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Physician Practice Benchmark Survey

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The Division of Economic and Health Policy Research conducts independent research to support AMA federal, state and private sector advocacy agendas.

One of the division’s most significant efforts is the Physician Practice Benchmark Survey, which focuses on the practice arrangements and payment methodologies of physicians who take care of patients for at least 20 hours per week and don't work for the federal government.

The benchmark survey was conducted in 2012, 2014 and 2016.

Policy Research Perspectives Based on the 2016 Benchmark Survey

This report offers 4 viewpoints on physician practice arrangements:

  • Whether physicians are owners, employees or independent contractors with their main practice
  • What best describes their main practice
  • The ownership structure of their main practice
  • How many physicians are in their main practice

This study shows that for the first time in 2016, less than 50% of physicians (47.1%) had an ownership stake in their practice. It also highlights that despite the continued trend toward larger-sized practices, the majority of physicians still work in small practices. In 2016, 57.8% of physicians worked in practices with 10 or fewer physicians.

Using data from the AMA’s 2016 Physician Practice Benchmark Survey, this paper presents estimates of claim frequency among U.S. physicians and explores whether the likelihood of claims varies by age, gender, specialty and practice arrangement. It finds that 34% of physicians had a claim filed against them during their careers and that claim frequency varies by certain factors, particularly age, specialty and gender.

This report provides a look at the extent to which physicians are in practices that (1) participate in medical homes and Accountable Care Organizations (Medicare, Medicaid or commercial) and (2) receive fee-for-service (FFS) and alternative payment models (pay-for-performance, capitation, bundled payments, or shared savings). 

In 2016, 59.1% of physicians were in practices that received payment from at least 1 APM. Nonetheless, FFS remained a dominant source of practice revenue with an average of 70.8% of practice revenue coming from this method, similar to what was observed in 2012 and 2014.

In 2016, we also found that 25.7% of physicians were in a practice that belonged to a medical home and, across the 3 ACO types, participation rates ranged from 20.9% for Medicaid ACOs to around 32% for Medicare and commercial ACOs.

However, we found that it was not unusual for physicians to be uncertain about practice participation. For medical homes and Medicare ACOs, roughly 1/4 of physicians indicated that they did not know if their practice belonged to that model.

This report provides a current look at whether, and to what extent, physicians treat patients with different types of insurance or who were uninsured. Results from the 2016 Benchmark Survey show that nearly all physicians had privately insured patients (98.0%) and most saw Medicare patients (89.3%), but most also had Medicaid (82.6%) and uninsured patients (75.6%).

The results for 2016 were then compared to those from the 2012 Benchmark Survey to see how physicians’ patient mix changed since the Affordable Care Act (ACA) went into effect. The results indicate that, as a percentage of their patients, physicians saw more Medicaid and privately insured patients in 2016 compared to 2012, and the average uninsured patient share went down. However, the changes for Medicaid and uninsured patients were only evident in states that chose to expand their Medicaid programs under the ACA.

Policy Research Perspectives Based on the 2014 Benchmark Survey

This report examines physician participation in medical homes and Medicare Accountable Care Organizations (ACOs) as well as the prevalence of alternative payment models (APMs) and the extent to which they are used in different types of practices.

In 2014, nearly one-quarter of physicians worked in practices that were part of a medical home and close to 30% worked in practices that were part of a Medicare ACO. Although 59% of physicians said their practice received revenue from at least 1 APM, fee-for-service (FFS) payment was still the dominant payment method used by insurers to pay physician practices.

This report provides a rare and detailed look at how physicians are paid by their practices. In 2014, 33 cents of every dollar earned by nonsolo physicians was received through pay based on productivity. Fifty cents of every dollar was received through salary. Just over half of nonsolo physicians said that their compensation was based on more than 1 method. This report also examines differences in compensation structure across specialty and practice type.

This report offers 4 viewpoints on physician practice arrangements:

  • Whether physicians are owners, employees or independent contractors with their main practice
  • What best describes their main practice
  • The ownership structure of their main practice
  • How many physicians are in their main practice

This study’s findings show that dramatic changes have taken place over the previous 30 years. Among these was the very large decrease in the share of physicians who own their practices, from approximately three-quarters to only one-half. In the short term, the share of physicians who worked directly for a hospital or in practices that were at least partially owned by a hospital increased from 29% in 2012 to 32.8% in 2014.

Previous Policy Research Perspectives

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