2011 Salary Survey Results

CMs are being paid more but working longer hours

Salaries for case managers are increasing but the vast majority of case managers are working far more than the typical 40-hour week, according to the 2011 Hospital Case Management Salary Survey.

The 2011 Salary Survey was mailed to readers of Hospital Case Management in the September issue. More than half of the respondents (74%) were case management directors. The rest were case managers, utilization managers, or had other titles.

The majority of respondents (73%) to the 2011 salary survey report that they got a raise last year but 27% reported no raise. The majority of raises (60%) were in the 1% to 3% range, with 23% reporting raises of 13% or more. Just over 10% of respondents reported raises that exceed 7% and only one respondent reported a decrease in salary. This compares to the 2010 salary survey where 24% of respondents reported no raises and 3% said their salary decreased.

About 95% of respondents report receiving salaries of $60,000 a year or more with the majority of respondents (25%) reporting an income in the $90,000 to $99,999 range and 26% reporting salaries of $100,000 or more.

Case managers can expect their salaries to remain stable in the future but shouldn't expect any large raises, regardless of the extra duties they may take on, experts say. Decreasing reimbursement and the economy in general is causing hospitals to tighten their belts and put raises on hold. Some have laid off workers and a few have closed their doors.

Salaries for case managers have remained consistent for the past few years as organizations try to stay budget neutral, says B.K. Kizziar, RN-BC, CCM, principal of BK & Associates Case Management Specialists, a Southlake Texas consulting firm. "The uncertainty with the economy is keeping salaries down for now. Raises are mostly to adjust for cost of living. In addition, employees are having to pay more for their health insurance and fewer hospitals and other organizations are reimbursing case managers for continuing education, conference attendance, or certification," she adds.

Victoria Choate, RN, CCM, RN-BC, CCP, PAHM, vice president of performance excellence and chief quality officer for Cheyenne (WY) Regional Medical Center reports that the hospital has not made any changes in salary structures but stays competitive with other area hospitals.

At the same time they report fewer raises and case managers report putting in long hours. More than 85% of respondents report working more than 40 hours a week with 36% putting in more than 50 hours.

As all payers tighten their reimbursement, the Centers for Medicare and Medicaid Services (CMS) and commercial payers roll out initiatives to scrutinize hospital records, and as the emphasis on transitions in care increases, case managers are being given more responsibility than ever before. Catherine M. Mullahy, RN, BS, CRRN, CCM, president and founder of Mullahy & Associates, a case management training and consulting company based in Huntingdon, NY, says that the additional work, particularly the paperwork, that case managers must tackle decreases the time they spend with patients, creating an atmosphere of discontent that is causing some hospital-based case managers to look elsewhere for work.

"Why would people go to nursing school to spend the day on the telephone or working with data? Nurses went to school to take care of patients but as case managers, there are spending so much of their time at their desks, she says." When hospital-based case managers have limited patient contact, they don't get that 'feel-good' feeling and often get burned out and look for other opportunities, Mullahy continues.

Choate reports that in order to facilitate the additional workload, Cheyenne Regional Hospital has streamlined case management processes and workflows to ensure that case managers are doing the essential work with a defined focus on patient and physician satisfaction. "We have a robust case management team comprised of RN case managers, master of social work and bachelors of social work. We have not laid off anybody, nor do we have plans to lay off," she says.

Today's case managers are well educated. Among respondents to the Salary Survey, 69% have a bachelor's degree or higher and 31% have completed a post-graduate degree.

The majority of respondents to the Salary Survey are older and experienced case managers. More than 75% have worked in case management for 10 years or longer and 12% have 25 or more years experience as a case manager. Almost 70% of respondents have working in the healthcare field for 25 years or longer.

More than 70% of respondents are over age 50 while 12% report being 61 years or older. Only 10.5% report being age 40 or younger.

At the same time, there are a lot of young case managers entering the field, says Beverly Cunningham, MS, RN, vice president of clinical performance improvement at Medical City Dallas Hospital. "We do have some aging in the field, but it's not an issue at my hospital," she says.

Sources

  • Victoria Choate, RN, CCM, RN-BC, CCP, CPHQ, Vice President of Performance Excellence and Chief Quality Officer, Cheyenne (WY) Regional Medical Center. E-mail: vikki.choate@crmcwy.org.
  • Beverly Cunningham, RN, MS, Vice President, Clinical Performance Improvement, Medical City Dallas Hospital. E-mail: Beverly.Cunningham@hcahealthcare.com
  • B.K. Kizziar, RN-BC, CCM, CLP, Owner, B.K. and Associates, Southlake, TX. E-mail: BK and Assoc@att.net.
  • Catherine M. Mullahy, RN, BS, CRRN, CCM, President and Founder of Mullahy and Associates, Huntington, NY. E-mail: cmullahy@mullahyassociates.com.

Resource

To access Deborah Hale's webinar "Observation versus Inpatient Level of Care — Clinical Facts and Documentation to Support Your Claim" visit www.reliasmedia.com. Under "categories" click on "Case Management."

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