Dollars and Disparities: Unraveling Executive Compensation Patterns in American Non-Profit Healthcare

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Introduction: This study examines trends in executive compensation at non-profit hospitals across the United States from 2018 to 2022. The research aims to address gaps in the current literature by providing an up-to-date analysis of compensation practices and their relationship to hospital financial metrics. Methods: A descriptive longitudinal study was conducted using data from Form 990 filings of 20 randomly selected non-profit hospitals across four U.S. regions. Executive compensation data, along with hospital financial metrics, were extracted and analyzed. Statistical analyses included descriptive statistics, non-parametric tests for trend analysis, and correlation studies using Kendall's Tau B. Results: The median increase in executive compensation over the five-year period was 23.4%, with a median annual increase of 6.2%. Significant positive correlations were found between executive compensation and hospital revenue (τ = 0.676, p < 0.001), net assets (τ = 0.600, p < 0.001), and net income (τ = 0.273, p < 0.001). However, percentage changes in these variables over time were not significantly correlated. Conclusion: The study reveals significant growth in executive compensation at non-profit hospitals, with notable regional variations. While compensation correlates strongly with hospital financial metrics, the lack of correlation in their respective changes over time suggests a complex relationship. These findings raise important questions about resource allocation and compensation practices in non-profit healthcare institutions, highlighting the need for further research and policy discussions.