Recent announcements by two major contract firms operating in the healthcare segment highlight the growing impact of the Food as Medicine trend and its implications for the growing market in home-delivered healthy meals to discharged hospital patients and others suffering from a combination of food insecurity, unhealthy dietary habits and chronic illness.
First, Elior North America, launched its LiveWell with Traditions unit to provide customized, home-delivered meals for health plan, Medicare Advantage Organization and Managed Care Organization members. It was followed almost immediately by the launch of Chef2Home by Metz Culinary Services, designed to deliver appealing, medically tailored meals directly to health plan members, patients and individuals seeking healthy meal options in their homes and other gathering places, including those receiving a meal benefit through Medicare, Medicaid, private health plans and other programs. The company sees it as a natural extension of its existing operations in the healthcare markets, noted Metz President/CEO Jeff Metz in announcing the program.
“With three decades of experience bringing exceptional dining to congregate settings, such as senior networks and hospitals, we’ve come to learn the nutritional requirements and dining preferences of patients,” he said. “Chef2Home is just the latest example of Metz innovation as we expand to meet the individualized needs of our culinary guests across the country.”
That general sentiment had been echoed by LiveWell by Traditions President John Kirk in Elior’s launch announcement.
"With our longstanding history in providing community meals, we deeply understand the impact that good nutrition makes on the physical and mental health and wellbeing of the seniors and home-bound individuals we serve,” Kirk offered. “This impact is just as powerful in chronically ill and post-acute care individuals who require meals that are tailored to their dietary requirements. We are proud to launch LiveWell with Traditions to meet the growing need for medically-customized meals with our established expertise in delivering nutritious, home-delivered meals along with compassionate care for those we serve."
Outside of the traditional healthcare foodservice providers like Metz and Elior, the medically tailored delivered meal trend is also attracting startups with solid financial backing, such as “digital food pharmacy” Season Health in Texas that recently scored $34 million to scale up its business, which is to work with dietitians to develop meal plans aimed at helping patients manage chronic conditions like diabetes and kidney issues. It has partnerships with major healthcare providers like Geisinger, CommonSpirit Health and Cricket Health.
A growing trend
This past spring, a comprehensive academic narrative review and report titled Food As Medicine: How Food and Diet Impact the Treatment of Disease and Disease Management argued as one of its conclusions that hospitals must be a model for advancing food as medicine and should integrate dietary evidence for the prevention and treatment of disease into institutional practices and programs. The report from the Center for Food As Medicine and the Hunter College NYC Food Policy Center also recommended that federal, state and local government agencies should provide financial incentives and guidance to public and private hospitals and healthcare settings that develop and maintain food as medicine programs, including medically tailored meals and produce prescriptions.
"There must be a complete overhaul of the meals served at hospitals to ensure that hospital food is medically tailored to address individual patient health," the report stated. "Hospitals should provide meals that are easy and simply duplicated by their patients which would allow them to prepare nutritionally sound meals in their own homes."
More recently, NYC Health + Hospitals announced the launch of a new research study called Food for Health to measure the dietary and health impact of a produce prescription program for children aged 2 to 8 years old with overweight or obesity who are at risk of chronic diseases later in life. Described as the first study of its kind in the nation, the randomized, controlled trial will enroll more than 250 families whose children receive pediatric care at NYC Health + Hospitals/Queens.
Families who enroll will receive a doctor’s prescription for fruits and vegetables for their child, and families randomized to the Food for Health group will also receive 24 weeks of free home delivery of locally-grown produce. In addition, all participating families will receive educational materials on healthy eating, child-friendly recipes for meals and snacks, and child-safe cooking equipment to encourage children to participate in preparing their food. The study’s goal is to test if removing financial, transportation and access barriers to fresh produce improves children’s diets and health and supports the development of long-term healthy eating habits.
Gardens and pantries
Embracing Food As Medicine principles a mission already being embraced by healthcare organizations around the country in various ways, certainly starting with overhauling their own in-house meal programs to menu healthier offerings, but also through initiatives ranging from screening admissions and discharges for food insecurity and then connecting them with area services to providing take-home meals and meal boxes to ease the transition away from the clinical setting and encourage healthier eating that might prevent readmission.
A number of hospitals and medical centers have been cultivating their own gardens on rooftops and other areas and even full-scale farms they use to grow healthy items both for their own kitchens and for distribution to the community. Many more have over the years held nutrition education sessions both on their premises and in the communities they serve, sometimes engaging their dining staff chefs to conduct cooking demos, in an effort to convey both the value and the relative ease of adopting a healthier diet.
More recently, food pantries both on healthcare facility grounds and in locations inside communities of need have been cropping up, funded by the healthcare organizations and outside grants, or in partnership with local social service entities.
For instance, UH Conneaut in Ohio recently opened a food market called Food For Life Market, the fourth in parent University Hospitals’ network, that is stocked with nutritious food like whole grains, meat, dairy and fresh, canned and frozen produce that food insecure patients can referrals to from their primary care providers.
Eskenazi Health in Indianapolis hosts a Crooked Creek Food Pantry on its premises for which private providers screen individuals and offer a “food-as-medicine prescription” for the pantry. Memorial Sloan Kettering operates 13 food pantries in cancer clinics around the metro New York City area under its Food to Overcome Outcome Disparities (FOOD) initiative to improve food security among immigrants and other medically underserved people who are undergoing treatment for cancer and other chronic illnesses. They offer fresh fruits and vegetables and healthy, low-sodium, low-sugar options to help patients manage their conditions, and the program also works with community partners to refer patients to other resources, such as food pantries and soup kitchens, as well as to help eligible patients apply for food assistance programs.
All around benefits
Elsewhere in New York, The Food as Medicine (FAM) project is looking to measure the impact of a produce prescription program to reduce food insecurity and improve health with the help of a significant USDA food as medicine grant. In partnership with Mount Sinai Health System and the Icahn School of Medicine at Mount Sinai, and the Institute for Family Health's Bronx Health REACH Project, FAM will collect data on dietary health and behavior and reduction of household food insecurity with the long-term goal to reduce healthcare use and associated costs.
That cost reduction factor is one of the primary motivators of this trend, along with the ethical sense of responsibility that healthcare providers feel to promote long-term health and wellness and to find positive ways to serve communities outside its traditional mission of providing clinical services to the already afflicted.
Public policy is also beginning to take interest, as is reflected by the USDA grant to FAM. In California, a pilot program under the state’s five-year CalAIM initiative is using private health plans, not county social service, to deliver healthy meals to discharged patients to get them to embrace better dietary habits to control their chronic conditions such as diabetes and kidney disease. The program is one designed to see how the state can reduce the exploding costs of its Med-Cal healthcare system for low-income residents.
Getting healthy food directly to discharged patients with limited resources and poor dietary habits is a growing field through programs like “food pharmacies” set up by hospitals. For instance, at MedStar Good Samaritan Hospital in Baltimore, the "Food Rx" program dispenses food education and the actual tools that patients need to get started on a healthier lifestyle, including healthy food delivered directly to a patient's home that they can use to cook meals for themselves and their families.