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Bruce McPherson,)]TJ -1.44973 -1.4 TD [(Executive Dir)18(ector of the Alliance for Advancing Nonpr)17(ofit)]TJ T* [(Healthcar)18(e, in W)36(ashington, D.C., moderated the session.)]TJ ET BT /F12 1 Tf 10 0 0 10 36 385.5 Tm -0.0169 Tc (Br)Tj 0.9664 0 TD -0.0168 Tc 0.0278 Tw (uce McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 119.8071 385.5 Tm -0.0169 Tc (Let\325)Tj 1.3769 0 TD -0.0168 Tc (s star)Tj 2.14892 0 TD -0.017 Tc 0.028 Tw [(t with the basics. T)111(o whom do the)]TJ -11.90653 -1.40001 TD [(IRS\325 intermediate sanctions apply)91(, and what does it take to)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (avoid the sanctions?)Tj ET BT /F13 1 Tf 10 0 0 10 36 334.5 Tm (Ken Acker)Tj 4.65577 0 TD (man:)Tj ET BT /F1 1 Tf 10 0 0 10 108.115 334.5 Tm (This is such an elementar)Tj 10.35976 0 TD (y question, yet it is)Tj -17.57126 -1.4 TD (just amazing to us in Clark Consulting-Healthcar)Tj 19.95731 0 TD (e Gr)Tj 1.77578 0 TD (oup that)Tj -21.73309 -1.40001 TD -0.0169 Tc (ther)Tj 1.63691 0 TD -0.017 Tc 0.028 Tw [(e ar)18(e people not paying suf)17(ficient attention to the law)55(. The)]TJ -1.63691 -1.4 TD [(T)111(axpayer Bill of Rights, Section 4958 of the Inter)-19(nal Revenue)]TJ T* [(Code, has been ar)18(ound for about eight years, and it is ver)-1(y)]TJ T* [(specific to all nonpr)18(ofit or)-1(ganizations. Some nonpr)18(ofit)]TJ 0 -1.40001 TD [(organizations seem to be much mor)17(e focused on Sarbanes-)]TJ 0 -1.4 TD [(Oxley \(the 2002 federal law is designed to pr)18(otect investors by)]TJ -0.0169 Tc (impr)' 1.85883 0.00001 TD -0.0168 Tc 0.0278 Tw (oving corporate disclosur)Tj 10.28588 0.00001 TD (e practices\), which doesn\325)Tj 10.63097 0.00001 TD (t legally)Tj -22.77568 -1.40002 TD -0.017 Tc 0.028 Tw [(apply to them, than they ar)18(e on the T)110(axpayer Bill of Rights.)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (Section 4958, known as inter)Tj 12.14518 0.00001 TD (mediate sanctions, pr)Tj 8.79716 0.00001 TD (ovides that)Tj -20.94234 -1.40001 TD (the IRS can impose a penalty or tax or both on overpaid CEOs)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw [(and/or individual boar)18(d members who appr)17(ove the excessive)]TJ T* [(payment transaction. Befor)18(e Congr)17(ess passed this law)55(, the IRS)]TJ T* [(basically had two options: do nothing or r)18(emove the tax-)]TJ 0 -1.40001 TD [(exempt status of the organization. Consequently)91(, in most)]TJ T* [(cases, they did nothing. W)-24(ith the new law the ball game has)]TJ -0.0168 Tc 0.0278 Tw (changed considerably)' 8.82463 0.00001 TD (, and the IRS has published final)Tj -8.8246 -1.4 TD -0.017 Tc 0.028 Tw [(r)18(egulations pr)17(oviding a safe harbor)92(, which is a good thing. The)]TJ 27.9 62.90001 TD -0.0168 Tc 0.0278 Tw (safe harbor for boar)Tj 8.28645 0.00001 TD -0.017 Tc 0.028 Tw [(ds and healthcar)18(e or)-1(ganizations involves)]TJ -8.28645 -1.4 TD [(basically thr)18(ee things. First, independence; that is, the)]TJ T* [(gover)-18(ning boar)18(d has to appoint an independent committee)]TJ -0.0168 Tc 0.0278 Tw (made up of members who have no issues or conflicts of)' (inter)' 1.84216 0.00001 TD -0.017 Tc 0.028 Tw [(est. Secondly)92(, the committee needs to hir)17(e an experienced)]TJ -1.84216 -1.4 TD [(independent outside expert to pr)17(ovide the committee with)]TJ T* [(total compensation advice. Many boar)18(ds seem too focused on)]TJ T* [(the cash side of the equation, when it\325)111(s all about cash, benefits)]TJ T* [(and per)18(quisites. That\325)110(s what state attor)-18(neys general ar)18(e)]TJ T* [(inter)18(ested in, that\325)110(s what the IRS is inter)18(ested in, and that\325)111(s)]TJ T* [(what boar)18(ds need to be inter)17(ested in. And thir)18(dly)92(, and this is)]TJ T* [(wher)18(e most failur)17(es occur)92(, the compensation committee needs)]TJ T* [(to contemporaneously document the decision: those pr)17(esent;)]TJ -0.0168 Tc 0.0278 Tw (whether disqualified persons absent themselves during the)' T* -0.017 Tc 0.028 Tw [(pr)17(ocess; and the rationale for the decisions, especially for any)]TJ T* [(decisions that ar)18(e outside the payment range. T)110(o my)]TJ T* [(knowledge, ther)18(e has yet to be a single case on r)17(ecor)18(d wher)17(e)]TJ -0.0168 Tc 0.0278 Tw (the IRS has even challenged the compensation decisions of)' (boar)' 1.86005 0 TD (ds when they followed this pr)Tj 12.30399 0 TD (ocess. )Tj ET BT /F13 1 Tf 10 0 0 10 315 436.5 Tm (Glenn Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 378.2332 436.5 Tm (In the first element of the safe harbor)Tj 15.44841 0 TD (, the)Tj -21.77173 -1.4 TD (independent compensation committee must document)Tj T* -0.017 Tc 0.028 Tw [(advance appr)18(oval, not after)54(-the-fact appr)18(oval of executive)]TJ -0.0168 Tc (compensation.)' ET BT /F13 1 Tf 10 0 0 10 315 371.5 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 371.5 Tm -0.0168 Tc 0.0278 Tw (Also, Len Henzke of the IRS \(a tax law specialist in)Tj -5.13885 -1.4 TD -0.017 Tc 0.028 Tw [(the Exempt Organizations Division\) r)17(ecently was speaking to a)]TJ (gr)' 0.8375 0 TD -0.0168 Tc 0.0278 Tw (oup of health lawyers and made a ver)Tj 15.70425 0 TD (y specific point about)Tj -16.54175 -1.40001 TD (the need for absolute independence in the r)Tj 18.23815 0 TD (elationship)Tj -18.23815 -1.4 TD (between the compensation committee and the outside thir)Tj 24.42306 0 TD 0 Tc (d)Tj -24.42306 -1.4 TD -0.0168 Tc (par)Tj 1.33864 0 TD -0.017 Tc 0.028 Tw (ty expert.)Tj ET BT /F12 1 Tf 10 0 0 10 315 278.5 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 370.648 278.5 Tm -0.017 Tc [(Regar)18(ding the use of independent consultants)]TJ -5.5648 -1.4 TD -0.0168 Tc 0.0278 Tw (and independent committee members for executive)Tj T* -0.017 Tc 0.028 Tw [(compensation, what is the curr)17(ent status?)]TJ ET BT /F13 1 Tf 10 0 0 10 315 227.5 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 227.5 Tm 0.028 Tw [(Ther)18(e ar)17(e literally hundr)18(eds if not thousands of)]TJ -5.13885 -1.4 TD -0.0168 Tc 0.0278 Tw (hospitals that ar)Tj 6.58628 0.00001 TD (e still behind the cur)Tj 8.40979 0.00001 TD (ve. In many cases, they\325r)Tj 10.06239 0.00001 TD 0 Tc (e)Tj -25.05846 -1.40002 TD -0.017 Tc 0.028 Tw [(pr)17(obably smaller hospitals. The larger you ar)18(e, however)92(, the)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (bigger the tar)Tj 5.65438 0.00001 TD (get you ar)Tj 4.20374 0.00001 TD -0.017 Tc 0.028 Tw [(e. The mor)18(e aggr)17(essive your)]TJ -9.85812 -1.40001 TD -0.0168 Tc 0.0278 Tw (compensation package needs to be to attract the right kinds)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw [(of people, the mor)18(e at risk you ar)17(e, vis a vis the media, unions,)]TJ T* [(state attor)-18(neys general who ar)18(e getting ver)-1(y aggr)18(essive ar)18(ound)]TJ T* [(this subject, and the IRS. W)18(e\325ve got the soft audits going on)]TJ T* [(with the IRS now)55(, and undoubtedly ther)17<65D5>111(s going to be some)]TJ T* [(egr)18(egious pay practices that will sur)-1(face and become a big)]TJ -0.0168 