INFOGRAPHIC | Unrestricted On-Call Pay for Advanced Practice Providers

Insight into on-call pay practices for Advanced Practice Providers

Advanced practice providers (APPs) continue to be an important resource as organizations strive to meet patient demand. Developing an effective on-call pay approach for APPs helps to increase patient access and support care coverage needs, and understanding the data and benchmarks regarding this premium pay practice is critical. This infographic highlights important unrestricted on-call pay trends and metrics including prevalence, thresholds, hourly rates for call coverage, compensation methods and important considerations in developing or updating your organization's related policies.

Learn more about SullivanCotter's Advanced Practice Provider Compensation and Pay Practices Survey, featuring data from more than 600 organizations on nearly 67,000 individual APPs.


CASE STUDY | The Value of APPs in Driving Organizational Performance

Advanced practice providers (APPs) are one of the fastest growing workforces in health care.



Advanced practice providers (APP) are one of the fastest growing workforces in health care. Not only has the APP workforce more than doubled in the last 15 years, but physician assistants and nurse practitioners are also ranked as the third and fourth best overall jobs in 2018 by U.S. News & World Report.

The focus on team-based care continues to intensify. In order to truly help transform care delivery, the role of APPs must be more clearly defined to better partner with physicians. Health systems and medical groups nationwide seek to drive better performance as the industry transitions from volume- to value-based care, and achieving the strategic goals of access, quality, affordability and provider satisfaction is a top priority.

As one of the top 10 largest children’s hospitals in the country and Arizona’s only pediatric quaternary care hospital for high acuity, complex conditions, leadership at Phoenix Children’s Hospital (PCH) recognized the need to utilize APPs more effectively to help transform patient care delivery.

Like many organizations, the number of APPs had grown swiftly and organically without a comprehensive strategy to support its sustainability. PCH realized that while they employed almost 100 APPs representing nearly $10 million in payroll, the lack of strategy had created obstacles regarding recruitment, utilization and job satisfaction. This left the organization unable to tap into the full potential of their rapidly growing APP workforce.

PCH partnered with SullivanCotter to develop a comprehensive workforce strategy to integrate, optimize and engage APPs in achieving the organization’s goals of increasing access, quality, affordability and provider satisfaction.


Senior leadership at PCH collaborated with a team of advisors from SullivanCotter to assess the utilization of their current APP workforce and developed a systemic approach to redesign care models and build the culture and infrastructure necessary to support the optimization of APPs.

Supported by decades of clinical and operational health care industry experience, as well as proprietary APP data on utilization, compensation and leadership structures, SullivanCotter provided unique insight into the evolving role of the APP and the challenges health systems and medical groups face when trying to utilize this workforce more effectively.

“Medical group, hospital and nursing executives must be fully aligned and work together
throughout the entire process to ensure the optimization and engagement of all team
members, including physicians, advanced practice providers, registered nurses and
medical assistants.”

Dr. Jared Muenzer, MD, MBA
Senior Vice President and Chief Operating Officer, Phoenix Children’s Medical Group

The approach included three phases: education and assessment, program design, and implementation.

A number of PCH leaders were involved throughout the process – including the CEO, CMO, COO of the medical group, SVP/CNO, Surgeon in Chief, executive general counsel, and physician and APP leaders. Physicians were also meaningfully engaged in the assessment and design and led the implementation efforts in their divisions.

To start, all APPs were surveyed to learn more about their current utilization and perception of the culture at PCH. Key policies were also reviewed to assess current practices compared to federal and state regulations as well as national trends and leading practices.

Findings from the initial assessment uncovered the following:

  • Only 42% of APPs felt they were being utilized to their maximum potential
  • APPs were performing many activities that could be completed by other team members such as RNs, MAs or social workers
  • Medical staff bylaws were more restrictive than state law or CMS requirements
  • Clinical privilege lists were out of date
  • There was no formal orientation program for APPs, though over 40% were hired as new graduates
  • APPs received limited education on documentation and billing
  • Multiple key stakeholders desired clarification on the NP and PA scope of practice

Using the findings from the assessment, SullivanCotter worked with PCH executives and physicians to develop a list of guiding principles. To help inform a comprehensive APP strategy, the organization determined it must:

  • Define models of care based on patient needs and clinical specialty
  • Ensure providers work to their full potential and support top-of-license practice
  • Bill based on service provider
  • Build a culture and infrastructure to support the utilization, retention and engagement of APPs
  • Measure progress to ensure sustainability and identify new opportunities for improvement
  • Develop a provider workforce plan that includes APPs in addition to physicians

Facilitated by SullivanCotter, these guiding principles were then used by multiple clinical divisions (cardiac surgery, CVICU, cardiology, emergency services, urgent care, orthopedics, urology, gastroenterology and transplant) to re-examine and redefine the role of APPs in patient care delivery.

