Physician productivity per full-time provider rose 9% between 2023 and the fourth quarter of 2025, measured in work relative value units, according to Kaufman Hall's Physician Flash Report. Physician compensation over the same period rose only 6%, and net patient revenue per wRVU fell 1%. For practice executives who set compensation formulas, that three-point gap is the number to watch heading into 2027 budget season.

The productivity-pay gap, by the numbers

Kaufman Hall, a Vizient company, publishes the Physician Flash Report each quarter using standardized data from more than 200,000 employed physicians and advanced practice providers across more than 100 specialties. The Q4 2025 edition, released in February 2026, found wRVUs per FTE up 9% since 2023 while compensation climbed only 6% in the same window. Net patient revenue per wRVU, the report's proxy for reimbursement, dropped 1%.

The report also tracks what it costs a health system to employ a physician. The median investment, or subsidy, per physician reached $315,358 in the fourth quarter of 2025, up 4% since 2023. Labor now makes up 84.4% of total physician practice expenses, and advanced practice providers account for 40.7% of the employed provider workforce Kaufman Hall tracks. For an independent practice competing against a hospital system for the same candidate, that subsidy figure is a useful benchmark: it is roughly what the hospital-employed alternative is worth to the employer, even before the physician's own compensation is counted separately.

What AMGA's 2026 survey adds

AMGA's 2026 Medical Group Compensation and Productivity Survey, published June 26, 2026, pulls from 451 medical groups representing nearly 188,000 providers nationwide and reports on 2025 activity. It found overall median provider compensation up 4.3%, a smaller rise than Kaufman Hall's employed-physician figure but consistent in direction: pay grew, though not by much. Advanced practice clinician compensation rose 4.1%. Physician wRVUs climbed 2.4% and net patient visit volumes rose 2.0%, both slower than the compensation growth in the same survey.

Primary care told a different story. Net patient visits per primary care physician fell 2.2%, which AMGA translates to roughly 60 to 90 fewer encounters per doctor per year. Primary care wRVUs still rose 2.0%, and the average wRVUs generated per visit climbed from 1.86 to 1.94, meaning primary care physicians did more per encounter even as encounter counts fell. AMGA also flagged a shrinking pay gap between nurse practitioners and physician assistants in medical specialties: the historical wage differential dropped from more than $7,000 to under $400. The survey cites the AAMC's projection of a shortfall of up to 86,000 physicians by 2036 as part of the pressure pushing groups to rely more heavily on advanced practice providers.

MGMA: fewer specialties are gaining ground

MGMA's 2026 Provider Compensation and Productivity Data Report looked at 23 common specialties and found wRVUs fell in 16 of them, while total patient encounters fell in all 23. Median total compensation kept climbing across the group even as that underlying productivity slipped, a break from the pattern MGMA has tracked in prior years, when compensation growth mostly tracked wRVU growth. Pay went up in nearly every specialty MGMA measured, while the work generating that pay went down in most of them.

The table below lines up the three surveys side by side. Each measures a different population, employed physicians for Kaufman Hall, medical-group-employed providers for AMGA, and MGMA's broader specialty panel, so the figures should not be averaged together. Read as a set, they point the same direction: compensation is rising faster than the productivity used to justify it in wRVU-based comp plans.

SourceSampleCompensation changeProductivity change
Kaufman Hall Physician Flash Report, Q4 2025200,000+ employed physicians/APPs, 100+ specialties+6% since 2023wRVUs/FTE +9% since 2023
AMGA 2026 Compensation and Productivity Survey451 medical groups, ~188,000 providers+4.3% overall (2025)wRVUs +2.4%, visits +2.0% (2025)
MGMA 2026 Provider Compensation and Productivity Report23 common specialtiesMedian compensation still climbingwRVUs down in 16 of 23 specialties

Source: Kaufman Hall Physician Flash Report Q4 2025 Metrics; AMGA 2026 Medical Group Compensation and Productivity Survey; MGMA 2026 Provider Compensation and Productivity Data Report.

What this means for an independent practice

Most independent practices do not employ physicians the way a health system does, so the $315,358 subsidy figure will not apply directly. It is still useful as a ceiling check: if a competing hospital system is effectively subsidizing that much per physician, an independent practice's recruiting and retention offer has to compete against that number in some form, whether through base pay or ancillary income sharing.

The more direct signal is the wRVU-to-pay ratio inside your own compensation plan. If a plan pays a fixed dollar amount per wRVU that has not been revisited since 2023, and reimbursement per wRVU has fallen 1% in that time per Kaufman Hall, the plan is quietly overpaying relative to collections unless the practice has offset it with volume or payer mix changes. MGMA's finding that wRVUs fell in 16 of 23 specialties makes this a wider issue than any one specialty's contract. Practices that review collections per wRVU by provider each month will catch this drift before it shows up as a year-end compensation shortfall.

The AAMC's projected shortfall of up to 86,000 physicians by 2036, cited in AMGA's report, adds a longer-term pressure: fewer physicians competing for the same patient volume typically pushes compensation up regardless of productivity trends, which makes the wRVU-based comp model harder to hold steady over the next decade.

Sources

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