Two researchers with Johns Hopkins University in Baltimore believe community-based organizations (CBOs) must become involved to adequately address food insecurity among high-risk Medicaid patients.
Food insecurity, defined as “limited or uncertain access to adequate food,” affected more than 12 percent of U.S. households in 2016, according to Katherine Rediger, MSN, CRNP, and D.R. Bailey Miles, MD. A lack of healthy food options is associated with worse health outcomes and diseases such as hypertension and diabetes.
Although the federally funded Supplemental Nutrition Assistance Program (SNAP) aims to reduce food insecurity, it is inadequate in many cases for high-need, high-cost (HCHN) patients, the researchers wrote in an opinion piece published in the Annals of Internal Medicine. Healthy food may be too expensive or unavailable in their communities, and the patients may not be able to shop or cook for themselves, which is where CBOs enter the equation.
Miles and Rediger defined HNHC patients as having at least three chronic medical conditions and a functional limitation. By partnering with Medicaid managed care organizations, CBOs can deliver medically tailored meals to improve nutrition and reduce hospital admissions for these individuals.
“In one study, 30 percent of hospitalized HNHC patients who were surveyed reported food insecurity, and an additional 25 percent were marginally food-insecure,” the authors wrote, noting HNHC individuals account for 5 percent of Medicaid beneficiaries but half of the expenditures. “As a result, partnerships to address food insecurity in HNHC populations may provide the highest return on investment to managed care organizations given the high medical expenditures in this subset of patients.”
One such collaboration in Philadelphia resulted in reductions of up to 31 percent in healthcare costs, and a greater likelihood patients would be discharged home rather than a nursing home following a hospital visit.
Gathering outcomes data and demonstrating the value of the partnerships could be crucial to maintaining continuing financial support, wrote the authors, who suggested a percentage of cost savings be set aside for additional funding of the programs.
“Access to healthy foods is a fundamental aspect of health and wellness,” Rediger and Miles wrote. “We believe that forging partnerships between clinical organizations and CBOs will help reduce food insecurity, thereby supporting improved health outcomes, reduced healthcare costs, and savings for payers.”
Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.