Healthcare Issues & Trends

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Our Top 8 Most Popular Industry Intel

Posted on May 15, 2013 by INTEGRATED

In honor of National Healthcare Week, we at INTEGRATED wanted to give back to the dedicated professionals that make our healthcare facilities the places of trusted care that they are.  We thank the men and women in our hospitals nation-wide that play an essential role as providers of care.

Our experts are constantly developing new and insightful content for our clients and the healthcare industry. And here, we've pulled together the top eight most-popular items from the past year, ranging from articles to webinars to videos.

We hope these resources provide your organization with intel that help it operate more effectively, and prepare better for the future. 

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National Trends in Healthcare Leadership Compensation

Posted on May 6, 2013 by INTEGRATED

The following article is shared as it was originally published on the INTEGRATED website in 2012.

It is critical for organizations to evaluate executive pay in terms of the total value of all elements of compensation and benefits.  Limiting the evaluation strictly to the value of salary or annual cash compensation is no longer sufficient. To this end, organizations need accurate data on total compensation, including benefits, perquisites, and the value of deferred compensation.
 
The standard executive compensation package includes salary, short-term incentive compensation, standard benefits, supplemental executive benefits, deferred compensation, and severance arrangements. Many packages also include perquisites (particularly for CEOs).  A growing minority of health care organizations (particularly those over $1.0B in net revenues) also provide long-term incentive compensation or retention incentives.  Large health care organizations also frequently use contractual allowances (signing bonuses, re-signing bonuses, housing allowances, low-interest loans, etc.) to help recruit experienced executives from across the country. All of this amounts to increasingly complex compensation arrangements, which necessitate a high level of specialized expertise to audit and evaluate.
 
The job of board members in tax-exempt health care organizations continues to grow more complex and challenging. Governing compensation is just one of the many tasks requiring diligence and technical expertise. In order to satisfy regulatory requirements while remaining competitive in a challenging market, it is critical to retain expert outside advisors on compensation.
 
The mix of pay elements varies dramatically from one organization to another. The mix of pay and the inclusion of specific elements (such as long-term incentives, supplemental benefits, and severance) affect not only the competitiveness of the package, but can also reflect the priorities and culture of the organization. For example, an organization which emphasizes a performance-oriented culture may provide average salaries and a high level of short- and long-term incentive opportunity.  An organization focused on retaining a high-performing leadership team may provide extensive supplemental benefits, long-term incentives, and retention incentives for key executives.  

The following is a brief summary of highlights found in the 2012 National Healthcare Leadership Compensation Survey, conducted by INTEGRATED Healthcare Strategies:

  • The data compiled for the National Healthcare Leadership Compensation Survey is effective February 1, 2012. Year-over-year trends represent changes from February 1, 2011 (the effective date of the previous survey) to February 2012.
  • The median percent increase over the previous 12 months for both system and hospital CEOs was 3.0%.  Projected increases reported for the upcoming fiscal year for all executives is also 3.0%.
  • Consistent with 2011 reporting, Chief Executive Officers have a total incentive opportunity as high as 80% to 100% of salary at target or expected value, if they are eligible for both short- and long-term incentives. Some other senior executives have a total incentive opportunity as high as 50% to 60% of salary at target or expected value.
  • Incentive plans can vary greatly between independent and subsidiary hospitals. As expected, subsidiary organizations show a higher prevalence for offering both short- and long-term incentive programs because they typically adopt an incentive structure similar to that of their parent system.

The 2013 National Healthcare Leadership Compensation Survey is currently open for participation and will publish on August 30, 2013. 
 
Other surveys currently open for participation or purchase include:
 
National Healthcare Staff Compensation Survey:  Participation open; publication on June 28, 2013
 
National Nursing Compensation Survey:  Publication on May 10, 2013
 
Medical Director Survey:  Participation open; publication on August 30, 2013
 
Advanced Practice Clinician Survey:  Participation opens on July 2, 2012; publication on December 27, 2013
 
INTEGRATED also conducts custom surveys tailor-made for healthcare organizations.  See more details on all our compensation surveys online or contact our Compensation Survey Department at Comp.Surveys@IHStrategies.com  or call 1-800-821-8481.

What healthcare organizations were saying about staff compensation in 2012

Posted on May 2, 2013 by INTEGRATED

Healthcare leaders and human resource executives struggle to design pay programs that make the best use of limited resources while maintaining or even improving employee understanding and engagement.  It is critical for healthcare organizations to rely on comprehensive benchmark data to ensure they develop effective compensation programs.
 
