Improving Health Outcomes While Curbing Costs with Medically Tailored Meals

Written by Hanh Nguyen, Whole Person Care Project Assistant.

 

On May 9^th, 2018, CHLPI, the Food is Medicine Coalition, Tufts Friedman School of Nutrition Science & Policy, and the House Hunger Caucus’ Food is Medicine Working Group, brought together an expert panel for a discussion on improving health outcomes and curbing costs with medically tailored meals.

Health and food are fundamentally linked. For people who are living with chronic illnesses, or have critical medical conditions, nutritious food is essential to maintaining and regaining health. Congressman Jim McGovern of Massachusetts, a founding member of the Food is Medicine Working Group, opened the briefing by addressing the nation’s lack of a comprehensive-coverage of medically tailored food and nutrition within healthcare. The Ryan White HIV/AIDs program is the only federally funded program for medically tailored meals. “The support through the program has enabled organizations across the country, like God’s Love We Deliver in New York City and Community Servings in my home state of Massachusetts, to carry out their missions of providing nutritious food to those in need,” said McGovern. “Now the organization is serving a much broader population and federal funding should reflect that.”  McGovern hoped that leaders of the working group are able to “think concretely about what we could do at a federal level to advance this cause.”

Noting that 5% of the Medicaid population consume roughly 50% of healthcare costs, the briefing brought food and nutrition to the center of the conversation about healthcare delivery and financing. In an environment of rising healthcare costs and tight budgets, expert panelists discussed how an integration of medically tailored meals into public and private health insurances will not only improve health outcomes but also significantly reduce healthcare costs.

 Our Food:  The #1 Cause of Poor Health

“Food is the single biggest cause for poor health in the U.S.,” said Dr. Dariush Mozaffarian, Dean of Tufts Friedman School of Nutrition Science & Policy. Diet-related diseases, such as cardiovascular diseases and type 2 diabetes, can each cost up to $300 billion per year in direct health care, causing enormous economic burdens. Healthy and appropriate medically tailored food can not only prevent these fatal diet-related medical conditions but also substantially reduce the amount of dollars spent on healthcare each year.

Karen Pearl, President & CEO of God’s Love We Deliver, defined medically tailored meals (MTMs) as a highly specialized healthcare intervention that is managed by a Registered Dietary Nutritionist (RDN) and designed based on evidence-based practice guidelines to address specific complex health conditions of the individual. God’s Love We Deliver has served 1.8 million medically tailored meals per year to seven thousand people in the state of New York. “Nutrition has the ability to fight disease and help people dealing with life threatening illnesses,” said Pearl. “You can feed somebody medically tailored meal for a half of a year for the price of the night in a hospital.”

A recent-released study conducted by Dr. Seth Berkowitz, Assistant Professor of Medicine at the University of North Carolina School of Medicine, demonstrated strong positive results for high healthcare utilizing participants who received medically tailored meal intervention. Dr. Berkowitz reported that over an average of 18 months of follow-up, participants showed a decrease of 70% in emergency department use, a 50% cut in hospitalization rates, and a reduction of $220 in healthcare costs per month.

Bill George, President & CEO of Health Partners Plans, shared similar results from a program for diabetic patients who received Medical Nutrition Therapy in the form of medically tailored meals. Patients who received medically tailored meals three times a day, seven days a week for six to 18 weeks experienced a reduction of 19% in medical costs per month, as well as decreases in inpatient admission and emergency room visits by 26% and 7%, respectively. “We’re here to advocate that Food is Medicine become supported by the federal government,” said George. “But more largely, what I’m trying to advocate is for people to realize that traditional ways of managing medical conditions don’t always work, because of social determinants of health.”

For medically-complicated individuals, simply providing resources to purchase food may not be enough. Medically tailored meals can fill the gap in existing interventions for those who require a more complex healthcare delivery system. Food and nutrition innovation is essential for the future of healthcare. The inclusion of a comprehensive-coverage of medically tailored meals at the federal level maximizes opportunities to meet the needs of people living with severe medical conditions, lower healthcare costs, and improve health outcomes.

Robert Greenwald, Faculty Director of Harvard Law School’s Center of Health Law and Policy Innovation, outlined key measures that Congress must take to transform the healthcare delivery system. For example, Congress must urge the Centers for Medicare and Medicaid Services (CMS) to test the impacts of medically tailored meal on Medicare and Medicaid by launching a rigorous demonstration program. Additionally, Congress must clarify and expand Medicare and Medicaid coverage of medically tailored meals to alleviate the suffering of people living with chronic illnesses.

“For people living with chronic and serious health conditions, what should be clear is that health and food are inextricably linked,” said Greenwald. “For those people that have chronic and serious health conditions, unhealthy and inappropriate food is poison. Medically tailored meals, on the other hand, are food is medicine.”

CHLPI will work with Congressman McGovern and other congressional champions to advance the integration of medically tailored food nutrition into healthcare. Please check back for updates and watch the Briefing here!