South Carolina Nurse Family Partnership Pay for Success Project

In January 2016, South Carolina launched a pay for success (PFS) project to connect low-income mothers and their children with nurse home visiting services. South Carolina’s Department of Health and Human Services (SCDHHS) used the pay for success contract to deliver preventive services to first-time mothers in the state’s Medicaid program with the goal of improving the health outcomes of mothers and their babies.

Through the South Carolina Nurse-Family Partnership project (SC NFP), South Carolina provides nurse home visiting services to approximately 4,000 mothers over a six-year period. Mothers who enroll in Nurse-Family Partnership services receive individualized home visits from trained nurses from early in their pregnancy until their child’s second birthday.

The SC NFP project employed several innovative techniques to expand and evaluate preventive services:

1. The use of a ‘pilot period’ to test changes in program enrollment and data transfer.
2. The development of a PFS outcome metric focused on enrolling high-risk mothers.
3. State-Federal Partnership.
4. Combination of Fee-for-Service and Pay for Success.
5. The incorporation of philanthropic investment and rollover of success payments.
6. The incorporation of a randomized controlled trial (RCT) and a long-term evaluation.

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