Food is Medicine for People with Serious Illness, So Who Fills the Prescription?

A DC community-based organization, Food & Friends, overcomes healthcare financing obstacles to provide millions of medically tailored meals for people with serious illness in the DC-Maryland-Virginia region. Despite the research showing the benefits of proper nutrition for people living with serious illness, including improved health outcomes and cost savings, this kind of non-medical support is seldom financed by major payers, such as Medicare and Medicaid. Food & Friends step up with the support of public and philanthropic contributions to ensure that the nutritional needs of people living with serious illness are being met by delivering meals, and groceries, and providing medical nutrition therapy. We recently connected with leaders from the organization, which is a part of the national Food Is Medicine Coalition, to discuss our shared purpose and the policy landscape for addressing the nutritional needs of those living with serious illness.

C-TAC’s policy priorities focus on improving the quality of life for individuals and families impacted by serious illness by expanding access to community-based supports that meet holistic non-medical needs, such as access to proper nutrition. Like other non-medical supports, medically tailored nutrition services are limited under traditional Medicare and Medicaid programs and coverage varies between private health plans. According to Food & Friends Executive Director, Carrie Stoltzfus, the organization’s largest source of financial support is philanthropy followed by; public funds from the federal Ryan White HIV/AIDS Program; state and local funds; and partnered Managed Care Organizations (MCOs). To receive meals and nutrition therapy, patients must meet certain qualifications related to their medical condition and be referred by providers who assess their nutritional needs.

While Food & Friends has developed partnerships with health plans to create referral and financing streams for patients, Stoltzfus says that in a perfect world more insurers, such as Medicare, would cover their services. Currently, state-administered Medicaid MCOs have more flexibility to cover non-medical supports, but current Medicare legislation limits such flexibilities for its beneficiaries. Research shows that patients who receive medically tailored meals are less likely to be readmitted to the hospital or a nursing home compared to those who do not, and this results in decreased healthcare expenditures.

According to Food & Friends Director of Government Relations and Public Funding, Casey Dyson, lawmakers recognize the importance of nutritional support for people living with serious illness and there is legislative activity underway at multiple levels of government. The bipartisan Medically Tailored Home-Delivered Meal Demonstration Pilot Act of 2021 (H.R. 5370) was introduced in the House last year and aims to create a pilot program through CMS’ innovation center that will ensure access to lifesaving medically tailored meals at home for Medicare beneficiaries. Dyson pointed to California’s CalAIM program to exemplify how state Medicaid agencies are already covering services provided by organizations like Food & Friends. The state uses pre-approved ‘In Lieu of Services’ (ILOS), optional cost-effective alternatives to covered Medicaid services, to support beneficiaries’ health-related social needs.

As the legislative push for healthcare financing to support health-related social needs continues, organizations like Food & Friends create access to community-based services for countless individuals. Our advocacy efforts are aimed at progressing legislation, such as H.R. 5370, that improves access to community-based services and removes financial barriers for people living with serious illness. Our Core Principles for Care Models establish a foundation for new models and indicates that models should account for the social needs of patients. To learn more about C-TAC’s policy and advocacy work, visit our website here.

To learn more about the work of Food & Friends, visit their website here.