Why the biggest, most volatile line item in senior care needs the same discipline providers already apply to supplies — and what that looks like in practice for your community.
Applying purchasing discipline to the hardest category of all
For years, the promise of a group purchasing organization has been straightforward: aggregate demand, standardize what you buy, and give providers visibility and leverage they can’t get building by building. Dining. Medical supplies. Administrative. Maintenance. Each category got more predictable and less expensive once someone brought structure to it.
Workforce was always the exception — the largest expense on the ledger and, paradoxically, the one most operators had the least structure around. That’s the gap Incite set out to close.
“The goal of Incite is to address our members’ challenges in the marketplace, and there hasn’t been a bigger challenge in the marketplace over the last five years than workforce.”
— Michael Dragone, Co-Founder and President, Incite Strategic Partners
Rather than build a staffing agency, Incite did what a GPO does: it found the right partner and brought structure to the category. That partner was SnapCare, a national workforce-technology and clinical-staffing company and a 2025 McKnight’s Excellence in Technology Award winner.
“We took the time to find a partner like SnapCare that had a proven track record in staffing, and it has just clicked in the marketplace. It really has worked out — far exceeded our expectations.”
— Michael Dragone
The result, Incite Workforce Solutions powered by SnapCare (IWS), extends the same GPO logic providers already trust for supplies into their single largest and most unpredictable spend. What follows is less a product pitch than a way of thinking about the problem.
Workforce isn’t just staffing
The most useful reframe in the entire conversation is also the simplest: staffing is usually a symptom, not the problem.
Most workforce discussions still orbit a single question — who’s covering tomorrow’s shift? That question is real but treating it as the problem is what keeps providers reactive. As SnapCare’s Jeff Richards put it, workforce has become much more than a staffing issue. Providers are managing an interconnected set of challenges — recruitment, retention, scheduling, labor spend, and workforce visibility — all at once, and each one touches quality, operations, and financial performance.
That’s why IWS frames the challenge as running deeper than staffing: the real drivers are volatility, month-end surprises, turnover, overtime creep, and unanticipated spend. Fill a shift and you’ve solved tonight. Understand why the shift was open and you’ve started solving next quarter.
You can’t optimize what you can’t see
Before any of that can happen, a provider has to be able to see their own workforce clearly — and most can’t, because the standard tools look backward.
Richards pointed to a familiar culprit: Payroll-Based Journal data lags about a quarter behind, and the way labor spend is categorized often doesn’t reflect how labor is actually being used inside a building.
“You’re looking backwards no matter what.”
— Jeff Richards, Chief Strategy Officer, SnapCare
That isn’t a knock on PBJ, which was never built as a real-time management tool. It’s a description of the blind spot providers operate in when their only structured view of the workforce is retrospective and coarse.
Closing that blind spot is the first thing IWS does. It starts with a consultation on total workforce management — internal staff, overtime patterns, recruitment and retention practices, and how external labor is being sourced — and puts real-time visibility around agency spend, overtime, and labor cost per patient day. Only once the picture is clear can anything be optimized.
Managing 30 agencies isn’t a strategy
Visibility tends to surface the same surprise almost everywhere.
“Sometimes they think they’re using five or six agencies. And when we talk to all the building operators, it turns out it can be as high as 30 or 40.”
— Jeff Richards
That sprawl is a predictable outcome of years of crisis staffing — when a shift has to be filled tonight, you call whoever answers, and after four years across dozens of buildings, the vendor list quietly balloons. The cost isn’t only rate. It’s administrative burden, inconsistent credentialing, no negotiating leverage, and no coherent picture of who is walking into the building.
Here IWS applies the most recognizable GPO move of all: consolidation. Narrowing 30 or 40 suppliers down to five or six best-in-class partners on a single platform, with standardized rates and centralized approval workflows. Not to strip away relationships that work — IWS is built to keep the staffing partners a provider values — but to add governance, transparency, and consistency across all of them.
