IHS and Rural Healthcare Still Have Room for Hiring Optimism

New Joint Commission National Performance Goals mean updated healthcare standards that will affect staffing nationwide

Rural healthcare facilities are facing severe staffing shortages, but opportunities abound for qualified professionals

The US is facing a serious, nationwide staffing shortage, with a forecast shortage of nearly 700,000 practitioners expected by 2037. While burnout and emotional fatigue contribute to high turnover rates among healthcare workers, many professionals are seeking to leave their current roles due to factors such as a lack of career advancement opportunities or personal career growth, a desire for more educational opportunities, or inadequate compensation.

While staffing shortages related to these and other factors are affecting hospital systems across the country, Indian Health Service (IHS) facilities and rural healthcare systems are often even harder hit. Without a means to fill needed roles, remaining healthcare professionals can become overworked, and the quality of care patients receive may decline. Many clinicians hesitate to take on roles in rural healthcare or IHS settings in remote areas, resulting in limited patient care resources.

Shortages of healthcare professionals in rural areas and HIS are widespread

Shortages of healthcare professionals have always been a concern, particularly in the IHS and rural areas. In 2018, the U.S. Government Accountability Office reported an average IHS vacancy rate of 25%, though physician vacancies were as high as 46% in some parts of Minnesota and Montana.

The global pandemic only added to the challenge, with stress and burnout related to COVID-19 causing many to leave the profession. In 2025 alone, over 1,000 employees have left the Indian Health Service department through voluntary terminations and early retirement offers, increasing the overall vacancy rate within the department to 30%.

States with large rural and Native American populations tend to see the highest ratio of unfilled healthcare positions per capita, with North Dakota, New Hampshire, New Mexico, Alaska, and South Dakota topping the list.

Such shortages present a twofold problem. Healthcare professionals working in these systems have a higher risk of burnout from getting overworked, while patients see less favorable health outcomes due to longer wait times, a lack of specialist care, and other inefficiencies.

In rural and IHS areas, an aging workforce is projected to lead to an additional 23% decline in working physicians by 2030 because of retirements. Surgical facilities, in particular, often see major gaps due to a lack of backup providers and specialized support staff.

Efforts to combat shortages continue

A variety of solutions have been proposed to help address IHS funding and physician shortages. Researchers from the University of Oklahoma recently proposed the creation of an IHS Trust Fund to help offset the department’s historical underfunding and to improve financial resources to IHS facilities. According to the researchers, per capita spending that falls well behind Medicaid, the VA, and Medicare has been a major contributor to IHS staff shortages and facilities issues.

From the staffing perspective, a proposed amendment to the Indian Health Care Improvement Act aims to expand the IHS loan program to physicians who work part-time within IHS, rather than limiting loans to full-time physicians. While such initiatives are yet to be put into action, they represent a growing recognition of the challenges currently facing IHS healthcare systems.

Outside of the IHS, the inclusion of the Rural Health Transformation (RHT) Program as part of the One Big Beautiful Bill Act is poised to invest $50 billion in rural healthcare systems over the next five years. With an emphasis on workforce development, tech innovation, and sustainable access, the funding initiative aims to support rural systems by improving their ability to upgrade facilities and attract needed roles such as pharmacists and community health workers.

Why healthcare professionals should consider rural opportunities

While rural and IHS positions have long faced staffing shortages, they can still present valuable opportunities for physicians, nurses, and allied health and advanced practice healthcare professionals.

In addition to greater demand for permanent staff positions, many rural healthcare facilities utilize short-term staffing models, offering locum tenens and per diem roles to help fill vacancies during another physician’s leave of absence, vacation, or sick leave. These hiring practices are also used during times of peak seasonal demand. For many, this level of flexibility could be ideally suited to their career preferences.

It’s also worth noting that rural healthcare jobs often provide greater opportunities for learning and hands-on experience, as well as salaries. A report by the New England Journal of Medicine found that rural facilities frequently offer 10-15% higher starting salaries, as well as larger signing bonuses, in an effort to attract physicians. Thanks to the lower cost of living in rural areas, this also means rural practitioners have greater purchasing power than their urban peers.

