High Healthcare Utilizers Benefit from Meal Delivery Programs

Medicare and Medicaid beneficiaries participating in certain food delivery programs have fewer costly emergency department visits and hospital admissions, according to a new study.

Berkowitz

The study, published in the April issue of Health Affairs, found that Medicare and Medicaid dual eligibles who participate in either a medically tailored meals program or a non-tailored food program stay healthier.

The study, funded by AARP Foundation in partnership with Massachusetts General Hospital and the community-based health plan Commonwealth Care Alliance, is the first to demonstrate how this specialized intervention can lead to fewer costly emergency department visits and hospital admissions.

“Individuals dually eligible for Medicare and Medicaid often face significant clinical and social risk, and consequently often have high levels of emergency department use, along with other associated health services such as inpatient admissions,” says lead study author Seth A. Berkowitz, MD, MPH, assistant professor of general medicine and clinical epidemiology in the UNC School of Medicine. During the time of the study, he was an assistant professor at Massachusetts General Hospital/Harvard Medical School, in Boston.

Study details

Berkowitz and colleagues examined two meal programs and medical claims data for adults who were dually eligible for Medicaid and Medicare coverage from January 1, 2014, to January 1, 2016. One group received home-delivered meals from Community Servings, whose meals are medically tailored meals to fit the medical and nutritional needs of those with diabetes, HIV/AIDS, cancer, heart disease, kidney disease, and other life-threatening illnesses. The other group was given a Meals on Wheels-type non-tailored meal program. Both groups were compared to a control group of patients with similar demographics and illness profiles.

The researchers found that participants in both meals programs experienced fewer emergency department visits and emergency transportation services, but only Community Servings clients who received medically tailored meals had fewer inpatient admissions, resulting in a 16% net reduction in healthcare costs, according to the authors. Average monthly medical costs for medically tailored meal participants was $843, compared to $1,413 for the control group, reflecting gross savings of $570 per month, or net savings (factoring in the cost of the meals) of $220 per month.

Food insecurity causes more than an estimated $77 billion in additional healthcare expenditures annually in the United States.

“There is good evidence that food insecurity and poor nutrition are associated with poor health, but we know less about whether nutrition interventions might improve health,” Berkowitz says. “This study sought to determine whether use of these meal delivery programs was associated with indicators of better health. This study suggests that addressing nutrition in these individuals may be a way to help reduce some of that utilization, and ultimately help vulnerable individuals stay healthier.”

Berkowitz believes it would be reasonable for executives to see if there are organizations in their area that can provide this kind of service, and consider forming contracts with them if the executives have patients who may benefit.

“As these can be relatively expensive interventions, I would recommend having a strong plan for evaluation to make sure the resources are being directed where they can do the most good,” he says.