INTEGRATED Healthcare Strategies published its 2012 National Healthcare Staff Compensation Survey in June 2012.  This survey, along with our National Healthcare Leadership Survey, is co-sponsored by the American Society for Healthcare Human Resources Administration (ASHHRA).  The 2012 National Healthcare Staff Compensation Survey compiled data from a record-high 881 participating hospitals and healthcare systems, representing over 850,000 incumbents.  Following are highlights from the survey:

  • 92% of respondents intended to provide at least some staff-level positions with market compensation increases within the next 12 months
  • Merit compensation increases were planned for over the next 12 months by 93% of respondents
  • Nation-wide, organizations provided a 2.2% average merit increase to staff-level positions within the last twelve months
  • Nationally, an average 2.9% vacancy rate was reported for full-time staff-level employees

The statistics shown here are a small sample of data extracted from the 2012 National Healthcare Staff Compensation Survey.  The full survey report was available to both participant and non-participant organizations and provided results on an extensive list of 278 staff-level benchmark positions, ranging from clinical professional technical jobs to support and non-clinical positions.  It surveyed numerous specialties, home care, and PRN benchmarks.  Position and special pay practice data is presented nationally and regionally.  The results cover comprehensive data on special pay practices including call pay practices, shift differentials, certification pay, career ladders, incentives, visit rates, and more.
 
The 2013 National Healthcare Staff Compensation Survey will publish on June 28, 2013. 
 
Other surveys currently open for participation or purchase include:

National Healthcare Leadership Compensation Survey:  Participation closes on May 10, 2013 with publication on August 30, 2013
 
National Nursing Compensation Survey:  Publication on May 10, 2013
 
Medical Director Survey:  Participation now open with publication on August 30, 2013
 
Advanced Practice Clinician Survey:  Participation Opens on July 2, 2012 and closes on September 27, 2012; publication on December 27, 2012
 
INTEGRATED also conducts custom surveys tailor-made for healthcare organizations.  See more details on all our compensation surveys online or contact our Compensation Survey Department at Comp.Surveys@IHStrategies.com  or call 1-800-821-8481.

Parting Gifts: Severance Paid on Voluntary Termination

Posted on April 22, 2013 by David Bjork

Somehow the most egregious examples of bad practices in executive compensation come from distinguished educational and cultural institutions, rather than from hospitals and health systems.

When Jacob Lew was nominated to become Secretary of the Treasury, the press discovered that NYU gave him a parting gift of $685,000 when he quit his position there to go to Citigroup.  NYU called it severance, but acknowledged that Lew left voluntarily and that the payment wasn’t required by the terms of his contract.

A spokesman for NYU, John Beckman said, “It is not uncommon for large organizations to make payments to senior officials on their departure, as happened in this instance.”
He must have known something the rest of us didn’t, since no one else seems to think it is usual for tax-exempt organizations to  give parting gifts to people who leave voluntarily. 

It turns out he did know something the rest of us didn’t:  the New York Times reported that NYU gave Dr. Harold Koplewicz, an executive at NYU’s medical center, $1,230,000 when he left to found a competing organization.  This, too, was characterized by NYU as severance, even though Beckman said Dr. Koplewicz left voluntarily.

Severance is paid when an employer fires an executive—not when the executive quits voluntarily.  It is either a payment of damages for breaking an executive’s employment contract or payment in exchange for a release from potential claims for discriminatory or unjust termination.

Yes, sometimes employers allow an involuntary termination to be characterized as voluntary resignation, and go ahead and pay severance anyway—but not when someone is resigning to take another job—since one of the purposes of severance is to provide income continuity while the person who was fired searches for another position.

Severance paid on voluntary termination, though, is nothing but a parting gift—and parting gifts are private inurement—gifts not earned through work, not warranted by contract, just a misappropriation of charitable assets.  Why give a parting gift to someone who was paid $800,000 a year while working for NYU, as Mr. Lew was?  Gifts of this magnitude—unearned gifts—expose the recipients to risk of intermediate sanctions, and it would be hard to defend as customary practice or fair market value for services rendered.

Other universities may provide parting gifts in the form of severance to executives who resign, but it is not something that can be easily justified or excused as a common practice among large organizations, as Mr. Beckman asserts.  Most large organizations have better things to do with their resources than give money away to someone who was already paid fairly—even generously—while working. 

It is one thing to provide a placque or a watch or a gift certificate when someone retires, but few employers want to give that kind of congratulatory recogniztion to an employee who is quitting to take a job elsewhere.  It is quite another thing to provide a gift of this magnitude and claim that it is common practice.

If other colleges and universities do provide parting gifts of this magnitude, it must be because they ignore the fact that their tax-exemption depends on their using their resources to fulfill their mission, or because their trustees pay no attention to the way the university gives away its charitable assets to former employees.

Read more about David Bjork, Phd and INTEGRATED Healthcare Strategies on the INTEGRATED website.

Introduction to Employee Engagement

Posted on April 11, 2013 by INTEGRATED

Employee engagement is a fascinating world.  When used as a metric, it's a powerful predictor of what type of work force an organization has and its impact on business success.

But engagement is complicated and complex.  What does it means? How does it work? Who benefits?

So we got Dr. David Rowlee, our employee engagement expert, to give us simple answers to these complex ideas. We promise--he'll make it Clearly Understandable.

For instance, did you know that a strongly engaged work force in healthcare organizations has a measurable positive impact in critical areas like quality care, clinical outcomes, patient safety, innovation and profit margin?

See more ways to simplify employee engagement--WATCH THE VIDEO SERIES at clearlyunderstandable.com.

And find out more about INTEGRATED Engagement Survey services at integratedhealthcarestrategies.com.


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