Clinical Report: A Nationwide Assessment of Earnings in Advanced Heart Failure
Overview
A national survey of advanced heart failure and transplant cardiology (AHFTC) physicians examines compensation, workload, and productivity in university and community settings. University-based respondents report lower compensation and fewer work relative value units (wRVUs), including after adjustment for clinical effort. Previously reported findings from the same survey describe high job-related intellectual stimulation and satisfaction alongside dissatisfaction with compensation and work-life balance.
Background
Information on AHFTC compensation is limited, particularly in university settings. Some national compensation surveys do not distinguish AHFTC as a separate specialty or adequately represent university-based physicians. This study provides additional findings from a national survey to characterize compensation models, effort allocation, and productivity across practice settings.
Data Highlights
Metric | University-Based | Community-Based |
|---|
Median Compensation | $450K | $550K |
Adjusted wRVU | 8.6K (IQR 6.7K-10.7K) | 11.1K (IQR 8.5K-13.3K) |
Achieved wRVU Target | 78% | 100% |
Key Findings
Among 183 respondents, 49% received salary-only compensation, 6.6% received productivity-only compensation, and 44% received a combination.
University-based respondents reported significantly lower compensation than community-based respondents (P < .01).
Approximately 54% of university-based respondents reported a wRVU target, compared with 41% of community-based respondents.
University-based respondents generated fewer wRVUs after adjustment for clinical effort (P < .01) and allocated more time to education and research.
Compensation correlated with unadjusted and clinical effort–adjusted wRVU productivity across the cohort. Compensation per wRVU for clinical work did not differ significantly between settings after adjustment for clinical effort.
Women in community settings reported lower compensation than men despite no significant difference in wRVU productivity. No significant compensation difference between women and men was observed in university settings.
Clinical Implications
The authors identify improved compensation as important to AHFTC job satisfaction. Previously proposed strategies include higher base salaries and wRVU conversion rates, compensation for call responsibilities, and recognition of program growth and outcomes. The findings also highlight limitations of productivity-based compensation in a specialty with substantial work that does not generate wRVUs.
Self-reported metrics, missing productivity data, and broad compensation categories limit precision. The survey reflects 2024 compensation and productivity without adjustment for inflation.
Conclusion
This national survey documents differences in AHFTC compensation, effort allocation, and productivity by practice setting despite similar total work hours and call responsibilities. The authors recommend regular surveys to improve transparency and support workforce advocacy.
Related Resources & Content
Perceptions of careers in advanced heart failure and transplant cardiology: results of a national survey of advanced heart failure and transplant cardiologists — Patel PA, Seals AL, Chien C, et al — Journal of Cardiac Failure — July 20, 2026.
Compensating heart failure cardiologists: is the RVU model the right model? — Uriel N, Elad B, Brailovsky Y, et al — Circulation: Heart Failure — 2026.
Interest in advanced heart failure and transplant cardiology fellowship: a national survey of cardiology fellows — Gilbert O, Patel P, Ponir C, et al — JACC: Heart Failure — 2024.
The HFSA Advanced Heart Failure and Transplant Cardiology Fellowship Consensus Conference — Drazner MH, Ambardekar AV, Berlacher K, et al — Journal of Cardiac Failure — 2024.
A roadmap to reinvigorating training pathways focused on the care of patients with heart failure: shifting from failure to function — Blumer V, Kittleson MM, Teerlink JR, et al — Journal of Cardiac Failure — 2023.
2025 cardiovascular provider compensation and production survey report — MedAxiom — MedAxiom — October 2025.
HFSA president’s update: November 2025: building the future heart failure workforce—together — Margulies KB — Heart Failure Society of America — November 2025.
