Survey Finds Slight Increase in Physician Compensation and Sharp Decline in Productivity in 2020

Alexandria, VA – Data from the 34^th annual AMGA Medical Group Compensation and Productivity Survey demonstrates the profound effect of COVID-19 on physician compensation. Though the survey, conducted by AMGA Consulting, found very modest increases in compensation, there were significant decreases in productivity, which can be directly tied to the pandemic. The data reveals the devastating economic impact of COVID-19 on healthcare provider organizations and indicates that they may need to rethink their compensation models in order to remain resilient in the face of future disruptions. 

“The trends we saw in this year’s survey were the obvious result of flat compensation combined with a decline in volume of services,” said AMGA Consulting President Fred Horton, M.H.A. “Medical groups paid a steep price to retain their physician talent, even though productivity steeply declined. COVID-19 highlighted the need for medical groups and health systems to reconsider their compensation plans so that they rely less on obligatory annual pay increases and more on incentivizing productivity that rewards valuable outcomes. The shift to more value-based compensation models will help organizations become more resilient against future economic downturns.”

The survey found that in 2020, overall physician compensation increased by 0.12%, down from the 3.79% increase seen in 2019. Meanwhile, overall production decreased by 10.17% in 2020, compared to a 0.56% increase the previous year. The compensation per work RVU (wRVU) ratio increased to 10.82%, up significantly from the 2.14% observed in 2019.

Respondents employed various strategies for addressing this disparity: 50% reported limiting reductions in physician production compensation (i.e., guaranteeing compensation), and 25% reported advancing physician draws/salaries to be balanced at a later date. Data indicates that the mostly flat change in pay was due largely to how medical groups handled compensation throughout the COVID-19 pandemic.

“While stark, this decline in wRVU was not surprising,” said Elizabeth Siemsen, AMGA Consulting director. “Medical groups temporarily cancelling elective procedures, an inability for some patients to access healthcare services for portions of the year, and the apprehension of other patients to seek in-person care for fear of COVID-19 infection all played a role in the declines we observed.”

Primary Care

In 2020, median compensation for all primary care specialties increased by 0.40%, median productivity decreased by 10.63%, and compensation per wRVU increased by 12.55%. This is compared to 2019, where compensation increased by 4.46%, median productivity increased by 0.44%, and compensation per wRVU increased by 2.6%.

Fig. 1) Change from 2019-2020: Primary Care

Medical Specialties_­

In 2020, median compensation for all medical specialties increased by 0.39%, median productivity decreased by 10.81%, and compensation per wRVU increased by 10.56%. This is compared to 2019, where compensation increased by 3.52%, median productivity increased by 0.9%, and compensation per wRVU declined by 1.75%. A sample of medical specialties with remarkable changes to the compensation per work RVU ratio are cardiology, gastroenterology, hematology/medical oncology, and neurology.*

Fig. 2) Change from 2019-2020: Specialty Care

* Survey contains compensation and productivity data on all provider specialties.

Surgical Specialties

Surgical specialties presented the largest decline in productivity of any specialty group, with a median wRVU decrease of 11.97%, compared to a 1.95% increase observed in 2019.

Fig. 3) Change from 2019-2020: Surgical Specialties

Advanced Practice Clinicians

Advanced practice clinicians also saw a significant decline in compensation and wRVUs in 2020, as seen in the table below. By contrast, in 2019, median compensation increased by 2.29% for nurse practitioners (NPs) and 2.99% for physician assistants (PAs), while wRVUs declined by -0.35% for NPs and increased by 5.84% for PAs. However, it should be noted that pure production compensation models are less common for advanced practice clinicians than they are for physicians.

Fig. 4) Change from 2019-2020: Advanced Practice Clinicians

About the Survey

The 34^th edition of the AMGA’s Medical Group Compensation and Productivity Survey is its most comprehensive ever, containing data from 398 medical groups, representing over 190,000 providers from 168 physician, advanced practice clinician, and other specialties. To learn more about the survey, visit https://www.amga.org/compsurvey.

For press copies of the survey, please contact Matt Clarke.

###

About AMGA
AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.