Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals


INTEGRATED is Offering Data on Healthcare Executive, Director, and Staff Compensation and Benefits

Posted on November 27, 2012 by Gallagher Integrated

Economic challenges, recent legislation, and compliance requirements all impact your compensation and benefit practices. To help guide your decisions, INTEGRATED Healthcare Strategies has monitored compensation trends over the past four years through our Salary Increase & Benefit Trends Survey. We look to healthcare organizations to provide valuable insights about past, current, and future compensation plans for executive, middle management, and staff positions. We invite you to participate in our survey as we gather information on:

  • Organizational demographics
  • Salary increase budgets for executive, middle management, and staff positions
  • Executive incentive plan modifications and performance criteria
  • Perquisite eligibility and expenditures

The survey will take no more than 10 to 15 minutes to complete.

*Please note: This survey must be completed and submitted in a single session; answers cannot be saved to submit at a future date.

Participation Deadline: December 21, 2012

PARTICIPANTS OF THE SALARY INCREASE AND BENEFIT TRENDS SURVEY WILL RECEIVE THE COMPLETE SURVEY REPORT FREE OF CHARGE.

Does Your Board Meet its Responsibility for Overseeing Physician Compensation?

Posted on November 26, 2012 by Gallagher Integrated

INTEGRATED Healthcare Strategies is pleased to offer a convenient, free-of-charge webinar on December 12, 2012 from 10:30 a.m. - 11:30 a.m., CST to the healthcare industry. The topic, focused on a healthcare organization's responsibility for overseeing physician compensation, is one that many facilities need education on - in a hurry. It's troubling to realize that a large majority of hospitals and health systems boards are unaware of their responsibility for physician pay oversight. Their lack of involvement in other case is simply that the sheer number of agreements that need to be reviewed overwhelms them.

More and more healthcare organizations are employing physicians, but many boards do not oversee physician compensation like they do executive compensation.

In this webinar, our executive and physician compensation experts will offer guidance to help you:

  • Establish criteria for physician compensation “reasonableness.”
  • Set standards for delegating routine compensation decisions to management so only exceptions to the criteria go to the board committee for review.
  • Close the major knowledge gap on this topic between boards and executive teams.
  • Enhance physician alignment with your organization while ensuring compensation plans are reasonable and in line with fair market value.

Click here to REGISTER for this now!

Best Practices for Board Compensation Committees

Posted on November 20, 2012 by Gallagher Integrated

Healthcare boards are composed of volunteers who are honored to serve their communities.  But today regulations and scrutiny require more time, oversight and accountability from board members for everything from quality to cost effectiveness to reasonableness of physician and executive pay.  Boards need resources and guidance to help them use their time and talents more effectively.

We’d like to share a few resources that our healthcare executive compensation expert, David Bjork, recently authored for the Center for Healthcare Governance (CHG).  Below is a brief excerpt from the article, "Smarter Compensation" that appeared in the 2012 issue of Trustee magazine.  It reviews four basic rules that can help boards make better executive compensation decisions.

While boards and their compensation committees do a good job of overseeing executive compensation, there are several common flaws in what is otherwise a strong process. First, committees often don’t take time to look at larger governance issues such as compensation philosophy, peer group data and mix of pay. Meeting agendas are so full that members tend to focus only on required actions. The committee manages to complete all tasks for the year by maintaining the program and following precedent, rather than evaluating it and questioning whether past practices are right for the future.

Read full article

In addition, visit the CHG website to read David’s “Best Practices for Board Compensation Committees.”  It offers steps board compensation committees can take to strengthen governance of executive compensation. View this tool and others on the CHG website’s Governance Tools.

Hospital Executive, Director & Staff Salary Increase & Benefit Trends

Posted on November 15, 2012 by Gallagher Integrated

Economic challenges, recent legislation, and compliance requirements all impact your compensation and benefit practices.  To help guide your decisions, INTEGRATED Healthcare Strategies has monitored compensation trends over the past four years through our Salary Increase & Benefit Trends Survey.  We look to healthcare organizations to provide valuable insights about past, current, and future compensation plans for executive, middle management, and staff positions. We invite you to participate in our survey as we gather information on:

  • Organizational demographics
  • Salary increase budgets for executive, middle management, and staff positions
  • Executive incentive plan modifications and performance criteria
  • Perquisite eligibility and expenditures
     

The survey will take no more than 10 to 15 minutes to complete.
 
