The intersection of food and health has been known for a long time. However, the “food as medicine” movement, which has been a big trend lately, has gained momentum. As societies grapple with rising healthcare costs and gain a greater understanding of the impact of nutrition on health, healthcare organizations are embracing the idea that food can be powerful medicine.
While companies like Kaiser Permanente, Highmark Health and other healthcare organizations are dedicating resources to improving the nutrition of the communities they serve, Elevance Health appears to be taking it a step further.
Last June, the Indianapolis, Indiana-based insurance company announced that Dr. He appointed Kofi Essel as pharmaceutical director as his inaugural dinner. After working for six months, she recently explained to MedCity News why Elevance hired her.
“I think the opportunity to hire a food pharma director was a recognition of, ‘Hey, if we want to take this seriously, we want to bring some more expertise to the topic,'” Essel said in an interview. “They needed to pull that from the outside to really boost the internal efforts.”
Before joining Elevance, Essel was a pediatrician at Children’s National Hospital in Washington, D.C. George Washington University School of Medicine and Health Sciences Culinary Medicine Program. He also conducted a lot of training and research on public health, food and nutrition. In other words, there has long been a clear, clinical connection between what we put into our bodies and how healthy we are.
At Elevance, Essel focuses on applying food as medicine “across every line of business,” be it Medicaid, Medicare or commercial insurance. The insurance company has more than 47 million members. While food insecurity and nutrition-related diseases affect people with all types of insurance coverage, not all food-as-medicine strategies work for everyone.
“Each line of business is looking for something a little different, and we adapt to what their members need to improve their health outcomes, whether it’s an age-related issue, whether it’s a disability-related issue, whether it’s an issue of what resources they have and have access to,” he said. Essel said. “We have to think about all of these pieces when we design interventions.”
Some strategies Elevance is exploring include working with the Supplemental Nutrition Assistance Program (SNAP), utilizing medically specific meals, producing prescriptions, and improving nutrition education. SNAP is a federal government program that provides food assistance to low-income people. Essel said the insurer is using a combination of these approaches in various pilots across its business lines but declined to provide additional information about them.
An integrated health delivery system, with no specific positioning of food as medicine, was more upfront about its efforts.
Pamela Schwartz is managing director of population health at Kaiser Permanente, headquartered in Oakland, California. Schwartz leads Kaiser’s food and nutrition strategies, but also focuses on other social determinants of health, such as housing. She has a team specifically working on food and other social determinants.
Kaiser serves approximately 12.6 million members. A quarter of them struggle with food and nutrition insecurity, Schwartz said. Half of Medicaid members struggle with food and nutrition insecurity. Having a dedicated team focused on food as medicine “elevates” the organization’s ability to “address” the problem, he said.
“This allows us to build a comprehensive portfolio of efforts specifically aimed at addressing this issue and improving these outcomes for people,” he said.
Some of their efforts include: $50 million commitment to food and nutrition security, which the organization announced in 2022. at Kaiser Permanente in October started A study to measure the effects of providing the Instacart Health Fresh Fund to Medi-Cal members with diet-related diseases. This builds on a previous study that sent members specially prepared food boxes. From this study, Kaiser learned that members wanted choice in their meals. The work with Instacart provides members with a stipend to shop for their own healthy groceries.
such as Kaiser Permanente, Highmark Health, Headquartered in Pittsburgh, Pennsylvania, the company also brings efforts to use food as medicine under the title of social determinants of health (SDOH). The organization has approximately 7 million members.
Nebeyou Abebe, SDOH senior vice president, said he assigned Austin Price, SDOH director of stakeholder engagement and impact, to work with SDOH staff and stakeholders outside the community on medicine-as-food strategies and initiatives.
Abebe added that creating a special role for food as medicine is not something he would do at Highmark. Food insecurity is just one part of SDOH. Social isolation, transportation barriers, intimate partner violence, and other factors also affect a person’s health.
“There are a lot of social needs and social problems that our members experience,” Abebe said. “So I will never have a manager for each of these SDOH areas. But I have a special resource within the corporate SDOH team that helps coordinate and collaborate with key stakeholders across the organization to drive our food-as-medicine strategy: Price.
Highmark Health also started Various food initiatives, including the Healthy Neighborhood pilot in West Virginia in partnership with Vandalia Health Network, Marshall Health, Mountain Health Network, InComm Healthcare and Dollar General. Provides eligible West Virginia residents with debit cards that they can use to purchase nutritious foods exclusively at Dollar General stores. The company recently expanded the program with West Virginia University Health System.
While Elevance, Kaiser Permanente, and Highmark Health have slightly different ways of approaching food as medicine within their respective organizations, they have similar desires: to have a meaningful impact on food and nutrition security and diet-related diseases.
Schwartz added that he would like to see more collaboration between health organizations to make progress on food and nutrition security.
“I don’t think where we do it and how we do it should be a competitive thing,” he said. “I think it should be, how can we most effectively treat and prevent diet-related diseases? The health sector needs to come to the table together to find out what is most effective here.”
It’s no surprise that payers are increasingly targeting food insecurity and availability of nutritious food as a key capability. In fact, recent studies show that just covering medically tailored meals could save payers $13.6 billion annually.
Dr. D., a practicing physician and executive director of the Center for Health Solutions and the Institute for Health Equity. Jay Bhatt explained that taking a dedicated role as medicine for food, as Elevance has done, is not the only path payers and healthcare organizations are taking. at Deloitte. Other strategies include creating a food safety task force, integrating food insecurity into existing roles, collaborating with outside organizations, training clinician networks, and collaborating with employers.
But whatever strategy the payer chooses, one thing is clear:
“Organizations may have one person to provide leadership, but the work on this issue needs to be incorporated through the organization into its overall health equity strategy, operations, measurement and financial priorities,” Bhatt said. “Food equity cannot be a side hustle.”
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