Comparison · verified July 2026
MakeShift alternatives, when the rules are clinical
MakeShift is a cloud employee scheduling and time-tracking platform from Calgary's AppColony, used across healthcare, retail and other shift-based industries. It publishes entry pricing, ships staff mobile apps, and syncs schedules into payroll. Its scheduling engine is general-purpose: positions and skills match people to shifts, but nothing in its public documentation blocks an expired licence.
From $99/month per location · No sales call · No card to start
At a glance
- MakeShift publishes real entry pricing: $3.75 per employee per month for its Core plan, plus $2.00 per employee per month for the time and attendance add-on (verified July 2026). Higher tiers are quoted.
- It earned its reputation on ease of use and mobile-first staff scheduling, and it began in healthcare: the company was established, per MakeShift, in 2014 to schedule healthcare teams.
- The engine is general-purpose. Positions and skills are matching criteria, not dated credentials; its public documentation does not describe licence-expiry blocking, nurse-to-patient ratios, exclusion screening, or a CMS PBJ export.
- Its integrations are genuinely useful: a documented payroll-platform sync through a marketplace listing, calendar subscriptions for Google, Outlook and Apple, and a public API.
- MedAligna prices per location rather than per employee ($99–$249 per month), and the clinical rules are the product: expiry blocks, ratios with acuity, exclusion screening, PBJ.
What MakeShift does well
It is easy to like. MakeShift's scheduling and staff apps are built for the person doing the rota and the person working it: available shifts get claimed from a phone, exchanges happen with notifications rather than phone calls, and managers stop being the switchboard. Its healthcare customers say exactly that in its case studies.
It is also straight with buyers in a way this category mostly is not: the Core plan price is on the website ($3.75 per employee per month, July 2026), there is a free trial, and its payroll marketplace listing spells out precisely what syncs. Publishing your price and your integration surface is behaviour we would rather praise than pretend not to notice.
Where the fit breaks down for clinical teams
MakeShift matches people to shifts by position and skill, and that model carries a lot of industries well. What it does not carry is the part of healthcare scheduling that is regulation rather than preference: a skill tag has no expiry date, so nothing refuses to schedule the RN whose licence lapsed on Tuesday; there is no nurse-to-patient ratio held against a census, no federal exclusion screening, and no CMS Payroll-Based Journal export in its public documentation.
None of that is a hidden flaw; it is what general-purpose means. The question for a clinic, an agency or a facility is whether the scheduler should merely record the roster you chose, or refuse the one you are not allowed to run. If an audit, a surveyor or a board could ask you about it later, it belongs in the second category.
Skills are not credentials
A position or skill in MakeShift is a matching label a manager assigns. A credential in MedAligna is a dated document with an owner: it expires on a date, it is checked against the end of every shift, and an assignment past that date is refused with the reason on the cell. The two look similar on a feature list and behave nothing alike in March when the licence lapses.
Per-employee pricing reads cheap and scales linearly
At $3.75 per employee per month, twenty staff cost $75 and look like a bargain. A 90-bed facility rostering 120 people is at $450 before the time-and-attendance add-on, and every hire moves the bill. MedAligna is flat per location, so the price is a number you can say out loud a year from now.
Which one is right for you
MakeShift is a good general scheduler that healthcare teams also use. MedAligna is a healthcare scheduler. The split follows from that.
Stay with MakeShift if…
- Your workforce is mixed and only partly clinical: recreation, support, retail and care staff on one roster.
- Its payroll-platform sync is doing real work in your payroll workflow.
- Nobody is holding you to ratios, PBJ, exclusion screening or credential blocking.
- Per-employee pricing suits your headcount, and the team likes the apps.
Look at MedAligna if…
- You are accountable for clinical rules: licences that expire, ratios against census, OIG screening, the PBJ file.
- You want a violation blocked before publish, not discovered after.
- You schedule on-call coverage with escalation, not just shifts.
- You would rather pay per location than watch a per-employee price scale with your roster.
