Kristen Gerencher, MSOT
March 2, 2021, 3PM (PT)
Key takeaways:
- Medically tailored meals help people too sick to shop and cook for themselves, and more Medicare and Medicaid programs are covering them.
- Health insurers Humana and Oscar Health are delivering food for members with food insecurity during the pandemic.
- Geisinger Food Farmacy offers healthy food and diabetes education to people with type 2 diabetes who are experiencing food insecurity.
When a person calls God’s Love We Deliver and says they’re sick and hungry, the first order of business is getting a customized meal delivered to their home. The paperwork can wait.
“We believe being sick and hungry is a crisis that demands an urgent response,” said Karen Pearl, president and CEO of the volunteer-driven organization that cooks and delivers medically tailored meals to people living with serious illness in the New York City area. Once the immediate need is taken care of, “we work with them to get a form from a doctor that documents their diagnosis or diagnoses.” Healthcare providers and health plans often make referrals to God’s Love on patients’ behalf as well.
Pearl rarely worries about being pranked when such a call comes in. The need is great. Over 40% of God’s Love’s clients have four or more diagnoses. They also tend to have at least one problem with activities of daily living, such as food shopping, cooking, or lifting. General weakness is a common issue for those living with life-threatening illnesses such as cancer, HIV, advanced diabetes, or multiple sclerosis.
Photo credit: Kerri Brewer/GLWD (Styled by: Lauren Radel)
The medically tailored meal movement started during the AIDS emergency 35 years ago. “From pandemic to pandemic, what we really know how to do is find people who are really alone and isolated and desperate for the right food for their illness,” Pearl said. God’s Love is on track to deliver nearly 2.5 million meals to over 10,000 vulnerable people this year.
What are medically tailored meals and who qualifies for them?
At God’s Love, clients work with staff nutritionists to develop a layered diet that accounts for factors such as:
- Concurrent medical conditions
- Medication considerations and side effects
- Food allergies
- Chewing and swallowing issues
Most medically tailored meals arrive frozen. They’re all low sodium and labeled by the day they were cooked and when they should be used by, Pearl said. There are regular menus and modified menus that remove items like tomatoes. Other menu options include:
- Vegetarian
- Pescatarian (fish only)
- Renal
- Children’s menu for kids under 13
- Soft menu for people who have trouble chewing or swallowing
- Minced
- Pureed
Does insurance cover medically tailored meals?
More insurers — many of them Medicare and Medicaid programs — are covering medically tailored meals for seriously ill members because evidence suggests the specialized diets help reduce healthcare costs. Medicaid programs in California, North Carolina, and other states are experimenting with or continuing to partner with local organizations that deliver medically tailored meals.
The Food Is Medicine Coalition, a network of peer organizations that share best practices in medically tailored meals, has grown to 25 participating agencies.
What does the evidence show about medically tailored meals?
Patients who received medically tailored meals had lower admission rates to hospitals and skilled nursing facilities than those who didn’t, according to a 2019 study in JAMA Internal Medicine. What’s more, the specialized meals appeared to contribute to 16% lower healthcare costs in the group receiving medically tailored meals. Other studies also suggest people who receive meals customized to their illnesses are less likely to be admitted to the hospital.
Some health improvements are measured in less academic ways. “Clients tell us how much better they feel, which is also equally important,” Pearl said.
As some clients regain their strength and begin to heal, they’re able to come off their medication, she said. Others may still need their medications but make gains toward better health. “Someone with advanced multiple sclerosis doesn’t get better, but certainly has a much better quality of life having access to good nutrition for their circumstances.”
For some who are living with pain, this low-tech intervention can be lifesaving. A client who came to God’s Love after a year of eating only ice cream because of chewing issues and pain told Pearl the group saved his life, she said. “We worked with him on that. He was quite grateful.”
How many deaths annually are attributed to bad diet?
