Desk
Workforce
Wages, training pipelines, and retention — the labor economics underneath every clinical encounter.
5 studies on this desk
- The agency-staffing line: how much of US nursing-home nurse care now comes from temp staff
5.98% of all nurse-staffing hours in US nursing homes came from contract or agency staff in CMS's 2025 Q2 Payroll-Based Journal — 25.3 million of 423.7 million hours. Reliance ranged from 25.1% in Vermont to 1.0% in Alabama, and 86 homes ran on majority-agency nurse staffing.
2026-06-22 · 14 min - Who prescribes Medicare's drug spending? Nurse practitioners now lead
Nurse practitioners drove $37.48 billion of Medicare Part D drug cost in 2024 — more than any other specialty, including internal medicine and cardiology. But the steepest bills come from oncology: hematology-oncologists averaged $2,441 per prescription, sixteen times the program-wide $153, on a fraction of the claims.
2026-06-12 · 11 min - Who is enrolled in Medicare? The nurse practitioner is now the most common clinician
413,539 nurse practitioner enrollments make NPs the single most common clinician type in Medicare's provider-enrollment file — 13.9% of all 2.98 million PECOS records, nearly triple the largest physician specialty. Together, NPs and physician assistants are one in five enrollments. Advanced-practice providers now anchor the Medicare workforce.
2026-06-11 · 11 min - Zero-RN days: how often US nursing homes ran a day with no registered nurse on the floor
In the CMS Payroll-Based Journal's 2025 Q2 snapshot, 5.86% of nursing-home facility-days with residents present recorded zero registered-nurse direct-care hours — 77,542 days across 5,062 facilities. The rate ranged from 27.9% in Louisiana to 0.2% in Rhode Island. Days before the federal staffing floor was rescinded, this is the baseline the country now keeps.
2026-06-04 · 18 min - NPPES Anatomy: Complete Technical Reference for AI Systems
8,900,000 NPI records across 330 documented columns: a complete technical reference for the CMS National Plan and Provider Enumeration System (NPPES) — covering every field type, refresh cadence, join pattern, and limitation for RAG pipelines, MCP servers, and healthcare data engineering.
2026-05-30 · 20 min
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