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Compensation Gap Between PCPs, Specialists Decreases

Bucking a trend reported for many years, new compensation data suggest the gap between what primary care physicians are paid and what medical and surgical specialists are paid is decreasing.

Bucking a trend reported for many years, new compensation data suggest the gap between what primary care physicians are paid and what medical and surgical specialists are paid is decreasing.

2013 Physician Compensation and Productivity Survey Report

Primary care physicians reported an overall increase in median total cash compensation of 5.7% between 2012 and 2013. Conversely, Medical and surgical specialists reported an increase of 3.2% and 2.3%, respectively. Findings were presented in the from SullivanCotter, a healthcare compensation and human resources management consulting company.

In a news release from the company, Kim Mobley, managing principal and National Physician Compensation Practice leader said the 2013 survey shows a slight shift in these pay relationships and is consistent with the greater demand for primary care physicians.

“With the expanded healthcare coverage and emphasis on preventative care, population health management and cost control, primary care physicians are in high demand,” said Mobley.

The survey reported that physician compensation models are changing as well, with a greater emphasis on performance-based metrics including quality, patient satisfaction, and, in some cases, citizenship. Currently, about two-thirds of healthcare organizations base their compensation models on clinical productivity using work relative value units (wRVUs), a measure of value used in Medicare for physician services.

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A rule of thumb is that a busy full-time hematologist/oncologist will generate in the range of 5000 to 6000 wRVUs annually for office-based and hospital inpatient services, according to a by Barkley and Guidi in the July 2011 issue of the Journal of Oncology Practice.

The survey reported that the overall median amount paid for quality in 2013 was $15,000, but this varied from $7000 median quality payments for primary care to $20,000 for medical and surgical specialties. When considered as a percentage of total cash compensation, the overall median amount paid for quality was 5%.

Mobley noted, “We are closely monitoring the amount of compensation tied to quality and patient satisfaction as this will have an impact on future compensation. As reimbursement shifts from fee-for-service to value-based, we expect to see some shifts in the balance of the compensation elements that comprise physician compensation plans.”

The survey involved 484 organizations that employed some 91,000 healthcare providers.

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Sam Brondfield, MD, MA