Let Food be Thy Medicine: An Ancient Idea Driving the Business of Food Innovation in Health Care
“Let food be thy medicine and medicine be thy food.” — Hippocrates
Food as medicine is not a new concept and can be linked back to Hippocrates, c. 460 — c. 370 BC. Recently, the concept of “food is medicine” has been getting a lot of attention and the movement is going mainstream. A recent article by Time on the trend, “Why Food Could Be the Best Medicine of All”, was widely shared on social media, and this week, “Eat to Beat Disease” debuts as a food-based prescription for health backed by new evidence-based science. Author Dr. William Li says that if food is indeed medicine, it’s time we start treating it that way.
Food as medicine is not only an important aspect of treating illness but preventing it. Half of US adults have at least one preventable chronic disease related to poor dietary habits. Back in 2003, an extensive report by the World Health Organization (WHO), “Diet, Nutrition, and Chronic Disease,” recognized the link between food and the prevention of diabetes, cardiovascular disease, and cancer. But access to healthy food is a problem and a key social determinant of health.
Food deserts
“We know a ZIP code is just as important as a genetic code in determining a person’s health — impacting medical needs and access to care.” — Dr. Trent Haywood, BCBS Institute
According to recent research by the International Food Information Council (IFIC) Foundation, 95 percent of US shoppers report seeking healthy food options, but only 28 percent say nutritious food is easy to find. Eleven percent, many who live in food deserts, report that finding healthy food is just too difficult. The people that could benefit the most from a better diet may have the least access, including disadvantaged populations and the elderly.
Industry Roundup: Improving access to healthy food
Food insecurity and food as medicine programs have the same goal — to increase access to nutritious foods. Health insurance plans, hospitals, and startups are investing in innovative food programs to improve access and healthcare outcomes. Some burgeoning initiatives include:
- Blue Cross Blue Shield of Massachusetts (BCBSMA) and Community Servings are partnering to provide medically tailored meals to Medicare Advantage (MA) members who need post-acute care for congestive heart failure. The new program is part of a bigger commitment to help MA members manage chronic conditions.
- FoodQ, operated by the Blue Cross Blue Shield Institute, is fighting food deserts with pilot programs in Dallas and Chicago, where Kitchfix provides meal delivery.
- The Cleveland Clinic’s Community Farmers Markets program provides broad access to fresh produce and supports the WIC Farmers’ Market Nutrition Program (FMNP), Ohio Electronic Benefit Transfer (EBT) cards, and USDA Senior Farmers Market Nutrition Program coupons. Markets are located near hospitals and health centers in the community.
- A variety of healthy meal-based benefits by Anthem are being introduced as a result of MA’s new personal care benefit announced by the US administration for 2019.
- ProMedica’s three-acre farm and Veggie Mobile serve Lenawee County in Michigan. While the initiative is available to all residents, ProMedica Bixby and Herrick Hospital patients who screen positive for food insecurities receive a box of food and a voucher to redeem produce at the Veggie Mobile.
Outcomes: Tackling chronic disease with healthy diet and behavior modification
While health plan sponsored programs aimed at improving diet and reducing disease are still relatively nascent, some are already producing powerful results. Omada Health’s Digital Diabetes Prevention Program is a preventive benefit under ACA provided by payers and employers. Clients bill Omada through medical claims.
Omada recently concluded a two-year trial with low-income, underserved populations (PUP) reporting strong engagement and weight loss results. Thirty-seven percent of 230 participants had insurance through Medicaid, and 60 percent had insurance through a medical safety net plan. Three percent were uninsured.
Participants received a wireless scale synced to their accounts, access to a year-long, CDC-approved nutrition curriculum customized for their circumstances, and access to a bilingual Omada health coach. Nearly 40 percent of participants lost at least five percent of their starting body weight and 55 percent completed a minimum of nine of the initial 16 lessons.
Solera Health launched a partnership with Feeding America, and serves as a partner for the California Food is Medicine Coalition (CalFIMC) pilot. This project is making medically-tailored meals and nutrition services available to three different types of chronically ill California Medicaid members. The pilot looks to demonstrate how medical nutrition services should be included in Medicaid coverage like other healthcare services.
Geisinger Health believes that while people want to eat better, many may not know how to or have the means to do so. Its Fresh Food Farmacy program targets low-income adults whose type 2 diabetes is not well controlled.
By providing free food for the treatment of diabetes, at a cost of $2,400 per patient per year, the risk of death or serious complications is reduced by more than 40 percent, and medical costs went from $240,000 to $48,000 per member.
Community Servings demonstrates an average annual savings of $2,640 for individuals using their medically-tailored meals — a 16 percent reduction in healthcare costs. Its plan offers 15 different types of meal plans with the differentiator being customized meals for up to three chronic diseases.
We’re just entering the beginning of food innovation in health care. According to Quantified Ventures, outcomes-based financing in Medicare has a promising future. Paying for healthy food is becoming part of a multi-pronged approach to address the social determinants of health. As the evidence of ROI grows, reimbursements will continue shifting upstream, with technology playing a key role in streamlining food provision as a health benefit.
Written by Angela Dunn for Patchwise Labs
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