2010 Salary Survey Results

Salaries are increasing, but so are CM responsibilities

Do more with less the new motto

Despite rising health care costs and shrinking reimbursement, many case managers report that they received a raise last year, but at the same time, their responsibilities increased.

The 2010 Hospital Case Management salary survey was mailed to readers with the July issue. Among the respondents, 64% were case management directors, 18% were case managers, and the remainder had various titles including utilization manager, social worker, and discharge planner.

The majority of respondents (71%) reported that they got a raise last year. This compares to 73% of respondents in 2009.

The majority of raises reported in the 2010 salary survey (47%) were in the 1% to 3% range, with 24% reporting raises of 4% or more. A quarter of respondents reported no raise last year, and 4% reported a salary decrease for the year. In 2009, 24% reported no raises, and 3% said their salary decreased.

The majority of respondents to the salary survey are older and experienced case managers. About 70% have worked in case management for 10 years or longer, and 79% have 22 or more years experience in the health care field.

About 94% of respondents are over age 40, while 68% reported being 50 years or older. Only 6% of respondents were age 40 or younger.

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.

They add that hospitals across the country are penny-pinching these days. Some are laying off workers and putting raises on hold. Others have closed their doors due to declining revenues.

"In the economic climate we all find ourselves in, hospitals are being very frugal due to decreased volumes and uncertainty over health care reform," points out Brian Pisarsky, RN, MSHA, ACM, CPUR, director of case management services, DCH Regional Medical Center and DCH Northport Medical Center in Tuscaloosa, AL.

In many places, the usual raises are being decreased for all hospital employees, and not just case managers, adds B.K. Kizziar, RN-BC, CCM, principal of BK & Associates Case Management Specialists, a Southlake, TX, consulting firm.

"The uncertainty with the economy is keeping salaries down for now. Several clients have told me that there will be no raises for staff this year," adds Kimberly Gilbert, RN, case management consultant, clinical advisory services for Pershing, Yoakley and Associates in Atlanta.

About 94% of respondents reported receiving salaries of $60,000 a year or more with the majority of respondents (25%) reporting an income in the $80,000 to $90,000 range and 30% reporting salaries of $100,000 or more.

At the same time, case managers reported putting in long hours. Nearly 85% of respondents said they worked more than 40 hours a week, with 34% putting in more than 50 hours.

As all payers tighten their reimbursement and the Centers for Medicare & Medicaid Services auditors scrutinize hospital records, case managers are being given more responsibility than ever before but they aren't necessarily getting paid more, Kizziar points out.

Cathy Campbell, BSN, MBA, CHC, FACHE, concurs, saying that case managers are wearing more hats than ever before but in most cases, the pay is staying the same. Campbell is chief nursing officer at Dallas Medical Center and president of the Dallas-Fort Worth chapter of the Case Management Society of America.

"Hospitals are focusing on cutting costs, and at the same time, case managers are being given more accountability for successful outcomes, smooth transitions in care, and monitoring the length of stay. But salaries and benefits aren't increasing. Do more with less is the new motto," Kizziar adds.

The emphasis on getting patient status correct at the time of admission and pressures to move patients through the continuum as quickly as possible typically mean that case managers are covering the hospital for longer hours each day, and often on weekends and holidays.

"The last two facilities where I have worked have had some in-house case management staff on weekend. Some nurses take the job of case manager so they won't have to work weekends or off-shifts. But I don't believe the weekend work will affect the profession, especially since having a job has become a luxury," Campbell says.

On the plus side, weekend work offers opportunities for case managers who don't want to work full-time but do want to keep their hands in health care, Kizziar says.

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