USA TODAY International Edition

‘ Food as medicine’ may lower care cost

Medicaid funds could pay for healthier fare

- Medora Lee

“Food as medicine” may be coming to a health plan near you.

More states are testing Medicaid programs that’ll provide more people with healthy foods and, potentiall­y, lower health care costs.

Medicaid typically only covers medical expenses, but Arkansas, Oregon and Massachuse­tts received approval from the Centers for Medicare & Medicaid Services last year to use a portion of their Medicaid funds to pay for food programs, including medically tailored meals, groceries and produce prescripti­ons ( fruit and vegetable prescripti­ons or vouchers provided by medical profession­als for people with diet- related diseases or food insecurity). California already was running a food program under a different centers approval. The aim is to see whether providing people with nutritious foods can effectively prevent, manage, and treat diet- related diseases.

“A lot of what ails our health care system is overutiliz­ation because we’ve never changed the lifestyles that take us into the health care system in the first place, and that starts with your diet,” said Indiana Sen. Mike Braun at a hearing in December.

How does ‘ food as medicine’ work?

Though different processes will be tested, Massachuse­tts and California allow medical profession­als to refer struggling patients to a local food assistance organizati­on to determine their needs. That could result in grocery store gift cards, kitchen supplies, cooking classes, nutrition counseling, or a service that will deliver “medically tailored meals” to patients. In Massachuse­tts, patients are checked on every three months.

In November, the U. S. Department of Agricultur­e invested $ 59.4 million partly to support so- called “produce prescripti­ons” from a health care provider for fresh fruits and vegetables.

Does food as medicine work?

“The relationsh­ip between what we eat and how it affects our health and mortality is clear,” said Dan Glickman, co- chair of the Task Force on Hunger, Nutrition, and Health, at a hearing in December.

A study published last fall estimated that if all patients in the U. S. with mobility challenges and diet- related diseases received medically tailored meals, 1.6 million hospitaliz­ations would be avoided, with a net savings of $ 13.6 billion annually.

Another study in 2019 found that over the course of about a year, the meals resulted in 49% fewer inpatient admissions and a 16% cut in health care costs compared with a control group of patients who did not receive the meals.

What’s next?

There is more work to be done to determine if this idea can flourish and the best ways to implement it.

This spring, the American Heart Associatio­n and Rockefelle­r Foundation will launch a $ 250 million “Food is Medicine” Research Initiative to determine if such programs can be developed cost- efficiently enough to merit benefit coverage and reimbursem­ent for patients, said Kevin Volpp, director at the University of Pennsylvan­ia’s Center for Health Incentives and Behavioral Economics and leader of the initiative.

The Centers for Medicare & Medicaid Services requires such programs to be neutral to the federal budget and capped at 3% of the state’s total Medicaid spend, according to Madeline Guth, senior policy analyst with Kaiser Family Foundation’s Program on Medicaid and the Uninsured.

Other issues include finding food suppliers, defining what’s “nutritious,” and who would ultimately qualify. Because there are strict guidelines now, only a very small percentage of Medicaid recipients are eligible in these pilots, Guth said.

“CMS is indicating what it approved for those states is setting the stage for what it’s willing to approve and looking to approve for other states,” Guth said. “There could be more coming, but these states will be the model and what we’ll be watching over the next year or so.”

 ?? NODAR CHERNISHEV/ GETTY IMAGES ?? In November, the U. S. Department of Agricultur­e invested $ 59.4 million partly to support “produce prescripti­ons” for vegetables and fruits.
NODAR CHERNISHEV/ GETTY IMAGES In November, the U. S. Department of Agricultur­e invested $ 59.4 million partly to support “produce prescripti­ons” for vegetables and fruits.

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