2018 Medical Practice Employee Salary & Benefits Survey

Presented by:

Bill Clayton

Is My Staff Competitively Compensated?

Clark Schaefer Hackett Firm Overview

Size of Firm: Top 100 accounting & consulting firm in the United States

Office Locations: Cincinnati, Cleveland, Columbus, Miami Valley, Northern Kentucky, Springfield, Toledo (Work in Multiple States)

Services: Full service firm - Practice Management and Accounting/Tax Services Combination (CPAs plus Business Advisors)

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Clark Schaefer HackettEvolution of Healthcare Services

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Accounting & Tax

Healthcare Audits

Valuation Specialist

Traditional Accounting

Acquired Consulting Firm

Litigation SupportManagement Contracts

Enhanced Practice Management Program

PPMCs Alternative

Outline of This Secession• Overview of Survey

• Big Picture – Four Sections of Survey Report• Details of each section• Group Discussion • Frequency of Survey• Next Step – Webinar / Excel Tool

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Major Sections of Survey Report

Section One – A User’s Guide - Page viSection Two – Response Recap – Page xSection Three – Compiled Survey Data – Page 1 - 29Section Four – Position Descriptions / Data Methodology -30

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Section One – A User’s Guide Page vi

User Guide – Three Parts• Report Organization – summary of the individual data

tables• Statistical Interpretation – information regarding the

percentiles, mean, count, etc. (This is worth reading.)• Interpreting the Data / Using the Survey Report – step

by step outline in using the data and building your own review.

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User Guide – Section Descriptions1. Response Recap – provides the demographics of the participants

for the state of Ohio who participated in the Ohio MGMA 2018 Salary Survey.

2. Total Support Staff per Full Time Physician Tables – shows the number of FTEs in percentiles for each specialty. (Excludes any extenders such as Nurse Practitioner and Physician Assistant.)

3. Total Support Staff per All Providers Tables - shows the number of FTEs in percentiles for each specialty. (Includes any extenders such as Nurse Practitioner and Physician Assistant.)

4. Fringe Benefits Tables – provides data on different fringe benefits offered, hours for full-time status and basis of pay increases.

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User Guide – Section Descriptions5. Vacation and Sick Day Allowance Tables – provides data

on the vacation and sick days allowance (and also PTO Allowance) for non-management and management by the number of days and includes annual paid holidays.

6. Types of Retirement Plans Offered Tables and Graph –provides data on the types of retirement plans offered.

7. Retirement Contributions – provides data on the retirement contributions.

8. Compensation Average Increase – data on the average increase for 2016, 2017 and projected 2018.

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User Guide – Section Descriptions9. Bonus Analysis / Decision Makers – provides data on

who pays bonuses and who the decision makers are regarding compensation decisions.

10. Bonus Tables – provides data by selected position types (under selected percentiles)

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User Guide – Section Descriptions

12. Ohio / Northeastern Ohio / Dayton / Central Ohio / Southwestern Rates by Position Tables – provides data by positions (under selected percentiles)

13. Ohio / Northeastern Ohio / Dayton / Central Ohio / Southwestern - Hourly Rates by Position and Length of Employment

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User Guide – Section Descriptions

Appendix A contains the position descriptions for each of the positions used in the survey.

Appendix B contains the data compilation methodology used in this report.

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Response Recap

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Total Number of Surveys Included: 111

Geographic Distribution:

Northeastern Ohio (Cleveland/Akron Market) 17.12%

Northwestern Ohio (Toledo Market) 5.41%

Central Ohio (Columbus Market) 23.42%

Southwestern Ohio (Cincinnati Market) 22.52%

Dayton/Springfield Ohio MSA Market 29.73%

Southeastern Ohio 1.80%

Response Recap

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Ownership/Primary Affiliation:

Federally Qualified Health Center (FQHC)2.70%

Independent Rural Health Clinic (RHC) 0.00%

Hospital Owned Rural Health Clinic (RHC)0.00%

Practice Management Company 5.41%

Individual Hospital 2.70%

Health System 7.21%

Independent Medical Group 81.98%

Practice Size Breakdown:

Unknown 2.70%

1-4 Physicians 44.14%

5-10 Physicians 27.93%

11-20 Physicians 11.71%

>20 Physicians 13.51%

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Types of Practices that Participated: # %93 83.78%

