August 19, 2025 • 19 mins
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Health Affairs' Rob Lott interviews Cal Chengqi Fang of the University of Chicago about his recent paper that explores how pay gaps grew between nonprofit hospital CEOs and employees from 2009–23.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Rob Lott (00:00):
Hello, and welcome to A Health Podicy. I'm your host,
(00:04):
Rob Lott. In recent years, we'veseen a number of reports and
studies suggesting that somenonprofit hospitals and health
systems may not be as purelybenevolent as we might imagine.
(00:25):
For example, we know thatalthough they're not necessarily
beholden to shareholders,nonprofit hospitals can be just
as focused on maximizing revenuein ways that put the
organization's balance sheet andits executives own interests
before the needs of thecommunities they serve. Of
(00:45):
course, not all nonprofithospitals are the same and this
creates a challenge forpolicymakers trying to assess
any given hospital's commitmentto truly advancing community
well-being and equity.
One way to make just this kindof assessment is to look at wage
inequality within the hospital.That is just how much more the C
(01:10):
suite is making compared to theaverage worker in the hospital.
It's a relatively simplemeasure, but its implications
are complex, raising bigquestions about the ethics of
health care delivery. And it'sthe subject of today's health
policy. I'm here with Cal Fang,a PhD student at the University
(01:32):
of Chicago.
Along with his coauthors, he hasa groundbreaking new study in
the August issue of HealthAffairs, examining the gap
between nonprofit hospital CEOcompensation and average
employee wages from 2009 to2023. I can't wait to hear more
about their research and learnmore about what it means for our
(01:56):
health system going forward. CaoFeng, welcome to A Health
Odyssey.
Cal Fang (02:01):
Thank you very much, Rob, for the fantastic
introduction, and I'm reallyhonored to be here to share what
we have found in this study.
Rob Lott (02:10):
Great. Well, let's start with some context. Can you
say a little bit about what wecan learn or maybe hope to learn
about our health system writlarge by looking specifically at
wage inequality?
Cal Fang (02:24):
Yeah, of course. I really like your introduction.
You brought up thismisconception. Not to say
misconception, but in a way, thepublic holds an impression that
hospitals are all fueled byaltruism, especially the
nonprofit ones. And of course,so, these are institution that
(02:44):
save lives and provide criticalpublic goods.
But when we zoom in on averagewage inequality inside these
hospitals, we start to seesomething deeper. We think it
may be give us a sense of who'sbeing prioritized and what arm
is being valued more within thesystem, not just in their
(03:05):
mission statements, but thestory in their financial
statement may be, will be moreinteresting. Say if we see
nonprofit hospitals with wageinequality similar to a fortune
500 companies, then maybe weshould reexamine our belief and
have a conversation about whathospitals, particularly the
nonprofits one should be like.As you mentioned, there has been
(03:31):
growing literature, moreconversations in academia and in
public media about the fact ofnonprofit hospitals functioning
resembling more like corporateentities in how they allocate
resource making daily decisions.This shift was some called the
financialization, some calledcorporatization of healthcare,
(03:52):
might be happening faster andmore broadly than most of the
public are aware right now.
Studying wage inequality sourcegive us a new lens. It helps us
understand not just howhospitals operate, but how the
values of the health care systemand the industry itself are
evolving.
Rob Lott (04:12):
Got it. Okay. And you alluded to some of those reports
and media pieces. I mentionedthem as well. My sense is that a
lot of what we know about thesechanges have been sort of
captured anecdotally.
And I'm wondering if you couldmaybe paint a picture for us of
the sort of academic field ofknowledge in this space before
(04:35):
you set out to conduct thisstudy. What do we already know
about wage inequality and howdoes it relate to things like
workers or patients' experienceor satisfaction, hospital
sustainability, their impact onthe neighborhoods and the
communities. Could think of 10other questions that I might
(04:56):
ask. What's the landscape thatyou entered as you approached
this study?
