PRACTICE MANAGEMENT ADVANTAGE 2020 …

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PRACTICE MANAGEMENT ADVANTAGE

2020 Allergist/immunologist compensation data yields surprising results

2020 was a year filled with challenges for practicing allergists/ immunologists, as COVID-19 shutdown orders and safety concerns strained College members' ability to serve patients. Many pivoted to telemedicine and leveraged government programs to help cover staff and overhead costs. Given all the turmoil, one might expect a disastrous impact on allergist compensation, but the data from Medical Group Management Association's (MGMA) Provider Compensation survey show otherwise. Although patient volumes and work relative value units (wRVUs) ? a measure of physician productivity ? were down considerably across the board for allergy/ immunology practices, median total compensation was flat or down just slightly over the prior year.

The College appreciates our partnership with MGMA, which enabled us to collect allergy-specific provider compensation data for our specialty. Those of you who participated in the MGMA Provider Compensation survey have direct access to the detailed survey results and made it possible for the College to report this important information.1

Allergist/immunologist MGMA survey participation

Allergist/immunologist participation in the MGMA Provider Compensation Survey increased in 2021, continuing a fiveyear upward trend.

A total of 439 nonacademic allergists/immunologists participated in the 2021 survey (based on 2020 data), a 3.8% increase over 2020. Participation among academic allergists also increased slightly in 2021 to 169. The total number of participating allergists increased by 3.8% to 608 in 2021. Additionally, allergists from across the country participated in the survey this year, with a generally even mix across all four geographic sections (Eastern, Midwest, Southern and Western).

For full-time physicians, the median nonacademic total compensation (including provider wages, bonus/ incentive payments, research stipends, honoraria and profit distributions) for 2020 was $324,530 when allergy/ immunology (A/I) and pediatrics A/I were combined. This was a very slight decrease over the prior year, following a threeyear consecutive increase. However, median work relative value units (wRVUs), which measure physician productivity, had a double digit percentage decline, as did median

1 N ote: due to COVID-19 and the burden it placed on allergy practices, we did not participate in MGMA's practice cost and revenue survey this year. We fully expect to participate in 2022 and look forward to reporting this data next fall.

total patient encounters. These results were consistent with MGMA's overall findings for nonsurgical specialists2, which experienced a decrease in median total compensation of 1.29% but a more significant decline in wRVUs.

MGMA PROVIDER COMPENSATION SURVEY PARTICIPATION ALLERGIST/IMMUNOLOGIST COUNTS BY REPORT YEAR

Non-academic

2021 2020 2019 2018 2017

Allergy/Immunology

354

370

418

322

303

Pediatrics: Allergy/ Immunology

85

53

39

41

45

Total Allergy/Immunology 439

423

457

363

348

Academic

2021 2020 2019 2018 2017

Allergy/Immunology

96

103

68

85

45

Pediatrics: Allergy/ Immunology

73

60

54

77

39

Total Allergy/Immunology 169

163

122

162

84

Total Allergy/Immunology 608

586

579

525

432

Source: 2021 MGMA DataDive Provider Compensation. Used with permission from MGMA Copyright 2021. . Data is protected by MGMA copyright and is prohibited to be shared or published without MGMA's consent..

We saw a similar result with academic allergy/immunology compensation. The median academic total compensation for the combined A/I and pediatrics A/I in 2020 was $200,874, up slightly over the prior year. Median wRVUs, however, declined more significantly, although the number of academic allergists reporting wRVUs continued to increase. A total of 65 academic allergists reported this data for 2020, which is the highest number participating to date.

So how could total compensation remain essentially flat for allergists and other nonsurgical specialists when wRVUs and total encounters declined so significantly? The answer is likely due to the Provider Relief Fund (PRF) and Paycheck Protection Program (PPP), which provided much needed cash infusions to practices during the pandemic. Back in August of 2020 when the College surveyed members about government financial assistance, 65% of those surveyed said they received or expected to receive a PPP loan, and 35% said they received or expected to receive funds from the PRF. It's likely those numbers grew as the pandemic continued and additional rounds of the PRF were approved.

For comparison purposes, Medscape's 2020 allergist compensation data (reported in 2021) showed average A/I

2MGMA Provider Pay And The Pandemic, an MGMA Data Report based on 2021 MGMA DataDive Provider Compensation.

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compensation of $274,000, with approximately 179 allergist participants. This was a 9.0% decrease over the prior year and followed a consistent increase in A/I compensation over the previous three years.

