Jun 28
2023
New AMGA Survey Reveals Increase In Primary Care Compensation
Primary care also had more significant increases in work relative value units (wRVUs) than other specialties.
“We’re seeing that the compensation levels for primary care have increased this past year, greater than in other specialty types, which in our opinion, is evidence that the E/M coding changes that CMS [Centers for Medicare and Medicaid Services] put into effect in 2021 are now being reflected in organizations’ compensation plans,” said Elizabeth Siemsen, AMGA Consulting director. “Survey results indicate that the gains for primary care are evident as the smoke clears from the slow transition to the utilization of new wRVU weights for compensation calculation and the volume swings of the pandemic.”
With data on more than 190 specialties included, the 2023 survey reveals that compared to the compensation increases in primary care, overall physician specialty types show relatively nominal increases in compensation.
Data in the 2023 report indicate a more stable trend for physicians and other providers than seen over the past few years. The overall increase in median wRVUs increased by 2.9% compared to the prior year. Primary care physician wRVUs account for the bulk of that, with an increase of 4.0%, while medical and surgical specialties were limited to 1.7% and 1.4%, respectively. Additionally, more groups reported wRVU data in the 2023 survey. Finally, 2022 was a full year without the pandemic causing a significant impact on volume.
Compensation per wRVU percentages have not returned to levels that were trending prior to the pandemic, with an overall increase of 0.3%, compared to an average of 2.8% from 2016 to 2019. This aligns with the similar pacing of compensation and wRVU growth. However, primary care saw a more significant increase of 1.5% in median compensation per wRVU, compared to no increase and -0.2% decrease for medical and surgical specialties, respectively. This this may be further evidence of the impact of 2021 wRVU changes, which, based upon AMGA Consulting’s work in the industry, were more fully implemented in 2022 than in 2021.
The increase in median compensation and wRVUs for advanced practice clinicians (APCs) follows the pattern of that of the physicians, with the larger increases in compensation and wRVU production for nurse practitioners and physician assistants practicing in primary care specialties. In addition to the impact of the CMS changes, the APC results may demonstrate the impact of the post-pandemic hiring market for APCs and the increased APC utilization to address access by medical groups as patient demand rebounded.
The 2023 survey also provides data on medical groups’ median net collections. Overall median net collections increased 5.2%, which is higher than the corresponding percentage increases in compensation. This level of disconnect between collections and physician compensation is more pronounced than in prior years.
“It is clear from the data that revenue gains are not going directly to physician compensation,” said Fred Horton, MHA, AMGA Consulting president. “Rather, groups are using that revenue to address non-provider expense increases. A lower compensation-to-collections ratio suggests that a higher percentage of revenue is going to cover all the expenses that have seen an increase in the past few years. These include staff expense, supply expense, and the like. Basically, we see that this data reflects that organizations are focusing on the management of the changing financial demands for medical group operations.”
About the Survey
The 36th edition of the AMGA’s Medical Group Compensation and Productivity Survey contains data from 446 medical groups, representing over 193,000 providers from 194 physician, advanced practice clinician, and other provider specialties. To learn more and purchase the survey, visit amga.org/compsurvey.