For immediate release on November 26, 2018

Provider Compensation a Top Concern and Opportunity for Healthcare Organizations Seeking to Deliver Value in an Uncertain Landscape

Dallas, Texas, — November 26, 2018 Amid political and regulatory uncertainty, the fundamental needs of the US healthcare system remain unchanged: providers must deliver high-quality care to more patients in a more cost-effective manner. “Downward pressure on reimbursement and the need for efficiency are driving our clients to look for performance gains across the physician enterprise,” said Josh Halverson, a principal at ECG Management Consultants. “Compensation is the single largest line-item expense for a provider organization, accounting for anywhere from 50% to 70% of operating costs. It is a natural place to look for opportunities to create better alignment with organizational goals while rewarding and recognizing high-performing providers.”

The internal pressures of physician burnout and changing professional expectations of both early-career physicians and those exiting the workforce add further complexity to the challenge of developing fiscally sustainable compensation approaches that can accommodate physicians’ professional and lifestyle objectives. “It is a complex balancing act,” Halverson said. “The information ECG provides in our annual survey is extremely valuable in helping our clients develop and restructure their compensation agreements to achieve their goals.”

ECG’s 2018 Physician Compensation Survey indicated median primary care physician (PCP) compensation was flat compared to 2017, while specialists experienced a 2.0% increase. The survey also found that median work relative value unit (WRVU) production, a major component in production-based compensation plans, decreased by 2.0% for PCPs and 2.1% for specialists. Steady or increased compensation coupled with lower WRVU production suggests that organizations are encouraging providers to focus more on the quality of care than on the number of tests or procedures performed.

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

  • About 80% of physicians are paid under some form of variable compensation plan, indicating that the market is generally not moving toward straight-salary plans.
  • On average, benefit expenses account for 16.0% of compensation per physician full-time equivalent (FTE), which is roughly in line with historical trends.
  • Quality metrics and patient satisfaction scores are the principal nonproduction incentive metrics used in physician compensation plans, with 65% of organizations using quality metrics and 40% using patient satisfaction scores.
  • Compensation for all advanced practice provider (APP) types increased by 6.6% over 2017. Notable increases include surgical physician assistants’ compensation, which increased by 6.3%.
  • Of organizations surveyed, 68% pay established APPs using a flat salary plan.
  • Average benefit expenses per APP FTE rose 0.7%, to 23.3% of compensation, continuing the upward trend from previous years.
  • The physician recruitment landscape continues to be challenging, with 64% to 100% of open positions in four of the five most highly recruited specialties taking six months or longer to fill. The notable exception is urgent care, with only 20% of open positions taking over six months to fill

About the Survey

ECG’s Physician Compensation Survey is now in its 19th year and is the most comprehensive provider performance study in the healthcare industry. The 2018 results are based on responses from more than 27,534 physicians and 7,511 APPs, with benchmarks for 109 physician specialties and 15 APP types. The survey reports on critical provider performance trends such as physician compensation methodologies, compensation and production benchmarks, primary care panel size, CPT procedure code distributions, physician and APP benefit trends, and additional key performance metrics (e.g., work standards, recruiting and turnover rates by specialty, patient access).

To learn more about ECG’s Physician Compensation Survey and other survey offerings, contact Maria Hayduk at [email protected].

About ECG

ECG is a strategic consulting firm that is leading healthcare forward, using 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 each client’s unique needs, 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