Health system executives are navigating reimbursement pressures, high labor costs and workforce workforce challenges, and new benchmarking data shows how their own compensation is moving against that backdrop.
Gallagher, which maintains one of the nation’s largest proprietary healthcare compensation databases, shared its three most recent National Healthcare Leadership Compensation Survey reports with Becker’s, with benchmarks effective on Jan. 1 of 2024, 2025 and 2026. The most recent edition features input from 3,845 participants across 469 healthcare systems, 2,556 hospitals, 698 clinic/medical groups and 279 non-acute care facilities, covering 387 executive positions and representing more than 149,000 incumbents. The reports benchmark base salary, short- and long-term incentives, projected salary increases, market movement and total compensation philosophy.
The data shows median projected salary increase budgets for healthcare executives have held flat at 3% for three consecutive years, even as actual pay continues to climb well above that mark.
Below are nine takeaways on healthcare executive pay budgets and compensation trends, according to the three most recent editions of the survey.
1. Median projected salary increase budgets have held flat at 3% for CEOs, executives, directors and managers in each of the past three years, and organizations project the same 3% for the year ahead.
2. Actual pay has consistently outrun those budgets. Year-over-year salary movement for systems averaged 4.8% in 2024, 4.6% in 2025 and 4.8% in 2026, running roughly 1.5 to 1.8 percentage points above budget every year.
3. Hospitals followed the same pattern, with actual movement of 4.8% in 2024, 4.5% in 2025 and 4.6% in 2026, signaling sustained upward pressure in the healthcare leadership market.
4. The gap points to a persistent tension: Budgets stay anchored at 3%, but competition for executive talent continues to push real pay closer to 5%.
5. Short-term incentives remain a core part of executive pay, offered to CEOs or senior executives by the vast majority of organizations across all three years.
6. Long-term incentives remain less common, used by roughly one-fourth of systems and fewer hospitals.
7. Most organizations still anchor executive base salaries near the market median rather than leading the market.
8. Signing bonuses consistently outpace retention bonuses. Across the three years, 47% to 48% of organizations offered signing bonuses, versus 24% to 26% offering retention bonuses.
9. Benefits are a major piece of total rewards, with most organizations spending 20% to 34% of salary on executive benefits, including medical, disability, life insurance, retirement, paid time off, perquisites and severance.
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