Survey Shows Divergent Trends in Provider Compensation and Productivity
Alexandria, VA – AMGA’s 33rd annual 2020 Medical Group Compensation and Productivity Survey shows provider pay increased in 2019, but work relative value unit (wRVU) production remained stagnant. This trend mirrors that found in last year’s survey, which showed similar disparities between annual pay and productivity gains.
The survey, conducted by AMGA’s subsidiary, AMGA Consulting, found that in 2019, overall physician compensation increased by 3.79%, up from the 2.92% increase seen in 2018. Meanwhile, overall production increased by 0.56% in 2019, compared to a 0.29% increase the previous year. Compensation per wRVU ratio increased by 2.14% in 2019, down from the 3.64% in 2018.
“We have now seen this same trend of divergent key metrics for several years in a row, and we have to wonder how long it can continue, given that the vast majority of revenue is still, by and large, generated via work RVU productivity,” said Fred Horton, M.H.A., AMGA Consulting president. “AMGA’s members are concerned about this ongoing trend, and we suspect the industry-wide response to COVID-19 will speed up efforts to mitigate this pattern. At the same time, we are seeing revised care models and rapid telehealth expansion. When combined, it is certain that change is taking place, but the ultimate landing place is far from clear.”
Primary Care
In 2019, median compensation for all primary care specialties increased by 4.46%, median productivity increased by 0.44%, and compensation per wRVU increased by 2.6%. This is compared to 2018, where compensation increased by 4.91%, median productivity increased by 0.21%, and compensation per wRVU increased by 3.57%.
Fig. 1 Change from 2018-2019: Primary Care
Type | Compensation | wRVUs | Compensation per wRVU |
|---|---|---|---|
| Family Medicine | 3.75% | -0.17% | 2.86% |
| Internal Medicine | 5.65% | 1.29% | 2.77% |
| Pediatrics | 5.06% | 1.47% | 1.11% |
| All Primary Care | 4.46% | 0.44% | 2.60% |
Medical Specialties
In 2019, median compensation for all medical specialties increased by 3.52%, median productivity increased by 0.93%, and compensation per wRVU declined by 1.75%. This is compared to 2018, where compensation increased by 3.39%, median productivity increased by 1.9%, and compensation per wRVU increased by 2.65%. A sample of medical specialties with more remarkable changes to the compensation per work RVU ratio are cardiology, gastroenterology, hematology/medical oncology, and neurology.*
Fig. 2 Change from 2018-2019: Specialty Care
| Type | Compensation | wRVUs | Compensation per wRVU |
|---|---|---|---|
| Cardiology (General) | 2.47% | 1.80% | 0.77% |
| Gastroenterology | 2.83% | 2.61% | -3.11% |
| Hematology and Medical Oncology | 4.14% | -1.50% | 4.01% |
| Neurology | 3.46% | -0.35% | 1.19% |
| Medical Specialties | 3.52% | 0.93% | -1.75% |
* Survey contains compensation and productivity data on all provider specialties.
Surgical Specialties
Surgical specialties presented the largest increase in productivity of any specialty group, with a median wRVU increase of 1.95%. The following table highlights changes in compensation and productivity from 2018 to 2019 for certain surgical roles.
Fig. 3 Change from 2018-2019: Surgical Specialties
| Type | Compensation | wRVUs | Compensation per wRVU |
|---|---|---|---|
| OB/GYN (General) | 5.65% | -0.86% | 2.42% |
| Emergency Medicine | 4.05% | 1.86% | -0.75% |
| General Surgery | 4.68% | 2.65% | 1.52% |
| Orthopedic Surgery | 6.88% | 5.24% | 0.33% |
| All Surgical Specialties | 4.84% | 1.95% | -0.40% |
Advance Practice Clinicians
Care model changes are leading nurse practitioners and physician assistants to more frequently work with their own panel of patients. The following figures capture changes in compensation and productivity from 2018 to 2019 for these roles. However, pure production compensation models are less common for advanced practice clinicians.
Fig. 4 Change from 2018-2019: Advance Practice Clinicians
| Type | Compensation | wRVUs | Compensation per wRVU |
|---|---|---|---|
| Nurse Practitioner – Primary Care | 2.29% | -0.35% | 3.53% |
| Physician Assistant – Primary Care | 2.99% | 5.84% | 0.40% |
“Certainly, a need for a call to action has been heightened, as this market trend persists. Add in the many ramifications and unknowns of COVID-19, and medical groups are operating in unfamiliar and uncomfortable territory,” Horton said. “The pressure for more operational efficiency is greater than ever, and the concern is that payers, facing some of the same pressures, will push for more managed expense models, rather than profit/risk sharing through two-sided risk. The epic challenges of today will force new thinking and, hopefully, breakthroughs needed for not simply sustaining compensation levels, but leading to organizations that are truly resilient.”
About the Survey
The 33rd edition of the AMGA’s Medical Group Compensation and Productivity Survey is its most comprehensive ever, containing data from 317 medical groups, representing over 127,000 providers from 169 physician, advanced practice clinician, and other specialties. To learn more about the survey, and to purchase, please visit amga.org/compsurvey.
For press copies, please contact Matt Clarke.
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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.