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Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

arstechnica.com

61–70 of 149 posts

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#61
The purpose of non profits is to handle all the cost centers. Everything that is expensive is billed under the non profit. Then they have exclusive deals with their other for profit entities in all high margin areas.

Thus the whole non profit becomes a loss lead for other services to be pushed and offered. Its a good thing for them their cost center is not taxed.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#62

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

This all may be true, but it doesn't change the fact that I have no interest in donating my money to an organization that is going to give a sizable chunk of it to some rich CEO rather than the people that I'm trying to donate to.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#64

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

Wasn't there analysis that company performance is inversely correlated to CEO compensation?

I remember seeing a chart, though I don't remember whether the analysis was well done & researched or not

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#65

The article is a bit misleading in that it uses revenue. Typical margins in a health-system is slim. 3-6%. So, actual 1-2% charity care of revenue is quite significant. The thesis is correct that a health-system CEO shouldn’t make $17m/yr. It’s a non-profit largely funded by tax payers and maintains its market share by government regulations. Just the charity care component is a bit misleading.

Disclaimer at the start: I'm asking this because I want to understand more about the situation that you are presenting, not as an indirect way to "um actually" you. How would margins be defining in this case? When I hear that the margins at gas at a gas station are x%, I understand that they are basically talking about how much I pay per gallon minus how much the gas station paid per gallon. However, it feels like de…

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Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#66

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

Frankly, I think this sort of thinking is wrong almost all of the time. I understand why hiring boards feel they have no choice, but the reality is, outside of maybe 15 people from the past century, there are no clear number ones and number twos. Talent ranking just isn't that accurate. Pro sports has exactly the same problem. If you happen to actually get a LeBron James or Shohei Ohtani, then yeah, they absolutely deserve probably 50 times what they'll ever actually get paid. They're worth more than the rest of the team combined.

But if you don't have them, you're locking yourself into a supermax contract for Russell Westbrook or John Wall and scuttled your franchises hopes of winning for at least the next decade until you get the balls to suck it up and blow up the entire organization and admit you were wrong.

A tiny number of elite individuals are legitimately worth all the damn money in the world, but they're nearly impossible to identify in advance. But that promise sucks in the money men to pay these ridiculous salaries out of sheer hope that maybe they'll strike gold even though they almost never do. Hell, it's even worse in business because someone can just get lucky for a really long time. Market conditions you didn't even see coming might nonetheless make you look like a genius just for making a correct guess. At least in sports the winners are actually the best at what they do.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#67

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

> Shaming organizations into lowering exec comp probably won’t work: there’s a strong economic incentive to pay competitively.

Well I think you're right on the first half but I don't think you're correct on the second half.

Paying a CEO 5M vs 17M is a rounding error to a double-digit billion dollar company. Its like getting something on Amazon instead of Alibaba, sure Amazon is 3x the price but you obviously find the item cheap enough otherwise you'd be on Alibaba. Or perhaps you want the item now and don't want to spend months searching for a new CEO.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#68

The article is a bit misleading in that it uses revenue. Typical margins in a health-system is slim. 3-6%. So, actual 1-2% charity care of revenue is quite significant. The thesis is correct that a health-system CEO shouldn’t make $17m/yr. It’s a non-profit largely funded by tax payers and maintains its market share by government regulations. Just the charity care component is a bit misleading.

Disclaimer at the start: I'm asking this because I want to understand more about the situation that you are presenting, not as an indirect way to "um actually" you. How would margins be defining in this case? When I hear that the margins at gas at a gas station are x%, I understand that they are basically talking about how much I pay per gallon minus how much the gas station paid per gallon. However, it feels like de…

Here are 2 relevant scenarios.

A homeless alcoholic withdraws and gets seizures, spending a week in the ICU. He is not on Medicaid, but qualifies. After paying for all his care and applying for Medicaid on his behalf. The hospital might get 50 cents back for every dollar they spent. (They spent on doctors; nurses, medications; EMR bill, case management, etc.).

This guy will essentially come back 5-6 times per year. With negative margins every time because that’s how Medicaid is designed.

2nd scenario is a 70 year old with a knee replacement surgery and great insurance Medicare + supplemental. He spend a day and half in the hospital and the money that his insurance paid, would be ~130-150% cost of care.

Average everything out; and you end up with 3-6% margins.

Obviously, salaries are big part of the cost. So, perhaps the margins will be better if the CEO is paid less. But, overall its a low-margin business because the biggest payers are Medicaid and Medicare and they more or less pay whatever they want via legislative means.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#69

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

We shouldn't have unelected individuals making choices that have such a high impact on society in the first place. You've detailed the mechanisms behind their high pay, but that is far from justifying it.

Re: Nonprofit hospitals skimp on charity while CEOs reap millions, report finds

#70

CEO salaries should be understood in relationship to the resources that they control. For example, this CEO chose to spend $85M on travel nurses to counter the union strike happening at a hospital in their network. Presumably the CEO thinks that this gamble is worth it in forcing the union’s hand. That may be a terrible decision, but it shows the extent of resources a CEO of a $6bn organization commands. This is one…

I’m glad you used the travel nurse example because it shows why the comp is so high:

The board has to guarantee above all else that the CEO is aligned to serving the board and shareholders above all others ESPECIALLY their employees

So every CEO is just stating what their soul is worth.

I mean I guess it’s good that it’s so high because psychopaths that can perform at that level without fucking over their masters or being unpredictable are rare.

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