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Massachusetts Food is Medicine State Plan Launches!!

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After years of hard work, the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI), Community Servings, and nearly 40 Planning Council organizations debuted the Massachusetts Food is Medicine State Plan at the Massachusetts State House on Tuesday June 18, 2019. With the support from legislative sponsors Senator Julian Cyr and Representative Denise Garlick, the event drew over 200 people with a line out the door comprised of government officials, non-profit group members, health care providers, health care payers, public health advocates, food systems practitioners, and academics from across the state. The launch of the State Plan was also highlighted by WBUR, who quickly published a story on the morning’s events.

The Massachusetts Food is Medicine State Plan initiative brought together hundreds of individuals and organizations, all united by the belief that food is medicine. Research increasingly shows that Food is Medicine interventions—such as medically tailored meals and produce prescription programs—are an effective, low-cost strategy to improve overall health outcomes, decrease utilization of expensive health care services, and enhance quality of life for people living with, or are at risk for, serious diet-related medical conditions. Present at the State Plan Launch were David Brown, a client of Community Servings’ medically tailored meal delivery program, and Max Makowski, a client of FLAVORx’s produce prescription program. Brown and Makowski spoke avidly to the audience about how Food is Medicine services improved their lives and health, reminding us that food and nutrition are crucial for people living with chronic illnesses.

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In his remarks, Senator Julian Cyr called attention to the massive, avoidable $1.9 billion in health care spending stemming from food insecurity each year. “Part of the reason Food is Medicine is so important and has so much promise is the potential for not only improving quality of life, access, and getting at food insecurity, but the potential for cost savings as well,” said Cyr. “Because of the State Plan, we have a blueprint now to equip our health care system to identify and respond to food insecurity.”

The State Plan provides a framework for creating a health care system that truly recognizes the critical relationship between food and health and ensures access to nutrition services needed to treat, manage, and even prevent diet-related chronic diseases. Representative Denise Garlick said passionately, “I feel that food is such a ubiquitous part of our day to day life. We have always had the power; we just haven’t utilized our power.”

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As the keynote of the event, a panel of experts discussed the origins and next steps for the State Plan. Robert Greenwald, Faculty Director of the Center for Health Law and Policy Innovation, conveyed that Massachusetts has always been a leader in health care policy, setting the tone for broader health reforms across the country. “We are making progress but much more work needs to be done,” said Greenwald. “The good news is we now have a State Plan that includes very specific recommendations as to what it's going to take to create a fully integrated health care system”.

The State Plan Report provides 15 recommendations, known as the Food is Medicine 15. These recommendations outline specific, concrete action items for key stakeholders within the world of nutrition, food, and health. It also establishes a Massachusetts Food is Medicine Coalition and three Task Forces charged with addressing critical barriers and driving broader systems and policy change. Inaugural leaders of each Task Force were present on the panel to discuss their vision for advancing the State Plan.

David Waters, CEO of Community Servings, asserted that, “As people are looking for new innovations, an old innovation has risen to the top, which is food.” He added, “If you want to make an impact on someone's health outcome, you'd better think about it in a holistic way of what's going on in that household...if we could also find a way to make sure that an entire household's nutrition needs are met, that's going to have the biggest impact.” In the same vein, Dr. Maryanne Bombaugh, President of the Massachusetts Medical Society stated, “Without addressing the social determinants of health, we will never have health equity.” Dr. Bombaugh placed high importance on educating health care professionals on food and nutrition to ensure patients have access to the information and care they need to heal and thrive. Richard Sheward, Director of Innovative Partnerships at Children’s HealthWatch, believed that “the State Plan is a great way of coalescing a diverse array of stakeholders around figuring out what works best” to address nutritional needs within the context of health care in the Commonwealth.

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With strong leadership from individuals, organizations, and policymakers committed to achieving the goals of the State Plan, Massachusetts can achieve widespread, sustainable access to Food is Medicine interventions. The time is now for us to come together, take initiative, and continue to drive change so that all Massachusetts residents receive the nutritional services they need to live healthy, happy, and productive lives.

