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Nutrition Assistance Program Draws Payer Support

Analysis  |  By Christopher Cheney  
   April 17, 2017

A Massachusetts nonprofit is building a data-supported financial case to demonstrate that nutrition-intervention services are beneficial to patients and payers.

For frail patients with multiple chronic medical conditions, eating is a crucial part of their treatment.

"In America, a third of patients enter hospitals malnourished. The stay for those patients is three times longer and three times as costly. If you could address patient malnutrition at home, you could have a significant impact on re-hospitalization rates, on ER visits, on healthcare costs, and on clinical outcomes," says David Waters, CEO of Boston-based Community Servings.

The organization, which was founded 28 years ago to provide medically tailored meals for AIDS patients, today prepares about 2,500 meals per day for patients with any of about three dozen illnesses.

"Much like a pharmaceutical prescription, it is a food prescription. We can take our 17 medical diets, and we can customize them in up to three different ways; so, you are getting exactly the kinds of foods your doctor wants you to eat."

About three years ago, the leadership of Community Servings realized demand for nutritional-intervention services in New England could not be met through the organization's philanthropically based business model, Waters says.

Gathering Data

"We are a $6.5 million organization. About $4 million of that comes from philanthropy, but we can't raise the money fast enough to meet the demand. We are based in Boston and feed about 1,800 people a year in 20 cities across Massachusetts. We are the only medically tailored meals program in the six New England states."

To develop a more robust business model that includes financial support from healthcare payers, Community Servings is gathering data to show the significant return on investment from boosting patient nutrition.

"As we build this data-driven outcome model and the financial argument, then you can replicate what we do all across the country," Waters says.

Community Servings is conducting three research studies with Seth Berkowitz, MD, MPH, a researcher at Massachusetts General Hospital.

"We actually don't know much yet about the benefits for a medically tailored meal program like Community Servings. We know that programs like Meals on Wheels, which generally serve an older and socially isolated but otherwise healthier population, do show benefits in terms of keeping people out of the hospital and out of nursing homes," Berkowitz says.

The research challenge is quantifying the impact of nutrition on frail and complex patients, who are often resource-strapped, he says.

"The very sick type of patients that Community Servings works with often have much more complicated dietary needs, and need to follow a stricter diet than the kinds of patients the Meals on Wheels results were seen in. We think the potential for benefit is there. We know that following a medically appropriate diet keeps you healthier."

Two Goals

Berkowitz says his research work on medically tailored meals has two goals:

  1. To help people follow a healthier, more medially-appropriate diet.
  2. To improve use of healthcare services.

The results from a diabetes-nutrition pilot study involving Community Servings patients should be ready for publication this summer. Manna, a medical-nutrition organization based in Philadelphia, has already collected impressive ROI data, Waters says.

Claims Data Shows Reduced readmissions

At last year's annual Food Is Medicine symposium held at Harvard Law School's Center for Health Law & Policy Innovation, Manna presented payer-claims data for 1,000 medically complex patients who received nutrition-intervention services similar to the Community Servings program.

"They saw a 20% decrease in medical costs for patients who received the nutrition intervention. They also saw a 32% drop in hospital admissions and an 8% drop in ER visits," Waters says.

As Community Servings gathers data with Berkowitz, it also is collecting healthcare-payer support. "We have been able to secure four insurance contracts that are helping us to pay for feeding people. They are some of the first contracts of their kind in the country."

 

Christopher Cheney is the CMO editor at HealthLeaders.


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