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Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare And Medicaid Beneficiaries

An Evidence-Based Practice

Description

In dually eligible Medicare and Medicaid beneficiaries, meal delivery programs may reduce the use of costly health care. Medically tailored meals delivered to nutritionally vulnerable patients may be an important way to improve the utilization of healthcare and its expenses by leading to fewer inpatient admissions and lessen the effect that food insecurity has on costly health services.

Goal / Mission

In this study, it was sought to examine whether home delivery of medically tailored meals or non-tailored food reduces the use of selected health care services and medical spending among Commonwealth Care Alliance members. Because there is knowingly an association between food insecurity and emergency room visits, it was hypothesized that the medically tailored meals would cause a reduction in ER visits and other costly healthcare services and expenditures.

Impact

Researchers estimate monthly net savings of $220 per participant for medically tailored meals and $10 per participant for the non-tailored food program. This study suggests that vulnerable patients, in this case, the dually eligible Medicaid and Medicare, can benefit from meal delivery programs.

Results / Accomplishments

The medically tailored meals group compared to a control group saw 70% reduction in ER visits and 52% reduction in inpatient admissions. The non-tailored food group compared to the control group saw only a 44% reduction in ER visits and 12% reduction in inpatient admissions. Examining the differences between the medically tailored meal group and non-medically tailored meal group, the former program was associated with significantly lower medical spending compared to those not receiving any meal support (average monthly difference of $570 and $156 per participant, respectively)

About this Promising Practice

Organization(s)
Commonwealth Care Alliance (CCA)
Primary Contact
Seth A. Berkowitz, MD, MPH
102 Mason Farm Road
Ambulatory Care Center
Suite 3100
Chapel Hill, NC 27514
(984) 974-4462
https://www.commonwealthcarealliance.org
Topics
Health / Health Care Access & Quality
Health / Physical Activity
Health / Older Adults
Organization(s)
Commonwealth Care Alliance (CCA)
Source
Health Affairs Journal – Authors’ analysis of CCA data
Date of publication
1/4/2019
Date of implementation
2013
Geographic Type
Urban
Location
Massachusetts
Target Audience
Adults, Older Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.