Additionally, other project teams were enlisted to help ensure the continued optimization and engagement of the APP workforce. They focused on the development of new:

  • Leadership structures
  • Privileging and competency assessment (FPPE/OPPE) processes
  • Onboarding processes with clearly defined roles for preceptors and physicians
  • Documentation and billing education and guidelines
  • Marketing and branding approaches more inclusive of APPs

The progress of the clinical and operational implementation was monitored by an executive steering committee on a quarterly basis through scorecards for each committee and clinical specialty.

“This process has produced clear and compelling results to reinforce the idea that APPs can
help drive organizational performance and improve outcomes. This is critical in an emerging
value-based health care environment and is necessary to meet the growing demand for
highly-trained health care providers.”

Julie Bowman, MSN, RN
Senior Vice President, Patient Care Services and Chief Nursing Officer, Phoenix Children’s Hospital


The PCH leadership team understood that APPs were a valuable but underutilized resource and championed the optimization of this workforce as a key organizational strategy. This helped to improve access and health outcomes for its patients and achieve its goals for expansion and financial performance. Over a two-year period of redefining their care models and implementing the strategy, PCH was able to accomplish the following:

  • In orthopedics, a 197% increase in APP wRVUs with no decrease in physician wRVUs, and a 12% increase in surgeries (productivity and revenue) with no additional staff
  • In gastroenterology, a 50% increase in APP wRVUs with slight increase in physician wRVUs, a 31% increase in APP outpatient visits and a 9% increase in physician outpatient visits (productivity and access)
  • In urology, a 31% increase in APP wRVUs with slight decrease in physician wRVUs due to a decrease in physician FTEs, and over 250% increase in APP post-operative visits
  • In less than a year, reduced time to fill APP positions by 50% (down from 79 days to 38.5 days)
  • APP turnover decreased by an average of 47% since 2016
  • Implemented a comprehensive onboarding program for APPs that was also adopted for new physicians
  • Added APP representation to multiple medical staff committees


As health systems and medical groups consider developing their own APP strategies to improve the way care is delivered in today’s evolving market, PCH’s model is transferrable to both pediatric and nonpediatric organizations. There are a number of key lessons learned from PCH’s journey for other organizations to consider.

The following guidelines are essential to the implementation process:

  • Ensure active participation and engagement from hospital, medical group, nursing and  executive leadership throughout the process
  • Identify physician champions early on
  • Care model redesign must focus on all team member roles, including physicians, APPs, registered nurses, medical assistants, care managers and more
  • Align physician and APP performance management, compensation and incentive plans
  • Ensure some early successes
  • Conduct regular key stakeholder meetings to provide updates on progress
  • Agree upon implementation plan and hold key physician, APP and service line leaders accountable

About Phoenix Children’s Hospital

Phoenix Children’s Hospital (PCH) is one of the 10 largest children’s hospitals in the country and Arizona’s only “Best Children’s Hospital,” ranked in all 10 specialties by US News & World Report. This includes a 433-bed acute care facility with 18 clinical divisions and six sites of care serving pediatric inpatient, outpatient, urgent care, emergency and trauma services. In 2015, Phoenix Children’s Hospital had 18,773 inpatient admissions, 80,514 visits to the Emergency Department, 237,514 outpatient visits, and 16,491 surgical cases.

In 2017, Phoenix Children’s Hospital received the Phoenix Business Journal’s prestigious HealthCare Leadership Award and was named to Best Companies AZ’s “100 Best Arizona Companies” list for health care. An internal survey placed the hospital in the 90th percentile for employee satisfaction.

