Smaller CHCs Adapting to the Market: Administrative Support Staff
On a biennial basis (every other year), NWRPCA facilitates a robust salary and benefits survey with the help of the Region X CHCs that participate. The resulting report (available here) is intended to help Region X CHCs better understand what salaries & benefits are being offered in different markets (e.g. urban vs. rural) by position type (e.g. Nurse Practitioner, HR Coordinator). And in understanding this, Region X CHCs are able to better understand what kind of compensation needs to be offered to be competitive in hiring and retaining staff.
One interesting data point that came out of the most recent report is that the turnover rates for administrative support staff went from being very comparable between small (1-4 sites), medium (5-9 sites), and large CHCs (10+ sites) in 2021 to having a huge disparity in 2023. While medium and large CHCs made very significant progress in their ability to retain administrative support staff (i.e. reduce turnover), the turnover rates for small CHCs only got worse in 2023.
One interesting data point that came out of the most recent report is that the turnover rates for administrative support staff went from being very comparable between small (1-4 sites), medium (5-9 sites), and large CHCs (10+ sites) in 2021 to having a huge disparity in 2023. While medium and large CHCs made very significant progress in their ability to retain administrative support staff (i.e. reduce turnover), the turnover rates for small CHCs only got worse in 2023.
We can attempt to understand what is creating this disparity by reviewing the salaries of administrative support staff and how these salaries have changed in recent years. While we do not have this data broken down by small, medium, and large CHCs per se, we do have it broken down by an overall budget threshold of more than or less than $34M. With this in mind, we can think of the budget size as somewhat of a proxy for CHC size. In other words, CHCs with budgets greater than $34M are going to primarily be medium and large CHCs. Similarly, CHCs with budgets less than $34M will primarily be small CHCs.
If we take “Executive Assistant” for example (one of the positions that would be categorized as administrative support staff), we can see that large budget CHCs (>$34M) paid a median salary of $61,048 in 2022—up 18.7% from 2020’s median salary of $51,459. This starts to help paint the picture as to why medium and large CHCs greatly improved their turnover rates among administrative support staff in 2023. Small budget CHCs (<$34M) on the other hand, paid a median salary of $46,280 in 2022—down 11% from 2020’s median salary of $52,000. In essence, we went from having small budget CHCs and large budget CHCs paying out median salaries very competitive with one another in 2020 to large budget CHCs paying a median salary 31.9% higher than that of small budget CHCs in 2022.
While the rationale for paying each individual administrative support staff position is going to vary widely across CHCs, one could look at these figures and broadly speculate that medium and large CHCs adapted themselves to the competitive market rate for these positions in 2022 and, hence, greatly reduced turnover as a result. On the flip side, one could speculate that small CHCs seemed to lag behind in this area—whether it be due to budget constraints or otherwise, offering compensation more in line with prior years. However, the good news is that this seems to have only been a temporary lag. Going back to our “Executive Assistant” example, small budget CHCs paid a median salary of $70,939 in 2024—a whopping 58.3% increase from 2022’s median of $46,280.
If we take “Executive Assistant” for example (one of the positions that would be categorized as administrative support staff), we can see that large budget CHCs (>$34M) paid a median salary of $61,048 in 2022—up 18.7% from 2020’s median salary of $51,459. This starts to help paint the picture as to why medium and large CHCs greatly improved their turnover rates among administrative support staff in 2023. Small budget CHCs (<$34M) on the other hand, paid a median salary of $46,280 in 2022—down 11% from 2020’s median salary of $52,000. In essence, we went from having small budget CHCs and large budget CHCs paying out median salaries very competitive with one another in 2020 to large budget CHCs paying a median salary 31.9% higher than that of small budget CHCs in 2022.
While the rationale for paying each individual administrative support staff position is going to vary widely across CHCs, one could look at these figures and broadly speculate that medium and large CHCs adapted themselves to the competitive market rate for these positions in 2022 and, hence, greatly reduced turnover as a result. On the flip side, one could speculate that small CHCs seemed to lag behind in this area—whether it be due to budget constraints or otherwise, offering compensation more in line with prior years. However, the good news is that this seems to have only been a temporary lag. Going back to our “Executive Assistant” example, small budget CHCs paid a median salary of $70,939 in 2024—a whopping 58.3% increase from 2022’s median of $46,280.
With large budget CHCs paying a similar median salary of $70,375 in 2024, small budget CHCs have positioned themselves much more competitively as it relates to retention for this type of position. If we were to extrapolate from this example, we would expect small budget CHCs and, by proxy, small CHCs (1-4 sites) to report significantly improved turnover rates for administrative support staff in 2025 during the next NWRPCA salary & benefits survey.
It is important to acknowledge that the conclusions drawn above were extrapolated from just one of the positions that comprise “administrative support staff” and are not necessarily representative. However, the point of this article is not to perform a full and robust analysis, but rather to walk readers through the thought process of noticing an interesting trend and then utilizing the report’s related data to begin to paint a picture of what could be contributing to this trend—as well as how we might expect the trend to change based on the most recent data.
Should your organization choose to purchase NWRPCA’s Salary & Benefits Survey Report (available here), you will also receive NWRPCA's below referenced 2025 Provider Productivity Expectations Report at no additional cost!
It is important to acknowledge that the conclusions drawn above were extrapolated from just one of the positions that comprise “administrative support staff” and are not necessarily representative. However, the point of this article is not to perform a full and robust analysis, but rather to walk readers through the thought process of noticing an interesting trend and then utilizing the report’s related data to begin to paint a picture of what could be contributing to this trend—as well as how we might expect the trend to change based on the most recent data.
Should your organization choose to purchase NWRPCA’s Salary & Benefits Survey Report (available here), you will also receive NWRPCA's below referenced 2025 Provider Productivity Expectations Report at no additional cost!
