Capacity Building & Workforce Intelligence. The workforce that powersoutcome-based operations.
Health organizations are short of skilled people and full of repetitive work. We redesign roles around people working with AI, train teams for the new work and stand up the centers that sustain it.
A short call with a senior expert. No patient information needed.
Where capacity is lost
- Open roles
- Repetitive tasks
- Uneven skills
- Turnover
- Training backlog
How we build capacity
- 1Map work to roles and skills
- 2Redesign roles around people and agents
- 3Train for the new work, role by role
- 4Stand up and hand over the center
What you get
- Teams ready for AI-human work
- Faster ramp-up
- Less reliance on scarce hires
- Sustainable delivery
Built on how healthcare workforces are measured and credentialed
- HRSA workforce projections
- Bureau of Labor Statistics occupational data
- AHIMA and AAPC credential pathways
- ANCC and ACCME education standards
- Competency-based assessment
- Joint Commission competence standards
Watch 46 seconds
You can’t hire your way out: how we redesign roles around people and AI
Read the film as text
- You can't hire your way out.Open roles stay open, and the work keeps piling up.
- Why it matters138,000 nurses have left the workforce since 2022. Source: NCSBN Open roles. Repetitive tasks. Uneven skills. Turnover. A training backlog.
- Roles change, role by role.Coder: Routine, clear-cut encounters moves to agents; Complex cases, edge rules, audits grows for people. Biller or follow-up specialist: Status checks and rework moves to agents; Payer escalations and root causes grows for people. Clinical reviewer: Gathering charts moves to agents; Clinical judgment and appeals grows for people. Manager: Chasing status moves to agents; Capacity and quality decisions grows for people. We map the work, redesign the role, train for it, and hand over the center.
- What you get.Teams ready for AI-human work. Faster ramp-up. Less reliance on scarce hires. Sustainable delivery.
- During Health.The workforce that powers outcome-based operations. Book a workforce review, or Free readiness scorecard, at duringhealth.com.
What is changing in the health workforce right now
Dated facts, each with its source. This part of the page is refreshed regularly; the rest is built to last.
13 hours
a week spent on prior authorization per physician
The AMA’s 2025 survey of 1,000 physicians found about 40 requests a week, 95% of physicians reporting care delays and 40% employing staff who work only on prior authorization.
81%
of physicians now use AI professionally
More than double the 2023 rate, in a survey of nearly 1,700 doctors. The most common uses were summarizing research and standards of care (39%) and documenting billing codes, charts or visit notes (28%).
138,000
nurses who left the workforce since 2022
NCSBN’s national workforce study also found about 40% of nurses intend to leave or retire within five years, so retention is a capacity issue as much as hiring.
NCSBN, National Nursing Workforce StudyAs of Oct 2026
8% → 3%
projected RN shortage, 2028 to 2038
HRSA projects the national registered nurse shortage easing but not closing over the decade. Capacity has to come from how work is organized and how people are trained, not from hiring alone.
Every number links to its source.
What most organizations get wrong about capacity
Myth
“Hiring more people will fix capacity.”
Fact
There are not enough skilled people to hire, and national projections expect shortages to persist. Capacity comes from redesigning the work so scarce people do only what only they can do.
Myth
“Training is a one-day event.”
Fact
Skills fade without practice and feedback. Role-based programs with real cases, coaching and measured competency change the work. A slide deck does not.
Myth
“AI will make workforce planning easier.”
Fact
It makes it harder first. Tasks change faster than job descriptions, so roles, skills and review responsibilities have to be redesigned on purpose.
Four things you can hold us to.
AI-human workflow design
Redesign roles around people working alongside agents.
What you get
- A task-by-task map of what people and agents each do
- Role definitions with review responsibilities named
- Handoff and escalation rules
- A capacity model showing hours released and where they go
Role-based upskilling
Targeted training that lifts capability where it matters.
What you get
- Skills assessment by role
- Learning paths for coders, billers, nurses, analysts and managers
- Practice on real, de-identified cases
- Competency checks and refreshers
Center build-out
Stand up and enable delivery centers and capabilities.
What you get
- An operating model and staffing plan for a delivery center
- Recruiting profiles, onboarding and quality systems
- Tools, security and workspace
- Build-operate-transfer to your ownership when you are ready
Everything we do in capacity building and workforce intelligence
Ten service areas, from planning who you need to keeping them. Most engagements start in one and grow into the others.
Workforce strategy & planning
Knowing what you need before you hire or train.
- Demand and capacity modeling
- Skills gap analysis
- Build, buy or borrow decisions
- Succession and coverage planning
AI-human workflow & role design
Roles built for people working with agents.
- Task and workflow mapping
- New role definitions
- Review and escalation rules
- Capacity released and redeployed
Competency frameworks & assessment
Defining and measuring what good looks like.
- Role competency models
- Practical assessments on real cases
- Accuracy and quality scoring
- Individual and team skill maps
Role-based upskilling
Training that changes the work.
