Healthcare Admin vs Physican Pay Data

Burrell College of Osteopathic Medicine
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Kierkegaard's Bud

Kierkegaard's Bud

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Truly impressive how the gutter of admin work has artificially elevated itself to the insane highs. If you overlay student loans growth pace with physician pay, this graph is even more impressive.
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Dral said:
How exactly was 'growth' defined? Is it number of individuals? pay? both? something else?
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This is staff growth. There's tons of money in healthcare because that's the main expense people spend on as discretionary income increases, but clinical staff growth is always going to be limited, even if residency slots were not a barrier there's only so many people who have the capacity to become physicians, so lots of that money is going to end up absorbed by non-clinical personnel.
 
Kierkegaard's Bud said:
The pie is only getting bigger, that’s what’s even more surprising.
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It won't that long for healthcare to make up 30% of the country GDP, and that when people will be ok with medicare for all.

Administrators doing nothing making over 1 mil. Any tech in the hospital is making 100k+

NP/PAs making 150k+. CRNAs are making over 300k working 40 hrs/wk

The whole system is bloated
 
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Splenda88 said:
It won't that long for healthcare to make up 30% of the country GDP, and that when people will be ok with medicare for all.

Administrators doing nothing making over 1 mil. Any tech in the hospital is making 100k+

NP/PAs making 150k+. CRNAs are making over 300k working 40 hrs/wk

The whole system is bloated
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Wut? You mean CEOs?
 
SurfingDoctor said:
So the 1%?

Ok. Though you obviously know, most hospital CEOs and down don’t make $1 million annually unless they are part of a big healthcare organization with thousands of employees.
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I check mine the other day, which is not part of a big healthcare organization (1 hospital with < 300 beds) and he make ~700k plus bonuses. My guess is that his total compensation 800-850k. The guy has a business degree from a no name school.
 
Splenda88 said:
I check mine the other day, which is not part of a big healthcare organization (1 hospital with < 300 beds) and he make ~700k plus bonuses. My guess is that his total compensation 800-850k. The guy has a business degree from a no name school.
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Neat. N=1

I’ve seen the payrolls of most HCA CEOs. They make less than $500K. Still the 1% though. If you are the CEO for some sh-hole HCA community hospital, they are lucky to crack $200K. Still wealthy by American standard though. What’s the median income in the US?
 
SurfingDoctor said:
Neat. N=1

I’ve seen the payrolls of most HCA CEOs. They make less than $500K. Still the 1% though. If you are the CEO for some sh-hole HCA community hospital, they are lucky to crack $200K. Still wealthy by American standard though. What’s the median income in the US?
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Interesting. I thought even the smaller hospital (100-200 beds) CEOs salary were 400k+. Thanks for letting me know that's not the case.

The median household income now is ~75k. I agree that 200k+/yr is a lot of money for most people.
 
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Splenda88 said:
Interesting. I thought even the smaller hospital (100-200 beds) CEOs salary were 400k+. Thanks for letting me know that's not the case.

The median household income now is ~75k. I agree that 200k+/yr is a lot of money for most people.
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Most of the smaller hospitals hemorrhage money, for various reasons, HCA being no different. The CEOs of those hospitals still make more, as do the top executives and physicians, but they still hemorrhage money. A majority of the employees make nothing by comparison. These facilities are also often prone to closures and buy outs.

www.beckershospitalreview.com

8 hospitals closing departments or ending services

Here are eight department closures or services ending, announced, advanced or finalized that Becker's has reported in February:
www.beckershospitalreview.com www.beckershospitalreview.com
 
Splenda88 said:
I check mine the other day, which is not part of a big healthcare organization (1 hospital with < 300 beds) and he make ~700k plus bonuses. My guess is that his total compensation 800-850k. The guy has a business degree from a no name school.
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That's still less than lots of doctors...
 
Splenda88 said:
Physicians are the only players not getting a piece of the pie.
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When you factor in inflation, physician CMS reimbursement is down 40% from 2000! Anyone, please give me 1 or 2 fields showing similar trends, including increased cost of training and increased cost of working (eg. malpractice insurance, paying staff in private practice). Bonus if their field is 50% as competitive as medicine is when it comes down to admissions etc
 
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vm26 said:
When you factor in inflation, physician CMS reimbursement is down 40% from 2000! Anyone, please give me 1 or 2 fields showing similar trends, including increased cost of training and increased cost of working (eg. malpractice insurance, paying staff in private practice). Bonus if their field is 50% as competitive as medicine is when it comes down to admissions etc
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And yet, this guy thinks young doctors just need to suck it up.

