Large hospital systems are leading the ‘food is medicine’ movement

An apple a day can’t keep the doctor away entirely—but it can lead to better health outcomes overall. In fact, hospital executives might encourage providers to prescribe apples (among other items from the produce department) as part of growing “food is medicine” programs.

The treatment modality, prescribed in concert with traditional medicines and pharmaceuticals, is gaining traction at large hospital systems across the nation. Through “food is medicine” programs, centers, and partnerships, medical professionals are prescribing medically tailored produce, groceries, and meals; providing targeted nutrition education to patients and surrounding communities; and screening patients for food insecurity to combat cardiovascular disease, high cholesterol, and blood pressure, and decrease the risk of chronic conditions. And these initiatives benefit not just patients’ health, but overburdened providers: Eating a more nutritious diet can reduce the risk of diet-related disease, bring down hospital readmissions, and lower national healthcare costs.

But how these impactful programs will be funded long-term and at hospitals that aren’t part of affluent healthcare systems is still up in the air.

Growing momentum

Even though the national conversation about the efficacy of “food is medicine” was spurred only recently by US Secretary of Health Robert F. Kennedy Jr.’s public support (and overstatement) of the method, the healthcare industry has been enthusiastic about it for years. Pamela Schwartz, the executive director of community health at Kaiser Permanente, said “food is medicine” is well suited to meet the moment and is now bolstered by more and more research.

“The nation is seeing a lot of disease and a lot of costs associated with disease. The healthcare costs are higher. And coming out of Covid, we’re seeing a lot of sicker patients,” Schwartz told Morning Brew. “So in a way, it’s the perfect storm.”

She and Kaiser Permanente as a whole have established many “food is medicine” initiatives in the last few years that have brought together industry players. The hospital system’s Food is Medicine Center of Excellence provides nutrition screening, prescribes medically tailored meals and produce, and includes a “research hub” to document the efficacy of the interventions. Kaiser Permanente’s Food is Medicine Network of Excellence, in partnership with Tufts University and a half dozen other healthcare systems, is a channel through which members can share best practices and evidence, as well as work together to inform state and national “food is medicine” policy.

“We’re trying to operationalize and scale things to find a different way, an innovative way, for treating and preventing diet-related disease and hunger,” Schwartz said, by “grabbing on to this thing that seems to have a lot of momentum right now.”

In order to gather more evidence, Kaiser Permanente is partnering with Instacart to test whether a $100 monthly stipend through the company’s Fresh Funds program affects the health of populations in California. Fresh Funds are Instacart credits that doctors and healthcare workers can program their patients to receive in the grocery app, to be used on specific foods.

“You can use your own Instacart account; you could log in with a new one…And then everything’s tagged as ‘friendly’—it’s like, ‘Oh, this is Fresh Funds eligible,’” Sarah Mastrorocco, the VP and GM of Instacart Health, told Morning Brew. “I can just buy with Fresh Funds if I wanted to, I could add my own debit card or credit card, I could have my SNAP card and check out, too.”

Planting a seed

Northwell Health is also gathering evidence on “food is medicine” initiatives as they relate to repeat hospital visits and patient satisfaction scores. The health system’s Lenox Hill hospital, located in New York City, recently revamped its entire food program to bring it in line with the hospital’s other types of care, Northwell’s chief experience officer, Sven Gierlinger, told Morning Brew.

“It really started with this notion that we provide incredible clinical care, but the patient was served subpar food, which took away from that. And that’s what we saw through [patient] surveys,” Gierlinger said.

The hospital’s tray service menu, which is available to all its patients, is almost entirely plant-based and the result of collaborations between Northwell’s dieticians and chefs.

“These talented chefs are working very closely with our dietitians—not the other way around, where the dietitians were forced to design a menu out of frozen food or freezer food because the chef could not cook it,” Bruno Tison, Northwell’s VP of food systems and its corporate executive chef, told Morning Brew. “Now we have a perfect harmony between the dietitians and the executive chef. Both know their job: One is to bring the quality as high as possible, and the other is to keep our patients safe and make sure the food is nutritious.”

And while particularly high-quality hospital food doesn’t necessarily lead to better personal nutrition after discharge, Tison said that Lenox Hill’s menu can “plant the seed” in patients’ minds when it comes to eating a more plant-based diet.

Sustainable funding

Because Northwell’s new program greatly reduces food waste by buying fresh foods and leveraging the hospital’s purchasing power, the revamp was budget-neutral, Gierlinger said. But securing adequate funding for out-of-hospital “food is medicine” programs is still a challenge.

Priscilla Wang, a primary care physician and associate medical director for primary care health equity at Mass General Brigham, told Morning Brew that the hospital system’s robust “food is medicine” initiatives actually function on “limited set of resources.” Funding includes a portion of the hospital’s operational budget, community health funds, grants, philanthropy, and a state-based Medicaid waiver that allows prescribed food to be covered by insurance.

“We’ve had to cobble together a variety of ways in which to create programming and then offer it and then decide who can get it,” Wang said. “Even though I do believe, as a primary care physician, everyone should benefit.”

This incongruent reality, Wang said, is because providers believe strongly in “food is medicine” programming, but there isn’t really “structural and deliberate” funding for it. And though a bipartisan group of House representatives introduced a bill to allow Medicare to cover medically tailored meals, it’s been stuck in committee since last year.

“[Legislation] is one area, though, if we can get behind in a bipartisan way, that would be a game-changer,” Wang said, adding that “critical data…will be necessary to really start to move this at a national level, to really get payers and funders. But that’s one thing that’s around the bend—there’s a lot more rigorous studies being funded and happening at scale.”