A study by researchers at Tufts University contends that nationwide implementation of home-delivered meals prepared by registered dietitians to support individuals with complex, diet-sensitive health conditions could save the U.S. healthcare system approximately $32.1 billion annually. The savings associated with what are called medically tailored meals (MTMs) could also prevent more than 3.5 million hospitalizations related to conditions like diabetes, heart disease, and cancer according to the study published in Health Affairs.
“The most striking finding is that medically tailored meals, assuming full uptake by eligible individuals, were cost-saving in 49 of 50 states, highlighting their potential to reduce both financial and health burdens,” said first author Shuyue (Amy) Deng, a doctoral student at Tufts University’s Friedman School of Nutrition Science and Policy.
To evaluate the potential impact of MTMs on healthcare costs and patient outcomes across the United States, the investigators created a model to analyze health outcomes and spending from the perspective of Medicare, Medicaid, and private insurers. The data showed that providing MTMs to eligible individuals with diet-sensitive conditions and limitations in activities of daily living (ADLs) could significantly reduce healthcare expenditures. The estimates showed that more than 14 million Americans would qualify for MTMs, based on their diagnoses and the need for additional support in day-to-day tasks.
These models simulated 1,000 different scenarios to account for uncertainties using data from all 50 states and found that 49 states would experience net cost savings within the first year of program implementation. Connecticut showed the highest potential savings, at $6,299 per patient, while Alabama was the only state where the program was cost-neutral but still yielded health benefits.
“These results emphasize the potential for policymakers to integrate medically tailored meals into healthcare coverage at scale,” said Deng.
The study indicates there is significant potential for MTM programs to address chronic health conditions such as diabetes, cardiovascular diseases, and cancer. These diseases are often exacerbated by poor nutrition, leading to increased hospitalizations and long-term care costs. The study’s findings are especially relevant as nearly 90% of those eligible for MTMs are covered by Medicaid or Medicare, two programs that serve as vital channels for providing such care.
Data from the simulations of Maryland and Colorado, two states with different healthcare systems, also revealed how state-level factors affect the impact of MTMs. Maryland required only 2.3 patients per hospitalization avoided while Colorado required 6.9 patients. The varying results showed that the MTM program should be tailored to the specific needs and healthcare environment of each state. Regardless of the state-to-state variations uncovered by the model, the broader national trend indicated a significant positive impact on both health outcomes and healthcare expenditures.
In terms of public health implications, the study suggests that nationwide adoption of MTMs could substantially reduce disparities in healthcare, particularly for underserved populations with chronic conditions. By addressing both the health and financial burdens of diet-related diseases, MTMs could play a critical role in improving quality of life for vulnerable individuals while alleviating pressure on overburdened healthcare systems.
To implement food is medicine programs, states would need to be granted a Medicaid Section 1115 waiver to allow for the broader integration of MTMs into clinical practice. As of January, 16 states have approved or proposed such waivers, which allow for the inclusion of MTMs in Medicaid coverage. While gaining these waivers would be an important first step, the researchers acknowledged that other work would need to be done to address the logistical challenges of providing MTMs including training healthcare providers, integration of screening tools into electronic health records, and methods to ensure meal quality.
Building on their findings, the team now hopes to collaborate with state policymakers and healthcare providers to launch real-world pilot programs to evaluate outcomes with the potential in the future to conduct large-scale randomized control clinical trials to confirm the effectiveness of MTMs in reducing hospitalizations.
“Although cost analyses are relevant to payers’ coverage decisions, the primary goal of MTM programs is to provide high-quality medical care for patients with diet-sensitive chronic illnesses,” the researcher wrote.
