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Intermountain Healthcare — the largest medical provider in the state — will cut pay for physicians, nurse practitioners and physician assistants during the coronavirus outbreak, which an administrator said in a message sent to staff last week is financially necessary amid “the changing needs.”

The salary reduction discussion comes despite the growing demand for medical professionals to respond to the pandemic. Some hospitals across the country are being overwhelmed with coronavirus patients. And the cases in Utah increased to 806 Monday, with more expected in coming weeks, and four reported deaths.

“You’re putting your life on the line, and you’re being possibly exposed,” said one advanced practice provider at Intermountain who’s upset by the changes. The Salt Lake Tribune agreed to identify her only by her position because she fears being fired for speaking out.

“Now they’re reducing pay with the people who are on the front lines,” she added. “It’s just a slap in the face.”

The Tribune spoke with four staff members at Intermountain facilities. Their identities and employment were verified, but The Tribune has agreed not to name them due to their fear of retaliation. Each confirmed the pay cuts and provided internal documents from administrators explaining the changes.

Intermountain spokesman Daron Cowley responded with a statement Monday, saying that the compensation adjustments would come in June for “a limited number of physicians and advanced practice providers ... that experience significant reductions to their workload.” No cuts have happened yet.

“Intermountain is doing everything possible to keep employees working,” he said. "One way we’re doing this is through redeployment of employees to areas of need. If an employee is redeployed to another role, they’ll continue to be paid at their current rate."

For those unable to be reassigned, the company will pay up to four weeks for time missed, Cowley added, and “employees can also use their accumulated paid time off (PTO) to cover other missed work after the four weeks.”

The impending pay reductions were announced Friday in an email sent to staff that included a link to a video from Intermountain. That clip was uploaded to the company’s YouTube page one day earlier.

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“Our priority is to help you continue to work and have a stable income,” says Mark Briesacher, chief physician executive, in the recording. “We’re doing that through temporary measures for redeployment and compensation. This will help us meet the needs of our patients, as well as reduce uncertainty for you and your families.”

In the explanation, Briesacher notes that many physicians and caregivers statewide are “experiencing extremely high demand for clinical support” during the crisis. But others, he says, have seen a reduction in work because of canceled appointments and all elective and nonessential surgeries being postponed during the outbreak. Because of that, Intermountain is not receiving as much revenue.

In response, the company will be moving jobs around, requiring staff to move to areas of high need and changing shifts. Pay will adjust accordingly, too.

For example, nurses who have an 8-hour on-call shift as part of their 40-hour week have gotten paid at time and a half if they are then called in to work a full shift, some told The Tribune. That benefit will end and they will be paid as normal for only the hours they work.

Intermountain is also not offering hazard pay for those working directly with patients impacted by the pandemic.

“It’s absolutely demoralizing,” added one ICU nurse at Intermountain, who is already working with some COVID-19 patients. “You can’t pay me on good feelings.”

Some doctors at University of Utah Health, meanwhile, are trying to negotiate for hazard pay. U. Health spokeswoman Kathy Wilets said: “Right now, we’re reviewing all ways to support and recognize our teams for their efforts.”

The documents provided to Intermountain staff lack clear details about how many will be impacted by the cuts. But there are 2,400 physicians and advanced practice providers at Intermountain.

Briesacher says in the video that more information is coming on the efforts “to mitigate the impacts of reduced work.” The changes will also be revisited after two months.

A list of frequently asked questions sent to staff also appears to say that administrators, who are working from home during the virus, will not see salary reductions at this time.

“How does this affect the compensation of provider leaders? Will they take a pay cut too?” the document asks. The provided response then answers: “Intermountain is continuing to pay people for the work they are doing.”

The CEO of Intermountain made roughly $1.6 million in 2017, according to public tax documents. U.S. News reports the median salary for physicians nationwide was about $200,000 in 2018.

And the company, as a whole, has reported an operating income of $547.1 million on revenue of $7.72 billion for 2018, according to a health care database.

Briesacher says in the video that the company is amending compensation “to create flexibility.” That will primarily include physicians who work on an RVU — or relative value units — schedule that pays based on productivity and the number of patients seen. The documents that Intermountain sent out note that visits for those doctors are down 30% to 50%.

But the changes will also extend, Briesacher says, to shift-based and salary models.

“They have a lot of explaining to do,” added another advanced practice provider who works at an Intermountain facility. “They refuse to be transparent.”

She said that regardless of whether staff are in the ICU or emergency room, they’re still seeing patients and risking infection from the virus. She changes her clothes every day as soon as she gets home so she doesn’t possibly spread anything to her family, she said.

As much as possible, the doctors where she works have moved to video or telephone calls — but that work of reaching out to patients is still happening. There are people who continue to need help.

“Our work doesn’t stop just because patients don’t come in,” she added.

Another woman who works with vulnerable patients said insurance companies are compensating for the video calls but not the check-ups done by phone, even though many older patients don’t have the technology set up to support video. She’s trying to help prevent those individuals from coming in and being exposed to the virus, if they don’t have to be.

The woman believes the work she continues to do is important during the outbreak. But she said a pay cut will mean possibly not having enough money for her family.

“That’s going to impact everything, my ability to provide for my kids and give them shelter and food,” she said. “I really don’t make very much in my position.”

One advanced practice provider said Intermountain told employees two weeks ago that the company was economically sound. Then the announcement came Friday. The documents provided say that the changes are unrelated to the company’s finances, but rather “linked solely and directly to the work providers are and are not doing.”

“It took us all completely by surprise,” the advanced practice provider added. “We were all shocked given that we’re in the middle of a pandemic. It just adds to the uncertainty and fear. They’re just worried about their bottom line.”

Intermountain put in its video a note saying, “We’re all in this together.” One staffer responded: “Bull---t we are.”