Latest AMGA Operations and Finance Survey Reveals Medical Groups Challenged with Managing Expenses Amid Stagnant Revenue

Alexandria, VA – Data from the AMGA 2025 Medical Group Operations and Finance Survey reveal the ongoing struggle for medical groups to deliver quality, cost-effective care amid financial uncertainty. Increases to operating expenses that outpace reimbursement are challenging medical groups’ ability to sustain quality care, access, and other patient-centric services. 

“The current financial instability in healthcare is a direct consequence of a fundamental disconnect: Our medical groups are tasked with delivering increasing services while absorbing ongoing payment cuts. This imbalance exacerbates already tense staffing challenges and burnout. Today’s leaders face the impossible daily choice between optimizing efficiency and maintaining critical patient access,” said AMGA Consulting President Fred Horton, MHA.

The survey, conducted by AMGA Consulting, captures key performance indicators to support benchmarking and strategic planning for critical operations. Since the Centers for Medicare and Medicaid Services (CMS) Evaluation and Management (E/M) services overhaul kicked off a 2.9% decrease in the conversion rate ($36.09 to $34.89) in 2021, CMS reimbursement rates have continued to drop. Meanwhile, compensation and other operating expenses have increased, as evidenced by average provider compensation increases of 4.9% from the recent AMGA 2025 Medical Group Compensation and Productivity Survey.  

Compensation increases for physicians, advanced practice providers (APPs), and clinic staff as well as other operating expenses have resulted in an operating expense ratio (OER) greater than 100% for system-affiliated medical groups. Within these medical groups, which tend to have more government payers, provider compensation and benefits are 87% of net professional provider revenue in the 2025 survey, up 6 % from the prior survey period. Overall, the median OER from the 2025 survey, inclusive of salaries, benefits, and operating expenses, was 151% for system-affiliated organizations.  

“The concept of an investment per provider (i.e., OER greater than 100%) has existed for over a decade,” said AMGA Consulting Senior Director Matthew Wells. “One factor that has impacted the OER is growth in salaries and benefits. The average ratio of compensation to net collections for medical specialties in 2017 was 81.2%. Since that time, compensation for medical specialties has grown 27.7%, while net professional collections have grown 11.3%, intensifying the pressure that compensation growth has on the investment per provider.”

“When groups are stretched thin financially, their ability to sustain quality care and access can be at risk,” noted Horton.  “To navigate this imbalance and plan for effective change, groups must rethink their care model within the constraints of their financial reality.  Understanding your OER and anticipating continued market shifts is no longer optional, but is now critical for organizations to make informed decisions and ensure operational resilience.”

About the Survey
The 2025 edition of the AMGA Medical Group Operations and Finance Survey features data from more than 7,100 individual clinics and more than 34,500 providers. 

This year’s report includes a profile of the survey respondents along with key performance indicators and a focus on benchmark data for both private practice and integrated health system organizations. Metrics are reported per physician FTE, per provider FTE, and per 10,000 work relative value units (wRVUs). 

This survey contains data on an expansive list of benchmarks, such as:

 

• Operational overhead staffing by functional area and role
• Revenue cycle key performance metrics
• Financial performance from high-level summary metrics to line-item detail by clinic type

Press copies and data on a specific specialty or region are available. Please contact Taylor Martin if interested. 

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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. amgaconsulting.com

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. 

AMGA represents medical groups and integrated systems of care. Its diverse membership includes multispecialty medical groups, integrated delivery systems, accountable care organizations, and other entities committed to improving healthcare outcomes. AMGA advocates for the formation of innovative, clinically integrated systems of care that advance population health, enhance patient experience, and reduce healthcare costs. For more information, please visit www.amga.org.