BH VBC Contracts — 2026 Provider Guide
VBC Models Emerging in BH
- Bundled Episode of Care (30/60/90/180 day)
- Total Cost of Care (annual per-attributed-member)
- Capitation (PMPM regardless of utilization)
- Pay-for-Performance (quality-driven bonus)
- Shared Savings (upside/downside)
BH-Specific Quality Measures
- HEDIS FUH (Follow-Up After Hospitalization)
- HEDIS FUA (Follow-Up After ED for MH)
- HEDIS SAA (Substance Use Disorder Treatment Initiation)
- HEDIS SUD-13 (Continuity of Pharmacotherapy for OUD)
Provider Considerations
- Attribution methodology transparency
- Risk adjustment for high-acuity BH populations
- Data infrastructure for outcome tracking
- Care coordination workflow
- Financial modeling for capitation vs FFS
– KD, Revenant Care