AMGA: Clinician Compensation Increased 3.7% from 2020 to 2021

Clinician compensation growth and productivity from 2020 to 2021 are comparable to levels seen before the coronavirus pandemic, according to AMGA data.

Clinician compensation and productivity data from 2020 to 2021 indicate a return to pre-pandemic levels, according to the AMGA 2022 Medical Group Compensation and Productivity Survey.

The coronavirus pandemic had significant impacts on clinician compensation and productivity in 2020. Patient service volumes decreased, with some clinicians furloughed and declines in office visits and elective surgeries.

The AMGA 2022 Medical Group Compensation and Productivity Survey is based on data collected from 383 medical groups that employ 183,000 clinicians. The survey features several key data points.

• Median clinician compensation increased 3.7% from 2020 to 2021, compared to a 0.1% increase from 2019 to 2020
   
• Compensation per work unit (wRVU) fell in 2021—clinicians were compensated 11.0% less for each individual unit of work in 2021 than they were in 2020
   
• Productivity increased sharply—median total wRVUs increased by 18.3% from 2020 to 2021, compared to a 10.2% decrease from 2019 to 2020

The compensation increase indicates compensation growth is nearing pre-pandemic levels, Fred Horton, MHA, president of AMGA Consulting, told HealthLeaders. "You could say that should make up for two years of compensation, but there were guarantees put in place for 2019 to 2020 and productivity has not come all the way back. We are approaching the pre-pandemic compensation levels with the 3.7% rate of compensation escalation."

The 3.7% compensation increase from 2020 to 2021 compares favorably to compensation growth before the pandemic, he said. "On an annual basis, we normally see compensation increases of 1.7% to 3.0%. So, we are seeing a larger increase."

The increase in productivity offset the decrease compensation per wRVU, Horton said. "Based upon where productivity came in, it more than made up for the reduced compensation per work RVU. It made up for it in aggregate at an increase of 3.7% in compensation. So, even though we have a decreased compensation per work RVU, we have more than enough units in the marketplace to offset that decrease and still produce on average a 3.7% compensation increase for providers."

Two factors drove the 18.3% increase in median total wRVUs from 2020 to 2021, he said. "The first piece is a return of approximately 90% of the 10.2% decrease in median total work RVUs from 2019 to 2020. So, we almost returned to the productivity that we saw before the pandemic. The second piece, which is about 8% to 9% of the 10.2% decrease in median total work RVUs from 2019 to 2020, represents new values that were assigned to the evaluation and management (E&M) codes on an RVU basis. The RVU values went up for all of the E&M codes—the Centers for Medicare & Medicaid Services changed the RVU values on the E&M codes in 2021."

AMGA expects compensation and productivity to stabilize in 2022, Horton said. "Overall, we should be able to see more stable metrics—whether it is compensation, compensation per work RVU, or productivity. One of the things we have seen historically is that productivity tends to be relatively flat. We have seen large changes mainly because the coding weights changed. There should be the same underlying visit volume as we get back to pre-pandemic levels. I do not anticipate that there are going to be significant increases in productivity going forward."