Beyond Hiring and Outsourcing: A Workforce Infrastructure Model for Hospitals

Across hospitals, health systems, and large physician groups in the United States, patient access teams are often overwhelmed by an influx of calls and referrals. Prior authorizations are piling up in queues, and denials require follow-up. Meanwhile, revenue cycle leaders are facing workloads that exceed what their current teams can handle. Managers may have little choice but to reassign tasks to experienced employees simply to keep essential work moving.

The traditional response is to hire more staff.

However, when that approach becomes too slow, costly, or difficult, health systems often turn to a second familiar option: traditional outsourcing or temporary labor.

Yet ongoing workforce shortages in healthcare and rising administrative demands have revealed a significant limitation in this two-option strategy. Hospital leaders do not just need another way to fill gaps in their workforce.

What they need is a more flexible operating model: scalable workforce infrastructure that functions within the organization, increases administrative capacity where it is most needed, and expands without turning every increase in workload into another permanent full-time equivalent (FTE).

For hospitals, health systems, and large physician groups grappling with workforce shortages, escalating labor costs, complex administrative demands, and pressure to improve operational efficiency, recognizing this distinction is crucial.

The Bigger Problem Is Capacity, Not Open Positions

Healthcare organizations typically monitor workforce pressure by tracking vacancies, turnover, time to hire, and labor costs. These metrics are important, but they can mask a deeper issue: workload and authorized headcount do not always move together.

For example, authorization requirements can rise without an additional authorization specialist joining the team. Patient access volume can surge without an immediate increase in scheduling capacity.

Denials and aging accounts can accumulate faster than a revenue cycle department can recruit and train experienced staff. New locations, service lines, payer demands, referral trends, technology changes, and evolving patient expectations can all create more administrative work without the budget or local workforce needed to manage it.

This turns healthcare capacity management into more than just a recruiting challenge. It raises critical questions about where work should be performed, who should perform it, and how to expand capacity without adding another layer of fixed cost.

The American Hospital Association’s 2026 Health Care Workforce Scan describes hospitals and health systems redesigning staffing models and workflows, using technology to reduce administrative burden, and rethinking workforce roles. Although much of the report focuses on clinical staffing, its broader implication also applies to administrative operations: traditional recruitment alone is not enough to meet the current workforce challenge.

This is why healthcare workforce optimization cannot mean simply becoming better at hiring. It must also mean becoming better at structuring capacity.

The Economics Are Becoming Harder to Sustain 

For hospital executives, workforce strategy is tightly woven into financial strategy.

The American Hospital Association reports that hospitals spent more than $1 trillion on their workforce in 2025 and that workforce costs rose 5.6% from the previous year. Administrative friction adds another layer of expense: the AHA estimates that hospitals spent nearly $18 billion overturning claims denials and $43 billion trying to collect payments from insurers for care already delivered in 2025.

These pressures create a difficult balancing act.

Hospitals must maintain enough staff to preserve access, manage patient flow, secure reimbursement, and support the patient experience. However, repeatedly increasing permanent staff or relying on costly short-term solutions can intensify an already significant cost challenge.

And the demand for healthcare workers is not expected to decline.

The U.S. Bureau of Labor Statistics projects that healthcare and social assistance will be the fastest-growing major industry sector from 2024 to 2034, increasing 8.4%.

In practical terms, healthcare organizations will continue competing for talent in a field where demand is rising.

For leaders seeking to manage healthcare labor costs, the answer cannot simply be to reduce staff. Although that may address one expense, it can create capacity problems elsewhere.

The more useful question is: Which tasks genuinely require another traditional full-time employee, and which could be supported by a reliable alternative source of capacity?

This distinction is becoming increasingly important in the management of healthcare operations.

Administrative Work Is Consuming Scarce Capacity 

The need for a more flexible workforce model becomes even more apparent when hospital and physician-enterprise leaders examine how their employees are actually spending their time.

Consider prior authorization.

According to MGMA’s 2025 Prior Authorization Issue Brief, 89% of responding medical practices described prior authorization requirements as very or extremely burdensome. In addition, 92% reported hiring or reassigning staff to manage the growing volume of prior authorization requests.

The American Medical Association’s 2025 physician survey reflects similar administrative pressure. Practices completed an average of 40 prior authorizations per physician each week, requiring approximately 13 hours of physician and staff time. Forty percent of physicians reported having staff who work exclusively on prior authorization.

