Medically Supportive Food & Nutrition

Our Goal

Our goal is to improve health outcomes, advance health equity, and reduce avoidable healthcare spending by making medically supportive food and nutrition interventions permanent Medi-Cal benefits.

While Medically Supportive Food & Nutrition (MSF&N) has gained momentum under Medi-Cal, these services are optional, meaning that Managed Care Plans must opt into offering these services to Medi-Cal patients. For MSF&N to continue benefitting low-income patients, California must ensure that these interventions have a stable, long-term home within Medi-Cal. To reach this goal, California must transition MSF&N from waiver-based services to permanent, fully-covered benefits so that these essential services can continue producing improved health outcomes and addressing health disparities for low-income Californians across the state.

Visit the MSF&N coalition’s website to learn more about our implementation and policy advocacy work.

Background

Medically Supportive Food and Nutrition (MSF&N) interventions, commonly known as “food as medicine,” are food-based services integrated into healthcare that are used to prevent, treat, and reverse diet-sensitive medical conditions. The spectrum of MSF&N interventions includes: medically tailored meals, medically tailored groceries, medically supportive groceries, produce prescriptions, healthy food vouchers, food pharmacy, and nutrition education when paired with an accompanying food service.

In recognition of MSF&N’s potential in addressing chronic disease and health inequities prevalent across California, a group of Bay Area organizations came together in 2019 under the common goal of shifting food interventions from philanthropically funded services to standard healthcare benefits. Alongside a coalition of nearly 100 organizations, we led advocacy for Medi-Cal (the public health insurance for low-income individuals known federally as Medicaid) to incorporate MSF&N services into patient care.

This coalition was successful and in December 2021, California received approval to include food-based interventions as part of California Advancing and Innovating Medi-Cal (CalAIM), a large-scale initiative aimed at increasing quality of care and improving health outcomes for Medi-Cal patients. CalAIM is made possible through a 5-year Medicaid waiver, which grants California flexibility to pilot innovative services not offered through traditional healthcare. Embedded within CalAIM are an array of 15 different services known as Community Supports, which are designed to reduce healthcare costs and address health related social needs, such as lack of access to food. Since CalAIM’s start in January 2022, MSF&N services have reached hundreds of thousands of patients across California, making them the most utilized Community Support service. With public health care dollars paying for food-based interventions, California is better prepared to reduce diet-related disease and address the complex health needs of Medi-Cal patients across the state.

Too many individuals in California, and especially people of color, are living with preventable, chronic illnesses — such as diabetes, hypertension, and kidney disease — that diminish quality of life and shorten life expectancy. In the United States, chronic diseases account for over 90% of health care spending and are the leading cause of death and disability, with 6 in 10 adults living with at least one chronic condition.

A number of organizations across California and the country have piloted MSF&N interventions, and other states such as Massachusetts, North Carolina, and Oregon have also leveraged Medicaid waivers to cover food-based services. Evaluations from these programs demonstrate MSF&N’s proven impact in both improving health and reducing healthcare spending.

For example, a study undertaken in San Francisco shows that providing pregnant patients with a $40/month produce prescription for 6 months reduces the risk of preterm birth by 37%. In addition to positively impacting health outcomes, researchers have estimated that subsidizing healthy foods for Medicaid and Medicare patients could potentially save $40 to $100 billion in healthcare costs nationally. By fully adopting food and nutrition interventions, California has the potential to drastically improve the health of Medi-Cal recipients.