Tc 0.0278 Tw (issue. )' ET 0 0 0 0 k 36 27.945 540 30.591 re f 36 63.004 m 576 63.004 l S /GS0 gs Q endstream endobj 15 0 obj << /Length 9084 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 0 0 1 k (3)Tj ET BT /F13 1 Tf 10 0 0 10 37 711.4999 Tm (V)Tj 0.59538 0.00001 TD -0.017 Tc 0.028 Tw [(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 85.5145 711.4999 Tm -0.0168 Tc 0.0278 Tw (Ken, can you shed some light on the IRS)Tj -4.85145 -1.4 TD (evaluation of levels of compensation, as opposed to the)Tj T* -0.017 Tc 0.028 Tw [(structur)17(e of that compensation, such as contingent payments,)]TJ -0.0168 Tc 0.0278 Tw (bonuses, and the like?)' ET BT /F13 1 Tf 10 0 0 10 37 646.4999 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 88.3885 646.4999 Tm 0.028 Tw [(The IRS doesn\325)18(t have any tr)17(ouble with any of the)]TJ -5.13885 -1.4 TD [(structur)17(e as long as it is consider)18(ed in the context of total)]TJ T* [(compensation. Short-term incentives, long-ter)-1(m incentives,)]TJ T* [(r)18(etention bonuses, perfor)-1(mance bonuses\320all of that just needs)]TJ -0.0168 Tc 0.0278 Tw (to be within the context of total compensation. Then the issue)' T* -0.017 Tc 0.028 Tw [(of r)18(easonable peer comparators comes into play)91(.)]TJ ET BT /F12 1 Tf 10 0 0 10 37 553.4999 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 92.648 553.4999 Tm -0.017 Tc [(Ar)18(e ther)17(e other emerging best practices in this)]TJ -5.5648 -1.4 TD [(ar)18(ea that nonpr)17(ofit healthcar)18(e organizations should be)]TJ -0.0168 Tc (pursuing?)' ET BT /F13 1 Tf 10 0 0 10 37 502.5 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 88.3885 502.5 Tm -0.0168 Tc 0.0278 Tw (Compensation decisions need to be based on a)Tj -5.13885 -1.4 TD (well thought out compensation philosophy)Tj 17.68676 0 TD (, specific to the)Tj -17.68676 -1.4 TD -0.017 Tc 0.028 Tw [(organization. It gets all of the boar)17(d members on the same)]TJ T* (page in terms of the basis for a competitive pay system to)Tj -0.0168 Tc 0.0278 Tw (attract and r)' 5.0961 0 TD (etain the best senior executives. Ther)Tj 15.2064 0 TD (e ar)Tj 1.55385 0 TD (e various)Tj -21.85635 -1.40001 TD (pieces of a compensation philosophy)Tj 15.15808 0 TD -0.017 Tc 0.028 Tw [(. Ther)18(e is nothing mor)17(e)]TJ -15.15808 -1.4 TD (important than peer comparators. )Tj ET BT /F13 1 Tf 10 0 0 10 37 395.5 Tm [(V)55(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 85.5145 395.5 Tm [(This is fundamental to attract or r)18(etain top)]TJ -4.85145 -1.4 TD -0.0168 Tc 0.0278 Tw (managerial talent. 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So conceptually I think about for)55(-pr)17(ofit)]TJ -0.0168 Tc 0.0278 Tw (hospitals\325 CEOs as being potential candidates and potential)' T* -0.017 Tc 0.028 Tw [(valuable managerial assets for a nonpr)18(ofit hospital. )]TJ ET BT /F13 1 Tf 10 0 0 10 37 246.5 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 88.3885 246.5 Tm -0.0168 Tc 0.0278 Tw (A key question in peer comparators is whether)Tj -5.13885 -1.4 TD -0.017 Tc 0.028 Tw [(you\325r)18(e using local, state, r)17(egional, or national data. That\325)111(s)]TJ T* [(driven by whom the boar)18(d sees as competitors. Ar)17(e you)]TJ -0.0168 Tc 0.0278 Tw (competing on a national basis and r)' 14.84353 0.00001 TD -0.0169 Tc (ecr)Tj 1.22659 0.00001 TD -0.0168 Tc (uiting nationally? 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The compensation models )]TJ 27.8 62.3 TD -0.0169 Tc 0.0278 Tw (in for)Tj 2.14989 0.00001 TD -0.017 Tc 0.028 Tw [(-pr)18(ofits have been quite dif)17(fer)18(ent. A large amount of)]TJ -2.14989 -1.4 TD -0.0168 Tc 0.0278 Tw (compensation is or has been based on stock options,)Tj T* -0.017 Tc 0.028 Tw [(something that is not available to us. That\325)111(s the primar)-1(y)]TJ T* [(r)18(eason. The other important r)17(eason, again, is that we ar)18(e)]TJ -0.0168 Tc 0.0278 Tw (mission driven. Our mission goes beyond ear)' 18.46672 0.00001 TD (nings and does)Tj -18.46672 -1.4 TD -0.017 Tc 0.028 Tw [(not involve the distribution of ear)-18(nings for the benefit of)]TJ -0.0168 Tc (stockholders.)' 0 -2.3 TD 0.0278 Tw (On the other hand, an example of leadership candidate pools)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw [(wher)18(e we do include for)54(-pr)18(ofits as well as nonpr)17(ofits is our)]TJ 0 -1.40001 TD [(insurance company)92(, which is a 501(c )(4). 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For instance, in an)Tj -7.78481 -1.40001 TD (or)Tj 0.85532 0 TD -0.0168 Tc 0.0278 Tw (ganization that has academic aspirations, whether or not)Tj -0.85532 -1.4 TD (connected to a medical school, you have a number of people)Tj T* -0.017 Tc 0.028 Tw [(who ar)18(e in your top executive gr)17(oup who ar)18(e also heads of)]TJ -0.0168 Tc 0.0278 Tw (their discipline-based depar)' 11.25391 0 TD (tments or divisions. T)Tj 8.60394 0 TD -0.017 Tc 0.028 Tw (o try to peer)Tj -19.85785 -1.40001 TD [(comparators for those folks you may have to go to dif)17(fer)18(ent)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (benchmarking, such as the American Association of Medical)Tj (Colleges.)' 0 -2.3 TD (Another issue, and of course the compensation committee)Tj 0 -1.4 TD (and I, as CEO, talk about this, is that we\325r)Tj 17.21943 0 TD (e not simply wanting)Tj -17.21943 -1.4 TD -0.017 Tc 0.028 Tw [(to establish a de facto strategy of incr)18(easing our size in or)17(der)]TJ T* [(to get into a bigger)92(, higher paying peer gr)17(oup. )]TJ ET BT /F13 1 Tf 10 0 0 10 315 255.5 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 255.5 Tm 0.028 Tw [(W)18(e see r)17(evenue as a common measur)18(e in looking)]TJ -5.13885 -1.40001 TD -0.0168 Tc 0.0278 Tw (at comparative size. Complexity is also a major issue. The kind)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw (of organization that Glenn Steele is leading, a $1.5 billion)Tj -0.0168 Tc 0.0278 Tw (enterprise, is a ver)' 7.46955 0.00001 TD -0.0169 Tc (y dif)Tj 1.75886 0.00001 TD (fer)Tj 1.09768 0.00001 TD -0.0168 Tc (ent kind of or)Tj 5.68313 0.00001 TD (ganization, with a lar)Tj 8.71501 0.00001 TD (ge)Tj -24.72423 -1.40003 TD -0.017 Tc 0.028 Tw [(integrated multi-specialty gr)18(oup practice, the Geisinger Health)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (Plan insurance piece, as well as multiple sites and multiple)Tj -0.017 Tc (or)' 0.85532 0.00001 TD 0.028 Tw [(ganizations. So we try to measur)17(e that. It becomes dif)18(ficult.)]TJ -0.85532 -1.40001 TD [(A lot of compensation consultants don\325)18(t do it because they)]TJ 0 -1.4 TD [(don\325)18(t have the data. As far as the IRS is concer)-18(ned, it\325)110(s)]TJ T* [(acceptable to use for)55(-pr)17(ofit data. W)18(e do it only if the client)]TJ T* [(r)18(eally wants to use it, and it\325)110(s usually specifically targeted to)]TJ T* [(executives r)18(esponsible for insurance pr)17(oducts, or for)]TJ -0.0169 Tc (infor)' 1.91589 0.00001 TD -0.0168 Tc 0.0278 Tw (mation technology and sometimes finance. It\325)Tj 18.79115 0.00001 TD (s inter)Tj 2.50333 0.00001 TD (esting)Tj ET 1 w /CS0 CS 1 SCN 36 63.004 