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Interpreting salary data ie MGMA, Sullivan-Cotter, et al

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  • Interpreting salary data ie MGMA, Sullivan-Cotter, et al

    Overly basic question that has me stumped:

    In regards to physician compensation reports like MGMA, Sullivan-Cotter, AMGA, etc: what is the technical difference between base salary and total cash compensation (TCC)?

    Everything I have been able to find regarding TCC defines it as a base salary plus other income such as bonus, loan repayment, etc. Taxable income money. Money I get paid over the coarse of that contract year.

    I work in a small hospital and am negotiating directly with the CEO/CFO. They flat-out, blatantly told me that I am wrong and that TCC also includes intangibles like malpractice coverage, benefits, etc. Therefore the salary amounts they offer for a given production target are the base salary, not TCC. Am I way off base?

    If I haven't made myself clear, an example would be: X specialty quoted in Sullivan Cotter at Median productivity: 5000 RVU, base salary 200,000, TCC 250,000
    -I surmised that Y physician who produces 5000 RVU would earn $250k total: perhaps as a $200k base salary for 4000 RVU and and bonus of $50k for the additional 1000 RVU.
    -They are saying a physician producing 5000 RVU earns $200k and has some $50k worth of benefits from his/her gracious employers.

  • #2
    You are right. I hope they are being disingenuous. Someone who does not know this should not be a CFO.

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    • #3
      I suspect you are correct but do not know for sure. I wouldn't call fringe benefits such as health insurance "cash."

      At least for MGMA
      https://www.mgma.com/data/participat...r-compensation

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      • #4
        This is what I was afraid of finding out. The next question becomes: Is our hospital administration a)inept or b)crooked c)all of the above

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        • #5
          Do they respond to the surveys? Do they count benefits as cash compensation?

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          • #6
            Total compensation and total cash compensation are not the same thing. Check the fine print of whatever report you are looking at, it will have a description of what is or isn't included in those particular numbers. If there isn't a description in the report itself then check the website of the organization that published the report. Print a copy and take it to the person you're negotiating with.

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            • #7
              MGMA publishes the multi-page report to be filled out I believe. The instructions should be there to see what the definitions are. Just go to the source. Show it to them. Shut them up.

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              • #8
                Here is the MGMA website that explains this:

                https://www.mgma.com/data/participat...r-compensation

                The Total Cash Compensation from MGMA includes the base salary, any pay for covering call, any cash bonus paid, and any employer paid pension/401k contributions.

                It does not include benefits like health insurance, malpractice insurance, or employer paid payroll taxes.

                Here is a statement off that MGMA website.

                Click image for larger version

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                • #9
                  Thanks for all the input. I may contact the specific survey entity in question (not MGMA) and see if they will give an objective response that I can have in my hand. The rest of the issue becomes negotiation strategy for a c-suite who isn't bothered by being disingenuous and now can use the "we don't have extra money because of covid" stance when in reality our service is running at essentially full capacity.

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                  • #10
                    The COVID issue is real for most hospitals. Even if you are running at full levels, hospitals lost huge amounts during the lockdowns and many may have to lockdown again. Depending on your hospital, they may be continuing to see losses in lucrative outpatient business.

                    For compensation you will probably need to do what everyone does, see what your options are with other jobs.

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                    • #11
                      This is a small rural center not overly affected by COVID. Elective surgery (ortho, general, bariatric, GYN, ENT) was halted for March, April. Ramped up in May. Been running strong since. PCP have been busy as ever. The medical subspecialties we have never skipped a beat (cards, pulm). Only folks I can think of that probably scaled back a lot would be GI, oncology and derm. Wife and I have offers nearby but were hoping to be shown some love and not have to move....

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                      • #12
                        Originally posted by Superior View Post
                        This is a small rural center not overly affected by COVID. Elective surgery (ortho, general, bariatric, GYN, ENT) was halted for March, April. Ramped up in May. Been running strong since. PCP have been busy as ever. The medical subspecialties we have never skipped a beat (cards, pulm). Only folks I can think of that probably scaled back a lot would be GI, oncology and derm. Wife and I have offers nearby but were hoping to be shown some love and not have to move....
                        The best leverage is to explore the other offers. You and admin can go in circles about which compensation report is valid. Or you can tell them you have an offer on the table for X salary at another hospital.

                        It's like buying a car. If you drive up to negotiate at the dealership you will be shown a cubicle and given the grind. Or you can email/phone multiple dealers who compete against each other so you get the best price.

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                        • #13
                          Originally posted by Superior View Post
                          Thanks for all the input. I may contact the specific survey entity in question (not MGMA) and see if they will give an objective response that I can have in my hand. The rest of the issue becomes negotiation strategy for a c-suite who isn't bothered by being disingenuous and now can use the "we don't have extra money because of covid" stance when in reality our service is running at essentially full capacity.
                          That!
                          Interpreting the direction of the surveys seem Get cloudy in the “benefits”.
                          Compensation + benefits is your goal.
                          Pre and post tax deductions are definitely included. Employer funded benefits aren’t.
                          The regional numbers are sooo wide (cost of living, urban to extremely small rural, high volume to low volume practice setups) that it really doesn’t present a median or accurate number for your situation.
                          Regarding alternate offers and moving, that is cost of staffing just like recruiting expenses. Negotiable! Signing bonuses. No wonder those are included in surveys too. Renewing your contract eliminates costs for the hospital (or physician).
                          Since you have competitive offers, ask for a signing bonus! Regardless of the definitions, it’s compensation and benefits.
                          Surveys are at best a ballpark.
                          ​​​​​​​

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                          • #14
                            The hospital will not love you back. Get your data. Negotiate from a position of strength. The hospital's interests do not align with yours.

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                            • #15
                              In my mind if the CFO/CEO is incompetent or crooked does it matter? Would you want to work with this person in the future who is looking to screw you or does so out of Incompetence.

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