Most Healthcare Organizations Are Already Doing Retention Work
They Just Haven’t Named It Yet

Key Takeaways

The 10 findings shaping physician & APP retention in 2026

• Only 39% of organizations have a formal, documented retention strategy — but a nearly equal share are already doing informal, activity-based retention work. Just 16% have nothing in place.
• Most organizations sit in the productive middle. Roughly 80% are either running informal retention efforts or have a formal strategy with execution gaps — not starting from zero, not fully optimized.
• Unclear ownership is the #1 barrier for organizations without a strategy (51%) and still challenges 36% of those that have one.
• The “Recruitment Team Paradox”: recruitment teams are closest to turnover patterns but have the least influence over the broader retention strategy.
• Barriers differ by maturity. Organizations with a strategy face execution constraints — budget and competing priorities (61% each); those without face foundational ones — unclear ownership (51%) and lack of executive buy-in (48%).
• Strategy and execution often drift apart. Some organizations do more than their strategy documents (flexible scheduling, clinical autonomy, mentorship); others under-deliver on stated priorities (compensation, work-life balance).
• High-impact tools are underused. Career development, clinical autonomy, mentorship, D&I, and flexible scheduling are each used by only about half of organizations.
• Smaller organizations lean on compensation; larger ones diversify into development, mentorship, and wellness — a clear opportunity for smaller orgs to expand lower-cost levers.
• Measurement skews to lagging indicators. Satisfaction (81%) and turnover (78%) are widely tracked; days-to-fill (41%), cost-per-hire (22%), and internal promotion rates (8%) are not.
• Retention is a recruitment strategy — and demand is high. 74% of organizations without a strategy want to build one (42% very interested). Each provider retained reduces recruitment demand and speeds time-to-fill.

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Physician and advanced practice provider (APP) retention has become one of the defining workforce challenges in healthcare. As competition for clinical talent intensifies, the organizations that stabilize their workforce, ease recruitment pressure, and build sustainable staffing models will be the ones that treat retention as a deliberate strategy rather than a reaction to turnover.

To understand how organizations are actually approaching this work, AAPPR partnered with Industry Insights to field the Physician & Advanced Practice Provider Recruitment & Retention Strategy Survey. The resulting 2026 Physician & Advanced Practice Provider Retention Strategy Report draws on responses from 158 recruitment professionals and healthcare leaders, the overwhelming majority of whom work on internal, in-house recruitment teams.

The picture that emerges is more encouraging than you might expect. Most organizations aren’t starting from zero. They’re doing meaningful retention work already — they just haven’t formalized, aligned, or measured it yet.

The headline finding: progress and opportunity in equal measure

Fewer than four in ten organizations (39%) report having a formal, documented retention strategy. But here’s the part that reframes the conversation: a nearly identical share are already engaged in active, retention-related work without a formal structure in place. Only 16% report having no strategy or retention activities at all.

In other words, the gap isn’t usually between organizations that care about retention and those that don’t. It’s between organizations that have named and structured their efforts and those doing the work informally. That distinction matters, because it changes what “progress” looks like. For most organizations, the path forward isn’t a complete overhaul — it’s documenting what already exists, clarifying who owns it, and beginning to measure outcomes.

A maturity spectrum, not a pass-or-fail test

One of the most useful frameworks in the report is the idea that organizations sit somewhere along a retention maturity spectrum, ranging from no strategy, to informal activity, to a formal documented strategy, to a fully optimized approach with governance and ROI tracking.

What’s striking is the distribution. Roughly 39% of organizations are actively doing retention work that hasn’t yet been formalized, and an equal share have reached the formal-strategy stage but still wrestle with execution gaps. Together, those two groups represent nearly 80% of respondents — meaning most organizations are neither at the starting line nor fully optimized. They’re in the productive middle, with a clear next step available to them.

Movement between stages doesn’t require starting over. It builds on what’s already in place.

Ownership is the quiet make-or-break factor

If there’s a single theme that surfaces again and again, it’s ownership. Retention responsibility tends to be spread across recruitment, HR, clinical leadership, and executives. That broad involvement reflects how far-reaching retention is, but it can also blur accountability.

