Nutrition insecurity is the most common social need among Medicaid members. To address this issue and mitigate the negative health impacts, the Centers for Medicare & Medicaid Services (CMS) released state guidance in Fall 2023 outlining allowable nutrition supports under Medicaid and the Children’s Health Insurance Program authorities. Also known as Food is Medicine (FIM) programs, these supports provide eligible individuals access to healthy food resources aimed at preventing, managing, or treating specific clinical conditions in coordination with the health care sector.
Early implementation data shows Medicaid nutrition supports have been well received by providers and enrollees. However, adoption of these benefits is still nascent, and policymakers are grappling with policy design and implementation challenges, and identifying how to encourage service uptake within CMS policy guidelines under different Medicaid authorities. This session explored how states can better tailor nutrition service design and implementation to maximize positive impacts on enrollee health. It featured a panel discussion with Medicaid agency staff from Massachusetts and Michigan, who are pursuing nutrition supports under different Medicaid authorities.
This webinar is part of the Medicaid Health-Related Social Needs Implementation Learning Series, led by the Center for Health Care Strategies (CHCS) in partnership with HealthBegins and SIREN and made possible by the Kaiser Permanente National Community Benefit Fund at The East Bay Community Foundation.
Following are related resources that were shared with participants during the event:
- State Medicaid Program Requirements for Community Reinvestment: Will They Improve Health? – Join this webinar, January 14, 3 – 4 pm ET, to learn about new Medicaid community reinvestment opportunities that will enable states to require or incentivize contractors to reinvest in served communities, including through improving healthy food access. (SIREN at the University of San Fransisco, California, and the Center for Health Law & Policy Innovation at Harvard Law School)
- Food for Thought: Medicaid Nutrition Benefit Design Approaches for Equitable Implementation – This brief offers three approaches for Medicaid policymakers to implement or evolve their nutrition strategy, including by refining CMS-defined interventions to better meet member needs, centering member experience, and defining and standardizing eligibility to maximize impact. (CHCS and HealthBegins)
- Health-Related Social Needs (HRSN) Provider Resources – This resource library offers tools for providers seeking to launch HRSN interventions, including templates for contracting with health plans, a budgeting tool, and a claims job aid, among other resources. While geared toward Massachusetts, providers, plans, and government officials in other states may find these resources useful. (Health Resources in Action)
- Information for MassHealth ACOs and HRSN Providers – Beginning in 2025, Massachusetts Medicaid members enrolled with an accountable care organization (ACO) may be able to get help with food and housing needs. This web page provides details on the criteria for these services, including member eligibility, provider qualifications, and examples. It also offers a contact list for Massachusetts-based ACOs and providers interested in launching HRSN interventions and a sample HRSN member screening form. (MassHealth, Commonwealth of Massachusetts)
- Michigan In Lieu of Services (ILOS) Initiative – Beginning in January 2025, Medicaid health plans participating in Michigan’s Comprehensive Health Care Program can offer services that address members’ nutrition needs. This web page provides details about the state’s initiative for participating plans and providers, including guidance on partnership agreements and service pricing, FAQs, and more. (Department of Health & Human Services, State of Michigan)
- Common Measures for American Health Association (AHA) Health Care By Food Funded Studies – This tool shares a set of measures used in studies funded through AHA’s Health Care By Food initiative that can support states, plans, providers, and researchers in defining data to collect when designing HRSN interventions to support program evaluation. (Health Care By Food, AHA)
Agenda
I. Welcome and Introduction
Speaker: Tricia McGinnis, MPP, MPH, Executive Vice President and Chief Program Officer, CHCS, Amanda Bank, MPH, Program Officer, CHCS, and Pam Schwartz, MPH, Executive Director of Community Health, Kaiser Permanente
T. McGinnis and P. Schwartz provided opening remarks. A. Bank reviewed the current Medicaid policy landscape to address food/nutrition insecurity.
II. Existing Evidence Around Food is Medicine and the Rapid Cycle of Innovation
Speaker: Kevin Volpp, MD, PhD, Director, Penn Center for Health Incentives and Behavioral Economics, Mark V. Pauly President’s Distinguished Professor, Perelman School of Medicine and the Wharton School, University of Pennsylvania, and Scientific Lead, American Heart Association Health Care by Food Initiative
K. Volpp gave an overview of the emerging evidence base around FIM programs and discussed how states implementing Medicaid nutrition supports can learn as they go. K. Volpp highlighted evaluation design options to maximize the impact of FIM programs.
III. State Panel: Implementing Food is Medicine Programs in Massachusetts and Michigan
Speakers: Stephanie Buckler, Esq., Deputy Director of Social Services Integration at Massachusetts Executive Office of Health and Human Services; Brad Barron, MPA, Director, Managed Care Plan Division, Michigan Department of Health and Human Services (MDHHS); Katherine Commey, MPH, Manager, Strategic Engagement and Planning, MDHHS
S. Buckler provided an overview of Massachusetts’ nutrition support program, approved under 1115 waiver authority. B. Barron and K. Commey described Michigan’s nutrition support program, pending approval, under managed care in lieu of services.
A. Bank moderated a Q&A discussion to explore Medicaid nutrition support implementation challenges and considerations in each specific state context, maximizing innovation within CMS policy guidelines under each Medicaid authority.
IV. Closing
Speaker: A. Bank