- Coding, billing and HIM training
- Clinical and operations training
- Data and AI literacy
- Coaching and refreshers
Credential preparation & career pathways
Ways up that keep people.
- Preparation for industry credentials
- Career ladders in coding and HIM
- Internal mobility programs
- Mentoring
Onboarding & ramp-up programs
Productive sooner, with fewer early exits.
- Structured first-90-day plans
- Shadowing and graduated workloads
- Quality gates before independence
- Ramp-up measurement
Center build-out & build-operate-transfer
A delivery center that becomes yours.
- Operating model and staffing plan
- Recruiting, onboarding and quality systems
- Run under agreed service levels
- Transfer plan and handover
Retention & burnout reduction
Keeping the people who are hardest to replace.
- Workload and burnout diagnostics
- Removing low-value tasks
- Scheduling and flexibility models
- Recognition and career visibility
Workforce analytics
Capacity, productivity and quality in one view.
- Productivity and quality dashboards
- Backlog and turnaround tracking
- Training impact measurement
- Forecasting of hiring needs
Change management & leadership coaching
Leaders who carry the change.
- Stakeholder alignment
- Manager coaching
- Communication plans
- Adoption tracking
How an engagement runs: start with one team, not the whole organization
You see a measured change in capacity before you widen the scope.
Diagnose
Map the work, the roles and the skills, and find where capacity is lost.
You get
A capacity baseline and a ranked list of changesRedesign
Redesign roles and workflows around people working with agents, with review rules.
You get
New role definitions and a workflow mapTrain
Teach the new work role by role, on real cases, and check competency.
You get
Trained team members and competency resultsSustain
Run, measure and improve, or hand the program to your leaders.
You get
Playbooks, dashboards and an optional transfer path
Who we build capacity for
Hospitals and health systems
The problem
Open roles and turnover, with training that does not keep up.
A good first project
One department’s roles and workflows, redesigned and trained.
Revenue cycle and HIM leaders
The problem
Coders and billers are scarce, and backlogs grow.
A good first project
A role-based upskilling and career-path program.
Physician groups and MSOs
The problem
Rapid growth, uneven training and no shared standard of good work.
A good first project
A competency framework and onboarding program.
Payers and health plans
The problem
Operations teams must adopt new tools and rules faster than ever.
A good first project
AI-human workflow design for one operations team.
Is your workforce ready for AI-human work?
If you cannot tick most of these today, redesigning the work comes before buying more tools.
- You can name the work that only your most skilled people should do.
- Every role has a written description of current tasks, not last decade’s.
- Competency is measured on real work, not on course completion.
- New hires reach full productivity on a plan, with quality gates.
- Staff know where AI is used and who reviews its output.
- There is a visible career path in your hardest-to-fill roles.
- You track burnout signals and act on them.
- You can say how many hours automation released, and where they went.
Three questions to ask your team on Monday
- 01
Which tasks do our most skilled people do that someone else could do?
- 02
How long does a new hire take to reach full accuracy, and how do we know?
- 03
If we automated a third of this team’s work, what would those people do next?
If the answers are slow or different in every room, that is where we start.
Check our thinking before you call us
We publish how we read the rules and give away the tools. Judge the depth for yourself.
- Article
Agentic AI in US health systems: a governance checklist
Who approves what when people work beside agents.
- Tool
HIM technology readiness scorecard
Score people, process, data, technology and governance.
- Download
HIM technology readiness self-assessment
A 15-page workbook with a 90-day readiness plan.
- Article
NCCI edits explained: PTP edits, MUEs, modifiers and add-on codes
The kind of rule-reading that coders need to train on.
Do you replace staff with AI?
Our focus is removing repetitive work so skilled people can spend their time on judgment. We design roles around people working with agents and plan where released hours go.
How do you measure whether training worked?
By competency on real work: accuracy on a sample of cases, turnaround and quality scores before and after, not by course completion.
Can you train our coders and billers?
Yes. We build role-based programs on real, de-identified cases, with assessments and refreshers. We can also prepare people for industry credentials.
What is build-operate-transfer?
We stand a center up, run it under agreed service levels and hand it to you when you are ready to own it, with documented processes and trained people so ownership moves without a cliff.
Do you recruit staff for us?
We define the roles, profiles and onboarding, and can set up and run a center. Recruiting arrangements depend on the engagement and are agreed in writing.
How do you protect PHI in training?
We use de-identified or synthetic cases where possible. Where real records are needed, it is under a written agreement, including a business associate agreement where HIPAA applies.
How is an engagement priced?
By scope: one team or role, the program and the measures agreed up front. We begin with a defined first team so you can see the results before widening.
Start with one team. Prove the change, then scale it.
Tell us where capacity is tightest. We will tell you what to redesign, what to train and how we would measure the difference.
Please do not send patient information. Describe the situation without identifying anyone.