Harvard Legal Experts Identify Pathways to Mainstream Produce Prescription Programs

A new policy strategy report from Harvard Law School’s Center for Health Law and Policy Innovation aims to scale up the provision of nutrition benefits in health care and food systems.

Diet is a key driver of both poor health outcomes and health care costs, however nutritious foods can be out of reach, especially for those struggling financially amid the COVID-19 pandemic. The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) released a report highlighting opportunities to improve access to nutritious foods through federal, state, and institutional policies. The report focuses on the use of Produce Prescription (Produce Rx) Programs: interventions that enable health care providers to distribute benefits to patients to purchase fruits and vegetables at little or no cost.

Diet-affected chronic health conditions, such as cardiovascular disease, obesity, diabetes, and some cancers, cost the United States over a trillion dollars in direct medical expenses each year. Yet, eating more fruits and vegetables can considerably lower the risk of such diseases. Produce Rx programs promote access to healthy foods while reducing the financial burden of maintaining a healthy diet. CHLPI’s new report, Mainstreaming Produce Prescriptions: A Policy Strategy Report, recommends feasible and cost-effective pathways to increase access to produce prescriptions using existing health care and food system programs, such as Medicaid, Medicare, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

“Growing evidence demonstrates the ability of Produce Rx programs to drastically improve the health and well-being of patients struggling with diet-related diseases,” said Robert Greenwald, a clinical professor of law at Harvard Law School and faculty director of CHLPI. “Despite the promise of Produce Rx, access to these interventions remains extremely limited. Our policy strategy report highlights a variety of opportunities to leverage existing government-funded programs in order to make Produce Rx programs—innovative, evidence-based interventions—widely available to those who need them most.”

The new report outlines 20 recommendations to overcome key barriers to mainstreaming Produce Rx programs, addressing issues such as funding, research, patient data and privacy, infrastructure, and the need for programmatic guidance to advance the field. Among the recommendations are calls to broaden coverage of Produce Rx in Medicare and Medicaid, expand support for the GusNIP Produce Prescription Pilot, and enhance programs that support the viability of healthy food retailers, especially in low-income or historically marginalized communities.

“Our analysis of opportunities and gaps yielded clear results: there is more we can do to better connect patients with the foods they need to thrive,” said Emily Broad Leib, a clinical professor of law at Harvard Law School, deputy director of CHLPI, and faculty director of CHLPI’s Food Law and Policy Clinic. “Our report offers a roadmap for health care providers, payors, agency officials, local organizations, researchers, food retailers, and other stakeholders to take the steps necessary to scale up access to Produce Rx programs.”

“Our current food system puts healthy food out of reach for tens of millions of families, increasing the risk of chronic diseases that cut years off of their lives and straining our health care system,” said Devon Klatell, Managing Director of The Rockefeller Foundation’s Food Initiative. “We funded this report to better understand how we can create a healthier future by ensuring that everyone has access to affordable, healthy food and reducing the burden on our health care system.” 

Mainstreaming Produce Prescriptions: A Policy Strategy Report is available on CHLPI’s website, along with an Executive Summary and an analysis released last October titled, Produce Prescriptions: A U.S. Policy Scan.