MGMA data set deep dive (#2 in MGMA series)

Over the course of this year, MGMA will release five separate data reports. In May 2022 they published the 2022 MGMA Provider Compensation and Production report, which overall expressed promising improvements in physician compensation. In the report they addressed the data trends in productivity, physician compensation, advanced practice provider (APP) compensation, post-residency providers, and regional trends. Details surrounding this report were discussed in my recent blog, which I encourage you to check out! In June, MGMA released the 2022 Management and Staff Compensation report, “Competing for Talent and Building Culture amid the Great Reshuffle.” This report looks at compensation trends for C-suite to front desk positions and supplies a fascinating, enlightening, and somewhat horrifying insight into these trends across the workforce.

Admittedly, Theodore Roosevelt was quoted to say “comparison is the thief of joy.” In this case, please indulge me as I use these comparisons to educate and motivate. In the case of the MGMA compensation reports, comparing these numbers across healthcare positions helps to contextualize the role of physicians within the business of medicine and may help inspire you, my physician colleagues, to advocate for your values and your worth. Here is a deeper dive into some of the specific numbers they reported.

Inflation

As many of us noted acutely, inflation surged over the recent years reaching 8.6% in May, the sharpest increase in 40 years according to the Bureau of Labor Statistics. On average, practices previously accounted for 1 to 2.5% annual wage increases to try to match inflation. However in recent years, healthcare workers, as did everyone across the country, noted increased prices surrounding housing, gas, groceries, and other daily items. A poll of medical group practice leaders in December 2021 reported a 5% average cost-of-living increase, with some as high as 15-25%. As a result, the salaries and wages of healthcare workers generally rose.

Compensation Trends for Healthcare Workers

For physicians across the country and across provider types, median total compensation increased from 2019 to 2021. On average, specialties saw a 2-4% increase in total compensation in this timeframe. From 2020 to 2021, physicians saw the following increases in total compensation: primary care at 2.13%, surgical specialists at 3.89%, and nonsurgical specialists at 3.12%. Although we are grateful to see a long-awaited raise after years of pandemic related decreases in compensation and/or job losses, we can note that our compensation raises remain well under the inflation rates.

Management positions saw a relatively dramatic increase in median total compensation. From 2020 to 2021, executive managers saw a 6.56% increase, senior managers a 0.59% increase, and general managers a 3.5% increase. From 2019 to 2021 respectively, these managers saw a 19.73%, 5.07%, and 4.28% increase.

Registered nurses saw a 4.81% increase in median total compensation from 2020 to 2021 and 4.20% from 2019 to 2021. For clarity, these are for employed positions, not temp agency rates which saw very high wage increases.

Medical assistant statistics are reported as the increase in median hourly rate compensation, which was noted to increase by $1.14 from 2020 to 2021 and $1.55 from 2019 to 2021. Based on what I have personally seen at my current hospital, this was a 6% raise for MAs. When fun, relatively low stress, non-healthcare employers such as retail stores and ski resorts are compensating their employees without a skilled degree at $20/hour or more, this compensation adjustment for MAs bringing them to maybe $18-19/hour hardly encourages worker retention.

Regional Compensation Trends

Regional differences are also of interest, given the variability by position type. Management positions received the highest compensation in the Western region and lowest in the Southern region. Staff and nursing also reported highest median compensation in the Western region. This is in contrast to physician regional differences where certain southern states ranked highest median total compensation (Mississippi), and western states ranked in the lowest paying (Arizona, Idaho). Perhaps this indicates regional differences in budget allocation and/or valuation of physicians. Of note, however, the actual difference in pay by provider type by state is in the order of six figures ($102,462 to $612,630), as opposed to five to six figures for management ($23,527 to $31,077 for regional differences and $62,937 to $246,567 by state differences) and five figures for registered nurses by state ($53,962).

Recruitment and Retention

The ability to recruit new healthcare workers and retain those that are currently in place remains a struggle for much of the country. Many practices and regions have seen dramatic losses and costly turnover, and this report cites reasons for staff turnover were 21% for burnout and 59% for better pay and benefits elsewhere.

Provider availability gaps will continue to worsen as recruitment and retention remain a struggle. We’ve discussed the Great Resignation previously and we know that surveys show 1 in 5 physicians intend to leave medicine within the next two years. This resignation is not unique to physicians, however. In a November 2021 Hospital IQ survey, up to 90% of nurses reported they are considering leaving the profession within the next year. Additionally, 1 in 5 nurses is over 65 years old which indicates a likely loss of a significant portion of nurses simply due to retirement. In regards to MAs, home health aides, and nursing assistants, by 2026 a projected 6 million of these workers will leave their healthcare jobs permanently while only 1.9 million will join the workforce. 44% of medical practices reported that MAs were the most difficult staff position to recruit, which is not surprising given the aforementioned statistics.

In order to ensure competitive pay, employers are likely to need to consider additional measures to encourage their recruitment and retention of healthcare workers. An inability to fully staff a medical practice is a major limiting factor for providers, with most medical groups citing a lack of staffing accounted for an inability to attain higher productivity. A shortage in other clinical staff, such as nurses, technicians, billing personnel and other clinical workers has impacted staff morale and dissatisfaction among patients, limits on how many diagnostics tests and labs can be done, efficiency in processing claims and receiving reimbursements in a timely fashion, in addition to numerous other concerns. These concerns demonstrate the highly integrated, teamwork nature of our field, and are not unique to physicians, but span the front desk staff to MAs and RNs to physicians all the way to the C-suite. If you are someone who thinks or knows you should be seeing a raise in your compensation to reach fair rates and match or exceed inflation, contact us here at Contract Diagnostics so we can help you begin the review and negotiation and ultimately help you achieve your full worth. In the meantime, keep an eye out for my upcoming blogs around the remaining three MGMA data set reports that are scheduled to be released in 2022, Cost and Revenue, Practice Operations, and Better Performers.

Source: Manager and Staff Compensation: An MGMA Data Report. “Competing for Talent and Building Culture Amid the Great Reshuffle.” June 2022.