2026 Market Review Frequently Asked Questions
Market Review: The Process
Q1: What is the purpose of the market review process, and why are we doing it now?
A market review is a valuable tool that helps us understand how base pay for clinical and non-clinical roles at Cook Children's compare to the external labor market which includes organizations we compete with for talent, as well as health systems of similar size and complexity. Our goal is simple, that is ensuring that team members' pay remains aligned with market conditions and our Compensation Philosophy. Market reviews help us identify areas where adjustments may be needed and support informed, consistent compensation decisions across the organization.
Q2: Have we ever done a market review before?
Market reviews are a common practice across health care organizations. As labor markets evolve, regularly reviewing compensation is considered a best practice. While Cook Children's has conducted market reviews for specific roles in the past, we are committed to conducting an annual review for all roles. This ongoing approach helps ensure compensation remains current, competitive, and responsive to changing external labor market conditions.
Q3: Why is the market review happening now?
This review represents the final step in a year-long effort to establish a strong foundation for compensation moving forward. Our goal is to create a more consistent, predictable process for evaluating pay each year.
This work follows several important compensation initiatives:
- Spring 2025: Pay Range Updates – Pay ranges were adjusted to ensure team members would remain eligible to receive merit increases through base pay rather than lump-sum payments.
- December 2025: Merit Increases – Eligible team members received performance-based base pay increases tied to their prior-year contributions.
- December/February: Internal Reviews – Compensation was reviewed to ensure pay was appropriately aligned with other team members . Adjustments were implemented in December 2025 for nursing roles and February 2026 for non-nursing roles.
- June 2026: External Market Review – The final step was assessing external market data to ensure current pay rates remain appropriately aligned with the external labor market.
Q4: How often will market reviews occur?
Market reviews will be conducted at least annually for all non-executive and non-physician/advanced practice roles. If market conditions change significantly for a specific position between annual review cycles, we may conduct additional assessments as needed.
Market Review: Market Rates and Ranges
Q5: Where do market rates come from, and who do we compare ourselves to?
Reliable compensation information is not publicly available, so Cook Children's, in keeping with requirements, participates in several nationally recognized compensation surveys. These surveys collect, validate, and analyze pay data from thousands of organizations across the country. We compare ourselves to carefully selected peer groups, including:
- Local and regional health care organizations
- Children's hospitals with similar services and patient populations
- Health systems of similar size and complexity
- Non-health care organizations for certain specialized non-clinical roles
This approach provides an objective, data-driven, validated view of the external labor market.
Q6: What does market-competitive pay mean?
Pay is considered market-competitive when a team member's pay falls within an acceptable range around the external market rate for their position.Rather than focusing on a single number or percentage, competitive pay reflects our commitment to attracting, supporting, and retaining talented team members while providing a comprehensive total rewards package.
Q7: Do other health care organizations use the same market data?
While we cannot speak for other organizations, using validated compensation survey data is a widely accepted best practice. Most health care organizations rely on reputable survey sources to help inform compensation decisions.
Q8: Why do some organizations appear to pay more for certain roles?
Every organization has its own compensation strategy, workforce needs, and financial considerations. As a result, pay rates may vary by role, location, demand, recruitment challenges, and organizational priorities. Because we do not have access to another organization's full compensation strategy, we cannot directly compare specific pay decisions.
Q9: Will the market review result in a pay adjustment for everyone?
No. Because of recent merit increases, pay range updates, and internal adjustments completed over the past year, many team members' pay is already appropriately aligned with the external labor market rate for their role.
If a team member's pay falls within the market-competitive range, their compensation is considered competitive. While a market-based pay adjustment may not be needed at this time, compensation will continue to be reviewed through our annual processes.
If a team member's pay falls below the market-competitive range, leaders and the Compensation team review the situation to determine whether a pay adjustment is appropriate.
Q10: Are Advance Practice Providers (APPs) included in the market review?
No, APPs are not included in the market review. While the communications refer to “non-physicians”, this process specifically excludes both physicians and APPs. APPs have a separate review process, and further details regarding APP specific updates will be shared through CCPN leadership.
Market Review: Market-Based Pay Adjustments
Q11: For employees receiving a market-based pay adjustment, when is it effective?
Market-based pay adjustments for eligible team members are effective retroactively to June 28, 2026. While communications occurred over time, the effective date itself has remained unchanged.
Q12: Does performance affect eligibility for a market-based pay adjustment?
Yes. Market alignment is an important part of the review process, but performance and overall contribution are also considered.
Our goal is to make compensation decisions that reflect both external labor market and the expectations of the role. Individual situations are reviewed carefully in partnership with leaders and Compensation.
Q13: How does performance influence movement through a pay range?
Over time, factors such as performance, growth, increased responsibilities, and the development of new skills may influence how a team member progresses within the pay range. The goal is to recognize both market factors and individual contributions when making compensation decisions.
Q14: Are Years of Experience considered during market reviews?
Years of Experience are not a primary factor in the market review mechanics themselves. The market review focuses on external benchmarking data to assess how similar roles are compensated across the broader labor market.
Experience remains an important consideration in other compensation processes, including hiring decisions and internal equity reviews, which assess whether pay is appropriately aligned among team members performing similar work.
Market Review: Looking Ahead
Q15: What compensation reviews can we expect in Fiscal Year (FY) 2027?
FY 2027 runs from October 1, 2026, through September 30, 2027.
We anticipate the following events to occur in the next fiscal year:
- Fall 2026: Performance review process
- December 2026: Merit increases for eligible team members
- Summer 2027: Market Reviews and implementation of any resulting adjustments
The foundational work completed this year means that future reviews are expected to be more streamlined and require fewer adjustments. In addition to base pay, Cook Children's will continue investing in team members through benefits, retirement contributions, wellness programs, recognition initiatives, and other total rewards offerings.
Q16: Why are we moving away from applying the same pay increase to everyone in a role?
As our workforce grows and roles become increasingly specialized, factors such as market data, experience, performance, responsibilities, and internal alignment help create a more complete picture when evaluating pay. While a uniform increase may seem simpler, it does not always reflect the different contributions that team members bring to their roles.
Q17: What is the purpose of the Compensation Philosophy?
The Compensation Philosophy is the guiding framework for how compensation programs are designed and pay is delivered at Cook Children's. It reflects our values and principles and helps ensure our compensation programs remain competitive.
Q18: How is a Compensation Philosophy different from a Pay Strategy?
The Compensation Philosophy reflects our long-term beliefs and values about compensation. A Pay Strategy is a more immediate, practical approach used to support those beliefs in response to changing workforce, market, and business conditions.
Additional Questions
Q19: If a team member's pay is above the market-based pay range, will they receive a lump-sum payment instead of a pay increase?
No
Q20: Should team members with more experience always be paid more?
Experience is one of several factors in compensation decisions. Skills, performance, responsibilities, certifications, career progression, and market conditions may also influence compensation. Because every career path is unique, team members in similar roles may have different rates of pay for different reasons. Our goal is to consider the full picture rather than relying on any single factor alone.
Q21: Can we say Cook Children's pays at a specific market percentile?
No. The external labor market changes continuously, which is one reason regular market reviews are important.
Q22: Does the market review consider compensation beyond base pay?
The market review focuses specifically on base pay. Other forms of compensation, such as overtime, shift differentials, incentive programs and other supplemental pay opportunities, are evaluated separately and are not part of market benchmarking comparisons.