m 576 63.004 l S /GS0 gs Q endstream endobj 16 0 obj << /Length 8864 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q BT /F1 1 Tf 10 0 0 10 36 712.5 Tm 0 0 0 1 k -0.0168 Tc 0.0278 Tw (how the base cash compensation is generally a non-issue)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw [(when you compar)18(e the two. Nonpr)17(ofit executive base salaries)]TJ T* [(mor)18(e often than not will be in the ballpark, but it\325)110(s ar)18(ound the)]TJ -0.0168 Tc 0.0278 Tw (stock options and other incentives that the executives on the)' T* -0.017 Tc 0.028 Tw [(investor)55(-owned side dif)17(fer)92(.)]TJ ET BT /F13 1 Tf 10 0 0 10 36 633.4999 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 69.4042 633.4999 Tm -0.017 Tc (Organizational complexity is a huge factor that must)Tj -3.34042 -1.4 TD [(be consider)18(ed her)17(e. Not only the organization but also the)]TJ T* [(definition of the job and the complexity of the mission ar)17(e)]TJ 0 -1.40001 TD [(central to defining an appr)18(opriate level of compensation. )]TJ ET BT /F12 1 Tf 10 0 0 10 36 568.4999 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 91.648 568.4999 Tm 0.0278 Tw (Beyond establishing peer comparators that)Tj -5.5648 -1.4 TD -0.017 Tc 0.028 Tw [(accurately r)18(eflect the market in which you ar)17(e competing )]TJ T* [(for talent, what other considerations must be addr)17(essed in )]TJ -0.0168 Tc 0.0278 Tw (a compensation philosophy? )' ET BT /F13 1 Tf 10 0 0 10 36 503.5 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 87.3885 503.5 Tm 0.028 Tw [(Ther)18(e ar)17(e several other pieces. What is base)]TJ -5.13885 -1.40001 TD [(salary? Ar)18(e ther)17(e short-term incentives, and if so, what ar)17(e)]TJ 0 -1.4 TD [(they? Ar)18(e ther)17(e long-term incentives? What about benefits?)]TJ -0.0168 Tc (Her)' 1.4319 0 TD -0.017 Tc [(e I am talking about the costs per dollar of benefits. T)110(oo)]TJ -1.4319 -1.4 TD [(often boar)18(ds ar)17(e looking at only pr)18(evalence information; for)]TJ T* [(example, 75% of executives having long term car)17(e insurance.)]TJ -0.0168 Tc 0.0278 Tw (That tells you nothing about the specific br)' 17.71879 0 TD (eadth and depth of)Tj -17.71879 -1.4 TD (such coverage or the costs involved. Per)Tj 16.42324 0 TD (quisites get you quickly)Tj -16.42324 -1.4 TD (into quicksand, and we caution our clients to be ver)Tj 21.493 0 TD -0.0169 Tc (y car)Tj 1.92487 0 TD -0.0168 Tc (eful)Tj -23.41787 -1.40001 TD (about perks of any kind. )Tj 0 -2.3 TD -0.017 Tc 0.028 Tw [(A compensation philosophy is also about establishing wher)17(e)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (the healthcar)Tj 5.40279 0 TD -0.017 Tc 0.028 Tw [(e enterprise wants to be: at the 50th per)17(centile)]TJ -5.40279 -1.4 TD -0.0168 Tc 0.0278 Tw (for the CEO and senior executives, at the 65th, 75th, at the)Tj T* -0.017 Tc 0.028 Tw [(90th \320 we see it all. And that\325)111(s OK. Some want to be at the)]TJ T* [(75th per)18(centile with benefits but at the 65th per)17(centile for)]TJ -0.0168 Tc 0.0278 Tw (cash. )' ET BT /F13 1 Tf 10 0 0 10 36 261.5 Tm (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 69.4042 261.5 Tm (As you take an or)Tj 7.32788 0.00001 TD (ganization fr)Tj 5.18063 0.00001 TD (om one stage to)Tj -15.84893 -1.40002 TD -0.017 Tc 0.028 Tw [(another)92(, the compensation philosophy is extraor)17(dinarily)]TJ 0 -1.4 TD (important to articulate and, in fact, to disseminate. For)Tj T* [(instance, we have moved at Geisinger to a much mor)17(e)]TJ 0 -1.40001 TD -0.0168 Tc 0.0278 Tw (incentive-based compensation. Our philosophy is to set the)Tj 0 -1.4 TD -0.017 Tc 0.028 Tw [(base salaries at a lower target, at the 50th per)17(centile. But we)]TJ -0.0168 Tc 0.0278 Tw (have overall ambitions that our integrated health system,)' T* -0.017 Tc 0.028 Tw [(whether on a financial or pr)18(ogrammatic basis, is going to be )]TJ -0.0168 Tc 0.0278 Tw (at the 75th or 80th per)' 9.62646 0.00001 TD (centile of per)Tj 5.43148 0.00001 TD -0.017 Tc 0.028 Tw (formance in our cohort.)Tj -15.05794 -1.40001 TD -0.0168 Tc 0.0278 Tw (Thus, as our or)Tj 6.16744 0.00001 TD -0.017 Tc 0.028 Tw (ganization performs well, our total cash)Tj -6.16744 -1.40001 TD -0.0168 Tc 0.0278 Tw (compensation is going to be ramped up. )Tj 0 -2.3 TD -0.022 Tc 0.028 Tw [(For positions in our insurance company wher)18(e we had excellent)]TJ 27.9 61.4 TD [(candidates fr)18(om both nonpr)17(ofits and for)55(-)1(p)1(r)19(ofits, it was a)]TJ 0 -1.4 TD [(challenge to figur)18(e out comparable incentive tools and leverage)]TJ T* [(in negotiating r)18(elationships with those who had the incentive)]TJ -0.0223 Tc 0.0278 Tw (of an equity-based compensation model. But it was doable.)' ET BT /F13 1 Tf 10 0 0 10 315 647.5 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 647.5 Tm 0.028 Tw [(Ther)18<65D5>110(s certainly a tr)18(end in nonpr)17(ofit health car)18(e)]TJ -5.13885 -1.4 TD [(organizations\325 executive compensation towar)17(ds mor)18(e leverage)]TJ T* [(and that\325)111(s what Glenn is describing\320mor)17(e pay is at risk. About)]TJ T* [(80% of the nation\325)111(s nonpr)17(ofit healthcar)18(e organizations have)]TJ 0 -1.40001 TD [(short-term incentive plans in place. Long-ter)-1(m incentive plans)]TJ 0 -1.4 TD [(ar)18(e skewed to lar)-1(ger organizations. I think somewher)18(e in the)]TJ T* [(neighborhood of 18, 20, 22% of healthcar)17(e enterprises have)]TJ 0 -1.40001 TD (long-term incentive plans. )Tj ET BT /F13 1 Tf 10 0 0 10 315 526.4999 Tm [(V)55(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 363.5145 526.4999 Tm [(Our r)18(esear)17(ch shows a str)18(ong r)18(elationship between)]TJ -4.85145 -1.4 TD [(objective measur)18(es of financial per)-1(formance and CEO)]TJ T* [(compensation in nonpr)18(ofit hospitals, as much as you\325d see in )]TJ T* [(a set of for)55(-pr)17(ofit hospitals. The dif)18(ficulty in nonpr)17(ofit pay-for)55(-)]TJ -0.0168 Tc (per)' 1.33864 0 TD -0.017 Tc [(formance is trying to r)17(elate compensation to objective,)]TJ -1.33864 -1.4 TD [(non-financial community measur)18(es. Y)91(et they should be part )]TJ T* [(of a compensation philosophy)92(. The other thing we obser)-1(ve is )]TJ -0.0168 Tc 0.0278 Tw (a significant dif)' 6.2523 0 TD -0.0169 Tc (fer)Tj 1.09767 0 TD -0.0168 Tc (ence in job attributes acr)Tj 10.21271 0 TD (oss CEOs. For)Tj -17.56268 -1.40001 TD (example, if a CEO is also chair)Tj 12.42464 0 TD -0.017 Tc 0.028 Tw [(man of a boar)18(d, with dif)17(fer)18(ent)]TJ -12.42464 -1.4 TD -0.0168 Tc 0.0278 Tw (job attributes, you would expect compensation to var)Tj 22.10197 0 TD 0 Tc (y)Tj 0.33538 0 TD -0.0168 Tc (. As a)Tj -22.43736 -1.40001 TD -0.017 Tc 0.028 Tw [(final point, since nonpr)18(ofit hospitals can\325)17(t use compensation )]TJ 0 -1.4 TD [(as a disciplining device to the degr)18(ee that for)54(-pr)18(ofits can with)]TJ -0.0168 Tc 0.0278 Tw (contingent payof)' 7.02024 0 TD (f mechanisms like stock options, we see a)Tj -7.02024 -1.4 TD -0.017 Tc 0.028 Tw [(particularly str)17(ong r)18(elationship between CEO tur)-18(nover and)]TJ T* [(performance in nonpr)17(ofit