Five Questions to Identify Pay Gaps that National Trends Can Miss
Pay increases for health care staff are stabilizing nationally, but the pressure has not eased everywhere. Some regions, employee groups, and jobs are still moving well ahead of the average. An organization can look competitive overall while falling behind in critical roles, and those gaps often do not surface until turnover or vacancies occur.
Use these questions to pinpoint where compensation concerns may require a closer look:
1. Are some jobs moving faster than the rest of the market?
Pay for high-demand jobs can rise well above the overall increase. When salary ranges and pay decisions follow the average, these jobs fall behind first.
Organizations should ask:
- Which critical clinical, technical, or support jobs have seen the greatest market movement over the past year?
- Where is the gap showing up (e.g., base pay, hiring rates, range midpoints)?
- Are new-hire rates catching up to experienced employees, creating compression?
2. Are regional differences affecting your ability to compete?
National benchmarks may not reflect conditions in your labor market. SullivanCotter’s 2026 Health Care Staff Compensation Survey found that median base pay increased 3.1% nationally, but 5.3% in the West and 7.4% for registered nurses in that same region. An organization in a fast-moving market that budgets to the national data could fall behind in a single year.
Organizations should ask:
- How does pay movement in your region compare with the national market?
- Are local competitors raising pay faster than your organization?
- Do you have reliable data for the areas where you recruit?
- Are you benchmarking each job against the right market (e.g., local, national)?
3. Are jobs with few incumbents being overlooked?
In a broad compensation review, large employee groups drive the averages. Highly specialized jobs or those held by only a few employees can be easy to overlook, even when they are difficult to recruit or retain.
Organizations should ask:
- Which jobs have a small number of incumbents at your organization?
- Are these jobs essential enough that losing one or two employees would disrupt patient care, operations, or revenue?
- Do you have enough reliable market data to benchmark these jobs with confidence?
4. Are premium pay practices addressing the right workforce needs?
Shift differentials, weekend premiums, and other supplemental pay programs can support coverage when aligned with actual staffing challenges.
Organizations should ask:
- Which shifts or schedules are consistently difficult to fill?
- Are premiums targeted to the jobs and shifts where they are most needed?
- Have premium amounts kept pace with the market?
- Are your premium pay programs consistent and aligned across locations?
- Are premiums making up for base pay that has fallen behind?
For a closer look at evaluating premium pay design, see Are Your Premium Pay Practices Solving the Right Workforce Problem?
5. Is pay really the problem?
Pay may be only one part of the issue. Scheduling, workload, career opportunities, manager effectiveness, and the employee experience can also influence turnover and recruitment.
Organizations should ask:
- What are we hearing from employees and candidates?
- Are turnover and vacancy patterns concentrated in certain jobs, locations, or shifts?
- Would a pay adjustment address the underlying problem?
- What other workforce actions should be considered alongside compensation changes (e.g., scheduling flexibility, staffing levels, career paths)?
Next Steps for a More Targeted Review
If any of these questions point to gaps, a targeted review can help you focus compensation dollars where they will have the greatest impact, rather than spreading them across the entire workforce. It can also help you determine the budget and timing for these changes.
Explore SullivanCotter’s Health Care Staff Compensation Survey for national, regional, job category, and metropolitan market benchmarks, or connect with a SullivanCotter expert to discuss compensation concerns, premium pay practices, or broader workforce challenges.
