Workforce shortages in health care are reaching crisis levels. In response, some employers are rethinking their approaches to recruiting and retaining workers and adopting a "grow-your-own" model, investing in their lower-skilled frontline workers—creating career ladders and work-based learning systems that enable these workers to advance into higher skilled and higher paying jobs. Drawn on the experience of the Baltimore Alliance for Careers in Healthcare, this brief illustrates how a career ladder system could work.