Colorado Perinatal Care Quality Collaborative Social Return on Investment Study
Project Objectives
- Quantify the financial return of perinatal substance use intervention by calculating the social return on investment (SROI) generated by the Colorado Perinatal Care Quality Collaborative's Turning the Tide program across two fiscal years of full implementation.
- Separate what the program actually caused from what would have happened anyway by using early implementation data to establish a baseline, ensuring the analysis credited Turning the Tide only for outcomes it genuinely produced.
- Translate screening and referral activity into monetized social value by tracing the pathway from universal hospital-based screening, through services engagement, to measurable cost savings in healthcare utilization, criminal justice involvement, and productivity.
- Build a multi-stage attribution model grounded in statewide Medicaid benchmarks to connect Turning the Tide's influence over hospital protocols to individual-level treatment persistence outcomes.
- Provide Colorado Perinatal Care Quality Collaborative (CPCQC) with an honest, actionable SROI estimate that accounts for program maturity, data quality variation across sites, and structural changes introduced in FY2025, rather than presenting a single clean number stripped of context.
Project Description
Omni’s Center for Social Investment partnered with the Colorado Perinatal Care Quality Collaborative (CPCQC) to assess whether Turning the Tide (a statewide initiative supporting hospitals in identifying and responding to substance use during childbirth) was a worthwhile investment. The work began by developing a shared understanding of how the program operates in practice: what hospitals do, where interventions occur, and what outcomes the initiative is designed to achieve. This foundation informed every step of the analysis that followed.
With that clarity in place, Omni designed an SROI model that traced the pathway from hospital-based screening to real-world outcomes. The central question was simple: when a birthing person screens positive for a substance use disorder and is connected to services before discharge, what are the broader benefits to society? To answer this, Omni drew on CPCQC program data, published research, and Colorado Medicaid quality data to estimate downstream impacts—including reductions in emergency department utilization, criminal justice involvement, and productivity losses, and then determined what share of those benefits could reasonably be attributed to Turning the Tide.
A key challenge in the analysis was accounting for what might have occurred in the absence of the program. Omni addressed this by using early implementation data (captured before hospitals had fully adopted the model) as a baseline for comparison. This approach allowed the team to distinguish the program’s contribution from existing levels of care. The findings were further tested across a range of assumptions to ensure they were robust and credible.
The final report found that Turning the Tide generated an estimated $1.99 in social value for every $1 invested. Importantly, Omni contextualized this result by examining the factors driving year-over-year variation (such as rapid hospital enrollment, staffing changes, and the natural learning curve associated with onboarding new sites) providing CPCQC with a clear and nuanced understanding of what the results reflect.
We wanted to capture what it actually means when substance use screening rates go up and more birthing people leave the hospital with connections to services they wouldn't have had otherwise. Working with CPCQC to fully understand the Turning the Tide data and being honest about what the data could and couldn't tell us mattered as much as the final result.
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