E9-18998. Annual Pay Ranges for Physicians and Dentists of the Veterans Health Administration (VHA)

AGENCY:

Department of Veterans Affairs.

ACTION:

Notice.

SUMMARY:

As required by the “Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004” (Pub. L. 108-445, dated December 3, 2004) the Department of Veterans Affairs (VA) is hereby giving notice of annual pay ranges for Veterans Health Administration (VHA) physicians and dentists as prescribed by the Secretary for Department-wide applicability. These annual pay ranges are intended to enhance the flexibility of the Department to recruit, develop, and retain the most highly qualified providers to serve our Nation's veterans and maintain a standard of excellence in the VA healthcare system.

DATES:

Effective Dates: Annual pay ranges are effective on October 11, 2009.

FOR FURTHER INFORMATION CONTACT:

Lauren Kuiper-Rocha, Director, Compensation and Classification Service (055), Office of Human Resources Management, Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, [phone]. This is not a toll-free number.

SUPPLEMENTARY INFORMATION:

Under 38 U.S.C. 7431(e)(1)(A), not less often than once every two years, the Secretary must prescribe for Department-wide applicability the minimum and maximum amounts of annual pay that may be paid to VHA physicians and dentists. Further, 38 U.S.C. 7431(e)(1)(B) allows the Secretary to prescribe separate minimum and maximum amounts of pay for a specialty or assignment. In construction of the annual pay ranges, 38 U.S.C. 7431(c)(4)(A) requires the consultation of two or more national surveys of pay for physicians and dentists, as applicable, whether prepared by private, public, or quasi-public entities in order to make a general assessment of the range of pays payable to physicians and dentists. Lastly, 38 U.S.C. 7431(e)(1)(C) states amounts prescribed under paragraph 7431(e) shall be published in the Federal Register, and shall not take effect until at least 60 days after date of publication.

Background

The “Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004” (Pub. L. 108-445) was signed by the President on December 3, 2004. The major provisions of the law established a new pay system for Veterans Health Administration (VHA) physicians and dentists consisting of base pay, market pay, and performance pay. While the base pay component is set by statute, market pay is intended to reflect the recruitment and retention needs for the specialty or assignment of a particular physician or dentist at a facility. Further, performance pay is intended to recognize the achievement of specific goals and performance objectives prescribed annually. These three components create a system of pay that is driven by both market indicators and employee performance, while recognizing employee tenure in VHA.

Discussion

VA identified and utilized salary survey data sources which most closely represent VA comparability in the areas of practice setting, employment environment, and hospital/healthcare system. The Association of American Medical Colleges (AAMC), Hospital and Healthcare Compensation Service (HHCS), Sullivan, Cotter, and Associates (S&C), Physician Executive Management Center (PEMC), and the Survey of Dental Practice published by the American Dental Association (ADA) were collectively utilized as benchmarks from which to prescribe annual pay ranges for physicians and dentists across the scope of assignments/specialties within the Department. While aggregating the data, a preponderance of weight was given to those surveys which most directly resembled the environment of the Department.

In constructing annual pay ranges to accommodate the more than thirty specialties that currently exist in the VA system, VA continued the practice of grouping specialties into consolidated pay ranges. This allows VA to use multiple sources that yield a high number of physician salary data which helps to minimize disparities and aberrations that may surface from data involving smaller numbers of physicians and dentists for comparison and from sample change from year to year. Thus, by aggregating multiple survey sources into like groupings, greater confidence exists that the average compensation reported is truly representative. In addition, aggregation of data provides for a large enough sample size and provides pay ranges with maximum flexibility for pay setting for the more than 16,000 VHA physicians and dentists.

In developing the annual pay ranges, a few distinctive principles were factored into the compensation analysis of the data. The first principle is to ensure that both the minimum and maximum salary is at a level that accommodates special employment situations, from fellowships and medical research career development awards to Nobel Laureates, high-cost areas, and internationally renowned clinicians. The second principle, to attempt to establish a rate ra nge of ± 25 percent of the mean, is imperative to provide ranges large enough to accommodate career progression, geographic differences, sub-specialization, and special factors. This principle is also the standard recommended by World@Work for professional compensation ranges.

All clinical specialties for VHA physicians and dentists were reviewed against relevant private sector data. The specialties are grouped into five clinical pay ranges that reflect comparable complexity in salary, recruitment, and retention considerations. Two additional pay ranges apply to VHA Chiefs of Staff and physicians and dentists in executive level administrative assignments at the facility, network, or headquarters level.

Pay Table 1—Clinical Specialty

Tier level	Minimum	Maximum
Tier 1	$96,539	$195,000
Tier 2	110,000	210,000
Tier 3	120,000	235,000
Tier 4	130,000	245,000

Allergy and Immunology

Endocrinology

Family Practice

Geriatrics

Hospitalist

Infectious Diseases

Internal Medicine

Neurology

Preventive Medicine

Primary Care

Psychiatry

Rheumatology

General Practice—Dentistry

Endodontics

Periodontics

Prosthodontics

Assignments that do not require a specific specialty

Pay Table 2—Clinical Specialty

Tier level	Minimum	Maximum
Tier 1	$96,539	$220,000
Tier 2	115,000	230,000
Tier 3	130,000	240,000
Tier 4	140,000	250,000

Critical Care (board certified)

Emergency Medicine

Gynecology

Hematology—Oncology

Nephrology

Pathology

Physiatry

Pulmonary

Pay Table 3—Clinical Specialty

Tier level	Minimum	Maximum
Tier 1	$96,539	$265,000
Tier 2	120,000	275,000
Tier 3	135,000	285,000
Tier 4	145,000	295,000

Cardiology (Non-invasive)

Dermatology

Gastroenterology

Nuclear Medicine

Ophthalmology

Oral Surgery

Otolaryngology

Pay Table 4—Clinical Specialty

Tier level	Minimum	Maximum
Tier 1	$96,539	$295,000
Tier 2	125,000	305,000
Tier 3	140,000	325,000
Tier 4	150,000	335,000

Anesthesiology

General Surgery

Plastic Surgery

Radiology

Therapeutic Radiology

Urology

Vascular Surgery

Pay Table 5—Chief of Staff

Tier level	Minimum	Maximum
Tier 1	$150,000	$275,000
Tier 2	145,000	255,000
Tier 3	140,000	235,000

Pay Table 6—Executive Assignments

Tier Level	Minimum	Maximum
Tier 1	$145,000	$265,000
Tier 2	145,000	245,000
Tier 3	130,000	235,000

Principal Deputy, Deputy and Assistant Under Secretary for Health

Chief Officer and Chief Consultant

Network Director, Medical Center Director and Chief Medical Officer

National Program Manager and other VA Central Office Physician/Dentist

Pay Table 7—Clinical Specialty

Tier Level	Minimum	Maximum
Tier 1	$96,539	$375,000
Tier 2	140,000	385,000

Cardio-Thoracic Surgery

Interventional Cardiology

Interventional Radiology

Neurosurgery

Orthopedic Surgery

Dated: July 31, 2009.

John R. Gingrich,

Chief of Staff, Department of Veterans Affairs.