Joseph Papin, MD, on Aligning Incentives Across Care Teams in Risk-Bearing Organizations

 As healthcare continues its transition toward value-based care, risk-bearing organizations are under increasing pressure to deliver better outcomes while managing the total cost of care. Yet one of the most overlooked challenges in this transition is not technology or data; it is the alignment of incentives across care teams. According to Joseph Papin, MD, Principal at Suncoast Search Capital, sustainable success in risk-based models depends on whether clinicians, administrators, and care coordinators are working toward the same measurable goals.

In traditional fee-for-service environments, incentives are often tied to volume: more visits, more procedures, more throughput. Risk-bearing models, including shared savings and capitation arrangements, shift the focus toward outcomes, efficiency, and patient experience. However, if internal incentives are not redesigned accordingly, organizations may struggle to translate new payment structures into meaningful operational change.

The Misalignment Challenge

Dr. Papin highlights that many healthcare organizations enter risk-based contracts without fully addressing how performance expectations are distributed across care teams. Physicians, specialists, nurses, and administrative staff may operate under different metrics, leading to fragmented decision-making.

For example, a primary care provider may be incentivized to reduce hospital admissions, while a specialist operates under productivity targets that emphasize procedural volume. Without alignment, these competing priorities can undermine care coordination and increase overall costs—precisely the opposite of what value-based models aim to achieve.

Building a Unified Performance Framework

Aligning incentives begins with establishing a shared framework for performance. Dr. Papin emphasizes the importance of integrating clinical quality metrics, cost management goals, and patient outcomes into a cohesive system that is visible across the organization.

This includes:

• Defining clear, organization-wide quality benchmarks
• Linking compensation models to outcomes rather than volume
• Incorporating care coordination metrics into performance evaluations
• Ensuring transparency in how performance data is measured and reported

When all members of the care team understand how their roles contribute to shared goals, collaboration becomes more natural and effective.

The Role of Data and Transparency

Data plays a critical role in aligning incentives. Risk-bearing organizations require access to integrated clinical and financial data that can track performance in real time. Dr. Joseph Papin notes that transparency is key—providers must have visibility into how their decisions impact both patient outcomes and organizational performance.

Dashboards, reporting tools, and analytics platforms should not be limited to leadership teams. Instead, they should be accessible to clinicians and care managers, enabling informed decision-making at the point of care.

Clinical Leadership as a Unifying Force

A recurring theme in Dr. Papin’s perspective is the importance of clinical leadership in driving alignment. Physicians and clinical leaders play a crucial role in shaping care pathways, setting standards, and ensuring that operational changes reflect real-world practice.

When clinicians are actively involved in governance and incentive design, organizations are more likely to achieve buy-in and sustain long-term performance improvements. This approach helps bridge the gap between administrative objectives and clinical realities.

Moving Toward Sustainable Risk Models

Aligning incentives is not a one-time initiative; it is an ongoing process that evolves as organizations gain experience with risk-based care. Continuous feedback, performance monitoring, and adjustment of incentive structures are necessary to maintain alignment over time.

For Joseph Papin, MD, the takeaway is clear: risk-bearing organizations succeed not just because of contracts or technology, but because their people are aligned around a shared mission. When incentives reflect that mission, healthcare systems are better positioned to deliver coordinated, efficient, and patient-centered care.