For immediate release on December 3, 2018


Kimberly Miller
Marketing Manager

Investment in Pediatrics Continues as Healthcare Providers Work to Align Clinical Practice with Organizational Goals

St. Louis, Missouri – December 3, 2018 – Pediatric physician compensation increased for the 10th straight year according to survey results from ECG Management Consultants’ 2018 Pediatric Subspecialty Physician Compensation Survey. Pediatric physicians saw a 2.3% gain in 2018. The survey also found that overall levels of work relative value unit (WRVU) production, a major production component of compensation plans, decreased by 3.0%, the fourth decrease in production in five years. These changes are likely connected with decreased fertility rates, changing care models, and a focus on nonproduction metrics.

“Growing compensation coupled with relatively flat or decreasing revenues indicates that overall investment in pediatric clinical practice continues,” said principal Ken Roorda, a member of ECG’s Children’s Hospitals practice. “This has the potential to create a funding problem, and many organizations are working to address this concern by implementing advanced practice provider (APP) clinical models, optimizing clinical practices, introducing and refining incentive-based compensation plans, and reexamining entire organizational models. These changes are meant to better align physician practice with children’s hospitals’ goals of high quality and better access.” The resulting care models and plans are more likely to incorporate measures of quality and patient satisfaction than ever before.

Of the organizations surveyed, 50% report using a quality metric in their compensation plans, 32% use a patient satisfaction metric, and 45% use some other nonproduction-based measure. In aggregate, the percentage of total compensation tied to clinical quality, other quality, patient satisfaction, or other nonproduction metrics is 8.4%. This is a 1.2% increase from 2017.

Other key findings from this year’s survey include the following:

  • 74% of pediatric physicians are compensated under some form of variable plan, while 26% are paid under a flat salary plan.
  • For variable compensation plans, on average, 34.1% of total compensation is based on variable factors, most of which are production based, such as WRVUs.
  • Average benefit expense per physician full-time equivalent (FTE) increased by 3.0% and accounts for 18.7% of total compensation.
  • Overall, compensation for pediatric APPs increased, with child psychologists experiencing the largest gains, at 4.8%.
  • For APPs, benefit expenses decreased by 2.3% per APP FTE and now account for 22.3% of total compensation.
  • The recruitment landscape is mixed, with fewer open positions but longer recruitment searches—79% of positions remain open for at least six months, a marked increase over 2017 levels.
  • Education loan forgiveness programs emerged as a trending recruitment offering in 2018, with 33% of organizations reporting such a program as part of their recruitment package.

Median level of WRVU production has declined, on average, 1.3% annually since 2014. This decrease can be linked to fewer overall procedures per physician, driven by fewer evaluation and management codes (which comprises nearly 80% of WRVUs).

About ECG’s Survey

Now in its 12th year, the Pediatric Subspecialty Physician Compensation Survey contains data from nearly 10,000 pediatric providers across 111 organizations. It is the only compensation survey dedicated exclusively to meeting the unique data needs of the pediatric market, providing market-specific physician and APP compensation, production, compensation plan design, recruiting, benefits, and operations data.

To learn more about ECG’s Pediatric Subspecialty Physician Compensation Survey and other survey offerings, contact Angela Collins at

About ECG

ECG is a strategic consulting firm that is leading healthcare forward using the knowledge and expertise built over the course of four decades to help clients see clearly where healthcare is going and navigate toward success. With deep expertise in strategy, finance, operations, and technology, ECG builds multidisciplinary teams to meet the unique needs of every client—from discrete operational issues to bigger-picture strategic and financial challenges. Working as trusted partners with hospitals, health systems, medical groups, academic medical centers, children’s hospitals, ambulatory surgery centers, and healthcare payers across the country, ECG delivers smart counsel and pragmatic solutions to the critical challenges facing healthcare providers. ECG’s national presence includes offices in Atlanta, Boston, Chicago, Dallas, Minneapolis, San Diego, San Francisco, Seattle, St. Louis, and Washington, DC. Learn more about ECG at