Physician Production Declined and Pay Stagnated in 2017, AMGA Report Finds
Alexandria, VA – The AMGA 2018 Medical Group Compensation and Productivity Survey, conducted by AMGA’s subsidiary, AMGA Consulting, found that physician compensation and productivity did not meaningfully increase in 2017, as it typically has annually over the past decade.
Overall, the national median showed a decline in physician productivity by a weighted average of -1.63%, and an increase in compensation of only +0.89%. Although compensation per relative value unit (work RVU) was higher than average, 2017 was the first year physician compensation increased by less than 2% in over a decade.
“The 2018 survey’s results are surely different from those of years past, where we experienced an annual cash compensation increase of 2% to 3% almost across-the-board” said Wayne Hartley, M.H.A., COO, AMGA Consulting. “Production has stalled, and since many compensation plans are driven by production, total cash compensation has been impacted.”
Changes in provider productivity and compensation varied by specialty in 2017―in some cases substantially. Certain specialties, like cardiac/thoracic surgery, experienced a higher than normal compensation increase, while other specialties, like ophthalmology, faced a notable decrease.
The weighted average change in median compensation in all medical specialties during 2017 was +1.2%. Weighted average change in median work RVUs was -1.5%, and compensation per work RVU was +3.3%. Data below illustrate the variability among select specialties.
NATIONAL MEDIAN SPECIALTY HIGHLIGHTS: Specialty Care | |||
2017-2018 Percentage Change | |||
Compensation | Work RVU | Compensation per Work RVU | |
Cardiac / Thoracic Surgery | 6.4% | 4.7% | 2.2% |
Emergency Medicine | 1.0% | -4.7% | 1.5% |
General Surgery | 0.7% | -1.7% | 3.8% |
OB/GYN - General | 0.9% | -0.6% | 3.5% |
Ophthalmology | -2.3% | 0.7% | -1.7% |
Orthopedic Surgery | 0.9% | -0.2% | -0.3% |
Otolaryngology | 0.4% | -0.7% | 1.7% |
Urology | -0.1% | 1.7% | 1.1% |
Similar results were found in primary care specialties. The weighted average change in median compensation in primary care specialties in 2017 was +0.8%. The weighted average change in median work RVUs for primary care was -0.2%, and the weighted average change in compensation per work RVU was +2.3%.
NATIONAL MEDIA SPECIALTY HIGHLIGHTS: Primary Care | |||
2017-2018 Percentage Change | |||
Compensation | Work RVU | Compensation per Work RVU | |
Family Medicine | 1.1% | -0.4% | 1.8% |
Internal Medicine | -0.7% | 1.1% | 1.0% |
Pediatrics & Adolescent - General | 1.7% | -0.5% | 3.2% |
A definitive reason for 2017’s decline in productivity has not been established. However, the burdens of EHR use, patient complexity, and administrative and compliance requirements were identified as potential factors.
“Medical groups today consistently report several factors that have an impact on their clinical output,” said Fred Horton, M.H.A., president, AMGA Consulting. “These include the use of electronic health records, increasingly complex patients who require more face-to-face time, and various administrative and compliance requirements. The production levels reported this year could be a consequence of any or all of these factors.”
About the Survey
Now in its 31st year, the AMGA 2018 Medical Group Compensation and Productivity Survey presents data for 140 physician specialties and 27 other provider specialties, with breakdowns by region and group size (by physician FTE). The survey provides data on compensation, net collections, work RVUs, and compensation-to-productivity ratios.
This year’s survey received a record-setting number of provider responses. The responses came from 270 large, multispecialty medical groups and integrated health systems, representing more than 105,000 clinical providers. The average number of providers per participant group was approximately 380. Approximately 72% of respondents were AMGA members.
Other data include panel sizes, gross productivity, fringe benefits and benefits expense-to-compensation ratios, patient visits, compensation for experienced new hires and new residents or fellows, compensation and productivity for academic facilities, and compensation and productivity for nurse practitioner and physician assistant subspecialties.
All survey results are segmented by medical specialty and provide specific breakdowns by size of group and geographic region.
Limited copies of the survey are available for working press. For press copies, contact Matt Clarke at mclarke@amga.org. Surveys are also available for purchase here or by contacting AMGA at 703.838.0033 ext. 362 or cgibbs@amga.org. Survey data is also available in a subscription-based, interactive, online database. For details, visit amga.org/compsurvey.
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About AMGA Consulting
AMGA Consulting is an independent professional services firm that provides consulting and advisory services to multispecialty medical groups and integrated health systems across the United States. AMGA consultants bring real world experience from the front lines of health care, specializing in physician and provider compensation services, Fair Market Value (FMV) reviews, operational performance management, revenue cycle performance, strategy and organizational development.
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.