a program of ZERO TO THREE

Transform the promise of pediatric practice to support the overall development of young children so they thrive in school and life

The Scale of the Problem

While extensive research shows the importance of a child’s first three years, 6.7 million, or 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 risks and stressors that may create Adverse Childhood Experiences (ACEs). The healthcare setting offers critical touch-points of interaction with these families and is almost universally accessed in the United States. Yet very few pediatric practices include an early childhood development expert to address infant and early childhood development concerns.  As a result, many children living in poverty face behavioral and cognitive development challenges and/or enter kindergarten unprepared to learn.

Only 48%

of children living in poverty are ready for school by age 5

15 months

achievement gap between low and higher income children at age 5


likelihood of children living below the poverty line experiencing 4 or more ACEs compared to those in higher income families

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. 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.


greater likelihood that children receive a developmental assessment at 30-33 months


more non-medical referrals received by children (for behavior, speech, child abuse and neglect, etc.)

Up to $1,150

estimated annual savings to Medicaid per family based on HealthyStep’s interventions

Blue Meridian's Investment

Our five-year investment supports the next phase of HealthySteps’ multi-year national scaling plan and their continued effort to reach one million low-income children ages 0-3 annually by 2032 by partnering HealthySteps child development specialists with pediatric primary care providers – transforming the delivery and funding of pediatric primary care, leveraging it as an engine to drive better developmental trajectories and outcomes for young children and their caregivers.

$46.5M invested over five years

Serve 700,000 children ages 0-3 annually

Grow the impact of the HealthySteps model and improve outcomes for children and their families

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:

Strong Evidence Base

HealthySteps has amassed a significant body of external research that makes a compelling case for its model as a new standard for enhanced pediatric primary care during a critical developmental window – for children ages 0-3. The broader early childhood research base strongly affirms key outcomes of its model as important drivers of healthy early development for low-income children – lowering rates of child social-emotional concerns and Adverse Child Experiences (ACEs), and elimination of health equity gap in well-child visit attendance.

Demand-Driven Growth

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, payers, and public decision-makers who recognized the potential impact of the HealthySteps model.

As of 2021, HealthySteps network includes 200 sites across 25 states, DC, and Puerto Rico that reach as many as 340,000 children annually.

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.

About HealthySteps

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.

Learn more about HealthySteps

Rahil D. Briggs

National Director

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

Executive Director

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.

"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.

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