Medical groups and healthcare organizations reported a spike in compensation across a number of specialties in 2023, according to a recent survey.
The 2023 Medical Group Compensation and Productivity Survey, conducted by AMGA, included data on more than 190 specialties and reached 459 medical groups. These groups represented more than 189,000 providers and nearly 2,000 executive positions. About half of respondents are AMGA members. The findings were announced in July, but the full survey results were released in early September.
The survey found a number of specialties reported spikes in compensation: 3.6% for primary care; 5.1% for medical; 5.5% for surgical and 5.8% for radiology, anesthesiology and pathology. The median change for primary care from 2022 to 2023 was 6%, compared to this year’s 3.6%. Increases in primary care compensation are not as significant as in previous COVID-era years, a report on the survey’s findings said, when the Centers for Medicare and Medicaid Services (CMS) updated E/M work RVU values. The other specialty types are seeing compensation rise alongside related productivity.
“This year’s survey results are noteworthy in numerous areas. We are seeing significant productivity increases, which, in essence, drove the compensation increases across specialties,” Fred Horton, president at AMGA Consulting, said in a press release. Another key finding, he added, is that primary care has previously seen strong increases in compensation but had the lowest hikes of the major specialty categories and negative compensation per wRVU changes: “Given the primary care productivity increases, coupled with minimal compensation increases, their compensation/wRVU ratio actually decreased from past years.”
Of the 85 specialties that met the reportable minimum data requirements in all four regions of the U.S., nearly half (43.5%) have the highest compensation in the West while more than half (56.5%) have the lowest compensation in the East.
In a rollup of only the top three specialties in primary care—family medicine, internal medicine and general pediatrics and adolescent medicine—median compensation changed from $298,726 to $311,666 in 2024, an increase of 4.3%. Productivity increased at 4.6%. And recently hired physicians in family medicine produced wRVUs at about 85% of median, compared to 78% in 2023, indicating a change for newer hires.
Meanwhile, when looking at the top three medical specialties, which include more than 2,000 providers within each, median compensation increased more than 8% from 2023, while productivity went up nearly 9%. By contrast, hospitalists experienced a more moderate compensation and productivity growth (nearly 3% and 2.6%, respectively).
The increase of advanced practice clinicians generally mimicked that of physicians. Compensation went up between 4% and 9.3%. Productivity increased as much as 12.6% at median, demonstrating that these clinicians are being used as true providers and are more engaged in clinical care.
Overall median net collections increased 4.3%, which falls lower than the increases seen in compensation at 5.3% overall. This indicates they are not keeping pace with necessary compensation growth, Horton said in the release. “This issue, especially related to Medicare payment updates, must be addressed in order for organizations to afford necessary increases in compensation without continually relying on a need for providers to see more patients,” he said. Otherwise, groups will face challenges around work-life balance, burnout and provider satisfaction. “The big challenge is how to maintain a provider supply when you continually ask providers to do more to fund increases, rather than funding such increases with collections that keep pace with inflation. This trend of production driving increases in compensation is not sustainable.”
When it comes to the ownership breakdown of medical groups, a third were associated with a health system, while 16% were physician-owned. Another 18% were government-owned, 9% belonged to an insurance company or managed care organization and 8% were associated with a hospital. Just over a third were for-profit, while 61% were nonprofit. About a third of groups had an academic affiliation.
To be considered full-time, physicians are required to work between 36 and 40 clinical hours a week across most (68.5%) medical groups surveyed. For determining physician base salary, most (88%) reported relying on market salary data, which has not changed from past years. The most common determinants of other incentives and discretionary compensation were clinical quality and outcomes (86%) and patient satisfaction (74%)—respondents could choose more than one option.