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Mother and Infant Home Visiting Program Evaluation – Strong Start (MIHOPE-Strong Start), 2012-2016

Project Overview

The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) will evaluate the effectiveness of two evidence-based home visiting models to improve birth and health outcomes for expectant families enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). The two models that will be studied in MIHOPE-Strong Start are Healthy Families America (HFA) and Nurse-Family Partnership (NFP), both of which have shown some evidence of improving birth outcomes in prior research. The evaluation is part of the Centers’ for Medicare and Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation’s Strong Start for Mothers and Newborns initiative.

The Study. The overall goals of the study are to determine whether home visiting programs improve birth outcomes and reduce health care costs in the child’s first year. In addition, the evaluation is designed to investigate the features of local programs and of home visitation that lead to greater effects on birth outcomes and health care costs. CMS may use the results of the evaluation to help inform Medicaid reimbursement policies. The study, which uses a random assignment design, includes an impact analysis to measure what difference home visiting programs make on maternal prenatal health and health care use, preterm birth and other birth outcomes, and infant health and health care use. It also includes an implementation analysis that will describe the families who participate and examine how the program models operate in their local and state contexts. The primary data used in the study are expected to be from surveys completed by families and home visiting staff, Medicaid and CHIP data, vital records, and program service records. Up to 15,000 families and 100 local programs in 18-20 states are expected to participate in the study.

MIHOPE-Strong Start is closely integrated with MIHOPE, a study of four evidence-based home visiting models funded by the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. MIHOPE-Strong Start will include programs funded by MIECHV as well as those with other funding sources.

Project Timeline. Study enrollment and data collection will begin in 2014 and continue through September 2015. Data collected and analyzed for the study will be published in annual reports beginning in 2013 and continuing through 2017.

The contract to conduct the evaluation was awarded to MDRC with subcontracts to James Bell Associates, Johns Hopkins University, Mathematica Policy Research, and New York University. This project is being led by the Administration for Children and Families in collaboration with the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration.

The point of contact is Nancy Geyelin Margie.

  • The Mother and Infant Home Visiting Program Evaluation-Strong Start: First Annual Report

    Published: January 3, 2014

    The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start), developed by Centers for Medicare and Medicaid Services (CMS) and the Administration for Children and Families (ACF), funded by CMS, and implemented in partnership with the Health Resources and Services Administration (HRSA), uses a rigorous random assignment design to examine the effects of home visiting programs on birth outcomes and maternal and infant health and health care. The study will also...

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