2002 Salary Survey: Access managers taking visible spot in health care

For best salaries, be willing to move; a college or master’s degree increases earning potential

Patient access directors and managers are becoming more visible in the health care industry, suggests Scott Johnson, senior vice president and partner in J&J Resources, a health care placement firm based in Houston.

His firm, which works with professionals in accounting, finance, and the business office, has seen a 25% increase in patient access clients in the past four years, Johnson estimates. Some of that increase, he says, has been due to the move to a central business office (CBO) model by the large hospital chains Tenet and HCA.

What that means, he explains, is that Tenet or HCA will set up an off-site CBO in a large city, like Houston, and have that office handle billing and collections for eight or so hospitals. That strategy eliminates the top financial positions at individual hospitals, Johnson adds, leaving the access director or manager as the ranking financial person at each hospital.

Patient access positions are "as viable as anything else out there right now," he says. "The better money comes when you’re over the front end and the back end."

The vast majority of access professionals who responded to Hospital Access Management’s annual salary survey, meanwhile, report that they received a pay raise in the past 12 months, and a significant number of them saw an increase in the number of employees they oversee.

Thirty-five percent of respondents said they got a raise of between 4% and 6%, and almost the same number had a pay increase of between 1% and 3%. Another 11.36% saw their salary increase by between 7% and 10%.

Although more than 94% of those who responded to the survey work for hospitals, job titles represented ran the gamut from admissions supervisor to vice president of patient access and care management. The highest number (45.45%) said they worked in a medium-sized community setting, while 25% described their work environment as urban. Another 21.59% said they worked in a rural area.

The largest percentage, 78.41%, worked for a nonprofit organization, with the next highest number (12.50%) giving their affiliation as state, county or city government. Some 26% of respondents worked for hospitals with between 301 and 500 beds, another 25% said their hospital had between 101 and 200 beds, and 15.91% were at facilities with between 201 and 300 beds. (See Table 1)

By job title

Looking at salaries according to job title, results show that 42.86% of those who describe themselves as access managers make between $40,000 and $49,999 a year. Another 17.86% make between $50,000 and $59,999; and 17.86% make between $60,000 and $69,999.

Of those who gave their title as director, access management, 25% said they made a salary of between $50,000 and $59,999 a year, while another 21.43% reported making between $60,000 and $69,999. A little less than 18% of access directors said they earned between $70,000 and $79,999.

Only 10.71% of directors responding to the survey reported making between $80,000 and $89,999 a year, but the percentage making between $90,000 and $99,999 was slightly higher, 14.29%. A few access directors, 3.57%, reported salaries of between $100,000 and $129,999.

The great majority of access supervisors who completed the salary survey, 66.67%, said they made between $30,000 and $39,999 annually.

Respondents’ length of access experience was varied, but the highest percentage (30.68%) said they had worked in the field for 25 years or more. Correspondingly, 25% gave their age as between 51 and 55, while another 17% were between 46 and 50. Just 5.68% were between 56 and 60.

As usual, female respondents far outnumbered their male counterparts, at about 85%. The largest percentage of those surveyed said they work between 46 and 50 hours a week, with another 21.59% putting in between 51 and 55 hours.

Location and relocation are important

Johnson says his experience has shown that salaries for similar access positions can vary dramatically among different hospitals and health systems, and that some states are known for paying less. For some reason, he adds, Louisiana and Colorado are among them.

The salary for a director of patient access at a 350-bed hospital, he says, typically ranges from about $45,000 to around $65,000. A director at a hospital with between 500 and 1,000 beds, he notes, might make "as little as $55,000 or $60,000," or could be in the $85,000-$90,000 range with some potential for bonuses.

A regional access director with responsibility for six or seven hospitals, Johnson suggests, can make $100,000 or more, usually with some arrangement for bonuses. "It really depends on the organization," he adds. "Some companies say if you increase this or increase that, it’s tied to a bonus, and some don’t even offer bonuses."

One of the problems Johnson has in trying to recruit for patient access positions, he notes, is the reluctance of many candidates to relocate. "The people are qualified, the money’s good, but they won’t move."

This is true for business office and hospital information management positions, as well as for access jobs, he adds. (See Table 2, 3, 4 and 5)

The degree is key

Those who are in the market for an access position, Johnson suggests, will fare significantly better if they have a college degree, particularly a master’s. Being knowledgeable about the hospital revenue cycle and how it affects the entire organization is another huge plus, he says.

"If you’re working at a hospital where you have the opportunity to get more exposure to the back office," he adds, "that will be to your benefit."

And, Johnson notes, with the abundance of introverts in the area of patient financial services, an outgoing manner will stand you in good stead. "If I find somebody that has a good extrovert personality, it increases my level of interest." (See Table 6 and 7)