‘Uber for nurses’: gig-work apps lobby to deregulate healthcare, report finds

Billion-dollar tech platforms are aggressively pushing for deregulation of the “Uber for nursing” industry in an effort to expand gig work in the healthcare sector, according to a report published Tuesday.

The report from the AI Now Institute, Uber for Nursing Part II: How Gig Nursing Companies Are Lobbying States to Deregulate Healthcare, examines the use of artificial intelligence to staff hospitals and other healthcare facilities.

The report warns that growing use of the technology comes at the expense of workers’ rights, protections and pay.

As has increasingly become the case with ride-share companies, the “Uber for nurses” model relies on artificial intelligence to set pay rates for work shifts, to surveil performance metrics, and use that data to determine a worker’s future access to gigs and pay rates. The industry also allows nurses to bid on work shifts, with the lowest pay rate winning the shift.

The model has been lucrative for its promoters. Three nurse gig platforms have reached a $1bn valuation, according to the report, as they have received an influx of investments from private equity firms and are securing government contracts to staff public facilities, including Immigration and Customs Enforcement (ICE) detention centers.

“AI is incorporated into all these human management software systems, and for nurses, that means dropping them into all kinds of places, without orientation, without workers comp, without any way to protect themselves if they’re sick and they need to cancel,” said Dr Katie J Wells, co-author of the report and a senior fellow at AI Now. “That also means, for a lot of these apps, using AI technologies to facilitate a bidding war against nurses.”

A screenshot of a quick-bid auction from a nurse gig platform, Clipboard Health, states: “You can choose the rate you’d like as a bid, and the lowest bid wins!”

The auction allows gig nurses to make an hourly wage bid for work shifts at a medical facility, and the lowest-wage bid secures the position.

Clipboard Health also uses disciplinary point systems for gig nurses, including deducting points from nurses for cancelling a shift, with more points deducted for less notice being given for the cancellation, and other point deductions for showing up late to shifts.

Wells noted these trends are increasingly concerning, given healthcare has been one of the few sectors experiencing reliable and consistent job growth in the US.

The latest report found that since 2022 lawmakers in at least 17 states have introduced bills designed to make gig nursing platforms exempt from the regulations applied to other healthcare staffing agencies.