10 Health Care Trends To Watch In 2020

https://blog.providence.org/news/10-health-care-trends-to-watch-in-2020?_ga=2.242868994.1447754200.1576610293-1113187070.1573499391

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With 2020 shaping up to be another big year for health care, executives at Providence, one of the largest health systems in the country, today released their annual New Year’s predictions.

External forces will continue to bear down on health care, Providence leaders said. Politics, technology, social issues, labor shortages and heightened consumer expectations will all play a role. As a result, providers will feel more intense pressure to accelerate the transformation of health care.

“The question is whether providers can pivot fast enough,” said Rod Hochman, M.D., president and CEO of Providence. “In 2020, health systems that can get ahead of the major trends will be best positioned to meet the future needs of their communities.”

What can you expect next year? Here are Providence’s top 10 predictions.

  1. The value of health system consolidation will come to fruition in the form of large scale improvements in clinical quality and outcomes.

One of the most important reasons health systems have consolidated in recent years is to improve clinical quality and spread best practice across scale. Because clinical integration takes time, this will be the year that significant results begin coming to fruition. For example, Providence has leveraged its seven-state system to reverse the alarming national rise in U.S. mothers dying in childbirth. Thanks to collaboration among its clinical teams, Providence is one of the safest places for moms to give birth, having nearly eliminated preventable maternal deaths over the last three years. At the same time, Providence has reduced the cost of caring for moms covered by Medicaid, as well as the cost of NICU care. Expect more examples of improved outcomes and costs to emerge in 2020 as proven practices in other clinical areas begin bearing fruit on a large scale.

  1. Corporate social responsibility will take on a bigger role in tackling homelessness, suicide, the opioid crisis and other social issues that affect health.  

More companies will partner with health systems, government agencies, social services and other nonprofits to take action on the social determinants of health. Be Well OC is one example of the type of coalition that will make a significant impact in 2020. The public-private partnership in Orange County, Calif., brings diverse organizations together to meet the urgent need for mental health and addiction services in the community. Meanwhile, in cities like Seattle, Wash., health systems like Providence are partnering with the business community and other not-for-profits to address the growing homelessness epidemic.

  1. Personalized medicine and population health, two seemingly opposite approaches to health care, will begin working hand in hand to improve outcomes in the U.S.

The path to a healthier nation will be accelerated by treating both the unique needs of the individual down to the DNA level, as well as common issues shared by people in similar demographics. Health systems like Providence, for example, are using genomics to pinpoint a person’s biologic age, as well as tailor medical interventions to the individual. At the same time, Providence is coordinating care and resources across broad segments of people through steps such as cancer screenings and improving access to housing and nutrition. Combining the power of these two disciplines will help catapult the health of the nation.

  1. Health systems will prioritize digital access to care, convenience and personalization to compete with disruptors and collaborate with big tech.

Delivering same-day access to care – how, when and where people want it – will be a burning priority for health systems in 2020. New entrants will continue to disrupt the space and raise consumer expectations. Leading health systems like Providence will stay ahead of the curve with digital platforms that integrate telehealth, its in-store clinics at Walgreens and its vast network of specialty, primary care and urgent care clinics across the Western U.S. To help patients navigate these care options, Providence will also continue to develop its artificial intelligence capability, making its AI bot, “Grace,” more pervasive, helpful and capable. Providence will also continue to engage patients between episodes of care by providing personalized content and services to keep them healthy while developing a long-term, digitally engaged relationship with patients.

  1. As more health systems partner with tech companies to bring health care into the digital age, patients will count on providers to serve as the guardians of their personal health information. 

Machine learning and artificial intelligence will raise the potential for new breakthroughs in medicine and care delivery, and data will be key to this level of innovation. But whether tech companies are prioritizing the best interest of patients will remain a lingering question for the American public. Patients will look to providers to be their voice and advocates when it comes to protecting their health information. Expect providers to stand up for data privacy and security and take the lead in ensuring data is used responsibly for the common good.

  1. The race to bring voice-activated technology to health care will heat up and will be a central feature in the hospital and clinic of the future.

Just as Alexa and Siri are transforming the way we live our personal lives, voice and natural language processing are the future of health care. Expect innovation to accelerate around smart clinics and hospitals that make it easier for clinicians to treat and care for patients.  Voice commands that process and analyze information will support clinical decision making at the bedside and the exam room. As part of a new partnership between Providence and Microsoft to build the “care site of the future,” clinical communications and voice-activated technology will be a central feature.

