Providers are people too…

I have an FQHC client, a pretty well run organization, who had a Family Nurse Practitioner that would only see twelve patients in an eight hour day.  She claimed that she felt she could not possibly provide quality medical care seeing more than twelve patients a day.  Management felt she was, well, to be frank, […]

What is Internal Equity, and Why Do You Need it?

The missing element in most FQHC compensation programs is the most important one — the system that ensures that equity exists in the compensation opportunities offered to people in the various jobs in the organization.  Its great to be competitive, but employees are in contact with other employees far more than they are with the […]

Questionable Logic Taints Compensation Literature

Like any other field of study, the conclusions drawn by authors suggesting courses of action to be taken by their readers require that the underlying facts and logic be sound.  It is clear from reading a number of recent articles that the authors either do not completely grasp underlying compensation theory, or that they have […]

Compensation Waste 101 – End Unlimited Paid Time Off Accrual

In the black expanse of waste that organizations pour into ineffective compensation spending is a bright shining star — payments, typically to departing employees, for unused paid time off.  This isn’t just a waste of money when it is paid, but some accountants are now telling their clients that they may need to be accruing […]

ElementOne to Sponsor 2013 NACHC National Farmworker Health Conference

ElementOne, Inc. will be a Sponsor of the 2013 National Association of Community Health Center’s (NACHC) National Farmworker Health Conferernce to be held in San Diego California May 8-10.  In addition to providing financial support for the conference, ElementOne will have an exhibit in the display area to provide participants with additional information about the […]

Your employment budget is too precious to waste on the wrong people

As every one of my clients has heard at one time or another, I plan on writing a book some day, and it’s going to have a chapter entitled “management spends 95% of its time on the 5% of its employees that provide the least value.”   I will certainly need a more pithy chapter […]

What Exactly is Fully Functioning?

If we eliminate the word “expectations” from performance management terminology (see my last post), about 95% of the organizations in the United States are going to have to re-write their performance appraisal forms.  It is fair to ask what is going to replace that word, and my response is that we have to replace a […]

EEOC Targeting Gender Pay Equity

According to multiple sources, the Equal Employment Opportunity Commission, in concert with other agencies, is launching an aggressive campaign to identify and prosecute cases of gender-based pay inequities.  While concern about equal pay for equal work is an old one, reaching back as far as the Equal Pay Act of 1963, it has recently resurfaced […]

How do we take the economy into account… again?

Nearly ever week I get asked the question “how should we take the economy into account when evaluating our pay structure?”  The fact that this question was actually asked means that there is a fundamental lack of understanding about the way pay structures are designed, assuming of course that the structure in question was designed […]

IRS Form 990 — common sense says an FQHC should disclose more rather than less

When it comes to compensation, especially executive compensation, a frightening number of Federally Qualified Health Centers (FQHC) are about a hundred feet up on a tight-rope, without a net, and not wearing any underwear.  It really doesn’t matter now whether the executives at Manatee County (FL) Rural Health are actually paid reasonably or competitively, because […]

Compensation Waste 101 – When Raising Your Minimum Wage Will Lower Your Costs

Increasing the minimum wage does not improve the skills and contributions of those who currently earn the minimum wage – but increasing an organization’s minimum wage may be essential to achieving needed levels of productivity and performance.   Organizations of all types need to understand, from a business perspective, why being cheap is rarely the right […]

How do we take the economy into account…. again?

Twice in that last week I was asked the question “how should we take the economy into account when evaluating our pay structure?”  The fact that this question was actually asked means that there is a fundamental lack of understanding about the way pay structures are designed, assuming of course that the structure in question […]

Compensation Literature with Questionable Logic

Like any other field of study, the conclusions drawn by authors suggesting courses of action to be taken by their readers require that the underlying facts and logic be sound.  It is clear from reading a number of recent articles that the authors either do not completely grasp underlying compensation theory, or that they have […]

A Quick Guide for NonProfit Directors – How to Read Your Form 990.

The IRS Form 990 is the tax return filed by not-for-profit organizations, and also a significant document for the disclosure of information concerning the policies and practices of the organization.  Far too often, non-profit Boards do not take the opportunity to review this document — not surprising, as it can get to be a very […]

Job descriptions as performance appraisal forms… the ideal solution

Performance appraisal may well be the most despised management process around, and often for very good reasons.  Most performance appraisal forms are only marginally relevant to an employee’s job, and the results of the process itself yield very little – perhaps a token difference in a raise for a “higher performer” over a “lower performer;” […]

Compensation Waste 101 – Premium Pay for Covering Vacations

In this series of posts, I’ll identify practices in migrant/community health centers that may be a waste of precious employee compensation resources.  Today I’ll cover a policy I ran into recently while talking to one of my clients, one that I hope will soon be a “former policy” for them — the practice of paying […]

