7 Ways the Industry Falls Short
by Amy Jackson – SVP Product Leader, Compensation Management
Your analysts deserve better than being human calculators
Most of us went into clinician compensation because we like solving problems, not because we enjoy reformatting CSV files at 7 pm on a Friday. But somehow, that’s where we’ve ended up.
After two decades in this industry – from hospital administration to medical group management to building the compensation intelligence platform that should have existed all along – I’ve seen the same frustrations play out over and over. Here’s where the industry is failing us currently, and where I hope it takes us in 2026.
1. You’re forced to choose between cookie-cutter tools or vendor dependency chaos
Current compensation management systems trap you in an impossible choice. You can either:
- Use a basic tool that handles simple dollar-per-RVU calculations but breaks the moment you need complex, multi-tiered productivity bonuses
- Surrender control to vendor engineers who take weeks to implement changes and charge you for every modification
The tools that let you build your own logic can’t handle the complexity of real health care compensation, which involves multiple data sources, intricate threshold calculations, specialty-specific rules, and much more. Meanwhile, the sophisticated platforms require vendor-side programming that turns every plan adjustment into a costly, time-consuming project.
Your analysts shouldn’t need computer science degrees to build compensation plans, and you shouldn’t need to submit a help desk ticket to adjust a productivity threshold.
What comp teams expect in 2026: Visual, intuitive plan building that handles real-world complexity without requiring technical expertise or vendor dependencies.
2. No ability to test and model compensation plans before deployment
You’ve built your complicated productivity model perfectly. You think it’s right. You hope it’s right. However, you won’t know if it’s built correctly until you run payroll next month and face the inevitable clinician complaints.
Most systems offer zero ability to test compensation logic against real clinician data before going live. It means there’s no preview of what individual clinicians would earn, no modeling of cohort-level impacts, and no way to answer, “What happens if we change this threshold?” without actually changing it and hoping for the best.
You’re essentially performing surgery blindfolded, deploying untested compensation logic and praying it works correctly.
What comp teams expect in 2026: Real-time testing environments where they can validate logic against actual clinician data and model different scenarios before implementation.
3. Complete lack of transparency in plan logic and calculations
It’s likely that someone else built your current compensation plans. They might have done it years ago, or they might no longer work there. In either case, it can be extremely difficult to figure out things like why that urgent care model includes a mysterious 0.847 multiplier or how the complex neurology calculation was meant to work.
It means that there is:
- No logic diff viewer showing what changed between versions
- No documentation explaining why decisions were made
- No way for clinicians to understand their own compensation calculations beyond generic “you earned X RVUs at Y rate”
When clinicians question their pay or you need to modify existing logic, you’re reduced to archaeological work, trying to reverse-engineer decisions or calculations made by people who are no longer available to explain them.
What comp teams expect in 2026: Complete visibility into calculation logic with version history, step-by-step calculation breakdowns, and clear documentation of all plan components.
4. Legacy infrastructure prevents modern, intuitive user experiences
You likely have dozens of clinicians across multiple specialties, different effective dates, various organizational structures, and complex assignment rules. Your compensation management tool’s response? Here’s a spreadsheet-based interface that looks like it was designed in 1997.
There’s no visual mapping of who’s on which plan, no drag-and-drop logic building, and no intuitive workflows that match how your brain actually processes compensation planning. Instead, you get clunky forms, manual data entry, and interfaces that require extensive training just to perform basic tasks.
Modern software has proven that complex workflows can be intuitive and efficient, but compensation management tools remain stuck in an era of heavy-handed, user-hostile design.
What comp teams expect in 2026: Modern, intuitive interfaces with visual plan mapping, drag-and-drop functionality, and workflows that actually make sense to compensation professionals.
5. Exception handling is still handled inefficiently by humans
Clinicians work extra shifts, earn retention bonuses, start mid-month, or have complex billing arrangements that don’t fit standard models. These aren’t edge cases – they’re an average Tuesday.
However, most tools treat exceptions like actual exceptions, leading to manual workarounds, separate spreadsheets, and email chains with finance. A sophisticated compensation management platform suddenly becomes a collection of Post-it notes and “don’t forget to…” reminders.
What comp teams expect in 2026: Streamlined exception workflows that integrate seamlessly with standard compensation processes, reducing manual tracking and administrative overhead.
6. Building plans takes forever – and feels like it
Major organizational changes shouldn’t trigger compensation management crises, and software constraints should not drive plan design. When you acquire new practices, launch new service lines, or restructure existing plans, building compensation logic should be fast – maybe even enjoyable.
Instead, it’s a slog with weeks of back-and-forth, multiple rounds of testing, and endless revisions. By the time you’re done, the business requirements have changed twice and you’re already behind on the next project.
If we figured out how to make visual programming tools fast and intuitive for children, we can do the same for health care compensation professionals.
What comp teams expect in 2026: Rapid plan configuration and deployment that keeps pace with organizational changes and business needs. Software meets business needs, not the other way around.
7. Your tools don’t understand your actual workflows
Unfortunately, most compensation management tools were clearly built by people without extensive experience in health care compensation.
They don’t understand that you’re constantly switching between clinician-level details and organizational overviews. They don’t know that you need to see not just what was calculated, but why it was calculated that way. They’ve never experienced the panic of realizing your model might be wrong two days before payroll.
Your workflows are contextualized into the broader organization’s needs and strategy, but your software treats your comp model calculations as pure arithmetic – without the context to support your workflows surrounding that logic.
What comp teams expect in 2026: Software designed by people who understand health care compensation workflows, with features that support actual day-to-day operational needs.
The Real Problem
All of these issues are solvable. We have the technology, and we understand the workflows. The real problem is that the industry has accepted that compensation management should automate calculations to support our current norm: crisis management.
In 2026, I hope that your compensation team gets to think strategically instead of administratively. Because you deserve better than spending Friday nights reformatting CSV files.
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