  1. Simplifying the electronic medical record will become a rallying cry for clinicians.

With burnout on the rise among physicians, nurses and other caregivers, reducing the time it takes to chart in the electronic medical record will be key to improving the work environment for clinicians. Shifting the national conversation from EMR “interoperability” to “usability” will take on greater urgency. A simplified, more intuitive EMR means clinicians can spend less time on the computer and more time focused directly on patients, creating a better experience for clinicians and the patients they serve.

  1. The health care workforce will continue to evolve and adopt new skill sets. At the same time, talent shortages will become more pronounced.

As the sector changes at a rapid pace, the health care workforce will need to add new skill sets to keep up with innovations in medicine and care delivery. Clinicians will also need to become more proficient in managing the social determinants of health and caring for the whole person, not just physically, but also mentally and emotionally. Health systems will seek to stay competitive in a tough labor market by offering attractive pay and benefit packages. A commitment to investing in education and career development, as well as creating engaging work environments, will also be a key focus for retaining and recruiting top talent.

  1. Price transparency will remain a hot issue. But the focus needs to shift to giving patients the information they want most: what their out-of-pocket costs will be.   

Patients deserve to know what their health care costs will be up front, so they can make informed decisions as they shop for care. Rather than inundating them with a deluge of prices and negotiated rates for hundreds of services that may or may not be relevant to their personal situation, more emphasis needs to be placed on helping them understand what their specific out-of-pocket costs will be. The amount individuals pay is typically based on their insurance coverage. That’s why health systems like Providence are actively developing price estimator tools and self-service portals, based on blockchain and AI technology, to help patients more quickly and easily access this information.

  1. New alternatives to “Medicare for All” will emerge in the presidential debates. One viable option that should be taken seriously: free primary care for every American.

In the 2020 elections, concerns will be raised over whether Americans will lose their private commercial or employer-sponsored insurance under a Medicare for All plan. A new campaign platform — free primary care for all — should be considered as a more effective, affordable alternative. By guaranteeing access to primary care, the nation can focus on prevention, chronic disease management and helping Americans live their healthiest life possible. Providence is participating in the current administration’s innovative primary care pilots, which are showing positive results in terms of better outcomes and reduced costs.

 

 

 

 

The Four P’s of Talent Identification and Management at Your Company

https://www.leadershipdigital.com/edition/daily-career-leadership-2019-09-30?open-article-id=11666676&article-title=talent-identification-and-management&blog-domain=careeradvancementblog.com&blog-title=career-advancement

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“Talent management deserves as much focus as financial capital management in corporations.”
~ Jack Welch

One of the best ways to strengthen your company as a whole is to devote attention to developing your employee talent. If your staff isn’t given the proper encouragement or assistance needed to help them move forward within your company, it can be more challenging for the company itself to continue growing in its capabilities. There are several ways that you, as a leader, can help to develop the talent at your company. Talent identification and management begin with The Four P’s.

    1. Pinpoint individual strengths
      While specific roles at any company often require a specific set of skills, your employees will likely have additional strengths within those skill sets that can be utilized and honed whenever possible. Assess your staff in order to pinpoint each employee’s individual talents and areas of expertise, then find ways to incorporate those abilities into their daily workflow. This will not only make employees stronger contributors to your team, but will also likely provide them with greater job satisfaction, as they’ll be performing tasks using skills that can bring greater value to their team’s output.
    2. Practice engaging leadership
      Truly great leaders possess characteristics that encourage and inspire their staff. In order to bring yourself to a higher level of greatness as a leader, explore your existing strengths and see how you might be able to improve upon them and add new motivational elements into your leadership style. Above all, be a leader who provides adequate support for your team. Regularly engage with each of your employees and ensure their needs are being met so they can be better equipped to perform their jobs at an optimized level.
    3. Prioritize talent management
      Another way to ensure the continued development of your staff is to incorporate effective talent identification and management tools and practices into your business structure. A human capital management solution, for example, can have modules specifically geared toward optimizing your talent management practices. These kinds of software services can simplify the creation of career development plans for your current talent and improve your ability to monitor their progress throughout them. These tools can also automate components of your recruiting operations, like sending out application notifications, in order to speed up the process of cultivating and developing new talent alongside seasoned employees. By improving your company’s talent management practices, you may find it easier to determine what additional steps you can take to aid your employees in continuing to grow.
    4. Provide opportunities for growth
      In order to truly develop into more skilled and knowledgeable employees, your staff must be provided with opportunities to exercise their own leadership and to strengthen skills that might be important in the roles they aspire to. Sit down with individual team members and help them set work performance goals for themselves. Once they’ve established concrete, attainable goals for both the short and long terms, do what you can to aid them in achieving their objectives each step of the way.

