‘Food is Medicine’: Health reform should support nutritional counseling, medical meals, says HLS report

The Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School released the report “Food is Medicine: Opportunities in Public and Private Health Care for Supporting Nutritional Counseling and Medically Tailored, Home-Delivered Meals.”The report, funded in part by the M•A•C AIDS Fund, examines ways in which public and private health care programs like Medicaid, Medicare and new marketplace health insurance plans can support access to nutritional counseling and medically tailored home-delivered meals within their systems.

“We are at a unique point in time, when new health policy reforms, both within and outside of the Affordable Care Act, have opened the door for the inclusion of innovative services that both improve health outcomes and ultimately reduce health care costs,” said Robert Greenwald, Director of the Center.

“Through legal and policy analysis, our report identifies opportunities within our health care systems for integrating and reimbursing specific food and nutrition service interventions that can help move us toward reducing health disparities, promoting health, and reducing costs.”

For critically and chronically ill individuals, food is medicine. With adequate amounts of nutritious food, people who are sick have a better response to medication, maintain and gain strength, and have improved chances of recovery.

Despite this connection, support for these services has been largely divorced from our health care systems, limiting access in many cases to individuals who are elderly and disabled.

“Unfortunately, restricting access in this way only serves to perpetuate a cycle of increased costs and hospitalizations.” said Greenwald. “Providing these services for individuals, before they are home- bound and disabled or in need of hospitalization, would prevent such declines in health from happening in the first place.”

The nonprofit organization Community Servings in Boston, Massachusetts, has long understood this relationship between food and medicine, and has been providing nutritional counseling and medically- tailored home-delivered meals to individuals living with HIV and other chronic and critical illnesses for many years.

Yet, Community Servings and similar organizations across the country have traditionally been reliant exclusively on support from private charitable donations and periodic grants, in addition to the federal Ryan White AIDS Program (serving people living with HIV), a model that is ultimately unsustainable and forces many organizations to limit the numbers of individuals they can serve.

“This report assists organizations like ours in understanding how different kinds of health care systems work. It also makes recommendations for how we can form partnerships with public and private health insurance programs and work towards integration of our services into new models of care,” said David Waters, CEO of Community Servings.

“Ultimately, we all have the same goal: to keep critically and chronically ill individuals healthy and out of the hospital: it costs $20 a day for us to provide a person with medically tailored home-delivered meals, as compared to a hospitalization which can cost up to $4,000 a day.”

The Food is Medicine report is available for download on the Center for Health Law and Policy

Innovation website at www.chlpi.org.

The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) advocates for legal, regulatory, and policy reforms to improve the health of underserved populations, with a focus on the needs of low-income people living with chronic illnesses and disabilities. CHLPI works with consumers, advocates, community-based organizations, health and social services professionals, food providers and producers, government officials, and others to expand access to high-quality health care and nutritious, affordable food; to reduce health disparities; to develop community advocacy capacity; and to promote more equitable and effective health care and food systems.