Behavioral Health Homes
Behavioral Health Homes are an important component of Maine's Value-Based Purchasing strategy, a multi-pronged MaineCare initiative designed to improve the healthcare system, improve population health, and reduce cost. Behavioral Health Homes are a partnership between a licensed community mental health provider (the "Behavioral Health Home Organization" or BHHO) and one or more Health Home practices (a HHP) to manage the physical and behavioral health needs of eligible adults and children. Both organizations receive a per member, per month (PMPM) payment for Health Home services provided to enrolled members. Behavioral Health Homes build on the existing care coordination and behavioral health expertise of community mental health providers.
Participation in Behavioral Health Home services is entirely voluntary, and members can opt out of the service at any time.
Behavioral Health Homes, including provider requirements, are further described in Section 92 of the MaineCare Benefits Manual.
In April 2018, a Pay-for-Performance (P4P) provision for Behavioral Health Home (BHH) providers was implemented, placing one percent of total BHH payments at risk pending performance on a quality measure. The current quality measure is as follows: Of the MaineCare members assigned to the BHHO who had two or more fills of antipsychotic medication, the percentage of members who had at least one HbA1c or fasting blood glucose test. This measure was designed based upon the American Diabetes Association’s (ADA) recommendation: "Annually screen people who are prescribed atypical antipsychotic medications for prediabetes or diabetes." (Diabetes Care 2004 Feb; 27(2): 596-601. http://dx.doi.org/10.2337/diacare.27.2.596 / as amended 2010). The performance threshold for the quality measure has been set at 75%.
More information on the performance measure and P4P provisions can be found in Chapter III, Section 92 of the MaineCare Benefits Manual
Participating Behavioral Health Home (BHH) Provider Information
Materials and Forms
Questions? Email the VBP Unit for questions about the project, upcoming events, and meetings.