18 16.22%

Specialty: # % # %0 0.00% OB/GYN 10 9.01%

0 0.00% Occupational Medicine 0 0.00%

1 0.90% Oncology 2 1.80%

1 0.90% Ophthalmology 5 4.50%

1 0.90% Oral/Maxillofacial Surgery 0 0.00%

0 0.00% Orthopedic Surgery 6 5.41%

1 0.90% Otorhinolaryngology (ENT) 3 2.70%

3 2.70% Pain Management 0 0.00%

2 1.80% Pathology 0 0.00%

0 0.00% Pediatrics 15 13.51%

10 9.01% Physiatry (Physical Medicine & Rehab) 0 0.00%

3 2.70% Physical Therapy 1 0.90%

2 1.80% Plastic Surgery 2 1.80%

1 0.90% Podiatry 1 0.90%

2 1.80% Psychiatry 0 0.00%

1 0.90% Psychology Clinic 0 0.00%

0 0.00% Pulmonary 5 4.50%

5 4.50% Radiology Group 2 1.80%

18 16.22% Radiology: only Interventional 0 0.00%

0 0.00% Radiology: only Nuclear Medicine 0 0.00%

3 2.70% Rheumatology 0 0.00%

1 0.90% Urgent Care 1 0.90%

1 0.90% Urology 2 1.80%

0 0.00% Vascular Surgery 0 0.00%

Multi-Specialty:

General Surgery

Nurse Practitioner Primary Clinic

Neurosurgery

Neurology

Nephrology

Neonatology

Multi-Specialty

Internal Medicine

Infectious Diseases

Hospitalist

Hematology/Oncology

Gynecology

Allergy, Asthma, Immunology

Gastroenterology

Family Medicine

Endocrinology

Emergency Medicine

Dermatology

Dentistry

Chiropractic Clinic

Cardiovascular/thoracic surgery

Cardiology

Anesthesiology

Ambulatory Surgery Center

Single Specialty:

Types of Practices that Participated

Total Support Staff Per Full Time Position (Page 1) (Note Page 2 has per all providers)

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Total Support Staff per Full Time Physician Count

Specialty Practices Physicians Mean 10th %tile 25th %tile Median 75th %tile 90th %tile

Allergy, Asthma, Immunology 0 0 * * * * * *

Ambulatory Surgery Center 0 0 * * * * * *

Anesthesiology 1 18 * * * * * *

Cardiology 1 2 * * * * * *

Cardiovascular/thoracic surgery 1 2 * * * * * *

Chiropractic Clinic 0 0 * * * * * *

Dentistry 1 2 * * * * * *

Dermatology 3 4 * * * * * *

Emergency Medicine 2 1457 * * * * * *

Endocrinology 0 0 * * * * * *

Family Medicine 10 42 5.66 2.95 3.18 5.10 7.26 10.35

Gastroenterology 3 4 * * * * * *

General Surgery 2 5 * * * * * *

Gynecology 1 1 * * * * * *

Hematology/Oncology 2 67 * * * * * *

Hospitalist 1 45 * * * * * *

Infectious Diseases 0 0 * * * * * *

Internal Medicine 5 14 4.93 4.00 4.00 4.00 6.00 6.40

Multi-Specialty 18 874 7.32 2.72 3.74 4.21 8.80 15.70

Fringe Benefits – Page 3

Note you have other fringe benefits in the report (Vision, HAS, etc.) You also have Basis of Pay Increases.

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Fringe Benefits:

Employee/Self Paid

Fully Paid by Employer

Partially Paid by Employer Not Offered

Health Insurance Employee 0.90% 16.22% 78.38% 4.50%Health Insurance Dependents 45.05% 7.21% 42.34% 5.41%Dental Insurance Employee 34.23% 14.41% 37.84% 13.51%

Vacation & Sick Day AllowancePage 4

Small Sample: Non-Management 1-5 Years Employment

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1-5 Years Employment

Sick Vacation Personal

1-5 Days 62.07% 0.00% 85.71%

6-10 Days 37.93% 70.59% 14.29%

11-15 Days 0.00% 26.47% 0.00%

16-20 Days 0.00% 0.00% 0.00%

21-25 Days 0.00% 2.94% 0.00%

25+ Days 0.00% 0.00% 0.00%

Note in the report you have data for non-management and management, PTO allowance, etc.

Types of Retirement Plans OfferedPage 5

In the report you have eight other plan types.

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Types of Retirement Plans Offered

Plan Type Percentage Offering Plan

401(k) no employer contributions 4.50%

401(k) with employer contributions 77.48%

Company Retirement ContributionsPage 6

Also on this page you have percentage of annual income contributed by company.