hospitals, in contrast to for)55(-pr)17(ofit)]TJ -0.0168 Tc 0.0278 Tw (hospitals or the investor)' 9.77655 0.00001 TD (-owned sector mor)Tj 7.86387 0.00001 TD (e generally)Tj 4.36266 0 TD 0 Tc (.)Tj ET BT /F13 1 Tf 10 0 0 10 315 293.5 Tm -0.0168 Tc (Kibler:)Tj ET BT /F1 1 Tf 10 0 0 10 347.2836 293.5 Tm -0.017 Tc 0.028 Tw [(Our boar)18(d links our CEO\325)110(s incentive pay to both)]TJ -3.22836 -1.4 TD -0.0168 Tc 0.0278 Tw (financial and non-financial measur)Tj 14.16309 0.00001 TD (es. Finances ar)Tj 5.95313 0.00001 TD -0.017 Tc 0.028 Tw (e important,)Tj -20.11621 -1.40002 TD [(but we also try to align incentives with goals that ar)17(e good for)]TJ 0 -1.4 TD [(patients and our community)92(. Patient satisfaction is one of )]TJ T* [(our measur)18(es. W)17(e also scor)18(e our CEO on the success of our)]TJ -0.0168 Tc 0.0278 Tw (strategic plan, which includes many community benefits.)' ET BT /F13 1 Tf 10 0 0 10 315 200.5 Tm (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 348.4042 200.5 Tm (In Pennsylvania we have a limit on how much)Tj -3.34042 -1.4 TD (incentive can be based on financial per)Tj 16.07053 0.00001 TD -0.017 Tc (for)Tj 1.17141 0.00001 TD -0.0168 Tc (mance. It for)Tj 5.26309 0.00001 TD (ces us in)Tj -22.50503 -1.40002 TD (our incentive component of the compensation philosophy to)Tj 0 -1.4 TD (look at exactly what Bill is talking about\320patient satisfaction)Tj -0.0169 Tc (acr)' 1.20876 0.00001 TD -0.017 Tc 0.028 Tw [(oss the entir)18(e company)91(, accomplishment of strategic aims,)]TJ -1.20876 -1.40001 TD -0.0168 Tc 0.0278 Tw (access, quality)Tj 5.73931 -0.00001 TD -0.017 Tc 0.028 Tw [(. I think things ar)18(e moving in a dir)17(ection wher)18(e)]TJ -5.73931 -1.39999 TD [(we can actually measur)18(e the non-financial endpoints, and)]TJ 0 -1.4 TD [(we\325r)18(e compelled to do so.)]TJ ET 1 w /CS0 CS 1 SCN 36 63 m 576 63 l S BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 Tc (4)Tj ET Q endstream endobj 17 0 obj << /Length 9519 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q 1 w /CS0 CS 1 SCN 36 63 m 576 63 l S BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 0 0 1 k (5)Tj ET BT /F13 1 Tf 10 0 0 10 37.6803 712.5 Tm -0.017 Tc (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 89.0688 712.5 Tm 0.028 Tw [(In our jargon this is called a balanced scor)17(ecar)18(d)]TJ -5.13885 -1.4 TD [(appr)18(oach. W)17(e caution any of our clients when they start)]TJ T* (getting north of a 40% to 50% focus on financial)Tj -0.0168 Tc (per)' 1.33864 0.00001 TD -0.017 Tc [(formance. It needs to be balanced to be a good pr)17(ogram.)]TJ ET BT /F13 1 Tf 10 0 0 10 37.6803 647.5 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 71.0845 647.5 Tm -0.017 Tc [(The American Medical Gr)18(oup Association did a)]TJ -3.34042 -1.4 TD [(benchmarking study)92(. It was r)17(emarkable to me how few)]TJ T* [(organizations achieved best practice in this par)-1(ticular ar)18(ea. )]TJ T* [(I\325m sur)18(e best practice is not widely disseminated.)]TJ ET BT /F13 1 Tf 10 0 0 10 37.6803 582.4999 Tm -0.022 Tc [(V)55(an Hor)-18(n)1(:)]TJ ET BT /F1 1 Tf 10 0 0 10 85.6393 582.4999 Tm [(Looking at nonpr)18(ofit hospitals in the United States)]TJ -4.7959 -1.4 TD [(in the early-to-mid \32590s, we found that the average per)18(centage)]TJ T* [(of CEO compensation tied to financial perf)1(o)1(r)1(mance, going)]TJ T* [(f)1(r)18(om the worst hospitals to the best hospitals, was still only)]TJ T* [(ar)18(ound 8%. So we\325r)17(e nowher)18(e near the mark that Ken is)]TJ -0.0224 Tc 0.0278 Tw (suggesting, at least not as of the mid-\32590s.)' ET BT /F12 1 Tf 10 0 0 10 37.6803 489.5 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 93.3283 489.5 Tm -0.017 Tc 0.028 Tw (Ken, do you also try to counsel your clients on)Tj -5.5648 -1.4 TD [(the degr)18(ee to which they ar)17(e focusing on short-term versus)]TJ -0.0168 Tc (longer)' 2.56742 0 TD -0.017 Tc [(-term perfor)-1(mance? )]TJ ET BT /F13 1 Tf 10 0 0 10 37.6803 438.5 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 89.0688 438.5 Tm 0.028 Tw [(W)18(e do, and in fact long-ter)-1(m incentive pr)18(ograms)]TJ -5.13885 -1.4 TD [(ar)18(e ver)-1(y dif)18(ficult to manage. So we begin by saying, \322Get your)]TJ -0.0168 Tc 0.0278 Tw (house in or)' 4.63312 0 TD (der)Tj 1.24684 0 TD (. Be comfor)Tj 4.81549 0 TD (table with what you\325r)Tj 8.88061 0 TD (e doing with)Tj -19.57606 -1.40001 TD (shor)Tj 1.76679 0 TD -0.017 Tc 0.028 Tw [(t-term incentive plans. Make sur)17(e it\325)111(s working well, and is)]TJ -1.76679 -1.4 TD -0.0169 Tc (thor)Tj 1.69282 0 TD -0.0168 Tc 0.0278 Tw (oughly understood by the boar)Tj 12.83333 0 TD (d and by executive)Tj -14.52615 -1.40001 TD -0.017 Tc 0.028 Tw [(management, befor)18(e you even consider longer)54(-term incentive)]TJ 0 -1.4 TD -0.0168 Tc (plans.\323)Tj ET BT /F13 1 Tf 10 0 0 10 37.6803 331.5 Tm (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 71.0845 331.5 Tm 0.0278 Tw (I want to add an inter)Tj 9.06721 0 TD -0.017 Tc 0.028 Tw (nal management truth that has)Tj -12.40763 -1.4 TD [(become appar)18(ent to us at Geisinger)91(. When an organization)]TJ T* [(moves fr)18(om losing money to making money on operations, )]TJ T* [(it is inter)18(esting how valuable communication within the)]TJ -0.0168 Tc 0.0278 Tw (company family becomes. When you lose money on)' (operations ther)' 6.25909 0.00001 TD (e is little need to justify nonpr)Tj 12.26263 0.00001 TD (ofit status. As )Tj -18.52172 -1.40002 TD -0.017 Tc 0.028 Tw [(you achieve r)18(obust operations, folks at ever)-1(y level of our)]TJ 0 -1.4 TD [(organization need to understand the pr)17(ocess and cost of)]TJ T* [(r)18(ecruiting and r)17(etaining the best and the brightest, and how)]TJ 0 -1.40001 TD [(the boar)18(d benchmarks the pr)17(ocess.)]TJ ET BT /F12 1 Tf 10 0 0 10 37.6803 182.5 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 93.3283 182.5 Tm 0.0278 Tw (What I am hearing, then, is that benefits)Tj -5.5648 -1.4 TD -0.017 Tc (pr)Tj 0.8375 0.00001 TD -0.0168 Tc (ovided to the community need to be built into both pay-for)Tj 24.58625 0.00001 TD 0 Tc (-)Tj -25.42375 -1.40002 TD -0.017 Tc 0.028 Tw (performance and communications?)Tj ET BT /F13 1 Tf 10 0 0 10 37.6803 131.5 Tm -0.0224 Tc (Acker)Tj 2.55534 0.00001 TD (man:)Tj ET BT /F1 1 Tf 10 0 0 10 88.5133 131.5 Tm 0.0278 Tw (I think that some boar)Tj 9.04757 0.00001 TD (ds ar)Tj 1.95422 0.00001 TD -0.022 Tc 0.028 Tw (e very in tune with )Tj -16.0851 -1.4 TD [(this and ar)18(e demonstrating inter)-18(nally as well as to their)]TJ -0.0224 Tc 0.0278 Tw (communities the measurable contributions they\325r)' 19.93269 -0.00001 TD -0.0223 Tc (e making. The)Tj ET BT /F2 1 Tf 10 0 0 10 37.6803 89.5 Tm -0.022 Tc 0.028 Tw [((Minneapolis))-284(Star T)74(ribune)]TJ ET BT /F1 1 Tf 10 0 0 10 158.4243 89.5 Tm [(r)18(eleased an article on the Fairview)]TJ 15.74158 62.3 TD [(hospital system, as a r)18(esult of a 28-page r)17(eport by Minnesota)]TJ 0 -1.4 TD [(Attor)-18(ney General Mike Hatch. The title of the article was,)]TJ T* [(\322While Execs Got Bonuses, Fairview\325)111(s Low Income Patients Got)]TJ -0.0224 Tc 0.0278 Tw (Bill Collectors.