rural hospital CEOs, Cole Stockton, CEO of Highpoint Health – Riverview and Highpoint Health – Trousdale, told HealthLeaders.
Whether it's strategizing for physician succession planning or alleviating burnout, Stockton's tips for strengthening the workforce can put rural hospitals in better position for long-lasting success.
A new report reveals how digital health companies are attempting to take advantage of market shifts to get ahead of competitors.
Investments in digital health didn’t slow down at the start of the year in the face of volatile market conditions. On the contrary, they picked up pace as companies sought opportunities to "leapfrog" amid uncertainty, according to a report by Rock Health.
The research found that both startups and large players are utilizing various strategies to improve their positioning in the venture capital landscape, resulting in increased funding overall and larger late-stage funding rounds.
Through the first three months of 2025, digital health startups raised $3 billion across 122 deals, compared to $2.7 billion raised across 133 deals over the same period last year and $1.8 billion raised across 118 deals in the fourth quarter of 2024.
The average deal size jumped from $15.5 million in the fourth quarter of last year to $24.4 million in the first quarter, continuing seasonal patterns from previous years of first quarter totals beating fourth quarter numbers, the report stated.
Last year's 'David and Goliath' dynamic remained in the first quarter, with startups contributing to deal volume while large companies fueled deal size.
Dealmaking through the first three months was largely driven by earlier-stage funding. Seed, Series A, and Series B rounds made up 83% of labelled deals in the quarter, just a tick below 2024's 86%.
However, the quarter also featured a boom in late-stage funding rounds. The median Series D+ round size was $105 million, which almost doubled the $55 million across 2024 and marked the first time Rock Health tracked that figure above $100 million since 2021.
Companies of all sizes are pursuing different approaches to leverage market shifts, the report highlighted.
One of those strategies for companies is to add new healthcare features to their offerings through mergers and acquisitions. Of the 46 M&A deals Rock Health tracked in the first quarter, 67% involved digital health startups acquiring other digital health startups, compared to 53% across 2024.
"Tapestry weaving spikes when acquisition targets are cheaper and acquirers have cash on hand," the report's authors wrote.
Another approach companies are turning to is creating modular tech stacks to have more flexibility around their technology, allowing organizations to pivot as solutions like generative AI continue to evolve.
Meanwhile, channel partnerships are providing both smaller digital health startups and larger players a way of reaching consumers. Examples of this in the first quarter included Eli Lilly's LillyDirect adding partners and Amazon's Health Benefits Connector bolstering its network, Rock Health noted.
The final strategy the report called out was large companies engaging with startup competitors that are trying to be disruptors in their space.
"Instead of viewing innovators as outright competitors, these engagements position large enterprises as partners, investors, or future acquirers of potential rivals," the authors wrote.
An alternate resolution couldn't be reached in the back-and-forth saga of the distressed health system.
Following months of tumult, Crozer Health is ultimately set to close with no buyers found for the health system.
U.S. Bankruptcy Court Judge Stacey Jernigan approved Prospect Medical Holdings' move to shutter Crozer-Chester Medical Center and Taylor Hospital in Delaware County, resulting in another collapse of hospitals backed by private equity.
The full closures of the two facilities are expected to be completed within 30 days, leaving many patients in the area without access to necessary care.
Meanwhile, 2,651 Crozer employees will be laid off by May 2, according to the Worker Adjustment and Retraining Notification filing with the Pennsylvania Department of Labor & Industry.
"PMH recognizes the impact this action will have on patients as well as team members," Prospect said in a statement. "We’ve worked tirelessly with the Pennsylvania Attorney General and other parties to do everything possible to prevent this outcome. Unfortunately, we were unable to reach a viable alternative."
In delivering her support for the closure, Jernigan noted that there were no options left and that the parties "can't print money" to fix the problem.
“I lose sleep over this case and I’m sure other people lose sleep a whole lot more than I do," Jernigan said. "I worry about persons having a heart attack and they can’t get to a very close facility. I worry about people getting in a car wreck or getting shot, burned, a mama going into labor. I just hate the widespread consequences here."
Though Penn Medicine had made an offer of $5 million to support Crozer's operations and purchase assets at certain locations, the two sides couldn’t work out terms.
It marked the latest close call on nabbing a buyer for Crozer, which Prospect tried to sell to ChristianaCare in 2022, CHA Partners last year, and an unnamed consortium of nonprofits in February.
