To keep their chronically ill residents at home and out of hospitals or nursing homes, states are beginning to look at food-as-medicine models that deliver healthy, nutritious meals under doctors’ orders.
But there’s now a state that’s doing a lot more than looking.
California has launched a new, three-year, $6 million pilot program spearheaded by six local not-for-profit organizations, The New York Times reported. A group of 1,000 Medi-Cal recipients who have Type 2 diabetes or heart failure will receive free, strategically nutritious meals under the new program. Medi-Cal is California’s Medicaid program. Researchers will then compare that group to a larger population of Medi-Cal patients who didn’t receive the delivered meals, all with the goal of assessing whether the food-as-medicine approach does, indeed, reduce re-admission rates and slash health care costs.
“Food-as-medicine has intuitive appeal, and there is some limited evidence that management of diet can reduce complications such as readmissions,” Dan Mendelson, president of the Washington D.C.-based consulting firm Avalere Health, told Home Health Care News via email. “Health plans and governments are interested in expanding these programs—provided that they don’t add substantially to cost.”
Recent research has revealed that a lack of access to nutritious food often leads to higher readmissions rates. Home-delivered meals—both ones that are tailored to medical needs and meals that are not—have been found to curtail emergency department trips, inpatient admissions and the use of emergency transportation.
On a national level, there is currently “considerable experimentation” going on to gauge the food-as-medicine model’s effectiveness, Mendelson said. The Food Is Medicine Coalition, a national association of non-profits that supports nutrition-related public public, for example, has grown to include 27 member organizations scattered across more than states.
“Many states are starting to allow food as a benefit in Medicaid,” Mendelson said. “We expect to see these trends to continue—and to accelerate if food-as-medicine can prove positive medical outcomes.”
Meal delivery has been added as a supplemental benefit in Medicare Advantage plans. And many major providers, including insurance giant Humana (NYSE: HUM), are seeking ways to cover this service and other social determinants of health that impact hospital readmissions.
Funding for the California pilot program was approved in June 2017 as part of a state budget bill.
California may be among the first to fund a food-as-medicine program, but it’s definitely not the first to test the model’s ability to keep people at home and cut medical costs. A previous project by the Philadelphia-based Metropolitan Area Neighborhood Nutrition Alliance found that delivering medically-tailored meals to chronically ill seniors could lower health care costs as much as 55%. University of California San Francisco researchers had similar findings.
The pilot program’s non-profit partners include Project Open Hands in San Francisco, Health Trust in San Jose, Project Angel Food in Los Angeles and Mama’s Kitchen in San Diego, along with the North Bay Area’s Ceres Community Project and Food For Thought.
Although it doesn’t have any “direct experience” working with food-as-medicine programs itself, the California Association for Health Services at Home (CAHSAH) is supportive of all creative efforts to help patients become healthier and remain in their home longer, Dean Challis, president and CEO of the Sacramento-based organization, told HHCN.
“This looks like one of those inventive ideas that might have great merit,” Chalios said. “Nutrition is an important part of staying healthy and, obviously, can lead to somebody being able to stick around in their home, rather than have to go elsewhere.”
Roughly one-third of all Californians are enrolled in Medi-Cal.
“That covers a lot of people,” Challis said. “It’s always tough to fund those types of government-funded health care programs, so it will be interesting to see if Medi-Cal really grasps this program and implements it.”
Written by Robert Holly