Private Practice Owners
and
Independent Contractors
For additional information, please contact
Jeanette Janota, Surveys & Information Team
American Speech-Language-Hearing Association
Rockville, MD 20850
800-498-2071, ext. 8738
[email protected]
ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Contents
Executive Summary .....................................................................................................................1
Who They Are ...............................................................................................................................2
Highest Degree ..................................................................................................................2
Sex .......................................................................................................................................2
Age ......................................................................................................................................2
Years of Experience ...........................................................................................................3
Facility ................................................................................................................................3
Geographic Region ...........................................................................................................3
Population Density ...........................................................................................................3
Their Practices...............................................................................................................................4
Full-Time, Part-Time ........................................................................................................4
Additional Job ...................................................................................................................4
Activities ........................................................................................................................................5
Electronic Medical Records ........................................................................................................5
Who They Treat ............................................................................................................................6
Pediatric ..............................................................................................................................6
Autism ................................................................................................................................6
Early Intervention .............................................................................................................6
Insurance Denials ..............................................................................................................7
Adults .................................................................................................................................7
Interns ............................................................................................................................................7
What They Earn: Annual Salaries .............................................................................................8
What They Earn: Hourly Wages ................................................................................................8
Facility ................................................................................................................................8
Region of the Country ......................................................................................................8
Population Density ...........................................................................................................8
What They Earn: Per Visit ..........................................................................................................9
Medicare Provider........................................................................................................................9
Source of Payments......................................................................................................................9
Facility ..............................................................................................................................10
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Region of the Country ....................................................................................................10
Population Density .........................................................................................................10
What They Say About ASHA ..................................................................................................11
ASHA Offerings .........................................................................................................................11
Cultural and Linguistic Diversity ...........................................................................................11
Survey Notes and Methodology .............................................................................................12
Response Rate ..................................................................................................................12
Survey Reports ................................................................................................................12
Suggested Citation .....................................................................................................................13
Supplemental Sources...............................................................................................................13
Thank You ...................................................................................................................................13
Additional Information ............................................................................................................13
Figures
Figure 1:
Figure 2:
Figure 3:
Figure 4:
Figure 5:
Figure 6:
Figure 7:
Figure 8:
Sex of Owners/Contractors ...........................................................................2
Employed Full- or Part-Time ........................................................................4
Activities ...........................................................................................................5
Electronic Medical Record System ...............................................................5
2009 and 2010 Denials From Health Plans ..................................................7
Medicare Provider ..........................................................................................9
Payment Sources ...........................................................................................10
Items Rated Very Important ........................................................................11
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Executive
Summary
The American Speech-Language-Hearing Association (ASHA)
conducted a survey of speech-language pathologists (SLPs) in the
spring of 2011. The survey was designed to provide information
about health care–based service delivery and to update and expand
information gathered during previous SLP Health Care Surveys.
The results are presented in a series of reports.
This report is based on responses from SLPs who were private
practice owners or independent contractors in six types of health
care facilities: general medical hospitals, rehabilitation hospitals,
pediatric hospitals, skilled nursing facilities (SNFs), home health
agencies and clients’ homes, and outpatient clinics and offices.
Highlights:
Š
96% held master’s degrees.
Š
95% were female.
Š
Median age was 42; mean age was 45.
Š
Median number of years of experience was 15.
Š
41% worked in outpatient clinics or offices.
Š
38% worked in the South.
Š
49% worked in suburban areas.
Š
61% worked part-time.
Š
21% always use an electronic medical records system.
Š
40% of treatment time with pediatric patients was in the
area of language.
Š
32% of treatment time with adults was in the area of
swallowing.
Š
Private pay was the most common payment source (79%).
Š
68% said ASHA was doing an excellent or good job
serving its health care members.
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Who They
Are
The data in this report were gathered from the 665 speech-language
pathologists who indicated on ASHA’s 2011 SLP Health Care
Survey that they were independent contractors or owners or coowners of a private practice. The number of respondents is less
than 665 for those questions that some participants chose not to
answer.
Highest Degree
Of the SLPs who were owners or contractors (n = 659):
♦ 96% had a master’s as their highest degree,
♦ 4% had a doctoral degree.
Sex
Of the SLPs who were owners or contractors, most were female (see
Figure 1).
