It is that time of year when some of the largest survey companies begin to publish their compensation and production surveys. In this case, the Medical Group Management Association, or MGMA, has published the 2020 Provider Compensation survey based upon 2019 data. This will be an exciting year to review the data considering that so much will change next year due to COVID-19 and other material interruptions in services. Nevertheless, the AAPCP wanted to provide members with a review of the MGMA survey and how you should approach the most recent data.
Trends
One item we cannot stress enough is evaluating the data on trends over multiple years. Year to year variation happens for many reasons. For example, you could have a large group not submit to the survey. Or, you could have an increase in a sub-specialty. The reality is that on a year to year basis, it is unlikely the data is shifting as much or as little as it might show. However, when viewing the data through trends, you can see the logical shifts within the market.
Count
One item often overlooked is the count. The count is the number of individuals within the dataset within a particular category. For example, over the past three years, there as been an increase of 20% for anesthesiology respondents. In other categories, even with larger counts, such as family medicine without OB, there was a three-year increase of nearly 25%. The count is important because it can highlight some of the material changes occurring within the data. Keep in mind; the above is based upon total compensation only.
If you look at the count based upon other data, such as work RVUs, we get a different story. For example, for family medicine without OB, there has only been a 13% increase in respondents. This means more organizations are providing total compensation than work RVUs. The bottom line is that provider compensation and contracting professionals should keep these changes in counts in mind. It could highlight why data is increasing or decreasing.
Work RVUs
Another item that should be a critical focus is that of work RVUs. Based upon an evaluation of three years trends, it appears the large majority of specialties at the median increased production. Some experience substantial increases, such as GYN Oncology at approximately 20% and invasive cardiology at 10%. When looking at the 90th percentile, invasive had a 20% increase, and GYN Oncology had a 15% increase. These are interesting to note as it is likely organizations across the country have focused on the growth of oncology and cardiology. This could be one reason we see those increases. Should Total Compensation Match Total Production?
Total Compensation
Once again, utilizing a three-year trend, most specialties have experienced an overall increase at the median level for total compensation. There were some specialties experiencing decreases, such as anesthesiology pain management and maternal-fetal medicine. Once again, it is critical to review other data at the same time. For example, GYN Oncology has increased by approximately 20%, which might lead you to believe income for them has increased by 20%. While true, they also had to work hard to get it. Meaning, the production data also increased substantially. Invasive cardiology increased by approximately 6%, but once again, individuals appeared to have to work harder for that 6%.
Compensation Per Work RVU
Finally, one of the most utilized data points that are becoming increasingly tough to analyze is compensation per work RVU. The primary data issues with this statistic are that it (a) only takes into account respondents who provided work RVUs and total compensation, (b) it does not distinguish the fact that most providers do get paid for other services, and (c) you have many providers on salary models. Because of these reasons, the per work RVU statistic can be challenging. Nevertheless, there are some changes concerning these numbers.
At the median, there were some slight increases across the board. For example, invasive cardiology on a three-year trend is only at an increase of .23%, and GYN Oncology is at 5.69%. Family medicine without OB had very marginal gains with an overall increase over three years of almost 3%. One interesting factor is that many of the nurse practitioner and physician assistant specialties had substantial increases. These increases were far more than physicians. This, though, could simply mean more respondents are now reporting work RVUs, and those are less than expected from previous surveys.
Conclusion
This was an exciting year of data for MGMA. On the one hand, yes, compensation increased. However, the production also increased. This might mean that most organizations did not increase income for specialties, but rather organizations pushed for increased production. Also, each year we see material increases without production for nurse practitioners and physicians assistants. This could be due to the increased utilization of those types of healthcare professionals. Overall, a unique year but not an unexpected one for MGMA.
