How a Large Healthcare System Cut Turnover and Unlocked $20.7 Million in Employee Financial Support.

Healthcare systems face a particularly tough version of the retention puzzle: a multigenerational workforce with wildly different needs, real budget constraints, and a PTO liability that keeps growing on the balance sheet no matter what HR does. One large healthcare system decided to tackle all three problems with a single solution.

The Challenge

As this organization's workforce became increasingly multigenerational, HR was focused on meeting genuinely diverse employee needs and expectations across those different demographics. Budget constraints made it difficult to implement programs that could serve everyone effectively, so flexibility within the benefits package became a top priority.

Financial wellness was also a growing concern. National studies suggest only 44% of employees feel financially well, and more than half have taken some kind of action due to financial strain, a reality this organization's leadership recognized in its own workforce. They wanted to support responsible financial behaviors and help alleviate financial stress, not just check a benefits box.

Underneath both of those concerns was a familiar structural one: PTO liability was one of the largest line items on the organization's balance sheet, and it kept growing every year. Leadership wanted to reduce that liability at a fraction of the cost of traditional programs, ideally before year-over-year salary increases made the liability even more expensive, by simply repurposing the value of excess PTO hours already sitting on the books
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The Solution

This organization launched PTO Exchange with options allowing employees to convert their excess PTO into direct financial support or donate it to a charitable organization.

The Impact

In under two years since launch, employees at this organization have exchanged:

•    $20+ million in PTO value
•    575,000+ PTO hours
•    More than 12,300 individual exchanges processed

Employees who used PTO Exchange in the program's first year turned over at just a **4.83% rate**, and platform users overall saw a **61.4% lower turnover rate** than non-users — one of the strongest retention signals seen across PTO Exchange's client base.

The financial case has been just as compelling. The program has generated more than **$1.18 million in organizational savings**, including retained service fees, FICA savings from required exchange minimums, and reduced PTO liability ahead of annual salary increases.

In Their Words

"I appreciate [this organization] so much for having the PTO Exchange option. My car has been down for over a month now and I used PTO Exchange to obtain the extra funds I needed. I thank God for PTO Exchange because without it I would be back to square one! Thank you so much, it means a lot to know your company has your back!" EMPLOYEE

Why It Works for Healthcare

This organization's results show that PTO liability reduction and employee retention aren't competing priorities — they can be solved by the same program. By turning an already-budgeted benefit into something employees can put to immediate use, this healthcare system strengthened its bottom line and its relationship with its workforce at the same time.

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