Case Specific Nutrition wants to bring the primary care model to nutrition

On Fridays, we schedule our rounds with Healthcare Brew readers. Want to be featured in an upcoming edition? Click here to introduce yourself.

This week’s Making Rounds spotlights Robert Marty, COO of Pennsylvania-based Case Specific Nutrition, which provides wellness services and medical nutrition therapy. Marty shared how misconceptions about dietitians and corresponding insurance coverage has made nutrition therapy an underutilized service in the healthcare industry.

This interview has been lightly edited for length and clarity.

Tell me more about Case Specific Nutrition’s practice model and your role there.

The reason that our private practice model is something that we’re so proud of—and we are looking to expand—is because healthcare is about trust: You have to hear, see, and understand the person in front of you. That’s where the biomedical model, with the 15-minute primary care physician visit where you’re told to consume less salt or do the Type 2 diabetes diet, is not solving the underlying issue. It is behavioral change, it is motivational interviewing, but then it’s that clinical background that makes sure that everything we’re recommending is based on science.

I do everything that isn’t providing the service: that’s our credentialing with insurance, maintaining licensure, making sure that we’ve got general liability for all our practitioners. It’s going out and talking to employers about their medical benefits, and how meeting with a dietitian or participating in the CDC diabetes prevention program might be covered through their insurance already. The marketing, the onboarding, all that stuff.

What’s the biggest misconception about the work Case Specific does?

That registered dietitians are only for people with Type 2 diabetes or professional athletes. Or that a registered dietitian is going to give someone a meal plan and say, “If you can’t do this, I can’t help you.” That is a very outdated perception.

Your private practice dietitian is going to build trust with you first. They don’t employ a specific dietary belief, such as Keto. They’re trained to meet you where you’re at, and that relationship is going to last several months. It’s based on getting to know your life, your eating habits, your learned behaviors. Over time, that’s where you’ll see change.

A lot of people don’t know what a registered dietitian does, and they don’t know that many insurance carriers view medical nutrition therapy as preventative, so there might not even be a cost.

What healthcare trend are you least optimistic about, and why?

Medicare and Medicaid, in regards to medical nutrition therapy. There have been discussions for years about expanding Medicare coverage for registered dietitian visits. Right now, Medicare Part B only covers it for patients with Type 2 diabetes or renal failure with a physician referral. Medicaid has better coverage, but it covers less than commercial payers.

Dietitians offer a cost-effective clinical service, and theoretically, if you implemented them more formally into the Medicare and Medicaid model, then our poor primary care physicians—who are overwhelmed, scheduling six months out, and giving 15-minute appointments and not feeling great about that—would have somebody in front of them who is better equipped to talk about their acute needs.

Tell us one new or old health tech product or platform that’s made your life easier.

Our electronic health record, Healthie. The company is constantly looking at its integration software, its client-focused app that people can download and track their activity. Users can sync their fitness device, take pictures of their food—all that stuff. The company makes private practice more feasible because it provides what is fundamentally needed, but it also looks at what it can add to make sure that practices can evolve as trends change.