Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015.

PURPOSE: To quantify and determine the relationship between oncology departmental/division heads and private industry vis-à-vis potential financial conflict of interests (FCOIs) as publicly reported by the Centers for Medicare and Medicaid Services Open Payments database. METHODS AND MATERIALS: We extracted the names of the chairs/chiefs in medical oncology (MO) and chairs of radiation oncology (RO) for 81 different institutions with both RO and MO training programs as reported by the Association of American Medical Colleges. For each leader, the amount of consulting fees and research payments received in 2015 was determined. Logistic modeling was used to assess associations between the 2 endpoints of receiving a consulting fee and receiving a research payment with various institution-specific and practitioner-specific variables included as covariates: specialty, sex, National Cancer Institute designation, PhD status, and geographic region. RESULTS: The majority of leaders in MO were reported to have received consulting fees or research payments (69.5%) compared with a minority of RO chairs (27.2%). Among those receiving payments, the average (range) consulting fee was $13,413 ($200-$70,423) for MO leaders and $6463 ($837-$16,205) for RO chairs; the average research payment for MO leaders receiving payments was $240,446 ($156-$1,234,762) and $295,089 ($160-$1,219,564) for RO chairs. On multivariable regression when the endpoint was receipt of a research payment, those receiving a consulting fee (odds ratio [OR]: 5.34; 95% confidence interval [CI]: 2.22-13.65) and MO leaders (OR: 5.54; 95% CI: 2.62-12.18) were more likely to receive research payments. Examination of the receipt of consulting fees as the endpoint showed that those receiving a research payment (OR: 5.41; 95% CI: 2.23-13.99) and MO leaders (OR: 3.06; 95% CI: 1.21-8.13) were more likely to receive a consulting fee. CONCLUSION: Leaders in academic oncology receive consulting or research payments from industry. Relationships between oncology leaders and industry can be beneficial, but guidance is needed to develop consistent institutional policies to manage FCOIs.

Executive compensation in health care: a systematic review.

BACKGROUND: Despite continued scrutiny over executive earnings in the health care industry, the evidence for executive pay determinants is uncertain and inconclusive. Theoretical motivations for executive compensation practices have been debated, and questions remain about the explanatory power of previously applied theoretical models. PURPOSES: Our systematic review considered evidence of executive compensation determinants among health care organizations and sought to identify factors affecting executive pay that are commonly supported by previous studies. We also aimed to survey the theoretical perspectives employed in health care executive compensation studies to address how organization theory may explain executive remuneration practices at health care organizations. METHODOLOGY/APPROACH: Twenty-one eligible studies were identified after a search of the MEDLINE/PubMed and CINAHL electronic reference databases and the reference lists of relevant studies. Eligible studies included those examining health care organizations and providing empirical, regression-based outcomes regarding the determinants of executive compensation. Each eligible study was coded to identify pertinent information, including study settings, executive compensation measures, executive compensation determinants and their measures (e.g., financial performance measured as profit margin), outcomes (direction and level of statistical significance of regression model coefficients), and theoretical applications. FINDINGS: Studies are mixed in their findings regarding the statistical significance of various determinants of executive compensation. Many studies indicate that, in addition to firm financial performance, other factors may influence health care executive compensation, including organizational size and human capital attributes. Agency theory was the predominant framework applied, yet the findings suggest a complementary theoretical perspective may better explain health care executive compensation. PRACTICE IMPLICATIONS: To address critics who assert health care executive compensation levels are not consistent with organizational performance, health care organization CEOs, board members, and consultants would benefit to carefully consider and effectively communicate the numerous factors influencing executive compensation beyond firm financial performance.

Taking a beating. Healthcare execs see stock holdings, company portfolios nosedive.

The pounding that healthcare companies have taken on Wall Street is getting personal for their CEOs, whose holdings at their respective companies are down more than $180 million in value this year. "The key driver of incentives is stock holding. That's where the action is," says Wayne Guay, left, of the Wharton School. Boards may want to consider increasing their CEOs' relative weighting to equity compensation, he says.

The manager and equipment decisions: the capital budget.

As part of his or her role in preparing a departmental budget, a manager must often become involved in budgeting for capital expenditures, those purchases that are of a type and sufficient dollar value to be capitalized and depreciated. Depending on the value of a proposed purchase, the department manager may have only a partial voice in the process; some significant purchases will require administrative approval, whereas some major acquisitions will require approval by the board of directors. Planning for possible capital purchases should begin well before the start of the annual budget exercise. Listing a capital item in the department's budget request does not imply approval; often, there are many more "needs" than there are capital funds available. Therefore, there must be a consistent process for identifying the proposed purchases that will be funded, such process necessarily including detailed specification of the need for a particular capital purchase, identification of all reasonable alternatives, consideration of any constraints, detailed financial comparison of alternatives, assessment of intangible factors, and a recommended choice.

Strong performance. Healthcare executives reaped big rewards in 2010, with returning hospital CEOs seeing a 58.2% gain in compensation.

Healthcare CEOs saw their compensation slip relative to other industries but still earned big paydays last year. "2010 was a great year for corporate earnings and stock performance," says Steve Kaplan, left, a professor of finance and entrepreneurship. "Part of the reason for the increase in pay is that the CEOs delivered in 2010."

Sustainability and the health care manager: Part II.

Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability.