SullivanCotter Report: Pay Compression for Advanced Practice Providers is Growing as Organizations Address Patient Access

CHICAGO--(BUSINESS WIRE)--SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and data products for health care and not-for-profits, has released its 2025 Advanced Practice Provider Compensation and Productivity Survey Report.

While the advanced practice provider (APP) workforce remains in high demand, APP compensation growth shows signs of stabilization following years of large increases. This year’s survey results show hospital-based specialties had the highest growth in median base salary and median total cash compensation (TCC) from 2024 to 2025 – up 6.2% and 5.7%, respectively. Median TCC for primary care specialties grew by 4.0% while medical (2.8%) and surgical (2.4%) specialties saw the lowest increases.

The survey is the most comprehensive resource of its kind, examining APP compensation and productivity across U.S. hospitals and health systems. It draws on data from nearly 800 organizations, covering more than 155,000 individual APPs and approximately 6,700 APP leaders. Results include compensation and productivity benchmarks – such as wRVUs and encounter volumes – broken out by specialty.

“Many organizations are analyzing APP productivity and performance to help determine the return on investment. Having reliable, specialty-specific benchmarks is key to understanding the degree of utilization and which areas in your organization have the greatest opportunity for improved APP performance,” said Zachary Hartsell, APP Workforce Practice Leader, SullivanCotter.

Consistent with previous years, the limited supply of anesthesiology providers continues to place upward pressure on compensation for certified registered nurse anesthetists (CRNA) and certified anesthesiologist assistants (CAA). From 2022 to 2025, the survey data shows a sizable 22.9% increase in median TCC for CRNAs and a substantial 40.7% increase for CAAs. While year-over-year growth is still high for these providers with a 5.2% increase for CRNAs and a 6.4% increase for CAAs, the change is not as significant as in past years.

Health care organizations are relying more on APPs as the solution for workforce shortages and patient access challenges driven by an aging population, physician shortages, evolving workforce expectations, regulatory changes, and more. As a result, many are prioritizing premium pay, including incentive compensation, shift differentials, and additional shift pay offered during recruitment.

As of 2025, 55% of organizations utilize incentive pay for at least some of their APPs. Primary care has the largest incentive as a percentage of base salary at 7.6% while medical, hospital-based and surgical specialties were all less, around 5%. Shift differentials and extra shift pay continue to be common practices as well. The 2025 survey data shows that 66% of organizations provide shift differentials to either some or all departments. Hourly premiums typically range from $4 to $9, which is equal to 10% to 15% of base rates. And 82% of organizations provide pay for extra shifts for at least some APPs at a median rate of $85/hour, or 25% of base pay.

“As APPs play a central role in addressing health care access and workforce challenges, organizations are adopting more strategic, data-driven approaches to compensation and workforce planning,” said Dr. Hartsell. “The survey reflects both the growing influence of APPs and the increasing complexity of compensation models designed to attract, retain, and engage this vital workforce.”

Additionally, APP leadership positions continue to expand in scope as health systems recognize the strategic importance of this workforce and the need for a more formalized leadership structure. Compensation patterns differ across the levels of APP leaders – including top leaders, leads, manager-level and clinical-level. Top APP leaders are generally placed into separate leadership grades, while managers or leads often receive premium pay on top of their salary.

“Other forms of compensation for these leadership positions are evolving as well. Across the market, most APP leaders are eligible for some form of incentive pay – especially at the top level where the majority of their work is administrative and strategic in nature,” adds Lacey Buckler, Principal, SullivanCotter.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improves outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, and data products to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision, and values.

For more information on SullivanCotter’s surveys, please visit our website at www.sullivancotter.com, or contact us via email or by phone at 888.739.7039.

Note to media: Additional data and interviews are available on request.