\323 That gets back to your point. It is incr)' 21.68859 0.00001 TD -0.0223 Tc (easingly)Tj -21.6886 -1.4 TD -0.022 Tc 0.028 Tw [(important that boar)18(ds focus on community benefits.)]TJ ET BT /F12 1 Tf 10 0 0 10 315.8401 633.4999 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 371.4882 633.4999 Tm -0.017 Tc [(What about fund-raising? Is that also fr)18(equently)]TJ -5.56481 -1.4 TD [(a key dif)18(fer)17(entiator in the performance goals and)]TJ T* [(compensation for a nonpr)18(ofit versus for)54(-pr)18(ofit CEO?)]TJ ET BT /F13 1 Tf 10 0 0 10 315.8401 582.4999 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 367.2287 582.4999 Tm 0.028 Tw [(My bias is that philanthr)18(opy is the futur)17(e of)]TJ -5.13886 -1.4 TD [(nonpr)18(ofit healthcar)17(e. It\325)111(s certainly a very impor)-1(tant element)]TJ T* [(that\325)111(s been ignor)17(ed way too long. Some organizations have)]TJ T* [(done a gr)18(eat job with it; others ar)17(e just bar)18(ely getting started)]TJ T* [(with it. Y)92(ou do see it sometimes tied to a CEO\325)110(s incentive plan,)]TJ T* [(but it\325)111(s infr)17(equent. Ther)18<65D5>111(s no doubt that whatever is tied to)]TJ T* [(the short-term or long-ter)-1(m incentives will drive performance. )]TJ ET BT /F13 1 Tf 10 0 0 10 315.8401 475.5 Tm -0.0168 Tc (Kibler:)Tj ET BT /F1 1 Tf 10 0 0 10 348.1237 475.5 Tm -0.017 Tc [(W)18(e don\325)17(t use fund-raising as a criterion to measur)18(e)]TJ -3.22836 -1.4 TD -0.0168 Tc 0.0278 Tw (our CEO\325)Tj 3.6727 0 TD -0.017 Tc 0.028 Tw [(s performance. W)17(e have just begun to embrace)]TJ -3.6727 -1.4 TD [(philanthr)18(opy in a bigger way)91(, and our CEO has been a leader)]TJ T* [(in that pr)18(ocess. But the cur)-1(r)18(ent boar)18(d doesn\325)17(t assign an)]TJ -0.0168 Tc 0.0278 Tw (incentive to his fund-raising ef)' 12.44591 0 TD -0.017 Tc (for)Tj 1.17141 0 TD -0.0168 Tc (ts. In fact he doesn\325)Tj 8.13154 0 TD (t solicit)Tj -21.74886 -1.40001 TD (donations fr)Tj 4.97635 0 TD -0.017 Tc 0.028 Tw [(om boar)18(d members, or keep track of what we)]TJ -4.97635 -1.4 TD -0.0168 Tc 0.0278 Tw (give. I\325m sur)Tj 4.98624 0 TD (e he wants us to give, and give gener)Tj 15.5325 0 TD (ously)Tj 1.99133 0 TD -0.0169 Tc (, but )Tj -22.51007 -1.40001 TD -0.017 Tc 0.028 Tw [(we don\325)18(t want that to cloud the gover)-18(nance/CEO r)17(elationship.)]TJ ET BT /F13 1 Tf 10 0 0 10 315.8401 354.5 Tm [(V)55(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 364.3547 354.5 Tm [(Our r)18(esear)17(ch has found that the boar)18(d structur)17(e)]TJ -4.85146 -1.4 TD -0.0168 Tc 0.0278 Tw (itself can have a significant impact on the ability of the)Tj T* -0.017 Tc 0.028 Tw (organization to be successful in raising donations. The CEOs)Tj T* [(who ar)18(e mor)17(e powerful on their boar)18(ds appear to be able to)]TJ T* [(significantly incr)18(ease the donations. At the same time, ther)17(e)]TJ T* [(ar)18(e other things that seem to make or)-1(ganizations less able to)]TJ 0 Tc (r)' 0.29827 0.00001 TD -0.0169 Tc (ecr)Tj 1.22658 0.00001 TD -0.017 Tc [(uit donations. Most notably)92(, significant physician)]TJ -1.52485 -1.40002 TD [(participation on the boar)17(d tends to r)18(educe the level of)]TJ 0 -1.4 TD [(donations and the ability of the CEO to r)17(ecruit donations.)]TJ ET BT /F12 1 Tf 10 0 0 10 315.8401 219.5 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 371.4882 219.5 Tm 0.0278 Tw (Do you think the compensation expectations )Tj -5.56481 -1.4 TD -0.017 Tc 0.028 Tw [(of executives in nonpr)18(ofit health car)17(e organizations have)]TJ T* [(changed over time? For instance, as a pr)18(oduct of the \32560s, I)]TJ -0.0169 Tc (star)' 1.48774 0.00001 TD -0.0168 Tc 0.0278 Tw (ted my car)Tj 4.36854 0.00001 TD (eer in 1970, driven by a desir)Tj 12.03727 0.00001 TD (e to apply business)Tj -17.89355 -1.40002 TD -0.017 Tc 0.028 Tw [(knowledge and skills to nonpr)18(ofit health car)17(e organizations)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (with a social mission. I was inter)Tj 13.24596 0.00001 TD (ested in making a decent)Tj -13.24596 -1.4 TD (living, but also wanted the psychological r)Tj 17.31902 0.00001 TD -0.017 Tc 0.028 Tw [(ewar)18(ds of doing)]TJ -17.31902 -1.40001 TD -0.0168 Tc 0.0278 Tw (good work. Also, the health car)Tj 13.10463 -0.00001 TD (e world of the 1970s was a )Tj -13.10463 -1.39999 TD -0.017 Tc 0.028 Tw [(lot less challenging in terms of competition, r)17(egulation, and)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (payment. )Tj ET Q endstream endobj 18 0 obj << /Length 9287 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 0 0 1 k (6)Tj ET 0 0 0 0 k 36 76.504 540 643.496 re f BT /F13 1 Tf 10 0 0 10 37 711.4999 Tm 0 0 0 1 k -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 70.4042 711.4999 Tm 0.0278 Tw (Having been in and ar)Tj 9.13325 0.00001 TD (ound academics for 27 years, )Tj -12.47367 -1.4 TD -0.017 Tc 0.028 Tw [(in Chicago, Boston, and now in Pennsylvania with dif)17(fering)]TJ T* [(organizational str)-1(uctur)18(es and aspirations, I have not seen)]TJ T* [(health system leadership car)18(eer paths primarily driven by what)]TJ -0.0168 Tc 0.0278 Tw (people think they ar)' 8.28694 0.00001 TD (e going to make. I\325ve just never talked to)Tj -8.28694 -1.4 TD -0.017 Tc 0.028 Tw [(anybody who has gotten into a leadership position wher)17(e)]TJ T* [(compensation was the driving for)18(ce.)]TJ 0 -2.3 TD [(The complexity of the jobs has incr)18(eased dramatically as has)]TJ 0 -1.4 TD [(the expectation for formal training. Ther)17(e ar)18(e not many people)]TJ 0 -1.40001 TD [(like me, I think, who will lear)-18(n it on the str)18(eet in the futur)17(e.)]TJ 0 -1.4 TD [(Formal business training is now a pr)17(edicate and that is a good)]TJ -0.0168 Tc (thing.)' ET BT /F13 1 Tf 10 0 0 10 37 525.4999 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 88.3885 525.4999 Tm 0.028 Tw (Because of the complexity and enormous change)Tj -5.13885 -1.4 TD [(that we\325ve all seen over the last 30-plus years in health car)17(e,)]TJ T* [(the best of the best ar)18(e r)17(equir)18(ed in health car)18(e management.)]TJ T* [(W)-24(ith that have come changes in what that kind of leadership)]TJ T* (needs and deserves in the way of compensation.)Tj ET BT /F13 1 Tf 10 0 0 10 37 446.5 Tm 0 Tc (V)Tj 0.59538 0 TD -0.0168 Tc 0.0278 Tw (an Hor)Tj 3.11181 0 TD -0.017 Tc (n:)Tj ET BT /F1 1 Tf 10 0 0 10 85.5145 446.5 Tm -0.0168 Tc (While I can\325)Tj 4.83641 0 TD (t speak to the motivation issue, I)Tj -9.68786 -1.4 TD (would underscor)Tj 6.92705 0 TD -0.017 Tc 0.028 Tw [(e what Ken and Glenn have laid out her)18(e.)]TJ -6.92705 -1.4 TD [(Not only have the organizations become much mor)17(e complex,)]TJ T* (but I would argue that the value of managerial talent in those)Tj T* [(positions is much gr)18(eater today than it was 20 years ago. The)]TJ -0.0168 Tc 0.0278 Tw (need for keen decision-making ability to char)' 18.63551 0 TD (t the path of)Tj -18.63551 -1.4 TD -0.017 Tc 0.028 Tw [(these organizations is much gr)17(eater)92(, and it\325)111(s only logical fr)17(om)]TJ T* [(our