With support from the Institute for Child Success (ICS), the
Tennessee Commission on Children and Youth (TCCY) studied
the feasibility of using Pay for Success (PFS) financing, an
innovative mechanism, to improve outcomes for its youngest
children. PFS financing, also called “Social Impact Bonds,” can
bring new resources, new partners, and a new focus on outcomes
to early childhood services. Tennessee was one of four jurisdictions selected to receive technical assistance from ICS in 2016 through the U.S. Social Innovation Fund’s PFS program. The feasibility study focused on the possibility of expanding three evidence-based home visiting programs—Healthy Families America (HFA), Parents as Teachers (PAT), and the Nurse-Family Partnership (NFP)—for families in need.
The study concluded that Tennessee could feasibly expand home visiting using PFS financing to improve outcomes for low-income mothers and their children. HFA produces at least two PFS- suitable outcomes and could expand once the program launches a new data system and builds the capacity of local service providers to manage to outcomes. PAT demonstrated strong intermediate outcomes and, with additional data on longer-term “impact outcomes” that can be measured in Tennessee, could consider expansion under PFS in the future. NFP produces at least three outcomes in Tennessee that meet the criteria for PFS financing, and research indicates that the benefits of investing in NFP significantly exceed the costs. With TennCare as a possible outcome payor, Tennessee could use PFS financing to expand NFP in six high-need counties, including Shelby County where Le Bonheur Children’s Hospital currently implements the program.
Because the NFP is most immediately ready for PFS financing (having been expanded with PFS financing in South Carolina), the remainder of this Executive Summary focuses primarily on NFP. This Summary accompanies a presentation of the feasibility study findings. Note that neither provides the sum total of the feasibility study, which included multiple rigorous analyses and deliverables.
Tennessee: Highlights of a Pay for Success Feasibility Study
Mary C. Garvey, Institute for Child Success