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Medical groups and healthcare organizations reported a 6.1% increase in primary care compensation from 2021 to 2022, compared with increases of 1.5% and 1.6% for medical and surgical specialties, respectively, announced by the American Medical Group Association (AMGA).

Primary care also had more significant increases in work relative value units (wRVUs) than other specialties, the 2023 Medical Group Compensation and Productivity Survey showed.

"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 [evaluation and management] coding changes that CMS put into effect in 2021 are now being reflected in organizations' compensation plans," Elizabeth Siemsen, AMGA's consulting director, said in a statement. "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."

Looking at specific primary care categories, internal medicine, family medicine, and pediatrics and adolescent-general care had increases in compensation of 6.4%, 6.1%, and 5%, respectively.

As for wRVUs, they increased 8.9% for pediatrics and adolescent-general care, 3.4% for family medicine, and 1.8% for internal medicine. And for primary care overall, there was a 4% increase.

Compensation per wRVU increased 2.6% for family medicine and 1.6% for internal medicine, and decreased 1.2% for pediatrics and adolescent-general care. For all primary care, there was a 1.5% increase.

Tochi Iroku-Malize, MD, MPH, MBA, president of the American Academy of Family Physicians (AAFP), told 番茄社区app in an email that the organization has "long advocated for a fair level of compensation that will sustain the primary care workforce required to meet the needs of an aging population with increasing levels of chronic conditions."

"Given that more than 70% of family and other primary care physicians are employed, course correcting for decades of underinvestment in primary care requires both payers and employers to take decisive action," Iroku-Malize said. "The AAFP is pleased to see indications that payers and employers of primary care physicians are listening."

"These compensation improvements reflect long overdue investment in our primary care workforce and the AAFP will continue to advocate for family physicians to be fairly compensated for the comprehensive care they provide to patients across their lifespan," she added.

As for medical specialties, there were "relatively nominal increases in compensation," compared with compensation increases in primary care, AMGA said.

Select medical specialties -- hematology/oncology, cardiology, and neurology -- had increases of 3.2%, 2.1%, and 1.9%, respectively, while gastroenterology had a 0.6% decrease in compensation.

The increase in wRVUs for medical specialties overall was 1.7%, and compensation per wRVU remained flat.

Select surgical specialties -- orthopedic surgery, general surgery, and ob/gyn -- had increases of 4.6%, 2.5%, and 2.4%, respectively, while emergency medicine had a 0.7% decrease in compensation.

The increase in wRVUs for surgical specialties overall was 1.4%, and compensation per wRVU decreased 0.2%.

Further findings from the survey showed that medical groups' overall median net collections increased 5.2%, which was higher than corresponding percentage increases in compensation, AMGA noted. "This level of disconnect [is] more pronounced than in prior years," the organization said.

"It is clear from the data that revenue gains are not going directly to physician compensation," Fred Horton, MHA, AMGA's consulting president, said in a statement. "Rather, groups are using that revenue to address non-provider expense increases."

"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," Horton added. "These include staff expense, supply expense, and the like. Basically, we see that these data reflect that organizations are focusing on the management of the changing financial demands for medical group operations."

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