November 12, 2026 – The McKinsey Institute for Economic Mobility, supported by the McKinsey Health Institute, today released a new report, Rural healthcare and America’s $340 billion workforce earnings opportunity, examining how addressing healthcare workforce shortages could strengthen access to care in rural communities across the U.S. while creating significant economic opportunities for millions of American workers.
The report finds that approximately 38 million Americans have the potential to transition into nursing and allied health careers—nearly 100 times the nation’s estimated shortage of 400,000 healthcare workers. Transitioning just one percent of this population, or approximately 384,000 workers, could largely close the national shortage and generate an estimated $340 billion in additional lifetime earnings, including roughly $28 billion accruing to rural communities.
Drawing on U.S. census and labor market data and a national survey of 808 working-age adults, including 559 rural residents, the research identifies four key findings:
- America has a substantial, largely untapped workforce of potential healthcare workers. An estimated 38 million Americans, defined in the report as the “bridge workforce,” could potentially transition into nursing and allied health roles. McKinsey’s Census-based analysis finds that 69 percent of bridge workers work full time, with median annual earnings of $28,000. Transitioning into healthcare careers could increase annual earnings by approximately $40,000 on average.
- Expanding healthcare career pathways could generate $340 billion in additional lifetime earnings and strengthen local economies. Transitioning approximately one percent (384,000) of bridge workers into nursing and allied health roles could largely close the national workforce shortage while generating an estimated $340 billion in additional lifetime earnings, including approximately $28 billion in rural communities.
- Interest in healthcare careers is high, but financial and logistical barriers prevent workers from pursuing them. Fifty-eight percent of surveyed bridge workers not currently employed in healthcare expressed interest in entering the field. However, among interested respondents, 43 percent cited the inability to afford lost income as a barrier to training, while 41 percent cited difficulty balancing training with work and family responsibilities.
- Closing workforce gaps requires rethinking the path from training to employment. The research finds that challenges across recruitment, education, job placement, and retention prevent interested workers from entering and remaining in healthcare careers. Paid training, flexible education models, stronger connections between employers and educators, and improved working conditions could help address these barriers.
“One of the most important findings of this research is that the talent needed to address America’s healthcare workforce shortage already exists within communities,” said Yenli Wong, Partner at McKinsey & Company and a leader of the McKinsey Health Institute. “Millions of Americans are working in jobs that don’t fully reflect their skills or earning potential, while healthcare providers struggle to fill critical roles. By creating more accessible pathways and addressing immediate income needs, we have an opportunity to strengthen the healthcare workforce while opening doors to more stable, higher-paying careers.”
Strengthening rural healthcare could also strengthen local economies
Rural communities face particularly acute healthcare workforce challenges. Approximately 92 percent of rural counties were designated as primary care Health Professional Shortage areas in 2023. Persistent staffing shortages are contributing to rising operating costs, reductions in essential services, and hospital closures.
The research suggests that addressing workforce shortages could help rural communities strengthen both their healthcare systems and their economic foundations.
“For rural communities, access to healthcare and economic opportunity are deeply connected,” said Sarah Tucker-Ray, Senior Partner at McKinsey & Company and a leader of the McKinsey Institute for Economic Mobility. “Building stronger pathways into healthcare careers could help communities retain essential services, create more stable, higher-paying jobs, and strengthen their economic resilience.”
Innovative workforce models demonstrate pathways to expanding healthcare access
The report highlights several examples of healthcare providers, educational institutions, and workforce organizations developing innovative approaches to recruiting, training, and retaining healthcare workers.
- Covista: As America’s largest healthcare educator, Covista serves 100,000 students across five accredited institutions, preparing nurses, physicians and behavioral health professionals. Through Chamberlain University and Walden University, Covista combines online coursework with local clinical training and partners with healthcare systems to connect that training to employment opportunities, including at rural hospitals, helping working adults pursue healthcare careers without leaving their jobs or communities. More than 75 percent of Walden University and Chamberlain University students work full time while attending school, and more than 30 percent of alumni report practicing in rural or medically underserved areas.
- Futuro Health: The nonprofit connects recruitment, training, learner support, and job placement to help working adults pursue healthcare careers. Futuro Health has helped nearly 12,000 learners earn credentials, including individuals from rural and medically underserved communities. Recent participants have achieved an average program completion rate of approximately 90 percent, with 73 percent of graduates working in or in fields related to their training.
Five priorities for closing healthcare workforce gaps
The report identifies five areas where states, healthcare providers, and educational institutions could take coordinated action:
- Build paid, job-linked training pathways that allow workers to maintain income while developing skills, with clear connections to available healthcare jobs.
- Redesign education for working adults through flexible schedules, hybrid learning, and community-based training programs that accommodate work and family responsibilities.
- Expand faculty and clinical training capacity through shared resources, simulation-based learning, and opportunities for experienced clinicians to become educators.
- Strengthen coordination between employers and educators to align training programs with local workforce demand, hiring timelines, and career pathways.
- Improve working conditions and career advancement opportunities through flexible scheduling, childcare support, mentorship, and sustainable career pathways that help healthcare workers remain in the profession.
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About the McKinsey Institute for Economic Mobility
The McKinsey Institute for Economic Mobility is an institute within McKinsey & Company dedicated to advancing inclusive economic growth and expanding economic opportunity. The institute develops research and insights, convenes leaders across sectors and advances practical approaches to some of the most consequential challenges affecting economic mobility. Through this work, IEM helps institutions better understand barriers to economic opportunity and translate insights into action. For more information, visit www.mckinsey.com/institute-for-economic-mobility.