This is not just about completing forms. It is about capacity.

Every hour spent tracking down documentation, navigating payer portals, checking authorization status, following up on claims, rescheduling patients, or clearing administrative backlogs is an hour unavailable for patient-facing, clinical-support, or higher-value operational work.

These administrative bottlenecks can create a domino effect: a clearance issue can lead to a scheduling conflict; a scheduling conflict can hinder access; an incomplete authorization can result in a denial; and a denial can delay cash flow.

That is why healthcare administrative support should be viewed as essential operating infrastructure rather than peripheral clerical work.

What Workforce Infrastructure Looks Like in Practice

A workforce infrastructure partnership adds talent without treating every increase in workload as another traditional employee or transferring the work to a disconnected vendor process.

Instead, trained healthcare administrative professionals operate within the organization’s existing departments, systems, workflows, and performance expectations.

This is the core idea behind GMVA’s model.

GMVA acts as an insourcing workforce infrastructure partner for hospitals, health systems, and large physician groups. Its specialists work within client EHRs, scheduling tools, phone systems, and established processes, so organizations do not have to shift their work into a separate operating environment.

The support system surrounding these specialists is just as important as the specialists themselves. GMVA’s model includes the Secure WorkZone for controlled access, the GMVA Quality Assurance program, and Virtual Medical Managers who oversee each engagement.

For enterprise healthcare organizations, the model should also include defined workflow ownership, appropriate access controls, client-established performance measures, clear escalation protocols, and continuity planning.

For many hospitals and physician groups, it makes the most sense to begin with functions that have a clearly defined workload and are measurable, repeatable, operationally important, and often constrained by staffing.

GMVA’s workforce infrastructure is designed to provide an integrated administrative layer throughout the patient journey. This includes financial clearance and authorization management, patient access operations and care coordination, and revenue cycle performance and recovery.

Practically, hospital and physician-enterprise leaders can evaluate opportunities such as:

• Financial clearance and authorization management: Eligibility verification, documentation tracking, payer follow-up, authorization status management, and related workflows.
• Patient access operations and care coordination: Scheduling, registration, referrals, call support, appointment management, and patient communications.
• Revenue cycle performance and recovery: Claim-status follow-up, denial management, appeals support, aging A/R, billing workflows, and reimbursement recovery.

Leaders can evaluate these workflows through measures such as turnaround time, backlog volume, call abandonment, denial inventory, days in A/R, schedule utilization, and cash recovered.

The aim is not to replace the internal healthcare workforce but to strengthen it. This approach supports a more practical view of healthcare workforce optimization:

Keep essential internal talent focused on work that requires institutional knowledge, clinical judgment, leadership, or direct accountability while adding capacity for high-volume administrative workflows.

One key takeaway is not that every hospital or physician group should transfer all administrative work to an external partner. Instead, leaders should identify essential tasks that are constrained by capacity and determine whether those tasks genuinely require another local FTE or can be performed by an integrated external team.

This creates a more targeted strategy for managing healthcare capacity.

Turn Workforce Strategy Into an Operating Strategy

Healthcare workforce shortages cannot be solved through recruitment alone. Administrative demands are also unlikely to become simpler.

The organizations most likely to thrive over the next decade will be those that stop viewing workforce design as a simple choice between hiring more staff and outsourcing work.

There is an alternative operating model: establish a strong internal core, use technology to improve workflows where appropriate, and build scalable workforce infrastructure around that core.

Together, these elements allow administrative capacity to grow without requiring fixed headcount to increase at the same rate.

For CEOs, CFOs, COOs, chief human resources officers, revenue cycle executives, patient access leaders, ambulatory operations executives, and physician-enterprise leaders, this model offers a more adaptable way to address workforce constraints.

Not every capacity issue requires another permanent position. Leaders can instead build a workforce structure that adapts to the work itself.

That is what GMVA’s workforce infrastructure partnership is designed to provide: additional administrative capacity that operates within the systems and workflows healthcare organizations already use, while keeping internal teams focused on work that requires their expertise.

If your organization is evaluating new approaches to administrative support across patient access, authorization management, or revenue cycle operations, schedule a workforce-capacity conversation with GMVA to identify where additional support could have the greatest measurable operational impact.