Cal Fang (05:02):
So we've known for a while that wage inequality is a
growing issue in the broader USeconomy. Economic Policy
Institute did this study in02/2023, and their numbers show
that from 1978 to 02/2022, CEOpay at top US companies grow
more than 1200% while theaverage workers pay barely grow
(05:24):
over 15%. By 02/2022, CEOs atthe largest three fifty public
companies were making threeforty four times what the
typical workers earn. Now,hospitals aren't public
corporations, but prior researchhas shown that similar patterns
of inequality existed in thehealthcare sector, including
(05:45):
nonprofit hospitals. There wasthis one paper published on JAMA
Internal Medicine about thetrend prior to 2015.
After that, Long Institute alsopublished a series of work on
this topic. They even had thishospital index, which ranked
hospitals by their socialresponsibility performance. One
(06:05):
of the variable that they lookat is the wage inequality. But
there was a gap in ourunderstanding of wage inequality
trend in nonprofit hospitals ofmore recent years. Given
everything that has happened,COVID, financial shocks, labor
shortage, we wanted to buildupon this pre work and ask how
(06:26):
have things changed in thesemore turbulent years.
In terms of the implications forwage inequality, we know that
workers wage are tied to thingslike job satisfaction and that
the dissertification of job ofhouse workers can spill over to
care quality and patientoutcome. So while we don't have
(06:47):
conclusive evidence right now onhow wage inequality itself
affects patient directly, it'sreasonable to assume that
extreme disparities mightundermine moral law or trust
inside hospitals. And that's notjust a workforce issue, it's a
care quality issues too.
Rob Lott (07:08):
Got it. Okay. Well, let's take a closer look at your
paper. What exactly did you seekto measure and how?
Cal Fang (07:16):
We wanted to measure how big the pay gap is between
hospital CEOs, top executivesand the other hospital workers
and how that gap has changedover time. We focused
specifically on nonprofithospitals from 2009 to 2023,
which is mostly due to a datareason. To do this, we combine
(07:41):
two big national data sets. Oneis the IRS Form nine ninety.
Shout out to all the healthservice researcher out there.
It's a really good data set thatis oftentimes overlooked by
people in this field. Sobasically it is a tax return
form similar to the W-two youand I would have to submit to
(08:01):
IRS at the end of the year, allthe nonprofit hospital have to
file this every year and theyhave to report a lot of
important information, operationdecision, financial status,
asset holding, which includedthe CEO and executive
compensation. The other data isMedicare cost reports, which
include wage and hourinformation for all types of
(08:22):
hospital workers, nurses,technician, housekeepers, and
dietary workers and so on. Butpeople in this field are
probably aware Medicare costreports have relatively a large
missingness issue for some ofthe variables. So we weren't
able to use all the variablesthat we were interested in.
(08:43):
At the end, we had to try tofind what can capture what we're
interested in, but at the sametime, have a good data quality.
Using these data, we calculatedthe average annual wage.
Rob Lott (08:56):
Got it. Okay, and so give us your findings. What did
you learn from the study?
Cal Fang (09:02):
The biggest takeaway is that wage inequality in
nonprofit hospitals has grownsteadily over the past fifteen
years. In 2029, hospital CEOswere making about 10 times what
the average hospital workersearn. By 2023, that ratio had
grown to 12 to one. So comparedto what economic policy
(09:24):
institute find, the number isrelatively not as shocking, but
it's still very large gap. Andthe reason we're seeing a number
not as big could be due to one,the existing study sometimes
focused on the really largeentity.
And we included all thenonprofit hospital. And the
(09:44):
second reason is the, like wejust say, the total average
variable that we use, thedenominator of our ratio
included CEO and the topexecutives pay as well. So if we
are only looking at CEO versusother workers, this ratio would
have been larger. We also foundthat CEO and executive wages
increased a lot faster thanwages for everyone else. While
(10:08):
average hospital worker wagesgrow about 10% over this period,
CEO pay jumped by more than 27%.
Rob Lott (10:16):
Wow. Alright. I wanna dig into those numbers, but
first, let's take a quick break.And we're back. I'm here with
(11:18):
Cal Feng, talking about hisrecent research looking at the
gap between nonprofit hospitalCEO compensation and, average
employee wages.
