Performance incentives in the Massachusetts behavioral health program.

Since 1996, the Massachusetts Behavioral Health Partnership (the Partnership/MBHP) has been the behavioral health carve-out vendor for the Commonwealth of Massachusetts Primary Care Clinician (PCC) Plan. Its use of performance standards and incentives has become one of the central organizing activities for both the Commonwealth and the vendor, and one of the program's hallmarks. Each year, the Commonwealth uses a participative process for generating suggestions for performance incentives, which are then negotiated with the Partnership. Success or failure of projects is judged in accordance with objective measures developed for each incentive project. From 1996 to 2004, 123 performance projects have been completed. Some projects have become contract requirements, and others have developed into programs or services. The performance incentive process blends features of more traditional performance standards with performance-based contracting approaches. This process gives both the Commonwealth and the Partnership the flexibility to reflect changing state policies and to develop a contract that meets the most current needs of members.