Physician compensation sees slight rise, productivity falls in 2020

In 2020, during the depths of the COVID-19 pandemic, physicians saw a slight increase in compensation but a steep decline in productivity.

According to a news release, the latest AMGA Medical Group Compensation and Productivity Survey ties the lost productivity directly to the COVID-19 pandemic that saw a pause on many healthcare procedures and services.

“The trends we saw in this year’s survey were the obvious result of flat compensation combined with a decline in volume of services,” AMGA Consulting President Fred Horton says in the release. “Medical groups paid a steep price to retain their physician talent, even though productivity steeply declined. COVID-19 highlighted the need for medical groups and health systems to reconsider their compensation plans so that they rely less on obligatory annual pay increases and more on incentivizing productivity that rewards valuable outcomes. The shift to more value-based compensation models will help organizations become more resilient against future economic downturns.”

Overall physician compensation increased by 0.12 percent in 2020 which is down from the 3.79 percent increase seen the previous year. During the same period, overall production fell by 10.17 percent compared to the 0.56 percent increase in 2019. The compensation per work RVU (wRVU) ratio increased to 10.82 percent which is a significant increase from the 2.14 percent the year prior, the release says.

The respondents have employed a number of strategies aimed at closing this gap, with 50 percent limiting reductions in physician production compensation and 25 percent advancing physician draws/salaries to be balanced at a later dat. The mostly flat change in pay was largely due to how medical groups handled compensation during the depths of the COVID-19 pandemic, according to the release.

“While stark, this decline in wRVU was not surprising,” Elizabeth Siemsen, AMGA Consulting director, says in the release. “Medical groups temporarily cancelling elective procedures, an inability for some patients to access healthcare services for portions of the year, and the apprehension of other patients to seek in-person care for fear of COVID-19 infection all played a role in the declines we observed.”

Primary care specialties saw a median 0.4 percent increase in 2020 while the median productivity decreased by 10.63 percent and compensation per wRVU increased by 12.55 percent. The previous year compensation increased by 4.46 percent, median productivity increased by 0.44 percent, and compensation per wRVU increased by 2.6 percent, the release says.

The median compensation for all medical specialties increased by 0.39 percent, median productivity dropped 10.81 percent, and compensation per wRVU shot up 10.56 percent. In 2019 compensation increased by 3.52 percent, median productivity rose 0.9 percent, and compensation wRVU declined by 1.75 percent. The biggest rises in compensation per work RVU ratio are cardiology, gastroenterology, hematology/medical oncology, and neurology, according to the release.

The largest decline in productivity was seen among the surgical specialties with a median wRVU decrease of 11.97 percent compared to the 1.95 percent increase seen in 2019. General surgery saw the largest decrease with a 2.69 percent drop in compensation and aa 12.18 percent decrease in wRVUs, the release says.