Compensation Waste 101 – Extra Pay for Covering Vacations

In this series of posts, I’ll identify practices in organizations that may be a waste of precious employee compensation resources.  Today I’ll cover a policy I ran into recently while talking to one of my clients, one that I hope will soon be a “former policy” for them — the practice of paying employees extra […]

Think Carefully about “Total Compensation” Pay Ranges

I’m not nearly as big of a fan of fruit as I should be, but it is my tendency to always want to compare apples to apples (which is my favorite fruit, by the way).  That makes me very leery of base pay ranges based on “total cash compensation” and my suggestion is that you […]

Compensation in the Family Owned Business

Family-owned businesses provide unique management challenges in a number of ways, not the least of which is the compensation paid to family members.  In this post, I will briefly examine some of the challenges and suggest some relatively simple solutions to what often seem to be insurmountable problems.  Up front it should be noted that […]

2012 FQHC Compensation Resolutions

We shouldn’t need January 1st as an excuse to work on improving compensation programs, and honestly, any change that was supposed to go into effect on January 1st should have been finalized months ago. Effective management of a Federally Qualified Health Center requires consistent monitoring of its largest expense — employee compensation.  Instead of dwelling […]

We are now ElementOne

Our journey to ElementOne Every organization need to evolve in order to thrive, and we’re excited to read you in on our journey of evolution to ElementOne. For thirty years as Merces Consulting, the effectiveness of your workforce has been our business, helping our clients ensure that they have “the right people, in the right […]

The Fascination with Compensation Tools

Last week I had the opportunity to spend several days with a new client working through a job evaluation exercise.  What makes this client somewhat unique is that the CEO is their former VP of Human Resources, which certainly makes explaining compensation principles a lot easier.  What struck me, however, was that this CEO, despite […]

Welcome Kelsey Hogan

Kelsey Hogan has joined the professional staff at ElementOne, Inc. as a Compensation and Organization Specialist. She also functions as the firm’s Marketing Specialist, responsible for managing the firm’s social media programs, as well as marketing, communications and advertising campaigns. Kelsey has been working with ElementOne for three years in various part-time administrative support and […]

Welcome Back Linda Budd!

Linda Budd has returned to the staff at ElementOne, Inc. after leaving 15 years ago to focus on family life. She maintained her skills during this time by dabbling in free-lance consulting work out of her home office in Rochester Hills, Michigan. Linda is a woman of all trades. She is a professional worker, mother, […]

Help for the FQHC Board in Managing CEO Compensation — Bring on the B.A.M.

The typical Federally Qualified Health Center (FQHC) Board of Directors has only one employee to manage – its Chief Executive Officer.  Many not-for-profit Directors have little to no experience in managing executive pay and performance.  In FQHCs, where more than half of the Directors must be service users, many Board members may have no business […]

Compensation Waste 101 – Why Raising Your Minimum Wage Will Lower Your Costs

Increasing the minimum wage doesn’t improve the skills and contributions of those who currently earn the minimum wage – but increasing an organization’s minimum wage may be essential to achieving needed levels of productivity and performance.   Federally Qualified Health Centers (FQHCs) need to understand, from a business perspective, why being cheap is rarely the right […]

The Ideal Performance Appraisal Form, and How to Make it Relevant

Performance appraisal may well be the most despised management process around, and often for very good reasons.  Most performance appraisal forms are only marginally relevant to an employee’s job, and the results of the process itself yield very little – perhaps a token difference in a raise for a “higher performer” over a “lower performer;” […]

Physician Compensation in the FQHC Environment May Yet Be Competitive

One of the most widely held beliefs in the FQHC community is that provider compensation, particularly physician compensation, lags the general market, making it extremely difficult to attract and retain competent staff.  There are also occasional rumblings that productivity expectations, often at the typical “standard” of about 4,200 encounters per year, may be unrealistic.  These […]

You Have Total Compensation Ranges at your FQHC. You Know That, Right?

This is a cautionary tale, as well as an informative one.  I was asked to take a look at the compensation program of a Federally Qualified Health Center (FQHC), and read the report of the consultant who generated it, which of course I agreed to do (who doesn’t want to see what the competition does, […]

Get Ready to Respond to Media Inquiries About CEO Compensation

Most health centers don’t have a public relations staff, an official spokesperson trained in the arts of media relations, or a lot of experience responding to calls made after the clinic is closed a few hours before the midnight publication deadline.  With an increase in media reports concerning compensation and the financial activities of FQHCs, […]

External Challenges Call for More than Just Casual Internal Reflection

Last week I attended the NACHC Farmworker Conference in Denver, met with clients and colleagues and listened to a number of speakers.  Most of the speakers addressed the external challenges facing FQHCs — cuts in grants, concerns about Medicare and Medicaid reimbursements, fewer opportunities for expanding services, the need for expanding advocacy — or the history […]

