Payers of behavioral healthcare have an interest in incentivizing behavioral health providers to improve the quality of their care. Pay for performance links clinical performance (including patient satisfaction and clinical outcome measures) to monetary incentives designed to motivate and reward quality of care. There are overpay for performance efforts underway in the US, including from the Centers for Medicare Medicaid Services (Bachman, 2006). These value based payment models typically use clinical outcomes as at least one benchmark. In 2006, Bachman’s outline of pay for performance behavioral health models included the importance of a clinical information system for tracking cases and data, such as clinical outcomes measures and other quality benchmarks (i.e., patient satisfaction and adherence to clinical practice guidelines) that could be associated with bonus payments or a differential payment of abase fee.