Part of the reason why margin pressure is outstripping staffing as a major priority for medical group leaders is that wages have continued to climb, and budget season is in full swing for those with November approvals looming. 

A Sept. 9, 2025, MGMA Stat poll sought to give these leaders a sense of what their peers are doing when it comes to compensation: Nearly two-thirds (64%) of medical groups are targeting a 1% to 3% increase in base pay for staff in their 2026 budgets, while almost one in four (23%) have 4% to 6% increases built into their budgets, and just 1% have an average increase of 7% or more. Another 10% say they have no increase budgeted for base pay specifically. The poll had 349 applicable responses. 

Among leaders budgeting 0% base growth, most signaled true wage freezes with no alternative mechanisms; a few left the door open for selective market adjustments to prevent poaching, or performance-tied bonuses limited to management or providers. Several noted incentives had been discontinued or would depend on practice income. 

Responses from the majority of practices — in the 1%–3% and 4%–6% budget ranges — point to a bifurcated playbook for the year ahead:

• Many groups plan across-the-board cost-of-living (COL) increases (often ~3%) to maintain equity and minimize compression, while others target outsized lifts to hard-to-hire roles — most frequently medical assistants (MAs) and front-desk/scheduling staff, with recurring mentions of nurses (mainly RNs and LPNs) and advanced practice providers (APPs).  
• Leaders commonly layer merit-based differentiation, year-end or productivity bonuses, profit sharing, and one-time or probationary step-ups (e.g., off-cycle reviews at six months).  
• A handful weight higher percentages toward lower-paid staff, or add training/credential bonuses and select sign-on incentives for MA pipelines.  
• Several clarified that APPs remain on separate productivity/bonus schemes even when staff receive uniform base lifts. 

Overall, the themes from respondents’ open-ended comments on which roles are being targeted to the highest increases and other tactics used in compensation (e.g., bonuses, merit-based increased) mirror findings found in recent MGMA DataDive data reports and other MGMA Stat polls: MAs/front office remain prominent retention risks, and base-rate creep in nursing is structural — hence the blend of modest COLA, targeted premiums for scarce roles, and time-bound incentives to stretch budgets without permanently inflating fixed costs. 

As you settle your budget for 2026, know this: wage growth remained broad‑based in 2024 and continues to reset the floor for the future. The 2025 MGMA DataDive Management and Staff Compensation dataset covers positions across more than 4,300 groups; our member-exclusive data report highlighted how median pay rose again for nearly every job family, with double‑digit year‑over‑year (YoY) jumps for supervisors (+12%), senior/general managers (~+11%), and several clinical ladders. The West still pays materially more than other regions, widening national recruiting gaps.  

• MGMA members can get the full story in the data report. 

What base‑increase range fits your risk profile? 

Plan with three scenarios 

• A 1%–3% “maintenance” lift can work where roles are stable and hiring pipelines are healthy. Since 2020, staff pay has reset higher — about half of the past 10 years’ growth occurred in that window — and hourly rates are still creeping up. Build your budget assuming continued growth in base pay rather than trying to lean on bonuses alone. 
• A 4%–6% plan better aligns with how the market is moving for many roles. In 2024, RN pay rose 11.9% YoY and triage nurses were up 14.3%. RN hourly pay is roughly $11 higher than in 2020. Specialist and RCM‑adjacent roles (such as managed-care admin) also moved quickly, with percentage gains from the high single digits into the low 20s. 
• Reserve a 7%+ tier for areas where you need to catch up or address persistent vacancies and turnover. General accounting posted the single‑year jump at 17.4% YoY, and imaging/radiology has been climbing for multiple years. Groups in lower-pay regions (South/East/Midwest) may need to budget a premium to compete with Western offers; the executive management-gap alone approaches $96,000.  

Where to target outsized lifts 

Clinical nurses (triage, RN, LPN) 

Every tracked nursing role except patient care assistants (PCAs) shows strong five‑year growth; triage nurses lead the decade (+84%). Given competition from hospitals/virtual care, budget above-average increases for triage and RN roles.  

Revenue integrity, accounting, and managed‑care administration 

These back‑office skills intersect revenue protection and compliance and have outpaced headline inflation; organizations that can manage it might consider 8%–10% merit pools for finance/RCM titles to keep offer‑accept ratios high.  

Supervision and frontline coordination 

Multi‑site scale and larger teams are pushing supervisor pay up faster than many other bands; guard against compression as you lift supervisor rates. Meanwhile, MAs remain hard to fill — 47% of practices cited MA hiring as their top challenge — even as internal pipelines modestly improve.  

Beyond base: tools to stretch value without permanent bloat 

The data point to base pay as the engine of recent growth for key roles, but you can blunt long‑term fixed costs with smart complements: 

• Mid‑band resets to restore spread (+~3% across incumbents) and transparent pay grids to reduce resignation intent.  
• Targeted, time‑bound incentives — stay/spot bonuses for supervisors and long‑tenured leaders; link executive variable pay to cash‑flow margin rather than ratcheting base.  
• Career ladders and micro‑promotions (e.g., MA-to-LPN apprenticeships, PCA-to-CNA upskilling) to relieve pressure on entry roles while preserving differentiation.  
• Certification bonuses (often under $3,000) for high‑impact credentials instead of permanent band bumps.  
• Geographic arbitrage via compact licensure, hybrid/remote roles, and selective relocation support to compete with higher‑pay markets.  

Compression, equity, and timing 

A notable warning sign: practice executives with 21 years or more experience now earn about $3,500 less than newcomers — evidence of a “loyalty gap” created by aggressive offer floors. Bake equity audits and re‑leveling into your 2026 plan to maintain trust and career‑long growth curves. With most boards approving budgets in November, finish internal benchmarking (64% of practices do this annually), model three base scenarios, and pre‑authorize mid‑year adjustments for hot roles.  

Join MGMA Stat 

Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/mgma-stat. Polls will be sent to your phone via text message.