Healthcare compensation growth is moderating, but hospitals and health systems continue to face significant staffing pressures across nursing, specialized clinical roles, and local labor markets. SullivanCotter’s 2026 Health Care Staff Compensation Survey, covering nearly 2,600 organizations and 2.6 million clinical and non-clinical employees, found that median national base pay increased 3.1% from 2025 to 2026, down from 4.3% the previous year. The findings highlight how healthcare employers are shifting toward targeted pay adjustments, localized compensation benchmarks, and more strategic workforce planning.

Healthcare Employers Shift Toward Targeted Pay Strategies

Healthcare organizations are entering a more measured phase of compensation management, according to new workforce benchmarks from SullivanCotter. Although national salary growth has slowed, regional disparities, competition for specialized talent, and persistent recruitment challenges continue to complicate workforce planning for hospitals and health systems.

The consulting firm’s 2026 Health Care Staff Compensation Survey draws on data from nearly 2,600 organizations representing 2.6 million employees. The findings indicate that employers are moving away from broad-based pay increases toward more selective investments in positions and markets where recruitment and retention pressures remain high.

Median national base pay increased 3.1% between 2025 and 2026, compared with 4.3% a year earlier. The median salary increase budget remained at 3.0% for the third consecutive year, and participating organizations are projecting the same increase for 2027. Average salary structure adjustments, meanwhile, reached 2.7% in 2026, up from 1.6% in 2025.

For HR leaders, these trends suggest that compensation planning increasingly requires more granular workforce data rather than a uniform response across departments.

Regional Pay Differences Complicate Workforce Planning

National averages obscure substantial differences between healthcare labor markets. SullivanCotter found that median base pay increases for healthcare staff ranged from 1.9% in the Northeast to 5.3% in the West.

Registered nurses experienced particularly pronounced movement. RN pay increased by 7.4% in the West, while increases exceeded 4% in the North Central, South Central, and Southeast regions.

Differences also appear in absolute compensation levels. Median RN base pay in Los Angeles was approximately 46% above the national median, compared with 35% above the median in New York City and 28% in Boston. Across all staff positions, New York City and Los Angeles were 28% and 26% above the national median, respectively.

These figures underline the limitations of national salary benchmarks when employers compete for talent in expensive metropolitan areas. Hospitals operating across multiple regions may need localized compensation structures to balance affordability with their ability to recruit and retain qualified staff.

For workforce analytics teams, combining job-level compensation benchmarks with vacancy rates, turnover data, and recruitment timelines can help identify where pay adjustments are most likely to address operational problems.

Specialized Roles Continue to Face Pay Pressure

Although most positions experienced comparatively modest increases, the survey found substantial variation at the individual-job level. Among positions with positive changes in median hourly base pay, 69% recorded increases of 1% to 5%, while 27% saw increases between 5% and 15%. Another 4% experienced increases of 15% or more.

Positions with some of the largest movements included food service workers, licensed practical nurses in ambulatory care, specialty registered nurses, ECMO technicians, sleep technologists, and research pharmacists.

These roles compete within different labor markets, and some face recruitment pressure from employers outside healthcare. That creates challenges for compensation teams trying to maintain internal pay equity while responding to external competition.

SullivanCotter recommends using job-level market data to identify when targeted salary structure changes or off-cycle increases may be warranted. Such adjustments can be more precise than raising compensation across an entire workforce, although their effectiveness depends on local labor conditions and the reasons employees leave or decline offers.

Higher Minimum Wages Raise Pay-Structure Questions

Competition for entry-level workers has also changed healthcare employers’ minimum pay rates. In 2022, 16% of surveyed organizations reported minimum rates above $15 per hour. By 2026, that share had reached 69%.

Over the same period, the proportion paying exactly $15 per hour fell from 54% to 23%, while only 8% reported minimum rates below that threshold.

Higher starting rates can help employers compete for entry-level talent, but they can also create wage compression when experienced employees earn only marginally more than new hires. HR teams may consequently need to reassess pay bands, job classifications, and progression rules to preserve internal equity.

The findings reinforce the importance of treating minimum pay decisions as part of a broader compensation architecture rather than isolated recruitment measures.

Premium Pay Becomes a More Targeted Staffing Tool

Hospitals are also using shift differentials to attract employees to difficult-to-fill schedules. SullivanCotter reported a median flat-dollar differential of $7 per hour for staff RNs working weekend nights, compared with $3.25 across all jobs. Weekend evening differentials were $5.50 for RNs and $2.75 across all jobs.

Across surveyed organizations, 53% use flat-dollar shift differentials. Others apply percentage-based premiums, flat hourly rates, or a combination of methods.

These incentives can help address specific coverage gaps, but employers must evaluate their financial sustainability and consistency. Premium structures that are poorly aligned with actual staffing needs can increase labor costs without necessarily improving retention or coverage.

HR Technology and Workforce Planning in 2027

The survey points toward a more data-driven approach to healthcare workforce management. Compensation benchmarks can inform decisions, but employers also need reliable information about employee skills, career progression, engagement, vacancies, and retention.

HR technology platforms, workforce analytics, and compensation management software can help consolidate these inputs and support scenario planning. However, technology alone cannot resolve shortages or burnout. Its value depends on data quality, implementation, and whether leaders translate analysis into effective staffing and employee-development strategies.

As healthcare employers prepare for 2027, the challenge will be to connect pay decisions with career development, skills acquisition, benefits, and the overall employee value proposition. SullivanCotter’s findings suggest that the next phase of compensation management will depend less on blanket increases and more on identifying where targeted investment can make a measurable difference.

Market Landscape

Healthcare workforce management is shifting toward more localized and role-specific compensation strategies. Slower national pay growth does not eliminate competition for nurses, specialized clinical professionals, or entry-level workers. Instead, differences in geography, occupation, and shift requirements make workforce planning more complex.

HR technology, compensation analytics, and workforce management platforms can help employers identify pay disparities, model labor costs, and connect compensation decisions with recruitment and retention data. For healthcare organizations, the priority is balancing financial sustainability with competitive pay, internal equity, employee development, and reliable staffing.

Top Insights

• Median healthcare staff base pay rose 3.1% in 2026, down from 4.3% in 2025, according to SullivanCotter.
• Regional differences remain substantial, with healthcare staff pay increases ranging from 1.9% in the Northeast to 5.3% in the West.
• The share of surveyed organizations paying minimum rates above $15 per hour rose from 16% in 2022 to 69% in 2026.
• Weekend-night RN shift differentials reached a median $7 per hour, highlighting the continued use of targeted staffing incentives.
• Healthcare HR teams are increasingly challenged to connect compensation benchmarks with workforce analytics, career development, retention, and labor-cost planning.

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