Massachusetts Study: Meal Programs Can Reduce Health Costs
Good health for Massachusetts families is about more than access to traditional medical care. The social determinants of health (SDOH) – factors such as food insecurity, lack of affordable housing, transportation barriers, limited access to well-paying jobs, and exposure to violence – contribute to poor health outcomes, drive up health care costs, and create health inequities across race and income.
Food insecurity – the lack of consistent, dependable access to enough food for active, healthy living – affects approximately thirteen percent of U.S. households and is associated with $77 billion in excess health expenditures annually. In a Massachusetts-based study recently published in Health Affairs, researchers found that addressing food insecurity through meal assistance programs can improve outcomes and reduce costs because program participation was associated with lower medical spending.
Seeking to determine the impact of meal assistance programs on recipients’ health care use and spending, researchers looked at two types of programs, both of which served adults who are dually eligible for Medicaid and Medicare and are members of Commonwealth Care Alliance, the Massachusetts non-profit, community-based health plan.
The first program was “medically tailored,” meaning it served adults with specific dietary needs due to a chronic condition such as diabetes or renal insufficiency. This program delivered enough lunches, dinners and snacks for five days. The second program was not tailored – more like the well-known “Meals on Wheels” program—and it delivered five days’ worth of lunches and dinners each week. Researchers randomly selected a group of CCA members who, during the same period, did not receive either meal program, to serve as a control group.
Compared with the control group, individuals who participated in the tailored meals programs were:
- Significantly less likely to visit the emergency department
- Significantly less likely to be admitted to the hospital
- Significantly less likely to use emergency transportation services
Likewise, compared with the control group, individuals who participated in the non-tailored meals programs were also significantly less likely to visit the emergency department or use emergency transportation but no significant differences were found for inpatient admissions.
While the researchers acknowledge the importance of confirming these results in larger samples and in different settings, they posit that their results “support the overall approach of increasing the integration between health care and social services sectors.” With the recent implementation of MassHealth Accountable Care Organizations (ACOs), the Commonwealth has a unique opportunity to make progress in the integration of these interconnected – but too often divided – elements of true health.
HCFA was chosen by MassHealth to participate in their Social Services Integration Work Group, which advises MassHealth on how best to leverage the value of social services to improve the health of MassHealth members enrolled in their ACOs. HCFA also is one of the leaders of the Alliance for Community Health Integration, which was founded by the Massachusetts Public Health Association to advance policies that focus on the underlying social determinants of health. The Alliance is supporting a requirement that MassHealth collect comprehensive data on the impact of the social supports being provided to members enrolled in ACOs, to help identify the most effective activities of the program on social determinants.