Salary Survey-Salaries look good as risk management jobs change
Health care risk management is an expanding field in which the best opportunities may not be found in the traditional roles, say leaders in the field. Income is holding steady for most risk managers, but there are some reasons to be optimistic, according to the exclusive 1999 Healthcare Risk Management salary survey.
HRM mailed about 1,500 surveys in the July 1999 issue. A total of 140 were returned, for a response rate of 9%. The results were tabulated and analyzed by Ameri can Health Consultants, publisher of HRM.
Income plateauing
Income is holding steady this year, compared with upward trends of the past two years. Directors of risk management report a median income of $62,500, the same as last year. The median income for directors of risk management was $57,500 in 1997 and $52,000 in 1996. The 1998 survey results suggested that fast rise in income could be attributed to the dramatic changes in risk managers' job descriptions over the past few years. The same results this year could mean risk managers are seeing a plateau in those increases — the job changed, income changed, and now the deal is complete. The income level for those with the title of "risk manager" also was the same as last year, $62,500.
No matter what title they use, about half of the survey respondents reported an increase of 1% to 3% in income from the past year. About 15% reported no change, and the rest reported a decrease. About half report no change in staff size, with the rest split evenly between decreasing and increasing staff size. That is the same result seen last year and in 1997. In the 1998 survey, 55% said there had been no change in staff size, compared with 68% in 1997. In last year's survey, 23% reported an increase in staff size, compared with only 2% the year before.
You may not be quite as tired this year as in some previous years, if the survey results are any indication. Respondents report working a median of 46 to 50 hours per week. In the 1997 survey, 75% reported they worked 61 to 65 hours per week, way up from the 46 to 50 hours per week reported in 1996. Like the change in income, the change in overtime was attributed to the change in job descriptions that had risk managers taking on new duties that might have been assigned to several other people in the past. The 1998 survey suggested that risk managers had learned to accommodate those new tasks in their work schedules better, with a median reporting working 46 to 50 hours a week.
The 1999 survey also shows that, as in recent years, the typical HRM reader is a woman 46 to 50 years old, with a master's degree.
'A good time to be a risk manager'
Even without any dramatic increase in income, "this is a good time to be a risk manager," says Sandra Johnson, RN, ARM, FASHRM, regional manager of risk management at Imperial Point Medical Center in Ft. Lauderdale, FL. The many changes going on in health care, including an emphasis on compliance and fraud, make risk managers more valuable than ever to their insti tutions, she says.
"Risk managers have always talked about fighting their way up from the cellar to a position where they can really be respected as part of the leadership team," Johnson says. "These changes and the emphasis on risk management put you right in the boardroom."
There has not been a corresponding increase in income for most risk managers, she says. That disparity is probably most obvious for risk managers who have taken on compliance responsibilities, as Johnson has. Even so, Johnson says there is reason to expect increased income for health care risk managers who continue to grow in their careers.
"I don't see it as a big negative that we haven't seen a significant increase in salary," she says. "I think in a lot of cases it's just that the hospital doesn't know yet what the job is going to entail when they put you in that compliance position. It will be obvious before long what these duties mean, and I think the compensation will catch up at that point."
Look for opportunities for more influence
One way to advance in your career as a risk manager is to look for ways to have more influence in the hospital, says Jeanne Pores, ARM, vice president of hospital affairs at Physicians' Reciprocal Insurers in New York, the second largest underwriter of physicians and hospitals in New York state. Pores worked for years in hospital risk management before taking her current position. Speaking at the recent meeting of the American Society for Health Care Risk Management (ASHRM) in Chicago, she explained that risk managers should look for opportunities outside of the "typical" health care risk management concerns.
Many risk managers become so focused on the clinical concerns of their jobs that they can overlook some of the less obvious liabilities and exposures that have little to do with patient care, she says. Pores cites the hospital's workers' compensation program as an example. In some hospitals and other health care organizations, an employ ee's workers' comp claim is handled with little or no input from the risk management department. The claim is filed by the employee, approved the supervisor, and then human resources processes it, often with little input.
"That makes workers' comp an easy system to abuse," she says. "If you get involved and apply risk management concepts to that process, you can cut costs and show that your insurance premium went from $1 million last year to $800,000 this year, for example. That's not something you can do with bad baby cases. You may know that your efforts avoided five bad baby cases this year, but you can't show it."
As another example of how health care risk managers can improve their contributions by looking beyond patient care issues, Pores recounts an incident at a hospital where she used to work as risk manager. A prominent benefactor of the hospital, already responsible for several building projects, also had donated several original Andy Warhol prints to the hospital. They had been hanging in a public area of the hospital for five years when Pores thought to ask whether they were insured. They were not.
"Knowing that these prints were extremely valuable, I immediately became paranoid about them and obtained specialty insurance to cover them," she says. "Sure enough, about a week later someone stole one of them. The benefactor took the insurance money and bought another Warhol print for the hospital. Can you imagine the benefactor's reaction if we had to tell him that the print was lost and there was no insurance?"
The hospital also sought help from the art community to display the prints in ways that deter theft. Pores says she was proud to have saved the hospital from a significant financial loss while preserving the relationship with the benefactor.
"These are things you walk around and never pay attention to because it's not a patient care issue," she says. "But it's a loss to your hospital, so it's a risk management function."
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