Becker's Hospital Review

37 37 CEO/STRATEGY 10 Most Concerning Issues for Hospital CEOs By Molly Gamble F or the 13th year in a row, hospital CEOs ranked financial challenges as the No. 1 issue facing their organizations in 2016, according to an American College of Health- care Executives survey. Each year, the ACHE surveys community hos- pital CEOs to identify the top challenges their organizations are facing. Below are the top 10 issues identified by hospital CEOs in 2016. e results reflect 383 CEOs' responses. 1. Financial challenges 2. Government mandates 3. Patient safety and quality 4. Personnel shortages 5. Patient satisfaction 6. Access to care 7. Physician-hospital relations 8. Population health management 9. Technology 10. Reorganization (e.g., mergers, acquisi- tions, restructuring, partnerships) CEOs also ranked specific aspects of the top three categories they found most pressing. CEOs could choose as many as desired. Here are the top three for each. Within financial challenges 1. Medicaid reimbursement — 63 percent 2. Increasing costs for staff, supplies, etc. — 60 percent 3. Reducing operating costs — 55 percent Within government mandates 1. CMS regulations — 67 percent 2. CMS audits — 57 percent 3. Cost of demonstrating compliance — 51 percent Within patient safety and quality 1. Engaging physicians in improving the cul- ture of quality/safety — 59 percent 2. Engaging physicians in reducing clinically unnecessary tests and procedures — 57 per- cent 3. Redesigning care processes — 48 percent n The Chief Compliance Officer's Paycheck is the Fastest Growing in the C-Suite By Emily Rappleye T he increasing focus on regulatory issues may already be affecting executive pay within medical groups — and it appears chief compliance officers are poised to capitalize on this trend. The CCO role was the only position in medical groups' C-suites with solid compensation growth from 2014 to 2016 — increasing 17.5 percent — according to a recent survey conducted by the American Medical Group Associ- ation. The survey polled 78 medical groups, most with 100 or more physicians. Participants spanned the nation and roughly 58 percent were affiliated with a health system. Comparatively, over the same time period, physician CEO total cash compensation dropped 3.9 percent, CNO compensation decreased 6.8 percent and CMO pay dropped 8.7 percent. Some C-suite roles experienced increases, though most were modest compared with that of the CCO. For example, nonphysician CEO total cash compensation increased 3.6 percent from 2014 to 2016 and CIO pay increased 2.6 per- cent in that time span. CFO pay increased 3.6 percent during the same time period, with most of that increase occurring in 2016. Between 2015 and 2016, CFO pay increased 11.8 percent, the largest jump in pay last year. However, AMGA attributed this to a reporting change — the report this year only includes data on CFOs, leaving out information on vice president of finance positions that was previously included. Though some of the results can be attributed to changes in participants or methodology, AMGA noted another trend in its data: the decline in incentive compensation. Roughly half (48 percent) of C-suite incumbents reported earning incentive compensation in 2016, compared to 62 percent in 2015. "The 2016 survey indicates that leadership compensation is not simply increasing by a consistent 3 percent or 4 percent year-over-year," Tom Dobosenski, president of AMGA Con- sulting, said in a statement. "The survey results show that factors such as the magnitude of incentive compensation, executives' achievement of those metrics and the available labor force for some specialized positions are important." A look at the total paychecks also shows CCOs could be experiencing the most growth in pay because they are still among the lowest paid executives in the C-suite. Here is how median total cash compensation stacked up for medical group executives in 2016, according to the AMGA survey. CEO/president (physician) — $600,508 CEO/president (nonphysician) — $429,373 CMO — $366,512 CFO — $308,624 COO — $298,500 CNO — $245,800 CIO — $250,000 CCO — $198,500 n

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