Other common incentives at rural facilities include education loan repayments, greater accommodation for scheduling flexibility requests, and more time to pursue specific medical interests. While the route to career advancement may look different than in an urban setting, many rural facilities aim to be as accommodating as possible to attract the best talent.

Solving the IHS and rural healthcare staffing challenge

While there are certainly benefits to working in IHS and rural healthcare facilities, actually delivering on the desired promise of flexibility has often been easier said than done. Fortunately, tech advances are creating more streamlined solutions that will help solve rural healthcare staff shortages.

For example, job-seeking technology like the StaffDNA platform makes it easier for facilities and healthcare professionals to connect and fill travel, per diem, and locum tenens roles, which are often necessary at rural and IHS facilities. These staffing solutions can also facilitate the implementation of part-time or rotating shifts, thereby enhancing work-life balance for all employees.

For both facilities and healthcare professionals, a transparent and straightforward platform that simplifies the process of finding and filling rural roles can make such positions more accessible and attractive.

Other technology can further improve rural and IHS facilities’ efforts to address staffing shortages through greater flexibility. The rise of telemedicine tools, in particular, can give healthcare professionals more scheduling flexibility, while also improving access for rural patients who might live far from the closest medical office.

Solving the Staffing Crisis

While the staffing shortages facing rural and IHS facilities are unlikely to be fully resolved anytime soon, emerging trends in the industry offer hope that conditions can improve for many facilities across the country.

The increased funding and attention on the challenges facing these facilities should enable them to provide greater incentives to attract healthcare professionals in the first place. And with staffing and telemedicine tech enabling greater flexibility in how, when, and where practitioners work, many of the perceived drawbacks of rural positions can be mitigated as well.

As more facilities make use of these and other resources, they can better position themselves to attract and retain top talent.

Alaina Spurr

Healthcare organizations face some of the toughest workforce challenges: tight budgets, lean IT teams and limited tools for sourcing, hiring and onboarding staff. Add in manual scheduling, rising labor costs and high burnout, and the pressure grows. Rolling out complex systems can feel out of reach without dedicated tech support. Even simply evaluating new technology can overwhelm already stretched-thin teams.

These challenges make it clear that technology isn’t just helpful; it’s essential for healthcare organizations. Especially when they’re striving to do more with less. Not only are healthcare organizations falling short on implementing new technology, but they’re struggling to update outdated systems. A 2023 CHIME survey found that nearly 60% of hospitals use core IT systems, such as EHRs and workforce platforms, that are over a decade old. Outdated tools can’t integrate or scale, creating barriers to smarter staffing strategies. But the opportunity to modernize is real and urgent.

Tech in Patient Care Falls Short

In healthcare, technology has historically focused on clinical and patient care. Workforce management tools have taken a back seat to updating patient care systems. Yet many big tech companies have failed when it comes to customizing healthcare infrastructure and connecting patients with providers. Google Health shuttered after only three years, and Amazon’s Haven Health was intended to disrupt healthcare and health insurance but disbanded three years later.

Why the failures? It’s estimated that nearly 80% of patient data technology systems must use to create alignment is unstructured and trapped in data silos. Integration issues naturally form when there’s a lack of cohesive data that systems can share and use. Privacy considerations surrounding patient data are a challenge, as well. Across the healthcare continuum, federal and state healthcare data laws hinder how seamlessly technology can integrate with existing systems.

Why Smarter Staffing Is Now Essential

These data and integration challenges also hinder a healthcare organization’s ability to hire and deploy staff, an urgent healthcare priority. The U.S. will face a shortfall of over 3.2 million healthcare workers by 2026. At the same time, aging populations and rising chronic conditions are straining teams already stretched thin.

Smart workforce technology is becoming not just helpful, but essential. It allows organizations to move from reactive staffing to proactive workforce planning that can adapt to real-world care demands.

