Senate considers Pay-for-Success nurse home-visiting pilot targeting Medicaid recipients in rural Utah

SALT LAKE CITY — The Utah Senate considered a bill to establish a nurse home-visiting pilot under a Pay-for-Success model that would focus on Medicaid recipients in rural parts of the state.

Senator Escamilla, the bill sponsor, said the program would use evidence-based nurse home visits addressing metrics such as preterm births, child injury, immunizations, postpartum depression screening and enrollment targets for high-risk mothers. He said the program includes a trigger mechanism requiring approval of performance measures and contractual elements by the Executive Appropriations Committee before the pilot takes effect.

Escamilla framed the model as using private-sector capital to share risk while generating measurable returns that reduce long-term state spending on costly outcomes. In floor discussion, Senator Dayton asked whether non-taxpayer-funded alternatives were available; Escamilla said most evidence-based programs in the state are federally funded and that the Pay-for-Success arrangement leverages private investment to expand proven services to rural and high-need populations.

Sponsors emphasized the program targets Medicaid recipients in rural Utah and asserted the approach is data-driven. The sponsor called the question and moved to a roll-call vote in the segments provided.