This time, Peralta walloped Bailey's 83-mph cutter over the wall in left to hand the Red Sox a painful 4-3 loss to the Tigers.
"Yeah, I think so," said manager John Farrell, when asked if Bailey might have to switch roles at least temporarily. "Whether that's backing him out of that to get him some work to get on track a little bit more, or what the internal options are and out of fairness to Andrew and others down there late in the game, we'll talk more about that internally to make a potential change."
Andrew Miller, Junichi Tazawa and Koji Uehara are all candidates to replace Bailey in the ninth inning if Farrell makes a change.
Bailey's slump has been dramatic. In his last five appearances, the righty has converted just two of five save opportunities, posting a 15.75 ERA while allowing a .444 opponents' batting average.
This time, Bailey came on with a 3-2 lead. His outing started by walking Victor Martinez on five pitches.
"Anytime there's a save opportunity, that's the cardinal rule -- you can't let the first guy reach base, let alone the tying run," said Bailey. "I'm just not being myself out there. I've got to pitch better."
Peralta came up next and worked the count to 1-2 before putting one out of the yard.
"I felt I had him set up," Bailey said. "I just didn't execute the right pitch. That's what happens when you're ahead in the count and leave one over the plate. Like I said, the way [John] Lackey threw the ball tonight, he deserved a better outcome."
Bailey is as exasperated as anyone by the way he has pitched of late.
"Very frustrating," Bailey said. "Your starting pitcher goes out there against a great offense and pitches a hell of a game. It's very frustrating. Once again, I've got to make better pitches. I've got to find a way to grind through it. Everything feels good. I'm just missing spots. I've got to keep grinding through it."
Lackey was in line for the win after giving up two runs over seven innings.
It was Lackey's fifth quality start in his last six outings, as he lowered his ERA 3.03.
"I feel pretty good. I threw the ball pretty good," said Lackey. "I was able to locate some offspeed stuff and the fastball for the most part. I've been feeling pretty good for a while now. I'm just trying to pound the zone and throw strikes and try to get ground balls and get us as deep in the game as I can."
For the 44-31 Red Sox, it was a tough way to start a four-game showdown against another first-place team.
"Well, extremely tough," said Farrell. "[Bailey] gets ahead in the count after the leadoff walk to Martinez. Just looking at the pitch on replay, he gets the ball to the edge, but just enough elevation for him to get under it and drive it out of the ballpark. It's a tough way to end a game after I thought we played the game exceptionally clean tonight. Lackey was outstanding once again. But until you record that last out, they're not over."
All season long, Boston has shown the ability to bounce back from a tough loss.
"This is not going to affect Boston. They're a first-place team in the [American League East]," said Tigers manager Jim Leyland. "This is Major League Baseball. You play every day. Whoever pitches best tomorrow is going to win the game. This is a nice win for us, but it wasn't life or death if we lost the game, and fortunately we won the game."
The Red Sox see a clear reason for Bailey's recent lack of success. His fastball does not have the same life as it did before going on the disabled list retroactive to April 29 with a right biceps injury.
However, Bailey feels healthy and nobody has an answer for why the velocity has dipped.
"There's work being done, through long-toss program, through the work that he does with the strength and medical staff here," said Farrell. "He doesn't talk of any inflammation or any kind of uncomfortable feeling in the shoulder, and yet the results are what they are."
"There's peaks and valleys in this game with velocity in outings, and right now, I've got a little bit of both going, and I'll come out of it," Bailey said. "We've got a great team here. The way Lackey threw the ball, I've got to get back to doing my job. I'll keep on grinding through it."
This was a hard-fought contest throughout.
David Ortiz snapped the 2-2 tie with a single to right against lefty reliever Phil Coke in the top of the eighth. Coke got himself into trouble in that inning, walking Jacoby Ellsbury and Shane Victorino.
It was Ortiz who broke the scoreless tie in the top of the fourth when he launched a solo homer to right, his 15th of the season.
Jose Iglesias got a fifth-inning rally started when he led off with a triple to right. Ellsbury then smashed a single up the middle and Lackey had a 2-0 lead.
Later in the game, Ellsbury helped with his glove, making a fine running catch against Prince Fielder in front of the wall in right-center to complete a 1-2-3 eighth for Uehara.
The Tigers had their first fruitful rally in the fifth. Andy Dirks started it with a one-out walk. With two outs, Brayan Pena and Austin Jackson came through with singles to load the bases. The hit by Jackson was a slow roller to third. Up stepped Torii Hunter, and he blooped a single into short right, bringing home two runs to tie the game.
The Tigers thought they had momentum with Miguel Cabrera at the plate, but Lackey came through with a big strikeout.
"It's fun," Lackey said of the showdown. "Obviously he's a great player. In a spot like that, you have to be careful. You have to make some pretty good pitches to get him out."
Now Bailey is the one who has to go back to the drawing board to figure out how he can make good pitches when it counts.
And if it has to be in an inning besides the ninth for a while, Bailey understands that.
"I haven't talked to [Farrell] about that, but if he feels that need is necessary, that's his decision," Bailey said. "I've got to go out there and get people out. That's the bottom line. Whatever situation he wants that in is his call. I've had success in this league. I know how to get people out. I've just got to get back to doing it."