INFOGRAPHIC | 2018 Benefits Practices in Hospitals and Health Systems Survey

INFOGRAPHIC | 2018 Benefits Practice in Hospitals and Health Systems Survey

Data to to benchmark executive, physician and employee benefits programs

Uniquely focused on only hospitals and health systems, this survey helps organizations address challenges related to executive, physician and employee benefit programs. This includes comprehensive benchmarking data and insights as it relates to optimizing benefit offerings, implementing retirement plans for evolving executive and physician roles, and keeping pace with emerging trends in paid time off allowances, continuing medical education, severance policies, disability programs and more.

View highlights from two different sections of SullivanCotter’s 2018 Benefits Practices in Hospitals and Health Systems Survey, featuring data from more than 200 health care organizations.

Executive Benefits Practices


Physician Benefits Practices


AHA Trustee Insights | Key Action Steps for the Compensation Committee

Ensure alignment between executive compensation and key health system objectives

The marketplace for health care continues to evolve, and organizations are increasing the size and scale of their operations in response. New executive positions are emerging and growing in organization-wide impact while selected roles, especially at the subsidiary hospital-level, are narrowing in scope – leaving health care leaders to reconsider whether their current compensation strategy is still the best fit.

To help ensure continued alignment between executive compensation and key organizational objectives, not-for-profit hospitals and health systems must periodically review and update these programs in the context of a rapidly changing health care environment.

Featured in the March edition of the American Hospital Association's Trustee Insights, SullivanCotter highlights important action steps for the compensation committee as they determine if corresponding updates are necessary.


HFMA | Advanced Practice Providers Optimize Efficiency and Improve Financial Performance

Advanced practice providers (APPs) play a critical role in transforming care delivery

With a looming physician shortage and an ever-increasing population of patients, access to primary care and specialty providers remains a chief concern for health care organizations nationwide. To help meet this demand and avoid potential disruption to quality, service and cost, many hospitals and health systems are rapidly expanding the number employed APPs.

To support the critical role APPs play in transforming care delivery, improving performance and helping to achieve key financial results, organizations must undertake a deliberate and strategic review of the scope of practice, care team role, levels of engagement, governance, and compensation and payment structures for all APPs.

Featured in a recent edition of the Healthcare Financial Management Association’s CFO Forum, learn how SullivanCotter partnered with Phoenix Children’s Hospital to develop a comprehensive APP workforce and utilization strategy aligned with organizational goals and objectives – helping to improve overall financial performance while enhancing patient access, quality of care, and APP retention and satisfaction.


INFOGRAPHIC | 2018 Advanced Practice Provider Compensation and Pay Practices Survey

With the demand for advanced practice providers (APPs) on the rise, organizations are looking for better ways to attract, engage and retain the best talent.

As health care evolves, APPs play a critical role in helping to achieve greater access, lower the cost of care and address the growing physician shortage. Understanding trends in compensation, pay practices, productivity, work effort and more is critical as health care organizations develop comprehensive strategies to manage and utilize their growing APP workforce.

View highlights from SullivanCotter's Advanced Practice Provider Compensation and Pay Practices Survey, featuring data from more than 600 organizations on nearly 67,000 individual APPs.


PODCAST | Governing Health: Executive Compensation Trends

Board Engagement and Expertise

In a rapidly evolving health care environment, establishing executive compensation and related pay practices remains a critical responsibility of the Board of Directors. These decisions are complex, highly regulated and require heightened board engagement and specialized expertise.

In this edition of the Governing Health Podcast Series, Michael Peregrine, Partner, McDermott Will & Emery, welcomes two of the leading voices on executive compensation trends and practices in health care: Ralph DeJong, Partner, McDermott Will & Emery and Tim Cotter, Chairman and Managing Director, SullivanCotter.

This episode includes a discussion of:

  • Latest executive compensation reports
  • Evolving use of metrics, data and performance outcomes
  • Development and maintenance of incentive plans
  • Post-merger compensation trends
  • Relationship between talent management, retention and compensation
  • Impact of the Tax Cuts and Jobs Act


HFMA | Health Care Executives with Unique Skills are Leading Total Rewards Trends

Evolving Executive and Physician Leadership Talent Requirements

SullivanCotter’s Bruce Greenblatt, Principal, and Kim Mobley, Managing Principal, are featured authors in the Winter 2019 issue of HFMA’s Strategic Financial Planning newsletter.

