New Survey Shows Impact of Workforce Challenges on Medical Groups

Post-Pandemic Data Reveal Groups Evolving to a New Way of Operating

Alexandria, VA – AMGA’s newly released 2022 Medical Group Operations and Finance Survey reveals that workforce challenges over the past few years have led to changes in provider organizations’ operations. The survey captures data from a period when groups are still dealing with the pandemic on a large scale and have had to adopt to the new realities of healthcare delivery. 

Impact of Workforce and Staffing Challenges

Most significantly, the survey data indicate staffing ratios have declined while overall staffing expenses have increased. The overall direct patient care staffing showed a 11.3% decrease in clinic staffing full-time equivalents (FTEs) on a per provider basis when compared to pre-pandemic medians. In roles at risk for high turnover, such as medical assistants, data show a more significant decline.  At the same time, overall staffing expenses have increased 15%.

“The changes in staffing ratios in key direct patient care roles highlight the ongoing challenges faced by medical groups as they have managed the volume recovery post-COVID without the same staffing resources to provide care,” said AMGA Consulting Chief Operations Officer Rose Wagner, RN, MHS, FACMPE. “This situation will force medical groups to optimize, and hopefully leverage, technology to automate their processes. They have had to learn how to operate as efficiently as possible, to work with the staff they have, while also managing higher labor costs. This trend is unlikely to change for the foreseeable future.”

Care Model Changes

Staffing constraints persist across roles within the medical group. One area where care model changes are progressing to combat physician shortages and address patient access issues is the increase in the utilization of advanced practice clinicians (APCs). Despite a brief dip last year, the pandemic has led to increases into APC-to-physician ratios for most specialty types.

"The use of APCs has been steadily increasing as groups try to adopt a lower cost care model in the midst of a nationwide physician shortage,” said Wagner. “The challenge going forward will be for groups to implement a defined care model that appropriately utilizes APCs with clear delineation of duties between the APC and the physician. We often find that an organization’s provider complement is the result of availability of providers, rather than an orchestrated, and well-thought-out approach to provider staffing." 

Overall Investment per Physician

The overall investment per physician at the medical group level shows improvement for both system-affiliated and independent groups, but there remains a difference in performance between the two group types. The 2022 survey results also show an increase in clinic labor expense and revenue due to the bounce-back in patient volume from the early stages of the pandemic. Additionally, primary care benefited from the increase in revenue due to the Centers for Medicare & Medicaid Services (CMS) work relative value unit (wRVU) weight changes implemented in 2021.

“Improving medical group financial performance is an incredibly complex and demanding endeavor,” said AMGA Consulting President Fred Horton, MHA. “Over the past few years, medical groups have had to juggle the rebound in patient volume, a decrease in staffing FTEs as a result of labor shortages, CMS wRVU weight changes, and a host of other operational challenges. 

“It is important that groups evaluate this year’s results with caution. It would be a mistake to consider the last few years a stable period of time. Looking ahead, groups need to be operating as efficiently as possible amid the growing labor shortages and increasing supply costs and the continued decrease in the CMS conversion factor.” 

About the Survey

The 2022 edition of AMGA’s Medical Group Operations and Finance Survey is its most comprehensive operations survey yet, featuring data representing more than 24,000 providers across 5,600 clinic sites.

This survey includes data on key performance indicators down to the specialty level: 

• Patient access (office visits, telehealth visits, scheduling, etc.)
• Revenue cycle (resources, claims reporting, denials, A/R days, etc.)
• Operational support (staffing by department, resources, structure, location, etc.)
• Clinic staffing (per physician, per provider, per 10,000 wRVUs)
• Revenue and expenses (per physician, per provider, per 10,000 wRVUs)
• And more

For press copies, please contact Taylor Martin.

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 healthcare 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. For more information, visit amga.org