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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 15: Continuous and Adequate Insurance

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Strategy. Outreach to Communities Experiencing Inequities

Approach. Support outreach to communities experiencing inequalities in health insurance coverage.

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Overview. Race, ethnicity, language spoken at home, household income, number of functional difficulties, and immigration status are among the demographic, socioeconomic, and cultural factors that affect access to health care and coverage for children and youth with special health care needs (CYSHCN). Title V programs, Medicaid agencies, and family leader organizations have developed strategies to promote health equity that go beyond translating materials. In an effort to ensure health care access and coverage equity, states have developed partnerships that pool resources and leverage organizational expertise, ensure staff is representative of the population served, and maximize outreach and enrollment efforts to reach the most vulnerable CYSHCN.1

Evidence. Expert Opinion/Field Generated. The Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (CYSHCN) has identified this strategy as an innovative strategy. Read more in theirĀ practice report.

Target Audience. Systems.

Outcome. Percent of children, ages 0 through 17, who are continuously and adequately insured. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support outreach to communities experiencing inequalities in health insurance coverage,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of partnerships that pool resources and leverage organizational expertise, ensure staff is representative of the population served, and maximize outreach and enrollment efforts.
  • Number of outreach activities in communities experiencing inequalities in health insurance coverage.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of partnerships that pool resources and leverage organizational expertise, ensure staff is representative of the population served, and maximize outreach and enrollment efforts.
  • Percent of outreach activities in communities experiencing inequalities in health insurance coverage.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of at-risk communities with designated outreach programs through partnerships including Title V.
  • Number of children enrolled in communities experiencing inequalities in health insurance coverage in which Title V is providing outreach.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of at-risk communities with designated outreach programs through partnerships including Title V.
  • Percent of children enrolled in communities experiencing inequalities in health insurance coverage in which Title V is providing outreach.

Notes. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs. Inequities Financing Strategy.

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.