Physician Pay Increased, Productivity Remained Stagnant in 2018, AMGA Survey Finds

Data from AMGA’s 2019 Medical Group Compensation and Productivity Survey shows physician compensation increased in 2018, while changes in work relative value unit (wRVU) productivity remained low.

The survey, conducted by AMGA’s subsidiary, AMGA Consulting, found that overall physician compensation increased by a med­ian of 2.92%, compared to a 0.89% increase the previous year. Productivity increased by 0.29%, compared to a 1.63% decline in 2017. Compensation per wRVU ratio increased of 3.64%, compared to a 3.09% increase the previous year.

“The 2019 survey shows that physician compensation in 2018 rebounded from a stagnant 2017,” said Fred Horton, M.H.A., AMGA Consulting president. “While productivity also increased, it did not increase enough to surpass the decline we saw in last year’s survey, meaning productivity still has not risen since 2016.”

Primary Care

In 2018, median compensation for all primary care specialties increased by 4.91%, up significantly from 0.76% in 2017. While compensation increased more than it had over the past several years, productivity was flat, with wRVUs increasing by only 0.21% in 2018. As a result, the median compensation per wRVU ratio increased 3.57%, the largest increase for primary care specialties in four years.

Fig. 1 Change from 2017-2018: Primary Care

Type Compensation wRVUs Compensation per wRVU
Family Medicine 6.25% 1.23% 3.53%
Internal Medicine 5.90% -0.34% 3.95%
Pediatrics -0.04% -0.96% 3.04%
All Primary Care 4.91% 0.21% 3.57%

“As healthcare organizations move from volume-based to value-based payment models, we’ve observed increased scrutiny on primary care performance. Medical groups continue to focus on delivering care in the most appropriate setting with the greatest efficiency—and often place primary care providers at the center of this strategy,” said Elizabeth Siemsen, AMGA Consulting director. “Concurrently, in recent years, the AMGA survey has shown a slow uptick in the proportion of primary care physicians reported at less than a 1.0 clinical FTE, indicating an increase in part-time providers. In order to recruit and retain the primary care workforce, it may be that the market demanded a compensation course correction this past year.”

Specialty Care

Medical specialties saw an increase of 1.9% in median wRVU production over last year’s survey. The compensation per wRVU ratio increased by 2.65%, and the overall median compensation was up for medical specialties by 3.39%. A sample of medical specialties with more remarkable changes to the compensation per work RVU ratio are cardiology, dermatology, gastroenterology (GI), hospitalist–internal medicine, and psychiatry.*

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AMGA Endorses CMS Data-Sharing Initiatives

AMGA has endorsed two new Centers for Medicare & Medicaid Services (CMS) initiatives that are designed to ensure providers have access to claims data. Expanding access to administrative claims data for providers and their patients has been a longstanding AMGA priority.

The initiatives include Data at the Point of Care (DPC) and MyHealthEData. DPC is a new pilot application programming interface (API) program that would make beneficiaries’ Medicare claims data available to the provider for treatment. MyHealthEData, relies on Medicare’s Blue Button 2.0 initiative to provide beneficiaries and their providers with claims data. AMGA appreciates CMS enabling providers to access Medicare beneficiary claims data directly within their existing workflows through APIs, and we share CMS’ belief that access to a patient’s complete health record is crucial to managing a patient population and improving health outcomes.

Jerry Penso

“Access to claims data from all payers has been a longstanding priority for AMGA and its members,” Jerry Penso, M.D., M.B.A., AMGA president and CEO, said. “CMS’ latest initiatives support AMGA’s work by allowing providers to access Medicare claims data, and in effect, ensuring the successful transition from volume to value. If successful, CMS’ initiatives should inspire commercial insurers to follow suit in data sharing, a crucial step in delivering the most effective care for patients and improving health outcomes.”

Over the past four years, AMGA members repeatedly have indicated that access to timely Medicare and commercial payer administrative claims data is the most significant barrier to assuming risk. The DPC pilot and the MyHealthEData initiative could benefit organizations transitioning to value-based care. A study in the Annals of Internal Medicine further found that access to this data could be very helpful in providing effective courses of treatment with patients; however, care coordination challenges were still present. AMGA looks forward to working with CMS to help ensure the success of these initiatives and demonstrate the need for data sharing in the commercial setting.

AMGA’s comments on the DPC pilot program and the MyHealthEData initiative are available here.