Early Health "Pay for Success" Social Impact Finance: Scaling Up Prenatal Health Care in Virginia

Published Friday, November 28, 2014 | by Janis A. Dubno, Debra L. Gordon

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This ReadyNation paper focuses on using PFS finance to scale-up effective early health interventions. One health problem centers on pre-term and low birth weight (LBW) infants, who face significant risks for medical and developmental disabilities, which, as this paper discusses, saddles government and private entities with billions in additional spending from birth and infancy and throughout a child's life. The major cause of preterm and LBW births is not medical, but social: poverty, stress, alcohol and drug use, smoking, obesity, and adolescence pose the greatest risks for poor birth outcomes. 

One option for reversing these trends is home nurse visiting, in which nurses and peer counselors provide support and education to high-risk pregnant women in their homes. With only about 15% of high-risk mothers in Virginia with children under age 5 receiving such services, PFS finance can be used to pay for expanding nurse visiting programs through Virginia's Medicaid program. 

Lastly, this paper includes a spreadsheet model of how PFS finance works to scale up prenatal counseling as well as steps to identify and implement early childhood PFS finance in Virginia.