And, one of the takeaways,recent takeaways you just
mentioned, is that that gap grewgenerally on average. I'm
wondering if you can say alittle bit about how the COVID
(11:41):
pandemic affected those trends.
Cal Fang (11:44):
COVID definitely shook things up, maybe not in the way
people expected. There was a lotof media coverage early in the
pandemic about CEOs makingmillions while frontline workers
were experiencing pay suspensionor seeing pay cuts. So one might
expect a wage and quality tospike, but we actually saw a
(12:05):
slight narrowing in the CEO toaverage worker pay ratio in the
early pandemic years defined as02/2019, 02/2020, 2021 in our
study. That was largely drivenby raising wages for contract
staff, like travel nurses.Hospitals were desperate to step
up at the time and they had topay a premium for it.
(12:28):
So even though executive paystayed high and were continue
growing at the time, thedenominator, the average worker
wage also went up, whichnarrowed the gap temporarily. By
2022 and 2023, which is definedas a later COVID year in our
study, exactly which startedclimbing back more and the
(12:49):
overall trend of growinginequality picked back up. Yeah,
COVID actually more like a shortterm shock than a permanent
reset.
Rob Lott (12:59):
Okay. And can you say a little more about the kind of
variation that you see sort ofunder the hood with these
numbers? What kind ofcharacteristics are associated
with higher inequality versuslower inequality when you're
looking at one hospital versusanother?
Cal Fang (13:17):
We saw a pretty clear pattern. Hospitals that are
large, urban, or part of ahealth system, meaning they're
like one of a chain hospital,tend to have the highest CO pay
and the biggest wage gapsbetween executives and frontline
workers. These are oftenhospitals with more resource and
(13:39):
more complex operations. So thatdidn't come up as a surprise.
But what was really interestingis that the opposite group,
smaller, rural and independenthospitals actually saw the
biggest increase in CEO and topexecutive pay during our study
period.
Also because of the sample sizeissue, we did not get
(14:00):
significant results on how thepay gap has changed in these
hospitals. But it might be thecase that even though their pay
gaps started out smaller,they're catching up fast. This
means that wage inequality isn'tjust a big system problem
anymore, it's spreading morebroadly across the healthcare
sector.
Rob Lott (14:21):
Okay. And I'm wondering if you can sort of
take us back to those early dayswhen you ran the numbers, they
came back and you were kind oflooking at these findings for
the first time. How surprisedwere you? Was this sort of
confirmation of what yoususpected or was there anything
that kind of caught you offguard?
Cal Fang (14:38):
I would say it's sort of a mixture. To be honest, we
were not surprised by thegeneral trend. After all, there
have been so many reports, newsstories showing the widening
wage gap across the whole USeconomy. And there doesn't seem
to be a reason to believenonprofit hospitals would be an
exception. Especially, we nowknow that due to the
(15:00):
financialization process,nonprofit hospitals are
functioning more and more likefull profit entities.
But we were surprised by some ofthe subgroup analysis results.
For example, we expected thebiggest increase in CO pay to
happen at large urban hospitals.And instead, like we just
discussed, it was the smallerrural and independent hospitals
(15:21):
that showed the most growth overtime. That wasn't something we
saw coming, and it suggests thewage inequality is spreading
over in this industry. It'sshowing up in places we've
historically seen as more, like,community based or resource
limited.
We also look into something thatcame up a lot in media coverage
(15:44):
during the pandemic, claims thatCEOs at hospitals receiving
CARES Act of funding, theprovider relief fund, were
getting big raises. We wanted tosee if the data supported that,
and at least in our analysis, wedidn't find clear evidence that
those hospital were increasingCEO pay more than other
(16:05):
hospitals.
Rob Lott (16:07):
Got it. Got it. So there is this sort of suspicion
that some of the hospitals thatreceived kind of a big relief
check from the federalgovernment around COVID maybe
were using some of those fundsto pad their CEO salaries. And
what you're saying is thatthere's there's no evidence that
was the case.
Cal Fang (16:27):
Yes. Basically, is the case.
