Physician salary increases for 2014 are expected to be roughly on par with last year, according to the Hay Group's 2013 Physician Compensation Survey.
However, the survey says, longer-term shifts in compensation show the changing medical landscape.
Median salary increases for physicians across all organization types will be about 2.4 percent, the survey said, with group-based practices coming in at 3.7 percent and hospital-based settings slightly lower at 2.2 percent. There will also be a differential between primary care physicians and specialists, with the former to get slightly larger increases, particularly in hospital-based settings.
"We have been seeing a slowdown in pay rate increases for physician specialists, and a bump up for generalists, over the last several years, and this trend seems to be continuing," said Jim Otto, senior principal in Hay Group's Healthcare Practice. "This may be reflective of fewer graduates pursuing general medicine and additional responsibilities for generalists in driving pay-for-performance health care. The question remains if and how declining hospital revenues and reimbursement changes will affect physician pay."
The survey also found that 63 percent of physicians have annual incentive plans, down just slightly from 64 percent last year. Hay reported that the measures used to determine incentive payouts — both for individual and group performance — reflect providers' shifting emphasis on quality and patient outcomes.
For individual physician performance, there were upticks in plan metrics related to patient satisfaction (70 percent), quality (86 percent) and outcomes (54 percent), compared with 2012 (66 percent, 77 percent and 39 percent, respectively). Group performance metrics in physician incentive plans tracked similarly upward for patient satisfaction (60 percent, up from 50 percent) and quality (69 percent, up from 56 percent).
"We expect an evolution — not revolution — in incentive plan design for physicians in coming years," Otto said. "Providers are looking to translate their organizational goals in a more tangible way that will drive the desired behaviors and outcomes they want to achieve. They are still struggling with the best ways to align physicians and other employees with broader goals, and to measure output quality."