Medically Tailored Meals: Cost Savings and Client Benefits
Medically tailored meals (MTMs) are an essential part of any “food is medicine” strategy. As the state of Colorado considers how to include MTMs as a covered benefit under Medicaid, our Project Angel Heart team is sharing what we’ve learned about their power to support Coloradans living with severe illness.
Background
The growth of “food is medicine” programs across the U.S. in recent years is an attempt to address the burden of diet-related illness, which costs an estimated $1.1 trillion each year.[1] The White House National Strategy on Hunger, Nutrition, and Health, released in 2022, notes that expanding access to “food is medicine” interventions, including medically tailored meals, groceries, and produce prescription programs, can effectively treat or prevent diet-related health conditions, optimize well-being, reduce food insecurity, and reduce health care costs.[2] Almost concurrently, the Centers for Medicare & Medicaid Services (CMS) started encouraging and approving state plans to include nutrition services that address health-related social needs (HRSN).[3]
Client Reported Outcomes
We survey our clients every quarter to understand how our meals support their health and well-being. Through these surveys, we learn how to improve our meals and nutrition education to have a lasting impact on our clients’ lives. In 2022, we partnered with Kaiser Permanente’s Institute for Health Research to validate client self-reported outcomes. That analysis found that:
- 73% of meal recipients reported improvements to their overall stress
- 59% reported improvements to their ability to adhere to their prescribed health regimen
- 63% reported improvements to their overall health
- 64% reported improvements to their ability to live independently at home
- 63% reported improvements to their ability to afford other basic needs, such as housing and medication
- 57% reported improvements to their energy levels[4]
This is consistent with our own findings. In our latest quarterly survey, almost 90% of veterans reported improved eating habits, 85% of clients with cancer reported our meals reduced their level of stress; more than 70% of clients with end-stage renal disease reported our meals helped them live independently at home; and 65% of clients overall said our meals and nutrition support helped them follow their health care plan.
Studies Evaluating Cost Savings in Colorado
In 2018, our team conducted a research study using medical claims data from the Colorado All Payer Claims Database to examine our clients’ health care costs before, during, and after they received medically tailored meal deliveries. This study found:
- our clients experienced a 13% reduction in hospital readmissions overall compared to individuals who did not receive Project Angel Heart meals; and
- our clients living with COPD, CHF, and diabetes saw their monthly medical costs go down an average of 24%.[5]
Our partners at the Colorado Community Health Alliance (CCHA), conducted an independent study in 2023 that found their members who received Project Angel Heart meals had a 62% reduction in inpatient care costs. Factoring in the cost of meals and delivery, this amounted to $1,142 in cost savings per member over an eight-month average after completion of meals.[6]
Studies Evaluating Cost Savings in Other States
Some states have already seen cost savings data as a result of providing MTMs as a covered benefit through Medicaid.
In Massachusetts, all 17 Accountable Care Organizations (ACOs) in the state are offering nutrition supports within their Flexible Services programs. One ACO reported an $11,309 reduction in the total cost of care for members that received nutrition supports, as compared to a $345 reduction during the same period for a comparison group of eligible members who declined nutrition supports.[7]
In New York, under their Medicaid Social Care Initiative, the state covered medically tailored meals for individuals diagnosed with cancer, diabetes, heart failure, and/or HIV/AIDS who have had one or more recent hospitalizations. They saw:
- 63% decrease in emergency department visits
- 66% decrease in urgent care visits
- 45% decrease in acute inpatient utilization[8]
Peer Reviewed Cost-Savings Literature
There is substantial peer-reviewed evidence that demonstrates the impact of medically tailored meals in reducing hospital visits and health care costs. Many states cited these references when shaping their nutrition benefits for state health plans.
An economic evaluation from the Tufts University Friedman School of Nutrition Science and Policy found that if every eligible patient were able to access medically tailored meals, in just the first year, our country would realize 1.6 million avoided hospital visits and $14 billion in savings for our health care systems. The modelled intervention consisted of ten MTMs per week for a mean of eight months.[9]
Additional research includes:
- Medically tailored meals for the management of symptomatic ascites: the SALTYFOOD pilot randomized clinical trial (Tapper et al., 2020)
- Association Between Receipt of a Medically Tailored Meal Program and Health Care Use (Berkowitz et al., 2019)
- Medically Tailored Meal Delivery for Diabetes Patients with Food Insecurity: a Randomized Cross-over Trial (Berkowitz et al., 2019)
- Meal Delivery Programs Reduce The Use Of Costly Health Care In Dually Eligible Medicare And Medicaid Beneficiaries (Berkowitz et al., 2018)
- Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health (Palar et al., 2018)
[1] https://www.rockefellerfoundation.org/wp-content/uploads/2021/07/True-Cost-of-Food-Full-Report-Final.pdf
[2] https://www.whitehouse.gov/wp-content/uploads/2022/09/White-House-National-Strategy-on-Hunger-Nutrition-and-Health-FINAL.pdf
[3] https://www.medicaid.gov/sites/default/files/2023-01/addrss-hlth-soc-needs-1115-demo-all-st-call-12062022.pdf
[4] Green, S., McPhail, T., Martin, D., Comer, A., Hwang, M., & Boxer, R. (2022). Project Angel Heart: Supplemental Nutrition Services Evaluation Report. PiER Center at the Institute for Health Research, Kaiser Permanente Colorado.
[5] https://www.projectangelheart.org/wp-content/uploads/2018/06/PAH_ImpactStudy_OnePager_FINAL.pdf
[6] https://gazette.com/opinion/guest-column-whole-person-care-supports-patients-saves-money/article_5e68f1a8-a4cd-11ee-a9e4-efd46896e071.html#google_vignette
[7] https://www.mass.gov/doc/1115-waiver-extension-request/download
[8] https://www.health.ny.gov/health_care/medicaid/redesign/med_waiver_1115/docs/2022-09-02_final_amend_request.pdf
[9] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797397