HealthWorkforce IQ/Hospitals & Facilities
For hospitals & health systems

Stop labor budget drift before it hits the P&L

Prevent out-of-band rates and compounding variance with pre-approval guardrails across internal OT, travelers, and agency submissions—without slowing care delivery.

When busy weeks hit, “exceptions” become the new normal—rates lock in before finance ever sees the drift.

Without exposure control
  • Out-of-band agency submissions slip through in approval rushes.
  • Overtime becomes structural before anyone sees the crossover.
  • Traveler extensions lock in rate drift with no reference point.
With guardrails + benchmarks
  • Every rate checked pre-approval against bands + market references.
  • Exceptions escalate with quantified variance, context, and policy rationale.
  • Leaders see exposure forming by unit/role—before budgets break.
Labor exposure control — real-time signalsLive
Decision moment
Rate approval: in-band flows; out-of-band escalates with variance + market context attached.
Internal vs agency rate bands
82% in band
Submissions checked pre-approval
Overtime exposure
$412k
Projected next 30 days
Threshold breach alerts
7
Rate band + OT risk
Threshold breaches — last 7 days
UnitRoleSubmittedApproved bandStatus
ICURN · Night$88.00$68–$76Out of band
EDRN · Day$84.50$70–$78Out of band
Med/SurgCNA · Night$41.00$32–$37Out of band
ORTech · Day$63.00$54–$60Escalated
Threshold breach detected
OR Tech · Day exceeds approved band by $3.00. Escalate with policy context and market reference attached.
Who this is for
Hospitals are consensus buyers. Align the room on the same labor exposure view.
CFO / VP Finance
Volatility + variance control
VP Operations
Continuity of care + throughput
Workforce Strategy / HR Analytics
Policy, benchmarks, guardrails
Nursing Leadership
Staffing decisions without disruption
Tier 1 — Primary exposure control

The “stop the bleeding” controls: guardrails before rates are approved.

These are the decision points that create labor cost volatility. Make them measurable, governed, and exception-driven—without adding friction.

Primary exposure control
Primary

Agency cost exposure control

Risk
  • Agency submissions normalize out-of-band pricing.
  • Finance sees drift only after it hits budgets.
Guardrail
  • Benchmarks agency submissions against live market references.
  • Flags out-of-band submissions pre-approval with quantified variance.
Outcome
  • Reduced premium leakage.
  • Faster approvals with guardrails in place.
Rate distribution — ICU RN
$64$72$80$88
Out of band: +$12/hr
Flagged before approval.
Primary exposure control
Primary

Contract labor rate guardrails

Risk
  • Traveler usage spikes under pressure.
  • Extensions lock rates without a consistent reference.
Guardrail
  • Tracks contract rate bands by role, unit, and region.
  • Applies policy guardrails + escalation thresholds before approvals.
Outcome
  • Predictable traveler spend.
  • Fewer emergency approvals and rate surprises.
Contract banding — OR Tech
In band70%
Near threshold18%
Out of band12%
Primary exposure control
Primary

Internal labor drift prevention

Risk
  • Overtime becomes structural and compounding.
  • No visibility into when OT exceeds market alternatives.
Guardrail
  • Compares overtime cost vs market contract rates by role/unit/shift.
  • Surfaces crossover points where OT becomes inefficient.
Outcome
  • Targeted intervention without blanket OT bans.
  • Earlier control of compounding leakage.
OT vs market — ED RN
Overtime rate
$108
Above crossover
Market contract
$86
Comparable shift
The workflow stays familiar

No new tools. No retraining. Decisions stay where they already happen.

Routine approvals keep moving. Only true exceptions escalate—already packaged with market context, policy guardrails, and an audit-ready rationale.

1
Step
Rate submitted
Internal OT, traveler, or agency rate enters the workflow.
2
Step
Benchmarked automatically
Compared against live market references for role/unit/shift.
3
Step
Guardrail checked
Policy thresholds and rate bands applied in-line.
4
Step
Approved or escalated
In-range flows; out-of-band escalates with variance + context.
5
Step
Decision logged
Traceable rationale captured automatically for governance and reporting.
Tier 2 — Intelligence & forecasting

See variance pressure early—so decisions happen before budgets break.

