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2018 Physician Compensation & Production Survey Summary

2018 Physician Compensation & Production Survey Summary

We are pleased to present the results of our fourth annual Physician Compensation and Production Survey, effective January 1, 2018.  For this survey, Integrated Healthcare Strategies received physician compensation and productivity data on 50,651 physicians from 241 practices and 944 individual sites of service.

Participation in our survey continues to increase, with the number of individual physicians received increasing over 35% this year.  As survey participation increases, Integrated Healthcare Strategies is able to report data on additional specialties.  The 2018 Physician Compensation and Production Survey represents physician data from 135 different specialties, which has continued to increase from 126 specialties in 2017, 120 specialties in 2016, and 92 specialties in 2015.

At median, Integrated Healthcare Strategies has identified the following year over year changes in total cash compensation and total cash compensation per work RVU rates in the 2016, 2017, and 2018 surveys:

 

Total Cash Compensation - Year over Year % Change

Specialty Grouping

2016-2017

2017-2018

Average % Change

All Specialties

1.2%

2.2%

1.7%

Primary Care

-0.1%

1.5%

0.7%

Surgical

3.1%

2.6%

2.9%

Medical

1.4%

0.2%

0.8%

Hospital-Based

3.1%

2.0%

2.6%

Total Cash Compensation per Work RVU - Year over Year % Change

Specialty Grouping

2016-2017

2017-2018

Average % Change

All Specialties

2.8%

3.1%

3.0%

Primary Care

0.9%

4.3%

2.6%

Surgical

3.1%

0.0%

1.5%

Medical

3.3%

0.8%

2.0%

Hospital-Based

5.9%

5.0%

5.5%

 

 

With the increasing complexity of physician compensation arrangements, Integrated Healthcare Strategies’ compensation and production survey provides healthcare organizations with insight regarding the individual components of pay that make up their total cash compensation.  We believe that reporting compensation data in this manner provides valuable intelligence on pay practices and compensation for physicians in an ever-changing landscape.

Although productivity-based incentives remain the dominant driver of compensation, the evolution of pay-for-performance to these expanded payment models has also led to an increase of non-productivity compensation components such as those tied to quality and/or operational metrics, as well as advanced practice provider (“APP”) supervision and utilization payments.

With the continued shift in reimbursement from volume-to-value, qualitative and/or operational incentive opportunities are highly prevalent, with 82% of organizations reporting they offer some sort of qualitative/operational incentives. Historically, we have seen quality compensation programs including metrics such as patient satisfaction, clinical outcomes, and citizenship.  However, we are starting to see a shift from individual physician goals to goals that are based on the clinical and financial performance of groups, practices, and service lines.

Given the shortage of physicians in the country, we have also found that organizations continue to increase the number of employed APPs, re-evaluate their care delivery models, and expand the roles held by APPs as they continue to be utilized more as independent providers within team-based care models.

Over 70% of organizations offer APP supervisory payments to their physicians, with the most prevalent method for payment being a fixed annual stipend per 1.0 FTE supervised.  With this increase in APC utilization, we have also seen an increase in the payments and further expansion of the payment methodologies regarding physician supervision of APPs.   Integrated Healthcare Strategies’ physician compensation and production survey is the only compensation survey reporting APP supervision payments.

The standardization of physician compensation models continues to be a driving factor for many organizations hoping to address areas such as recruitment and retention, compensation inequities, and regulatory compliance.  However, the increased prevalence of different payment mechanisms in areas such as productivity-based compensation, quality/operational incentives, and APP supervisory payments demonstrate the fact that while compensation programs should be driven by an organizational philosophy, the compensation models that are derived from the philosophy should remain flexible to address unique challenges that may be presented due to local market factors, differences in physician specialties, and other shifts within the healthcare industry.

Our fourth annual Integrated Healthcare Strategies Physician Compensation and Production Survey continues to provide new and valuable industry insights into the detail behind these different cash components of compensation that will help guide organizations towards success in the dynamic landscape of healthcare.

Integrated Healthcare Strategies will be hosting a webinar on October 4, 2018 highlighting additional findings from the Physician Compensation and Production Survey.   To register for the webinar, or for more information about the Physician Compensation and Production Survey results, please email us at GallagherIntegrated.PhysicianServicesMN@AJG.com.