Many healthcare workers are seeing raises in 2024, but the size and certainty of those increases depend heavily on where you work, who employs you, and whether a union negotiates on your behalf. Federal employees got a guaranteed 4.7% base raise in January 2024. Unionized workers at large systems like Kaiser Permanente are seeing 5% increases. But for a large share of the workforce, pay has been flat or even declining when adjusted for inflation.
Federal Healthcare Workers: 4.7% Base Raise
If you work for the VA or another federal agency on the General Schedule pay scale, you received a 4.7% base pay increase effective January 2024. That’s the largest federal raise in over two decades. Depending on your duty station, locality pay adjustments push the total increase higher. In some metro areas, the combined raise lands above 5%. For example, employees in certain high-cost regions saw total increases of 5.07% to 5.4% when locality pay is factored in.
This applies broadly to nurses, pharmacists, lab technicians, administrative staff, and other GS-scale employees at federal facilities. It does not apply to contracted workers or those paid under separate pay authorities, though the VA has its own additional tools for adjusting nurse and physician pay to stay competitive with local markets.
Unionized Workers: Larger Guaranteed Raises
Healthcare workers covered by union contracts are generally seeing the strongest wage gains in 2024. The most notable example is Kaiser Permanente, where a coalition of unions representing tens of thousands of workers secured a new national agreement after a historic strike in late 2023. That contract includes 21% in across-the-board raises over four years: 6% in October 2023, followed by 5% in each of the next three years, including October 2024. Workers also received a $1,500 ratification bonus.
Kaiser isn’t alone. Healthcare unions across the country have been leveraging post-pandemic staffing shortages to negotiate stronger contracts. If you’re in a unionized role, your raise timeline and amount are spelled out in your collective bargaining agreement, making it the most predictable path to higher pay in this industry.
California’s New Healthcare Minimum Wage
California passed SB 525, which creates a staggered minimum wage specifically for healthcare workers. The law affects everyone from janitorial staff to medical assistants at covered facilities, though the timeline varies by employer type.
For hospitals and clinics with a high share of government-funded patients, rural independent facilities, and those in smaller counties, the minimum rose to $18 per hour starting June 1, 2024, with 3.5% annual increases built in through 2033. Larger health systems with 10,000 or more full-time employees, dialysis clinics, and facilities in Los Angeles County are on a faster track toward $25 per hour, though that threshold doesn’t fully kick in until June 2026. Other covered employers will reach $23 per hour by June 2026.
If you’re a lower-wage healthcare worker in California already earning above these thresholds, the law may not immediately change your paycheck. But for those closer to the floor, particularly in clinics, nursing homes, and support roles, it represents a meaningful and legally mandated raise.
Nurses: A Mixed Picture
For registered nurses, 2024 salary trends are uneven. According to the American Nurse Journal’s annual salary survey, only 53% of nurses reported a pay increase in the previous 12 months, down from 61% the year before. Meanwhile, 12% said their pay actually decreased, and 35% reported no change at all.
The data shows a widening gap. A larger share of nurses reported earning $69,000 or less compared to the prior year (29% vs. 25%), while the percentage earning $130,000 or above also grew slightly (15% vs. 13%). In other words, higher-paid nurses in specialized or travel roles continued to gain ground, while many staff nurses saw stagnation. As one survey respondent put it: “Despite the increase in workload, there has been no commensurate increase in pay.”
Travel nursing rates, which spiked dramatically during the pandemic, have come back down significantly. Nurses who moved into travel contracts for the premium pay may find that the math has shifted. Staff positions are offering more competitive signing bonuses in some regions, but base hourly rates for bedside nurses have not kept pace with inflation in many markets.
Physicians and Private Practices: Medicare Cuts Add Pressure
For doctors and other providers who bill Medicare, 2024 brought a pay cut rather than a raise. The Medicare Physician Fee Schedule conversion factor dropped 3.4%, from $33.89 to $32.74 per service. Overall payment rates fell by 1.25% compared to 2023.
A new add-on billing code (G2211) was introduced to better compensate primary care and longitudinal care visits, which may help offset some losses for family medicine and internal medicine providers. But because Medicare operates under budget neutrality rules, funding that new code means redistributing money away from other services. Specialists in procedural fields may feel the pinch more acutely.
This matters beyond just doctors. When a private practice or small clinic sees lower reimbursement from Medicare, that tightens the budget available for staff raises across the board. Medical assistants, front desk staff, and billing teams at physician-owned practices are often the most affected by these downstream reimbursement pressures.
What’s Driving the Variation
The short answer to whether you’ll get a raise in 2024 comes down to a few key factors. Union membership is the single strongest predictor of a guaranteed, above-inflation raise. State-level legislation like California’s SB 525 creates a floor but only in certain states. Federal employment offers a reliable annual adjustment, though it doesn’t always keep up with local cost-of-living increases.
For the majority of healthcare workers employed by private hospitals, clinics, and long-term care facilities without union contracts, raises are discretionary. Many large hospital systems have announced wage adjustments to address retention problems, but these tend to be targeted at hard-to-fill roles like ICU nurses or surgical techs rather than across-the-board increases. If your employer hasn’t announced a 2024 raise, the leverage you have comes from the broader labor market: healthcare job openings still outpace available workers in most regions, which gives you negotiating power even without a formal pay bump on the table.