Physicians more productive but generating less revenue: Report

Physician pay and productivity increased in the fourth quarter of 2024, but physicians generated less reimbursement for hospitals, according to Kaufman Hall’s “Physician Flash Report.”

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The Feb. 4 report includes data from 200,000 providers showing the investment, or subsidy, per physician was up 5% to $306,792, and work relative value units increased 8% to 6,313 year over year for the quarter.

Overall for medical care providers, the median net patient revenue per provider FTE increased 9.7% year over year to $399,980. The breakdown by specialty for the fourth quarter of 2024 was:

  • Primary care: $498,000
  • Medical specialty: $394,000
  • Surgical specialty: $405,000
  • Hospital-based specialty: $255,000

The median physician wRVUs per full-time physician hit 5,976 for primary care; 7,139 for medical specialty, 6,948 for the surgical specialty and 5,444 for the hospital-based specialty. But net patient revenue per wRVU dropped 1% from 2023 and 2% from 2024.

“Overall revenue per wRVU continues to fall, highlighting broader reimbursement challenges and an indication that traditional fee-for-service structures aren’t sustainable,” according to the report. “When examining revenue per wRVU by specialty cohort, primary care revenue is holding steady while other specialties have seen a decline. Value-based care and other risk sharing models could be a material driver of these differences, and point to value-based care as having a positive impact on revenue.”

Physician compensation also increased. The median physician paid compensation per full-time physician was $371,589 in Q4, up 8% year over year. The breakdown by specialty was:

  • Primary care: $305,000
  • Medical specialty: $420,000
  • Surgical specialty: $491,000
  • Hospital-based specialty: $368,000

Total expenses per full-time provider hit $645,530 in the fourth quarter and the median labor as a percent of total expense hit 83.9%, up from 83.6% the previous year. Despite increased productivity, physicians had less support. The median full-time support staff per 10,000 wRVUs dropped from 3.28 in the fourth quarter of 2023 to 3.01 in the Q4.

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