Make Your Form 990 Work For You

One of my FQHC colleagues described the Form 990 as the ultimate public relations piece.  After all, it contains a ton of information, including a lot that can make you look bad, or at least appear to look bad.  Given that, in a vacuum, people tend to see what they want to see, why not […]

Provider Compensation in a Highly Effective FQHC — Part of a Series

I’ve spent more time dealing with provider compensation in the last three years than I did in my first seventeen years working with FQHCs.  There is much more interest now in provider compensation, and there are many people out there advocating for one or another “best practice” approach.  Our FQHC clients take very different approaches […]

My Pay is in the WHAT?

We don’t have a “mailbag,” but I do watch the search terms that lead people to this blog.  Last week, I saw one that looked like this: “should we warn people their pay is in the 990.” That got me thinking that beyond the obvious YES!!! it might be worth explaining what it all means […]

FQHC CEO Compensation Governance Study Raises Concerns

Fewer than 10% of Federally Qualified Health Centers (FQHCs) nationwide follow best practice Chief Executive Officer (CEO) compensation governance processes, less than a quarter have an appropriate decision-making process in place for determining CEO compensation from year to year, and nearly 40% make decisions on CEO compensation without using competitive labor market information.  Almost of […]

Closing the Gap on FQHC Provider Compensation

We hear all the time about the struggles that not-for-profit health centers have in recruiting providers, and time and time again, it seems that the primary cause is alleged to be compensation.  After twenty years of working with FQHCs, we’ve found that while offering less than the competition doesn’t help matters, there are dozens of […]

EEOC Targeting Gender Pay Equity Concerns

According to multiple sources, the Equal Employment Opportunity Commission, in concert with other agencies, is launching an aggressive campaign to identify and prosecute cases of gender-based pay inequities.  While concern about equal pay for equal work is an old one, reaching back as far as the Equal Pay Act of 1963, it has recently resurfaced […]

CEO Performance Evaluation is Not Rocket Science

I shouldn’t be giving this away for free, but I hope that readers see the simplicity of this, and stop wasting time, effort and money on this topic, and move on to more complex things that are more worth time, effort and money.  Here is the secret to the optimal CEO performance evaluation system:   […]

Communicating Your Compensation Programs is Essential

I’m frequently asked “what should we communicate about our compensation plan?” and I always start with the premise that “if you don’t communicate it, it doesn’t exist.”  That’s a corollary to the old rule that says “if you don’t write it down, it didn’t happen.” or the more modern “no pic, didn’t happen.”  The bottom […]

Quickly Ban any Bans on Talking About Salaries

A lot of “compensation tips” arrive in my inbox, from a lot of well-meaning folks, some of whom you probably consider to be “experts.”  One of today’s includes a tip cautioning employers about their rules banning talk about salaries.  Basically, they call telling employees not to talk about pay a waste of time, because with […]

Bad Compensation Data Leads to Bad Decisions

There are competing problems in compensation management to deal with, competing mostly to be the factor that creates the most bad decisions — a misguided direction toward over-reliance on labor market data, and what can best be called a veritable cornucopia of sources of “bad data.”  While the advent of internet data collection and reporting […]

FQHC Employee Costs Continue to Rise

Employee Costs Continue to Rise in Federally Qualified Health Centers The cost of FQHC employees continues to grow as a percentage of total expenses, according to the results of our recent study of tax filings of more than 1100 FQHCs nationwide.  Median total salaries and benefits as a percent of total expenses rose by 1.8% […]

Job Evaluation is Hardly “Esoteric”

Just saw an update from a compensation survey service I subscribe to that said “it is no accident that job evaluation, skill-based pay valuations, job analyses, and other esoteric approaches have waned in the last decades, only to be replaced with competitive pricing focused on salary surveys,”  and further goes on to assert that years […]

Higher Pay Doesn’t Mean Provider Incentives Work

There seems to be a belief that if a provider incentive plan results in more productive providers earning more, the incentive plan works.  Not quite sure that makes sense.  The key here is the use of the word “incentive.”  To measure the success of an “incentive” plan, we need to know what the motivation was […]

Physician Incentives in Michigan FQHCs 2013

There are some people running around talking up productivity incentives for providers — in fact, they are telling you that you “have” to have them in order to attract and retain physicians, and that “everyone has one.”  Before you listen too carefully to what they have to say, ask yourself if they have a stake […]

The Joy of Having a Compensation Committee

Just got off the phone with the CEO of a long-time client; we were talking about the implementation of a “best practice” governance program to help guide the FQHC’s Board toward making credible decisions on CEO compensation.  While everything that’s part of a best practice program is essential and valuable in its own right, we […]

FQHC Medical and Dental Director Compensation

Today we know a little more about provider compensation in the Federally Qualified Health Center world — at least a little more than what we knew yesterday about the compensation of Medical Directors and Dental Directors.  ElementOne’s analysis of the Form 990 filings of more than 1,100 FQHCs paints a picture that shouldn’t really surprise […]

Is There a “Self-Selection” Effect in FQHC Executive Compensation Surveys?