Big Hoss
 
vm26 said:
When you factor in inflation, physician CMS reimbursement is down 40% from 2000! Anyone, please give me 1 or 2 fields showing similar trends, including increased cost of training and increased cost of working (eg. malpractice insurance, paying staff in private practice). Bonus if their field is 50% as competitive as medicine is when it comes down to admissions etc
Click to expand...

Support your state medical association and the AMA. Like them or not, they're the only ones lobbying for us on the state and national level.

Still, I don't understand how after decades they (AMA, Congress, etc.) haven't been able to secure an inflationary adjustment to Medicare rates. Hospital reimbursement is tied to inflation, but not us "little guys." Hence why so many docs are now employed rather than independent, despite care being better when the doc is working for themselves/for a physician-owned group.

Higher costs, less reimbursement--of course physician-owned practices will be shutting down. Hospitals have higher costs too, but they can charge more as well (facility fees anyone? for a clinic appointment???). We've seen a number of clinics here shut down/get bought by the local large healthcare corporations. Sadly, the corporation can't seem to keep PCPs happy and thus we have a major PCP shortage.

Let physician owned small-ish groups bill a higher amount for more personalized service. And get rid of the EMR requirements/penalties--it's great in the hospital, but unless the whole country is on the same EMR and networked (which I'd vote for), private clinics don't need an EMR.

Healthcare is generally best if physicians, nurses, and/or nuns make the decisions.
 
Which is why once im done with residency, im hoping to join a physician owned group first and foremost
 
RangerBob said:
Support your state medical association and the AMA. Like them or not, they're the only ones lobbying for us on the state and national level.

Still, I don't understand how after decades they (AMA, Congress, etc.) haven't been able to secure an inflationary adjustment to Medicare rates. Hospital reimbursement is tied to inflation, but not us "little guys." Hence why so many docs are now employed rather than independent, despite care being better when the doc is working for themselves/for a physician-owned group.

Higher costs, less reimbursement--of course physician-owned practices will be shutting down. Hospitals have higher costs too, but they can charge more as well (facility fees anyone? for a clinic appointment???). We've seen a number of clinics here shut down/get bought by the local large healthcare corporations. Sadly, the corporation can't seem to keep PCPs happy and thus we have a major PCP shortage.

Let physician owned small-ish groups bill a higher amount for more personalized service. And get rid of the EMR requirements/penalties--it's great in the hospital, but unless the whole country is on the same EMR and networked (which I'd vote for), private clinics don't need an EMR.

Healthcare is generally best if physicians, nurses, and/or nuns make the decisions.
Click to expand...

You make a lot of reasonable, sound points.

Getting rid of physician owned anything and slashing our reimbursement at times almost seems like a "plan". Probably more likely just the end-result of much stronger Hospital/HC system lobby and dysfunctional (bought) government.

Zero-sum game/budget neutrality from CMS is absurd given how much and how freely our government throws money around nationally and internationally

Most physicians do not support AMA (maybe 15%?) or their subspecialist societies in part due to their bureacratic nature. I've been an ACR member since residency and an AMA member past few years, primarily based on their physician "recovery" plan. Kinda losing hope but will maybe renew for this year.

Most/many physicians are clueless about reimbursement/practice expense etc. I'm about 10 years out and the concept of knowing what I am making $/wRVU happened past few years.

I could go on and on but its preaching to the choir.
 
Splenda88 said:
I was referring to MRI/CT tech etc...
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MRI Tech here and I clear about 67k gross in a University Health System. Our department has 10 full time techs and we accumulate 100k+ in outpatient charges every day between 2 scanners (about 12 hours of scanning). That doesn't include 8 hours of inpatient scanning that occurs after the outpatient schedule. Between our compensation and the Rads reading the images, it doesn't take a mathematician to see that techs and Rads could be compensated significantly more for the revenue that we generate.

Only MRI techs pulling 100k+ a year where I work have been there at least 10 years, and we're the best paid imaging modality outside of Nuc Med as far as I know.
 
RangerBob said:
Support your state medical association and the AMA. Like them or not, they're the only ones lobbying for us on the state and national level.

Still, I don't understand how after decades they (AMA, Congress, etc.) haven't been able to secure an inflationary adjustment to Medicare rates. Hospital reimbursement is tied to inflation, but not us "little guys." Hence why so many docs are now employed rather than independent, despite care being better when the doc is working for themselves/for a physician-owned group.

Higher costs, less reimbursement--of course physician-owned practices will be shutting down. Hospitals have higher costs too, but they can charge more as well (facility fees anyone? for a clinic appointment???). We've seen a number of clinics here shut down/get bought by the local large healthcare corporations. Sadly, the corporation can't seem to keep PCPs happy and thus we have a major PCP shortage.

