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Without action, the healthcare workforce shortage is set to nearly double by 2040. The Covista Healthcare Workforce Index, based on a model by Oliver Wyman, found that pairing workforce investment with care delivery innovation could close 92% of the gap.
At a glance
The Covista Healthcare Workforce Index (the Index) is based on a model by Oliver Wyman, a leading global management consulting firm with expertise in healthcare and education. The Index draws on more than 60 academic, industry and business data sets and interviews with health system leaders to size the 2040 healthcare workforce gap, testing which interventions actually close it. The model estimates that:
Closing the gap is possible, but only with a full portfolio approach.
The model projects that pairing workforce supply actions (attracting, developing and retaining talent) with care delivery innovation can close 92% of the projected 2040 gap.
The shortage is a hidden cost on American families—and it's getting worse.
The model estimates that unfilled healthcare positions cost the average family about $430 a year today. Left unaddressed, that could climb to $1,250 a year by 2040, with 7% of the annual growth attributable to inflation (both CPI and medical inflation). Rural and underserved communities bear the heaviest toll.
Closing the gap could mean longer, healthier lives.
Solving the nursing shortage alone could save nearly 100,000 lives cumulatively by 2040, according to the model. Closing the physician gap could add more than six months to average life expectancy and cut specialist wait times by 20%.
Macro headwinds could widen the shortage further.
External trends, such as retirement, general career entry rates and fewer international nurses and physicians entering the U.S. workforce, could make the shortage materially larger in 2040. The model suggests that workforce planning should assume a larger, more variable shortage, not a stable one.
Care delivery innovation is a real accelerant, not a replacement for people.
The Index estimates that AI, breakthrough therapeutics like GLP-1s and redesigned care models can meaningfully ease pressure on the demand side of the shortage, but their impact is uncertain.
Investing in people has the potential for immense impact yet is routinely overlooked.
Supply actions—expanding the talent pathway, training more clinicians and keeping the ones we have—is estimated to close over half of the 2040 gap.
Closing the gap requires stakeholders to act together, not in sequence.
Health systems, policymakers and educators each have distinct roles to play—and coordinated, sustained action across all three, and all levers, could help close the gap.
Charting the path to 2040
What is the healthcare workforce gap?
America’s healthcare workforce shortage—the gap between the current number of healthcare workers and the number needed to meet America's needs—is not a future risk—it’s here, it’s large, it’s structural and it may be costing more than most people realize. This isn't just a staffing problem. It's a hidden cost on every American family and a matter of life and health. The stakes are concrete, not hypothetical.
Building on the 2026 Covista Care Capacity Monitor, the Covista Healthcare Workforce Index is part of an ongoing series exploring the healthcare workforce shortage. The research looks to identify innovative solutions and fresh perspective around how stakeholders can work together to address the structural challenges around it.
Closing the 2040 gap requires a portfolio approach
The healthcare workforce shortage is structural and structural problems demand structural solutions. The modeling results make it clear: the power lies in the portfolio. No single strategy solves the workforce shortage on its own—but together, they have the potential to fundamentally change healthcare. Care delivery innovation and supply actions—attracting, developing and retaining a talent pipeline—each chip away at the gap individually and cumulatively. The model projects that closing the gap by 92% could be available when every lever is activated—which is exactly why coordinated investment is the most effective path forward.
This is where portfolio thinking pays off: leadership gets the greatest return by resourcing and executing all approaches concurrently, rather than treating them as a menu to choose from.
The Index's portfolio approach: the projected amount each lever closes by 2040
Source: Analysis for the Covista Healthcare Workforce Index.
Note: None of these levers reduce the number of workers the system needs — they close the gap between how many workers we'll need and how many we'll have. The care delivery innovations are slightly overlapping, so their impact together is slightly less than the total of each lever in aggregate.
Bold supply action scenarios and most likely care deliver innovation scenarios.
The modeling for the Covista Healthcare Workforce Index forecasts that today, unfilled positions drive an estimated $46 billion a year in avoidable costs for the healthcare system—driven by overtime premiums, temporary staffing and patients turning to costly ER visits when they can't get timely primary or specialty care. Left unaddressed, the same model projects that figure to nearly triple to $140 billion annually by 2040 with 7% of the annual growth attributable to inflation (both CPI and medical inflation).
