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10 Physician Specialties That Drive the Most Revenue for Hospitals

Surgery
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The amount of hospital revenue from physicians had been increasing steadily prior to the COVID-19 pandemic, with gains for both primary care physicians and specialists, according to a 2019 survey by physician recruiting firm Merritt Hawkins.

While the 2020 numbers will look much different, the 2019 survey shows significant increases over prior years in revenue driven for hospitals by a range of specialties, including internal medicine, cardiology, neurosurgery and gastroenterology.

The 2019 Merritt Hawkins survey is based on 62 responses, from positions including chief financial officers, representing 93 hospitals. Find out the 10 highest-revenue specialties for hospitals, the factors driving increased revenues, and how the pandemic is affecting the financial outlook for hospitals in 2020 and beyond.

Factors Driving Revenue Increases Pre-Pandemic

Physicians, both employed and independent, generated an average of roughly $2.38 million a year for their affiliated hospitals, up 49% from the 2016 survey. Primary care physicians brought in an average of $2.1 million and specialists an average of $2.4 million. For both PCPs and specialists, average revenue was up 52% from 2016, with both categories reaching their highest points in the seven years the study has been conducted.

Experts point to three primary factors for these increases. First, higher cost per hospital stay has driven up inpatient revenue, even as the number of inpatient admissions has stayed flat or even decreased. Second, the number of outpatient procedures has grown significantly over the past decades, as have their costs. Finally, the aging population is requiring more frequent—and more complex—care, resulting in higher revenues across specialties.

An additional consideration: the increase of physicians employed by hospital systems, particularly in primary care. About 34% of specialists report being in independent private practice, compared to about 26% of primary care physicians, according to the 2018 Survey of America’s Physicians by the Physicians Foundation. Employed doctors may be more likely to order testing, treatments and admissions to their affiliated hospital system.

The Top 10 Revenue-Driving Specialties for Hospitals

The 2019 Merritt Hawkins shows these 10 specialties generated the highest average annual net revenue for their affiliated hospitals. The list includes the average salaries for these specialists and their increased average hospital revenue from the previous survey in 2016.

1. Cardiovascular Surgery

  • Average revenue: $3.7 million (first year this specialty has been included in the survey)
  • Average salary: $425,000

2. Cardiology (Invasive)

  • Average revenue: $3.48 million, up 42% from 2016
  • Average salary: $590,000

3. Neurosurgery

  • Average revenue: $3.44 million, up 40% from 2016
  • Average salary: $687,000

4. Orthopedic Surgery

  • Average revenue: $3.29 million, up 20% from 2016
  • Average salary: $533,000

5. Gastroenterology

  • Average revenue: $2.97 million, up 109% from 2016 
  • Average salary: $487,000

6. Hematology/Oncology

  • Average revenue: $2.86 million, up 69% from 2016
  • Average salary: $425,000

7. General Surgery

  • Average revenue: $2.71 million, up 25% from 2016
  • Average salary: $350,000

8. Internal Medicine

  • Average revenue: $2.68 million, up 46% from 2016
  • Average salary: $261,000

9. Pulmonology

  • Average revenue: $2.36 million, up 98% from 2016
  • Average salary: $418,000

10. Cardiology (Noninvasive)

  • Average revenue: $2.31 million, up 83% from 2016
  • Average salary: $427,000

The Effect of COVID-19 on Hospital Revenues

The COVID-19 outbreak has placed unprecedented burdens on healthcare, not least of which financially. Many health systems were already facing economic challenges prior to the pandemic, and many now find themselves coping with the added costs of COVID-19. These include specialized medical supplies, personal protective equipment, isolation units, and expanded intensive care capacity. The massive rates of unemployment also resulted in large-scale loss of health insurance, increasing the amount of uncompensated and charity care provided by hospitals.

At the same time, revenues saw a steep decline as state lockdown orders required the cancellation of non-emergency and elective procedures. Many Americans also voluntarily postponed care, including for life-threatening conditions like heart attack, stroke and breast cancer. As a result, the American Hospital Association estimates hospitals collectively lost an average of $51 billion a month from March through June 2020.

While the pandemic has eased in certain regions of the country and hospitals have again started scheduling full slates of procedures, the financial impact of COVID-19 remains deep. Ideally, as patients become more comfortable with safety precautions, employment (and employer-based insurance) continues to recover, and, longer-term, new vaccines and therapies help bring the virus under control, hospitals can expect to see improved financial health as well.

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  1. 10 physician specialties that generate the most revenue for hospitals. Becker’s Hospital Review. https://www.beckershospitalreview.com/finance/10-physician-specialties-that-generate-the-most-revenue-for-hospitals.html
  2. Survey: Physicians Generate an Average $2.4 Million a Year Per Hospital. Merritt Hawkins. https://www.merritthawkins.com/uploadedFiles/MerrittHawkins_RevenueSurvey_2019.pdf               
  3. 2019 Physician Inpatient/Outpatient Revenue Survey. Merritt Hawkins. https://www.merritthawkins.com/uploadedFiles/MerrittHawkins_RevenueSurvey_2019.pdf
  4. Patients deferring lifesaving care during pandemic, study suggests. Becker’s Hospital Review. https://www.beckershospitalreview.com/cardiology/patients-deferring-lifesaving-care-during-pandemic-study-suggests.html
  5. Hospitals and Health Systems Face Unprecedented Financial Pressures Due to COVID-19. American Hospital Association. https://www.aha.org/system/files/media/file/2020/05/aha-covid19-financial-impact-0520-FINAL.pdf
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