REFORM- Medicaid on groceries? ‘Food as medicine’ programs to cut medical costs

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“Food as medicine” may be coming to a health plan near you.

More states are testing Medicaid programs that’ll provide more people with healthy foods and, potentially, lower healthcare costs. 

Medicaid typically only covers medical expenses, but Arkansas, Oregon and Massachusetts received approval from the Centers for Medicare & Medicaid Services (CMS) last year to use a portion of their Medicaid funds to pay for food programs, including medically tailored meals, groceries and produce prescriptions (fruit and vegetable prescriptions or vouchers provided by medical professionals for people with diet-related diseases or food insecurity). California already was running a food program under a different CMS approval. The aim is to see whether providing people with nutritious foods can effectively prevent, manage, and treat diet-related diseases.  

“A lot of what ails our health care system is overutilization because we’ve never changed the lifestyles that take us into the health care system in the first place, and that starts with your diet,” said Indiana Senator Mike Braun at a hearing in December. 

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How does ‘food as medicine’ work? 

Though different processes will be tested, Massachusetts and California allow medical professionals to refer struggling patients to a local food assistance organization to determine their needs. That could result in grocery store gift cards, kitchen supplies, cooking classes, nutrition counseling or a service that will deliver “medically tailored meals” to patients. In Massachusetts, patients are checked on every three months. 

In November, the U.S. Department of Agriculture (USDA) invested $59.4 million partly to support so-called “produce prescriptions” from a health care provider for fresh fruits and vegetables. 

Does food as medicine work? 

“The relationship between what we eat and how it affects our health and mortality is clear,” said Dan Glickman, co-chair of the Task Force on Hunger, Nutrition, and Health, at a hearing in December. 

A study published last fall estimated that if all patients in the U.S. with mobility challenges and diet-related diseases received medically tailored meals, 1.6 million hospitalizations would be avoided, with a net savings of $13.6 billion annually. 

Another study in 2019 found that over the course of about a year, the meals resulted in 49% fewer inpatient admissions and a 16% cut in health care costs compared with a control group of patients who did not receive the meals. 

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What’s next? 

There is more work to be done to determine if this idea can flourish and the best ways to implement it.

This spring, the American Heart Association and Rockefeller Foundation will launch a $250 million “Food is Medicine” Research Initiative to determine if such programs can be developed cost-efficiently enough to merit benefit coverage and reimbursement for patients, said Kevin Volpp, director at the University of Pennsylvania’s Center for Health Incentives and Behavioral Economics and leader of the initiative. 

CMS requires such programs to be neutral to the federal budget and capped at 3% of the state’s total Medicaid spend, according to Madeline Guth, senior policy analyst with KFF’s Program on Medicaid and the Uninsured.

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Other issues include finding food suppliers, defining what’s “nutritious,” and who would ultimately qualify. Because there are strict guidelines now, only a very small percentage of Medicaid recipients are eligible in these pilots, Guth said.

“CMS is indicating what it approved for those states is setting the stage for what it’s willing to approve and looking to approve for other states,” Guth said. “There could be more coming, but these states will be the model and what we’ll be watching over the next year or so.” 

Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday morning.