Compensation Administration: Operations Effectiveness Review

CHRISTUS Health is a Catholic not-for-profit health system made up of more than 600 centers, including hospitals, clinics, and urgent care centers in Texas. The organization struggled with ongoing concerns about the efficiency and effectiveness of the physician compensation team.

ECG was asked by CHRISTUS Health to provide an interim vice president of physician compensation to ensure effective operations and help solve the following: 

• Decreased work output and quality, leading to mistakes in executing clinician contracts and recruiting clinicians in a timely manner 
• Distrust of the compensation administration department by clinicians and operational leadership 
• Low workplace engagement and satisfaction among compensation administration staff

ECG began the engagement by conducting a compensation administration operational and process assessment, reviewing the following:

• Staff resources
  • Staff capabilities and capacity 
• Data collection processes and policies
  • Reconciliation process 
  • Reconciliation timelines 
  • Monthly, quarterly, and annual clinician compensation reconciliation process 
  • Productivity accrual and journal entry process 
  • Communication of reconciliation summaries 
• Clinician employment management
  • Clinician employment and termination processes 
  • Contract management 
• Compensation and/or service change process
  • Change-of-contract process
  • Guarantee transition process
  • Changes in draw
  • Overpayment and underpayment processes
  • 90‑day payout process

ECG developed recommendations for each key functional area of the CHRISTUS physician compensation administration and outlined actionable plans and priorities for implementation.

In partnership with CHRISTUS leadership, ECG:

• Embedded a consultant as an interim vice president to help lead the compensation administration team and ensure the stability of the compensation plan and team. 
• Increased and improved the work efficiency and effectiveness of the compensation administration team. 
• Reduced the turnaround time for providing clinicians with offer letters and compensation quote assessments for the purposes of negotiation. 
• Implemented clinician status coordination as part of the weekly compensation meeting with CHRISTUS leadership to review impending changes to clinician status and modifications in compensation. 
• Developed monthly productivity reconciliation reports to use in discussions with CHRISTUS operational and clinical leadership and to reconcile biweekly and monthly compensation reports. 
• Updated reconciliation timelines to ease compensation administration burden and create alignment across CHRISTUS ministries. 
• Extensively supported contract renegotiations, facilitated discussions with acquisition targets, and provided opinions of compensation request feasibility.

ECG’s work resulted in an improved perception of the compensation administration team among clinical and operational leadership. We also assisted in hiring a vice president of physician compensation and are providing ongoing support to the new leadership at CHRISTUS Health.