Jeanne Cohen and Motive Medical Intelligence on Physician-Level Precision in Value-Based Care

As the healthcare industry recalibrates its ambitions for value-based care (VBC), one reality has grown increasingly difficult to ignore: aggregate data isn’t enough. Executives and clinical leaders charged with reducing costs and improving outcomes have long relied on population-level metrics and episode-based models to guide transformation. But when avoidable variation in care still accounts for hundreds of billions in waste, a shift in measurement strategy becomes essential.

This Q&A with Jeanne Cohen, founder and CEO of Motive Medical Intelligence, examines what it means to refocus value-based care through the lens of individual physician performance. Rather than rely on opaque metrics and team-based scoring, Motive’s clinical analytic system, Practicing Wisely, generates a transparent, defensible, and scalable infrastructure for performance assessment at the National Provider Identifier (NPI) level. Cohen outlines how this framework is not only gaining clinician trust but also delivering measurable gains in care appropriateness, resource optimization, and cost reduction.

Q: Why is measuring individual physician performance a critical factor for value-based care success?

A: For value-based care (VBC) arrangements to achieve their clinical and financial goals, performance must be measured where the clinical decisions are made — by the individual physician. Variation at this level drives most of the avoidable quality deficits and excess cost that capitation and other risk models aim to eliminate. Focusing only on aggregate group or population metrics leaves this critical layer invisible and limits any corrective actions.

We believe physicians control cost and quality of care – it’s why Motive created the Practicing Wisely clinical analytic system, the only solution in the industry that measures performance and improvements at the physician level for Appropriateness of Care, Quality, and Waste – which it does across 20 clinical specialty areas, including primary care and pediatrics. It helps clinicians understand how their care aligns with national best practices — based on evidence, guidelines, and real-world data — and how they can do better.

Our solution measures and reports at the individual National Provider Identifier (NPI) level and at the Tax Identification Number (TIN) or group level. This dual reporting offers complementary, not competing, vantage points on the physician’s pattern of decision-making to support multiple use cases for performance data, from actionable information about individual physician decision-making to network contracting and steerage at the group level.

This approach confers three material advantages over traditional, episode or population -based measurement:

• Credibility with clinicians. Practicing Wisely’s transparent, evidence-linked methodology and traceability to medical society care standards make its findings defensible, trusted and highly acceptable to physicians, fostering engagement and practice improvement, instead of resistance.
• Actionability at the point of decision. Because each metric evaluates an individual physician’s practice patterns based on qualified cases, organizations can provide clinicians with precise feedback and track changes at the individual level over time, instead of issuing broad “team” averages. This is a proven approach that drives changes in practice behaviors among physicians.
• Direct cost-management leverage in any capitation model. By quantifying the dollars tied to each inappropriate decision, Practicing Wisely shows exactly where eliminating low-value care can release savings. We see instances, all the time, where eliminating overuse of a single procedure or diagnostic could result in multiple millions of dollars a year in savings.

In short, measuring individual physician performance is indispensable to VBC success. Practicing Wisely’s dual NPI/TIN framework turns that measurement into a credible, actionable, and financially potent management tool for every value-based program. 

Q: Practicing Wisely is described as a “clinical analytic system.” Explain what this is? What does that mean in practice?

A: Practicing Wisely is not another standalone application or black box piece of technology; it is a clinical analytic system. This technology-enabled measurement infrastructure transforms national claims data and evidence-based clinical care guidelines published by medical societies into a unified, physician-specific performance system.

Practicing Wisely is a system of change.  Every measure is delivered with clear rationale, supporting materials such as clinical guides and evidence, along with engagement strategies to foster physician and group improvement to build payer–provider trust. It is designed to empower, not penalize, physicians, while helping all healthcare stakeholders align around shared goals in value-based care. For many physicians, it’s the first time they’ve had meaningful, evidence-based visibility into their own clinical practice patterns. These insights are empowering and positive and ultimately drive change.

Because every measure is traceable back to explicit clinical guidelines and calculated at both the individual-NPI and rolled-up TIN level, the data is immediately credible to physicians, actionable for contracting and utilization teams, and granular enough to pinpoint waste that capitation programs must control. Organizations can rely on the same transparent dataset across multiple functions — quality improvement, network design, incentive programs, risk-share analytics — thereby eliminating the divergent “black-box” metrics that often sow confusion and physician resistance.

But most notably, Practicing Wisely gives physicians individual insights into their care practice to align with clinical standards, refine their practice patterns, reduce costly low-value care and drive out waste. 

Q: How does Practicing Wisely drive physician acceptance and enable robust engagement and practice changes?

A: Practicing Wisely earns clinician trust — and the sustained behavior change that follows — by making its measurement process transparent and methodologically rigorous.