Rob Lott (16:31):
Got it. Okay. Well, let's look ahead for a moment
For our listeners, our readerswho might be reading your paper
and wondering, oh, boy, what dowe what do we do about this?
Where do we go from here interms of potential policy
solutions? I'm wondering if yourpaper were to inspire perhaps
(16:53):
concrete or specific policychange or improvement in the
space, what would you envision?
Cal Fang (16:59):
Building up on what Lon did with their hospital
index about the socialresponsibility performance, one
concrete idea we'd love to seetaken seriously is adding wage
inequality as a factor in hownonprofit hospitals are
evaluated, especially when itcomes to their community benefit
(17:21):
obligations. Right now,nonprofit hospitals can maintain
their tax exempt status byreporting things like charity
care or community investments.Those are good, have their own
issue, but wage practice aren'treally part of the conversation.
And that's a gap because in manyplaces, nonprofit hospitals are
(17:42):
some of the largest employers inthose small towns that come into
LMI. So when there is a big paygap between executives and
frontline workers in thesenonprofit hospital, it doesn't
just reflect internalpriorities, it can actually
reinforce inequality in thebroader local economy.
(18:03):
That matters, especially whenlow wage rate rolls in hospitals
are disproportionately held bywomen and people of color. Wage
inequality in hospitals in thatway, in part becomes a racial
and gender equity issues aswell. So I think the next step
is asking, if these institutionsare supposed to serve the
(18:25):
community, shouldn't we belooking at how they treat their
workforce as part of thatcondition?
Rob Lott (18:32):
Great. Well, perhaps that's a good spot for us to
wrap up, and a good way to thinkabout the implications of your
research going forward. CalFeng, thank you so much for
taking the time to chat with us.I really enjoyed it.
Cal Fang (18:46):
Thank you so much. It was such an honor.
Rob Lott (18:49):
And to our listeners, thanks again for tuning in. If
you enjoyed this episode, goahead and subscribe, recommend
it to a friend, leave a review,and, of course, tune in next
week. Thanks, everyone. Thanksfor listening. If you enjoyed
today's episode, I hope you'lltell a friend about a health
(19:10):
policy.
Hello, and welcome to A Health Podicy. I'm your host,
(00:04):
Rob Lott. In recent years, we'veseen a number of reports and
studies suggesting that somenonprofit hospitals and health
systems may not be as purelybenevolent as we might imagine.
(00:25):
For example, we know thatalthough they're not necessarily
beholden to shareholders,nonprofit hospitals can be just
as focused on maximizing revenuein ways that put the
organization's balance sheet andits executives own interests
before the needs of thecommunities they serve. Of
(00:45):
course, not all nonprofithospitals are the same and this
creates a challenge forpolicymakers trying to assess
any given hospital's commitmentto truly advancing community
well-being and equity.
One way to make just this kindof assessment is to look at wage
inequality within the hospital.That is just how much more the C
(01:10):
suite is making compared to theaverage worker in the hospital.
It's a relatively simplemeasure, but its implications
are complex, raising bigquestions about the ethics of
health care delivery. And it'sthe subject of today's health
policy. I'm here with Cal Fang,a PhD student at the University
(01:32):
of Chicago.
Along with his coauthors, he hasa groundbreaking new study in
the August issue of HealthAffairs, examining the gap
between nonprofit hospital CEOcompensation and average
employee wages from 2009 to2023. I can't wait to hear more
about their research and learnmore about what it means for our
(01:56):
health system going forward. CaoFeng, welcome to A Health
Odyssey.
Cal Fang (02:01):
Thank you very much, Rob, for the fantastic
introduction, and I'm reallyhonored to be here to share what
we have found in this study.
Rob Lott (02:10):
Great. Well, let's start with some context. Can you
say a little bit about what wecan learn or maybe hope to learn
about our health system writlarge by looking specifically at
wage inequality?
Cal Fang (02:24):
Yeah, of course. I really like your introduction.