For instance, if one of their goals is to expand their understanding of the daily responsibilities of your company’s executive team, create an opportunity for them to shadow you or another company leader so they can gain insight into whether an executive career path could be a good fit for them. The more your employees are able to broaden their comprehension of your company’s functionality beyond their own duties, the greater the likelihood that they’ll be able to develop into well-informed and well-rounded contributors.

 

Unprecedented Growth in Healthcare Workforce Demand in the 2020s: US Bureau of Labor Statistics

https://www.amnhealthcare.com/unprecented-growth-in-healthcare-workforce-demand-in-the-2020s/?utm_source=pardot&utm_medium=email&utm_campaign=hb-09-2019

The latest data from the US Bureau of Labor Statistics portray a very challenging decade ahead for healthcare organizations trying to find the nurses, physicians, and other healthcare professionals they need.

While healthcare shows the fastest and largest new job growth compared to any other industry, the most alarming data may be the projected annual job openings in key professions, which are many times greater than the numbers of new jobs.

The Bureau of Labor Statistics (BLS) Employment Projections states that the aging population of the United States is the reason behind the growth in healthcare employment and job openings: “Increased demand for healthcare services from an aging population and people with chronic conditions will drive much of the expected employment growth.”

Employment in healthcare occupations is projected to grow 14% from 2018 to 2028, much faster than the average for all occupations, adding about 1.9 million new jobs — more than any other industry. Registered nurses, the occupation with the third highest job growth from 2018-2028, are projected to grow from 3,059,800 to 3,431,300, an increase of 371,500 new jobs.

The aging population also is driving retirements in the healthcare industry, which, along with other job separations, is fueling intense growth in job openings in healthcare. The latest projections show an average of 650,300 job openings per year for all healthcare practitioners and technical occupations from 2018-2028. There will be 210,400 nurse job openings each year, which represents an increase of about 6,000 annual nurse job openings a year from the 2016-2026 employment projections.

The tsunami of retirements among Baby Boomer nurses and other practitioners is coupled with immense opportunities to seek new and better jobs in the superheated healthcare jobs marketplace. The result is a huge and growing number of job openings, many of which cannot be filled.

Data from another BLS survey, Job Openings and Labor Turnover Survey, show that job openings outnumber job hires in healthcare by 2:1. There are approximately a half million unfilled healthcare jobs.

The upcoming decade is expected to see a worsening of this problem. By 2030, all Baby Boomers will have reached 65; the generation will be nearing full retirement. By 2035, the number of people over 65 in the United States will be greater than the number under 18 – for the first time in the nation’s history. The result of growth in retirement-age people and relative stasis in the number of young people will be that there will not be enough people to fill the work shoes of retirees – in healthcare and all professions.

 

Everybody’s leaving!

https://www.inc.com/bill-murphy-jr/nick-saban-alabama-assistant-coaches-michael-locksley%E2%80%8B-maryland-football.html?utm_source=incthismorning

Next time you recruit someone amazing to your business, only to have that person leave for a bigger opportunity elsewhere, think about Nick Saban.

Saban, the head football coach at the University of Alabama, is considered one of the greatest college coaches of all time. His teams have won six national championships — five at Alabama and one at Louisiana State University — tied with another Alabama coaching legend, Bear Bryant, for most in college football history.

Now, he’s getting credit for a statistic that might seem a mixed blessing, but one that great leaders will recognize as a compliment: Saban’s teams endure (or maybe “enjoy”) near-constant churn among his assistant coaches. As the Wall Street Journal pointed out on Sunday, not a single on-field assistant coach from Alabama’s national championship victory in 2017 remains on the team today.

Thirty-eight assistants have moved on since 2007. Most of them leave for jobs with higher profiles or more responsibility elsewhere. Last year, USA Today calculated that there were 15 former Saban assistants in head coaching jobs in either the NFL or college football. Add another to that list: Michael Locksley left Alabama earlier this year to become the head coach at the University of Maryland.

As a head coach, and a coaching recruiter, Saban says he’s only interested in assistants that he believes will be very successful — making it unsurprising to him that they’re later recruited away from him.

“I think if you look at most of the coming and going, it’s people getting better jobs,” he told the Journal. “I actually look for people who have goals and aspirations, who are hard workers and very committed to what they do. So people sometimes favor hiring guys that have been in this program.”

