2002 Salary Survey Results: While income is stable, the future offers many paths for RMs
Liability crisis puts more emphasis on financial aspects, insurance
Incomes held steady for health care risk managers this year, according to results of the 2002 Healthcare Risk Management salary survey. Some observers say that holding on to a good income in the future may require taking steps now to ensure you’re a key player in your organization and not relegated to a support position.
The median income for health care risk managers in this year’s survey is $65,000, the same as the previous two years. Before that, the HRM salary survey had shown an upward trend in income. In 2000, the median income was $62,500, the same as for 1999. Prior to 1999, the median income for directors of risk management was in the upper $50,000 range. (See, "How Long Have You Worked in Risk Management?")
Consistent with the flat income levels, the survey shows that the median salary increase over the past year was only 1% to 3%. This year, 40% reported increases in that range, almost identical to last year’s 39%. Another 34% reported increases of 4% to 6%, up slightly from last year. Eleven percent reported higher increases, including one lucky reader whose income increased 21% in the past year. Ten percent report no change in their income, and 2% reported a decrease. (See, "How Long Have Your Worked in Health Care?")
Long hours continue to be standard for risk managers. Thirty-five percent reported working 46-50 hours per week, and 13% reported working 51-55 hours per week. Four percent say they worked more than 65 hours per week. (See, "What is Your Annual Gross Income from Your Primary Health Care Position?")
Don’t let yourself be marginalized
The salary survey figures support a trend that has worried some risk management leaders for a while now. Grena Porto, RN, ARM, DFASHRM, senior director of clinical operations at VHA Inc. in Berwyn, PA, and past president of the American Society for Healthcare Risk Management, says she thinks many risk managers are being marginalized within the organizations that employ them. Any risk manager who still is trying to do the same job he or she did five years ago is falling behind, she says.
"Some risk managers have been marginalized because they have not gotten on the patient safety wagon and also because their skills are not where they need to be if they don’t have performance improvement skills," she says. "Hospitals are now doing a lot of research work with focus groups and data management, and risk managers are not a big part of that. They’re almost never in the lead with those things. I worry about that."
If risk managers are resisting the new emphasis on patient safety because it doesn’t seem like traditional risk management, Porto says, that is a big mistake. In many ways, patient safety is a more genuine part of risk management than the issues that often take up so much of your workday.
"The focus on loss control and claims litigation has distracted people in many ways from the real work of preventing patient injury," she says. "Patient safety is the new focus, and I worry that if that’s what the skills of today and tomorrow are, risk managers will be reduced to low-level positions because they don’t have those skills. You can end up as just the person who manages claims."
Porto advises sharpening your performance improvement skills, and she says you should pay particular attention to redesigning clinical procedures and systems to compensate for work force issues. With every health care provider facing shortages of nurses, pharmacists, and other staff, risk managers can play an important role by combining clinical knowledge with a patient safety emphasis to help the organization cope with fewer staff. (See, "On Average, How Many Hours a Week Do You Work?")
Overall a good time to be a risk manager
Despite all the challenges and the changing career path, this is "an outstanding time to be a risk manager," says John Metcalfe, vice president or risk management services with Memorial Health Services in Long Beach, CA. The hard insurance market, the patient safety emphasis, and changing accreditation requirements all make the risk manager an important resource for health care providers, he says.
"All risk managers have to be tuned in to changes in the marketplace and various patient safety issues. Risk managers have to carefully monitor the sentinel event reports that the Joint Commission distributes, other clinical issues that influence patient care outcomes, and what’s going on in the legal community," he says. "You also have to be tuned into union activity, anything that contributes to employee dissatisfaction and unrest."
Staying on top of all those topics requires ongoing education, so Metcalfe says risk managers should routinely pursue seminars, conferences, professional publications, and other resources that help them stay abreast of rapidly changing issues. Metcalfe and his staff participate in a number of satellite audio conferences every year and attend both national and local meetings of their professional societies.
"There’s always lots of networking, making sure we take everything into consideration before making a decision," he says. "That’s one thing that highlights my career. I’ve always been eager to bounce things off of people — lawyers, physicians, some people in government that I’m close to. I’m always measuring my biases and prejudices against theirs."
Metcalfe says he is pleased with what he sees in income levels for health care risk managers, though the outlook is better for upper-level risk managers. That’s all the more reason to improve your skills and seek a higher position in the organization, he says.
Risk financing is an increasingly important area for risk managers to explore, says Nancy Hacking, CPHRM, FASHRM, director of risk and safety management at Concord (NH) Hospital and Capital Region Health Care. For most risk managers, however, risk financing is not familiar territory. That means you can’t just walk into a meeting and join the discussion tomorrow.
"You may have to convince senior management about the value of having the risk manager participate in insurance discussions," she says. "The risk manager needs to ensure that the risk management program is discussed and financial accomplishments are highlighted on a regular basis. Then when insurance renewal time rolls around, the risk manager is in the position of having the most intimate knowledge of the program, the program’s strengths and weaknesses, and areas where improvement is being sought."
With that knowledge, and with upper management aware that you are the best source for that information, the risk manager can participate in the discussions with the underwriter. Once you’re involved in that process, you should be the called on to address concerns of the underwriters such as past claims issues. You also can promote programs that have been put in place to address areas of concern.
Remember that involvement in these financial meetings may take time, and you can encourage that change by developing a relationship with the CEO or CFO. Volunteer to serve on board committees and other programs that will let you work more closely with financial matters, she suggests.
Porto agrees that risk managers should become more involved with risk financing, but she cautions that you should not see that as your one and only new goal. Risk financing can help get you involved with key functions of your employer, but don’t forsake your primary role in patient safety, she says.
"We’ve done ourselves a disservice by saying that you know you’re really big and important when you’re doing risk financing, but it’s not such a big thing if you’re working with patient safety because that doesn’t take so much skill anyway," she says. "That’s a terrible attitude that we hear too much these days as people start to realize that risk financing is something they should get involved in. You can get involved in it, but don’t forget everything else you do."
The 2002 HRM Salary Survey was sent to about 1,200 readers in the June 2002 issue. A total of 194 were returned, for a response rate of 16%. The results were tabulated and analyzed by American Health Consultants, publisher of HRM. (See, "In the Last Year, How Has Your Salary Changed?")
Incomes held steady for health care risk managers this year, according to results of the 2002 Healthcare Risk Management salary survey.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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