Primary Care Compensation Growth Surpassed Other Specialties in 2022

Primary care compensation and productivity grew at faster rates than other specialties in 2022, a survey from the American Medical Group Association (AMGA) found.

AMGA’s 36th annual Medical Group Compensation and Productivity Survey reflected data from 446 medical groups representing over 193,000 providers from 194 physician, advanced practice clinician, and other provider specialties.

Compared to other physicians, compensation growth from 2021 to 2022 was higher for primary care specialties. Overall, primary care compensation rose by 6.1 percent.

Within the primary care sector, compensation increased by 6.4 percent for internists, 6.1 percent for family medicine physicians, and 5.0 percent for pediatric and adolescent primary care physicians.

Productivity, measured in work relative value units (wRVUs), also increased for primary care physicians, with wRVUs growing by 4.0 percent and compensation per wRVU rising by 1.5 percent.

“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 put into effect in 2021 are now being reflected in organizations’ compensation plans,” Elizabeth Siemsen, director of AMGA Consulting, said in the press release.

“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.”

Under the 2021 Medicare Physician Fee Schedule, CMS increased wRVUs for common office and outpatient evaluation and management (E/M) services.

The overall increase in wRVUs reported by medical groups for all specialties was 2.9 percent, with primary care accounting for the largest part of that growth.

Medical and surgical specialties saw stable trends in compensation and productivity in 2022.

Compensation grew by 1.5 percent from 2021 to 2022 for medical specialties, while wRVUs increased by 1.7 percent. Hematology and medical oncology specialists had the highest compensation and wRVU increases of 3.2 percent and 3.6 percent. Meanwhile, compensation declined by 0.6 percent and wRVUs fell by 1.6 percent for gastroenterologists.

Among surgical specialties, compensation increased by 1.6 percent and wRVUs grew by 1.4 percent. Within the sector, orthopedic surgeons saw the steepest compensation increase at 4.6 percent and the biggest decline in productivity at -2.6 percent.

More medical groups reported wRVU data in the 2023 survey, AMGA noted. Additionally, 2022 was the first full year since 2020 without the pandemic significantly impacting volume.

Overall, compensation per wRVU grew just 0.3 percent, representing the 1.5 percent growth in the primary care sector, a 0.2 percent decrease among surgical specialties, and no change among medical specialties.

Compensation and productivity growth were similar among advanced practice clinicians (APCS), with nurse practitioners (NPs) and physician assistants (PAs) practicing in primary care specialists seeing more significant increases.

For NPs in primary care, compensation grew by 6.1 percent and wRVUs increased by 10.9 percent. PAs in primary care saw a 7.0 percent hike in compensation and a 10.7 percent increase in wRVUs. Meanwhile, compensation and wRVUs for NPs working in medical specialties grew by 6.2 percent and 1.8 percent. Compensation and wRVUs for PAs in medical specialties increased by 5.0 percent and 0.4 percent.

These results may reflect the increased utilization of APCs to help maintain care access amid staffing shortages and rebounding patient demand.

The AMGA survey also found that medical groups’ median net collections increased by 5.2 percent, which is higher than the increases in compensation.

“It is clear from the data that revenue gains are not going directly to physician compensation. Rather, groups are using that revenue to address non-provider expense increases,” said Fred Horton, MHA, president of AMGA Consulting.

“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.”