NSI puts the average travel nurse fee at $91.23 per hour, compared with $59.46 for an employed staff RN with benefits.

Over the course of a year, that works out to an additional $66,081 per nurse. Most efforts to cut that spend focus on the rate. The rate matters, but it is only part of the problem.

Three changes make the biggest difference: stronger retention, flexible scheduling, and internal float pools. All three reduce how often a gap ends up becoming agency spend.

Stronger retention

In the NSI survey, 70.7% of hospitals anticipated decreasing travel and agency usage. The harder question is how to actually get there.

One place to start is with the nurses who are already on staff. When hospitals are able to keep experienced nurses in their roles, they are preserving capacity that would otherwise need to be covered while a position sits open.

Of course, nurses leave for many reasons, and there is no single answer to retention. But the day-to-day work experience matters. NSI lists working conditions and workload or staffing ratios among the top reasons RNs voluntarily resign. As we've written before, changes in scheduling behavior, from declining open-shift pickup to repeated preference overrides, can also surface signs of disengagement long before an exit interview.

That makes staffing and scheduling part of the retention conversation. A nurse's experience is shaped not only by compensation or benefits, but by whether the schedule feels sustainable week after week and whether there are enough people around them to do the work safely.

Flexible scheduling

For many nurses, flexibility is a meaningful part of that day-to-day experience. Research published in JAMA Network Open on nurses who recently left hospital staff roles found that adequate staffing, flexible scheduling, and better wages or benefits were the top factors that could increase their likelihood of returning.

For a hospital, offering more flexibility does not have to mean giving up control of coverage. It can mean giving nurses a clearer way to share their preferences, see open shifts, pick up extra work when it fits their lives, and request swaps or drops without relying on a chain of texts and phone calls.

It can also give managers more time to respond. When an open shift is visible early and can be offered to qualified staff across the organization, there are more opportunities to fill it internally.

Internal float pools

Even with strong retention and more flexible scheduling, hospitals will still have gaps to cover. Nurses call out, census changes, and some units need additional support. An internal float pool gives hospitals another option before they turn outside the organization.

NSI lists internal staffing pools among the strategies hospitals already use when facing nursing shortages. The idea is to build a qualified group of nurses who can move across units or facilities as needs change. As we explored in How to Get Central Staffing Right, that model becomes much more useful when leaders can see available staff across units and facilities and coordinate that capacity where it is needed most.

Hospitals may still use differentials or incentive rates to make those shifts attractive. But there can be a meaningful difference between paying an internal premium and automatically moving a shift to an external agency. With NSI reporting an average travel nurse fee of $91.23 per hour versus $59.46 for an employed RN including benefits, every shift you keep in house is a shift you are not paying the travel rate for.

Reduce the number of gaps that reach an agency

None of these approaches solves agency reliance on its own. They work at different points in the staffing process: stronger retention means fewer vacancies, greater flexibility creates more opportunities for existing staff to fill open shifts, and an internal float pool provides another source of qualified coverage when gaps remain.

That does not mean agency labor disappears, nor should it. A long medical leave, an unexpected census spike, or several simultaneous vacancies may still require outside support. The opportunity is to make agency coverage a more intentional choice instead of the default response to every open shift.

That is ultimately where the financial case for better workforce technology comes in. The software itself does not save money. What saves money is giving hospitals enough visibility and flexibility to address more gaps before premium labor becomes the only option.

The real opportunity is not finding a cheaper way to fill the gap. It is creating fewer expensive gaps in the first place.