AI Now Institute 報告警告「護理版 Uber」平台遊説放寬監管，護士保障或受損

A new AI Now Institute report published April 21, 2026, warns that gig-work platforms marketed as "Uber for nursing" are aggressively lobbying states to rewrite healthcare staffing rules, a push that could leave nurses with less pay, fewer protections, and less control over their shifts, according to The Guardian.

The report, titled Uber for Nursing Part II, identifies apps like Clipboard Health, ShiftKey, CareRev, and IntelyCare as the main players reshaping how hospitals and long-term care facilities fill shifts. According to the report, the ten most prominent gig nursing platforms have raised roughly $1.4 billion in funding, with ShiftKey valued at $2 billion and Clipboard Health at $1.3 billion.

Researchers say the platforms' AI-driven pricing, performance surveillance, and contractor classifications are creating a new category of gig work that looks a lot like rideshare, and may be on track for similar regulatory battles.

The report describes a system where nurses download an app, get rated on performance, and often bid against each other for shifts. Platforms use algorithmic pricing, including CareRev's "Smart Rates" system, which recommends hourly shift rates based on market demand and past performance, according to the AI Now Institute.

Some platforms run "Quick Bid" auction systems where nurses bid against each other for the same shift, with the lowest rate winning. The report also raises concerns about what it calls "surveillance wages," or algorithmic wage discrimination, where platforms may use personal data to set different pay rates for nurses doing identical work. A companion Roosevelt Institute brief found that some platforms "use data-brokers to determine nurse debt levels and offer lower wages to those with highest debt loads."

Workers are classified as independent contractors, which excludes them from minimum wage protections, overtime, workers' compensation, and unemployment insurance, according to the AI Now Institute. Nurses also report arriving at facilities with no paid training or orientation, and say shift cancellations and ratings can permanently affect their access to future work.

One 29-year-old St. Louis nurse identified only as Dana, quoted in coverage of the researchers' earlier interviews, said: "I love being a nurse. But I hate being a nurse right now with these greedy, immoral, corporate companies have done to health care."

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Since 2022, lawmakers in at least 17 states have introduced bills to carve gig nursing apps out of the rules that apply to traditional healthcare staffing agencies, per the report. Eight states, including Colorado, Illinois, Iowa, Louisiana, Minnesota, Missouri, Nevada, and Rhode Island, have already advanced exemption bills. Six more, including Georgia, Ohio, Pennsylvania, California, Missouri, and Wisconsin, have seen bills aimed at carving platforms out of worker protection laws.

The lobbying is well-funded. Federal lobbying by Clipboard Health and ShiftKey exceeds $1.1 million combined, and the platforms work alongside Amazon and Uber through the Coalition for Workforce Innovation, the report states.

Not every state is on board. In 2025, New York classified gig nursing platforms as healthcare staffing agencies, requiring annual registration and quarterly wage reporting, and blocking independent contractor classification. Following the law, Clipboard Health, Nursa, and KARE ceased operations in the state, the report says.

Gig platforms are a fast-growing slice of the nurse staffing market, and the rules governing them are being written right now. The AI Now Institute warns that bidding wars and algorithmic pricing can push profession-wide wages down, while contractor classification strips nurses of the benefits and protections most healthcare workers expect. Healthcare facilities are already spending heavily on these services, with one Colorado nursing home spending $2.9 million in 2022 and a Chicago hospital spending $2.7 million annually on platform staffing, signaling that this model is not going away.

For nurses picking up shifts on an app, the report suggests paying close attention to rating systems, cancellation policies, and whether the facility provides any orientation or training. For unionized nurses, the authors flag risks of job displacement as facilities substitute gig workers for permanent staff.

State legislation is also the place to watch. Bills in Colorado, Illinois, Wisconsin, and other states could determine whether gig nurses are treated as employees or contractors, a classification that affects pay, safety, and accountability when something goes wrong at the bedside.

🤔Have you picked up a shift through an app like ShiftKey, CareRev, or Clipboard Health? Tell us about your experience in the comments.  

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1. Published on

   April 22, 2026

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