A groundbreaking California health care program has doctors prescribing food to sick, low-income people — and it’s actually keeping them out of the hospital.
The program, launched on Friday by the California Food Is Medicine Coalition alongside Senator Ben Allen (D) and assembly members Blanca Rubio (D) and Richard Bloom (D), will deliver free, custom-prescribed meals to individuals who are insured by Medicaid and suffering from congestive heart failure (a chronic heart condition that requires strict dietary adherence).
“We provide meals to people who are critically ill, and we have seen results where you actually bring down health care costs because they stay out of the hospital longer, they adhere to their medication and they don’t go to the emergency room as often,” explains Richard Ayoub, executive director of Project Angel Food, one of the nonprofit organizations participating in the new program.
According to Ayoub, Project Angel Food and the other five organizations involved in California’s new pilot program — Ceres Community Project, Project Open Hand, Mama’s Kitchen, Health Trust and Food for Thought — have been delivering meals to sick people for years. Now their services will be reimbursed through Medicaid.
Why Is Food So Crucial to the Health Care Industry?
California’s program is part of a larger national Food Is Medicine Coalition, which is comprised of 27 member organizations providing healthy, medically prescribed meals to people struggling with serious illnesses. Its objective is to make medically tailored nutrition and food central to the health care system, which will in turn produce better health outcomes, lower the cost of care and improve patient satisfaction.
Philadelphia-based MANNA, one of the aforementioned organizations, published a persuasive study in 2013 finding that medical costs could be reduced by a staggering 50 percent if individuals consumed prescribed meals. They also found that these individuals visited the hospital significantly less and were 23 percent more likely to return home from the hospital instead of needing long-term care.
So while Project Angel Food and other nonprofits have been feeding sick people for many years, this study was influential in fast-tracking the $6 million pilot program through the California state legislature in just over a year. Policymakers are confident that the health of these individuals will improve, keeping them at home instead of at the hospital, saving the government massive amounts of money in the long run. A total of 1,000 individuals, all on Medicaid health care, will be fed three meals a day for three months, with funding extending over a period of three years.
Ayoub explains that the initial program focuses on those suffering from congestive heart failure, as the condition is chronic and requires strict dietary adherence. For example, sufferers are only supposed to consume around two grams of sodium — the equivalent of one teaspoon of salt — each day. “That’s just a can of Campbell’s soup,” he points out. “A lot of vegetables and food naturally have sodium. A stalk of celery, for example, has 32 milligrams.” The danger of consuming any more than that is that their bodies may retain water, increasing the volume of blood and forcing their weakened hearts to work even harder.
This is just one of the reasons many of these chronically ill individuals, some of whom are elderly and all of whom are low-income, have trouble providing themselves with three sufficiently healthy meals per day. Many compromise their nutrition and, as a result, they end up being hospitalized time and again. The overall idea is that feeding these people a prescribed diet will positively impact their health in a major way.
How Does It Work?
For California’s pilot program, a nutritionist goes into the home of the patient and assesses their individual needs, doing everything from looking at the food they are eating to making sure their microwave is working.
Then the nutritionists come up with a customized meal plan for each patient. All meals are frozen in a flash freezer and do not contain any additives or preservatives, which means they have a shelf life of five weeks. The patient only has to pop their container in the microwave. It keeps nutrition simple and, according to Ayoub, delicious.
That same dietician will check on each person four times over the three-month duration of the program, doing a home visit at the very end. “What’s really important is that this program not only improves the health of the patient, but also their quality of life,” he explains. “They are going into the hospital so much and so often, and this is keeping them in their homes longer.”
He also explains there is a human component: “Nutrition is very frustrating and overwhelming for people, and this gives them a visitor who cares about them,” he says. “There’s that human touch. And just that idea that humans care about you helps you get better, and the psychology helps you care more too.”
So How Much Does It Cost?
According to Ayoub, the three-month program costs $5,000 per person — the same amount as a single hospital stay. He ensures that California is going to get a clear return on its investment and is confident that other states will follow suit. “By spending money on food that will help these people get better, it will save them money.”
As for the pharmaceutical industry, he doesn’t think they have anything to worry about. In fact, it could be the opposite. While he believes that food is medicine and does improve health, he also acknowledges that it doesn’t necessarily replace medication, but instead goes hand in hand with it. “It will help the pharmaceutical industry in the long run,” he says. “We find that when people have food, they take their medicine more regularly.”
Ayoub is confident this pilot study is going to be a game changer and that eventually Medicaid, along with other health insurance companies, will make prescribed food a benefit, just like prescription drugs. “My goal is that it becomes a medical benefit for everyone, and in the future doctors won’t just write prescriptions for medicine, but also for food.”
What’s On the Menu?
This isn’t bland hospital food we are talking about! “We did a taste test and assemblywoman Blanca Rubio asked for seconds!” Ayoub exclaimed. He provided us the delicious recipe below:
Chicken and Rosemary With Wine
2 1/2 pounds of split chicken breasts; five ounces each
2 2/3 cups of white wine
1/2 cup of dried rosemary
6 1/2 cups of chicken stock; no sodium
1 2/3 teaspoons of salt
1/2 cup of dried basil
1/3 cup of dried oregano
1 tablespoon of garlic puree
2 3/4 teaspoons of white pepper
4 fluid ounces of canola oil
1. Cook chicken breast pieces until done. Cool.
2. Chop chicken into pieces.
3. Boil together the wine, chicken stock, rosemary, garlic, oregano, salt, basil, garlic and white pepper.
4. When the rosemary has sunk to the bottom and the mixture has been allowed to steep, add the oil and chicken pieces.