These signals support better decisions. They don’t replace your workflow—they make it proactive.

Budget variance prevention (forecasting)

Problem
  • Budgets break mid-quarter.
  • Forecasts rely on lagging views of commitments.
What the platform does
  • Models future exposure from current commitments + trend signals.
  • Flags variance risk before it hits the P&L.
Outcome
  • Fewer surprises.
  • More defensible forecasts to leadership.
Forecast — exposure early signals
Early signal from commitments + market pressure—before rates are locked.

Regional market pressure early signals

Problem
  • Local demand spikes cause rate shocks.
  • Teams react after the damage is done.
What the platform does
  • Surfaces regional demand/supply pressure and early warnings.
  • See pressure before rates spike — not after budgets break.
Outcome
  • Proactive staffing strategies.
  • Better negotiation posture and leverage.
Early signals — last 14 days
Metro A
High
Metro B
Moderate
Metro C
Rising
Financial anchor
Hospitals use this to prevent 2–5% labor budget drift by spotting exposure weeks earlier—before rates are locked.

"We used to find labor cost exposure after the fact—overtime climbing, traveler extensions creeping up, and agency submissions normalizing out-of-band pricing. Now we see drift as it forms. Routine approvals stay fast, but exceptions arrive with variance, market context, and a decision trail. That’s prevention and governance without disrupting care delivery."

VP
VP of Workforce Operations
Regional Health System, 8 facilities
Tier 3 — Executive oversight & governance overlay

Guardrails, traceability, and executive confidence—without micromanagement.

This is an operating layer, not another toolset: leadership gets drivers, variance, and decision traceability across finance, operations, and nursing.

Executive oversight & variance drivers

Overlay
Protect
  • Variance drivers by unit/role/source.
  • Out-of-band approvals and trends.
  • Exposure visibility before budgets break.
Trace
  • Exceptions include rationale + context.
  • Approvals linked to guardrails.
  • Audit-ready decision history.
Outcome
  • Governance without slowing the floor.
  • Cleaner audit + board reporting.
  • Stronger confidence in approvals.
Guardrails
Policy thresholds, rate bands, and escalation rules protect approvals pre-commitment.
Decision traceability
Exceptions capture variance, context, and rationale—no reconstruction later.
Role-based visibility
Finance, operations, and nursing see the right view with controlled access.
Operational reliability
Fast checks in-line so approvals keep moving and care delivery stays uninterrupted.
Powered by the platform

A proven system—applied to hospital labor governance.

Hospitals aren’t buying a custom solution. They’re buying an operating layer that connects data ingestion, benchmarking, guardrails, modeling, and decision views.

Layer
Data ingestion
Bring internal rates, contracts, and submissions into one consistent model.
Layer
Benchmarking
Live references by role/unit/shift/region for internal + external labor.
Layer
Guardrails
Policy thresholds, rate bands, and escalation rules applied pre-approval.
Layer
Modeling
Forecast exposure and variance risk from current commitments and trends.
Layer
Decision views
Dashboards with drill-down + audit trail for executive oversight.
For hospitals & health systems

See how hospitals control labor exposure—without slowing approvals.

30 minutes. We’ll walk through your labor exposure flows (internal OT, travelers, and agency submissions) and show how benchmarking + guardrails prevent variance before it hits the P&L.

What you'll receive:
  • · Finance & workforce walkthrough mapped to your labor cost drivers
  • · Example guardrails: rate bands, thresholds, escalation routes
  • · OT vs market crossover view for targeted leakage reduction
  • · Executive oversight view with audit-ready decision logs

Designed for hospitals and health systems managing internal labor, travelers, and agency relationships—where better visibility reduces volatility without disrupting care delivery.

Request a finance & workforce walkthrough

Submit your information. We’ll respond within 24 hours to schedule a walkthrough focused on labor exposure control, variance prevention, and executive traceability.

Every request reviewed manually. Response within 24 hours with scheduling options.