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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Outreach to Communities Experiencing Disproportionately Low Health Outcomes

Approach. Support outreach to communities with historically low health insurance coverage

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Overview. Language spoken at home, household income, and number of functional difficulties, are among the demographic and socioeconomic 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 positive health outcomes that go beyond translating materials. In an effort to ensure health care access and coverage 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 CYSHCN populations who have additional health needs.[1]

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Boston University's Catalyst Center Financing Strategies Database

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs 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. Here are sample ESMs to use as models 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?")

PROCESS MEASURES:

  • Number of outreach events conducted in communities experiencing gaps in health insurance coverage. (Measures level of tailored outreach efforts)
  • Number of staff hired from a variety of communities to conduct outreach. (Shows commitment to representation and community engagement)

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

PROCESS MEASURES:

  • Percent of outreach events held in non-traditional community locations usable to communities experiencing challenges. (Evaluates meeting families where they are)
  • Percent of outreach staff who receive training on trauma-informed approaches. (Measures equipping staff with key skills)

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

PROCESS MEASURES:

  • Number of organizations serving communities represented in insurance outreach coalitions and planning efforts. (Measures collaboration)
  • Number of goals and strategies incorporated into outreach plans and policies as a result of partner input. (Shows impact of partnerships)

OUTCOME MEASURES:

  • Number of children in communities who receive recommended care coordination and support services. (Measures access to quality care)
  • Number of policies for systems changed to reduce barriers to health insurance access for communities. (Shows progress toward access)

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

PROCESS MEASURES:

  • Percent of outreach funding and resources allocated specifically to efforts focused on communities experiencing the greatest insurance challenges. (Measures investment where it is most needed)
  • Percent of CYSHCN served through outreach efforts. (Indicates representative reach)

OUTCOME MEASURES:

  • Percent reduction in the uninsured rate for CYSHCN in communities experiencing challenges. (Measures coverage progress)
  • Percent increase in CYSHCN who receive all needed services and supports. (Indicates access to comprehensive care)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs. Inequities Financing Strategy.
https://ciswh.org/project/the-catalyst-center/financing-strategy/inequities/

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.