How Much Practice Revenue Is Fee-for-Service? 67.7% in 2024

Fee-for-service (FFS) payments made up 67.7% of practice revenue in 2024, according to the American Medical Association's 2024 Physician Practice Benchmark Survey of 5,000 physicians. Alternative payment methods (APMs) supplied the other 32.3%.

The FFS share was 71.9% in 2014, so it lost 4.2 percentage points in ten years. The AMA's figure is the average share of practice revenue that physicians reported. Roughly one in five physicians in each survey year did not know their practice's FFS share, and the AMA leaves them out of the revenue-share analysis.

The fee-for-service share of revenue, 2014 to 2024

The AMA runs the survey every two years. Across the six waves, the FFS share fell in four of five steps and held flat once, between 2018 and 2020. The largest drop was 1.4 percentage points, from 69.1% in 2022 to 67.7% in 2024.

Survey year	FFS share of practice revenue	APM share of practice revenue
2014	71.9%	28.1%
2016	70.8%	29.2%
2018	70.3%	29.7%
2020	70.3%	29.7%
2022	69.1%	30.9%
2024	67.7%	32.3%

Source: AMA Policy Research Perspectives 2025-5, average share of practice revenue reported by physicians, excluding physicians who did not know the share.

Of every $100 of practice revenue, about $72 came from FFS in 2014 and about $68 in 2024. The AMA titled its report "A Decade in Review Shows Stagnant Growth Between 2014 and 2024."

How many practices still take fee-for-service payments

In 2024, 82.8% of physicians worked in practices that received at least some FFS revenue, down from 85.9% in 2014. The peak was 88.1% in 2020. Another 62.4% worked in practices that received some payment from at least one of the four APMs the survey asked about, up from 59.0% in 2014.

Practices that run on FFS alone are now a minority. Only 28.0% of physicians reported that all of their practice's revenue came from FFS in 2024, compared with 33.6% in 2014. The share whose practices took all revenue from APMs rose from 6.5% to 10.8%. The largest group, 61.2% in 2024, worked in practices with a mix of both, against 59.9% in 2014.

Which alternative payment methods practices receive

Bundled payments and pay-for-performance lead the four APMs. In 2024, 38.5% of physicians worked in practices that received bundled payments and 37.6% in practices that received pay-for-performance payments. Capitation reached 20.3% and shared savings 17.7%.

Payment method	2014	2022	2024
Fee-for-service	85.9%	86.4%	82.8%
Bundled payments	34.5%	39.6%	38.5%
Pay-for-performance	32.7%	41.4%	37.6%
Capitation	26.1%	25.5%	20.3%
Shared savings	13.6%	22.2%	17.7%

Source: AMA Policy Research Perspectives 2025-5, percentage of physicians in practices that received at least some revenue from each method.

Capitation in 2024 sat at its lowest level since 2014. Shared savings rose over the decade, from 13.6% to 17.7%, after it reached 22.2% in 2022.

Part of the drop from 2022 to 2024 reflects what physicians know. In 2024, 32.4% of physicians did not know whether their practice received shared savings payments, and 22.6% did not know about capitation. Those figures rose by about 6 and 4 percentage points from 2022. The AMA links the gap to employed physicians, who report less awareness of practice contracts than owners do.

Practices in ACOs and medical homes still earn most revenue from fee-for-service

Joining a care delivery model goes with a lower FFS share. Physicians in practices recognized as a medical home reported 56.6% of revenue from FFS, against 73.1% in practices that were not. The gaps for accountable care organizations (ACOs) ran from 13 to 17 percentage points.

Care delivery model	FFS share, participants	FFS share, non-participants
Medical home	56.6%	73.1%
Medicare ACO	60.3%	75.0%
Medicaid ACO	58.5%	75.4%
Commercial ACO	61.5%	74.7%

Source: AMA Policy Research Perspectives 2025-5, 2024 survey, average FFS share of practice revenue.

Every participant group still received more than half of its revenue from FFS. The AMA says many APMs are built on top of FFS payments, which keeps the FFS share high even for ACO members.

ACO membership itself fell in the 2024 survey. Overall, 53.5% of physicians reported that their practice belonged to at least one ACO type, down from 57.8% in 2022. Commercial ACOs reached 40.8% of physicians, Medicare ACOs 37.6%, and Medicaid ACOs 28.6%. Medical home recognition dropped from 34.4% in 2022 to 25.6% in 2024. The AMA attributes part of the decline to more "don't know" answers from employed physicians.

Why ownership changes the payment mix

The 2024 survey counted 57.5% of physicians as employees, up from 43.0% in 2014. Owners fell from 50.8% to 35.4% over the same period. Ownership matters because hospital-owned practices join care delivery models more often. In the AMA data, 46.3% of physicians in hospital-owned practices reported a Medicare ACO, against 30.0% in physician-owned practices. For commercial ACOs the figures were 46.2% and 36.0%.

Size and specialty mix show the same pattern. In 2024, 47.7% of physicians in multi-specialty practices reported a commercial ACO, and 24.0% of physicians in solo practices did. For Medicare ACOs the figures were 47.1% and 17.0%.

Using the 67.7% figure on your own revenue

The AMA number is a survey average, so a practice can compare its own payer data against it. At the average split, a practice that collects $1 million would see about $677,000 from FFS and $323,000 from APMs. A practice that finds its split near 100.0% FFS sits in the group that was 28.0% of physicians in 2024. A practice with some revenue from each side matches the largest group, 61.2% of physicians in 2024.

In the AMA data, the FFS share of practice revenue has not dropped below 67.7% in any survey year since 2014.

Sources

• American Medical Association, Policy Research Perspectives 2025-5: Alternative Payment and Delivery Models, A Decade in Review Shows Stagnant Growth Between 2014 and 2024, September 2025
• American Medical Association, Practice participation in value-based care is up since 2014, October 22, 2025