2005 mgma of greater st. louis salary survey
DESCRIPTION
TRANSCRIPT
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2005 MGMA OF GREATER ST. LOUIS SALARY SURVEY
Curt Mayse & Tamara O’Reilly
LarsonAllen Health Care Group
August 16th, 2005
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Session Objectives
2005 MGMA Salary Survey— Process outline— Key Survey outcomes
Survey Historical Perspective— Trends over past surveys
“Pearls” of the process
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How does is this information benefit you?
• Benchmark your practice against peers regarding compensation and benefits
• Local Healthcare Trend Analysis
• Specific job/position categorization
• Historical examination of Salary data
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Process Outline
• Survey distributed to all members – 150 groups
• For the first time, Survey respondents were able to begin, end and return to the Survey multiple times ~ it wasn’t necessary for the survey to be completed all at once
• Multi-dimensional completion avenues were provided to respondents (e.g. on-line; manually; etc.)
• 38% response rate
• 57 surveys considered valid
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Process Outline (continued)
• 904 physicians were represented, 164 Mid-level Providers— 43% Primary Care— 57% Specialist
• Nearly 2,972 employees were represented (19% increase)
• 80% from independent groups
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Respondents by Type of Affiliation
Individual Hospital1.96%
University9.80%
Health System5.88%
Insurance Company
7.84%
Owned/Managed by Practice
Management Company
3.92%
Independent Medical Group
80.39%
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Respondents Grouped by
• Type of Affiliation
• Practice Size
• Practice Type
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Respondents by Practice Size
10.53%
35.09%
21.05%
15.79%
10.53%
3.51%3.51%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
1 Physician
2 - 3Physicians
4 - 5Physicians
6 - 10Physicians
11 - 15Physicians
16 - 20Physicians
> 20Physicians
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Respondents by Revenue
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
2004 22.22% 22.22% 18.06% 18.06% 9.72% 9.72%
2005 11.32% 18.87% 28.30% 5.66% 16.98% 11.32% 7.55%
< $1MM$1MM to $1.99MM
$2MM to $3.49MM
$3.5MM to
$5MM to $9.99MM
$10MM to $20MM
> $20MM
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Respondents by Practice Type
Single Specialty only Primary Care
12.28%
Multi-specialty predominantly specialty care
7.02%
Multi-specialty but predominantly primary care
7.02%
Multi-specialty only
7.02%
Single Specialty without primary
care66.67%
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Local Trends
• Average salaries rose by 3.5% overall from 2004
• Biggest increases:— RN Specialty – 18.33%— Coder (Non Certified) – 14.28%— Business Office Manager – 8.00%— LPN – 5.93%— Ultra Sound Technician – 5.94%— Billing Clerk – 5.30%— Medical Secretary – 5.06%
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Local Trends (continued)
• Biggest decreases:— Lab Technician (Certified) – 23.25%— Phlebotomist – 15.46%— Medical Records Clerk – 12.52%— Referral Coordinator – 13.06%
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How Salary Increases are Determined?
Merit80.36%
General, Across the Board12.50%
Cost of Living7.14%
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When are Salary Increases Given?
Employee's anniversary date
60.00%
Fiscal year12.73%
Calendar year27.27%
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How Often is Salary Reviewed?
Annually94.64%
Semi-Annually1.79%
Quarterly3.57%
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Average Salary Increases 2003-2004-2005
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
2003 1.59% 6.35% 52.38% 22.22% 17.46%
2004 3.08% 9.23% 43.08% 18.46% 26.15%
2005 4.17% 6.25% 54.17% 18.75% 16.67%
< 1.99% 2.00 - 2.99% 3.00 - 3.99% 4.00 - 4.99% 5.00%+
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Reviews at Time of Salary Increase
Reviews at Same Time of Salary Increase
Yes87.72%
No12.28%
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Bonuses
• Annual bonuses – 75% provided some sort of staffing bonuses
• Criteria for bonuses based on:— percentage of productivity and/or physician income— percentage of organization’s net profit— deferred compensation— discretionary
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Bonuses by Practice Size
77.78%
100.00% 100.00%100.00%
86.67%
72.73%
50.00%
75.00%
66.67%66.67%
100.00%
73.33%63.64%
50.00%
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
<$1MM $1MM to$1.99MM
$2MM to$3.49MM
$3.5MM to$4.99MM
$5MM to$9.99MM
$10MM to$20MM
>$20MM
Administrator Staff
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Bonus Determination
8.62%
15.52%
3.45%5.17%
12.07%
55.17%
8.89%
2.22%
6.67%6.67%
2.22%
73.33%
0.00%5.00%
10.00%15.00%20.00%25.00%30.00%35.00%40.00%45.00%50.00%55.00%60.00%65.00%70.00%75.00%80.00%
Discretionary % of Productivityand/or physician
income
% of organization's
net profit
Other formulabonus
Deferredcompensation
Combination of all factors
Admin Staff
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Salary and Benefits ~ what do employees expect?
