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You just had a checkup with your family doctor. Your weight and blood pressure have been creeping up over the last few years, now putting you at greater risk for a heart attack, stroke, or Type 2 diabetes. Your doctor hands you a prescription – for carrots and broccoli. What's going on?
Your doctor is on board with the food is medicine (FIM) movement. Let’s see what it’s about.
The problem
More than 40% of Americans are obese – not just overweight. More than 70% of adults are overweight. Unhealthy eating contributes to 500,000 deaths annually in the United States. The relentless and expensive health problems because of poor nutrition cost the U.S. economy $1.1 trillion each year.
What is FIM?
There’s no single definition, but FIM refers to food and nutrition programs that are part of healthcare and intended to treat or prevent diet-related diseases. It includes medically tailored meals (MTMs) that are personalized for specific health conditions and produce prescription programs in which healthcare organizations or insurance plans offer benefits to buy fruits and vegetables. The early research analyzing FIM has been promising.
Evidence shows that delivering FIM programs may:
- Improve health outcomes for people with diabetes, heart failure, HIV/AIDS, and chronic liver disease.
- Reduce healthcare use and costs.
- Address health disparities.
- Reduce nutrition and food insecurity for patients.
Some studies that show the impact of medically tailored meals have promising results. The Geisinger Health Plan in Pennsylvania discovered that providing fresh food to patients with diabetes has a more significant impact on their health than traditional medications. The healthcare provider “prescribes” food to some people and their families, which they can buy at fresh food “pharmacies” in hospital complexes or nearby. Over four years, the average HbA1c levels of these patients dropped 2.4%, resulting in a 27% drop in emergency room visits.
A team at Tufts University in Boston has also done studies of both medically tailored meals and produce prescriptions. Their analysis shows that national use of medically tailored meals for patients with diet-related conditions could prevent 1.6 million hospitalizations and result in savings of $13.6 billion in the first year.
Tufts calculated that the national use of produce prescription programs for U.S. patients with diabetes and food insecurity could prevent 292,000 cardiovascular health events and add 260,000 quality-adjusted life years. However, the cost of such a program would be slightly higher than the amount it would save in health care costs.
Medicare plans lead the way
The Medicare Advantage plans offer the most solid evidence that the U.S. healthcare industry is starting to take food as medicine seriously. Most Medicare Advantage insurers lure new members with supplemental benefits such as hearing, vision, and dental services. Since 2019, they have also been allowed to offer supplemental benefits that are not directly related to medical services.
Initially, Medicare allowed the plans to provide MTMs – healthy meals prepared for people with advanced and costly diet-related conditions such as diabetes, heart failure, end-stage kidney disease, and cancer. These meals, usually delivered to patients at home or in group settings, are intended for people who have been recently discharged from the hospital. In most cases, MTMs are provided for only a few weeks.
Gretchen Jacobson, PhD, the vice president of the Medicare program at the Commonwealth Fund, noted that the fruit and vegetable benefit is relatively easy for people to use, involving a debit card for use at the store. Also, the produce prescription benefit applies to a much greater number of people than the medically tailored meals benefit. The recipients of produce prescriptions can shop and prepare meals.
The Medicare Advantage supplemental benefit that became effective in 2020 went beyond medically tailored meals and allowed plans to cover food and other supports for chronically ill patients, such as transportation, air quality equipment, pest control, and home medications. To qualify for these benefits, a Medicare beneficiary must have one or more serious chronic conditions and have a high risk of hospitalization or other adverse health outcomes that require rigorous care coordination. These criteria do not include food insecurity. A Medicare Advantage plan member does not have to be low-income to qualify. This is true of many food as medicine programs.
How can you try this program?
In addition to Medicare, there are commercial insurance plans that cover MTMs and produce prescriptions; Humana is one of those. You may need to call the phone number on your insurance card for information about insurance coverage. If you have certain diet-related medical conditions you may be eligible. Inform and encourage family, friends, and others to look at government-sponsored insurance plans, such as Medicare, to check their benefits. Help them check with private insurance plans as well.
Discuss FIM with your healthcare provider. A prescription for the MTMs or produce is required from a provider to participate in the programs.
Even if you are not eligible for the FIM programs, you’ll find plenty of information on healthier foods and meal plans that you can follow. You don’t have to wait until you have a chronic, costly disease to benefit from healthier food choices.
