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 practice arrangements shows that the shifts toward larger practices and away from physician-owned practices accelerated between 2018 and 2020.


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.

2012-2018 Data on Physician Compensation Methods: Upswing in Compensation through the Combination of Salary and Bonus

This report (PDF) provides a detailed examination of how physicians were compensated by their practices between 2012 and 2018. The data show that the percentage of physicians paid by a combination of two or more methods increased from 48.2% in 2012 to 57.3% in 2018 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; increasingly, salary was used in combination with 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.

Payment and Delivery in 2018: Participation in Medical Homes and Accountable Care Organizations on the Rise While Fee-for-Service Revenue Remains Stable

This report (PDF) provides a detailed look at the extent to which physicians are in practices that participate in care delivery models (medical homes and accountable care organizations) and are involved in various payment methods (fee-for-service, pay-for-performance, shared savings, bundled payments, capitation).

53.8% of physicians reported participation in at least one type of accountable care organization (Medicare, Medicaid, or commercial) in 2018, up from 44% in 2016. Participation in medical homes was 31.9% in 2018, up from 25.7% in 2016.

The data on payment methods show that 63.1% of physicians were in practices that received payment from at least one alternative payment method (pay-for-performance, shared savings, bundled payments, and capitation). However, the data also show that alternative payment methods have not replaced fee-for-service in the practice revenue stream. In 2018, an average of 70.3% of practice revenue came from fee-for-service and 29.7% from alternative payment methods; similar findings were present in 2012, 2014, and 2016.

Updated Data on Physician Practice Arrangements: For the First Time, Fewer Physicians are Owners Than Employees

This report (PDF) offers four viewpoints on physician practice arrangements:

  • Whether physicians are owners, employees or independent contractors with their main practice
  • The practice type in which they work (e.g., single or multi-specialty group)
  • How many physicians are in their main practice
  • The ownership structure of their main practice

This study shows that in 2018 a new milestone has been reached - 2018 marked the first year in which there were fewer physician owners (45.9%) than employees (47.4%). The report also shows that while the distribution of physicians has been shifting toward large practices and practices that are hospital-owned, in 2018 40% of physicians still worked in practices that were both small (10 or fewer physicians) and physician-owned.

2016 survey

2014 survey

2012 survey

Private practices

Payment and delivery models

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