Independent Review Finds Ballad Health’s Provider Recruitment and Retention Efforts Outpace National Trends

Published review highlights Ballad Health as an example of success in sustaining rural healthcare access against backdrop of worsening national shortages

An independent review and publication by national healthcare consulting firm PYA found that Ballad Health has made progress in recruiting and retaining medical providers systemwide, even as national healthcare workforce data show worsening shortages. The firm was so compelled by Ballad Health’s success that it developed a national case study and white paper, Sustaining Access in Rural Communities: A Proven Model for Provider Needs Assessment, to help other rural systems learn from Ballad Health’s approach.

The independent review and publication supports findings by the State of Tennessee and the Commonwealth of Virginia over multiple years that Ballad Health has created a public advantage through enhanced access to care – something not likely to have happened but for the merger creating Ballad Health.

Prior to the merger creating Ballad Health in 2018, the system faced challenges common in rural regions — provider shortages, an aging clinical workforce and rising demand for both primary and specialty services. Ballad Health implemented a data-driven provider needs assessment and has measured its efforts annually. Through a combination of working with independent physician groups to recruit into their practices or through direct employment, Ballad Health has continued to make measurable progress, succeeding in areas where many rural systems are struggling.

Since early 2018, Ballad Health has recruited more than 800 providers, including 100 primary care clinicians, expanding access in rural Tennessee and Virginia and closing long-standing gaps in care. During that same period, primary care adequacy across the region improved from 62% to 72%, and eight of 12 physician specialties now outperform national benchmarks.

“Data grounded in real community need is the most powerful tool we have in protecting access to rural healthcare,” said Alan Levine, chairman and CEO of Ballad Health. “The national forecast for physician specialties continues to worsen, so it is important for Ballad Health to continue our efforts alongside our partners at ETSU, and in the physician community, as we work together to ensure our region can access needed specialties. This national problem is getting worse, not better.”

The independent analysis also found that Ballad Health’s workforce stability far exceeds national trends. The organization’s full-time nurse turnover rate dropped to 12.6% at the end of the fiscal year in June 2025, and has decreased even more since, to a current low of 11%. This is well below the national average of more than 15% for hospitals. Ballad Health’s success reflects the system’s commitment to supporting its people through competitive pay, childcare access and professional growth opportunities.

“These results show what’s possible when strategy, data and purpose come together,” said Dr. Clay Runnels, Ballad Health’s chief physician executive. “We’re not just recruiting providers — we’re strengthening teams, improving access and building a system that will serve this region for the next generation. Because of the national problem, we must stay diligent in our efforts.”

According to PYA, Ballad Health’s model demonstrates how intentional workforce planning can reverse the trends that have left many hospitals struggling to recruit and retain clinicians.

“Sustainable access to care is a challenge facing most all rural providers,” said Tynan Kugler, PYA Principal. “The success of Ballad Health’s model and their recruiting and retention results compelled us to publish a national white paper so other health systems can learn from Ballad Health’s leadership in rural workforce planning.”

Ballad Health continues to update and refine its provider needs assessment annually to respond to demographic shifts, provider retirements and changing community needs — ensuring recruitment remains responsive, effective and rooted in measurable results.