Meanwhile, at the top of the pyramid, the pay is good. No backs are being broken:
Elon Musk gets $29B pay package from Tesla board to keep him at EV maker – NY Post
While rural hospitals struggle to stay alive, cash-heavy urban hospitals can simultaneously be defined as rural for the purpose of extracting additional Medicare money from the federal government:
“Hundreds of urban hospitals have taken advantage of a 2016 policy change that allows them to be simultaneously classified by Medicare as rural and urban facilities for payment purposes, according to a new study…
“By securing a rural designation, the hospitals can apply to reimbursement programs intended to backstop rural providers, including sole community hospital status, rural referral center status, Medicare-dependent small rural hospital status, additional graduate medical education slots and lower eligibility standards for the 340B Drug Discount Program. At the same time, they’re still able to lean on urban hospital benefits such as urban wage indexes for calculating Medicare inpatient prospective payment system reimbursements.”