Innovation
Medical-Financial Partnership (MFP)
Los Angeles
Description
The Medical-Financial Partnership (MFP) is a pediatric care model centered on longitudinal, one-to-one parent social work support embedded within prenatal and pediatric primary care.
Families are paired with an MFP social worker early in pregnancy or their child’s infancy and work together for 9 to 12 months to identify and pursue goals aligned with family priorities across financial stability, mental health, physical health, and early relational health (ERH). MFP social workers serve as family-centered, culturally attuned care coordinators and cross-sector navigators, integrating health care with social and financial supports. This longitudinal support incorporates other core MFP innovations, including the Benefits Explorer Tool (BET) and the Parent Voice Note (PVN), creating a coordinated and relationship-driven care experience.
Need / Problem Statement
Social drivers of health such as income, employment, housing stability, and access to benefits are often as or more influential as medical treatment in shaping health outcomes, particularly for families facing economic hardship.
Financial insecurity is closely linked to chronic stress, poor health outcomes, barriers to care adherence, and challenges to early child development. Without the MFP lens, pediatric care often lacks the structure and capacity to address these interconnected needs in a sustained way. Families from historically and presently marginalized communities are left to navigate complex systems largely on their own.
Process
The MFP one-to-one Longitudinal Parent Social Work Support Program has evolved over eight years through iterative, parent-driven design and continuous implementation assessment.
Program development is informed by ongoing feedback from families, clinicians, and community partners, allowing the model to adapt to emerging needs and priorities. Continuous quality improvement has been central to the program’s design, ensuring relevance, sustainability, and alignment with family goals.
Partnership
Families are central partners in every stage of the MFP.
Members of the MFP Family Leader Group participate in ongoing co-design sessions to shape program processes, tools, and family experience. Their input informs how families are engaged, how services are delivered, and how success is defined.
The partnership also includes community-based organizations, clinician leaders, and Los Angeles County Department of Health Services (LAC-DHS) administrative leadership. Together, these stakeholders create a sustained feedback loop between families, providers, and systems that supports shared ownership and continuous improvement.
Implementation
Beginning in 2018, the MFP one-to-one Longitudinal Parent Social Work Support Program was rolled out across multiple DHS clinics. The program was integrated into preventive care through prenatal visits and well-child visits to ensure families were connected to supports during key developmental periods. Because nearly all families attend prenatal and pediatric visits during the early years, the leveraging of these visits as a near-universal access point addresses underutilized services and aligns medical care with the broader conditions shaping family health and well-being.
Implementation has been intentionally iterative, with regular refinements informed by parent feedback, staff experience, and evaluation findings. Improvements have been ongoing and embedded into daily workflows, making the program a durable component of pediatric care rather than a time-limited intervention.
Changes & Outcomes
Since its launch, the MFP has demonstrated significant benefits across financial stability, mental health, and care quality.
The annual qualitative implementation assessments show consistently high parent satisfaction and strong clinician support for program expansion.
Parents describe the MFP as a trusted and supportive part of their care, while clinicians report increased confidence that families are receiving meaningful follow-through rather than one-time referrals. Iterative improvements driven by parent input have kept the program responsive to family priorities, strengthened early relational health, and aligned parent and child health outcomes.
Measurement for Success
Success is tracked through a combination of quantitative and qualitative methods, including:
Process and implementation metrics
Surveys measuring longitudinal impact on quality of life, mental and physical health, parent self-efficacy, social risks, and financial outcomes
Interviews with families to identify strengths and opportunities for improvement
Clinician and staff feedback on integration and workflow alignment
Ongoing evaluation cycles to inform adaptation and refinement
Payment & Funding
- Funding type: The MFP is supported through braided funding, including philanthropic support, public payer funding, and federal and state sources such as California ACEs Aware and the National Institutes of Health (NIH).
- Anticipated gains: The program is currently undergoing formal evaluation to assess gains, with early indicators suggesting meaningful impact across family well-being, workforce support, and care quality.
To learn more about this innovation please email Drs. Monique Holguin ([email protected]) and Adam Schickedanz ([email protected]), Co-Directors of the Medical-Financial Partnership and PSP’s Los Angeles Proof Point Community.
Resources
