Health care administrators can instantly tell you how they serve patients, notes Surya Kolluri, head of the TIAA Institute. But ask those same leaders to define their employee value proposition (EVP), he says, and they may come up blank. 

“If you don’t have a good answer to that question, of course you’re going to have burnout,” Kolluri says. 

A 2025 TIAA Institute report on health care workforce productivity tells a familiar story: Health systems are struggling to keep pace with an aging population, and more than 40 percent of surveyed health care employees say that staffing shortages and a lack of resources are a major problem. But the report also shows what these workers care about most, providing a window into how employers can boost retention efforts. 

While pay topped the list, benefits and culture weren’t far behind. By aligning their benefits packages with what nurses care about — and by communicating clearly about benefits like retirement packages — Kolluri says that health care systems can create a proverbial burnout “shock absorber” that keeps nurses in the health care sector. 

“We need to expand the equation,” Kolluri says. “This means looking to new strategies, collaborations, and perspectives, which reach beyond zero-sum competition for a finite pool of talent. Instead, successful efforts will expand the pipeline by cultivating new sources of talent and embracing a wider set of elements in the employee value proposition.”

What is EVP?
According to Gartner, an organization’s employee value proposition (EVP) “captures the set of attributes that external talent and internal employees perceive as the value they gain by working in an organization.”

What nurses want

The nursing shortage isn’t just a pipeline problem. It’s a retention issue.

The 2024 National Nursing Workforce Study reports that 40 percent of nurses intend to leave the workforce by 2029. Other than retirement, the top reasons people leave nursing are burnout, workload, understaffing, and inadequate salary, according to the study. 

Unsurprisingly, health care employees rate salary as the most important job feature (69 percent). However, TIAA found that recent pay increases have done little to improve employee satisfaction or end nursing shortages, with nearly half of hospitals reporting RN vacancy rates of more than 10 percent. While average earnings in the health care sector went up by 20 percent between 2020 and 2024, only 52 percent of health care employees feel they are paid fairly, the lowest level for any industry. 

But the report cites the “silver lining” of nurses placing a high value on EVP-related factors like benefits (45 percent), work-life balance (44 percent), flexibility (35 percent), culture (33 percent), and other intangible aspects of their jobs. 

“Shaping the employee value proposition (EVP) beyond compensation can play a vital role in attracting and retaining employees,” the TIAA report states. “Benefits like retirement saving, wellness resources, and educational support, together with job features like work-life balance and workplace culture, can build satisfaction while mitigating stress.” 

Making retirement an EVP pillar

Although nurses value retirement benefits and other perks, Kolluri says that health care providers typically don’t communicate about these benefits effectively. As a result, employees may not understand the full value of their compensation package. Kolluri recommends that health care organizations actually list out the monetary value of employee benefits — including not only 401(k) matching, but also health insurance premiums and employer Social Security and Medicare contributions — and include that information with employee paychecks. 

“Organizations need to communicate the full benefits that the employee is getting,” Kolluri says. “Typically, the employee only sees the paycheck. But when you add everything up, it’s a much bigger number.”

“I can’t tell you how many people have not even looked at their retirement account,” Kolluri adds. “It’s just not what they’re thinking about. They’re busy caring for patients.” 

Kolluri notes that different benefits appeal to different employees depending on their age and stage of life. For example, while student loan repayment benefits may excite younger nurses, older workers are more likely to be moved by the opportunity to take leave to care for an aging parent. Kolluri acknowledges that nurses in their twenties may view a conversation about retirement savings as the equivalent of “eat your spinach,” but he says there are ways to frame the issue to appeal to employees of all ages. 

When talking to younger workers, Kolluri typically brings up longevity, noting that a significant portion of their generation is likely to make it to age 100 — essentially receiving a 20-year “bonus” compared to earlier generations. The question is how they’ll afford to use that time. “We talk about spreading that bonus out across their lives by taking trips and sabbaticals, and how they need to be able to finance those things,” Kolluri says. “Then, they’re all-in.” 

Kolluri also recommends that health care organizations communicate about retirement in terms of the thing that research shows employees care about the most: their paychecks. While a retirement savings goal can feel abstract, he says nurses and other workers are more responsive to the idea of replacing their current income in retirement. “People are more in tune with their paycheck than with a lump sum,” he says. 

How TIAA partners with health care institutions and nurses

TIAA works closely with health care organizations, providing retirement plan packages, helping health care leaders think through what their benefits packages should look like, and helping them investigate questions unique to their specific situations. 

“Benefits and retirement plan design are important pillars of EVP, and those are areas where we help our clients,” Kolluri says. “The TIAA Institute is committed to engaging with health systems, experts, and TIAA teams to continue exploring these questions and surfacing new insights and models.”

The organization has a track record of not only partnering with health care institutions, but also of spearheading research into how to address the nursing shortage. In 2022, the TIAA Institute published a white paper on nursing retention, which reported that nurses reacted favorably when presented with potential benefits such as Retiree Healthcare Savings Plans (RHSPs). 

“Nurses are not thinking about being retired and sick when you are 25 or 35,” said a nurse referenced in the white paper. “You think you will never reach retirement. Then you blink, and you are there.”