Figure 1. Sex of Owners/Contractors
5%
Male
Female
95%
n = 656
Age
Of the SLPs who were owners or contractors (n = 661):
♦ the median age was 42,
♦ the mean age was 45,
♦ the modal age was 35.
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Years of
Experience
Years of experience influenced the likelihood of owning a private
practice or being an independent contractor (p = .000). For example,
of SLPs who had 1–3 years of experience, 19% were owners/
contractors; of SLPs with 31 or more years of experience, 59% were
owners/contractors.
♦ The median number of years of experience for the SLPs who
were owners/contractors was 15 (n = 660).
♦ The median number of years of experience for those who
were not owners/contractors was 10 (n = 1,102).
Facility
Of the SLPs who were owners or contractors (n = 652):
♦ 1% worked in pediatric hospitals,
♦ 3% in rehabilitation hospitals,
♦ 8% in general medical hospitals,
♦ 10% in skilled nursing facilities (SNFs),
♦ 37% in home health agencies or clients’ homes,
♦ 41% in outpatient clinics or offices.
Geographic
Region
Of the SLPs who were owners or contractors (n = 663):
♦ 17% worked in the Midwest,
♦ 19% in the West,
♦ 26% in the Northeast,
♦ 38% in the South.
Population
Density
Of the SLPs who were owners or contractors (n = 647):
♦ 18% worked in rural areas,
♦ 33% worked in metropolitan/urban areas,
♦ 49% worked in suburban areas.
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Their
Practices
Full-Time,
Part-Time
SLPs were more likely to work part-time than full-time as private
practice owners or independent contractors (see Figure 2).
Figure 2. Employed Full- or Part-Time
39%
Full-time
Part-time
61%
n = 665
Owners/contractors in outpatient clinics and offices (50%) and
home health agencies or clients’ homes (41%) were more likely than
those in other types of facilities to be employed full-time (p = .000).
Region of the country (p = .096) and population density (p = .271)
had no effect on whether owners/contractors worked full- or parttime.
Additional Job
Half (52%) of the part-time owners/contractors reported that they
held an additional job in the profession. An additional job was
reported by 94% of the part-time owners/contractors in
rehabilitation hospitals, 88% of those in pediatric hospitals, 87% in
general medical hospitals, and 79% in SNFs, but only 40% in
outpatient clinics and offices and 34% in home health agencies and
clients’ homes (n = 383; p = .000).
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Activities
Regardless of whether they were employed full- or part-time,
private practice owners/contractors spent the overwhelming
majority of their time providing direct treatment to individuals or
groups (see Figure 3).
Figure 3. Activities
100%
75%
72% 75%
50%
18% 18%
25%
3% 3%
8% 5%
0%
Full-time
Part-time
n = 581
Electronic
Medical
Records
Slightly fewer than half of the owners/contractors reported using
an electronic medical record system for documenting clinical
activities (see Figure 4).
Figure 4. Electronic Medical Record System
21%
Always
Sometimes
Never
55%
24%
n = 644
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Who They
Treat
Pediatric
Autism
Early
Intervention
The ages of populations served by private practice owners/
contractors were fairly evenly distributed:
♦ 28% of their services were delivered to infants and toddlers,
♦ 23% to preschoolers,
♦ 21% to school-age children,
♦ 28% to adults.
Of those who treated pediatric patients (n = 489),
♦ 2% of their time was spent on prevention/wellness,
♦ 2% on voice/resonance,
♦ 4% on fluency,
♦ 5% on augmentative and alternative communication
(AAC),
♦ 7% on cognitive communication,
♦ 10% on swallowing and feeding,
♦ 29% on articulation-phonology,
♦ 40% on language,
♦ 2% on other areas.
Children with autism accounted for a median of 20% of the
caseload of owners/contractors who worked in home health
agencies and clients’ homes or outpatient clinics and offices.
Nearly half (45%) of the owners/contractors said that they provide
early intervention (EI) services to children between birth and 3
years of age under the direction of an individualized family service
plan. SLPs in SNFs were least likely (19%) to provide EI services,
while those in home health agencies and clients’ homes were most
likely (69%; p = .000).
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Insurance
Denials
During 2010, 27% of the owners/contractors received denials from
health plans for speech-language services for children because the
plans claimed that public schools provided those services. An
additional 50% did not receive denials, and the remaining 24% did
not know. Half did not know how denials in 2010 compared to the
previous year (see Figure 5).
