Dear Workforce How Do We Determine the Best Ratio of Administrators to Other Employees in Our Health Care Organization

Dear Size Matters:

The short answer, as you may have suspected, is that there is no typical ratio of administrative support to other employees in health care. We conducted an unscientific poll of 19 health care organizations, including hospitals, long-term-care companies and a couple of organizations that offer primary, inpatient and long-term care. We threw out two outliers, whose numbers were way off the beaten path, and with the remaining 17, here’s what we found:

The smaller the organization is, the higher its proportion of administrators to total employees. There’s a minimum level of support needed, even for the smallest of providers, but the need does not increase in direct proportion to the number of employees overall, or the number of patients served.

Secular not-for-profit and faith-based health care organizations seem to be able to get by with a smaller proportion of administrative support personnel than do for-profit organizations.

The numbers here represent ratios of administrative employees to total number of employees.

The for-profit hospitals we polled ranged from a ratio of 1-to-10 (one admin support person for every 10 employees) to about 1-to-12.

One secular nonprofit hospital reported 2,486 employees, 177 of whom were in administrative support jobs, or a ratio of about 1-to-14. At the other end of this category was a hospital with a ratio of 1-to-17.5.

The faith-based health care organizations we surveyed ran leaner, for the most part, than the other organizations we looked at, ranging from a low ratio of 1-to-15 to a high of 1-to-22.

The consensus among the health care human resources professionals we spoke with is that the administrative support staff, as a proportion of the total number of employees, has diminished somewhat over the last 20 years. Even as the administrative burden on health care has increased in recent years, technological advances in general, and specifically in health care, have allowed many providers to shift human resources away from administrative tasks and toward patient care. Most see this trend continuing.

SOURCE: Richard Hadden and Bill Catlette, co-authors, Contented Cows Give Better Milk, March 15, 2007

LEARN MORE: Please review a series of tools, including worksheets, for workforce planning. Also of interest: how health care organizations can determine the best staff-to-manager ratio.

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The information contained in this article is intended to provide useful information on the topic covered, but should not be construed as legal advice or a legal opinion. Also remember that state laws may differ from the federal law.