The Scale of the Problem
While extensive research shows the importance of a child’s first three years, 6.7 million low-income children too often do not get the support they need during this critical window to ensure the best start in life. Compounding the problem, these families can be difficult to reach, making it a challenge to deliver knowledge and resources. As a result, many children living in poverty face behavioral and cognitive development challenges and/or enter kindergarten unprepared to learn.
A Promising Solution
HealthySteps helps children from low-income households stay on track developmentally by integrating a child development specialist into the pediatric primary care team. The HealthySteps Specialist's role is to promote healthy relationships, foster positive parenting, strengthen early social and emotional development, and ensure access to services that address both child and family needs.
Roughly 90% of low-income children under age four do not attend pre-K or other formal programs, making it harder to reach them to address potential delays. The healthcare setting offers critical touch-points of interaction with these families, and is almost universally accessed in the United States. But pediatricians are tasked with addressing physical health as their primary focus, and may not have the time or expertise to sufficiently address children's cognitive or social-emotional wellbeing.
Only 48% of children living in poverty are ready for school by age 5
The achievement gap between low and higher income children at age 5 is 15 months
Today, 90% of all children ages 0-3 see a pediatrician. By leveraging this existing channel, many more low-income families can receive knowledge and resources to support their child during these formative years. HealthySteps’ model of enhanced pediatric care supports a child’s social, emotional, cognitive and behavioral development as well as their physical development and can set the standard for enhanced pediatric care nationwide.
Children are 8x more likely to receive a developmental assessment at 30-33 months
1.4x more non-medical referrals (for behavior, speech, child abuse and neglect, etc.)
Estimated net savings to states’ Medicaid budgets such as between $2.1 and $6.6 million annually in South Carolina
Blue Meridian’s Investment
Our investment supports the first phase of HealthySteps’ national scaling plan which focuses on testing growth strategies, expanding the evidence base, and strengthening central office support to local sites. As part of this plan, HealthySteps will expand through partnerships with large, influential health systems that serve a high proportion of low-income children and engage with state-level agencies, so that they adjust policies to allow for coverage of enhanced care programs like HealthySteps. Key markers of success include the following:
$39 million over five years
Serve 75,000 annually by 2021
Deliver program to at least 60% of children within large health systems in NY, SC and CO, and one national system –DoD Military Health System
Why We Are Excited About HealthySteps
Every organization in our investment portfolio is ready to embark on significant scaling and displays a variety of strengths. Here are highlights of the tremendous potential we saw in HealthySteps’ strategy and why we invested:
Extraordinary Reach at a Critical Stage
Extensive research shows the importance of a child’s first three years to their future achievement, yet there is no formal mechanism to reach the majority of low-income parents and children during these years. By leveraging pediatric practice, a system that reaches nearly all children under age 6, HealthySteps has the ability to reach a significant proportion of low-income young children during this critical developmental window.
HealthySteps has had strong organic demand to expand its services right from the start. What began as just a two-site pilot in 1995 grew quickly into a large and informal network of 74 sites by 2015, driven by interest from doctors, hospital systems, and payers who recognized the potential impact of the HealthySteps model.
Since its merger with ZERO TO THREE in 2014, HealthySteps has had impressive growth, adding more than 40 sites, while still looking to deepen their evidence base, including a recent implementation assessment across its current network. As of 2017, HealthySteps has a presence in 15 states, including Washington D.C and Puerto Rico, reaching 36,000 children ages 0-3 annually nationwide.
Low Cost with High Reach
By integrating a specialist into an existing pediatric care team and office, HealthySteps is able to deliver its interventions at a low-cost and avoid large infrastructure costs at each site. Additionally, HealthySteps offers strong potential for measurable cost savings for healthcare payers
HealthySteps is a national model of enhanced pediatric primary care that improves children’s lives by integrating a child development specialist into the primary care team The HealthySteps Specialist’s role is to promote healthy relationships, foster positive parenting, strengthen early social and emotional development, and ensure access to services that address both child and family needs, with a particular emphasis on families living in low-income communities.
HealthySteps is a program of ZERO TO THREE, a national nonprofit dedicated to ensuring babies and toddlers have a strong start in life.
"I have everything I need to be this child's mother."
Learn how HealthySteps supports and empowers parents to set their young children up for success.
Rahil D. Briggs
Rahil D. Briggs, PsyD serves as National Director of HealthySteps, a program of ZERO TO THREE. Dr. Briggs is the founder and former director of Pediatric Behavioral Health Services at Montefiore Medical Group, one of the nation’s largest integrated pediatric behavioral health services in the nation. She is also an Associate Professor of Pediatrics, Psychiatry and Behavioral Sciences at Albert Einstein College Medicine.
Matthew Melmed, JD is Executive Director and a member of the Board of ZERO TO THREE. A recognized leader and tireless advocate devoted to promoting the health and development of infants and toddlers, he has led ZERO TO THREE since 1995 and overseen its considerable growth. Melmed chairs the Board of Generations United and served as the first elected Chair of the Children’s Leadership Council.