Scientists point out that malnutrition encompasses both ends of the spectrum — hunger and obesity. Around the world, about 11 million deaths a year are associated with poor nutrition, a study in The Lancet found. This included a high intake of sodium, and low consumption of whole grains, fruit, nuts, and seeds. Among the most striking findings of the study is that one in every five deaths could be prevented if people improved their diets. The authors listed the leading causes of diet-related death and disability as:
- Cardiovascular disease
- Several kinds of cancer
- Type 2 diabetes
This is roughly consistent with America’s leading causes of death, but diabetes ranks seventh on the U.S. list. Nutrition-related disease and death rates have grown along with obesity rates over the last three decades. Poor nutrition, along with lack of physical activity, contributes to about 678,000 deaths every year.
How do programs like Geisinger Fresh Food Farmacy work?
At Geisinger Fresh Food Farmacy, they work with people living with household food insecurity and type 2 diabetes — identified as having hemoglobin A1C greater than 8.0. When clients are given a prescription for healthy food, they are included in a team approach to diabetes education. They receive recipes and kitchen tools such as measuring cups, nutritional counseling, and enough healthy food to prepare 10 meals a week for themselves and their families.
Participants pick up healthy food at one of three locations in central Pennsylvania. The program has served nearly 600 patients since it started in 2016, according to the Geisinger website. It’s also resulted in decreases of around 18% in key health metrics. Don’t miss out on savings!Get the best ways to save on your prescriptions delivered to your inbox. By signing up, I agree to GoodRx’s terms of service and privacy policy, and to receive marketing messages from GoodRx.
Do other health insurance plans cover food for members?
More Medicare Advantage plans are starting to cover food for their members.
Humana’s Well Dine delivers meals for eligible Medicare-covered members who are discharged from the hospital or skilled nursing facility and those with certain chronic conditions such as:
- Congestive heart failure
- Coronary artery disease
- Diabetes
- End-stage renal disease
Humana members who meet the criteria may receive up to 20 meals per condition and up to 60 meals per plan year. Patients can call 1-800-457-4708 to check their eligibility and request the service, available at no extra charge, according to Humana’s website.
Separately, Humana learned that hunger wasn’t just a risk for the chronically ill and recently discharged. It lurked in plain sight. In March 2020, the company called members to check on their care and whether they had enough medication at home.
When some of Humana’s mostly older adult members revealed they lacked food or lived in a household with food insecurity, that’s when the Basic Needs program was born. It allows those experiencing food insecurity to receive up to 14 emergency meals — either fresh or shelf-stable — delivered to their homes. The program has delivered 1.2 million such meals since last March, Dr. Andrew Renda, associate vice president of population health for Humana, wrote in an email.
“It was the right thing to do, and very much aligned to our emphasis on human care and whole person health,” he wrote.
“We launched the Basic Needs program to meet urgent and emergent needs as a result of the pandemic. Over time, we will study the impact of these meals on health outcomes, but our first principle was to address this social determinant of health during the national (and global) health crisis,” Renda wrote.
At the start of the pandemic, Oscar Health, another health insurer, began covering the cost of grocery deliveries for members in need, the Associated Press reported.
What can I do if I’m worried about getting enough to eat?
There are several resources available to help people who are living with food insecurity. Among them:
- Meals on Wheels America: This organization supports older adults with mobility challenges by delivering meals to their homes. Eligibility varies by local programs.
- Second Harvest Food Bank: This is a nonprofit organization dedicated to providing free healthy food to those in need.
- Feeding America: This is America’s largest food-relief organization.
- Supplemental Nutrition Assistance Program (SNAP): This is a government program that provides nutrition benefits to people with low income.
The bottom line
More Medicare and Medicaid programs are covering medically tailored meals for people with serious chronic illness. Evidence suggests that customized meals reduce healthcare costs and improve quality of life. Commercial health insurers are also starting to cover more programs related to healthy food, food insecurity, and nutrition.
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