The Index also translates this cost to the family level and it isn’t spread out evenly. For the average family, that's roughly $430 a year, climbing to $1,250 by 2040, according to the model. This is money spent not on better care, but on the inefficiency of not having enough people to deliver it.
Closing the gap can lead to longer and healthier lives
The Covista Healthcare Workforce Index estimates that solving the nursing shortage alone could save nearly 100,000 lives by 2040. Closing the physician gap could add more than six months to average life expectancy. Closing the specialist gap could cut wait times by 20%.
Estimated benefits of addressing shortages by 2040
Source: Analysis for Covista Healthcare Workforce Index.
More nurses could catch problems before they become emergencies.
Stretched across more patients, bedside nurses have less time to catch early warning signs—a subtle change in vitals, a slower recovery—before they escalate. Closing the nursing shortage could lead to more consistent monitoring and faster escalation and fewer preventable hospital deaths.
More physicians could mean conditions get caught and managed earlier.
Better primary care access and preventive medicine mean hypertension or early-stage cancer could get caught at a routine visit versus an ER crisis—driving longer life expectancy. More specialists mean less time for disease to progress while patients wait for a referral. Longer waits in oncology or cardiology could result in a treatable condition to advance untreated.
More behavioral health specialists could mean crises are caught before they escalate.
Long waits for a first appointment aren’t a stable holding pattern—conditions could progress until the eventual point of contact becomes a crisis rather than routine care. Closing the behavioral health gap could lead to faster access to a first appointment and more consistent follow-up, which could keep conditions managed.
More allied health professionals could mean the diagnostic chain doesn't break.
A cancer diagnosis, fracture treatment or stroke workup is only as fast as the radiology tech or lab available to complete it, regardless of how quickly the ordering clinician acted. Closing the allied health gap could mean that the imaging, lab work and other diagnostic steps that a diagnosis depends on keeps pace, rather than becoming the bottleneck.
Macro headwinds could widen the shortage further
External trends could make the shortage materially larger in 2040. This includes continued burnout pushing clinicians to early retirement, fewer international nurses and physicians entering the U.S. due to immigration restrictions and broader demographic trends that impact higher education like the slowing birth rate, changing opinions about higher education and fewer people entering college. The Covista Healthcare Workforce Index estimates the magnitude of impact on the shortage based on retirement trends and general career entry rates for a range of scenarios. Workforce planning should assume a larger, more variable shortage, not a stable one.
Care delivery innovation helps but isn’t the whole answer
Care delivery innovations—AI, breakthrough therapeutics and care model redesign—are widely (and understandably) touted as solutions that help alleviate the workforce shortage. Nonetheless, the Covista Healthcare Workforce Index projects that the potential impact of care delivery innovation interventions is uncertain.
That vision may be too optimistic, as adoption so far has been slow: tight budgets limit investment, and fragmented single purpose solutions overwhelm already-stretched IT teams. Structural barriers, from nurse-patient ratio limits to trust concerns, could further cap AI's impact. Even when health systems clear these hurdles, AI only delivers value in the hands of clinicians trained to use it well—to trust it appropriately, question its outputs and know when to override it.
Humanity is still central to healthcare. AI may be able to draft a discharge summary, flag a drug interaction or triage a patient to the optimal care setting based upon symptoms, but it currently can't build the trust that gets a hesitant patient to follow through on a treatment plan or make the judgment call in a complex case that falls outside its training data. A diagnostic algorithm can flag a concerning scan, but it takes a person to sit across from a patient, deliver that news and help them decide what comes next.
Breakthrough therapeutics can help prevent the complications and chronic management that consume clinical capacity. GLP-1s and CAR-T cell therapy have resulted in major innovations in how care is delivered and the health of patients; they could shrink the gap by a further 21%—an estimate driven primarily by GLP-1s, given their scale of adoption.
The opportunity for care model redesign can bolster access to primary care, letting clinicians practice to the full extent of their licenses and expanding care outside of the hospital. Enacting care model redesign by routing patients to the optimal setting and practitioner can cut another 13%. Much of that opportunity starts at the front door of the system: strengthening primary care so more conditions are prevented or managed before they require an ED visit or specialist referral at all, not just redirecting patients after the fact.