Let physician owned small-ish groups bill a higher amount for more personalized service. And get rid of the EMR requirements/penalties--it's great in the hospital, but unless the whole country is on the same EMR and networked (which I'd vote for), private clinics don't need an EMR.

Healthcare is generally best if physicians, nurses, and/or nuns make the decisions.
Click to expand...
Unfortunately, hospital admin/insurance corps (until recently, hopefully)/big pharma/PE firms have been crazy successful in painting doctors as the big money makers in healthcare. Because of this, it’ll be near-impossible for any legislature that increases physician compensation to pass because to the layman who has zero clue regarding the finances behind medicine DocToRs mAkE tOo MuCh MoNEy aND sHoULd dO tHiS fOr FrEe bECauSe tHeY’RE aLtRuiSTiC AnD HeALthcARe iS a RiGhT. ****, the number of people who think Residents make six figures is stupidly high, with the truth being Residents make like $12-15 an hour when you do the math, and multiple studies showing their productivity to a hospital worth ~$130k a year.
 
Lost in Translation said:
Unfortunately, hospital admin/insurance corps (until recently, hopefully)/big pharma/PE firms have been crazy successful in painting doctors as the big money makers in healthcare. Because of this, it’ll be near-impossible for any legislature that increases physician compensation to pass because to the layman who has zero clue regarding the finances behind medicine DocToRs mAkE tOo MuCh MoNEy aND sHoULd dO tHiS fOr FrEe bECauSe tHeY’RE aLtRuiSTiC AnD HeALthcARe iS a RiGhT. ****, the number of people who think Residents make six figures is stupidly high, with the truth being Residents make like $12-15 an hour when you do the math, and multiple studies showing their productivity to a hospital worth ~$130k a year.
Click to expand...
I disagree. Most Americans I run into feel physicians work hard for their income and are reasonably compensated for the amount of education they went through, the work they do, and the responsibility they have.

More folks are surprised at how little pediatricians and employed PCPs make, in my experience.
 
RangerBob said:
I disagree. Most Americans I run into feel physicians work hard for their income and are reasonably compensated for the amount of education they went through, the work they do, and the responsibility they have.

More folks are surprised at how little pediatricians and employed PCPs make, in my experience.
Click to expand...
Kids can't vote and most adults don't vote in favor of kids... only themselves. Seems obvious why the system is the way it is.
 
RangerBob said:
I disagree. Most Americans I run into feel physicians work hard for their income and are reasonably compensated for the amount of education they went through, the work they do, and the responsibility they have.

More folks are surprised at how little pediatricians and employed PCPs make, in my experience.
Click to expand...
I think most people don't actually know how much employed PCPs make.
 
RangerBob said:
Correct. I should have said "if/when they find out, most people are surprised at how little pediatricians and PCPs make"
Click to expand...
I can't speak to peds but being in medical school and seeing the commonly floated around pay scales for which specialties make the most, I am actually quite surprised by PCP pay. The numbers floated around usually undershoot what my wife brings home in both jobs she's had now as an attending by a fair amount. I'm not saying we're out buying mansions or that she really feels fairly compensated for all that she has to deal with, but it is definitely not the dire straights (by physician standards) we were initially led to believe before seeing contracts.
 
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chssoccer7 said:
I can't speak to peds but being in medical school and seeing the commonly floated around pay scales for which specialties make the most, I am actually quite surprised by PCP pay. The numbers floated around usually undershoot what my wife brings home in both jobs she's had now as an attending by a fair amount. I'm not saying we're out buying mansions or that she really feels fairly compensated for all that she has to deal with, but it is definitely not the dire straights (by physician standards) we were initially led to believe before seeing contracts.
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PCPs can make a lot of money when they do things right or are valued by the system employing them.

Unfortunately in our neck of the woods they're not valued by the corporate overloads and are underpaid/overworked, and very few independent practices remain, aside from concierge practices.
 
RangerBob said:
I disagree. Most Americans I run into feel physicians work hard for their income and are reasonably compensated for the amount of education they went through, the work they do, and the responsibility they have.

More folks are surprised at how little pediatricians and employed PCPs make, in my experience.
Click to expand...
Maybe I'm engaging in the wrong communities then because in other online forums a lot of who I suspect are college-students or otherwise part-time workers think that doctors who make over $200k make "too much".
 
vm26 said:
You make a lot of reasonable, sound points.

Getting rid of physician owned anything and slashing our reimbursement at times almost seems like a "plan". Probably more likely just the end-result of much stronger Hospital/HC system lobby and dysfunctional (bought) government.

Zero-sum game/budget neutrality from CMS is absurd given how much and how freely our government throws money around nationally and internationally

Most physicians do not support AMA (maybe 15%?) or their subspecialist societies in part due to their bureacratic nature. I've been an ACR member since residency and an AMA member past few years, primarily based on their physician "recovery" plan. Kinda losing hope but will maybe renew for this year.

