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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
NPM 15

child and father holding a paper cutout of a houseContinuous and Adequate Insurance


The Title V Maternal and Child Health Services Block Grant to States Program guidance defines the significance of this goal as follows:

Almost one-quarter of American children with continuous insurance coverage are not adequately insured. Inadequately insured children are more likely to have delayed or forgone care, lack a medical home, be less likely to receive needed referrals and care coordination, and receive family-centered care. The American Academy of Pediatrics highlighted the importance of this issue with a policy statement. The major problems cited were cost-sharing requirements that are too high, benefit limitations, and inadequate coverage of needed services.

NPM 15 Tools

MCHbest LogoNEW! The MCH Evidence Center is pleased to share Phase 1 of the MCHbest database: the Bank of Evidence-linked Strategies and Tools.

The database aggregates sample evidence-based/informed strategies that can be used as-is or adapted to develop Evidence-based or informed Strategy Measures (ESMs) for each of the MCH National Performance Measures (NPMs). Use the database along with the ESM Development Guide to work through the entire ESM process.


NEW! Watch a short video (below) discussing state-of-the-art, evidence-based/informed strategies that can be used or adapted as ESMs. Experts in the field discuss approaches, the science, and specific ways that Title V agencies can implement and measure these approaches.

Strategy Video

Presented by Allyson Baughman, Catalyst Center and Elisabeth Burak, Center for Children and Families


Introductory Resources

Summary of the Evidence

The evidence analysis review for this NPM is under development, so currently we rely on promising practices that appear to have utility.

Evidence Analysis Reports

Promising Practices

Strategies from the Catalyst Center: strategies states are using to improve and finance care for CYSHCN: behavioral health, benefits counseling, care coordination, CHIP, EPSDT, family supports, foster care, inequities, managed care, mandated benefits, Medicaid buy-ins, Medicaid waivers, premium assistance, relief funds, TEFRA, telemedicine, and transition services.

You can access strategies from AMCHP’s Innovation Station that have shown promise in advancing your NPM below. While these strategies may not completely align with your current activities, they can be used to help guide further development and measurement of your ESM.

Practice Name Primary Interest State Level of Evidence
Super Babies Program Birth Defects Prevention MN Emerging
Boys' Health Advocacy Program Child Health SD Promising
Health-e-access Telemedicine CYSHCN NY Best
Pediatric Practice Enhancement CYSHCN RI Promising
Utah Clicks: Universal Application System CYSHCN UT Emerging
Partners in Care: Together for Kids CYSHCN FL Emerging
Parent Child Assistance Program (PCAP) Substance & Tobacco Use WA Best
Universal Adoption of Bright Futures Child Health GA Cutting Edge
Women’s Health Education Navigation (WHEN) Program for justice-involved families Birth Outcomes NY Promising
MN Care Coordination Systems Assessment and Action Planning CYSHCN MN Emerging
First 5 California Kit for New Parents Family/Consummer Involvement CA Promising
Family Voices of California Project Leadership CYSHCN CA Promising
Nurse Family Partnership Home Visiting National Best
Partners in Pregnancy Infant Health VA Promising
Tampa Bay Doula Program Perinatal Health FL Emerging

Sample ESMs

Domain and National Performance Measure: Percent of children ages 0 through 17 who are adequately insured

Strategy [Source] Evidence-based/-informed Strategy Measure (ESM)
Support workforce development trainings for Title V staff to ensure knowledge of insurance coverage [3,4] # of staff who complete trainings about insurance coverage for children
Modify public insurance benefits to reduce Medicaid churning [3] Temporary eligibility criteria established to reduce loss of insurance benefit for families; #/% children automatically enrolled in Medicaid
Expand CHIP eligibility [3,4] #/% children newly enrolled in CHIP with expanded eligibility criteria
Offer insurance application assistance through community organizations [3] #/% of community organizations that offer assistance with insurance applications

[3] Women’s and Children’s Health Policy Center, Johns Hopkins Bloomberg School of Public Health. Environmental Scans.
[4] Association of Maternal and Child Health Programs & Johns Hopkins Bloomberg School of Public Health. Taking Action with Evidence: Implementation Roadmap Webinars.

Source: Sample Strategies and Evidence-based/informed Strategy Measures (ESMs) (WCHPC). A list of sample strategies and ESMs for each of the 15 NPMs. Sources are provided at the end of the document. 

Related ESMs. You can access ESMs being implemented by other states/jurisdictions that may serve as models for NPM 15.

Additional Learning

  • NPM 15 Transformation Tools (MCH Navigator and National MCH Workforce Development Center). Learning resources, implementation strategies, and links to the evidence base for the competencies needed to carry out NPM 15 activities.
  • Taking Action with Evidence Implementation Roadmap (Association of MCH Programs (AMCHP) and WCHPC). Archived webinars and additional learning and implementation resources.
  • Historical Resources from the MCH Digital Library (NCEMCH). This bibliography is automatically generated to pull resources from MCHLine, the MCH Library's online catalog of seminal resources, in support of NPM 15. Coming soon.

Additional Resources

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.