Source: Analysis for the Covista Healthcare Workforce Index
Supply actions have the potential for immense impact yet are routinely overlooked
If there's no silver bullet, the data still points somewhere specific and it's the lever most health systems have underinvested in for years. Investing in people, what the Covista Healthcare Workforce Index identifies as "supply actions", is estimated to be among the most reliable ways to address the shortage, and among the most overlooked by health systems. Supply actions can potentially close 57% of the 2040 gap.
The Index’s supply action detail of the 2040 healthcare workforce gap and projected amount closed by lever
Source: Analysis for the Covista Healthcare Workforce Index.
Note: None of these levers reduce the number of workers the system needs — they close the gap between how many workers we'll need and how many we'll have.
Bold supply action scenarios and most likely care delivery innovation scenarios.
Expanding the nursing and healthcare talent pipeline
Attracting new talent could lead to reaching people the system doesn't reach today. The traditional healthcare workforce pipeline—recent high school graduates moving straight into a four-year, full-time program—was never built to reach everyone capable of doing this work. Non-traditional students, such as adult learners and career changers, are an untapped solution to the healthcare shortage. Attracting more prospective clinicians to the talent pool could close up to 7% of the 2040 gap. Opening doors for them would benefit from expanding access to healthcare education through hybrid, flexible learning models and support for tuition and financial challenges, especially in rural and underserved communities where needs are greatest, but fewer education and training opportunities exist.
A wider talent pool only helps if the system can train it, and today it often can't. Nursing schools in the U.S. turned away roughly 93,000 qualified applications in 2025. Medical schools and allied health schools also face bottlenecks to expanding the supply of healthcare workforce. For many people living in rural and underserved areas, educators and clinical rotation sites can be an hour's drive away. Solving for this could include expanding faculty and clinical placements, adding nursing, APP, and residency seats and accelerating pathways into practice. Support programs such as emergency financial assistance or AI learning support tools can help students stay on track toward graduation. All of these can help turn new entrants into practicing clinicians.
Partnering with nursing schools and health systems
Partnerships between health systems and educators may be an effective way to attract new talent to address shortages, especially those that pair employer funded education with guaranteed employment. Solving for a structural challenge works best when stakeholders share the investment, not just the goal.
A wider talent pool only helps if the system can train it, and today it often can't. Nursing schools in the U.S. turned away roughly 93,000 qualified applications in 2025. Medical schools and allied health schools also face bottlenecks to expanding the supply of healthcare workforce. For many people living in rural and underserved areas, educators and clinical rotation sites can be an hour's drive away. Solving for this could include expanding faculty and clinical placements, adding nursing, APP, and residency seats and accelerating pathways into practice. Support programs such as emergency financial assistance or AI learning support tools can help students stay on track toward graduation. All of these can help turn new entrants into practicing clinicians.
This also means investing in the workforce already here—upskilling current staff into higher-acuity roles and expanded scopes of practice. Developing talent could close 25% of the 2040 gap.
Improving retention must go hand-in-hand with expanding the talent pipeline. Retaining existing clinicians could close another ~25% of the gap. That means reducing burnout, improving wellbeing and safety, strengthening incentives and creating pathways for licensed clinicians to re-enter practice and for early-career clinicians to stay through apprenticeships and externships. It also means preparing today's workforce to lead and collaborate on adopting new tools and care models, maximizing their impact and fulfillment, not just their output.
Stakeholder implications: from findings to collective action
The healthcare workforce shortage took decades to build
The healthcare workforce shortage took decades to build. It will not close through a single fix, in a single budget cycle or by any one stakeholder acting alone. But the Index projects that it can close. The modeling estimates that multiple levers, moving together—and only if all are pursued at once—can close 92% of the projected gap. According to the model, acting now through a portfolio approach could significantly reduce the projected shortage while delaying action could allow the gap to continue to grow.
What makes this moment different from prior efforts is the opportunity to act on a portfolio deliberately. Health systems, policymakers and educators can act together and stay the course long enough for investments today to become the workforce of 2040.
“The opportunity in front of healthcare right now is real—AI, new therapeutics and smarter care models can ease pressure on this shortage in ways we couldn't have delivered a decade ago. But every one of those tools depends on having enough clinicians to put them to work.”
For speaking inquiries, contact thoughtleadership@covista.com.