In Short…
- Healthcare L&D leaders consistently lose leadership buy-in because they speak in program terms instead of business terms.
- The shift from “cost center” to “investment with measurable return” is the single most important reframe an L&D leader can make.
- The organizations winning on workforce development are the ones building governance, measuring impact, and moving at the speed of the business.
Most learning leaders in healthcare are good at designing programs. Fewer are good at the conversation that determines whether those programs ever get funded.
That gap, between what L&D knows how to do and what executive leaders actually need to hear, is one of the most persistent problems in healthcare workforce development. It doesn’t get solved by building a better curriculum. It gets solved by changing how learning leaders show up in the room.
We explored this directly in an episode of the Being Intrepid podcast with Darci Hall, head of HR Strategy, Learning and Development at Kaiser Permanente. What she described, across a career spanning Providence Health, Xerox, and now one of the largest nonprofit integrated health systems in the country, is a discipline that many L&D teams haven’t been trained for: making the business case to get leadership buy-in.
The Real Problem Isn’t the Program. It’s the Pitch.
Healthcare organizations face a specific and compounding workforce challenge right now. Budgets are tight. Turnover in key roles, including member services and clinical support, remains high. Younger employees arrive with different expectations about career development and don’t stay in organizations that don’t meet them.
Against that backdrop, learning teams often respond by designing better programs. The better program rarely gets funded, though, if the person approving the budget doesn’t understand why it matters.
The issue isn’t awareness. Most healthcare executives know workforce development is important. What’s missing is the translation layer: the ability to connect learning activity to the financial and operational outcomes that executives are actually managing. As Darci put it, “The biggest Achilles heel for learning and development professionals is not having that business mindset.”
Talk in business terms, don’t talk in learning terms. You’ll lose them.
The starting point to getting leadership buy-in is understanding what executives care about. That means knowing the organization’s strategic priorities, knowing what’s keeping the COO up at night, and connecting every learning initiative to those concerns. “Talk in business terms,” Darci said. “Don’t talk in learning terms. You’ll lose them.”
It sounds simple. It’s not easy. But it’s the prerequisite for everything else.
From Cost Center to Investment: The Language Shift That Changes Everything
L&D is widely treated as a cost center inside healthcare organizations. That framing turns every budget conversation into a negotiation over what to cut. The reframe that changes the dynamic is straightforward: stop calling it a cost and start calling it an investment. Then be prepared to show the return.
That last part is the commitment. Calling something an investment without measuring it is just spin. When Darci was at Providence Health, her team attached dollar figures to outcomes. Retaining just 1% of the workforce, she explained, represented $53 million in savings for the organization based on internal workforce analytics modeling. That’s the kind of number that earns a seat at the table.
At Providence Health, retaining 1% of the workforce translated to $53 million in savings.
Most L&D teams don’t calculate numbers like that, because they’re focused on program design rather than financial impact. The insight here is that those two things have to be built together. The business outcome comes first. The program follows from it. That sequence, outcome to investment to design, is what separates L&D functions that grow from ones that get cut.
Why Healthcare Makes This Harder
Healthcare has characteristics that make the credibility problem more acute than in most industries. It’s risk-averse by culture. Clinical environments are built on protocols, oversight, and caution, for obvious and important reasons. The challenge is that this same risk mindset often spills over into L&D decisions where it doesn’t belong.
As Darci described it: “We tend to translate that risk mindset to learning and development, where we can be [riskier], we can take more chances, we can practice, we can fail within learning, and still provide excellent patient care at the end of the day.”
The result is that decisions about modality changes, new technology, or redesigned healthcare onboarding programs get treated with the same scrutiny as clinical protocols. When learning moves slower than the workforce’s needs, people don’t get the development they came for. They leave.
What Gets Built When Learning Moves Faster
The organizations making real progress on workforce readiness in healthcare share a few things in common. They measure outcomes, not just completions. They build the business case in language the COO will recognize to gain leadership buy-in. They invest in practice and application, not just content delivery. And they design intentionally for career development, especially at the entry level, where the gap between wages and cost of living has made retention a genuine operational crisis.
