New Nutrition & Food Access Reports
The Population Health Alliance has posted a recording of their webinar, co-hosted with The Food Trust and the Center for Health Law and Policy Innovation (CHLPI), on a new report Addressing Nutrition and Food Access in Medicaid.
The report and webinar provide strong content on not only the specific technical details of reimbursement for food-related services (see for example the 2020 CHLPI overview on Produce Prescriptions for a technical details report), but also the systems required for successfully implementing food- and diet-based interventions to improve health across a population. The panel and the report provide examples of regions pulling together a portfolio of tools, from nutrition counseling to produce prescriptions to medically tailored meals, to be able to match the right service to an individual patient’s needs.
A second report, co-authored by CHLPI as part of the Aspen Institute initiative on Food and Society, provides some more insight into the system change requirements for effectively addressing the impact of diet-related health concerns in the U.S. The Food Is Medicine Research Action Plan (which also had its own webinar) highlights the range of “food is medicine” interventions and how they move across the continuum of care from early stage prevention to treatment of specific conditions, and how they have build from different levels of integration with clinical practice.
Understanding key elements of effective health care systems to address food and diet has implications for community partners and food organizations as well. The systems perspective introduces questions around how to support patient choice, bring programs to an appropriate scale to accommodate all eligible patients, share information to allow for tailoring individual food plans and integrating clinical services, measure health results, support flexibility to change food-based approaches if one program isn’t working, and also questions of who needs to be at the table in program design, blending both lived experience and specific subject matter expertise.
Without understanding the threshold system capacity needed to address diet-related health concerns, we have a double challenge - there’s the immediate need to do something about the health conditions that now affect more than half of American adults, but there’s also implications for the research used to guide best practices, policy, and funding. Studies search for leading indicators to suggest whether a particular project — a produce prescription, CSA share, food box, etc — can be expected to have a longer term health impact. An example of this type of measure would be dietary pattern change over a short span of time (such as pre- and post-surveys for an 8 week program). These indicators in the absence of considering broader health care and food system capacity only tell a small part of the story. It is not surprising, then, that we see inconsistent results in literature reviews of program evaluations when they focus on specific clinical outcomes.
The Addressing Nutrition and Food Access in Medicaid webinar, along with the separate Food Is Medicine Research Action Plan, are two excellent resources to inform this conversation.