When it comes to improving health, few opportunities are as obvious as Food Is Medicine (FIM). Nutritious food is essential to good health, and health-care organizations such as Centene are increasingly using FIM as a lever to drive better health outcomes and health-care savings.

This is especially critical in Medicaid, the government health insurance program for low-income Americans covering nearly one in five people in the US. Alarmingly, in 2023, 38 percent of households below the federal poverty level experienced food insecurity, highlighting the urgent need for effective interventions with a shared understanding of what actually improves health outcomes.

Food insecurity and poor nutrition are linked to chronic disease, higher health-care utilization, and increased costs. Research shows that people in food-insecure households spend roughly 45 percent more on medical care annually than their food-secure counterparts. Lower food security is also consistently associated with higher risks of hypertension, diabetes, heart disease, kidney disease, and more.

An estimated 60 percent of US adults have at least one chronic condition, with diet-related conditions like hypertension (27 percent), lipid disorders (22 percent), and type 2 diabetes (12 percent) being among the most common—and costly. In total, about 85 percent of all health-care spending is tied to the management of diet-related chronic diseases.

Against this backdrop, FIM programs are more than a “nice to have”—they offer a path to meaningful impact. High-intensity medically tailored meals (MTMs), for instance, are customized meal plans designed for individuals with complex conditions like HIV/AIDS, diabetes, heart failure, and liver disease. Studies show that MTMs can reduce hospitalizations by 49 percent, skilled nursing facility admissions by 72 percent, and overall health-care costs by 16 percent—even after accounting for the cost of the program.

Food Is Medicine programs are more than a ‘nice to have’—they offer a path to meaningful impact.

Medium-intensity interventions like medically tailored groceries involve providing specific food items tailored to the dietary needs of people with chronic conditions or pregnancy. These interventions have been shown to reduce health-care costs while improving dietary intake. Meanwhile, lower-intensity interventions like produce prescriptions, which provide vouchers or prescriptions for fresh fruits and vegetables, can reduce food insecurity and improve glucose management in people with diabetes.

At Centene, we’ve created an FIM program framework to guide our efforts in support of our 13 million Medicaid members across 30 states. Our approach begins with clearly defining our goals in each community, whether it be improving clinical outcomes, addressing food insecurity, or providing a community benefit. Research suggests that “high-dose” programs like MTMs are more effective for clinical impact, while “lower-dose” programs may be suitable to address food insecurity on a larger scale.

Our commitment extends beyond selection and implementation of the intervention to evaluation. Evaluations should measure both outputs (e.g., meals delivered) and clinical, financial, and member experience impact. This level of rigor is essential for refining interventions and contributing to a growing body of evidence that benefits the entire field.

In addition to healthy foods, nutrition counseling and education are critical components of any sustainable FIM strategy. They empower members with the knowledge and skills to make healthier choices, shop for nutritious foods, and prepare balanced meals after a formal FIM program ends. By collaborating with food vendors, health-care providers, and local community-based organizations, health plans can seamlessly incorporate education into food delivery services, community programs, and clinical touchpoints.

Beyond immediate interventions, connecting members to long-term support like the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is essential. These large-scale programs have proven track records: SNAP participation is linked to lower health-care costs and improved health outcomes, while prenatal WIC participation has led to longer pregnancies, fewer premature births, and health-care savings.

The barriers to healthy food access are multifaceted—food deserts, food swamps, lack of transportation, and other factors all contribute. Addressing these challenges requires collaboration across sectors: retail initiatives to increase healthy food availability, community programs to engage local stakeholders, policy work to drive systemic change, and ongoing research to test and refine interventions.

Health care is a powerful piece of the puzzle. By leveraging evidence-based FIM programs, integrating complementary services, and fostering cross-sector collaboration, we can transform food from a basic necessity into a strategic driver of better health and affordability.