Food Is Medicine: Providing Medically Tailored Meals to Community Members with Disease-associated Nutritional Risk Supports Stable BMI and Decreased Hospitalization (P12-005-19)

Abstract

Objectives MANNA, a Food is Medicine organization in Philadelphia, provides nutritional support for community members at nutritional risk from serious illness. MANNA's program of medically-tailored meals and nutrition counseling have been associated with lower healthcare utilization and costs, however the specific health outcomes that contribute to these effects are unknown. The objective of this research is to analyze change in body mass index (BMI) and proportion of recent hospitalizations in association with MANNA's program. Methods A retrospective chart review was conducted for 103 clients who answered a 2016 Client Satisfaction Survey and received at least six months of MANNA's program between Jan. 2015 and Dec. 2016. Data from the start of services and at 6-months follow-up were entered into Research Electronic Database Capture (REDCap) and analyzed using Statistical Analysis Software (SAS). Results The median age of clients in the sample was 66.0 years (interquartile range (IQR) 58.0—72.0). Primary diagnoses were cancer (53%), renal disease (15.7%), diabetes (7.8%), HIV/AIDS (3.9%), heart disease (3.9%) and “other” (16.7%). Half of the sample (52.0%) reported having insufficient money to buy food. Per weight history, two-thirds (63.3%) of clients had decreasing weight before program enrollment, 28.9% had stable weight and 7.8% had increasing weight. Change in BMI between initial intake and recertification was: median = 0.04; IQR (−0.84,−1.02). Analysis of variance followed by a multiple comparisons with a Bonferroni adjustment found no evidence of any difference in BMI change between diagnoses. Bivariate analysis with t-tests found no evidence of any difference in BMI change between clients with enough money for food and those without (P = 0.4277). McNemar's Test found evidence of a significant decrease in the proportion of clients who had recent hospitalizations at follow-up compared to the start of services (P = 0.0077). Conclusions Manna's program was associated with stable BMI. Change in BMI was not significantly different based on primary diagnosis or insufficient money to buy food. The proportion of client hospitalizations was significantly less after MANNA's program. Stabilization of BMI is a possible health outcome that contributes to lower healthcare utilization and cost savings in MANNA's clients. Funding Sources None.

Association of National Expansion of Insurance Coverage of Medically Tailored Meals With Estimated Hospitalizations and Health Care Expenditures in the US

“…Diet-sensitive conditions included diabetes, congestive heart failure, myocardial infarction, other heart disease, emphysema, and stroke, as defined as priority conditions in the MEPS 2019 Combined File, 15 and nonmelanoma cancer, chronic kidney disease, and HIV infection, as defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes in the MEPS 2019 Medical Conditions File. 16,17 These diagnoses were selected because they reflect the patient populations in previous MTM research [5][6][7][8][9][10][18][19][20] and are served by the national network of MTM providers. 4 The IADL limitations were defined as a positive survey response to receiving help or supervision using the telephone, paying bills, taking medications, preparing light meals, doing laundry, or going shopping due to an impairment or health problem.…”