It pays to be in the lab. It pays way less to be at the patient’s bedside.
People who work at biotechs, life sciences firms, and pharmaceutical companies pull in the largest salaries of anyone in health care — usually more than $100,000 per year, and frequently above $250,000, according to a STAT analysis of the median pay for employees at more than 200 publicly traded health care companies. These workers usually have advanced degrees and are steeped in knowledge of science and drug development. They are testing new therapies and conducting clinical trials.
But Americans who work at health care providers — especially those who care for vulnerable patients in nursing homes, hospices, assisted-living centers, and home care — continue to make the industry’s lowest wages. They help bathe and dress patients, clean linens and bedpans, and make sure patients take their medications. Most of these workers are women, a sizable percentage are Black and Hispanic, and most only get part-time hours. They’re lucky if their annual pay tops $40,000.
In addition to analyzing the 2021 CEO compensation of roughly 300 health care companies that were worth at least $1 billion in mid-March, STAT tracked the median pay of the industry’s rank and file. The trends in the data show that people in health care generally have higher-than-average salaries, when compared with workers in the rest of the economy.
Doctors, along with those in biotech, are among the highest-paid professionals. Many other types of clinicians and nurses also have comfortable salaries. But several health care companies pay most of their workforce low wages, and some rely on cheap foreign labor. And even with high industry salaries, health care CEOs often make 100 times what the average employee gets.
“If you were looking at the health care system anew and thinking about where you would want to invest your resources, I think there’s a real question about whether you would want to invest them in this upper echelon of health care leaders or whether you would want to invest in the nurses, home health aides, and folks who are on the frontlines delivering care,” said Katie Martin, president of the Health Care Cost Institute and a former federal health official.
Since 2018, publicly traded companies have had to report median employee compensation in their annual proxy filings. However, smaller firms and “emerging growth companies” do not have to disclose median worker pay, according to the Securities and Exchange Commission. Of the 300 companies STAT analyzed, 217 disclosed employee compensation.
The median employee at half of the 217 companies took home at least $100,000 annually — well above the U.S. median household income, which has hovered around $67,000 the past few years and declined at the outset of the pandemic. Roughly 70% of the companies paid a median employee at least that median household income.
A quarter of health care companies — all of which were biotechs or offered life sciences tools — paid their median worker at least $200,000. The average worker at 39 of those companies took home $250,000.
The most well-paid employees among the companies analyzed by STAT worked at Axsome Therapeutics, a biotech company based in New York City. The median Axsome employee made almost $691,000 last year. But there are some caveats. Axsome is very small, with only 108 full-time employees. That compensation figure also is based on the estimated fair value of stock granted to an Axsome staffer instead of the actual realized gains. Those stocks may not have vested or been exercised yet, and therefore the true value is unknown.
Two other biotechs paid their median workers at least a half-million dollars in 2021, with the same caveats of small workforces and unknown stock gains: Karuna Therapeutics and BridgeBio Pharma. Karuna has 107 employees; BridgeBio has 578.
At the other end of the spectrum is the median employee at 27 companies who made $45,000 annually or less. Some of those firms are medical device companies and suppliers that have a large part of their workforce in low-income countries.
For example, at Avanos Medical, which makes pain medication pumps, procedure trays, and other medical equipment, the median employee made $6,120 in 2021 — the lowest amount of any health care company tracked by STAT. That average worker was located in Mexico. The median employee at Align Technology, which makes Invisalign teeth straighteners, was a computer designer in Costa Rica taking home $13,011 — more than 8,700 times less than the $113.4 million Align CEO Joe Hogan made, the highest CEO-to-worker pay ratio.
Avanos and Align did not respond to requests for comment.
Workers at several U.S. provider companies make wages that straddle the federal poverty line. Addus HomeCare, which provides home health and hospice services, paid its median employee just under $14,000 last year. Brookdale Senior Living, which operates various types of senior communities and nursing homes, paid its median employee around $24,000 last year.
Addus has 32,000 workers, 73% of whom are home care aides. Roughly 90% of Addus’ aides, or 21,000 people, work 20 or fewer hours per week, the company said in filings. But at Brookdale, just 27% of its 33,000 employees work part-time.
“Brookdale Senior Living does not publicly share specifics related to associate pay or benefits, other than as required by applicable law,” Brookdale said in response to questions about employee pay. “However, associates at Brookdale earn competitive compensation and are presented with rewarding and impactful opportunities to enrich the lives of our residents and grow with our company.”
Addus did not respond to requests for comment.
Last year’s median annual pay for employees at the country’s largest acute-care hospital chains were all close to each other, as hospitals faced strikes and worker burnout during the second year of the pandemic. Many hospitals also increasingly relied on nurse staffing agencies.
Community Health Systems’ median worker made $61,000, HCA Healthcare’s was $56,000, and Tenet Healthcare’s was a little more than $55,000. Median pay at Universal Health Services, the country’s largest psychiatric hospital chain with a history of problems, was noticeably lower at roughly $45,000.