America’s public health programs must cover medically tailored meals

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American healthcare spends extraordinary sums caring for people after they get sick — more than $5 trillion each year and counting — and comparatively little keeping them well. Our recent study published in Nature Medicine offers fresh evidence in support of one of the most effective tools for closing that gap: meals tailored to the nutritional needs of the people who receive them.

The Tufts University Food is Medicine Institute — where one of us is director — and the University of Massachusetts Chan Medical School, in partnership with several of the largest healthcare systems in Massachusetts, found that six months of medically tailored meals were associated with 31 percent fewer hospitalizations and 20 percent fewer emergency room visits among Medicaid members. The medically tailored meals were designed by registered dietitians with Community Servings — a Boston-based nonprofit one of us leads — for people managing serious, diet-sensitive illnesses.

The intervention generated an average of $3,433 in per-person healthcare savings, essentially offsetting its own costs. Among patients with kidney disease, the program saved even more money, generating gross savings of $12,312. Large savings were also seen among those with cardiovascular disease ($10,450), depression and anxiety ($5,597) and diabetes ($4,123).

While we are hardly neutral observers, the findings are powerful, peer-reviewed and consistent with a growing body of evidence. When you prescribe the nourishing meals that people require, they get healthier — and the system spends less.

This should transform how Congress and state policymakers think about healthcare. While programs using food as medicine are growing across the country, much more needs to be done to ensure that all Americans can access these effective therapies.

First, Congress should pass the Medically Tailored Home-Delivered Meals Demonstration Pilot Act. This bipartisan bill, which has support in both chambers of Congress, would establish a six-year Medicare pilot in 10 states, laying the groundwork for broader coverage for seniors. It represents an essential opportunity, available right now, to provide medically tailored meals to older Americans who are affected by chronic diet-related conditions.

Second, federal and state leaders must require providers using food for medical treatment to meet evidence-based standards. The Nature Medicine results are not the generic outcomes of any home-delivered meal service. They reflect medically tailored meals provided as a highly rigorous clinical intervention.

Without a defined standard, insurance programs risk paying for meals merely labeled as “medically tailored” but lacking the rigor to improve health and lower costs. The national Food is Medicine Coalition, a network of 15 accredited nonprofit providers including Community Servings, has already developed the standard.

Third, we must advance and accelerate the science in this space. Research like ours is groundbreaking because it shows the path toward a more holistic, sensible and cost-effective healthcare. Yet for too long, funding for nutrition research has been mostly missing from our top national agencies. It’s time for Congress to prioritize nutrition science at the National Institutes of Health and other agencies.

We know it works. It’s time to deliver it at scale. Without decisive action, without swift policy change at federal and state levels, too many people who need medically tailored meals still cannot get it. We see the evidence locally. Right now, 220,000 people in Massachusetts qualify for medically tailored meals across Medicaid, Medicare and commercial insurance. This year, Community Servings will serve less than 4 percent of that total — 8,000 individuals — due to inconsistencies across insurance coverage, medical training for doctors and clinical care and referral pathways.

Today, too many individuals have nowhere to turn for medically tailored meals — a lifesaving intervention that, if incorporated fully into healthcare programs, can both improve well-being and avert costly acute care.

We can do more. We can do better. And we know how: Let us make medically tailored meals a standard available therapy in Medicare and Medicaid.

Dariush Mozaffarian is a cardiologist, public health scientist, and director of the Food is Medicine Institute at Tufts University. David Waters is the founder of the AMPL Institute and CEO of Community Servings. An advocate for integrating nutrition into healthcare, he helped create the first health insurance contracts for prescription meals.

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