Physician Workloads Rise as Reimbursement Falls, Raising Access Concerns

Physicians are working harder than ever, yet payment rates aren’t keeping pace, a new Kaufman Hall report warns. Physician productivity, measured by work relative value units (wRVUs), has climbed 11% over the past two years. But patient revenue per wRVU dropped 7%, while provider compensation fell 2% over the same period.

The mismatch stems largely from stagnant Medicare rates, which have declined 29% since 2001 after adjusting for inflation, according to the AMA. By law, Medicare physician payments are budget-neutral and not indexed to inflation, limiting increases. Medicaid reimbursements are even lower, and commercial payments often fail to close the gap.

Mounting reimbursement pressure, combined with inflation and higher labor costs, has pushed many practices to sell to hospitals or insurers, pivot to elective or concierge care, or shut down—reducing patient access. While Congress has floated reforms, recent CMS payment changes offer only modest, uneven relief.

18-08-2025