Figure 5. 2009 and 2010 Denials From Health Plans
3%
25%
Fewer in 2010
No change
More in 2010
51%
Don't Know
21%
n = 546
Adults
Interns
Of the private practice owners/contractors who treated adult
patients (n = 282),
♦ 3% of their time was spent on accent modification/
communication effectiveness,
♦ 4% on AAC,
♦ 8% on cognitive communication: traumatic brain injury,
♦ 8% on cognitive communication: dementia,
♦ 4% on cognitive communication: other,
♦ 9% on motor speech,
♦ 9% on voice/resonance,
♦ 17% on aphasia,
♦ 32% on swallowing,
♦ 6% on other areas.
The mean number of graduate student interns in 2010 was 2; the
median was 1. Half (51%) of the owners/contractors indicated that
there was no change in this number compared to 2009, but 7% said
that there were more, 7% said fewer, and 35% did not know.
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
What They
Earn:
Annual
Salaries
The salaries in this report are median salaries (the one in the middle
when salaries are ordered from lowest to highest). Salaries are
presented only when there are sufficient cases for the category, that
is, a minimum of 25 respondents.
What They
Earn:
Hourly
Wages
The median number of weekly hours worked by owners/
contractors who received an hourly wage was 20, with a range
from 1 to 53 hours. Owners/contractors who worked up through
20 hours per week (n = 194) earned a median hourly wage of
$60.00. Those who worked more than 20 hours (n = 115) received a
median hourly wage of $50.00.
Facility
Region of the
Country
Population
Density
Only 78 private practice owners/contractors, mostly in outpatient
clinics or offices (n = 58), worked for an annual salary. Their
median salary was $65,000.
Private practice owners/contractors in outpatient clinics or offices
(n = 148) earned a median hourly wage of $65.00, while those
working in home health agencies or clients’ homes earned $67.89
(n = 71), those in general medical hospitals earned $46.33 (n = 34),
and those in SNFs earned $46.20 (n = 53). Too few
owners/contractors worked in rehabilitation hospitals or pediatric
hospitals to report their results.
Owners/contractors in the Northeast earned $72.10 (n = 81).
Medians were lower in other areas:
♦ $55.86 in the West (n = 66),
♦ $50.00 in the South (n = 122),
♦ $47.96 in the Midwest (n = 52).
The median hourly wage was $60.00 in the suburbs (n = 151),
$58.30 in metropolitan/urban areas (n = 99), and $52.53 in rural
areas (n = 66).
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
What They
Earn:
Per Visit
A total of 166 private practice owners/contractors reported
receiving a per visit wage. Their median wage was $66.24. Nearly
all (n = 143) of them were employed in a home health agency or
client’s home, where their per visit wage was $67.06.
Medicare
Provider
Fewer than one quarter of the owners/contractors have enrolled as
Medicare providers (see Figure 6).
Figure 6. Medicare Provider
22%
Yes
No
78%
n = 638
The type of facility where the SLPs worked had no effect on
whether they had enrolled as a Medicare provider (p = .850).
Source of
Payments
Owners/contractors were invited to select from a list of five
sources of payments for services. The most common source was
private pay, followed by agency or school contract. Fewer SLPs
selected Medicare than any other source of payment (see Figure 7).
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Figure 7. Payment Sources
100%
75%
50%
25%
79%
64%
59%
46%
20%
0%
n ≥ 382
Facility
Payment sources varied by several characteristics. By type of
facility:
♦ Patient private pay ranged from 53% in SNFs to 90% in
outpatient clinics and offices (p = .000).
♦ Private health insurance ranged from 26% in SNFs to 67% in
outpatient clinics (p = .000).
♦ Medicaid was reported as a source by as few as 20% of
owners/ contractors in pediatric hospitals and up to 51% of
those in home health agencies or clients’ homes (p = .009).
Region of the
Country
By region of the country:
♦ Reimbursement from an agency or school contract ranged
from 57% in the South to 74% in the Northeast (p = .022).
♦ Private health insurance ranged from 39% in the Northeast
to 68% in the South and Midwest (p = .000).
♦ Medicaid was reported as a source by 19% of owners/
contractors in the Northeast, 32% in the West, 42% in the
Midwest, and 65% in the South (p = .000).
♦ Medicare was a source of payment for 13% of owners/
contractors in the Midwest and 28% in the South (p = .018).
