By Abie Kolt, Chief Operating Officer, Keeper

Healthcare runs on people who show up every day. Nurses, medical assistants, home health aides, caregivers, environmental services teams, and dietary staff. The work is constant, demanding, and essential.

But despite everything we’ve modernized in healthcare, from digital records to remote monitoring, how we pay healthcare workers has barely changed.

Most are still paid every two weeks. 43% of private businesses still pay this way. Sometimes even monthly.

In an industry facing historic staffing shortages, burnout, and turnover, that disconnect matters more than we often admit.

I believe the future of healthcare—and the broader workforce—includes a simple but powerful shift: giving people access to the money they’ve already earned, every day if they need it.

The Real Financial Pressure on Healthcare Workers

Healthcare workers are not immune to financial strain. In fact, many are on the front lines of it.

Large portions of the healthcare workforce are hourly. Home care, long-term care, behavioral health, and hospital support roles often pay modest wages, even as workloads increase. At the same time, workers are managing rising costs for housing, transportation, childcare, and healthcare of their own.

For many, the problem is not just how much they earn. It’s when they can access it.

When an unexpected expense hits between paychecks, workers are forced to bridge the gap with overdraft fees, high-interest credit, or payday loans. That stress doesn’t stay at home. It shows up at work as distraction, absenteeism, and burnout.

In healthcare, where staffing ratios and continuity of care directly affect patient outcomes, financial stress becomes an operational issue (not just a personal one).

Why Pay Timing Matters in High-Turnover Roles

Healthcare leaders talk often about recruitment and retention. Rightfully so.

But pay frequency rarely makes the list of retention levers, even though it directly affects day-to-day stability.

When workers can access earned wages to cover gas, childcare, or groceries before a shift, they are more likely to show up. When they feel less financial pressure, they are more likely to stay.

This is especially true in roles with unpredictable schedules, variable hours, or overtime-heavy weeks. In home care, for example, caregivers may work multiple short shifts across clients and rely on consistent cash flow to manage transportation and family needs.

Daily or on-demand pay doesn’t increase wages. But it improves how wages function in real life.

And that difference can influence whether someone picks up an extra shift, stays through a tough month, or leaves for another employer offering more flexibility.

Earned Wage Access Is Growing Because the Need Is Real

Across industries, earned wage access is being adopted at scale. Millions of workers now use EWA tools, and billions of dollars in wages are accessed early each year.

What’s notable is not just the growth, but the frequency of use. Many workers access their earnings regularly, not for discretionary spending, but for routine expenses.

In healthcare, where schedules can be demanding and paychecks are often stretched thin, this pattern is even more relevant. Workers are not looking for advances or loans. They are looking for access to compensation they have already earned.

That distinction matters. It reframes EWA not as borrowing, but as basic payroll flexibility.

Employers Are Starting to See the Business Case

In healthcare, financial stress has downstream effects that leaders can’t ignore.

Turnover is costly. Vacancy rates drive up overtime. Burnout leads to safety concerns and declining patient satisfaction.

Benefits that improve daily stability can support broader workforce goals, including:

• Reduced absenteeism
• Better shift coverage
• Improved morale and engagement
• Higher retention in hard-to-staff roles

This is why more healthcare employers are evaluating pay access alongside traditional benefits like training programs, wellness initiatives, and career pathways.

Pay timing is not a silver bullet. But it is a practical lever that supports the same outcomes healthcare leaders are already prioritizing.

Modern Care Requires Modern Compensation

Healthcare has changed dramatically in the last decade.

We’ve embraced telehealth. We’ve digitized clinical workflows. We’ve expanded care into homes and communities.

But payroll systems still operate on batch processing cycles that were designed long before mobile banking, real-time data, and automated reconciliation.

Today, it is technically possible to calculate earnings daily, integrate with payroll systems, and deliver wages securely without disrupting business operations.

So, the question is no longer whether daily pay is feasible. It’s about whether continuing to delay access to earned wages makes sense for a workforce that operates around the clock.

This Is About Respect, Not Rewards

For healthcare workers, the idea of daily pay is not about perks or convenience. It’s about dignity. It says: your time matters, your work matters, and you shouldn’t have to wait weeks to use money you’ve already earned.

In an industry built on care, compassion, and trust, compensation practices should reflect those same values. Giving people timely access to their earnings is one tangible way to do that.

Looking Ahead: A More Responsive Pay Model

I believe we are moving toward a future where pay is more responsive to how people actually live and work.

Not every worker will access wages every day. But every worker should have the option to do so when life requires it.

In healthcare, where the stakes are high and the workforce is under immense pressure, that flexibility can make a meaningful difference.

Daily pay aligns compensation with reality, reduces financial friction, and it supports the people who support all of us.

We talk a lot about the future of care. It’s time we also talk about the future of pay.

Because if someone works today, especially in healthcare, they should be able to get paid today.

If this resonates with you, get started here.