In 2019, Medical Groups Generated a Profit; Health System-Affiliated Groups a Loss, According to New Survey

A deeper dive into allocations and production is needed to understand trends

Alexandria, VA – AMGA’s newly released 2020 Medical Group Operations and Finance Survey reveals that although most groups saw improved financial performance in 2019, independent medical groups generated a profit, while health system-affiliated groups faced a loss. 

The survey shows the overall median profit/investment (P/I) per provider in 2019 to be -$22,028, an improvement from -$57,426 in 2018. For health system-affiliated medical groups, the overall median loss per provider (also known as “investment per provider”) in 2019 was -$163,994 in 2019, slightly better than -$165,050 seen in 2018. For independent medical groups, the profit per provider increased to $12,434 in 2019 from $5,200 in 2018.

The survey also measures median profit/investment (P/I) per physician. This metric includes financial performance divided by number of physicians only, whereas the per provider metric includes advanced practice providers (APPs) in the count of “providers.” In 2019, the overall median per physician was -$32,985, a significant improvement from -$98,840 in 2018. For health system-affiliated medical groups, the overall median loss/investment per physician in 2019 was -$278,505 in 2019, a decline from the -$225,261 seen in 2018. For independent medical groups, the profit per provider increased to $16,603 in 2019 from $6,296 in 2018.






P/I per Provider









P/I per Physician









“The numbers alone are not necessarily indicative of system-affiliated groups performing worse than independent groups,” said Fred Horton, M.H.A., AMGA Consulting president. “One reason for these divergent trends is that revenue generated from ancillary services, such as scans and lab work, is reflected in the bottom line of independent medical groups, but generally does not accrue to the bottom line of groups affiliated with a system. Another reason is that certain expenses are exclusive to system-affiliated medical groups, for example, system office allocations and centralized service expense allocations. Because of these nuances, we analyze compensation and production alignment, staffing ratios, and general volume-adjusted metrics to make a more apples-to-apples comparison.”

When medical groups employ both physicians and APPs, the “per provider” metric is typically utilized, with the metrics being divided by the total number of both physicians and APPs providers. 

P/I per physician or provider is a high-level metric of overall medical group performance. At the group level, this value represents an all-encompassing measure of all revenues and expenses for the medical group. It also takes into consideration system or overhead allocations, which may be applied differently from organization to organization.

In 2019, median expense type as a percentage of overall clinic costs (per physician) were split into three primary categories. Provider compensation and benefits accounted for 61% of expenses, staff salaries and benefits accounted for 21%, and other operational expenses accounted for 18%. The percentage of provider compensation and benefits increased from 56% in 2018. This creates a greater need for practices to be performing at optimal levels, given that the remaining percentage for staff salaries and benefits and operational expenses is shrinking.

About the Survey

The 2020 edition of AMGA’s Medical Group Operations and Finance Survey is its most comprehensive survey yet, featuring data from 41 independent and affiliated medical groups, representing more than 20,000 providers across 3,300 clinical sites.

More information about the survey can be found here.


 About AMGA Consulting 

AMGA Consulting assists healthcare organizations in navigating the changing industry environment. AMGA Consulting builds clients’ organizational capabilities through effective governance, operational improvement, strategic alignment, talent management, provider compensation design, fair market value analysis and total rewards solutions.

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 medical groups’ recognized excellence in the delivery of coordinated, high-quality, cost-effective care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.


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