Medically Tailored Meals Could Cut $13.6B, Avert Hospital Admissions

Medically tailored meals, a key tool in the push to address food insecurity and social determinants of health, could save the healthcare industry some $13.6 billion in costs from the payer perspective, according to recent data in JAMA Network Open.

The SDOH intervention could also thwart nearly 1.6 million hospitalizations, the researchers added.

Medically tailored meals (MTMs) are a social determinants of health intervention that acknowledge both the link between food security or access to nutritious food and health. Healthcare providers often prescribe MTMs that account for nutrition needs for certain diet-related illnesses, like diabetes or heart disease.

“In observational studies and pilot randomized clinical trials, patients receiving MTMs experienced better disease management and had fewer hospitalizations, emergency department admissions, nursing home visits, and lower health care expenditures compared with similar control patients,” the researchers, who hail from Tufts University and Tufts Medical Center, wrote in the study.

Nonetheless, medically tailored meals aren’t usually covered by health payers, including the public payers, Medicare and Medicaid.

But this recent analysis suggests that public policymakers should reconsider that coverage. In a policy simulation estimating annual hospitalizations and healthcare expenditures linked to MTMs, the researchers found medically tailored meals to be an effective strategy for not just improving care management but also cutting costs.

Said otherwise, MTMs might yield a good return on investment, making the case for coverage under public payers.

The analysis, which looked at more than 6 million US adults with Medicare, Medicaid, or private insurance and at least one diet-related illness and one limitation in instrumental activities of daily living, tested ten MTMs per week for around eight months between January 2021 and February 2022.

The medically tailored meals proved effective, leading to both lower healthcare utilization and lower healthcare costs and expenditures for payers, the researchers said.

Particularly, MTMs helped thwart 1.6 million hospitalizations. The intervention also yielded nearly $13.6 billion in net savings in healthcare expenditures from the payer perspective.

MTMs also yielded a strong return on investment, the researchers added. The program cost $24.8 billion for the study, but due to lower healthcare utilization, the researchers saw a $38.7 billion cut in healthcare expenditures. That shook out to around $13.6 billion in net savings for health payers, the researchers said.

The researchers predicted that payers would see long-term cost savings. Using 2019 dollars, the team projected that 10 years of the MTM intervention would cost $298.7 billion. The medically tailored meals would help avert 18,257,000 hospitalizations, yielding reductions in healthcare expenditures totaling $484.5 billion. All said, that’s a net savings of $185.1 billion.

These findings come as healthcare providers and payers nationwide look for evidence of ROI for key SDOH interventions, like medically tailored meals. Although MTMs are getting some traction across the country, the researchers said these efforts are still siloed and creating geographic disparities.

“Despite this accelerating use of MTMs, access depends on buy-in from state-level Medicaid administrators or managed care plan leadership and is therefore limited by geographic region and/or insurance carriers,” they wrote.

“The current limitations in national coverage of MTMs present an opportunity to improve health if future policies expand MTM access, with an additional opportunity to improve health equity if such policies prioritize patients with low income and/or food insecurity,” the researchers added. “Our findings support the use of MTM programs and the need for their timely implementation, scaling, and evaluation in both public and private health care.”

Healthcare policymakers may be in an environment increasingly amenable to implementing MTMs. In addition to some national efforts, the COVID-19 pandemic has exacerbated food insecurity problems, the health impacts of which are getting hard to ignore, the researchers contended.

Additionally, there is a considerable push in this area from leadership in DC. In late September 2022, the White House convened a weeklong conference on hunger, during which it released its National Strategy on Hunger, Nutrition, and Health.

The National Strategy comprises five key pillars, one of which calls on HHS to approve Medicaid 1115 Demonstration Waivers to implement medically tailored meals as part of covered benefits.

“When families can’t afford healthy food options, it’s harder for children to succeed in school, and it can lead to mental and physical health challenges for the whole family,” President Joe Biden wrote in the strategy’s introduction.

“For so many families—including families of color, those living in rural communities and territories, and low-income families—structural inequality, such as disparities in educational and economic opportunities and lack of access to health care, safe housing, and transportation, make the impact of hunger and diet-related diseases even more severe.”