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1 Page 1 of Salary Study Delves Deeper into Factors Driving Pay Starting in May 2008, HIM professionals participated in the second biennial AHIMA salary study. Nearly 11,000 individuals accessed the Web-based survey and 90 percent of them completed the full set of questions. The resulting data allows us to share with you and the industry positive statistics such as the overall average annual salary of survey respondents being $57,370, which is about $2,000 more than the 2006 study. The new survey included an enhanced set of questions and updated choices that more closely reflect the new AHIMA profile and offer some interesting new insights into what impacts HIM compensation. You will see information on traditional variables such as job levels, work settings, educational levels, credentials, and geography. You will also learn about impacts of facility size, supervisory responsibility, reporting structures, and information about bonuses and salary increases. Work Setting Analysis Regression analysis reveals that primary work setting is a key contributor to the variation in salaries of HIM professionals. The bar chart Primary Work Setting (see graphic 1) illustrates how respondents are distributed among the 11 primary work setting categories. Acute care hospitals employ a majority of the sample (53 percent) and set the baseline for salary levels. Clinic or physician practice represents nine percent of respondents followed closely by those working in an integrated healthcare delivery system (eight percent). Non-provider settings and other provider settings are groups that also are well represented in the sample (seven percent each). The non-provider category is made up of a variety of settings that do not directly deliver healthcare. Graphic 4, Non-provider Settings, provides more detail for this category. Vendors of HIM products and services (27 percent), corporate compliance (24 percent), government/public health agencies (19 percent), and insurers and managed care (14 percent) are the largest sub-groups here. Rehabilitation facilities, outpatient therapeutic centers, and community health centers are some of the many diverse settings that fall under the label of other provider settings.

2 Page 2 of 8 Compensation Matters Graphic 2 illustrates how the choice of primary work setting impacts average salary. While the overall average salary of respondents in this study was $57,370 the average salaries of those working in certain settings is significantly higher and in some cases significantly less than that average. Those indicating consulting services ($81,561), integrated healthcare delivery systems ($73,615), and non-provider setting ($68,683) report the highest average salaries. Home health or hospice ($41,415) and ambulatory surgery centers ($43,070) are at the low end in terms of average salary and are also the settings where the smallest percentage of respondents indicate working. The level of job responsibility is an obvious factor that drives compensation. Graphic 3 highlights not only the large diversity of titles and responsibilities that HIM professionals hold, but the continuum of salary levels that accompany those responsibilities.

3 Page 3 of 8 As expected, the executive level respondents report the highest average salaries. One of the new levels of detail included in the 2008 study was a breakout of the various types of director and officer positions held. Graphic 3 also shows that the respondents who are IS/IT directors and other directors report a higher average salary than HIM directors. One consideration here is that the sample includes a much higher incidence of HIM directors than the other groups, as there are not as many IS/IT directors who are members. Among officer titles, security officers report higher average salaries than compliance and privacy officers. Consultants are another group that report salaries at a rate significantly higher than the overall average. HIM technician roles that include transcription and CDI specialists as well as those in clerical and administrative support are at the lower end of the average salary scale. While impacts of individual factors get a lot of attention in this analysis, the cumulative effect of multiple factors is what ultimately defines the reality of an individual job and the resulting compensation. With that in mind, graphic 7 shows how primary work setting and job level category work together to determine average salaries. Graphic 7. Average Salary by Setting and Level Average Salary by Setting and Level Director Manager Supervisor Coding Professional Ambulatory Surgery Center $59,386 $48,369 $35,276 $41,818 Behavioral/Mental Health $56,532 $51,502 $41,833 $36,700 Consulting Services $97, 067 $86,214 $57,083 $57,700 Educational Institution $62,698 $51,721 $50,500 NA Integrated Healthcare Delivery System $102,129 $75,809 $59,374 $46,813 Acute Care Hospital $77,603 $65,068 $51,488 $43,673 Long-term Care or Nursing Facility $47,134 $44,361 $39, 998 $40,829 Clinic or Physician Practice $68,481 $53,542 $45,304 $37,589 Home Health or Hospice $55,389 $56,107 $42,758 $36,502