The constant churn arguably drives innovation, too. New assistant coaches have the chance to advocate for new strategies. That makes it harder for opposing teams to predict what Alabama will do on the field. 

There’s a saying: Good leaders attract followers; great leaders create more leaders.

If that’s true, then count Saban as a leader with an example worth learning from, no matter what your business or calling may be. Feel better about losing your top people when it happens. It’s inevitable if you’re a great leader.

 

 

 

Healthcare workforce development: New strategies for new demands

https://www.healthcareitnews.com/news/healthcare-workforce-development-new-strategies-new-demands

As hospitals and ambulatory sites grapple with the challenges of quality improvement, value-based care, cybersecurity and more, the size and shape of the workforce is changing as technology and imperatives evolve.

The healthcare workforce is evolving, often by necessity, thanks to the same gravitational forces that are affecting the rest of the industry and the economy at large: technological advances, competitive market forces, shifting imperatives that demand new skill sets, challenges with job satisfaction and burnout.

Whether they’re C-suite leaders, physicians, nurses, IT staff, data scientists, case managers, security pros or revenue cycle, billing and accounting experts, hospitals and health systems large and small are facing an array of challenges when it comes to finding the right people to fit the right roles.

There’s a lot that needs doing in healthcare these days, after all – managing the clinical and operational demands of value-based reimbursement, caring for a growing aging population with a shrinking number of doctors and nurses, fighting the good fight against relentless cybersecurity threats – and finding the right employees to do it all is more important than ever.

During July, Healthcare IT News and our sister publication, Healthcare Finance, will explore how hospitals and health systems are managing these challenges – optimizing their workforces and positioning skilled leaders to help drive long-term strategic success in those areas and others.

From the C-suite to the trenches, unique challenges persist

The recent 2019 HIMSS U.S. Leadership and Workforce Survey polled 232 health information and technology leaders from acute and ambulatory providers nationwide to gain some insights about the challenges they’re prioritizing and the organizational structures they’re putting in place to deal with them.

Surprisingly or not, “hospitals and non-acute providers appear to have very different strategies regarding information and technology leadership and workers,” according to the report.

For instance, inpatient sites are much more able to prioritize the hiring of skilled C-suite execs to guide strategic initiatives. But “the absence of information and technology leaders in non-acute organizations is unsettling as it becomes more challenging to advance capabilities in settings without strong executive champions.”

Likewise, hospitals and practices also differ substantially when it comes to more rank-and-file employees. The larger inpatient sites “tend to operate environments with fairly extensive opportunities, whereas non-acute providers tend to deal with static workforce demands,” according to HIMSS. “The culture that can result from these different settings is something healthcare leaders should take into consideration when developing a staffing strategy.”

And health system hiring strategies are indeed shifting as providers face an array of challenges that need skilled and forward-thinking workers to help solve them. The HIMSS report listed the top 10 of these as:

  • Cybersecurity, Privacy, and Security
  • Improving Quality Outcomes Through Health Information and Tech
  • Clinical Informatics and Clinician Engagement
  • Culture of Care and Care Coordination
  • Process Improvement, Workflow, Change Management
  • User Experience, Usability and User-Centered Design
  • Data Science/Analytics/Clinical and Business Intelligence
  • Leadership, Governance, Strategic Planning
  • Safe Info and Tech Practices for Patient Care
  • HIE, Interoperability, Data Integration and Standards

The big hurdle, however, is that many “hospitals are continuing to be negatively impacted by staffing challenges,” according to the study. “The negative impacts on providers resulting from paused/scaled back projects are significant enough to at least warrant an exploratory consideration,” said HIMSS researchers.

A look at the numbers tells one story: When it comes to workforce vacancy barely one-third 36% of providers polled by HIMSS say they’re fully staffed – while more than half (52%) said they have open positions (12% didn’t answer or weren’t sure).

Indeed, there’s plenty of hiring to be done for health systems trying to tackle some of the biggest ongoing strategic challenges.

Even though the size in provider workforces since 2018 increased for 38% of the providers in this year’s survey – it stayed the same for 37% and decreased for just 14% – the projection for 2020 is a further expected hiring boost at 34% of providers (compared with a status quo for 42% and a contraction at just 9%).

