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 Surveys have been conducted in every even year between 2012 and 2020. Policy Research Perspective reports, based on the surveys, provide detailed analysis of the data.

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The report on 2012-2020 physician compensation methods shows an upswing in compensation by multiple methods.

Physician Compensation Methods: The Combination of Salary and Bonus Continues to Dominate through 2020 as Physicians are Increasingly Paid by Multiple Methods

This report (PDF) provides a detailed examination of how physicians were compensated by their practices between 2012 and 2020. The data show that the percentage of physicians paid by a combination of two or more methods increased from 48.2% in 2012 to 59.2% in 2020 due to the increase in the percentage of physicians who received more than half their compensation from salary combined with at least one other method, namely bonus. Although salary remained the primary method used to compensate physicians, personal productivity was still an important factor in physician compensation, especially among practice owners.

The report also examines differences across physician employment status and practice ownership, and illustrates that physician owners of a private practice generally have a different compensation structure from the physicians they employ.

Payment and Delivery in 2020: Fee-for-Service Revenue Remains Stable While Participation Shifts in Accountable Care Organizations During the Pandemic

This report (PDF) provides a detailed look at the extent to which physicians are in practices that participate in medical homes and accountable care organizations (ACOs) as well as involvement in alternative payment methods (APMs).

In 2020, 54.9% of physicians reported participation in at least one type of ACO (Medicare, Medicaid, commercial), up 11 percentage points from 2016. The data generally show consistent participation increases for each ACO type since 2016, although participation in Medicare ACOs slightly decreased from 2018 (38.2%) to 2020 (36.7%). Participation in medical homes was 32.3% in 2020, compared to 31.9% in 2018.

The data on payment methods show that 66.8% of physicians were in practices that received payment from at least one APM (pay-for-performance, shared savings, bundled payments and capitation), up 9 percentage points from 2012. However, consistent over the 2014-2020 period, roughly 70% of practice revenue came from FFS and 30% from APMs. Nonetheless, the data also show a shift away from complete reliance on FFS between 2014 and 2020, as the percentage of physicians indicating all of their practice’s revenue comes from FFS decreased by 5 percentage points.

Telehealth in 2020: Survey Data Show Widespread Use Across Most Physician Specialties and for a Variety of Functions

This report (PDF) describes the rapid uptick in physicians’ use of telehealth between Sept. 2018 and Sept. 2020. Over that period, the share of physicians in practices that used videoconferencing to provide patient visits increased from 14.3% to 70.3%. Telehealth was used to treat a diverse set of patients with a variety of needs. In 2020, 58.0% of physicians said their practices used telehealth to diagnose or treat patients, 59.2% to manage patients with chronic disease and 50.4% to provide care to patients with acute disease. 10.6% of weekly visits were conducted via videoconferencing and 8.1% were conducted via phone. The largest share of visits conducted on a remote basis were by psychiatrists, 36.9% via videoconferencing and 29.0% via phone.

Recent Changes in Physician Practice Arrangements: Private Practice Dropped to Less Than 50 Percent of Physicians in 2020

This report (PDF) describes changes in physician employment status and practice size, type and ownership between 2012 and 2020. Although the 2020 data are consistent with earlier trends, the size of the changes since 2018 suggest that the shifts toward larger practices and away from physician-owned (private) practices have accelerated. 2020 was the first year in which less than half (49.1%) of patient care physicians worked in a private practice, a drop of almost 5 percentage points from 2018. 17.2% of physicians were in practices with at least 50 physicians in 2020, up from 14.7 % in 2018.

2018 survey

2016 survey

2014 survey

2012 survey

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