Physician Compensation Creeps Up While Productivity Dives

Physician compensation increased modestly as a result of the COVID-19 pandemic, while productivity took a sharp decline, AMGA (American Medical Group Association) reports.

A survey conducted by AMGA Consulting polled over 190,000 providers from nearly 400 medical groups to determine physician compensation and productivity trends in 2020, a pivotal year for healthcare providers with the COVID-19 pandemic.

The survey revealed that physician compensation increased slightly at 0.12 percent compared to 2019—a year that saw a significant 3.79 percent increase in pay for physicians practicing in medical groups.

Meanwhile, overall physician production declined by 10.17 percent in 2020. In contrast, physician production the previous year increased by 0.56 percent.

Combined, the compensation per work relative value unit (wRVU) ratio increased to 10.82 percent, AMGA reported. The ratio was up significantly from 2.14 percent the previous year.

“While stark, this decline in wRVU was not surprising,” Elizabeth Siemsen, AMGA Consulting director, said in a press 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.”

The changes in physician compensation and productivity were similar across specialties. In primary care, for example, median compensation increased by 0.40 percent and median productivity fell by 10.63 percent. For medical specialties, median compensation grew by 0.39 percent and median productivity decreased by 10.81 percent.

However, compensation per wRVU increased significantly more for primary care specialties at 12.55 percent in 2020. In comparison, compensation per wRVU across medical specialties rose by 10.56 percent last year.

Some medical specialties fare better than others though, the survey found. Specialties with compensation per wRVU increases above the average for medical specialties included cardiology (10.62 percent), gastroenterology (15.24 percent), hematology/medical oncology (10.39 percent), and neurology (12.84 percent).

On the other hand, surgical specialties saw a significant decline in physician productivity. The resulting median wRVU decreased by 11.97 percent in 2020 despite a 1.95 percent increase in 2019.

Surgical and many other medical specialists took a massive hit to volumes during the COVID-19 pandemic. Communities shut down during parts of 2020 when positive cases of the coronavirus hit new highs. These shutdowns included in-person care visits and scheduled, elective procedures.

At hospitals, for example, cardiology saw a 57 percent decline in volume in March and April, while breast health and cancer care saw declines of 55 and 37 percent, respectively.

Healthcare utilization has generally remained low in 2021, but physician practices and hospitals alike have started to recover from massive volume declines in 2020.

Now, positive COVID-19 cases are on the rise again. The most recent data report from the Centers for Disease Control and Prevention (CDC) shows that there are over 37.2 million cases of COVID-19 reported in the US, with a seven-day average that is 14.0 percent higher compared to the previous week.

The CDC attributed the rise in cases to new variants of the coronavirus, particularly the Delta variant, which makes up 98.8 percent of cases in the US right now.