You brought up thismisconception. Not to say
misconception, but in a way, thepublic holds an impression that
hospitals are all fueled byaltruism, especially the
nonprofit ones. And of course,so, these are institution that
(02:44):
save lives and provide criticalpublic goods.
But when we zoom in on averagewage inequality inside these
hospitals, we start to seesomething deeper. We think it
may be give us a sense of who'sbeing prioritized and what arm
is being valued more within thesystem, not just in their
(03:05):
mission statements, but thestory in their financial
statement may be, will be moreinteresting. Say if we see
nonprofit hospitals with wageinequality similar to a fortune
500 companies, then maybe weshould reexamine our belief and
have a conversation about whathospitals, particularly the
nonprofits one should be like.As you mentioned, there has been
(03:31):
growing literature, moreconversations in academia and in
public media about the fact ofnonprofit hospitals functioning
resembling more like corporateentities in how they allocate
resource making daily decisions.This shift was some called the
financialization, some calledcorporatization of healthcare,
(03:52):
might be happening faster andmore broadly than most of the
public are aware right now.
Studying wage inequality sourcegive us a new lens. It helps us
understand not just howhospitals operate, but how the
values of the health care systemand the industry itself are
evolving.
Rob Lott (04:12):
Got it. Okay. And you alluded to some of those reports
and media pieces. I mentionedthem as well. My sense is that a
lot of what we know about thesechanges have been sort of
captured anecdotally.
And I'm wondering if you couldmaybe paint a picture for us of
the sort of academic field ofknowledge in this space before
(04:35):
you set out to conduct thisstudy. What do we already know
about wage inequality and howdoes it relate to things like
workers or patients' experienceor satisfaction, hospital
sustainability, their impact onthe neighborhoods and the
communities. Could think of 10other questions that I might
(04:56):
ask. What's the landscape thatyou entered as you approached
this study?
Cal Fang (05:02):
So we've known for a while that wage inequality is a
growing issue in the broader USeconomy. Economic Policy
Institute did this study in02/2023, and their numbers show
that from 1978 to 02/2022, CEOpay at top US companies grow
more than 1200% while theaverage workers pay barely grow
(05:24):
over 15%. By 02/2022, CEOs atthe largest three fifty public
companies were making threeforty four times what the
typical workers earn. Now,hospitals aren't public
corporations, but prior researchhas shown that similar patterns
of inequality existed in thehealthcare sector, including
(05:45):
nonprofit hospitals. There wasthis one paper published on JAMA
Internal Medicine about thetrend prior to 2015.
After that, Long Institute alsopublished a series of work on
this topic. They even had thishospital index, which ranked
hospitals by their socialresponsibility performance. One
(06:05):
of the variable that they lookat is the wage inequality. But
there was a gap in ourunderstanding of wage inequality
trend in nonprofit hospitals ofmore recent years. Given
everything that has happened,COVID, financial shocks, labor
shortage, we wanted to buildupon this pre work and ask how
(06:26):
have things changed in thesemore turbulent years.
In terms of the implications forwage inequality, we know that
workers wage are tied to thingslike job satisfaction and that
the dissertification of job ofhouse workers can spill over to
care quality and patientoutcome. So while we don't have
(06:47):
conclusive evidence right now onhow wage inequality itself
affects patient directly, it'sreasonable to assume that
extreme disparities mightundermine moral law or trust
inside hospitals. And that's notjust a workforce issue, it's a
care quality issues too.
Rob Lott (07:08):
Got it. Okay. Well, let's take a closer look at your
paper. What exactly did you seekto measure and how?
Cal Fang (07:16):
We wanted to measure how big the pay gap is between
hospital CEOs, top executivesand the other hospital workers
and how that gap has changedover time. We focused
specifically on nonprofithospitals from 2009 to 2023,
which is mostly due to a datareason. To do this, we combine
(07:41):
two big national data sets. Oneis the IRS Form nine ninety.
Shout out to all the healthservice researcher out there.