After Prospect filed for chapter 11 bankruptcy in January, Crozer was placed into a receivership with FTI Consulting in February, which ended April 18.
When Prospect purchased Crozer for approximately $300 million in 2016, the Los Angeles-based company was owned by private equity firm Leonard Green & Partners.
Prospect then cut services before closing two of Crozer's four hospitals, Delaware County Memorial Hospital and Springfield Hospital, in 2022.
The company made a string of financial decisions, include the sale-leaseback with landlord Medical Properties Trust, "which saddled Crozer with unmanageable lease obligations and even higher levels of debt," a recent report from the Senate Budget Committee found.
Eventually, the siphoning of millions from its hospitals led to Prospect being unable to keep the facilities open.
Lawmaker reaction
Crozer's closure has enraged state Rep. and legislators, who have pointed to the decaying nature of private equity ownership with hospitals.
"Prospect caused this crisis, and they must be held accountable for their reckless actions that have led to today’s announcement," Pennsylvania Governor Josh Shapiro said in a statement. "Their conduct and mismanagement must be fully reviewed in the bankruptcy legal process to hold them to account under the law, and we must ensure this never happens again by passing legislation to get private equity out of the health care business in Pennsylvania, as I proposed in my budget address earlier this year."
The Delaware County Legislative Delegation, made up of Pennsylvania Sen. and Rep., was also critical in its reaction.
"Private equity’s decimation of Crozer is an abomination – the corporate abuse that our hospitals went through should be criminally illegal, and the investors and executives who did this to us should be held accountable," the group said in a statement. "The American healthcare system – by far the most expensive in the world – is fundamentally broken, and Crozer’s saga sadly exemplifies this.
"Our elected officials and financial and corporate regulators in Washington, D.C. and every state capitol must reign in the chaos before there is nowhere left to go for help. As Crozer demonstrates, privatization and for-profit systems are the problem, not the solution. We need bold action for the public interest."
Erik Wexler, the health system's new leader, told employees that steps are being taken to weather financial turmoil.
As it continues its steep climb out of the red to pursue financial sustainability, Providence is taking action to cut costs in several areas.
The Renton, Washington-based hospital operator is implementing a freeze on nonclinical hires, with president and CEO Erik Wexler telling employees in a memo that the organization is working to overcome challenges impacting the bottom line.
Those issues include low reimbursement rates from payers, elevated labor and supply costs, and fallout from last year's CrowdStrike outage and January's Los Angeles wildfires, according to Wexler.
"Over the last three months, the economic headwinds have shifted rapidly, forming a perfect storm that threatens our financial sustainability and, therefore, our ability to carry out our mission," he wrote. "We are being called to respond to the times to ensure the ministry thrives under a new reality of significantly reduced reimbursement and higher costs."
Along with pausing hiring for nonclinical positions, Providence is also restricting nonessential travel, filing lawsuits against insurers over payment delays and claims denials, and seeking out partnerships such as the joint venture with Compassus.
The moves are in addition to steps Providence has already taken to lower expenses, including ending major league sports sponsorships and spinning off its investment arm, Providence Ventures, to include other partners, Wexler highlighted.
Since taking over as CEO in January, Wexler has targeted leadership reorganization as well. Since the end of last year, 46 leadership roles were eliminated, Wexler said, while an Office of Transformation was formed to oversee technology solutions shortly after his appointment.
The changes were meant to build on the progress Providence has made in its effort to reach profitability. The system nearly halved its losses in 2024, finishing the year with an operating loss of $644 million, compared to $1.17 billion in 2023.
However, Wexler warned that 2025 is bringing its own set of roadblocks, like cuts to Medicare and Medicaid that have reduced Providence's funding by $500 million, with another $1 billion expected to be lost through additional potential cuts.
"[We] were making significant progress getting our costs in line with our revenue, and we were on track to finally break even this year," Wexler wrote. "But just as we were nearing that goal, the external economic conditions in 2025 took a sudden turn."
Providence isn't the only major health system that has turned to layoffs and hiring freezes to bring down costs. Mass General Brigham, for example, announced in February that it would conduct the largest layoffs in its history to close an anticipated budget gap of $250 million over the next two years.
While it can be tempting to come in and make changes immediately, seeking input from staff can go a long way for new hospital leaders.
In this episode of HL Shorts, Cole Stockton, CEO of Highpoint Health – Riverview and Highpoint Health – Trousdale, reveals the personal approach he's bringing to the role to address workforce challenges.