Population
Density
Population density affected two payment sources:
♦ Reimbursement from an agency or school contract ranged
from 53% in metropolitan areas to 79% in rural areas
(p = .000).
♦ Medicaid ranged from 38% in metropolitan areas to 43% in
suburban areas to 63% in rural areas (p = .002).
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
What They
Say About
ASHA
The first question on the SLP Health Care Survey asked about the
kind of job the Association is doing in serving its health care
members. A few owners/contractors (4%) said poor, nearly one
third (29%) said fair, more than half (55%) said good, and 13% said
excellent (n = 637). Region of the country (p = .656) and population
density (p = .140) had no effect on their responses, and both type of
facility and years of experience had too few respondents at each
level to be able to test for differences.
ASHA
Offerings
SLPs were presented with a list of five ASHA programs, products,
and services and asked to rate the importance of each on a 5-point
scale. More owners/contractors gave the highest rating (i.e., Very
important) to ASHA continuing education programs than to any of
the other items (see Figure 8).
Figure 8. Items Rated Very Important
50%
47%
40%
32%
28%
30%
20%
13%
8%
10%
0%
ASHA CE
programs
ASHA web Professional
ASHA
ASHA
pages
consultation products
policy
documents
n ≥ 640
Cultural
and
Linguistic
Diversity
When owners/contractors were asked how qualified they were, on
a 5-point scale, to address cultural and linguistic influences on
service delivery and outcomes, 10% said they were very qualified.
When very qualified was merged with the next response category,
33% identified themselves as qualified. Too little data were
available in some facility categories to test whether responses
varied by type of facility.
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Survey
Notes and
Methodology
Response Rate
The SLP Health Care Survey has been fielded in odd-numbered
years since 2005 to gather information of interest to the profession.
Members, volunteer leaders, and staff rely on data from the survey
to better understand the priorities and needs of SLPs.
The survey was mailed in February 2011 to a random sample of
4,000 ASHA-certified SLPs who were employed in health care
settings in the United States. Second (March) and third (April)
mailings followed, at approximately 3- or 4-week intervals, to
individuals who had not responded to earlier mailings.
The sample was a random sample, stratified by type of facility
and by private practice. Small groups, such as pediatric
hospitals, were oversampled. Therefore, weighting was used
when presenting data to reflect the actual distribution of SLPs in
each type of facility within ASHA.
Of the original 4,000 SLPs in the sample, 1 was deceased, 1 was
retired, 10 had bad addresses, 2 were not employed in the field,
and 63 were employed in other types of facilities, leaving 3,923
possible respondents. The actual number of respondents was
2,451, resulting in a 62.5% response rate. The results presented in
this report are based on responses from those 2,451 individuals.
Survey Reports
Results from the 2011 SLP Health Care Survey are presented in a
series of reports:
• Survey Summary Report
• Caseload Characteristics
• Workforce and Work Conditions
• Annual Salary Report
• Hourly and Per Visit Salary Report
• Private Practice Owners and Independent Contractors
• Survey Methodology, Respondent Demographics, and
Glossary
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ASHA SLP Health Care Survey 2011 ~ Private Practice Owners and Independent
Contractors Report
Suggested
Citation
American Speech-Language-Hearing Association. (2011). ASHA
SLP Health Care Survey 2011: Private practice owners and
independent contractors. Available from www.asha.org.
Supplemental
Sources
Medicare and SLPs in private practice. www.asha.org/practice/
reimbursement/medicare/SLPprivatepractice.htm.
Additional
Information
For additional information regarding the 2011 SLP Health Care
Survey, please contact Amy Hasselkus, Associate Director of
Health Care Services, at 800-498-2071, ext. 5686,
[email protected], or Janet Brown, Director of Health Care
Services, at ext. 5679, [email protected]. To learn more about
resources for ASHA members working in health care, visit ASHA’s
website at www.asha.org/slp/healthcare.
Thank You
Private practice resources. www.asha.org/slp/ppresources.htm.
ASHA would like to thank the SLPs who completed the 2011 SLP
Health Care Survey. Reports like this one are possible only because
people like you participated.
Is this information valuable to you? If so, please accept invitations
to participate in other ASHA-sponsored surveys and focus groups.
You are the experts, and we rely on you to provide data to share
with your fellow members. ASHA surveys benefit you.
8/9/11
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