As healthcare organizations continue to operate in a complex and uncertain environment, the following trends are impacting executive and physician leadership talent requirements and total rewards:

  • Consolidation activity as organizations expand geographically and increase their scale and service offerings
  • Disrupters outside the healthcare sector, including private equity and technology organizations
  • Changing payment models with more revenue at risk that often result in lower margins and capital
  • Care systems are streamlining operations and clinical activity to realize the promise of larger scope and scale
  • Value-based models focus on expanding access, providing a superior patient experience, and delivering high-quality and cost-effective care

To recruit, retain, and engage highly effective leadership in today’s marketplace, organizations must implement competitive total rewards programs. It is important to design rewards strategies that align:

  • Executive and physician leadership talent
  • Total rewards with market trends and benchmarks
  • Total rewards with performance


Modern Healthcare | New CMS Star Ratings Ignore Socio-Economic Factors

Assessing CMS Star Ratings

In a December issue of Modern Healthcare, SullivanCotter helps to analyze how the inconsistent application of peer groups between CMS’s new star ratings and the Hospital Readmissions Reduction program are creating sizable discrepancies in reported performance. By not risk-adjusting hospitals by peer groups based on their dual-eligible population in the latest preview of the CMS star ratings, hospitals with the largest percentage of dual-eligible stays fared worse than others in the readmissions category - hurting their overall star rating.


ACHE | Healthcare Changes and New C-Suite Roles

Evolving C-Suite Roles in a Rapidly Changing Health Care Environment

In this article featured in the November/December issue of ACHE’s Healthcare Executive magazine, SullivanCotter’s Mark Rumans, MD, Chief Medical Officer, and Christina Terranova Asselta, Managing Director, discuss how health systems have created and defined new C-Suite roles and changed their leadership teams to adjust to the rapidly changing health care environment.



INFOGRAPHIC | 2018 Health Care Staff Compensation Survey

Focusing on compensation and pay practices across the entire health care organization

Health care continues to evolve at a rapid pace, and organizations must balance the need to manage labor expense with the ability to compete and perform in an increasingly competitive talent market. This requires greater focus on compensation and pay practices across the entire health care workforce, including not just executives and providers but staff and other professionals in administrative, nursing, service and supervisory roles as well.

View highlights from SullivanCotter's 2018 Health Care Staff Compensation Survey, featuring data from nearly 600 organizations on 58,000 different health care professionals.


Acquiring Physician Practices: Key Strategic Considerations for a Successful Transaction

Evaluating physician practice acquisition opportunities

Featured in the November 2018 issue of hfm Magazine, Kyle Tormoehlen, Principal, and Dina Unrath, Principal, discuss how health systems must develop thoughtful strategies for evaluating physician practice acquisition opportunities due to the dwindling availability of acquisition prospects.

When developing a strategy for acquiring physician practices, health systems should address the following considerations:

  • The extent to which the strategic focus should be on primary care physicians versus specialists
  • Whether the objective for acquisitions is defensive or offensive
  • The need to acquire essential leadership talent
  • Whether acquiring practices or recruiting physicians is the more cost-effective approach



INFOGRAPHIC | APP Leadership Practices and Structures

Supporting APP retention and engagement

Advanced practice providers (APPs) comprise one of the fastest growing workforces in the United States and are integral to effective and efficient health care delivery.

Organizations are seeing the need for leadership structures and practices to help support this important workforce.

Looking to gain additional insight? Contact us to learn more about developing effective APP leadership practices, structures and compensation strategies to help support your growing APP workforce.


Split-Dollar Life Insurance: Risks, Benefits and Key Considerations

Delivering cost-effective executive benefits


Health care organizations are facing increased pressure as they try to recruit and retain top talent. At the same time, the onset of the 2017 Tax Cuts and Jobs Act and the introduction of a 21% employer-paid excise tax on compensation over $1 million for top-paid executives has left some hospitals and health systems asking the
following question: Is there a more cost-effective way to deliver compensation and benefits?

These challenges have triggered renewed interest in split-dollar life insurance, although limited adoption rates have been observed to date based on SullivanCotter’s 2018 Benefits Practices in Hospitals and Health Systems Survey Report. While, under certain circumstances, split-dollar life insurance has the potential to reduce costs for the employer while delivering a similar or greater benefit for the executive, it is a much more complex approach than cash-based compensation structures and carries risks that must be carefully evaluated.

