Physician compensation going up in primary care

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Pay in primary care is going up, compared with other specialties, according to a survey by AMGA Consulting.

Primary care compensation went up an average of 6.1%, beating pay raises of 1.5% and 1.6% for medical and surgical specialties, respectively, according to AMGA’s 36th annual 2023 Medical Group Compensation and Productivity Survey. Rates were 6.1% for family medicine, 6.4% for internal medicine, and 5% for general pediatric and adolescent medicine, according to the survey.

Work relative value units also increased in primary care at rates of 3.4% for family medicine, 1.8% for internal medicine, and 8.9% for general pediatric and adolescent medicine, AMGA said.

It appeared the increase in compensation levels is evidence that organizations are raising compensation based on 2021 evaluation and management coding changes implemented by the U.S. Centers for Medicare and Medicaid Services (CMS), AMGA Consulting Director Elizabeth Siemsen said in a news release announcing the figures.

“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,” Siemsen said.

Among medical specialties, cardiologists saw a 2.1% increase in compensation; gastroenterology decreased by 0.6%; hematology and medical oncology rose by 3.2%; and neurology grew by 1.9%. For surgical specialties, general obstetrics-gynecology rose by 2.4%; emergency medicine dropped 0.7%; general surgery increased by 2.5%; and orthopedic surgery grew by 4.6%, according to the AMGA figures.

As physician salary goes up, median compensation follows the same trend for advance practice clinicians. Primary care nurse practitioners (NPs) saw a 6.1% increase in compensation; physician assistant (PA) compensation grew by 7%. For NPs in medical specialties, compensation grew by 6.2%, while PAs in surgical specialties rose by 5%, according to the AMGA figures.

Those 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,” according to AMGA.

For the 2023 survey, median net collections grew by 5.2%, showing a larger disconnect between collections and physician compensation than in previous years.

“It is clear from the data that revenue gains are not going directly to physician compensation,” AMGA Consulting President Fred Horton, MHA, said in a statement.

“Rather, groups are using that revenue to address non-provider expense increases,” Horton said. “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.”

The 2023 survey was announced at the end of June. It contains data from 446 medical groups representing more than 193,000 physicians and other providers from 194 specialties, according to AMGA.