Most/many physicians are clueless about reimbursement/practice expense etc. I'm about 10 years out and the concept of knowing what I am making $/wRVU happened past few years.

I could go on and on but its preaching to the choir.
Click to expand...
i don't get how people wouldnt know their $/wrvu especially in a field like rads. Making high 6 figures for <40/wrvu in a traditional on-site setting isnt good pay. Maybe its easy for me to say because $/wrvu jobs are more common now but still shocks me how ignorant the avg rad is. What % of rads would you say have no clue what their $/wrvu is? or whats considered good?
 
jambro said:
i don't get how people wouldnt know their $/wrvu especially in a field like rads. Making high 6 figures for <40/wrvu in a traditional on-site setting isnt good pay. Maybe its easy for me to say because $/wrvu jobs are more common now but still shocks me how ignorant the avg rad is. What % of rads would you say have no clue what their $/wrvu is? or whats considered good?
Click to expand...

I would guess that most employed rads (academics, HC systems etc) do not know, however they have a buffer since their income is not solely dependent on CMS pro-fees. Hospitals/HC systems gets pretty high tech-fees for owning the scanners so they can distribute these profits, either with the radiology dept (like the current market) or to other departments if needed.

I would think that most partners in PP now have an idea of their $/wRVU. Part of this stems from the new norm of tele-rads, pay-per-click etc...With this said there is still confusion as "wRVU" is just a component of the "total professional fee" which is collected by the group. I have found that these terms, wRVU and total professional fee are used interchangeably but they are different. 2.0 wRVU for CT a/p with and without turns out to be around 2.7 RVU in total collections. This will vary with geography (different modifiers) to some extent.

For traditional PP I believe the medium is around $65-70/wRVU. I am assuming that this is pure wRVU and not total Pro-fee but may be wrong.
 
vm26 said:
I would guess that most employed rads (academics, HC systems etc) do not know, however they have a buffer since their income is not solely dependent on CMS pro-fees. Hospitals/HC systems gets pretty high tech-fees for owning the scanners so they can distribute these profits, either with the radiology dept (like the current market) or to other departments if needed.

I would think that most partners in PP now have an idea of their $/wRVU. Part of this stems from the new norm of tele-rads, pay-per-click etc...With this said there is still confusion as "wRVU" is just a component of the "total professional fee" which is collected by the group. I have found that these terms, wRVU and total professional fee are used interchangeably but they are different. 2.0 wRVU for CT a/p with and without turns out to be around 2.7 RVU in total collections. This will vary with geography (different modifiers) to some extent.

For traditional PP I believe the medium is around $65-70/wRVU. I am assuming that this is pure wRVU and not total Pro-fee but may be wrong.
Click to expand...

Even if there's a buffer, they're still doing a certain amount of wrvus per year and making some amount of $$$. Easy to do the calculation.

You're saying median after-expenses is 65-70/wrvu? or before expenses? I cant fathom its after expenses. That would be over a million for someone doing 15k wrvus
 
jambro said:
Even if there's a buffer, they're still doing a certain amount of wrvus per year and making some amount of $$$. Easy to do the calculation.

You're saying median after-expenses is 65-70/wrvu? or before expenses? I cant fathom its after expenses. That would be over a million for someone doing 15k wrvus
Click to expand...

True but its a moving target. Recently a large HC system in NE OH increased rad compensation by 10% without asking for a 10% increase in productivity. So these rads will be getting a bump up in $/wRVU where PP rads will be getting a bump down giving CMS cuts for 2025.

Median before expenses. Also unclear if this is "Pro-fee" versus "wRVU", though I am assuming its pro-fee. Its complicated. Below is some info I saved off of AM on the topic. Medicare conversion factor is likely lower now.


Common misconception that medicare pays $30-35/wRVU. The Medicare conversion factor ($33.8872 for 2023) is multiplied by an exam's TOTAL RVU (not wRVU) to generate payment. TOTAL RVU for a given exam and practice location = work RVU*geographic price index work (or GPCIwork) + practice expense RVU*GPCIpractice expense + malpractice RVU*GPCImalpractice.

Use CT head wo contrast (CPT 70450) in the state of TN (locality 1031235) as an example: Total RVU = 0.85*1 + 0.31*0.894 + .04*0.518 = 1.14786, which is then multiplied by CF $33.8872 to give payment $38.90.

If you express that as a multiple of the wRVU only, that's $45.76/wRVU. The other data for each exam and locality are available at that MPFS link I posted earlier, here again: https://www.cms.gov/medic...an-fee-schedule/search
 
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