For some, split-dollar life insurance evokes memories of past programs that did not deliver on the promises made or, worse, resulted in a cost to the executive rather than a benefit. Proponents of contemporary approaches cite refinements to the design, potential excise tax savings and reductions to operating expenses as reasons to consider such a program. However, a balanced review will also examine the long-term cost impact, inherent complexities, risks, optics, capital requirements and regulatory uncertainty.

The key is understanding the nuances of today’s split-dollar life insurance arrangements and under what circumstances they might warrant consideration.


Split-dollar life insurance is fundamentally different from cash-based compensation programs. Contemporary split-dollar life insurance programs are typically structured as follows:

  • In lieu of cash-based programs, the employer funds a life insurance policy with a single up-front premium. This is treated as a loan to the executive where the principal and interest is typically repaid upon death.
  • If the loan accrues interest at the Applicable Federal Rate (AFR) and is repaid, it results in no taxable income for the duration of the arrangement.
  • The executive can receive tax-free withdrawals from the policy each year during retirement.
  • The loan is not considered a cost from an accounting perspective, resulting in reduced operating expenses.
  • Since the arrangement is not considered taxable income, excise taxes may be reduced. Legislation specifies that regulations will be prescribed to prevent avoidance of the excise tax. As such, the potential reduction in excise taxes through use of split-dollar life insurance is uncertain, pending excise tax final regulations.


The potential benefits of split-dollar life insurance programs are primarily financial in nature:

  • Split-dollar life insurance commonly results in reduced operating expenses and, due to the accounting treatment, a shift from investment income to operating income. The long-term cost impact will depend on the investment income opportunity cost relative to the operating gains.
  • Availability of retirement income from split-dollar life insurance is typically adjusted to be higher than the alternative cash-based program. Due to the risks involved with split-dollar programs, executives must consider timing, amount of cash flow and potential variability in those amounts when deciding whether or not this arrangement is right for them.

There is no simple way to identify the financial impact without modeling projections under different scenarios. The financial impact can vary significantly based on the size of the loan, the age of the individual, interest rates, life insurance policy features and tax rates. How comparisons are made, including when retirement income is expected to be available and over what period, can have an impact as well.


Any expected financial benefits should be assessed against the following costs and risks associated with split-dollar life insurance:

  • Complexity and degree of confidence with impact to executive’s assets. Program tends to be a voluntary alternative to a simpler cash-based program and adopted only by those who can afford to accept the inherent risks.
  • Long-term commitment. The program may be in place for several decades, during which time there could be several unanticipated events impacting the program’s performance with no viable exit strategy.
  • Retirement income needs and cash flow. Program is only available through regular annual payments and not lump sums. This reduces the ability to adapt to an executive’s evolving financial needs and preferences.
  • Corporate cash flow. In many cases, the organization must increase its cash outlay to make the program attractive to potential participants. This can call into question whether tying up additional assets in the split dollar program is a good use of funds by a not-for-profit organization. While there may be financial benefits, the optics could be challenging to defend as the size of loans reportable on the Form 990 Schedule L can be significant – albeit without any reportable income on Schedule J.
  • Life insurance policy performance. The success of the split-dollar program hinges on the life insurance policy performance. Policy illustrations include assumptions about market-related factors, such as S&P500 index performance, as well as elements controlled by the life insurance company, including policy charges and crediting rates. Illustrations typically show one scenario based on current policy charges and another based on guaranteed charges – and the results can be substantially different. The ability to maintain current policy charges is contingent on the insurance company’s profitability.
  • Plan administration. Few organizations have the infrastructure necessary to administer the program internally and rely instead on outside administrators with associated expenses. Maintaining an understanding of these arrangements within the organization will be important as inevitable staff turnover occurs throughout the life of the program.


Those interested in pursuing split-dollar life insurance should follow a process that ensures robust analysis and engagement with all stakeholders.

Engage an independent advisor. Many organizations rely on advisors who can financially benefit from the placing of the insurance in the form of commissions. It is rare for organizations to have internal resources to evaluate these programs given how seldom they are currently being used. Acting on the organization’s behalf, an independent advisor can work with the individual brokers to ensure key objectives are being met and the proposals appropriately reflect the costs, benefits and risks of the arrangement. The independent advisor can then provide an assessment of the proposals, ensuring that the organization receives a balanced perspective and understands the critical aspects of the program that impact decision-making.

