Behavioral Health Homes (BHH) Pay-for Performance (P4P) Benchmark Announcement

In April 2018, the Department implemented a P4P provision for BHH providers, placing 1% of total BHH payments at risk pending performance on a quality measure. 

On January 30, 2026, MaineCare adopted a new BHH rule with an update for a P4P provision. Through this rule, the Department will withhold 4% of Per Member Per Month (PMPM) payments upon setting applicable performance thresholds. We will pay the remaining 4% of the rate to BHH providers every three (3) months if they satisfy the Minimum Performance Threshold. Subject to the availability of appropriations, the Department will reimburse BHH providers that meet the Excellence Performance Threshold an additional 1% of the total PMPM payments every three (3) months.

BHH P4P Measures 

There are now two measures for BHH P4P: 

  • Quality of Life / Patient Experience - Accesses patient experience data  
  • Access to Preventive and Ambulatory Care - Assesses members’ utilization of primary care services. 

The Department set the performance thresholds for the two measures included in the updated BHH rule and will begin withholding the 4% of monthly payment on May 21, 2027. The prior baseline benchmarks did not include Acentra data from the Quality-of-Life measure. 

The Department will send regular data reports, collaborate with BHH providers, and utilize other data sources or evidence-based materials to support quality improvement.

BHH P4P Benchmarks 

P4P utilizes two benchmarks which represent the composite score of the above performance measures. 

  • Minimum Performance Threshold 
    • A composite score of 65% as of May 21, 2027. 
    • When a BHH provider meets this threshold, they will receive the balance of their full BHH reimbursement (the remaining 4% of the rate). 
  • Excellence Performance Threshold 
    • A composite score of 78% as of May 21, 2027.   
    • Subject to the availability of appropriations, when a BHH provider meets this threshold, they are eligible to receive a 1% bonus payment. 

See MBM, Chapter II, Section 92, Behavioral Health Home Services for a full description of the P4P measures and methodology, including how benchmarks are established. 

For questions, please contact Kaley Haynes, BHH and OHH Program Coordinator.