The Healing Power of Food: A Prescription for Health and Savings

Exploring the 'Food as Medicine' Movement What You Need to Know

Food as Medicine’ Concept Gains Popularity Here’s What to Know

Nov. 21, 2023 – If you’re like 90% of U.S. adults, you may be falling short of the government’s dietary recommendations for fruits and vegetables. Low-income individuals face an even greater challenge in accessing healthy food. This is a big deal because diet plays a huge role in our overall health and health costs. In fact, diet-related diseases like hypertension, diabetes, and lipid disorders are the most common chronic illnesses affecting about 60% of American adults. And guess what? Diet is now the leading risk factor for death in the U.S., causing approximately 500,000 deaths each year.

Until recently, improving the nutrition of chronically ill individuals was primarily the responsibility of public health organizations, with little action from healthcare providers and insurers. But the tides might be turning now. Enter the “food as medicine” movement, suggesting that doctors should prescribe food as medical treatment. And this movement is gaining momentum, along with significant financial support, as emerging research demonstrates that food as medicine can actually save money.

The most prominent sign of this change is a new report showing that starting in 2024, a whopping 1,475 Medicare Advantage plans – about a quarter of the market – will offer eligible members financial assistance to purchase healthy food, primarily fruits and vegetables. To put this in perspective, back in 2020, when the Centers for Medicare and Medicaid Services (CMS) introduced new rules on supplemental benefits, only 101 plans offered this benefit. That’s quite a leap!

But it doesn’t stop there. The Biden administration has granted waivers to nine states, allowing them to use Medicaid funds to buy food for chronically ill enrollees. Additionally, several healthcare systems, including the likes of Kaiser Permanente, Geisinger, Dignity, Northwell, and Mount Sinai, have hopped on the food as medicine bandwagon.

Medicare Advantage Plans Leading the Charge

The Medicare Advantage plans are leading the pack, demonstrating that the U.S. healthcare industry is finally taking food as medicine seriously. These plans usually entice new members with supplemental benefits like dental services and vision care. However, since 2019, they’ve been allowed to offer extras that aren’t necessarily medical in nature.

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Initially, Medicare Advantage plans were permitted to provide “medically tailored meals,” which are healthy meals tailored for individuals with advanced and costly diet-related conditions. These meals are typically given to patients recently discharged from the hospital and are usually provided for a few weeks. However, only 336 Medicare Advantage plans will offer medically tailored meals as a supplemental benefit next year, a 27% drop from 2023. So, what’s the alternative that’s gaining popularity?

Enter the produce prescriptions! These prescriptions are all the rage, being offered by far more plans than medically tailored meals. They allow individuals to access a wide variety of fruits and vegetables to improve their overall diet. This benefit is not limited to the seriously ill but extends to a broader population who can shop and cook for themselves.

According to Gretchen Jacobson, PhD, the vice president of the Medicare program at the Commonwealth Fund, the fruit and vegetable benefit is far more accessible, typically involving a debit card for easy use at grocery stores. On the other hand, medically tailored meals are primarily for individuals with more severe health conditions.

But Why Are Insurers Jumping on the Food as Medicine Bandwagon?

Initially, Medicare Advantage insurers doubted whether covering social determinants of health, including food, would save them money or attract more members. But their viewpoints seem to be shifting. It’s possible that Medicare Advantage plans are viewing produce prescriptions as an additional way to attract and retain enrollees. Of course, they must demonstrate that this benefit proves beneficial to health.

For instance, Humana and Elevance Health, two leading insurers, have explained why they’re providing medically tailored meals and grocery allowances to some of their members. Humana offers its Healthy Options Allowance, providing up to $325 per month to eligible members for essential expenses like groceries, rent, and utilities. According to a Humana spokesperson, this program helps reduce stress and contributes to an overall healthier life, mentally and physically.

Similarly, Elevance Health offers nutritious meals and grocery allowances to many members, including a post-discharge meal benefit. By supporting access to healthy food, these insurers are helping their members prioritize their health expenses and alleviate the difficult choice between healthcare and necessities like good quality food.

Promising Findings: Early Research and National Modeling Studies

Studies examining the impact of medically tailored meals have shown positive results for individuals with various health conditions like diabetes, heart failure, HIV, AIDS, and chronic liver disease. Geisinger Health Plan, for instance, found that providing fresh food to people with diabetes had a greater impact on their health than medications alone. Over four years, patients who received food prescriptions experienced a 2.4% drop in their average HbA1c levels, contributing to a staggering 27% decrease in emergency room visits.

Produce prescriptions have also shown promise. Tufts University researchers conducted a study that showed no significant change in the mean HbA1c levels of its subjects compared to controls. However, this study only followed participants for six months during the COVID pandemic. On the other hand, an unpublished study presented by researchers at the American Heart Association meeting supports the use of these programs for low-income individuals with diabetes. While cost savings weren’t measured, reducing blood sugar levels typically leads to decreased healthcare expenses for diabetes patients.

National modeling studies from Tufts University further strengthen the case for food as medicine. For instance, the use of medically tailored meals for patients with diet-related conditions and limited abilities could prevent 1.6 million hospitalizations, resulting in savings of $13.6 billion in the first year alone. Similarly, produce prescription programs for individuals with diabetes and food insecurity could prevent 292,000 heart-related health issues and add 260,000 quality-adjusted life years. While the cost of these programs might exceed the healthcare savings it generates, a recent re-analysis with updated population data suggests that produce prescription programs could indeed reduce health expenses.

To reinforce these findings, ongoing studies at Duke University, the University of Texas, and several other universities involving Instacart, a popular online food delivery service, seek to further build the evidence foundation for food as medicine. Instacart Health has also partnered with prominent healthcare institutions like Boston Children’s Hospital and Mount Sinai Solutions, offering fresh grocery stipends to post-operative and post-partum patients insured by these institutions.

So, there you have it! Food as medicine is gaining traction, with Medicare Advantage plans leading the charge. Not only does this approach have the potential to improve health outcomes, but it can also result in significant cost savings for the healthcare industry. Who would have thought that our best medicine could be found in the produce aisle? Indulge in those fruits and vegetables, and remember, good health is just a prescription away!

What are your thoughts on the “food as medicine” movement? Do you believe in the healing power of food? Share your experiences and opinions below!