Organizations should assess these five considerations and reevaluate interest after each step:

  • Review of executives who might be suitable candidates and which cash-based programs could be exchanged  for split-dollar life insurance. If multiple executives may potentially participate, one or two individuals may serve as test cases.
  • Initial engagement with stakeholders to identify the level of interest from executives, the Board’s or Compensation Committee’s perspective on risks and optics, and determination of how program costs will be evaluated by the organization’s finance leaders.
  • Identification of one or more experienced insurance brokers who can develop a detailed proposal that supports the key strategic objectives. The proposal should include design features, cost analyses, benefit projections and stress testing of multiple assumption sets.
  • Independent assessment of the proposals that ensures a clear, unbiased summary of the program’s operation, impact on operating income/expenses and investment income, considerations for participants, program optics and disclosures, key risks and additional insights regarding assumptions.
  • Consideration of the proposals and independent assessment by all stakeholders, including potential participants, Board or Compensation Committee members and finance leaders.

If a split-dollar life insurance program is under consideration, a thorough assessment of potential risks and rewards must be conducted. Having an independent expert who can facilitate the process, deliver a balanced evaluation of options and ensure each party is asking the right questions and getting the answers they need is critical to making an informed decision.

Note that SullivanCotter does not sell insurance or receive commissions, referral fees or payments from those who do.

INFOGRAPHIC | 2018 Hospital-Based Physician Compensation and Work Effort Survey

Emerging Trends in Hospital-Based Physician Compensation and Work Effort

Featuring data from 45 health care organizations, this survey provides insight into the issues specific to hospital-based specialties, clinical work effort and the related compensation structures.

View highlights from this year's results and learn more about our Hospital-Based Physician Compensation and Work Effort Survey.



INFOGRAPHIC | 2018 Physician Compensation and Productivity Survey

Benchmarking physician compensation and pay practices

As health care organizations nationwide look to optimize clinical care and ensure financial stability in a highly complex environment, physician compensation programs are evolving to address changing models of care, the need for organizational alignment and a competitive market to talent.

View highlights from SullivanCotter’s 2018 Physician Compensation and Productivity Survey, featuring data from nearly 750 organizations covering more than 167,000 individual physicians and advanced practice providers.


Employers Choose Bonuses Over Raises

SullivanCotter Featured in the Wall Street Journal

In today's competitive talent market, organizations are looking for ways to attract and retain talent while controlling costs. The increasing use of incentives over traditional raises in base pay is trending across all industries. As health care organizations continue to focus on driving performance and enhancing organizational alignment, incentive compensation remains a key component of competitive total rewards programs. SullivanCotter was proud to contribute to this recent article, published in the Wall Street Journal, highlighting this shift in pay practices.


INFOGRAPHIC | Physician Executive Compensation

Emerging Compensation Trends for Physician Executives

Health care leaders with strong clinical backgrounds are in high demand as the focus on value-based care intensifies. As a result, there are more opportunities than ever before for physicians to move into executive positions at hospitals, health systems and medical groups across the country.

Gain additional insight from SullivanCotter's Physician Executive Compensation Survey and Medical Group Executive Compensation Survey.


INFOGRAPHIC | 2018 Manager and Executive Compensation in Hospitals and Health Systems Survey

Market Uncertainty and Change Requires Good Business Judgment

In today's unprecedented health care environment, organizations remain focused on two fundamental issues: optimizing clinical care and ensuring financial stability.  These new performance priorities are setting the agenda for executive talent and rewards, and require good business judgment when designing and implementing “best fit” pay programs and setting compensation.

Learn more and view highlights from our Manager and Executive Compensation in Hospitals and Health Systems Survey.



Modern Healthcare | Annual Executive Compensation Article

Prioritizing performance-based incentive strategies

Providing high-quality care and driving greater value for patients while also keeping costs in check remains one of the greatest challenges for hospitals and health systems nationwide - placing a premium on top executive talent with the skills and experience necessary to lead such efforts.

Amid these ongoing cost-containment initiatives, organizations continue to prioritize executive pay and new performance-based incentive strategies in order to attract, retain and engage leadership and keep pace in a world where the demand for talent outweighs supply.

Learn more from Modern Healthcare's annual executive compensation analysis, featuring data from SullivanCotter's 2018 Manager and Executive Compensation in Hospitals and Health Systems Survey and insights from Kathy Hastings, Managing Director, and Tom Pavlik, Managing Principal.