2020 MGMA PROVIDER COMPENSATION SURVEY FULL-TIME ALLERGISTS/IMMUNOLOGISTS

Non-academic data

# Reporting

Combined A/I and Peds A/I

Median total compensation1

339

$324,530

Median work RVUs2

243

3,798

Median total encounters3

72

2,287

Academic data

# Reporting

Combined A/I and Peds A/I

Median total compensation1

149

$200,874

Median work RVUs2

65

2,398

Source: 2021 MGMA DataDive Provider Compensation, based on 2020 data. Used with permission from MGMA Copyright 2021. . Data is protected by MGMA copyright and is prohibited to be shared or re-published without MGMA's consent.

1T otal compensation = provider wages, bonus/incentive payments, research stipends, honoraria and profit distributions. 2R VUs = relative value units. Work RVUs are a measure of physician productivity and are calculated by multiplying the number of services for each CPT code times the specific wRVU value for that code based on the CMS fee schedule. 3T otal encounters = total direct provider-to-patient interactions, regardless of setting. Includes televisits and e-visits.

However, the number of allergists participating in the Medscape survey is considerably less than those participating in the MGMA survey: 179 for Medscape's 2020 data versus a total of 608 for MGMA. In addition, Medscape's survey does not break out academic vs. non-academic compensation. Finally, the MGMA data shown is median compensation, compared with average compensation from Medscape; the median is typically a better representation for salary data. For all these reasons, it is difficult to compare MGMA and Medscape data.

MEDSCAPE ALLERGIST/IMMUNOLOGIST COMPENSATION DATA1 FULL-TIME ALLERGISTS/IMMUNOLOGISTS

2020

2019

2018

2017

2016

Average A/I compensation

$274,000 $301,000 $275,000 $272,000 $257,000

Approximate # reporting

179

175

193

293

192

1Medscape survey data for each year was reported in the following year. For example, the 2020 data shown here was reported in the 2021 Medscape survey.

In the Medscape survey, 55% of allergists reported some decline in compensation in 2020. However, average income for all physician specialties combined didn't change much in 2020. Most physicians in the Medscape survey saw a drop in patient volumes due to COVID-19, and allergists were no exception. Allergists reported an average decline of about 12%, from 74 to 65 patients per week.

MGMA reported 2020 A/I total compensation by ownership type for nonacademic practices. 2020 median compensation

for both physician-owned and hospital/integrated delivery system (IDS) owned practices decreased slightly from 2019. The 2020 median total compensation for physicianowned practices was 12.3% more than the median total compensation for hospital/IDS owned practices. Work RVUs were also higher, but only by 3.3%. While median work RVUs declined in 2020 for both physician-owned A/I practices and hospital/IDS-owned A/I practices, physician-owned practices saw a much larger decline.

2020 MGMA PROVIDER COMPENSATION SURVEY FULL-TIME ALLERGISTS/IMMUNOLOGISTS

Combined A/I and Peds A/I

Non-academic data

PhysicianOwned

Hospital/IDS Owned

Median total compensation1

$339,502

$302,219

# Reporting

168

149

Median work RVUs2

3,798

3,675

# Reporting

109

114

Source: 2021 MGMA DataDive Provider Compensation, based on 2020 survey data. Used with permission from MGMA Copyright 2021. . Data is protected by MGMA copyright and is prohibited to be shared or re-published without MGMA's consent.

1Total compensation = provider wages, bonus/incentive payments, research stipends, honoraria and profit distributions. 2R VUs = relative value units. Work RVUs are a measure of physician productivity and are calculated by multiplying the number of services for each CPT code times the specific wRVU value for that code based on the CMS fee schedule.

For practices planning to hire a new allergist this year, 23 allergists reported starting salary guaranteed compensation data in MGMA's 2021 Provider Placement Starting Salary survey. The median guaranteed compensation in 2020 for combined A/I and pediatrics A/I was $226,000. This represented a slight increase over the prior year.

2020 MGMA PROVIDER PLACEMENT STARTING SALARY SURVEY

Combined A/I and Peds A/I Provider Placement

# Reporting Starting Salary

Median Guaranteed Compensation

23

$226,000

Source: 2021 MGMA DataDive Provider Compensation, based on 2020 survey data. Used with permission from MGMA Copyright 2021. . Data is protected by MGMA copyright and is prohibited to be shared or re-published without MGMA's consent.

Please help us continue to provide this important data for allergy and immunology practices by participating in MGMA's surveys in 2022. Participating practices get free, direct access to the survey results, and all survey data is completely confidential and is never seen by any College member or staff. The Provider Compensation survey will open next year in January, and the Cost & Revenue survey will open in March. Watch your email and College Insider for announcements.

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