perspective that gr)18(eater compensation flow fr)17(om that.)]TJ ET BT /F13 1 Tf 10 0 0 10 37 325.5 Tm -0.0168 Tc (Kibler:)Tj ET BT /F1 1 Tf 10 0 0 10 69.2836 325.5 Tm -0.0169 Tc (It\325)Tj 0.67165 0 TD -0.0168 Tc 0.0278 Tw (s impor)Tj 3.07706 0 TD (tant for boar)Tj 5.26407 0 TD (ds to compensate talent. T)Tj 10.89875 0 TD (en)Tj -23.13989 -1.40001 TD -0.017 Tc 0.028 Tw [(years ago our system\325)111(s compensation philosophy was loosely)]TJ 0 -1.4 TD [(structur)17(ed. The executive committee of the boar)18(d would hold)]TJ T* [(a meeting in December)92(, guess at the inflation rate for the next)]TJ T* [(year)92(, and give the CEO a commensurate raise. If the bottom)]TJ T* [(line was good, and things wer)18(e r)-1(unning smoothly)92(, we\325d also)]TJ 0 -1.40001 TD -0.022 Tc [(give a bonus. When we adopted a mor)18(e disciplined philosophy)91(,)]TJ 0 -1.4 TD [(we found that we wer)18(e actually underpaying our very talented)]TJ -0.0279 Tc 0.0278 Tw (CEO. If I wer)' 5.09172 0.00001 TD (e the pr)Tj 3.14844 0.00001 TD (ospective CEO of a nonpr)Tj 10.3148 0.00001 TD (ofit health system,)Tj -18.55496 -1.40002 TD -0.022 Tc 0.028 Tw [(I would want my boar)18(d to adopt a disciplined appr)17(oach to)]TJ 0 -1.4 TD 0 Tc (r)Tj 0.29271 0.00001 TD -0.0223 Tc 0.0278 Tw (ecognizing and r)Tj 6.79336 0.00001 TD -0.022 Tc 0.028 Tw [(ewar)18(ding talent.)]TJ ET BT /F13 1 Tf 10 0 0 10 37 162.5 Tm -0.0168 Tc 0.0278 Tw (Kathy Swar)Tj 5.30707 0.00001 TD (tz:)Tj ET BT /F1 1 Tf 10 0 0 10 104.1273 162.5 Tm -0.0171 Tc (Fr)Tj 0.72543 0.00001 TD -0.017 Tc 0.028 Tw [(om the Harvar)17(d School of Public Health)]TJ -7.43816 -1.40001 TD -0.0168 Tc 0.0278 Tw (perspective, in my Depar)Tj 10.18044 -0.00001 TD (tment of Health Policy and)Tj -10.18044 -1.39999 TD -0.017 Tc 0.028 Tw [(Management ther)18(e ar)17(e two tracks that the two-year students)]TJ 0 -1.4 TD (can pursue, and to a limited extent this is also true of the one-)Tj T* [(year M.P)153(.H. pr)17(ogram for physicians. The ones who ar)18(e)]TJ T* [(inter)18(ested in management attend the Har)-1(var)18(d Business School)]TJ 27.8 61.9 TD -0.0168 Tc 0.0278 Tw (for quite a number of their courses in their second year)Tj 22.74828 0.00001 TD (. They)Tj -22.74828 -1.4 TD -0.017 Tc 0.028 Tw [(come back shaking their heads, in part because they r)17(ealize)]TJ T* [(that the other students in the business school courses ar)17(e in)]TJ T* [(fact going to go out and ear)-18(n huge amounts of money)91(. Our)]TJ -0.0168 Tc 0.0278 Tw (students view themselves as people who will go do good for)' T* -0.017 Tc 0.028 Tw [(the world and ar)18(e highly unlikely to ear)-18(n huge amounts of)]TJ T* [(money)92(, unless they rise to the top and become CEOs of health)]TJ T* [(plans or hospitals. W)18(e also have cr)17(eated a mid-car)18(eer pr)18(ogram)]TJ T* (that is largely targeted at physicians in hospitals who want to)Tj T* [(take on management r)18(oles. I think they r)17(ecognize that the)]TJ T* [(business schools don\325)18(t always of)17(fer them the context that they)]TJ -0.0168 Tc 0.0278 Tw (need for accounting practices, management practices,)' T* -0.017 Tc 0.028 Tw [(whatever it is. So I agr)18(ee with what Br)-1(uce and Glenn wer)18(e)]TJ T* [(saying. W)18(e can look back 30 years ago to when we all wer)17(e in)]TJ T* [(school, and I still think it\325)111(s tr)-1(ue now)55(. )]TJ ET BT /F13 1 Tf 10 0 0 10 315 492.4999 Tm [(V)55(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 363.5145 492.4999 Tm [(I support some of Kathy\325)110(s comments based on our)]TJ -4.85145 -1.4 TD [(experience with University of Rochester\325)110(s Simon Graduate)]TJ -0.0168 Tc 0.0278 Tw (School of Business Health Car)' 12.27694 0 TD (e MBA pr)Tj 3.96049 0 TD (ogram. A fr)Tj 4.81549 0 TD (ustration of)Tj -21.05292 -1.40001 TD (mine over the last 10 years in pr)Tj 13.29041 0 TD (oducing managerial talent for)Tj -13.29041 -1.4 TD (healthcar)Tj 3.77521 0 TD -0.017 Tc 0.028 Tw [(e delivery settings is that typically the salary str)-1(uctur)18(es)]TJ -3.77521 -1.4 TD [(ther)18(e ar)17(e r)18(elatively flat until you get to the very top levels of)]TJ T* [(the organization. Salaries below the top ar)17(e not meeting the)]TJ 0 Tc (r)' 0.29826 0 TD -0.0168 Tc (equir)Tj 2.0653 0 TD -0.017 Tc [(ements or expectations of a lot of today\325)111(s talented MBA)]TJ -2.36356 -1.40001 TD [(students with health car)18(e experience and knowledge. So,)]TJ 0 -1.4 TD [(many of our students go into healthcar)18(e consulting for a)]TJ -0.0168 Tc 0.0278 Tw (number of years, establishing r)' 12.68572 0 TD (elationships with deliver)Tj 9.85913 0 TD 0 Tc (y)Tj -22.54485 -1.40001 TD -0.0168 Tc (systems and then transfer)Tj 10.60834 0 TD (ring into them.)Tj ET BT /F13 1 Tf 10 0 0 10 315 315.5 Tm (Acker)Tj 2.58312 0 TD (man:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 315.5 Tm 0 Tc (Y)Tj 0.50237 0 TD -0.017 Tc 0.028 Tw [(ou\325r)18(e absolutely right. Ther)17<65D5>111(s been a very)]TJ -5.64122 -1.4 TD -0.0168 Tc (inter)Tj 1.84216 0 TD -0.017 Tc [(esting transformation in graduate schools of health car)17(e)]TJ -1.84216 -1.40001 TD -0.0168 Tc 0.0278 Tw (management over the last 30 years. Thir)Tj 16.67991 0.00001 TD (ty years ago, when)Tj -16.67991 -1.4 TD -0.017 Tc 0.028 Tw [(Bruce and I wer)17(e in school, essentially 100% of our classmates)]TJ T* [(would go into the pr)18(ovider side at some entr)-1(y-level position in)]TJ T* [(hospital management. T)111(oday you\325ll find some pr)17(ograms wher)18(e)]TJ -0.0168 Tc 0.0278 Tw (50%, 60%, 70%, 100% of those students ar)' 18.95713 0.00001 TD (e going to)Tj -18.95713 -1.40001 TD -0.017 Tc 0.028 Tw (corporate America -- drug companies, consulting, and)Tj 0 -1.4 TD -0.0168 Tc (investor)Tj 3.14369 0.00001 TD 0.0278 Tw (-owned for)Tj 4.58368 0.00001 TD -0.017 Tc (-pr)Tj 1.15358 0.00001 TD 0.028 Tw (ofit organizations.)Tj ET BT /F13 1 Tf 10 0 0 10 315 180.5 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 348.4042 180.5 Tm 0.0278 Tw (I think ther)Tj 4.50316 0.00001 TD -0.017 Tc 0.028 Tw [(e ar)18(e ways that you can str)-1(uctur)18(e your)]TJ -7.84358 -1.40001 TD [(compensation pr)18(ogram and disseminate it down into the)]TJ 0 -1.4 TD [(organization to help that middle management compr)17(ession)]TJ T* (challenge that Larry is talking about. It has to do with our)Tj 0 -1.40001 TD [(overall strategic goal. W)18(e car)-1(ry our Mer)18(cer benchmarking and)]TJ 0 -1.4 TD [(incentive compensation down to our top 125 managers. It\325)110(s)]TJ -0.0168 Tc (par)' 1.33864 0.00001 TD 0.0278 Tw (t of our basic philosophy and expectation. W)Tj 18.55278 0.00001 TD (e actually)Tj -19.89142 -1.40002 TD -0.017 Tc 0.028 Tw (celebrate the exporting of potential new leaders out to other)Tj ET 1 w /CS0 CS 1 SCN 36 63 m 576 63 l S /GS0 gs Q endstream endobj 19 0 obj << /Length 9596 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q 1 w /CS0 CS 1 SCN 36 63 m 576 63 l S BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 0 0 1 k (7)Tj ET 0 0 0 0 k 37.5 76.4999 538.5 642.212 re f BT /F1 1 Tf 10 0 0 10 38.5 710.2123 Tm 0 0 0 1 k -0.017 Tc 0.028 Tw [(organizations. Par)-1(t