How to Increase Access to Nutritious Food Through Medicaid Care Delivery

The Center for Health Law and Policy Innovation of Harvard Law School offers a deep dive into pathways for supporting Produce Prescriptions via Medicaid Managed Care.

Today, the Center for Health Law & Policy Innovation (CHLPI) of Harvard Law School, in partnership with DC Greens, released “Mainstreaming Produce Prescriptions in Medicaid Managed Care: A Policy Toolkit and Resource Library,” the third report in a series exploring ways to increase access to produce prescriptions (PRx). The new report explores how Medicaid Managed Care can increase food security and improve health for Medicaid enrollees by covering PRx services. 

Diets low in fruits and vegetables are a leading risk factor for many chronic conditions such as diabetes, and $1 trillion is spent every year in the US to treat these conditions. PRx can play an important role in responding to the epidemic of diet-related chronic disease and related costs, but access to PRx services is limited. This Toolkit, made possible with support from The Rockefeller Foundation, takes a deep dive into one of the most critical and widely available pathways for expanding access to PRx: Medicaid Managed Care (MMC). 

MMC is the dominant model for delivering health care services within Medicaid, in which states outsource care delivery and provider payment to private health insurance plans. While federal law and policy do not yet provide broad coverage of nutrition interventions in Medicaid, MMC offers unique flexibility to support PRx. The Toolkit is designed to help PRx stakeholders navigate these opportunities by providing information and guidance in three key areas of creating policy change:

• Articulating the Problem: an overview of the case for expanding access to PRx and key points for stakeholders to share at the local, state, or national level. 

• Identifying a Policy Solution: a range of federal, state and health plan actions to improve access to PRx through MMC.

• Building Capacity for Change: common strategies for PRx stakeholders to consider as they build capacity for local, state, and federal change.

“PRx programs have the potential to cost-effectively improve access to nutritious foods, improve health outcomes, and promote greater health equity,” said Katie Garfield, Director of Whole Person Care for CHLPI. “MMC flexibilities offer a promising pathway for expanding access to these critical nutrition services. Our Toolkit is aimed at helping stakeholders navigate these opportunities and shares vital resources for promoting widespread adoption.”

Kristin Sukys, Health Policy Consultant for DC Greens, stated, “Medicaid managed care can be complex — policy layering and decision making between CMS and states as well as between states and MMC plans allow for the creation of highly unique systems at the local level. Though flexible, MMC can also be intimidating. This Toolkit is a resource we’ve all been wishing for: it breaks down the layers and highlights the policy pathways best suited for boosting access to PRx programs in MMC. 
The first report in the series, “Mainstreaming Produce Prescriptions: A Policy Scan,” provides a high-level overview of current opportunities to sustain and scale PRx via U.S. health care and food policies. “Mainstreaming Produce Prescriptions: A Policy Strategy Report” builds on this framework by providing policy recommendations addressing core challenges limiting access to these vital programs.