When health systems talk about value-based care adoption, the conversation often turns quickly to incentives — specifically, financial incentives. Pay physicians differently and behavior will follow. But ask the physicians themselves what actually motivates them to engage with a new care model, and a more complex picture emerges.
We spoke with physician and operational leaders across Honest Health about what they’ve learned from supporting organizations navigating value-based care. Despite coming from different parts of the business, their perspectives consistently aligned around several core realities.
Driver 1: The impact in the room
Ask Scott Sears, Honest Health’s Chief Physician Executive, what motivates physicians above all else, and his answer is immediate.
“The single most powerful driver for a physician is having an individual impact on the person sitting in front of them. Behind a closed door. Baring their soul about things they’re struggling with. And knowing they helped.”
This sounds obvious. But its implications for value-based care adoption are significant. Policy strategy may shape the environment, but physicians engage when they can see how a model improves patient care in practice. They engage when they can see — concretely and specifically — how the new approach makes them more effective in the exam room.
That’s why the framing matters enormously. When value-based care is presented as an administrative requirement — as something being done to physicians rather than with them — it meets resistance. When it’s presented as a set of tools that help a physician do what they already care most about doing, the conversation changes.
“Every physician comes out of training wanting to have an impact,” Sears says. “What Honest Health can do is enable them to practice the way they always wanted to practice — before administrative complexity, data overload, and the pace of the modern clinical day got in the way.”
Driver 2: Proof of quality
Adam Silverman, MD, Market Chief Medical Officer for New York, draws on his own experience as a practicing physician to explain the second driver.
“Physicians want to deliver high quality care. They genuinely believe the care they’re delivering is the best. And it’s easy to think you’re the best when there’s no measurement, no yardstick.”
Sears takes the idea one step further: “All of us as doctors think we’re providing strong care. And yet 50 percent of us are below average by definition.”
That gap — between the care a physician believes they’re delivering and the care the data shows they’re delivering — is where value-based care can have its most profound effect. Not through shaming, but through the kind of transparent, specific feedback that most physicians have never had access to.
“I know I’m doing a good job because I have 352 diabetic patients and 92% of them are well-controlled. I know exactly who the other 8% are, and I know what I’m working on with them.” That’s the answer physicians want to give. Most of them have never had the data to say it.
Silverman echoes this from personal experience. “The newer generation of physicians is growing up in an environment where we’re very transparent around outcomes. I grew up in a time when nobody really talked about outcomes; there was no transparency. And so, it was easy to believe what was in your own head. But if you don’t measure it, you don’t know for sure.”
Driver 3: Aligned financial incentives — in that order
Financial incentives do motivate physicians in value-based care. But both Sears and Silverman are emphatic that they’re the third driver, not the first — and that leading with them is a strategic mistake.
“I always lead with the quality piece,” Silverman says. “I try to show people the data — that our readmission rates are too high, that preventable admissions are too high. Nobody ever wants to go to the hospital. If we can prevent it, it’s all the better.”
Mary Zuckerman, Vice President and General Manager for Michigan, puts the financial piece in its proper context: “I don’t think we should shy away from the financial motivation. Primary care physicians are very busy people. We’re asking them to do more or do things differently. Having aligned financial incentives can be a win-win. For independent doctors, these value-based contracts are critical to keeping the lights on.”
But she adds a caveat that applies equally to every financial incentive conversation: “At the end of the day, they’re going to be focused on the patients first. We always say: focus on doing the right thing for your patient, and it’ll work out.”
Driver 4: how you show up
Beyond the three drivers, all four of our leaders named a factor that isn’t a driver so much as a prerequisite: the way a VBC enabler shows up matters as much as what they bring.
Melanie Odelye, Market Chief Medical Officer for Michigan, describes the clinical voice as foundational. “Having a physician who is part of that conversation just gives it so much more credibility. You need to understand the nuance — there isn’t a cookie-cutter approach to taking care of a patient with multiple chronic diseases.”
Silverman emphasizes the importance of shared experience in those conversations. “I put myself in their shoes. I’ve been in those shoes. I think empathy goes a long way. Being able to sit in front of a doctor and say: I’ve done what you’ve done. I understand you believe in your professional autonomy. I understand you believe your quality is terrific. And then asking: what does the data show?”
“Value-based care can’t be done to physicians. It needs to be done with physicians.” The distinction isn’t semantic — it’s the difference between programs that get grudging participation and partnerships that drive real performance.
The organizations succeeding in value-based care have figured this out. The model changes. The data improves. The tools get better. But the physician relationship — built on trust, clinical credibility, and genuine partnership — remains the variable that everything else depends on.