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Contribution Type Yes No

401K Match % %

Profit Sharing Program % %

Compensation Average IncreasePage 7

In the survey you have seven other categories.

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Compensation Average Increase

2016 2016 2017 2017 2018 2018

Increase/Decrease Count % of Total Count % of Total Count % of Total

Increase < 2% 13 12.50% 14 13.46% 16 15.38%

Bonus Information on Page 8 and 9

You have bonus information and actual dollars for selected positons on page 8 and 9 of the report. You also have the percentage of who makes the compensation decision per three categories.

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Bonuses: Yes NoNon-Management Bonuses Paid in 2017

% %Non-Management Bonuses Paid Expected in 2018

% %Practice Administrator Bonuses Paid in 2017

% %Practice Administrator Bonuses Paid Expected in 2018

% %Physician Extenders Bonuses Paid in 2017

% %Physician Extenders Bonuses Paid Expected in 2018

% %

Rates by Position Tables – provides data by positions (under selected percentiles)

Page 10 through 19

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OhioHourly Rates by Position Hourly RateStaff Position Count Mean 25th %tile Median 75th %tile 90th %tileAccountant 8 $31.52 $26.60 $31.13 $36.00 $40.39Administrative Assistant 29 $19.21 $15.00 $17.64 $20.40 $27.67Administrative Secretary 5 $21.18 $18.85 $20.00 $23.00 $26.38

For Ohio / Northeastern Ohio / Dayton / Central Ohio / Southwestern. Note that “Ohio” has the total state data.

Hourly Rates by Position and Length of Employment Page 20 through 29

For Ohio / Northeastern Ohio / Dayton / Central Ohio / Southwestern. Note that “Ohio” has the total state data.

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Ohio Median Hourly Rates

Hourly Rates by Position and Length of Employment:<1 <1 1 to <5 1 to <5 5 to <10 5 to <10 >10 >10

Staff Position Count <1 Year Count 1 - 5 Years Count 5 - 10

Years Count >10 Years

Accountant 0 * 3 * 0 * 3 *Administrative Assistant 3 * 9 $17.08 7 $18.53 10 $18.56Administrative Secretary 1 * 0 * 2 * 2 *

Discussion SlideLet’s Talk About How You Will Use the Salary Report

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Basis of Pay Increases:

Cost-of-living 36.94%

Merit/performance based 74.77%

Longevity/seniority 30.63%

Practice profitability 43.24%

Patient satisfaction surveys 6.31%

Other 3.60%

Frequency of Compensation Reviews:

Anniversary 27.88%

Annually 61.54%

Other 5.77%

None 4.81%

When do you give raises – why? Do you do a review? (what format?)

Discussion

• What is the correct frequency of conducting the salary survey?

• Next Step - Webinar

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Using the Survey ReportStep One: List out each position and each employee in your organization. Create in a database the following: employee name, position description, start date, years experience, annual hours worked (plus overtime hours), pay rate, last date of raise, amount of last raise and then compare with the survey report. It may be helpful to retype sections of the survey data by position for comparison purposes.

Step Two: Create a ranking or rating system and rate each employee’s performance.

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Using the Survey ReportStep Three: Then choose a system to increase pay by a certain amount for each employee based on years of service, ranking, etc. For example, a range of zero to four percent increase range could be used for increases. Step Four: Compare the difference between your suggested pay increase (new hourly rate) and the survey. What is the difference between your recommendations and the report data? Consider experience, performance level, cost of turnover, etc. You should be prepared to discuss the differences. If needed, seek other survey data for comparison.

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Using the Survey Report

Step Five: Take the total hours multiplied by the new hourly rate to reflect the new salary total budget or effect on the facility.

Step Six: Review the data and seek the required approvals.

Special Note: When presenting the data for approval by a committee or a physician; it can be helpful to include the 25th percentile, the median and the 75th percentile from the survey report along with the actual pay and experience level.

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Statistical Interpretation Mean – the arithmetic average calculated by summing the data and dividing by the count.

25th percentile – the value where one quarter (25 percent) of the responses are lower and the remainder greater.

Median – the midpoint of all responses when arrayed from lowest to highest.

75th percentile – the value where three quarters (75 percent) of the responses are lower and the remainder greater.

90th percentile – the value where nine tenths (90 percent) of the responses are lower and the remainder greater.

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Bill Clayton, MBAPrincipal Healthcare Consulting614-286-0504wclayton@cshco.com

Ryan PetersHealthcare Consultant614-537-6079rpeters@cshco.com