Randomized Evaluation of the Nurse-Family Partnership
There is enormous policy interest in expanding programs that move beyond traditional health care walls into the community to improve health outcomes – and holding those programs financially responsible for doing so. Billions of public dollars are devoted to “home visiting” programs that seek to improve birth and long-term outcomes for low-income mothers and children. The Nurse-Family Partnership (NFP) program provides regular nurse home visits to low-income, first-time mothers through pregnancy and up to the first two years postpartum in order to improve the outcomes of both mothers and their children. South Carolina obtained a Medicaid waiver and generous philanthropic support to fund a landmark pay-for-success initiative that expanded NFP’s services across the state. This randomized evaluation will assess a number of “success indicators” relevant to the pay-for-success initiative, such as the program’s effectiveness in reducing injuries among newborns and toddlers, as well as study the potentially wide-ranging effects of NFP on the health and well-being of mothers and children for many years to come. The study aims to yield insights into the effectiveness of home visiting programs, the sustainability of more flexible public insurance benefits, and the potential role that evidence-based payments can play in driving improved outcomes.