— PTO (paid time off) has become an administratively flexible alternative for employers trying to meet ever increasing employee needs
— The PTO solution reduces a Practice’s time and energy to manage employee’s Vacation and Sick time
◊ National Average 24 Days◊ St. Louis (2003) 23 Days◊ St. Louis (2004) 25 Days◊ St. Louis (2005) 26 Days
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PTO Days by Years Employed
11.45
20.46
25.54
29.39 30.5027.70 28.61
21.46
0.00
5.00
10.00
15.00
20.00
25.00
30.00
35.00
<1 Year
1.1 - 3 Years
3.1 - 5 Years
5.1 - 10 Years
10.1 - 15 Years
15.1 - 20 Years
20.1 - 25 Years
>25 Years
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What is Considered Full Time?
Determination of Hours for Full Time Employee
35 - 40 Hours75%
30 - 34 Hours25%
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Positions Surveyed
• Office Manager
• Administrator
• Assistant Administrator
• Business Office Manager
• Administrative Assistant
• Accounts Payable
• Billing Clerk
• Coder/Analyst (Certified)
• Coder/Analyst (Not Certified)
• Collector
• File Clerk
• Information Systems Technician
• Patient Accounts Rep/Collections
• Receptionist
• Referral/Managed Care Coordinator
• Switchboard/Telephone Operator
• Medical Records Clerk
• Medical Secretary
• Transcriptionist
• Clinical Supervisor• Licensed Practical Nurse• Medical Assistant (Certified) • Medical Assistant (Not Certified)• Registered Nurse• Registered Nurse (Specialty Certified)• Surgery Scheduler• Lab Technician (Certified)• Lab Technician (Not Certified)• Phlebotomist• Lead/Chief Lab Technician• Ultrasound Technician• X-Ray Technician• Lead/Chief X-Ray Technician• Nurse Practitioner• Physician Assistant• Surgical Technician• Aesthetician
• Audiologist
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Sample Salary Page
Billing ClerkEnters charges and payments daily; responsible for billing and follow up on both
insurance and patient accounts; assists with patient inquiries.
CategoryLow
SalaryAverage
SalaryHigh
SalaryTotal FTE's
Average Years of Service
Average Years of Education
All Practices $25,667 $28,766 $32,094
$12.34 $13.83 $15.43
Under $1MM $28,870 $31,470 $28,600
$13.88 $15.13 $13.75
$1MM to $2MM $30,867 $32,323 $33,883
$14.84 $15.54 $16.29
$2MM to $3.5MM $25,646 $28,808 $32,510
$12.33 $13.85 $15.63
$3.5MM to $5MM $28,080 $29,120 $30,160
$13.50 $14.00 $14.50
$5MM to $10MM $23,941 $27,581 $31,720
$11.51 $13.26 $15.25
$10MM to $20MM $18,866 $23,712 $30,243
$9.07 $11.40 $14.54
> $20MM $21,715 $26,333 $31,158
$10.44 $12.66 $14.9845.00 7.68 *
101.20
*
9.00
14.20
2.00
24.00
6.00
6.42
*
5.25
7.63
4.00
6.41
5.00
*
1.29
1.00
0.96
*
1.67
0.29
By Revenue Type
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Sample Salary Page (continued)
CategoryLow
SalaryAverage
SalaryHigh
SalaryTotal FTE's
Average Years of Service
Average Years of Education
All Practices $25,667 $28,766 $32,094$12.34 $13.83 $15.43
Multi Specialty $23,608 $26,603 $29,037(but predominantly primary care) $11.35 $11.35 $13.96Multi Specialty $19,344 $23,941 $31,013(predominantly specialty care) $9.30 $11.51 $14.91Multi Specialty Only $17,306 $22,755 $24,128
$8.32 $10.94 $11.60Single specialty $27,310 $27,435 $27,560(with primary care) $13.13 $13.19 $13.25Single Specialty $26,333 $29,494 $33,114(without primary care) $12.66 $14.18 $15.92Specialty $28,080 $30,680 $32,240(with primary care) $13.50 $14.75 $15.50
101.20 6.42 0.96
37.00 5.00 *
3.00 * *
6.00 11.00 *
2.00 2.25 *
3.00 2.50 *
50.20 7.07 1.28
By Practice Type
•Insufficient Responses
NOTE: Low, average and high salary amounts are compiled from survey responses and each category is then averaged. If a respondent did not respond to all data elements, no adjustment was made and data may appear to be inconsistent in some instances (e.g., average salaries may be lower than low salaries).