*Please note: This survey must be completed and submitted in a single session; answers cannot be saved to submit at a future date.  

Participation Deadline:  December 21, 2012
 
PARTICIPANTS OF THE SALARY INCREASE AND BENEFIT TRENDS SURVEY WILL RECEIVE THE COMPLETE SURVEY REPORT FREE OF CHARGE.

5 Key Principles & Questions for Physician Leader Compensation

Posted on November 15, 2012 by Gallagher Integrated

As originally authored by Chad Stutelberg, Executive Vice President and Practice Leader with INTEGRATED Healthcare Strategies.
  
There has been an explosion in the number of health care organizations that contract with physicians to perform a variety of leadership roles.  While these contracts can provide significant improvements in physician engagement and alignment, this type of financial relationship can be a significant area of potential government scrutiny under a number of health regulatory provisions (e.g., federal and state physician self-referral and anti-kickback laws). 
 
Too many boards and executives do not know their physician leader contract obligations.  INTEGRATED has identified five key principals that board members should be aware of, along with a list of five questions that board members should ask of the organization’s management team.
 

5 Key Principals for Compliant Physician Leadership Agreements
 
Principle 1:  Written Agreement Signed By The Parties.  All arrangements should be reflected in a written, signed agreement.
 
Principle 2:  Description Of Services To Be Provided.  It is critical that the written agreement reflects a clear understanding of the physician’s duties and responsibilities.  All administrative and leadership services should be legitimate services that are important for the facility to carry out its clinical functions, and such services must be actually performed by the physician.  If a form agreement format is used, an exhibit should be attached to identify the specific services that the physician is providing.  If time is to be divided between organization duties and providing direct patient care, there should be some detail as to how the time is to be allocated.
 
Principle 3: Aggregate Compensation May Not Exceed Fair Market Value.  The amount of compensation paid to a physician in a leadership role should be set in advance, consistent with fair market value in an arms-length transaction, and not determined in a manner that takes into account the volume of value of any patient referrals or other business generated between the parties.
 
Principle 4:  Schedule When Services Will Be Provided.  If the services are to be provided on less than a full-time basis, the medical director agreement must specify when the services will be provided, for how long, and the rates charged for each service interval.
 
Principle 5:  Documentation Of Services Provided.  The agreement should require the physician to maintain appropriate time records demonstrating fulfillment of the duties outlined.  It should specifically define the documentation required by the physician unless it is otherwise apparent in separate records (e.g., in a patient’s chart that was reviewed by the medical director).  This will provide the parties to the agreement tangible evidence that the service are being provided.
 

5 Key Questions a Board Should ask Management About the Organization’s Physician Leadership Agreements

  1. Does the organization have a policy and procedure in place for entering into physician leadership agreements?  If not, the board should insist one be developed.
  2. How does the organization determine the number of physician leadership agreements and how are physicians selected for these role?  The Board should ensure that physicians in these roles are not chosen based upon a desire to purchase or induce referrals, but are selected for legitimate services the physician is qualified to provide.
  3. How does the organization determine the fair market value of the services being rendered by the physician?  It is advisable (but not necessarily required) that an organization obtain a written analysis from an independent third party consultant with expertise in the health care field to confirm that the payments are within fair market value for the services being provided.  However, even if an outside consultant is not retained, the board should insist that the organization has documentation in its files setting forth comparable data relied upon to support the fair market value of the compensation.
  4. What is the policy/procedure for documenting and monitoring the services that are provided by the physicians?  The board should also ensure that there is an appropriate process for tracking, monitoring and approving the services that are provided by the physicians.
  5. Who is responsible for auditing the services being rendered by the physician and compliance with the physician leadership policies and procedures?  If no such auditing is occurring, then the board should request that future audits begin to occur and that reports be provided to the relevant committee(s) of the board on the results of those audits.  Moreover, even if internal audits are being conducted and especially if internal audits are identifying problems, then the board should insist that the organization engage an outside reviewer through legal counsel to protect the findings through the applicable legal privileges, and to identify how to ensure that the organizations’ agreements come into compliance.

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