Pay for Success

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The nation’s first Pay for Success project aimed at improving health outcomes for mothers and children living in poverty launched in February 2016, when South Carolina Gov. Nikki Haley, S.C. Dept. of Health and Human Services director Christian Soura, other state officials, and leaders from the private sector announced the initiative.

South Carolina is using Pay for Success to fund statewide implementation of Nurse-Family Partnership and its home visitation program that works with low-income moms to encourage healthy pregnancies and strong early childhood development.

The Pay for Success project will bring Nurse-Family Partnership’s evidence-based program to an additional 3,200 first-time mothers and their babies enrolled across the state over the next four years, a significant increase over the 1,200 families currently benefiting from the high-impact intervention.

Four concrete goals serve as the project’s foundation:

  1. Reducing preterm births
  2. Decreasing child hospitalization and emergency department usage due to injury
  3. Iimproving healthy spacing between births
  4. Increasing the number of first-time mothers served in the lowest-income communities.

Pay for Success projects combine nonprofit expertise, private funding and rigorous evaluation to transform how government leaders respond to chronic social problems. Funders provide upfront capital to expand effective social services, and governmental entities pay for all, or part, of the program only if it measurably improves the lives of participants. Independent evaluators measure the effects of a program based on specific, predetermined metrics that benefit both individuals and society and generate value for taxpayers. J-PAL North America, a research center, based at the Massachusetts Institute of Technology, will lead the randomized-control trial evaluation of the South Carolina project.

The project mobilizes $30 million, with philanthropic funders committing $17 million to the project. Medicaid will fund approximately $13 million through a 1915(b) Medicaid Waiver awarded to the S.C. Department of Health and Human Services by the federal Centers for Medicare and Medicaid Services. Children’s Trust will partner as the project fiduciary.

Pay for Success Fact SheetPDF