Implementation of medically adapted meal programs associated with cost savings

Implementing programs that provide medically appropriate meals (MTMs) to people with diet-sensitive diseases can be linked to both better health outcomes and significant cost savings.

New research from researchers at Tufts University’s Friedman School of Nutrition Science and Policy suggests that MTMs lead to fewer hospitalizations nationwide, as well as a net savings of $13.6 billion per year. year.

“The goal of MTMs is first and foremost to improve health and well-being, and while the potential for savings is very encouraging, that should not be the only reason to invest in these and other programs. that meet nutrition-related needs,” study author Kurt Hager, MS said in an accompanying statement. “At the same time, the results are quite extraordinary. It is very rare to have cost savings in health care.

The interest of health care systems, patients and policy makers in the concept of food as “medicine” has been accompanied by a rapid increase in the availability of nutrition programs for patients with diseases chronicles. Medically Adapted Meals are personalized, fully prepared home-delivered meals for patients with advanced illnesses, but limited coverage for NTMs exists nationwide because neither Medicaid nor Medicare provides them as a covered benefit.

The present study analyzed data on the 1- and 10-year associations of MTMs with hospitalizations, healthcare expenditures, and net costs in patients with ≥1 diet-related illnesses and ≥1 instrumental activities of daily living (IADL) that are covered by Medicaid, Medicare, and private insurance.

The study sample for the economic evaluation was drawn from the 2019 Medical Expenditure Panel Survey, with the study conducted from January 2021 to February 2022. Diet-sensitive conditions included diabetes, congestive heart failure, myocardial infarction, other heart diseases, emphysema and strokes. , as well as non-melanoma cancer, chronic kidney disease and HIV infection.

Investigators estimated that a total of 6,309,998 American adults with Medicare, Medicaid and private insurance were eligible to receive MTMs. The average age was 68.1, with most being female (63.4%), non-Hispanic white (66.7%), and having Medicare and/or Medicaid (76.5%).

The most common qualifying diagnoses were cardiovascular disease (70.6%), diabetes (44.9%) and cancer (37.2%).

A meta-analysis of 5 previously completed studies found that implementing MTM was associated with reductions in annual healthcare expenditure of 19.7% (95% confidence interval [CI]6.9% – 32.4%) and annual hospitalizations of 47.0% (95% CI, 31.7% – 62.3%), compared with usual care.

If all eligible patients received MTMs, the current results indicate that the costs of the program would be $24.8 billion (95% uncertainty interval [UI], $23.1 billion to $26.8 billion). An estimated 1,594,000 hospitalizations (95% UI, 1,297,000 – 1,912,000) and 38.7 billion (95% UI, 24.9 – 53.9 billion ) in healthcare costs could be avoided within 1 year.

For all health care payers, the policy was estimated to result in associated net savings of $13.6 billion (95% UI, $0.2 billion to $28.5 billion).

Over 10 years, the MTM intervention is projected to cost $298.7 billion (95% UI, $279.7 billion to $317.4 billion) and potentially be associated with hospitalization reductions of 18,257,000 (95% unemployment insurance, 14,690,000 – 22,109,000) and cuts in health care spending. $484.5 billion (95% UI, $310.2 billion to $678.4 billion).

Net cost savings would be $185.1 billion (95% UI, $12.9 billion to $377.8 billion) if the target population received MTMs for 8 months per year during each of the 10 years modeled.

“For people with chronic conditions and physical limitations that prevent them from shopping and cooking for themselves, these programs are a very promising strategy for improving health and well-being,” Hager added. “The estimated reductions in hospitalizations and associated cost savings reflect this.”

The study, “Association of National Expansion of Insurance Coverage of Medically Tailored Mealor with Estimates Hospitalizations and Health Care Expenditures in the US,” was published in Open JAMA Network.

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