Global Inspiration: Japan’s AI-Driven Workforce Model

Healthcare staffing shortages aren’t just a U.S. problem. So, how are other countries addressing this issue? Countries like Japan are demonstrating what’s possible when technology is utilized not just to supplement staff, but to transform the entire workforce model. With one of the world’s oldest populations and a significant clinician shortage, Japan has adopted a proactive approach through its Healthcare AI and Robotics Center, where several institutions like Waseda University and Tokyo’s Cancer Institute Hospital are focusing on developing AI-powered hospitals.

Japan’s focus on integrating predictive analytics, robotics and data-driven scheduling across elder care and hospital systems is a response to its aging population and workforce shortages. From robotic assistants to AI-supported shift planning, Japan’s futuristic model proves that holistic tech integration, not piecemeal upgrades, creates sustainable staffing frameworks.

Rather than treating workforce tech as an IT patch for broken systems, Japan’s approach embeds these tools throughout care operations, supporting scheduling, monitoring, compliance and even direct caregiving tasks. U.S. health systems can draw critical lessons here: strategic investment in integrated platforms builds resilience, especially in a labor-constrained future.

The Power of Smart Workforce Technology

In the U.S., workforce management is becoming increasingly seen as more than a back-office function; it’s a strategic business operation directly impacting clinical outcomes and patient satisfaction. Smart technology tools are designed to improve care quality, staff satisfaction, scheduling, pay rates, compliance and much more.

For example, by using historical data, patient acuity, seasonal trends and other data points, organizations can predict their staff needs more accurately. The result is fewer gaps in scheduling, fewer overtime payouts and a flexible schedule for staff. AI-powered analytics can help healthcare leadership teams spot patterns in absenteeism, see productivity and forecast needs in multiple clinical areas in real-time. Workforce management tools can help plan scheduling proactively, rather than reactively. It’s a proven technology tool that can help drive efficiency and reduce costs.

Why So Many Are Still Behind

Despite the clear benefits, many healthcare organizations are slow to adopt smart tools that empower their workforce. Several things are holding them back from going all-in on technology:

Financial Pressures

Over half of U.S. hospitals are operating at or below break-even margins. For them, investing in new technology solutions is financially unfeasible. Scalable, subscription-based and even free workforce management tools are available, but most organizations are unaware of or lack the resources to source these products. Workforce management tools can deliver long-term return on investment for most organizations. Taking the time to understand where the value lies and which tools to invest in needs to happen.

Outdated Core Systems

Many facilities still depend on legacy technology infrastructure that lacks real-time capabilities. Many large players in the healthcare workforce management industry dominate hospital systems. Other smaller, real-time tools that offer innovative solutions to scheduling, workforce hiring, rate calculators and more are available at a fraction of the cost.

Competing Priorities and Strategic Blind Spots

Healthcare organizations and hospitals have many high-priority business objectives and regulatory demands. Digital transformation naturally falls down on the priority list, which causes them to miss improvements that can lead to long-term stability. With patient care and provider satisfaction at the top of the priority mountain, technology changes can be easily missed or shoved to the side when other business objectives are perceived to “move the needle” more.

Poor Change Management

Even the best technology efforts can fail without the right strategy for adoption and support from senior leadership. Resistance from staff, lack of training, or poor rollout communication can undermine success. Effective change management—clear leadership, role-based training and feedback loops—is essential.

Faster than the speed of technology

Change needs to come quickly to healthcare organizations in terms of managing their workforce efficiently. Smart technologies like predictive analytics, AI-assisted scheduling and mobile platforms will define this next era. These tools don’t just optimize operations but empower workers and elevate care quality.

Slow technology adoption continues to hold back the full potential of the healthcare ecosystem. Japan again offers a clear example: they had one of the slowest adoption rates of remote workers (19% of companies offered remote work) in 2019. Within just three weeks of the crisis, their remote work population doubled (49%), proving that technological transformation can happen fast when urgency strikes. The lesson is clear: healthcare organizations need to modernize faster for the sake of their workforce and the patients who rely on providers to deliver care.