Provider Compensation Grows as Health Systems Navigate Widening Gap Between Pay and Reimbursement

New AMGA survey finds compensation outpacing collections, a sustainability warning for medical groups and health systems nationwide

ALEXANDRIA, VA — Provider compensation continued its steady climb in 2025, even as reimbursement rates failed to keep pace, according to the AMGA 2026 Medical Group Compensation and Productivity Survey. Drawing on data from 451 medical groups and health systems representing nearly 188,000 providers across more than 190 specialties, the survey is among the most comprehensive benchmarking resources available to physician enterprise leaders.

Overall total clinical compensation rose 4.3% in 2025, a sustained increase that reflects both growing patient demand and the intensifying competition for clinical talent. Primary care specialties increased 3.7% in total clinical compensation, while medical specialties grew 4.3% and surgical specialties 3.2%.

Five-Year Compensation Trend by Specialty Category

Total Clinical Compensation — Median Change Year- over-Year	2026	2025	2024	2023	2022
Overall	4.3%	4.9%	5.3%	3.5%	3.7%
Primary Care	3.7%	5.7%	3.6%	6.0%	3.0%
Medical Specialties	4.3%	4.0%	5.2%	1.2%	4.1%
Surgical Specialties	3.2%	3.7%	5.3%	2.1%	3.9%
Radiology / Anesthesiology / Pathology	5.7%	5.1%	5.8%	1.0%	3.8%
APCs (NP and PA)	4.1%	4.3%	5.4%	5.7%	3.7%

Productivity Is Rising, Key Factor to Compensation Growth
Work relative value units (wRVUs) increased 2.4% overall in 2025, and patient visit volume grew 2.0%, signs of genuine demand expansion. However, a closer look at the data reveals a structural concern: Roughly half of compensation growth is being funded by increased provider output, not by gains in reimbursement.

“Over the past several years, provider compensation has increased, but approximately half of the increases have been supported by ongoing growth in wRVU production,” said Fred Horton, AMGA Consulting president. “In a marketplace with stagnant reimbursement, this is necessary to afford the increases in total cash compensation, but it is not sustainable. At some point productivity will top out, and providers are already adjusting their FTE and seeking alternative work arrangements in response to increased workloads.” 

A Signal Worth Watching: Primary Care Visits Decline as Complexity Rises
While visit volume increased across most specialties, primary care was a notable exception: Visits fell 2.2% in 2025, roughly 60 to 90 fewer visits per physician per year. Yet primary care wRVUs still grew 2.0%, and wRVUs per visit rose from 1.86 to 1.94. The data suggests that primary care physicians are seeing higher-acuity patients, a shift likely driven by both E/M coding changes and constrained access to specialists.

“The increase in wRVUs per visit for primary care physicians highlights the need for a strong team-based approach to access. Medical groups need to rethink how advanced practice clinicians and other providers are deployed within their care models,” said Matthew Wells, PhD, senior director, AMGA Consulting

APC Compensation Gap Narrows as Strategic Role Expands
APC compensation grew 4.1% overall, with productivity increasing 3.0%, reflecting the expanded clinical role APCs are playing across medical groups. One notable development: The longstanding compensation gap between nurse practitioners and physician assistants in the same specialty settings is closing. In medical specialties, that difference fell from more than $7,000 to under $400.

“Closing the compensation gap between nurse practitioners and physician assistants will make setting compensation for APCs easier in the future, especially in like settings and specialties,” said Kelsi O’Brien, AMGA Consulting vice president.

The Road Ahead: Sustainability Under Pressure
The compensation trends in this year’s survey play out against a difficult policy backdrop. Projected Medicaid and Medicare reductions, a looming physician shortage of up to 86,000 by 2036, and growing workforce expectations around work-life balance are converging on medical groups at the same moment that collections growth is trailing compensation. The AMGA survey data make clear that relying on productivity increases to bridge that gap is not a long-term solution.
“Organizations must focus on eliminating administrative waste and building an operational platform that supports providers at higher productivity levels without compounding burnout,” said Horton.

About the Survey
The AMGA 2026 Medical Group Compensation and Productivity Survey includes data on more than 190 specialties from 451 medical groups and health systems representing nearly 188,000 providers. It is one of the most comprehensive physician and APC compensation benchmarking resources in the country, covering physicians, nurse practitioners, physician assistants, and executive roles.

Press copies and data on a specific specialty or region are available. Please contact Taylor Martin if interested. For a deeper dive on the data, please view additional charts from the survey here. 

 

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About AMGA Consulting
AMGA Consulting assists healthcare organizations in navigating the changing industry environment 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, AMGA advocates, educates, innovates, and empowers members to deliver high-performance health. More than 175,000 physicians practice in AMGA member organizations, delivering care to one in three Americans. For more information, visit www.amga.org.