The Food as Medicine movement has potential beyond improving health outcomes — such programs can save money as well.

A new report by researchers from the Friedman School of Nutrition Science and Policy at Tufts University, supported by The Rockefeller Foundation, highlights the potential benefits of scaling Food as Medicine programs nationwide. These initiatives, which include medically tailored meals and produce prescription programs, have been shown to improve health outcomes while being cost-effective or even cost-saving.

For example, the report says, providing medically tailored meals and groceries to eligible recipients could prevent 6 million hospitalizations annually. After accounting for implementation costs, this policy is projected to generate net savings of $13.6 billion within one year and $185 billion over a decade.

Expanding produce prescription programs for diabetes patients could prevent 292,000 cardiovascular events. These programs have proven to be highly cost-effective when compared to traditional health care alternatives.

The findings underscore the significant potential of Food as Medicine programs to reduce health care costs while addressing critical health needs.

Robert Kennedy Jr., President-elect Donald Trump’s choice as Head of Health and Human Services, could push for public insurance to provide Food is Medicine benefits coverage. This would be consistent with Kennedy’s “Make America Healthy Again” theme. Kennedy, in response to Joe Biden’s plans to provide coverage for anti-obesity medications for Americans enrolled in Medicare and Medicaid, said, “If we just gave good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight.”

Based on that thinking, Kennedy might be open to coverage for Medically Tailored Meals (MTM). MTMs are fully prepared meals that are customized to meet the dietary needs of a person with a chronic or severe illness.

Part of the argument for providing Food as Medicine benefits would be based on cost savings. This would give Trump a widely popular program that could be a legacy builder for him. What politician could oppose providing poor and working people free healthy food so they stay out of the hospital while saving the country money as well?

There is already a GOP doctors’ caucus looking favorably at these types of initiatives.

Dariush Mozaffarian M.D. and other experts discuss this question in a current issue of the Journal of the American College of Cardiology. He concludes that MTMs are cost-saving when provided to high-risk, high-utilization patients.

But the economic viability of Food as Medicine initiatives depends on how “cost savings” is defined. Several metrics come into play:

Direct Cost Savings: A reduction in healthcare expenditures through fewer hospital visits, emergency room admissions, or medication requirements.

Cost-Effectiveness: Improvements in food security, diet quality, and health outcomes relative to program costs. Metrics such as cost per Quality-Adjusted Life-Year (QALY) gained are often cited as evidence of program success.

Healthcare Utilization Reductions: While programs might lower short-term healthcare usage, they do not necessarily lead to long-term systemic cost reductions due to sustained service demand.

While some studies suggest Food as Medicine programs may yield cost savings, others highlight their primary value in improving health outcomes rather than reducing overall healthcare expenditures. This distinction is critical, as improved outcomes might come with increased spending, especially if these programs are widely adopted.

Historically, major healthcare policy changes have been associated with significant increases in healthcare inflation. For instance:

Medicare and Medicaid (1965): The expansion of access led to increased utilization and spending, with healthcare inflation exceeding general inflation.

Affordable Care Act (2010): While the ACA aimed to control costs, its expanded coverage initially drove up spending before moderating healthcare inflation growth.

Integrating Food as Medicine programs into public insurance could follow a similar trajectory. Although these programs could improve health outcomes, the associated costs of food provision, logistics, and administration might drive healthcare spending higher. In other words, we should expect a short-term increase in spending when we make the investment to reduce future healthcare costs.

Looking retrospectively, we will be able to determine the actual cost savings. In terms of initiatives that are cost effective, it means we would produce better health outcomes for the same dollar spent.

A Food as Medicine program could resonate with Democrats for its focus on social determinants of health and Republicans for its potential cost-containment narrative. However, as with any major policy change, potential challenges include:

Administrative Complexity: Managing food provision logistics within public insurance programs would require significant infrastructure and oversight, increasing administrative costs.

Economic Ripple Effects: Increased demand for medically tailored meals could strain supply chains, exacerbating food and healthcare inflation.

Equity Challenges: Ensuring equitable access across diverse populations would necessitate careful policy design and implementation.

There’s a tension between improved health outcomes and increased costs, which we’ve seen with other programs.  Medicare, Medicaid, and the ACA expanded access but introduced significant cost pressures.

These historical parallels suggest that while Food as Medicine programs might enhance population health, we will have to make an upfront investment to save costs and improve outcomes.  Incorporating Food as Medicine into insurance coverage could be a cornerstone of a transformative healthcare agenda, addressing chronic disease and promoting equity.

Ed Gaskin is Executive Director of Greater Grove Hall Main Streets and founder of Sunday Celebrations.