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How are U.S. health care providers managing compensation amid COVID-19?

We conducted a flash survey to find out.

System og strategi for kompensasjon |Health and Benefits|Talent|Integrated Wellbeing
COVID 19 Coronavirus

March 26, 2020

U.S. health care providers are currently facing unique challenges due to COVID-19, which require rapid adjustments to employee staffing and support services.

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About our COVID-19 coverage

In our ongoing coverage of the COVID-19 outbreak, experts from across Willis Towers Watson share insight into what you need to know to manage your business and employees and reduce your risk.

With the number of confirmed and suspected COVID-19 cases mounting steeply, our nation’s health care providers are facing unprecedented challenges. While personal protective equipment supplies are grabbing our attention in the headlines, hospitals are adjusting their staffing to face the impending (or current) tsunami of patients.

Willis Towers Watson conducted a flash survey to understand how the 76 responding organizations (ranging from single facilities to multi-state, multibillion-dollar systems nationwide) are meeting this challenge.

Premium pay

Premium pay is usually provided in the form of overtime pay rates for all hours worked, an additional hourly kicker or a bonus shift differential.

Most organizations are not (yet) providing premium pay to staff, as many believe it is part of the job. However, those that do are uniformly in states with a large number of active cases (as of March 20, 2020), so these perspectives may change as the pandemic spreads. Nurses are the most likely to receive premium pay due to their increased exposure and potential staff shortages. Those in non-clinical roles are significantly less likely to receive premium pay but, where it is provided (also typically in states with a high case count), it is provided to environmental services/housekeeping.

Child care

With the need for employees to work longer hours, those with children may be struggling to find additional child-care coverage. The situation is even worse in locales where schools have closed. Major metropolitan areas like Chicago and New York City are creating “enrichment centers” to care for children of essential service workers.

Larger health care organizations have taken matters into their own hands by opening on-site child care centers (25% of respondents) or reimbursing additional expenses (14%). Smaller organizations are more likely to leverage local partnerships — though larger organizations are increasingly doing so as well.

Support services

Half of all respondents provide counseling support services, either through employee assistance plans (EAP) or on-site or both. Survey results suggest counseling support appears to grow more critical as case numbers spike.

About a quarter of organizations are also providing meals to support employees — in addition to catered meals from community members who can support both health care workers and struggling local restaurants with one donation. While one-third of respondents are not providing anything additional yet, they are exploring creative solutions to support employees through on-site food trucks or meals to go.


U.S. health care providers have been taking a proactive approach to supporting employees, which helps explain why staffing is not yet an issue for most respondents. Based on the leading indicators from the survey, we expect clinical support and nurses to be the roles most likely to experience staff shortages as the crisis deepens for a variety of reasons: childcare, absenteeism or the need to self-quarantine.

Organizations are preparing by redeploying clinical roles (88% of respondents) as well as administrative roles (70% of respondents). They are also hiring per diems and providing enhanced compensation to employees taking on additional shifts.

State governments are also working to support their providers: Illinois has encouraged hospitals to re-hire recent retirees who are not themselves in the high-risk categories by waiving licensure fees and expediting licenses; New York State is identifying clinicians employed by health insurance organizations as a potential source of talent.

Any additional compensation and support costs are somewhat offset by paid time off practices among health care provider organizations that are less generous than those of employers in other industries. Based on results from a prior flash survey, health care providers are less likely to pay hourly workers for time off due to COVID-19 exposure.

We also observe that health care providers are limiting any paid time off to the generally mandated two-week quarantine window, less than the three weeks provided by organizations in other industries. Health care provider organizations may feel more comfortable with these narrower windows because they are more aware and better equipped to manage infection control — or they may simply not be able to be as generous given the demand for their services.

More information

More information about COVID-19 and how health care providers and other employers are responding to this rapidly changing landscape can be found here and you can also forward questions to Additionally, please continue to visit our COVID-19 page for continued, up-to-the-minute research and insights.

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