The data makes the cost of that ambiguity clear. Among organizations without a strategy, unclear ownership is the single most commonly cited barrier (51%). And even among organizations that do have a strategy, more than a third (36%) still point to unclear ownership as an implementation challenge.

The report also surfaces what it calls the “Recruitment Team Paradox.” Recruitment teams are often closest to the realities of turnover — they see the patterns firsthand and frequently support retention efforts — yet they tend to have limited influence over the broader strategy. Closing that gap, by connecting recruitment insight to retention strategy, is one of the most actionable opportunities the report identifies.

Barriers look different depending on where you are

A particularly practical insight: organizations don’t all face the same obstacles at different intensities. They face different types of obstacles depending on their maturity.

Organizations that already have a strategy are mostly navigating execution constraints — competing priorities (61%) and limited budget (61%) top their list. They’ve made the decision to invest; the challenge is doing so effectively within existing resources. Organizations without a strategy face more foundational barriers — unclear ownership (51%) and lack of executive buy-in (48%). For them, the most effective first moves are establishing accountability and securing executive sponsorship.

Recognizing which set of challenges applies to your organization is what makes the next step the right step.

Strategy and execution don’t always line up

The report digs into the gap between what organizations include in their formal strategies and what they actually offer in practice — and the findings cut in both directions.

Some organizations are quietly doing more than their strategy reflects. Flexible scheduling, clinical autonomy, and mentorship programs all show up more often in practice than in documented strategy, suggesting many organizations are already investing in high-impact initiatives they haven’t formally captured. Others show the reverse: compensation and benefits, along with work-life balance, appear more often in formal strategies than they’re consistently delivered — a reminder that intention and execution can drift apart under resource and operational pressure.

Neither pattern is a failure. Both point to the same opportunity: align what’s being done with what’s being measured.

Expanding the toolkit beyond compensation

Work-life balance (92%) and compensation and benefits (82%) remain the foundation of most retention strategies. But the report highlights a set of high-impact tools that only about half of organizations currently use — career development pathways, clinical autonomy, mentorship programs, diversity and inclusion initiatives, and flexible scheduling.

Notably, larger organizations are more likely to lean on development, mentorship, and wellness programs, while smaller organizations rely more heavily on compensation. That points to a real opportunity for smaller organizations to diversify their approach with levers that don’t always carry the same financial weight. Compared to AAPPR’s 2022 study, the broader trend is clear: organizations are moving beyond compensation and bonuses toward a more intentional focus on long-term engagement and provider experience.

Measuring what actually matters

Most organizations track outcome metrics like employee satisfaction (81%) and turnover rates (78%). Valuable as those are, they’re lagging indicators — by the time they shift, the underlying issues are often well established.

Fewer organizations track the operational and financial diagnostics that offer earlier, more actionable insight. Days-to-fill (41%), cost-per-hire (22%), and internal promotion rates (8%) remain underutilized. The report makes a focused recommendation: pairing first-year retention, days-to-fill, and cost-per-hire helps connect retention efforts directly to recruitment performance and workforce efficiency — and helps demonstrate the financial value of retention investment.

Why this matters for recruitment

For recruitment professionals especially, the report reframes retention as a recruitment strategy. Recruitment and retention challenges tend to travel together, and each provider retained reduces recruitment demand, supports faster time-to-fill, and contributes to a more stable workforce. Left unaddressed, low retention can fuel a self-reinforcing cycle: more turnover drives more open roles, which drives recruitment costs up, which squeezes the budget available for the very retention efforts that would break the loop.

The good news is that the appetite to break that cycle is strong. Among organizations without a formal strategy, 74% are interested in developing one — including 42% who are very interested. What they most often need isn’t convincing; it’s capacity, executive sponsorship, dedicated resources, and leader training. The case for retention is largely already made. The work now is enabling organizations to act on it.

Find your next step

Whether your organization has no strategy, an informal one, a formal one, or a mature program, the report offers concrete, profile-based recommendations — along with a simple guide to the next step, the first metric to track, who should lead, and a realistic timeframe for each stage. The throughline is reassuring: progress doesn’t require waiting for a perfect, fully developed strategy. It starts with practical steps that build on what you already have.

Special thanks to our Signature Partner CHG Healthcare for sponsoring this research.