Darci’s work at Providence illustrates what this looks like in practice. By building intentional career pathing and access programs for underserved employees, Providence saw 54% of non-white minority employees engage with tuition assistance and move upward in their careers. That’s not just a workforce equity outcome. It’s a pipeline strategy. Filling a medical assistant or CNA role from within is faster, cheaper, and produces better-prepared staff than external hiring in a constrained market—a pattern well-documented across industries and increasingly confirmed inside healthcare systems themselves.
The lesson for healthcare payer organizations is the same. The agents most likely to stay, develop into senior roles, and become the people who train others are the ones who see a path. If learning exists only as compliance and onboarding delivery, it can’t create that path. If it’s connected to career development and visible to the people who need it most, it becomes a retention mechanism with real financial value.
The Technology Trap and What Change Management Actually Requires
There’s a version of this problem that appears specifically when organizations try to modernize their learning stack. A new platform or modality gets selected, often correctly, and the implementation focuses on the technology rather than the people. The result is a tool that nobody uses the way it was designed.
Darci was direct about experiencing this herself. After rolling out a learning experience platform during Covid at a previous organization, adoption stalled. “Our employees weren’t trained on how to pull and how to collaborate, how to think about education differently,” she said. “We hadn’t done a very good job of change management.”
Healthcare workers who’ve spent careers receiving assigned training aren’t automatically ready to take a self-directed approach. The change has to be managed, not just deployed. Organizational readiness is a design input, not an afterthought.
This is why governance matters as much as technology in any serious learning transformation. Darci’s first structural move at Kaiser was to establish a learning governance board, a cross-functional body that sets a unified learning strategy across markets and business units while honoring local needs. The goal is to replace a fragmented, distributed model, where learning looks different in every market and nobody knows what’s being built elsewhere, with a coherent system that can be measured and improved.
That structure won’t produce quick wins. It creates the conditions for consistent, measurable improvement over time.
The Next Five Years: Practice, Personalization, and Learning in the Workflow
The direction healthcare learning is heading is clear, even if most organizations are still some distance from it. Learning gets embedded into the work itself, not scheduled around it.
AI-supported practice, coaching in the flow of work, and personalized feedback at scale are already being deployed in pockets. The shift Darci describes isn’t theoretical: “People won’t have to stop and learn and then try to translate it. They’ll be doing it within their day-to-day activities.” For member services agents at a health plan, that means practicing a difficult call before it happens. For a new clinical support hire, it means getting feedback on real interactions rather than classroom simulations.
The industry average for reaching peak proficiency in call center roles is 4 to 6 months, according to McKinsey. Organizations redesigning around applied practice and real-time feedback are compressing that significantly.
What makes this meaningful at scale isn’t the AI itself. It’s the structure around it: cohort accountability, manager visibility into readiness, and continuous feedback loops that connect practice to performance. That’s the difference between a tool and a system. And building that system requires exactly the kind of credibility with operations leaders that this whole conversation keeps returning to: speak the language of the business, measure what matters to the people who fund your work, and design for outcomes, not activities.
The Mindset Shift That Actually Sticks for Getting Leadership Buy-in
For learning leaders who feel stuck, the path forward isn’t a new platform or a better instructional model. It’s a different starting point.
Stop trying to educate executives on learning. Start joining them in the conversation they’re already having. The workforce is changing. Member and patient expectations are rising. Competition for talent is real at every level, from entry-level call center staff to experienced clinicians. L&D sits at the center of how organizations respond to all of that, but only if learning leaders can make that case in a language that lands.
As Darci put it: “Workforce drives organizational performance. Period, end of statement.”
The organizations closing the gap between learning investment and workforce performance are the ones where L&D leaders figured that out early and built everything around proving it.
Workforce drives organizational performance. Period, end of statement.
Learn how healthcare payer organizations are redesigning learning for readiness and measurable performance impact.
