Primary Care Compensation Rising Faster Than Specialists, But…

The role of the primary care physician continues to be vital in the drive toward value-based healthcare, MGMA data shows.

A survey from Medical Group Management Association provides further evidence that primary care physician compensation is rising at a faster rate than that of specialists. However, the survey also shows that specialists earn nearly twice as much.

The findings, gleaned from comparative data from nearly 70,000 providers, found that primary care physicians reported a median compensation of $241,273 in 2014, a 3.56% increase since 2013. Median compensation for specialists rose to $411,852, a 2.39% increase since last year.

"The role of the primary care physician continues to be a linchpin with the new healthcare models," says Todd Evenson, COO at Englewood, CO-based MGMA. "Obviously hospitals are playing a role hiring at a brisk pace, strengthening their referral networks and trying to ensure that they can deliver on a quality-based model."

"To do that," he says, "they are going to have to lean on and leverage those primary care physicians as well as non-physician providers to change the way that healthcare is delivered away from the fee-for-service environment to one where they can coordinate care and provide value."

The MGMA trends are consistent with other industry watchers. Merritt Hawkins, the Irving, TX-based physician recruiters, this month issued its annual survey of physician demand and compensation. Primary care specialties were among six of the top 10 most requested recruiting searches for Merritt Hawkins in 2014. Primary care compensation growth also outpaced specialists but a huge compensation gap remains between primary care physicians and specialists.

"In terms of compensation, there is a differential there clearly today," Evenson says. "There have been efforts across the industry to have more harmonization. There will be a continued separation in terms of where we see those values, but obviously we are seeing a growth curve that is a little faster in the primary care space. Will that differentiation be somewhat less in the future? That is quite likely."

Evenson says the shift toward value-based care has been pronounced.

"In 2012 our survey showed on average that 6.67% of compensation for primary care physicians was based on quality measures. In 2014 that had already migrated to 10.83% for primary care. On the specialty side, it was 4.6% in 2013 and 7.3% in 2014," he says. "This clearly indicates that the quality component is becoming a larger factor."

In 2012, Evenson says, 50% of survey respondents said that their compensation was 100% productivity-based. In 2014 that number was 25%. "That shift is pretty sizeable in terms of the composition of these compensation plans aligning with value measures, and reflects what is going on in these reimbursement models."

Increasing compensation for primary care physicians likely will have positive effect on luring more medical students into the field, Evenson says, but he says that surveys show that compensation is not a top consideration when medical residents choose their specialty.

"Compensation is not a driver for physician satisfaction," he says. "Compensation is a component, but it is more related to the type of patient care that physicians would like to deliver.''