title: Compensation of chief executive officers at nonprofit US hospitals.
abstract: OBJECTIVE
  Hospital chief executive officers (CEOs) can shape the priorities and performance of their organizations. The degree to which their compensation is based on their hospitals' quality performance is not well known.
  
  
  OBJECTIVE
  To characterize CEO compensation and examine its relation with quality metrics.
  
  
  METHODS
  Retrospective observational study. Participants included 1877 CEOs at 2681 private, nonprofit US hospitals.
  
  
  METHODS
  We used linear regression to identify hospital structural characteristics associated with CEO pay. We then determined the degree to which a hospital's performance on financial metrics, technologic metrics, quality metrics, and community benefit in 2008 was associated with CEO pay in 2009.
  
  
  RESULTS
  The CEOs in our sample had a mean compensation of $595,781 (median, $404,938) in 2009. In multivariate analyses, CEO pay was associated with the number of hospital beds overseen ($550 for each additional bed; 95% CI, 429-671; P < .001), teaching status ($425,078 more at major teaching vs nonteaching hospitals; 95% CI, 315,238-534,918; P < .001), and urban location. Hospitals with high levels of advanced technologic capabilities compensated their CEOs $135,862 more (95% CI, 80,744-190,990; P < .001) than did hospitals with low levels of technology. Hospitals with high performance on patient satisfaction compensated their CEOs $51,706 more than did those with low performance on patient satisfaction (95% CI, 15,166-88,247; P = .006). We found no association between CEO pay and hospitals' margins, liquidity, capitalization, occupancy rates, process quality performance, mortality rates, readmission rates, or measures of community benefit.
  
  
  CONCLUSIONS
  Compensation of CEOs at nonprofit hospitals was highly variable across the country. Compensation was associated with technology and patient satisfaction but not with processes of care, patient outcomes, or community benefit.
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts3Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts5Cardiology and Vascular Medicine Section, Department of.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Joynt
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts7currently a medical student, University of California, San Francisco.
authors.forename: Sidney T
authors.initials: ST
authors.lastname: Le
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts4Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts4Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts6General Internal Medicine Section, Depart.
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
mesh_terms: D016542:Chief Executive Officers, Hospital / Q000191:economics*; D006742:Hospital Bed Capacity; D006784:Hospitals, Teaching / Q000191:economics*; D006786:Hospitals, Urban / Q000191:economics*; D006788:Hospitals, Voluntary / Q000191:economics*; D006801:Humans; D016014:Linear Models; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012189:Retrospective Studies; D012456:Salaries and Fringe Benefits / Q000191:economics*; D014481:United States