Do Top-Ranked Hospitals Pay More? Hospital Rank vs. CEO Compensation

Top-ranked hospitals in the United States are widely recognized for clinical excellence, research output, and institutional reputation. At the same time, many of these organizations offer multi-million-dollar compensation packages to their CEOs.

This raises a focused question:

Is there a relationship between hospital ranking and executive compensation?

Do higher-ranked hospitals systematically pay more for leadership - or is compensation driven by other factors, such as system size, geographic market, or organizational structure?

The Data: Rank vs. Compensation

The list below aligns ten leading U.S. hospitals (from widely recognized national rankings) with the compensation disclosed for their CEOs on IRS Form 990. The primary figure shown is actual total compensation in the most recent filing year, with the year noted. A tenure-wide average is also shown as secondary context. Two entries - UCLA and UCSF - operate under the University of California Regents, a public institution that does not file Form 990, and are therefore excluded.

What a Direct Relationship Would Look Like

If compensation were strongly tied to ranking, the table above would show:

• A monotonic pattern: higher-ranked hospitals consistently paying more
• Relatively small variance between similarly ranked institutions
• Clear clustering of top compensation among the top-ranked hospitals

That is not what the data shows. In 2024, Mayo Clinic - the #1-ranked hospital in the country - paid its CEO Gianrico Farrugia $4.9 million. The same year, #7-ranked NYU Langone paid its CEO Robert Grossman $36.0 million, more than seven times as much. Johns Hopkins Hospital, ranked #3, reported its most recent filing in 2023 with a total of $3.2 million for its health system president Kevin Sowers - the lowest on the list.

There is no monotonic pattern. Compensation does not cluster at the top of the ranking. If anything, the highest pay clusters around a different variable entirely: geography and organizational structure.

Why the Relationship Breaks

Several factors appear to override rank-based compensation:

1. Academic medical center vs. integrated health system. Mayo and Cleveland Clinic operate as integrated academic medical centers where the CEO's remit is narrower. NYU Langone and NewYork-Presbyterian are sprawling multi-hospital systems in the highest-cost healthcare market in the country, with compensation calibrated to the scale of operations rather than a clinical ranking.

2. Regional labor market. New York pays more than Minnesota and Ohio for the same role across essentially every industry. Nonprofit hospital CEO pay is no exception. Both top-compensation institutions on the list - NYU Langone (Grossman, $36.0M in 2024) and NewYork-Presbyterian (Corwin, $26.3M in 2024) - are in Manhattan. The next-highest, Cleveland Clinic (Mihaljevic, $9.7M in 2024), sits in a dramatically lower-cost market.

3. Revenue scale, not reputation. Mayo Clinic generates roughly $17 billion in annual revenue; NYU Langone generates about $13 billion. Their rankings are similar, their scales are similar - but their 2024 CEO compensation differs by a factor of seven. Reputation is not the driver.

4. Board culture. Some boards - notably those at Mayo, Cleveland Clinic, and Johns Hopkins - have long histories of deliberately restrained executive compensation relative to sector benchmarks. Others, particularly in the New York market, have been willing to pay whatever the broader healthcare executive market commands.

Competing Hypotheses

Three explanations compete:

• H1: Rank-driven compensation. Higher-ranked hospitals pay more. Not supported by the data.
• H2: Scale- and market-driven compensation. Pay is driven by revenue, labor market, and organizational structure, not clinical rank. Strongly supported.
• H3: No clear relationship. Compensation varies independently. Partially supported - there is no clear single driver, but the scale/market story explains more than chance.

The Notable Outliers

Two entries stand out:

NYU Langone (#7) - $36.0 million in 2024. Robert Grossman's compensation has trended upward steadily across his tenure, from roughly $7 million in 2016 to $36 million in 2024. It is the highest annual compensation on this list by a wide margin, and the trajectory suggests it is not a one-year anomaly. The organization operates at scale comparable to other national systems, but the New York labor market and NYU's specific board-approved compensation philosophy have produced sustained outlier pay.

Mayo Clinic (#1) - $4.9 million in 2024. The most prestigious hospital in the country, by most measures, pays its CEO less than every other major system on this list except Johns Hopkins. Mayo's board and culture have long resisted using for-profit benchmarking for executive pay, and the result is visible across every year of filings - not just a single data point.

Conclusion

The data answers the opening question clearly: hospital ranking and CEO compensation are not meaningfully correlated. Top-ranked institutions do not systematically pay more; some of them pay dramatically less.

The drivers that do matter - system scale, regional labor market, and board culture around compensation benchmarking - are visible in the filings but rarely discussed in public debate about nonprofit CEO pay. The public conversation treats "top hospital" and "top-paid hospital CEO" as if they should be the same institutions. They are not.

Rank does not determine CEO compensation - market, scale, and board philosophy do.

A Note on Methodology

Hospital rankings reflect widely cited national clinical rankings (U.S. News & World Report "Best Hospitals"). The primary compensation figure is the total compensation disclosed in the CEO's most recent Form 990 filing, with the year noted. Total compensation includes base salary, bonus, incentive pay, other reportable income, and deferred compensation as it vests. The tenure average is shown as secondary context and reflects the arithmetic mean of all years the CEO has filed Form 990 at that organization. Thomas Priselac stepped down as Cedars-Sinai CEO in late 2023; his figure reflects his last full year. UCLA and UCSF operate under the University of California Regents, a public institution that does not file Form 990; their CEO pay is set through separate public processes.

Compensation figures represent peak total compensation disclosed on IRS Form 990 filings, including base pay, bonus, deferred compensation, and other reportable income across all filing years (2001–2025). Separation packages, deferred-comp payouts, and emeritus/former officer entries have been excluded from these rankings, though one-time payments may still inflate individual totals. See the full methodology.

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