of what I found r)18(emarkable about)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (Geisinger was how many ter)Tj 11.84259 0.00001 TD -0.017 Tc 0.028 Tw [(rific people came thr)18(ough her)17(e)]TJ -11.84259 -1.4 TD [(and then made leadership contributions elsewher)18(e. )]TJ ET BT /F12 1 Tf 10 0 0 10 38.5 659.2123 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 94.148 659.2123 Tm -0.017 Tc [(W)18(e\325ve just been talking about extending)]TJ -5.5648 -1.4 TD -0.0168 Tc 0.0278 Tw (executive compensation philosophy and practices down into)Tj T* -0.017 Tc 0.028 Tw [(the organization. What about inter)-18(nal equity? What happens)]TJ T* [(to morale when managers and employees at all levels per)17(ceive)]TJ 0 -1.40001 TD [(that executives\325 compensation is of)18(f the char)-1(ts compar)18(ed to)]TJ 0 -1.4 TD [(their own? And what about exter)-18(nal per)18(ceptions?)]TJ ET BT /F13 1 Tf 10 0 0 10 38.5 566.2123 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 71.9042 566.2123 Tm -0.017 Tc (Every year our local newspaper publishes all our)Tj -3.34042 -1.4 TD -0.0168 Tc 0.0278 Tw (doctor and top administrative leadership salaries. Whomever)Tj -0.0169 Tc (we r)' 1.83168 0.00001 TD -0.017 Tc 0.028 Tw [(ecruit we war)-18(n that someday when they\325r)17(e walking into)]TJ -1.83168 -1.4 TD [(the Giant food stor)18(e somebody is going to know exactly how)]TJ T* [(much they make. So we\325r)18(e basically functioning under the)]TJ T* [(assumption that if ther)18(e is anything that we don\325)17(t want to)]TJ -0.0168 Tc 0.0278 Tw (have published, we\325d better not do it. In addition, we str)' 23.40388 0 TD (ess)Tj -23.40388 -1.4 TD -0.017 Tc 0.028 Tw [(inter)-18(nally and exter)-18(nally that we ar)18(e competing in a national)]TJ T* [(market. W)18(e have to compete using national benchmarks or)]TJ T* [(clinical pr)18(ograms will deteriorate ver)-1(y quickly)92(. Y)92(ou\325ve got to )]TJ T* [(be sur)18(e that ever)-1(yone, both inter)-18(nal and exter)-18(nal audiences,)]TJ -0.0168 Tc 0.0278 Tw (understand how you benchmark and your for)' 18.92805 0 TD (mal pr)Tj 2.63109 0 TD (ocess.)Tj -21.55914 -1.40001 TD -0.017 Tc 0.028 Tw [(Ther)18(e ar)17(e still going to be people that try to demagogue it,)]TJ 0 -1.4 TD [(but I think as long as you know you\325r)18(e doing the right thing)]TJ -0.0168 Tc 0.0278 Tw (you\325ve got a better star)' 9.6528 0 TD (ting point for your stor)Tj 9.43137 0 TD 0 Tc (y)Tj 0.33537 0 TD (.)Tj ET BT /F13 1 Tf 10 0 0 10 38.5 347.2123 Tm (V)Tj 0.59538 0 TD -0.0168 Tc (an Hor)Tj 3.11181 0 TD -0.017 Tc (n:)Tj ET BT /F1 1 Tf 10 0 0 10 87.0145 347.2123 Tm -0.0169 Tc (It\325)Tj 0.67165 0 TD -0.0168 Tc (s dif)Tj 1.70393 0 TD -0.017 Tc 0.028 Tw [(ficult, whether you ar)18(e in a community of)]TJ -7.22703 -1.40001 TD [(5,000 or over one million, as in Rochester)91(, Syracuse, or)]TJ 0 -1.4 TD [(Buf)18(falo. Ever)-1(y spring the papers come out publishing salaries)]TJ T* [(and raising this issue. Our friends in the nonpr)17(ofit insurance)]TJ -0.0168 Tc (sector)' 2.36234 0.00001 TD -0.017 Tc [(, because of New Y)92(ork State filings, need to make public)]TJ -2.36234 -1.40001 TD [(the compensation of anyone in the organization making mor)17(e)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (than $100,000. So it goes ver)Tj 12.32401 0.00001 TD (y deep. I also think that ther)Tj 11.64713 0.00001 TD -0.0169 Tc (e )Tj -23.97114 -1.40002 TD -0.017 Tc 0.028 Tw [(is a longstanding tension between medical staf)18(f and)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (administration, with the medical community not fully)Tj (appr)' 1.86005 0.00001 TD (eciating the value that managerial talent brings to the)Tj -1.86005 -1.40001 TD -0.017 Tc 0.028 Tw [(table. Many physicians don\325)18(t seem to understand why)]TJ 0 -1.4 TD [(executives of thir)18(d-par)-1(ty payers or executives who ar)18(e leading)]TJ T* [(large medical facilities should be paid the sums they r)17(eceive,)]TJ T* [(compar)18(ed to their own. That tension is going to exist.)]TJ ET BT /F13 1 Tf 10 0 0 10 38.5 142.2122 Tm -0.0168 Tc (Kibler:)Tj ET BT /F1 1 Tf 10 0 0 10 70.7836 142.2122 Tm -0.017 Tc [(W)18(e operate in a smaller community and we\325r)17(e the)]TJ -3.22836 -1.4 TD -0.0168 Tc (lar)Tj 1.00466 0.00001 TD 0.0278 Tw (gest employer in that community)Tj 13.60931 0.00001 TD -0.0169 Tc (. W)Tj 1.45944 0.00001 TD -0.0168 Tc (e employ about 4,000)Tj -16.0734 -1.4 TD -0.017 Tc 0.028 Tw [(people. Our community\325)111(s financial health depends upon the)]TJ -0.0168 Tc 0.0278 Tw (viability of our healthcar)' 9.90587 0.00001 TD (e system, so the community should)Tj -9.9059 -1.4 TD (expect qualified, well-paid leaders of its health system. I think)Tj 27.725 62.40001 TD -0.017 Tc 0.028 Tw [(the medical staf)18(f pr)17(obably feels the same way)92(. They want to)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (work in a well-managed facility)Tj 12.83197 0.00001 TD -0.017 Tc 0.028 Tw [(. It r)18(eally is a community)]TJ -12.83197 -1.4 TD -0.0168 Tc 0.0278 Tw (benefit to have good leaders in place, and good leaders)Tj (should be compensated fairly)' 12.02364 0.00001 TD 0 Tc (.)Tj ET BT /F13 1 Tf 10 0 0 10 315.75 645.2123 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 349.1542 645.2123 Tm -0.017 Tc 0.028 Tw [(Bill and his other dir)18(ectors ar)17(e making the case in )]TJ -3.34042 -1.4 TD [(their community that their medical center r)17(epr)18(esents a major)]TJ T* [(engine of economic gr)18(owth in addition to car)17(e-giving. But all)]TJ 0 -1.40001 TD [(it takes is one egr)18(egious situation, and all of us ar)17(e behind the)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (eight ball for a while, like the public allegations of executive)Tj (compensation excesses in the attempted conversion of)' T* -0.017 Tc 0.028 Tw [(Car)18(eFirst \(a nonpr)17(ofit health insur)18(er in Maryland\) to for)54(-pr)18(ofit)]TJ -0.0168 Tc (status.)' ET BT /F13 1 Tf 10 0 0 10 315.75 524.2123 Tm -0.017 Tc [(V)55(an Hor)-18(n:)]TJ ET BT /F1 1 Tf 10 0 0 10 364.2645 524.2123 Tm [(W)18(e want valuable managerial talent, and if the)]TJ -4.85145 -1.4 TD -0.0168 Tc 0.0278 Tw (CEO of a $4 billion company that drives employment in the)Tj 0 -1.39999 TD -0.017 Tc 0.028 Tw [(community is making a million dollars, I\325d pr)17(obably want to)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (pay him mor)Tj 5.24176 0 TD (e. He af)Tj 3.23759 0 TD (fects livelihoods and drives a lot of the)Tj -8.47935 -1.40001 TD -0.017 Tc 0.028 Tw [(economic engine in the community)92(.)]TJ ET BT /F13 1 Tf 10 0 0 10 315.75 445.2123 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 367.1385 445.2123 Tm 0.028 Tw [(Because healthcar)18(e enterprises ar)17(e often the)]TJ -5.13885 -1.4 TD [(major employer in many of our communities acr)17(oss the)]TJ T* [(country)91(, they\325r)18(e big targets. This r)18(equir)17(es ongoing education. )]TJ -0.0168 Tc 0.0278 Tw (It isn\325)' 2.17033 0 TD -0.017 Tc 0.028 Tw [(t a story or message you can tell once. It\325)110(s something I)]TJ -2.17033 -1.40001 TD [(think the