It's a really good data set thatis oftentimes overlooked by
people in this field. Sobasically it is a tax return
form similar to the W-two youand I would have to submit to
(08:01):
IRS at the end of the year, allthe nonprofit hospital have to
file this every year and theyhave to report a lot of
important information, operationdecision, financial status,
asset holding, which includedthe CEO and executive
compensation. The other data isMedicare cost reports, which
include wage and hourinformation for all types of
(08:22):
hospital workers, nurses,technician, housekeepers, and
dietary workers and so on. Butpeople in this field are
probably aware Medicare costreports have relatively a large
missingness issue for some ofthe variables. So we weren't
able to use all the variablesthat we were interested in.
(08:43):
At the end, we had to try tofind what can capture what we're
interested in, but at the sametime, have a good data quality.
Using these data, we calculatedthe average annual wage.
Rob Lott (08:56):
Got it. Okay, and so give us your findings. What did
you learn from the study?
Cal Fang (09:02):
The biggest takeaway is that wage inequality in
nonprofit hospitals has grownsteadily over the past fifteen
years. In 2029, hospital CEOswere making about 10 times what
the average hospital workersearn. By 2023, that ratio had
grown to 12 to one. So comparedto what economic policy
(09:24):
institute find, the number isrelatively not as shocking, but
it's still very large gap. Andthe reason we're seeing a number
not as big could be due to one,the existing study sometimes
focused on the really largeentity.
And we included all thenonprofit hospital. And the
(09:44):
second reason is the, like wejust say, the total average
variable that we use, thedenominator of our ratio
included CEO and the topexecutives pay as well. So if we
are only looking at CEO versusother workers, this ratio would
have been larger. We also foundthat CEO and executive wages
increased a lot faster thanwages for everyone else. While
(10:08):
average hospital worker wagesgrow about 10% over this period,
CEO pay jumped by more than 27%.
Rob Lott (10:16):
Wow. Alright. I wanna dig into those numbers, but
first, let's take a quick break.And we're back. I'm here with
(11:18):
Cal Feng, talking about hisrecent research looking at the
gap between nonprofit hospitalCEO compensation and, average
employee wages.
And, one of the takeaways,recent takeaways you just
mentioned, is that that gap grewgenerally on average. I'm
wondering if you can say alittle bit about how the COVID
(11:41):
pandemic affected those trends.
Cal Fang (11:44):
COVID definitely shook things up, maybe not in the way
people expected. There was a lotof media coverage early in the
pandemic about CEOs makingmillions while frontline workers
were experiencing pay suspensionor seeing pay cuts. So one might
expect a wage and quality tospike, but we actually saw a
(12:05):
slight narrowing in the CEO toaverage worker pay ratio in the
early pandemic years defined as02/2019, 02/2020, 2021 in our
study. That was largely drivenby raising wages for contract
staff, like travel nurses.Hospitals were desperate to step
up at the time and they had topay a premium for it.
(12:28):
So even though executive paystayed high and were continue
growing at the time, thedenominator, the average worker
wage also went up, whichnarrowed the gap temporarily. By
2022 and 2023, which is definedas a later COVID year in our
study, exactly which startedclimbing back more and the
(12:49):
overall trend of growinginequality picked back up. Yeah,
COVID actually more like a shortterm shock than a permanent
reset.
Rob Lott (12:59):
Okay. And can you say a little more about the kind of
variation that you see sort ofunder the hood with these
numbers? What kind ofcharacteristics are associated
with higher inequality versuslower inequality when you're
looking at one hospital versusanother?
Cal Fang (13:17):
We saw a pretty clear pattern. Hospitals that are
large, urban, or part of ahealth system, meaning they're
like one of a chain hospital,tend to have the highest CO pay
and the biggest wage gapsbetween executives and frontline
workers. These are oftenhospitals with more resource and
(13:39):
more complex operations. So thatdidn't come up as a surprise.
But what was really interestingis that the opposite group,
smaller, rural and independenthospitals actually saw the
biggest increase in CEO and topexecutive pay during our study
period.
Also because of the sample sizeissue, we did not get
(14:00):
significant results on how thepay gap has changed in these
hospitals. But it might be thecase that even though their pay
gaps started out smaller,they're catching up fast. This
means that wage inequality isn'tjust a big system problem
anymore, it's spreading morebroadly across the healthcare
sector.