Many of our clients and colleagues have expressed a concern that surveys of FQHC executive compensation, including those conducted by the National Association of Community Health Centers, State and Regional Primary Care Associations (“industry surveys”), and even those conducted by ElementOne, are subject to a “self-selection” effect — that is, only certain types of people […]

FQHC Compensation Resolutions for 2014

Now that the holidays have passed, and with the Super Bowl a couple weeks away, it is time to think about what your health center will want to accomplish in the area of employee compensation in 2014. Get your CEO Compensation Governance Program Squared Away Most health centers do not have a CEO compensation governance […]

Contemporaneous Documentation for the FQHC Board

It should go without saying, but after several recent conversations with clients, I’ll say it again — it doesn’t matter how well you’ve followed your “best practice” processes, gathered your competitive data, and made your executive compensation decisions correctly, if you haven’t documented them. There are three elements to establishing the “rebuttable presumption of reasonableness” […]

Tools Don’t Substitute for a Compensation Program

Not too long ago I had the opportunity to spend several days with a health center working through a job evaluation exercise.  What makes this client somewhat unique is that the CEO has a human resources background, which certainly makes explaining compensation principles a lot easier.  What struck me, however, was that this CEO, despite […]

Market Pricing is NOT Job Evaluation

Important Validations of Best Practice Approaches to Compensation

We are advocates of “best practice” compensation programs, and I have written extensively here on the methods and techniques that we feel are essential to proper compensation management.  We are adamant about doing things the right way — doing what is best for the organization, and what is best for its employees.  It may sometimes […]

Eliminate “Expectations” and Improve Performance Management

Given the power to change anything about how performance is managed in the US, I’d start with — well, just about everything.  But if you asked me for one word I’d love to eliminate from the performance management lexicon, it would be “expectations.”  That word causes more confusion, more discontent, and more inconsistency than any word […]

The “Real” Gender Pay Gap in FQHCs

If you’re reading this to find an expose’ about how Federally Qualified Health Centers have problems with how they pay male vs. female employees in the same job, you’ve come to the wrong article.  More and more studies across all industries debunk the concept that there is systematic deliberate discrimination in pay, and that certainly […]

Reviewing The Compensation Information in Your Form 990 – A Brief Guide for Board Members

The IRS Form 990 is the tax return filed by not-for-profit organizations, and also a significant document for the disclosure of information concerning the policies and practices of the organization.  Far too often, FQHC Boards do not take the opportunity to review this document — not surprising, as it can get to be a very […]

Keep Staff out of FQHC CEO Compensation Programs

Every year, across the country, hundreds of FQHCs make the fundamental mistake of having internal staff provide the information that will be used in the determination of the compensation of their Chief Executive Officers.  To be more specific, if our research projects to the entire population of FQHCs, the Boards of Directors of roughly 400 […]

Welcome to ElementOne, Inc.

Welcome to ElementOne, Inc, a management consulting firm dedicated to helping organizations — particularly migrant/community health centers — improve the return on their human resource investment.   ElementOne is the new name for Merces Consulting Group, Inc., a consulting firm founded in 1990 with nearly 20 years of experience working in the M/CHC industry.  Our new […]

The roles of the FQHC Board and the CEO in organization and compensation management

One of the trickiest situations I run into in my work with Federally Qualified Health Centers is helping to clarify the role of the Board and the CEO in decisions about organization design and compensation.  This is a crucial division of responsibility, because in situations where there is no clarity, there is most often conflict […]

What is the labor market…and will it take my debit card?

What exactly is the labor market, and what does it mean to a health center manager?  As managers, we want to know what the labor market is, so we can determine what data we need to collect.  The data will tell us what we have to pay in order to attract, retain and motivate the […]

Sometimes getting more can cost less…..

One of the best places to look for improvements in health center performance, as well as improvement in the quality (and quality of life) of your workforce is at the entry level — particularly in the front office and basic clinical functions.  Interested in raises of 50% and reducing labor costs more than 30%?  It’s […]

Covering up for bad performance management may well hurt your best employees

Sometimes management mistakes hit a little too close to home, and you realize that the things that organizations do to protect themselves from bad management can end up costing them their best people.  This week, someone I know very well ran into that sort of situation, and as a result, her employer is probably going […]