IRS 990 data; executive compensation; hospital CEO compensation; gender wage gap


Health and Medical Administration


Introduction: Senior executive positions in hospitals have traditionally been held by men, and do not reflect the gender, racial, ethnic, and cultural diversities of the communities they serve. Despite sex parity in medical school graduates, women remain underrepresented in hospital executive leadership positions. In this study, the authors examined differences in gender composition and compensation of Maryland hospital executives.

Methods: The authors examined 47 Maryland hospitals’ publicly available tax forms from 2013-2018. Data collected included hospital revenue and executive positions’ count, salary, and gender. Executive positions included President and/or Chief Executive Officer (P/CEO), Chief Financial Officer (CFO), Chief Medical Officer (CMO), Chief Nursing Officer (CNO), and Chief Operating Officer (COO). All monetary values were inflation-adjusted to the 2017 dollar.

Results: Women executives were underrepresented across most roles: P/CEO (41/272, 15%), CFO (72/260, 28%), CMO (28/182, 15%), and COO (44/147, 30%). CNO showed a higher proportion of women executives (129/140, 92%). There were no significant changes in the proportion of women executives over the study period (p=0.19). Men CNO’s had significantly higher salaries as a percentage of hospital revenue (0.16% vs 0.12%, p=0.04) and men COOs had significantly higher salaries as a percentage of hospital positive profit (3.65% vs 2.24%, p<0.01).

Conclusion: Data from Maryland hospitals suggest that women remain underrepresented in healthcare executive roles. Further, women executives are generally undercompensated compared to men in similar roles. This study further highlights the need for mentorship and dedicated career pathways to improve women representation in leadership roles in healthcare.