4 Page 4 of 8 Other Provider Setting (e.g. rehab) $72,653 $59,551 $48,329 $41,248 Non-provider Setting (government, vendor, assoc., etc.) $94,435 $75,057 $53,799 $48,115 Total $76,570 $64,225 $50,362 $43,359 As the data illustrates, the average salaries of all respondent directors working within an integrated delivery system ($102,129) are much higher than the average salary of directors in the sample who are working in behavioral or mental health ($56,532). Likewise, the average salary of managers in an acute care hospital ($65,068) is substantially higher than even the directors working in a long term care or nursing facility ($47,134). The variation in average salary is a bit less for coding professionals across all settings. The exception is coders working in consulting services who report an average salary of $57,700. Otherwise, the averages range from $36,502 for coders in home health or hospice, to $48,115 for those in non-provider settings. Additional Salary Considerations Education and certification are also important factors that drive salary levels. Graphic 5 shows that the overall average salary for directors varies by the highest level of education attained. While the average salary of directors in the sample with an associate degree is $59K, that figure grows to $68K for the baccalaureate degree group and to nearly $82K for those with a master s degree. Graphic 6 looks at the average salaries of those who are coding professionals by the type of AHIMA credential they have earned. For coders with the entry-level CCA credential, $37K is the average, while those with an RHIT who are coding earn closer to $53K, and those in the sample with an AHIMA mastery-level coding credential are earning more (CCS-P with $56K, and CCS with $58K).

5 Page 5 of 8 Organizational Factors Characteristics of the organization that you work for can also have a correlation with compensation level. This year s study looked at things like the total number of employees, the number of patients served, and the size of the HIM department. This is more relevant for certain work settings than others, and graphic 8 shows the positive correlation between the size of the HIM department and the distribution of salary for those in acute care hospitals. The trend lines show that as the size of the HIM department grows, the percentage of those in higher compensation ranges increases. The opposite is true for the hospitals with smaller HIM departments. While not shown to contribute significantly to the variation in salary, who the HIM department reports to in the organization was also tracked. Graphic 9 shows that reporting up through the chief financial officer or vice president of finance (46 percent) is most common. Other patient care executives (20 percent), and president or VP (14 percent) are next most likely. Supervisory responsibility is also a way to increase compensation, according to this data set. It indicates that about $500 per employee supervised is the positive impact to earning potential.

6 Page 6 of 8 Economic Trends The current economic challenges are impacting the job market, but as of the time of this study (May and June 2008) respondents reported that they were receiving salary increases and in some cases bonuses within the previous 12 months of the survey. Graphic 13 indicates that nearly three out of four respondents report having received a salary increase. A majority (60 percent) of them received a three to five percent increase, while 21 percent report having received increases of six percent or higher (see graphic 12). The reasons for receiving salary increases vary and often include more than one factor (see graphic 10). Merit increases are the most common (63 percent) followed by salary adjustments (25 percent). While earning credentials or completing additional education can result in increases, they are longer-term events and understandably less prevalent in the sample. Just two

7 Page 7 of 8 percent of respondents indicated having experienced a salary decrease in that same 12- month period. For those that did experience a pay decrease, graphic 11 shows that a change in employer was the most likely reason (49 percent). Changes in job description or responsibility accounted for eight percent. While across the board cuts was cited for six percent of those with decreases, just one percent reported that there was an HIM department-specific cut that was the cause. Bonuses can also contribute to overall compensation. Less than one third (28 percent) of respondents reported having earned a bonus in the previous 12 months. For those who did receive them, the average bonus size was about two percent of compensation or $1,000 in addition to a $50,000 salary. Location, Location, Location Geography is certainly another factor that can impact what HIM professionals are earning. As graphic 14 shows, when controlling for other factors there are four states that show a statistically significant increase to average compensation that can be attributed to living in that state.

8 Page 8 of 8 Conversely, by working in one of a list of 24 states, you could expect that your pay would be less due to that choice. The remaining states (with the exception of those with too small a sample to analyze) show no significant impact to compensation correlated to state location. Larger states with both urban and rural areas tend toward the list of no significant effect since the averages are impacted by salaries at both ends of the spectrum. Cost of living would also need to be weighed before making any decisions about relocating based on this map. The data presented here is far from the whole story. A combination of all the factors explored here help determine what an individual HIM professional will earn today and what is possible in the near or longer term future. The very rich data set that is leveraged here and made possible by those who participated allows AHIMA to continue to mine the data and better understand the patterns and trends. AHIMA plans to create some more targeted and detailed analyses that will be made available in other formats moving forward.