Strong Start for Mothers and Newborns Initiative: General Information

This initiative was a joint effort between the Centers for Medicare & Medicaid Services (CMS), the Health Resources and Services Administration (HRSA), and the Administration on Children and Families (ACF).

The Strong Start for Mothers and Newborns initiative, an effort by the Department of Health and Human Services, aimed to reduce preterm births and improve outcomes for newborns and pregnant women. On February 8, 2012, the Centers for Medicare & Medicaid Services announced the two strategies of this initiative to achieve these goals. The first was a public-private partnership and awareness campaign to reduce the rate of early elective deliveries prior to 39 weeks for all populations. The other component was a funding opportunity to test the effectiveness of specific enhanced prenatal care approaches to reduce the frequency of premature births among pregnant Medicaid or Children’s Health Insurance Program (CHIP) beneficiaries at high risk for preterm births.

The Strong Start effort to test new approaches to prenatal care was a four-year initiative to test and evaluate enhanced prenatal care interventions for women enrolled in Medicaid or CHIP who were at risk for having a preterm birth. The goal of the initiative was to determine if these approaches to care could reduce the rate of preterm births, improve the health outcomes of pregnant women and newborns, and decrease the anticipated total cost of medical care during pregnancy, delivery and over the first year of life for children born to mothers in Medicaid or CHIP.

The Strong Start initiative period of performance has concluded and is no longer active.

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There were 182 participating sites involved in the Strong Start for Mothers and Newborns Initiative. To view an interactive map of this Model, visit the Where Innovation is Happening page, and select this model from the drop-down menu on the left side of the page.

Two Strong Start Strategies

The Strong Start for Mothers and Newborns initiative had two strategies:

Effort to Reduce Early Elective Deliveries

Building on the work of the Partnership for Patients, this effort tested ways to encourage best practices and supports providers in reducing early electives deliveries prior to 39 weeks. CMS also teamed up with advocacy and professional organizations to increase public awareness efforts and develop new ones. Learn more...

Enhanced Prenatal Care Models

This initiative tested three evidence-based maternity care service approaches that enhanced care delivery, and addressed the medical, behavioral and psychosocial factors that might be present during pregnancy and contribute to preterm-related poor birth outcomes. The 27 Awardees tested one of three interventions for enhanced prenatal care: through Centering/Group Visits, at Birth Centers, and at Maternity Care Homes. Learn more...



This initiative builds on decades of work by organizations like ACOG, the March of Dimes, the National Partnership for Women and Families, the Society for Maternal-Fetal Medicine, and Childbirth Connection, showing that elective deliveries before 39 weeks increase the risk of significant complications for both the mother and the baby, as well as long-term health problems. In addition, Strong Start’s goals and focus were identified with the help of experts at the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), ACF and HRSA.

Babies born prematurely are a growing public health problem with significant consequences for families and an estimated cost to society of at least $26 billion each year. Each year, this is more than half a million infants in the United States, a number that has grown by 36 percent over the last 20 years.

Infants born preterm are at greater risk for mortality and many endure a lifetime of developmental and health problems. In addition to enormous medical needs, these children often require early intervention services, special education and have conditions that impact their productivity as adults.


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Additional Information

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