State Plan Launch Event Speakers:

Sarah Downer, Associate Director, Whole Person Care and Clinical Instructor on Law, Center for Health Law and Policy Innovation

Jean Terranova, Director of Food and Health Policy, Community Servings

Julian Cyr, State Senator for Cape Cod and the Islands District of Massachusetts

Denise Garlick, State Representative for the 13th District of Massachusetts

David Brown, Client, Community Servings

Katie Garfield, Staff Attorney, Center for Health Law and Policy Innovation

Robert Greenwald, Faculty Director, Center for Health Law and Policy Innovation; Clinical Professor of Law, Harvard Law School

David Waters, Chief Executive Officer, Community Servings

Dr. Maryanne Bombaugh, President, Massachusetts Medical Society; Gynecologist, Community Health Center of Cape Cod

Richard Sheward, Director of Innovative Partnerships, Children’s HealthWatch

Max Makowski, Client, FLAVORx

CHLPI is deeply committed to advancing the goals of the State Plan and establishing more coordinated and integrated food and health systems. To learn more, you can stream the video recording of the Massachusetts Food is Medicine State Plan Launch on our Facebook page.

New Research Highlights the Promise of Food is Medicine

Food insecurity and malnutrition are major drivers for poor health outcomes, population disparities and soaring health care spending. Roughly one out of every ten households in Massachusetts struggle with food insecurity, causing the state a staggering $1.9 billion in avoidable health care costs each year. Nutrition is increasingly recognized as a key social determinant of health because poor diet and food insecurity are connected to chronic health problems and frequent use of costly medical services.

A growing body of research shows that connecting medically complex individuals to Food is Medicine interventions, such as medically tailored meals (MTMs), is an effective and low-cost strategy to improve health outcomes, decrease expenditure of health care services, and enhance quality of life for these individuals.

Leading Food is Medicine researcher, Dr. Seth A. Berkowitz, in collaboration with Community Servings and the Massachusetts Department of Public Health, has released a new study that examined the association between participation in a medically tailored meals program and health care utilization and costs. This rigorous two-year cohort study, supported by Robert Wood Johnson’s Evidence for Action Program, is the largest study to date, with 499 MTM recipients, matched to 521 nonrecipients for a total of 1020 study participants.

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Key Findings:

  • Participation in the medically tailored meals intervention was associated with significantly fewer inpatient admissions and fewer skilled nursing facility admissions.

  • The study model estimated that, had everyone in the matched cohort received MTMs, average individual monthly health care costs would have been $3,838 vs. $4,591, a difference of $753.

  • This difference translates to a net reduction of approximately 16% in average monthly health care costs.

The findings from this study align with Community Servings’ 2018 study on dually eligible Medicaid and Medicare beneficiaries, which also found a 16 percent net reduction in health care costs for participants who received medically tailored meals. The new study builds upon this earlier research, which was restricted to Medicare-Medicaid dual eligibles, by highlighting the potential benefits of medically tailored meals for a broader segment of the population, including participants in Medicare, Medicaid, and private insurance.

The ability to address nutritional needs in the context of health care is becoming increasingly important for improving population health, particularly for the nation’s most vulnerable groups. Food is Medicine interventions play an important role in managing and even preventing many of the chronic diseases that drive health care costs across the nation. Medically tailored meal programs represent promising interventions and deserve further study as we seek improve both health and the value of health care in the U.S.

CHLPI will continue to monitor developments on Food is Medicine research. Please check back with us regularly for news and updates!

Boston City Council Passes Good Food Purchasing Program

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Last month, the Boston City Council unanimously voted to adopt the Good Food Purchasing Program (GFPP). GFPP requires the city to meet certain requirements for nutrition, sustainability, animal welfare, and labor, when making food purchases. This policy applies to purchases made by all city agencies, and will have the greatest impact on the Boston Public Schools, which spends approximately $18 million per year on food. GFPP helps ensure that this money is used to purchase healthy food and to support sustainable and responsible producers.

GFPP was developed by the Center for Good Food Purchasing, which helps manage the adoption and implementation of GFPP by cities and institutions. According to the Center, seven GFPP policies have been passed to date at the local or institutional level.

Boston’s ordinance goes beyond the other cities, and includes particularly strong language around racial equity. The ordinance seeks to support vendors that invest in disadvantaged communities — for example, vendors that hire disadvantaged community members, are women- or minority-owned, and pay all workers living wages — by awarding these vendors bonus points in the review process for purchasing contracts.

Boston’s policy also includes robust provisions to increase transparency in the food purchasing process. FLPC worked with a coalition of local advocates to strengthen the language in order to increase opportunities for the public to have their voices heard during the procurement process. We were thrilled to see the Boston City Council adopt language to establish public hearings on purchasing recommendations and require the public release of certain materials related to purchasing, such as vendor proposals and the agency’s evaluations and recommendations of these proposals. The Boston ordinance also creates a Community Advisory Council that will assist with the implementation process.

FLPC looks forward to continuing to work with local stakeholders and with the City of Boston towards implementation of the GFPP, and applauds Boston City Council for this exciting new legislation!

For more information about Boston’s adoption of the GFPP, see the press release.