Paying for Outcomes to Support More Missouri Families

The Children’s Trust Fund of Missouri (CTF), the state of Missouri’s foundation for child abuse prevention, was funding home visiting services on a fee-for-service basis. Eager to increase the positive impact of these services on children and families, CTF worked with Social Finance to design an outcomes rate card. This outcomes-based funding tool included a “menu” of high-priority outcome metrics CTF hoped for its home visiting service providers to achieve—like increases in full-term birth rates and decreases in child injury rates—and an associated payment for each outcome.

Based on strong positive responses from providers, CTF braided American Rescue Plan Act and philanthropic funds to expand the outcomes rate card statewide in February 2023. By the fall of that year, CTF had provided $316,000 in incentive payments to home visiting service providers for positive health outcomes achieved. These payments, in the form of unrestricted funds, have been used by providers to offer services to an even greater number of children and families across Missouri.

“This is excellent,” said one home visiting service provider in CTF’s annual report. “I’m pleased CTF has made the decision to take a look at connecting payments to outputs and outcomes.”

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Photo courtesy of the Children’s Trust Fund of Missouri.