OCTOBER 14, 2017

Welcome to the Health Care Compensation Update eNewsletter
Editor: Benjamin R. Grant

Survey: Healthcare Salaries Strong, but Workload a Worry
A soon-to-be-release survey by Health eCareers shows a continued upswing in health sector salaries and general confidence in the market, FierceHealthcare reports. The survey included more than 19,700 healthcare workers ranging from physicians and nurses to executives, IT personnel and social service workers. Of those, 87% reported making as much or more than last year. Average pay for healthcare executives increased 18% to $158,637. Nurse practitioner and physician assistant salaries rose 2% to $102,523 and $108,311, respectively, while physician pay edged up 1% to $258,039. Salaries for nurses grew 5% to $70,734. When asked about their chief worries in the coming year, one-third of respondents cited increased administrative burdens and patient load -- echoing recent studies on physician satisfaction and burnout.

Nursing Home Salaries for Administrators near $107k, DONs $93k
A few conclusions that may be drawn from the 2017-2018 "Nursing Home Salary & Benefits Report," the largest annual survey of long-term care professionals. Among all facilities that participated in the survey, the average annual salary of administrators increased by 4.5%, to $106,594, while salaries of assistant administrators plummeted by more than 9%, to $61,648. Directors of nursing fared reasonably well with an increase of 3.1%, to $92,822.

10 Common Physician Compensation Mistakes
Oncology: Failure to address site of service issue; Failure to address reimbursement reality; Unnecessary and/or poorly constructed PSAs: Call and coverage, Lack of an accurate denominator and Rate calculation; Failure to recognize a competitive offer; Too many low dollar incentives; Failure to adjust for a lack of call; Compensating physicians for APC work effort; Failure to manage bad behavior.
See presentation here

3 Legal Considerations About Physician Pay
Changing physician compensation plans is inherently difficult, but especially toilsome as reimbursement mechanisms continue to transition away from fee for service (FFS) and toward value-based care. First, Before you make radical changes, employed physicians as well as their leaders need to understand the basics of how their organization makes and spends money under its current value paradigm. Second, even though compensation linked to meeting certain metrics is often called a "bonus," physicians count on receiving it. The more metric-driven a comp plan, the more the program becomes, in the eyes of the law, essentially a commission. And a commission is considered to be wages. Third, Do a Test Run. No matter how much due diligence goes into creating a compensation plan, unintended consequences occur frequently. But a trial or shadowing period before implementing a new plan fully can help iron out some kinks.

Want to Kill Your Performance Rankings? Here's How to Ensure Success
Recently, a research group at the Neuroleadership Institute (where we are senior leaders) studied 27 companies that had gotten rid of formal ratings and were between two and five years into their new performance management framework. And of the 22 firms tracking employee engagement, all of them found that it went up after the new system was in place, and it has continued to do so. We consider the journey to reimagine performance management positive when managers are having more conversations with their team members about performance, these conversations are higher quality than the annual assessments they replaced, and engagement is going up -- not just in the first year, but in the second year as well. This standard was met by every organization we can find that took three steps. The first step is having a framework to encourage regular conversations. Firms that are succeeding at this transformation don't just remove ratings and tell managers to discuss whatever they want, whenever they want. They are putting explicit expectations in place, such as requiring four conversations about goals. Many firms provide guidance on the kinds of questions they want managers to ask in these conversations. The second step is to ensure that the conversations focus on the future, and are not just the same old assessment discussions but now without a ranking. The third step involves some kind of change management, such as training both managers and employees to have quality performance conversations; providing just-in-time tools, conversation guides, and continued focus; and consistent messaging from senior leaders throughout the organization.

What Is Your Workplace "Harvey Weinstein?"
It's hard to avoid the Harvey Weinstein scandal in the news this week. For those that missed it, Weinstein, a movie executive and co-founder of Miramax and The Weinstein Company, was terminated after multiple women came forward with detailed allegations of sexual harassment and assault. When we read about these allegations, our thoughts were twofold: (1) Are these acts of workplace violence under the OSH Act; and (2) What challenges are companies facing that they feel are too big and powerful to tackle? All U.S. employers are charged with having a safe workplace for employees this includes being safe from workplace violence. OSHA defines workplace violence as "any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site." Who or what is your workplace "Harvey?" Is it equipment that you know is unsafe and should be upgraded, but the cost is too high? Are you ignoring a workplace violence issue because it seems too complicated and might result in a loss of business? Is your Process Safety Management program deficient? Will the changes you think are needed result in a loss of production? Your workplace "Harvey" might be easy to ignore now, but what happens when the matter eventually comes to surface and someone is injured or worse? Your knowledge of the problem makes the company even more culpable even more liable. We invite everyone to address their workplace "Harveys" today



    You Received an Employment Screening Report from a Background Check Provider. Now What Do You Do?
    Tuesday, November 7, 2017
    12:00-1:00 p.m. CT
    Presented by AHA Health Forum

    Register Now

    You, the employer, decide that you want to obtain a background check on a prospective or existing employee. You obtain the proper authorizations and then submit the order request to your background check provider. A few days later you receive the completed background check report with some criminal "hits" and poor credit information -- now what do you do with the information you received? This session will cover an employer's responsibilities and limitations once it has received an employment background check report from a consumer reporting agency, including:
    • Hazards of not having a proper background check policy to base employment decisions on screening reports
    • Potential "barrier crimes" that may prohibit individuals from working in certain health care settings
    • State laws that may limit an employer's ability to consider certain criminal records, such as arrests or older conviction records
    • Various notification requirements under state and federal laws, including when conducting drug testing and when contemplating an adverse employment action based on the background check
    • Restrictions on the use of credit information
    • Consideration of "ban the box" laws
    • Concerns over Equal Employment Opportunity Commission guidance on the use of screening reports
    • Who is making the employment decisions, you or your outside background check provider?
    • This interactive and lively webinar will raise awareness and knowledge of the use of consumer reports for employment.


    • N. Alexander Erlam, General Counsel, Certiphi Screening, Inc.
    • Sadeq Khan, Associate General Counsel/Director of Compliance, Certiphi Screening, Inc.

Average Salary for Industry: Health Insurance

Mercer and PayScale Announce Strategic Alliance for Compensation Data and Software Solutions

PayScale, the leading provider of compensation management software and real-time salary data, and Mercer, a global consulting leader in advancing health, wealth, and careers, and a wholly-owned subsidiary of Marsh & McLennan Companies, have formed a strategic alliance to bring together Mercer's expertise in compensation consulting and information products with PayScale's strength in technology and data science to advance compensation data and software solutions for clients and the future workforce. In connection with this alliance, Mercer will secure an equity stake in PayScale, which has built the world's largest crowdsourced database of salary profiles utilizing big data technologies. This investment builds upon the firm's leading position in reward consulting and information and its recent launch of Mercer Digital to support clients as they transition to new models of work that are enabled by digital technologies. For PayScale, this relationship enhances the company's portfolio and product capabilities with deeper consulting and data expertise to tailor solutions to customers' needs. As Mercer will provide a global channel for distributing PayScale's products, PayScale will provide a channel for Mercer's products. Together, they will collaborate to develop new, innovative compensation and workforce data products and solutions.

For a complimentary PayScale benchmark analysis for a position of your choice, please email BenG@payscale.com.

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Health Care Compensation Update e-Newsletter is one of a family of free e-Newsletters providing a complimentary video presentations and regularly updated news and key resources on major health care issues such as pay for performance, bundled payments and MACRA. To view and subscribe to other e-Newsletters go to www.HealthCareeNewsletters.com.


Benjamin R. Grant