Rethinking Staffing, Reviving Healthcare: Aaron Littles Urges a New Era of Innovation and Collaboration

The U.S. healthcare system is under pressure, and not only from patient demand. According to data, 193 rural hospitals closed between 2005 and 2024, and in urban areas, the past few years have seen more closures than openings. Behind many of these shutdowns, experts say, lies a root cause often overlooked: broken staffing models.

For Aaron Littles, founder of PDTXperts and Streamlined Consulting, two companies rooted in healthcare staffing and operational consulting, the conversation must shift now. "We're in a new economic reality," he says. "Clinicians want to earn a decent wage, something they can live off of. It's time boards and executives start accepting that and making smarter decisions from there."

Littles, who has worked with both healthcare providers and other industries, believes staffing is no longer just a budget line. It's a strategic pillar. His experience navigating complex labor markets and helping organizations pivot has positioned him as a thought leader in the high-stakes world of staffing strategy and innovation.

The strain on hospitals is intensifying due to outdated assumptions about labor. Littles points to what he calls the "payroll pinch," a mismatch between what institutions are willing to pay and what qualified employees now require. "You can't run a hospital with 2012 wages in a 2025 world," Littles says. "It's not just inflation that's the problem. It's competition for talent, shifting work preferences, and a fundamental change in how clinicians want to work."

The travel nurse boom from the COVID-19 pandemic is largely behind us. However, new immigration policies affecting adjacent sectors like food processing and hospitality, staffing scarcity is spreading, and even the hospitals need to adapt.

"We're seeing deportations reduce the workforce in other sectors, but healthcare isn't immune. If we don't rethink how we attract and retain staff, we're going to lose more hospitals. And that's a loss communities can't afford," he states.

Littles argues that the biggest threat to any organization is its own inefficiency. "Healthcare staffing companies spend too much energy looking sideways, worrying about the competition. However, if your own internal processes are broken, that's your biggest loss point," he says. "Don't worry about the big healthcare service names. Fix your fill rates. Improve your tech stack. Tighten up your model."

This inward-looking discipline is only half the battle. The other half, according to Littles, is knowing when to collaborate. "If there's a gap in your capabilities, whether it's technology, logistics, or strategy, bring in a partner. Find someone who can help you pivot or evolve. Make it a win-win."

It's a principle he applies beyond healthcare. Through his consulting firm Streamlined, Littles helps organizations in various sectors examine not just what they do, but how they do it and who they do it with.

Littles is pushing for a boardroom-level shift in hospital providers' mindsets. He says too many executives cling to models that no longer work, waiting for old strategies to yield new results. "That's insanity," he says. "You need to start asking, Who can we acquire? Where can we diversify? Who should we be talking to that we aren't?' 'What innovative approach are we not thinking of?' Those are the questions that lead to growth."

He also believes hospitals and staffing firms alike need to reevaluate the traditional managed services provider (MSP) model. "Hospitals should be asking: are we really getting the service we need from these giants, at a price we can sustain?" he says. "There may be more overhead, more tech, but also more cost. Smaller, nimbler firms might be the smarter solution in today's market."

Beyond solving today's issues, Littles is focused on shaping the future. One of the biggest emerging challenges, he notes, is worker classification. "Most PRN and Per Diem nurses are shift-based, with an irregular schedule. That's a gig model. But healthcare hasn't caught up with that reality," he says.

He envisions a hybrid model: somewhere between traditional W-2 employment and full 1099 contractor status that offers both tax accountability and clinician flexibility. "That kind of innovation requires collaboration, not just within companies, but also with governing bodies. We need frameworks that reflect today's workforce, not one from a century ago."

For Littles, this is more than business. It's about future-proofing the systems that sustain lives. "Healthcare staffing isn't going away. How we do it must evolve. That means more collaboration, more listening, and smarter modeling," he says. "You've got to stop treating staffing like a short-term problem and start treating it like the cornerstone of your survival."

And to healthcare leaders who feel squeezed by tight margins and shrinking options, Littles has a simple message: "You don't have to do it alone, but you do have to do it differently."