MedAligna vs MakeShift, row by row
Binary, verifiable facts only. No adjectives; an opinion is not a comparison.
| Capability | MedAligna | MakeShift |
|---|---|---|
| Staff mobile app: swaps and open-shift claims | Yes | Yes |
| Published entry pricing | Yes | Yes |
| Calendar sync (Google / Outlook / Apple) | Yes | Yes |
| Payroll connection | Timesheet CSV export | Marketplace sync |
| Blocks a shift when a licence has expired | Yes | Not publicly documented |
| Federal exclusion (OIG) screening | Yes | Not publicly documented |
| Nurse-to-patient ratios with acuity | Yes | Not publicly documented |
| CMS Payroll-Based Journal (PBJ) export | Yes | Not publicly documented |
| On-call schedules with escalation chains | Yes | Not publicly documented |
| Pricing model | $99–249/mo per location | $3.75/employee/mo (Core) |
MakeShift is a trademark of its owner. MedAligna is not affiliated with, endorsed by, or sponsored by MakeShift. Comparison compiled from publicly available documentation and pricing pages, verified July 2026. If anything here is out of date or wrong, tell us and we will correct it.
The honest bit
You should probably stay on MakeShift if…
It is honest software at an honest price, and for plenty of teams it is the right call.
- Your roster is mostly non-clinical, and the clinical minority carries no ratio, credential or PBJ obligations you must enforce.
- The payroll-platform sync is load-bearing in your payroll workflow.
- Per-employee pricing is cheaper than per-location at your headcount, and you have checked the arithmetic at next year's headcount too.
- The team likes the apps, the schedule publishes on time, and nothing a surveyor could ask about is riding on the tool.
We would rather you stayed and told someone we were straight with you than switched and regretted it. This category is small, and reputations travel.
If you do move
- 01
Export your people and schedule
MakeShift exports schedules for payroll import, and MedAligna imports both your people and your assignments from CSV. Where a row breaches a clinical rule it is reported with the reason, which is the part a general scheduler never had an opinion about.
- 02
Turn the skill tags into real credentials
Where MakeShift had a skill label, MedAligna wants the licence with its expiry date. Each clinician uploads theirs once into a wallet they own, and every future schedule is checked against it.
- 03
Run both for one period
Build next month in MedAligna while the current month runs where it is. Compare, then cut over. Nobody should switch a live roster in one step.
MakeShift questions, answered
- What is a good MakeShift alternative for healthcare?
- One that treats clinical rules as enforcement rather than labels. MedAligna blocks expired credentials, screens against the OIG exclusion list, holds ratios against census and acuity, and generates the CMS PBJ file, at a flat $99–$249 per location per month with a 14-day self-serve trial.
- What does MakeShift cost?
- MakeShift publishes its Core plan at $3.75 per employee per month, with a time and attendance add-on at $2.00 per employee per month (verified July 2026). Its Advanced and Elite tiers are quoted on request. Credit where due: publishing any price puts it ahead of most of this category.
- Does MakeShift track licences and certifications?
- It documents positions and skills, which schedulers use to match people to shifts. Those are labels rather than dated credentials, and we could not find public documentation of an expiry date blocking an assignment. If that enforcement is what you need, ask MakeShift to demonstrate it, and ask us to demonstrate ours; both demonstrations take five minutes.
- Does MakeShift enforce clinical compliance rules?
- Its public documentation describes qualification-aware scheduling, fatigue management and budget awareness, but not nurse-to-patient ratios against a census, federal exclusion screening, ACGME duty hours, or a CMS PBJ export. For a general scheduler that is a reasonable scope. For a facility held to those rules, it is the gap.
- Does MakeShift integrate with payroll?
- Yes, genuinely well: a marketplace app syncs employee data from its payroll platform daily with single sign-on, and schedules can be exported for import back into payroll. MedAligna takes a different route to the same destination: captured hours export as a timesheet CSV, and Gusto's import matches the columns itself.
- When should I stay with MakeShift?
- When your roster is mostly non-clinical, the payroll sync is doing real work, and nothing a surveyor or auditor could ask about depends on the scheduler. A team that likes its scheduling app is not a problem to solve.
- What does a MakeShift alternative cost?
- MedAligna is $99, $149 or $249 per month per location, flat, however many staff you roster. At small headcounts MakeShift's per-employee pricing can be cheaper; run the arithmetic at your real roster size, including the time and attendance add-on, before deciding on price.
Decide it for yourself
Drive the real scheduler with no signup, or trial it with your own staff for fourteen days. Nobody will call you either way.