There’s one clause that changes the whole dynamic. In traditional staffing, converting a good contract clinician to a permanent hire triggers a steep conversion fee, and suppliers compete rather than collaborate. IWS inverts that: if a clinician fits, the provider can hire them directly, and any participating supplier agrees to that as a condition of the program. Marquis Companies CFO Steve Fogg has called that permanent-conversion outcome “the primary objective of the program.”
What that looks like in the numbers: Marquis
Marquis, one of the country’s most respected operators, worked with the program early. Dragone shared the results on Park Place:
“They’ve reduced their contingent staffing usage by 39%. They’ve increased their permanent staffing, and they’ve saved themselves $2 million along the way.”
— Michael Dragone
The sequence is the story. Permanent staffing went up as contingent utilization came down — not cost-cutting that thinned the care team, but a workforce rebalanced back into proportion after the pandemic years knocked it sideways.
That maps directly onto the outcomes IWS is built to produce: reduced reliance on premium external labor, measurable savings across buildings, and a more stable core of permanent caregivers.
Visibility changes more than cost
The savings are the easiest part to quantify and the least interesting part of what actually happens.
When providers can finally see total workforce utilization, they move from reacting to deciding. They can spot which buildings lean disproportionately on agency labor, catch the overtime creep that signals a retention problem before it becomes a vacancy, and plan instead of scramble. Richards described the downstream effect as a virtuous circle back into optimized care delivery for residents — more consistent teams, more familiar faces, fewer handoffs.
Stability, in other words, isn’t adjacent to quality of care. It’s upstream of it.
Why it takes both partners
None of this works as a technology drop-in, and that’s the point of the partnership.
Incite brings deep provider relationships, direct member feedback, and — as the exclusive GPO partner of AHCA/NCAL — a channel of trust a workforce vendor can’t manufacture. SnapCare brings the workforce expertise, technology, and clinical-staffing execution. IWS combines them into three moving parts that have to operate together: strategy (workforce economics and benchmarking), technology (visibility, analytics, and smart scheduling), and operational support (the governance and people to actually execute, not just advise).
The through-line back to Incite’s core mission is direct. Twenty-seven state affiliates now buy on Incite programs, generating close to $3 million this year that flows back to AHCA/NCAL and participating states.
“That will go back to AHCA/NCAL and the states that are participating in the program.”
— Michael Dragone
It’s the same revenue that funds more than $2 million in annual advocacy for the sector — the GPO flywheel applied to labor: aggregate the spend, bring it structure, and route the value back to the providers and the association that serve the field.
A note on why this matters for RN staffing specifically
The workforce headline this summer was genuinely good — the Bureau of Labor Statistics confirmed nursing home employment finally surpassed pre-pandemic levels in June 2026. But as AHCA President and CEO Clif Porter cautioned, “recovering our workforce is not the same as solving the workforce crisis.” Total headcount recovered; the hardest clinical roles didn’t fully follow. Federal projections still show a roughly 10% RN shortfall in the nursing home setting, and those are exactly the roles where external labor carries the steepest premium.
That’s the practical case for a structured workforce strategy over reactive staffing: when the scarcest, most expensive roles are the ones you’ll be managing for years, visibility and control aren’t a luxury. They’re how you protect both margin and care.
The future of workforce isn’t reactive staffing
If there’s one idea to carry out of the Park Place conversation, it’s that the providers navigating this best aren’t the ones with the fastest fill rates. They’re the ones who stopped treating workforce as a scheduling function and started treating it as a strategy — grounded in visibility, disciplined about supplier management, and built for the next decade rather than the next shift.
That’s the same shift a GPO represents in every other category. Workforce is simply the biggest, hardest, and most overdue place to make it.
Reference: AHCA/NCAL, “Nursing Homes Add 3,000 Jobs in June, Surpass Pre-Pandemic Levels,” July 2026; HRSA Bureau of Health Workforce, nursing model projections, December 2025.