Rob Lott (14:21):
Okay. And I'm wondering if you can sort of
take us back to those early dayswhen you ran the numbers, they
came back and you were kind oflooking at these findings for
the first time. How surprisedwere you? Was this sort of
confirmation of what yoususpected or was there anything
that kind of caught you offguard?
Cal Fang (14:38):
I would say it's sort of a mixture. To be honest, we
were not surprised by thegeneral trend. After all, there
have been so many reports, newsstories showing the widening
wage gap across the whole USeconomy. And there doesn't seem
to be a reason to believenonprofit hospitals would be an
exception. Especially, we nowknow that due to the
(15:00):
financialization process,nonprofit hospitals are
functioning more and more likefull profit entities.
But we were surprised by some ofthe subgroup analysis results.
For example, we expected thebiggest increase in CO pay to
happen at large urban hospitals.And instead, like we just
discussed, it was the smallerrural and independent hospitals
(15:21):
that showed the most growth overtime. That wasn't something we
saw coming, and it suggests thewage inequality is spreading
over in this industry. It'sshowing up in places we've
historically seen as more, like,community based or resource
limited.
We also look into something thatcame up a lot in media coverage
(15:44):
during the pandemic, claims thatCEOs at hospitals receiving
CARES Act of funding, theprovider relief fund, were
getting big raises. We wanted tosee if the data supported that,
and at least in our analysis, wedidn't find clear evidence that
those hospital were increasingCEO pay more than other
(16:05):
hospitals.
Rob Lott (16:07):
Got it. Got it. So there is this sort of suspicion
that some of the hospitals thatreceived kind of a big relief
check from the federalgovernment around COVID maybe
were using some of those fundsto pad their CEO salaries. And
what you're saying is thatthere's there's no evidence that
was the case.
Cal Fang (16:27):
Yes. Basically, is the case.
Rob Lott (16:31):
Got it. Okay. Well, let's look ahead for a moment
For our listeners, our readerswho might be reading your paper
and wondering, oh, boy, what dowe what do we do about this?
Where do we go from here interms of potential policy
solutions? I'm wondering if yourpaper were to inspire perhaps
(16:53):
concrete or specific policychange or improvement in the
space, what would you envision?
Cal Fang (16:59):
Building up on what Lon did with their hospital
index about the socialresponsibility performance, one
concrete idea we'd love to seetaken seriously is adding wage
inequality as a factor in hownonprofit hospitals are
evaluated, especially when itcomes to their community benefit
(17:21):
obligations. Right now,nonprofit hospitals can maintain
their tax exempt status byreporting things like charity
care or community investments.Those are good, have their own
issue, but wage practice aren'treally part of the conversation.
And that's a gap because in manyplaces, nonprofit hospitals are
(17:42):
some of the largest employers inthose small towns that come into
LMI. So when there is a big paygap between executives and
frontline workers in thesenonprofit hospital, it doesn't
just reflect internalpriorities, it can actually
reinforce inequality in thebroader local economy.
(18:03):
That matters, especially whenlow wage rate rolls in hospitals
are disproportionately held bywomen and people of color. Wage
inequality in hospitals in thatway, in part becomes a racial
and gender equity issues aswell. So I think the next step
is asking, if these institutionsare supposed to serve the
(18:25):
community, shouldn't we belooking at how they treat their
workforce as part of thatcondition?
Rob Lott (18:32):
Great. Well, perhaps that's a good spot for us to
wrap up, and a good way to thinkabout the implications of your
research going forward. CalFeng, thank you so much for
taking the time to chat with us.I really enjoyed it.
Cal Fang (18:46):
Thank you so much. It was such an honor.
Rob Lott (18:49):
And to our listeners, thanks again for tuning in. If
you enjoyed this episode, goahead and subscribe, recommend
it to a friend, leave a review,and, of course, tune in next
week. Thanks, everyone. Thanksfor listening. If you enjoyed
today's episode, I hope you'lltell a friend about a health
(19:10):
policy.
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