The 2026 Science of Staying: Why Stabilized Turnover Does Not Equal Recovery

After years of historic disruption, many health systems leaders are cautiously optimistic at the slowing of voluntary turnover and fewer spikes in exit rates. The acute phase of the workforce crisis appears to have passed, but stabilization in turnover is not resulting in the productivity, care quality, and access improvements many health systems had hoped to see. 

Turnover serves as a lagging indicator. When it declines, it signals that fewer clinicians are leaving organizations, but it does not signal that the underlying workforce strain has been resolved. Demand for services exceeds available capacity in many markets. Access gaps persist, particularly in high-acuity and specialty care. Productivity targets are rising yet staffing models remain fragile. In this environment, workforce stability is necessary, but insufficient, for proper recovery. 

New national data from SullivanCotter and Lotis Blue’s Science of Staying study, drawing on more than 1,000 patient-facing clinicians across 300 organizations, reveals a more complex reality. While 80% of clinicians report intending to stay in their current roles, 11% are considering leaving within 12 months. 9% had quit a health care job in the past year, down sharply from a 19% quit rate in the prior study. 

At first glance, those numbers suggest progress, yet nearly six in ten recent departures were driven primarily by job-related factors. While fewer clinicians are leaving, a greater proportion of exits are avoidable for health care employers. 

Therefore, retention should not be viewed simply as a human resource metric. It is a core operating lever. In a constrained labor market, every avoidable exit compounds staffing pressure, increases reliance on contingent labor, disrupts care continuity, and erodes margin. For those who remain, the day-to-day experience of work, the ability to envision a sustainable future with the organization, and confidence in long-term career viability take on greater weight. 

When turnover plateaus without corresponding improvements in productivity, engagement, or clinical throughput, it suggests that the system has reached equilibrium at a lower level of performance. For leaders planning for 2026, the question is not whether turnover has slowed but whether the workforce is structurally positioned to perform. 

The Employee Value Proposition: What Actually Moves Retention

The research examines 38 elements of the Employee Value Proposition (EVP), organized into eight dimensions, and applies predictive analytics to identify which factors most strongly influence decisions to stay, consider leaving, or quit. The findings reinforce a consistent pattern that not all retention levers carry equal weight. 

Factors related to the organization, care environment, and career exert disproportionate influence on decisions to stay or quit. Compensation and benefits remain essential, but primarily as threshold conditions. Once expectations of fairness and security are met, focus shifts elsewhere.  

Many organizations continue to deploy broad engagement initiatives or across-the-board incentives without isolating which job-related variables are actually impacting retention. The data suggest that dissatisfaction with foundational elements (i.e., job stability, meaningful work, adequate staffing, and the ability to exercise clinical discretion) has a far stronger psychological effect on turnover risk than incremental improvements to engagement programs.  

Precision in retention strategy means aligning investment with the variables statistically tied to risk, rather than relying on intuition, anecdotes, or legacy programs. As care delivery models evolve, organizations must intentionally integrate job design, career pathways, and performance expectations with the realities of clinical practice. When these practices are misaligned, even competitive compensation cannot offset the strain. 

Periods of lower turnover rates provide an opportunity. Converting stabilization into recovery requires more than targeted incentives; it requires redesigning work so that clinicians can envision both present effectiveness and a credible future within the organization.

Structural Strain Beneath Retention Stabilization 

Emotional stress remains one of the earliest warning signs of movement. Additionally, schedule rigidity, inability to practice at the top of license, and misalignment between performance metrics and high-value clinical work are among the strongest predictors of quitting. These are not cultural issues; they are structural design flaws. 

Care model transformation often demands greater throughput expectations without corresponding clarity around workload boundaries for clinicians. When productivity measures read volume over value, when documentation demands crowd outpatient interaction, or when staffing models limit clinical discretion, strain compounds.

Clinicians ultimately leave when the structure of work becomes incompatible with their professional identity or physically untenable. No amount of mission-driven messaging offsets a schedule that cannot be maintained or a care model that constrains clinical judgment. Clinicians want to see their employer demonstrate consideration for their well-being and autonomy. 

This represents a shift from crisis staffing to structural redesign. Filling open shifts will only stabilize short-term coverage. Redefining workload expectations, integrating scheduling with staffing realities, aligning performance incentives with care quality, and clarifying career pathways all help stabilize commitment. Organizations that treat retention as an outcome of how work is structured position themselves to improve productivity and enhance quality simultaneously.

Different Centers of Gravity 

While certain EVP fundamentals apply across roles, the drivers of commitment and sustained performance are not evenly distributed.  Health care systems that aim to improve access, productivity, and care quality must recognize that each clinical segment has a distinct “center of gravity” shaping how work is experienced.  

• Nurses’ importance patterns largely mirror the overall clinician sample, but schedule predictability carries outsized weight. Operational reliability (i.e., stable staffing, manageable physical demands, and flexible shifts) serves as the backbone of retention for nurses.
• Advanced practice providers (APPs) redistribute importance toward the care environment and career progression. Retaining APPs hinges on whether day-to-day work is both sustainable and positions them for long-term success. When growth pathways stall, dissatisfaction accelerates even if compensation remains competitive. 
• Physicians stand apart most sharply. Their retention decisions focus heavily on the care environment and total rewards, which together account for more than half of the overall influence. Being trusted to use clinical discretion ranks as the strongest signal of commitment, while satisfaction with compensation levels, perceptions of pay equity, and financial incentives meaningfully shape quit risk.   

The cost implications are substantial, especially for physicians, where turnover costs  routinely average $750,000 to $1.8 million per departure when considering coverage, onboarding, and lost productivity. But even short of departure, disengagement within this segment carries material operational consequences in a system already strained for capacity. For this reason, the 2026 Science of Staying study incorporated physicians into the sample to identify the drivers of commitment and attrition within this high-cost segment. 

A Strategic Inflection Point 

Health care has entered a quieter but more consequential phase of the workforce reset. Turnover has slowed, yet a greater proportion of departures are driven by job-related factors that organizations can influence. Clinicians are making increasingly deliberate decisions about where and how they work, and the financial and operational stakes of these decisions remain high. 

Incremental retention tactics will not be enough. Organizations should begin with a disciplined reassessment of clinicians’ day-to-day work:

• Redesign performance metrics to reinforce high-value clinical work
• Integrate scheduling, staffing, and workload models so the work becomes sustainable and more fulfilling
• Reduce administrative burden and restore clinical discretion, enabling clinicians to practice at the top of their license
• Prioritize early-tenure retention, where commitment to the organization is often formed or lost

Grounding the employee value proposition in empirically validated drivers of commitment provides direction. Integrating those drivers into job design, incentive structures, and care delivery models creates sustainable work.

Organizations that treat retention as an output of operating excellence will convert stabilization into transformation. Those who mistake stabilization for recovery risk allowing underlying strain to resurface, often in ways that are harder and more costly to correct.