Still, there’s nuance when one considers the differences between inpatient versus ambulatory organizations. While both are more likely to increase their workforces than to decrease them in 2020 (37% and 12% percent of hospitals, respectively, and 26% and 1% of outpatient sites), far more non-acute organizations expect their staff sizes to stand pat than hospitals (51 percent, compared with 38%).

“The variances in staffing growth trajectories evidenced in the two provider groups … has the potential to produce exceedingly different workplace cultures; a fast-paced environment in hospitals and a fairly stable setting in non-acute organizations,” according to the HIMSS report. “If true, then it is very possible these settings attract health IT workers with remarkably different needs/wants. Provider organizations looking to stabilize their workforce should take these factors into consideration when developing staff recruitment, retention and development strategies.”

What to expect in our Focus on Workforce Development

Over the course of this month, Healthcare IT News and Healthcare Finance will be exploring the many challenges related to staffing and workforce, across many facets of healthcare in the U.S.

We’ll examine the industry’s labor force spend (the percentage of total budgets may surprise you), and look at how how AI, telehealth and consumerism can help change that equation. We’ll learn how to attract top C-suite talent and combat clinician burnout. We’ll explore the benefits of apprenticeship programs, and see the strategies some hospitals are using to deal with labor shortages. And much more.

So, as your healthcare organization looks to the fiscal year or remaining calendar year ahead, be sure to check back at HITN and HF during July to learn from thought leaders and industry peers – about the best way to put the best people in the best position to help meet your strategic goals.

 

One of the constants of healthcare: Rising executive pay

https://www.modernhealthcare.com/executive-compensation/one-constants-healthcare-rising-executive-pay?utm_source=modern-healthcare-daily-dose-wednesday&utm_medium=email&utm_campaign=20190807&utm_content=article4-readmore

Average total cash compensation for health system executives rose 6.5% from 2018 to 2019, extending a consistent rise in executive pay that governance experts do not expect to slow.

Annual and long-term performance-based incentives have driven pay hikes of 4% to 7% each of the last four years, according to Modern Healthcare’s annual Executive Compensation Survey. Health systems’ ongoing expansions coupled with a highly competitive executive market will continue to drive up their base salaries and bonuses, experts said. But this dynamic is drawing ire from rank-and-file employees who aren’t happy with their pay and from consumers who are spending more on their care. It is also spurring new legislation.

Nevertheless, with baby boomers retiring in large numbers and demand soaring, the pay hikes aren’t going away anytime soon. “Healthcare organizations are becoming more complex and leadership skills are evolving,” which often translates to higher pay, said Bruce Greenblatt, a managing principal at SullivanCotter, the compensation consulting firm that has supplied data for Modern Healthcare’s annual surveys since 2003.

“Qualified talent is in short supply, which requires a deliberate approach to talent strategy as new roles emerge and new responsibilities unfold,” he said.

Providers look to select metrics and targets that will shape their organization for years to come. In doing so, they toe a delicate line ensuring their bonuses are attainable to keep executives engaged while not making them out of reach and damaging morale.

With more pay based on performance, there’s greater risk of poor program design, said Steve Sullivan, a managing director at executive compensation consulting firm Pearl Meyer. If you make a mistake, there is a lot of money on the line, he said.

“You don’t want to have giveaways and you don’t want to have plans so egregiously hard that they never have payouts because executives will disengage from the program,” Sullivan said. “You have to strike a balance between responsible compensation and something that is motivating and incenting.”

Larger systems paying more

Health system executives’ average base salaries increased 4.2% and ticked up even higher among organizations with more than $3 billion in revenue based in high-cost cities, according to Modern Healthcare’s 39th Executive Compensation Survey, made up of data aggregated from 1,149 hospitals and 401 health systems. System CEOs earned an average total cash compensation of $1.4 million in 2019, a 6.3% increase.

Executives who saw the highest total cash compensation hikes of 6.6% up to 13.3% were business development officers, administrative officers, internal audit executives, chief financial officers, planning executives, reimbursement executives, chief nursing officers, chief human resources officers and chief operating officers.

Incentives are typically tiered with a minimum threshold, a target and a stretch goal. They are often based on quality, safety and patient experience as well as financial performance. They may be related to ambulatory market share, employee and patient engagement, facilitating access to capital, bolstering physician alignment, inking successful joint partnerships and mergers, emergency department wait times and utilization, population health, shared risk, readmissions, hospital-acquired infections and length of stay, among other metrics.

The types of incentives offered are heavily dependent on the provider and the market. Some hospitals and health systems have stuck to the more traditional financial and market-share-based measurements, while more progressive organizations are targeting outcomes.

