Types of Performance-based Payment Systems

The type of performance-based payment systems implemented often depend on the type of payer (Bremer et al., 2008). When the payer is a managed behavioral health plan, pay-for-performance systems target different client types or conditions: drug and alcohol detoxification engagement and retention, admissions, depression or the presence of specific programming (e.g., Dialectical Behavior Therapy). However, state based systems are more broad in their coverages, focusing on all clients with substance abuse issues or across multiple conditions.

Recently implemented state-based systems in Maine, Delaware, and Oklahoma have incorporated incentives into their contracts that can be classified as follows:

• Incentives to Improve Aims
• Incentives to Spread Process Improvement