CEOs working for the Treasure Valley's two big nonprofit health systems received hefty compensation increases in 2013. But medical advancements and changing payment methods led to smaller paychecks for some of the area's highest-paid physicians.
The latest tax filings by St. Luke's Health System, Saint Alphonsus Health System and their hospitals show that pay boosts at the top exceeded overall raises the systems reported for employees, and for Idaho workers.
Total compensation - including salary, bonuses, retirement and other pay - rose an average of 14 percent for the six CEOs. St. Luke's Health System CEO David Pate again led the pack. His total compensation rose 19 percent to $1.2 million, mainly because of other compensation, including retirement pay.
Saint Alphonsus neurosurgeon Christian Zimmerman again led physician pay, earning $1.7 million. That was down 11 percent from more than $1.9 million in 2012.
As required by law for nonprofits, the tax filings are public. They disclose the pay of top executives and up to five highly paid nonexecutives for each institution.
The raises came as the hospitals' net revenue declined for the first time in recent years. (See more details in the box attached to this story).
Hospital officials say the raises were deserved.
"There are people here working really hard, and I think we have a lot to be proud of," said Jeff Taylor, St. Luke's chief financial officer. "Our board is actively involved in setting (executive) compensation, and we are transparent about it."
THE REST OF THE STAFF
All local nonprofit hospital CEOs got salary boosts in 2013.
The hospitals typically use a collection of factors to determine how their executives should be compensated. Often, the size of the organization influences the size of the CEO's paycheck. As St. Luke's has grown through hiring and acquisitions, for example, its executives' pay packages have grown to compensate for taking on more responsibility.
The hospital chief executives fared better than the average Idaho CEO, who made about $59 an hour in 2014 - or $123,000 for a full-time year.
Saint Alphonsus staff salaries went up 2 to 4 percent on average, according to Chief Financial Officer Blaine Petersen.
St. Luke's employees received merit-based increases of 0 percent to 4.25 percent, according to spokeswoman Beth Toal.
The change in total pay for hospital executives working under the CEOs varied, with some taking pay cuts but most receiving more. The median executive had a 3.6 percent increase - meaning half of executives got more and half less.
Idaho's median wage was "essentially unchanged" between 2012 and 2013, according to the Idaho Department of Labor. Last year's median Idaho wage was $14.68 an hour, or about $30,500 a year full-time.
WHAT THEY MADE
Joseph Caroselli, the former CEO of Idaho Elks Rehabilitation Hospital, had the smallest salary increase, at 3 percent. The Elks hospital operation has since been acquired by St. Luke's Health System.
Chris Roth, CEO of St. Luke's Regional Medical Center, had the largest salary increase, at 22 percent. Roth later was promoted to chief operating officer of the system.
Karl Keeler, CEO of Saint Alphonsus Medical Center-Nampa, also received a double-digit salary raise: 17 percent. Keeler later assumed leadership of the Saint Alphonsus hospital in Ontario in addition to the Nampa hospital.
DOCTOR PAY IS CHANGING
Surgeons - whose services are extraordinarily lucrative for hospitals - at both Saint Alphonsus and St. Luke's made more than executives, including CEOs.
Three surgeons in 2013 received base salaries exceeding $1 million and bonuses of about $11,000 to $83,000.
The average Idaho physician in 2014 would have made about $228,000 for a year of full-time work, based on the Department of Labor's annual wage survey.
While their salaries were striking, more than half of the top-paid doctors at local nonprofit hospitals actually took pay cuts in 2013.
That's partly because local hospitals are slowly adapting to a new world in which Medicare, Medicaid and private health insurers no longer want to pay solely based on volume, but instead are tying payments to quality and efficiency.
St. Luke's has transitioned some of its doctors to new payment schemes that reward them for high-quality work and having healthier patients, instead of just giving them lots of money when they rack up big medical bills for patients.
Saint Alphonsus Regional Medical Center, meanwhile, gave some of its doctors smaller paychecks. A top-paid neurosurgeon, whose compensation typically dwarfs other top-paid doctors', took a pay cut in 2013.
That's because Saint Alphonsus has a new "spine protocol" that puts more patients through physical therapy before considering neck or back surgery, Petersen said. And because of new medications and methods to treat people with cardiovascular problems, cardiologists who spent a lot of time in surgery have slowed down, Petersen said.
Audrey Dutton: 377-6448, Twitter: @IDS_Audrey