The bonuses differ based on short- and long-term goals, the latter becoming more prominent in recent years as boards and compensation committees emphasize the entire organization’s performance. Sometimes there is a trigger, such as operating margin, where executives miss out on all bonuses if it isn’t reached. For instance, Mercy Health, which is now Bon Secours Mercy Health, did not pay executives an incentive in 2016 since the system did not reach its incentive thresholds, the Cincinnati-based Catholic health system said.

“You want to make sure everyone is rolling in the right direction,” said Tom Giella, chairman of healthcare services for executive recruiter Korn Ferry. “You want to do what is right for the system, not an individual hospital or inpatient versus outpatient. It creates an incentive for everyone to work together.”

But even if the baseline isn’t reached, there typically isn’t a penalty, experts said. It will only lower their earning potential. “In some industries there can be a negative adjustment,” Sullivan said. “I haven’t seen that in healthcare. In healthcare, if there is a modifier it is going to be positive.”

Long-term view

Nearly half of larger health systems surveyed report using long-term incentive plans.

Dignity Health said a “substantial portion” of executive compensation is linked to organizational performance related to key clinical-quality and patient-satisfaction measures as well as community health investments and financial performance. Similarly, Kaiser Permanente said a third to half of pay is based on performance, linked to membership growth, expenses, operating income, and clinical and service quality improvements. Bon Secours Mercy said each of its employees are rewarded under the same incentive program, which includes quality, growth, financial and community benefit targets.

More providers are using deferred compensation programs, which can amount to hefty payouts at the end of an executive’s tenure.

In a related Modern Healthcare analysis of more than 2,000 not-for-profit hospitals, the 25 highest-paid not-for-profit health system executives received a combined 33.2% increase in total compensation in 2017, as their compensation rose to $197.9 million from $148.6 million in 2016.

The pay increases have spawned rallies and protests from more than 1,000 employees at Beaumont Health and Providence St. Joseph Health, both of which had chief executives in the top 25. Beaumont and Providence said in prepared statements that their CEO pay are not outliers compared to their peers.

California policymakers introduced a bill, recently passed by a state Senate subcommittee, that aims to boost not-for-profit health systems’ public disclosure requirements for executives’ deferred compensation.

“What surprises people I think as compensation becomes very generous because it is a competitive market, some think a hospital administrator shouldn’t expect to make more than the average physician,” said Paul Keckley, an industry consultant and managing editor of the Keckley Report. “Those days are long gone.”

Executives’ pay along with their respective C-suites are growing as health systems expand. New C-suite positions in 2019 included reimbursement executive, communications executive, academic affairs executive and operations executive, according to SullivanCotter’s data.

Physician leaders continue to be in high demand as providers look to influence clinical delivery redesign, population heath activities and quality improvement, said Tom Pavlik, a managing principal at SullivanCotter. Administrative roles in finance, consumer experience, IT, marketing and human resources are being filled by healthcare industry outsiders, he said.

“There is a lot of change as organizations are realigning to be operationally efficient and integrate clinical care delivery,” Pavlik said.

Among hospital executives, average base salaries rose 3.7% for hospitals that exceeded $300 million in revenue compared to 3.2% for smaller facilities. System-owned hospitals saw slightly lower base salary hikes than independent ones.

Average total compensation increased 5.3%, while CEOs of independent hospitals took home the highest raises at 9.2%, followed by chief financial officers of independent hospitals (6.5%), chief operating officers of system-owned hospitals (5.8%) and chief financial officers of system-owned hospitals (5.3%). Independent hospital CEOs earned an average of $758,300.

Providers rely on third-party consultants for accurate portrayals of market-based compensation reports that inform their compensation structures. But some of Pearl Meyer’s prospective clients are concerned about how their current adviser is interpreting the market, Sullivan said.

“With all the M&A, you have to create larger peer groups to generate a bigger sample,” he said.

This is a relatively new dynamic as the number of megasystems have swelled, Giella said.

“There is a war for talent and a big demand as systems have amalgamated so quickly,” he said. “They are getting through these growing pains where they have never dealt with this scale before, so it’s hard to look at historical trends. It’s very fluid so it’s hard to tell if you are paying someone fair compensation.”

One of Keckley’s regional health system clients told him that they are trying to figure out the most efficient and lean model.

“When I asked him what is keeping him awake, he said, ‘I want to be sure we are market-focused and that we are not just busy moving the deck chairs around.’ ”

DATA: Executive Compensation: 2019