Jamal Campbell once took pride in building financial models so elaborate that few people besides him could understand them. With enough formulas, linked worksheets, and carefully constructed assumptions, he could calculate almost anything a physician enterprise needed.
Then something in the organization would inevitably change. And each small adjustment exposed how much the process depended on one person’s knowledge rather than a reliable, repeatable system.
“I feel like a large part of my career, I prided myself on being able to just build these elaborate financial models,” Campbell said. “But as things change, a provider leaves, a new provider gets added, benchmarks get updated. Someone else is left with my financial model.”
Campbell, general manager of Physician Enterprise at Hallmark Health, joined Daniel Williams, senior editor and host of the MGMA Insights Podcast Network, to discuss how medical groups can bring compensation calculations, contracts, benchmarks, and provider performance into alignment.
He is direct in his argument: Physician compensation can't remain a collection of isolated files, manual handoffs, and undocumented institutional knowledge.
A chance encounter changed Campbell’s path
Campbell was pre-med in college and expected to become a physician — his parents were physicians, his godparents were physicians, and healthcare surrounded him from childhood. He entered college on the pre-med track and assumed the destination had already been chosen.
Campbell had never seriously questioned that future until one day, he was struggling through some comparative anatomy homework at the university library, when a stranger approached him and asked a simple question: Did he actually enjoy it?
“I remember being like, man, this is driving me crazy,” Campbell said. “All the memorization, et cetera. And I’m like, ‘I don’t know what else I’m supposed to do — I think I’m destined to be a doctor.’”
The stranger suggested going into finance, accounting, and management in healthcare, which sparked something in Campbell because he'd already taken an accounting course and liked working with numbers. “And so I headed down that road, took a bunch of electives, focused on finance and accounting, and the rest is history,” he recalled.
Compensation complexity lives in the handoffs
A physician’s compensation may draw from the EHR, practice management system, payroll platform, contract repository, productivity reports, quality results, and external benchmarks. But in many organizations, those sources don't communicate directly — employees export data, move it between systems, apply formulas, check exceptions, and send the results to another person.
“The biggest issue is that there are disparate systems where data is truly coming from,” Campbell said. “There are so many manual processes that exist, and if you can think about just a number of handoffs, anytime you have a number of handoffs, it just increases the risk for errors.”
Plan design compounds the problem. Having previously worked as a management consultant, Campbell admitted that he's "guilty of creating some of those elaborate algebraic equations that are utilized to pay providers."
The stakes are rising as compensation models move beyond simple salary or productivity formulas. According to MGMA’s 2025 Provider Compensation and Productivity Data Report, quality measures and other incentives are gaining ground as pure salary, productivity, and equal-share arrangements become less common. That shift gives medical groups more ways to connect compensation with access, quality, and strategic priorities, but it also increases the risk of a formula, contract term, or data field drifting out of alignment.
A 3% error rate can become a multimillion-dollar problem
Compensation errors don't just remain confined to payroll. They can produce overpayments, underpayments, contract disputes, compliance concerns, and distrust among physicians and advanced practice providers.
Campbell offered a blunt illustration: “Let’s say a good benchmark is 3% to 5%,” he said. “If I’m administering $100 million in provider compensation, that’s $3 million to $5 million it’s costing me on an annual basis.”
The known errors may represent only part of the exposure. “Most people have no line of sight into the magnitude of errors,” Campbell said. “Very few organizations truly track it. And even when they track it, it’s what they’re catching.”
Contract alignment creates another risk point. Campbell has encountered organizations in which the compensation model produced one result while the governing agreement required another. “I have the models, I’m calculating compensation,” he said. “But now I’m looking at the contract and it’s like, ‘Hey, this contract says X. We’re paying based on Y.’”
The governance around those models is inconsistent across medical groups. An April 2026 MGMA Stat poll found that 37% of organizations formally review physician compensation methodology annually, while 38% do so every two to three years. One quarter had gone at least three years without an update. The same article noted that only 36% of practices reported having a dedicated physician compensation team or committee in an April 2025 poll.
A compensation model can therefore remain in production for years without a structured review, even as contracts, staffing, benchmarks, fee schedules, and strategic priorities change around it.
Trust collapses when physicians cannot see the math
Physicians don't need to administer their own compensation plans, but Campbell argues that they must be able to at least understand the mechanics. “Most physicians and APPs have no clue how it actually works,” Campbell said. “They’re just trusting that you’re doing and administering it appropriately.”
That trust can fade quickly after a payment error or an unexplained variance. “We want our providers focused on providing patient care,” he said. “If they don’t trust us, it impacts engagement.”
Transparency also requires physician participation. A March 2024 MGMA Stat poll found that 60% of medical group leaders involved physicians in developing compensation methodology, down from 67% in 2019. Practices described using compensation committees, physician surveys, bonus-metric discussions, and annual strategic planning meetings to gather that input.
That downward shift may be a mistake, because bringing physicians into the process before a new model is finalized gives leaders a chance to identify confusing provisions and disputed measures before they reach payroll, and creates a forum for showing physicians exactly how their performance data becomes compensation.
Campbell’s experience growing up around physicians shapes how he presents compensation information. “They’re very, very data-oriented,” he said. “They don’t react well to you just telling them, ‘This is what you need to do, and here’s what’s important.’ You actually have to show the visual evidence.”
A single source of truth changes the speed of decisions
When compensation data and calculations reside inside a connected system, leaders can test changes without rebuilding a workbook or waiting days for an analyst to reconcile several files.
Campbell described a CFO asking what would happen if the organization adjusted a performance metric. In a manual environment, “it may take a few days for someone to get back to them and say, ‘Here are the implications.’” In an integrated system, leaders can change assumptions and view the effect against historical performance.
“You can actually change those dials on the fly and understand, here are the implications,” Campbell said. “The time to get necessary information is truncated significantly.”
The same approach can support fee-schedule changes, monthly closes, budgeting, and compliance monitoring. Hallmark’s Physician Enterprise model pulls information from source systems, performs compensation calculations, and applies guardrails established by an organization and its external advisors. Campbell emphasized that the technology does not determine fair market value or commercial reasonableness. It operationalizes the rules the organization has approved.
“You potentially have an issue before it actually becomes one,” he said.
Start by cataloging what is already in place
Campbell does not advise practices to begin with software selection. His first step is discovery.
“The first step is really understanding the variability of the compensation plans and mechanics that exist and actually cataloging all of those,” he said. Without that discovery work, an organization may begin implementation only to uncover undocumented exceptions or calculations that no longer make operational sense.
The review should trace how compensation moves from the governing contract through calculation, approval, and payment, revealing where the process relies on manual work or institutional knowledge. “Make sure you have alignment beyond just the physician comp team,” Campbell said. “Finance, human resources, operations, because this brings everything together.”
The work ultimately returns to the lesson Campbell learned in that library: Healthcare needed people who could understand physicians and numbers at the same time. Today, physician enterprises also need systems that can retain that understanding after a spreadsheet’s creator leaves.
“Our job is to make sure they have the necessary data and information on this side of the house, too,” Campbell said, “so that they can continue to do great things and impact lives in the way they do.”
Resources
MGMA Members: Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts!
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