All inclusion and exclusion criteria, guideline citations, and literature sources are exposed alongside every measure. Physicians can inspect exactly how each case was measured, eliminating the “black box” skepticism that underpins other clinical analytic tools. Motive designed the system from the ground up to be auditable, using deterministic measurements instead of opaque algorithms, and every result can be traced back to its source — clinical evidence.  Customers routinely highlight this rigor and transparency as the primary reasons physicians accept the findings and are willing to act on them.

Behind that transparency sits a data-intensive and rigorous evidence engine that marries more than 23 billion annual claims from national datasets to specialty-society care guidelines, maintained by the support of a network of more than 600 board-certified physicians. Emerging evidence is monitored continuously, and the full measure catalogue is refreshed twice yearly, ensuring concordance between clinical evidence and measurement.

Because the methodology is evident and tied to decisions physicians directly control, the data is viewed as fair and defensible; clinicians respond by self-correcting rather than disputing scores. Motive’s “range-of-better-practice” thresholds quantify how far each practitioner is from evidence-based performance and translate that gap into concrete clinical and financial impact, turning insight into a practical improvement target. Healthcare organizations can embed Practicing Wisely data in existing contracting, steerage, and care-management programs, so the same trusted measures drive incentives, peer comparisons, and education — aligning multiple levers around a single, physician-accepted framework.

Q: What are the most common blind spots that health plans or systems face when assessing physician performance? How does Practicing Wisely address that?

A: Health plans and delivery systems typically evaluate physicians using population-level quality scores, utilization counts, or cost dashboards. That approach leaves three recurring blind spots:

• Lack of accurate individual attribution. Most programs are episode-based and rely on empanelment or apportionment to assign responsibility for population- or organization-level scores, so the clinician making the decision remains unseen, leading to stalled accountability and improvement.
• Measures outside physicians’ control. Outcome metrics like “average A1c,” for example, measure many factors a doctor can only indirectly influence, providing limited guidance on what to do differently in care delivery.
• Opaque “black box” analytics. When clinicians cannot inspect the logic behind a rating, they discount the findings and resist change.

Practicing Wisely has been designed to make physician performance measurement fair, transparent and actionable to drive higher quality and lower cost.

• Actionable, decision-level insight. The solution reports exactly which stress tests, stents, antibiotics, or other interventions each physician ordered, tying performance to concrete choices the clinician controls.
• Clinical appropriateness at scale. Measures assess decisions against specialty-society guidelines, highlighting overuse, underuse, and potential harm on a case-by-case basis, not just total cost.
• Transparent, auditable methodology. All inclusion/exclusion rules, guideline citations, and calculations are transparent, replacing distrust with confidence and encouraging constructive dialogue about change.
• One trusted dataset for every program. Because the same physician-level tables feed contracting, network design, incentives, and care-management workflows, organizations avoid conflicting signals and payer-provider abrasion.
• Quantified financial impact. Practicing Wisely’s “range-of-better-practice” thresholds convert clinical gaps into dollar savings.

By making physician-level appropriateness visible, defensible, and linked to real financial savings, the solution transforms the industry’s biggest blind spots into clear opportunities for quality and cost improvements. 

Q: The press release mentions eliminating $395 billion in annual waste. What types of waste are most prevalent today, and what role do better insights — not just better incentives — play in reducing them?

A: VBC will only fulfill its promise when everyone—payers, providers, and physicians whose decisions directly impact care costs — can see the same picture of performance and act on it.

Research consistently shows that avoidable procedures and under-delivered preventive care remain the leading sources of healthcare waste. Examples abound: a five-week radiation protocol that outlives the guideline-endorsed three-week course — with no difference in outcomes but with much greater burden and potentially greater cost for the patient.

Financial incentives alone cannot eliminate such variation because physicians first need objective feedback on their care decisions. By identifying exactly which clinicians—and how many cases — are responsible, this solution turns an abstract incentive into a concrete list of actions that physicians can take ownership of. 

Q: How does Practicing Wisely ensure its results are defensible and auditable, rather than functioning as a ‘black box’ that payers and providers often distrust?

A: Our philosophy involves transparency. Our measure catalogue provides an audit trail from raw claim to clinical reference. In market discussions, this transparency is repeatedly called out as a chief differentiator — we’ve received comments such as “no black box and transparent methodology are what completely differentiates you.”  Because doctors can drill down to the actual patient cases on which they were scored, disputes convert to powerful positive clinical dialogue rather than data credibility debates, accelerating engagement and change. 

Q: Where do you see the biggest opportunities over the next 12–18 months—for providers, payers, and for Motive itself?

A: In clinical care quality and cost, physicians need to be making the right decision at the right time for the right patient every time. We still have foundational gaps – accessibility, communication, data interoperability, and knowledge interoperability – that must be closed if we are to deliver the highest quality care to all patients, and if we are to realize the value of the tremendous innovations, including AI, that are now available to healthcare. Closing these foundational gaps will enable us to write a transformative roadmap for healthcare 2030. And Motive will continue to do its part to support physicians in leading this transformation.