boar)18(ds, compensation committees and leadership)]TJ 0 -1.4 TD [(need to be pr)18(oactive about. They need to think about the)]TJ -0.0168 Tc 0.0278 Tw (message that they want to get out and how they want to get)' (it out. People need to understand the pr)' 16.6771 0 TD (ocess: it involves a)Tj -16.6771 -1.4 TD -0.017 Tc 0.028 Tw [(compensation committee made up of independent dir)17(ectors)]TJ T* [(and not involving management; the boar)18(d seeks exper)-1(t advice)]TJ T* [(and data so that it can make wise decisions to r)17(ecruit and)]TJ 0 Tc (r)' 0.29826 0.00001 TD -0.017 Tc [(etain the best; and ther)18(e ar)17(e complicating factors that must)]TJ -0.29826 -1.40001 TD [(be consider)18(ed. These include management challenges, scope)]TJ 0 -1.4 TD -0.0169 Tc 0.0278 Tw (of r)Tj 1.44252 0.00001 TD -0.0168 Tc (esponsibilities, size and complexity of the or)Tj 18.06244 0.00001 TD (ganization, )Tj -19.50496 -1.40002 TD -0.017 Tc 0.028 Tw [(and the competitive marketplace they\325r)18(e in and fr)17(om which)]TJ 0 -1.4 TD [(executives have to be r)18(ecr)-1(uited. )]TJ ET BT /F13 1 Tf 10 0 0 10 315.75 212.2123 Tm -0.0168 Tc (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 349.1542 212.2123 Tm (Ther)Tj 1.80414 0.00001 TD -0.0169 Tc <65D5>Tj 0.63364 0.00001 TD -0.0168 Tc 0.0278 Tw (s one other helpful appr)Tj 9.97141 0.00001 TD -0.017 Tc 0.028 Tw [(oach. W)18(e r)17(ecruit a lot )]TJ -15.74961 -1.40002 TD [(of executives fr)18(om outside our r)17(egion. And, it is our explicit)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (expectation that they spend a significant amount of time)Tj T* -0.017 Tc 0.028 Tw [(working in the community)92(. My suspicion is that over time )]TJ 0 -1.40001 TD [(this will help br)18(eak down a lot of the natural polarization.)]TJ ET BT /F13 1 Tf 10 0 0 10 315.75 133.2122 Tm 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 367.1385 133.2122 Tm 0.028 Tw [(My bias is that ther)18(e has to be mor)17(e education of)]TJ -5.13885 -1.4 TD -0.0168 Tc (boar)Tj 1.86005 0.00001 TD 0.0278 Tw (ds on gr)Tj 3.40532 0.00001 TD (eater transpar)Tj 5.71887 0.00001 TD (ency over CEO and senior executive)Tj -10.98424 -1.40002 TD -0.017 Tc 0.028 Tw [(compensation. It\325)111(s amazing that a cloister)17(ed gr)18(oup of dir)18(ectors)]TJ 0 -1.4 TD -0.0168 Tc 0.0278 Tw (might still be appr)Tj 7.46938 0.00001 TD (oving compensation packages for senior)Tj ET Q endstream endobj 20 0 obj << /Length 4741 >> stream /GS0 gs 1 g 0 792 0 0 re f /GS2 gs q 1 w /CS0 CS 1 SCN 36 63 m 576 63 l S BT /F0 1 Tf 8 0 0 8 31.5527 21 Tm 0 0 0 1 k (8)Tj ET BT /F1 1 Tf 10 0 0 10 36 712.5 Tm -0.017 Tc 0.028 Tw [(executives with the r)18(est of the boar)17(d not knowing anything)]TJ 0 -1.4 TD [(about it. In this day and age, with 990s \(annual IRS r)17(eports for)]TJ T* [(nonpr)18(ofit or)-1(ganizations\) and easy public access, with the)]TJ -0.0168 Tc (aggr)' 1.86005 0.00001 TD -0.017 Tc [(essive state attor)-18(neys general and aggr)18(essive media in)]TJ -1.86005 -1.4 TD [(some communities, it is amazing that ther)18(e ar)17(e still nonpr)18(ofit)]TJ -0.0168 Tc 0.0278 Tw (health car)' 4.06415 0.00001 TD -0.017 Tc 0.028 Tw (e organizations not making it a practice to annually)Tj -4.06415 -1.4 TD [(r)18(eport senior executive compensation. That\325)110(s a time bomb just)]TJ T* [(waiting to go of)18(f. )]TJ ET BT /F12 1 Tf 10 0 0 10 36 591.4999 Tm -0.0168 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 91.648 591.4999 Tm -0.017 Tc [(How pr)18(evalent is it for compensation committees)]TJ -5.5648 -1.4 TD (to be engaged in performance assessments and compensation)Tj -0.0168 Tc 0.0278 Tw (for executives other than the CEO?)' ET BT /F13 1 Tf 10 0 0 10 36 540.4999 Tm (Steele:)Tj ET BT /F1 1 Tf 10 0 0 10 69.4042 540.4999 Tm -0.017 Tc 0.028 Tw [(W)18(e do that as par)-1(t of our practice. In fact, we have a)]TJ -3.34042 -1.4 TD [(boar)18(d r)-1(ule that if ther)18<65D5>111(s mor)17(e than a certain per)18(centage)]TJ T* [(change in anyone\325)111(s compensation, even within our associate)]TJ T* [(gr)17(oup, which is what we call our doctors, advance appr)18(oval by)]TJ T* [(the boar)18(d is r)17(equir)18(ed.)]TJ ET BT /F13 1 Tf 10 0 0 10 36 461.5 Tm -0.0168 Tc (Acker)Tj 2.58312 0 TD (man:)Tj ET BT /F1 1 Tf 10 0 0 10 87.3885 461.5 Tm 0.0278 Tw (What Glenn is describing is best practice. The old)Tj -5.13885 -1.4 TD -0.017 Tc 0.028 Tw [(way was, \322 Mr)92(. or Ms. CEO, we\325ll r)17(eview your performance)]TJ T* [(and compensation. Y)92(ou make all the decisions r)17(elative to your)]TJ -0.0168 Tc 0.0278 Tw (executive team, and we don\325)' 11.97509 0 TD -0.0169 Tc (t car)Tj 1.81378 0 TD -0.0168 Tc (e if we ever see the data.\323)Tj -13.78887 -1.40001 TD (That\325)Tj 1.97228 0 TD -0.017 Tc 0.028 Tw [(s history)91(. That\325)111(s not the way to do it today)92(.)]TJ ET BT /F13 1 Tf 10 0 0 10 36 382.5 Tm -0.0168 Tc (Kibler:)Tj ET BT /F1 1 Tf 10 0 0 10 68.2836 382.5 Tm 0 Tc (W)Tj 0.90935 0 TD -0.0168 Tc 0.0278 Tw (e apply the same general compensation philosophy)Tj -4.13771 -1.4 TD -0.017 Tc 0.028 Tw [(to the senior VPs that we apply to the CEO. They\325r)17(e all)]TJ -0.0168 Tc 0.0278 Tw (working on the same goals.)' ET BT /F12 1 Tf 10 0 0 10 36 331.5 Tm -0.0279 Tc (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 90.4256 331.5 Tm -0.028 Tc (In r)Tj 1.28723 0 TD 0.028 Tw [(ecruiting and r)17(etaining executives for non-pr)18(ofit)]TJ -6.72979 -1.4 TD -0.017 Tc [(health car)18(e or)-1(ganizations, is it curr)18(ently a seller\325)111(s or buyer)-1111(s)]TJ -0.0168 Tc 0.0278 Tw (market, and how is that impacting compensation levels?)' ET BT /F13 1 Tf 10 0 0 10 36 280.4999 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 87.3885 280.4999 Tm 0.028 Tw [(The short answer is that it is r)17(esoundingly a seller\325)111(s)]TJ -5.13885 -1.4 TD [(market, especially for larger)91(, mor)18(e complex organizations)]TJ -0.0168 Tc (wher)' 2.08198 0.00001 TD 0.0278 Tw (e ther)Tj 2.40917 0.00001 TD -0.017 Tc 0.028 Tw [(e is a lot of competition ar)18(ound a r)17(elatively small)]TJ -4.49115 -1.40002 TD (cohort of talent. Also, when you take into consideration)Tj 0 -1.4 TD [(executive tur)-18(nover in healthcar)18(e enterprises, which has been)]TJ T* [(running somewher)18(e between 14% to 19% for the last several)]TJ 27.9 50.2 TD [(years, we find organizations paying somewher)17(e between 15%)]TJ 0 -1.4 TD [(to 20% above the median of the market to r)18(eplace their CEOs)]TJ T* [(fr)17(om the outside. The average tenur)18(e for a CEO of a health)]TJ -0.0169 Tc (car)' 1.20876 0.00001 TD -0.0168 Tc 0.0278 Tw (e enterprise is only about four years.)Tj ET BT /F12 1 Tf 10 0 0 10 315 647.5 Tm (McPherson:)Tj ET BT /F1 1 Tf 10 0 0 10 370.648 647.5 Tm -0.017 Tc 0.028 Tw [(So, by implication, the way to get ar)18(ound this is)]TJ -5.5648 -1.4 TD -0.0168 Tc 0.0278 Tw (good succession planning?)Tj ET BT /F13 1 Tf 10 0 0 10 315 610.4999 Tm -0.017 Tc 0 Tw (Ackerman:)Tj ET BT /F1 1 Tf 10 0 0 10 366.3885 610.4999 Tm 0.028 Tw [(Y)92(ou\325r)17(e absolutely right. 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