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Staffing Ratio per FTE Physician*
* MGMA’s Better Performing Practices annual guide states that in some cases a higher staffing ratio can create higher profitability
17.54%
28.07%
22.81%
15.79%15.79%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
< 1.99 2 - 2.99 3 - 3.99 4 - 4.99 5+
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Staffing Ratio Per FTE Physician
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
2004 14.08% 28.17% 15.49% 16.90% 25.35%
2005 17.54% 28.07% 15.79% 15.79% 22.81%
< 1.99 2 - 2.99 3 - 3.99 4 - 4.99 5+
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Current Staffing Needs
12.90%
6.45%
3.23%
22.58%
3.23%
7.53%
25.81%
1.08%
6.45%
2.15%
4.30%4.30%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
Physician Physician'sAssistant
Nurse Practitioner Nursing/Clinical Radiology Medical Records Front Desk Certified Coder Transcriptionist Billing/Collections Lab Manager
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Current Staffing Needs for Your Practice
0%
5%
10%
15%
20%
25%
30%
2004 28% 4% 4% 17% 3% 7% 17% 3% 4% 11% 1% 11%
2005 13% 6% 3% 23% 3% 8% 26% 4% 1% 6% 2% 4%
PhysicianPhysician's Assistant
Nurse Practitioner
Nursing/Clinical
RadiologyMedical Records
Front DeskCertified Coder
Transcriptionist
Billing/ Collections
Lab Manager
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Building Successful Teams in the Midst of Change
“Health and Mental health organizations are undergoing major changes in policies, procedures, structure and emphasis”,
Stewart Gabel, Leaders and Healthcare Organizational Change: Art, Politics, and Process
— One of the most significant essentials for success during transition is teambuilding
— Leaders that can challenge, motivate and empower their teams through change are successful
— Most change disrupts teamwork ~ the Leaders who can keep their work teams focused during changes will have Practices which thrive
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Essential One: Knowledge
Is your company/practice a learning organization? A learning organization includes the following characteristics:
— A belief that systems thinking is fundamental— A climate that encourages, rewards, and enhances individual and
collective learning— A view the holds surprises, mistakes, and failures as learning
opportunities— A desire for continuous improvement and renewal— Learning integrated with work
Knowledge is the foundation to Vision
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Essential Two: A Focused Vision
• The team must have a unified mission
• The team mission is not for customers, it is for the staff
• The team mission must be developed by the staff – for ownership
• Without Knowledge, the team mission is a false hope
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Essential Three: Faith
• Doubt and skepticism will erode the team spirit
• The dynamic team must have a strong faith and trust in the mission
• Faith is not stronger than the truth of its assumptions
• Therefore, Faith must be built on the first two factors:
• Faith, without Knowledge and Vision, is merely presumption
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Essential Four: Initiative
“Sooner or later all plans degenerate into work”- Peter F. Drucker, The Daily Drucker
How do you motivate your staff to do their part?— Motivation is an inside job ~ It is internal— Daily initiative comes from making sure each person is
doing the part of the whole that they feel best contributes to the overall mission
Initiative without Knowledge, Vision, and Faith is misguided energy AND without Initiative,
knowledge, vision and faith are just a dream!
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Essential Five: Training and Development
American Society of Training and Development found the following major competencies as models for human performance improvement:
- Industry or Corporation Awareness - Leadership Skills- Interpersonal-relationship skills - Technological Literacy- Problem-solving skills - Problem-definition skills- Systems thinking and understanding - Performance understanding- Knowledge of interventions - Business understanding- Organization understanding - Contracting skills- Advocacy skills - Coping skills- Ability to see the “BIG” picture
Great teams are made up of Knowledge workers, who have a focused Vision, believe in their mission and empower each other with their
Initiative and Skill Development
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Performance Management• Employee Performance Management Cycle
Measurable
Repeatable
Predictable
# 1 –JobDescription
# 2 –Hiring
# 3 –DiscussJobExpect.
# 4 –Training
# 5 –Determine1st and 2nd jobduties
# 6 –90 dayperformancereview
# 7 –Annualperformancereview
# 8 –SalaryIncreaseorDecrease
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Summary
A combination of competitive salaries and benefits along with an environment that fosters Knowledge; has a strong Vision and leads through Initiative and Skill Development creates productive and happy employees.
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Thank You
LarsonAllen Health Care Group
(314) 336-3726
www.larsonallen.com