Medically-tailored meal delivery tied to lower health spending

(Reuters Health) – Low-income people with chronic diseases who get free meals delivered that are tailored to their medical needs are less likely to be admitted to hospitals or nursing homes, a study in Massachusetts suggests.

Researchers followed 499 patients who had at least one year of weekly deliveries of 10 ready-to-eat meals customized to their specific health conditions. The study team also followed 521 individuals who had similar medical issues and other characteristics but didn’t receive the meals.

Overall, there were 1,242 inpatient hospital admissions and 1,213 skilled-nursing facility admissions during the study period.

The analysis found that if all the patients had received meal delivery, there would have been about half as many inpatient admissions and an even bigger reduction in skilled-nursing facility admissions.

Even after accounting for the cost of meals, researchers also calculated that average monthly health costs would have been about $753 lower per patient if everyone in the study received the meal deliveries.

“These results mean that if you have a serious medical illness that requires following a specific diet, and you would have trouble affording or otherwise following that diet, it would be worth looking into whether a medically-tailored meal program might be available to you, either through your health insurer or from a philanthropic organization in your area,” said lead study author Dr. Seth Berkowitz of the University of North Carolina at Chapel Hill.

Typically, medically-tailored meal plans are designed by a nutritionist for people with chronic health problems like cancer, AIDS or diabetes and may be covered by insurance for some low-income individuals who can’t afford their groceries, Berkowitz said by email.

Including the cost of meals and medical care, average annual health costs would have been $3,838 per person if everyone in the study received the free meal deliveries and $5,591 per person if nobody got these meals, researchers calculated.

The study wasn’t a controlled experiment designed to prove whether or how medically tailored meal delivery services might directly improve patients’ health.

But there are several ways meal delivery might help, Berkowitz said.

For one thing, people might follow dietary requirements like limiting salt, fat or sugar with meal delivery but not with foods they got on their own, Berkowitz said. This might lead to fewer disease flare-ups and help reduce the risk of hospital or skilled-nursing facility admissions.

Meal delivery may also free-up funds people would otherwise spend on food and allow them to instead devote more of their limited resources to other necessities like medicine or rent or heat, Berkowitz said.

For people who don’t have money or time to shop and cook, deliveries might also help to reduce stress and enable people to focus on other aspects of their health and self-care, Berkowitz added.

“Many patients are too ill to grocery shop or cook and may not have the means to hire someone to help,” said Samantha Heller, a nutritionist at New York University Langone Medical Center in New York City who wasn’t involved in the study.

“In other instances, patients may not have the knowledge or skills to make appropriate choices to help them manage their health and budget,” Heller said by email.

While the ease of having meals delivered that are customized to patients’ health needs can make it easier for them to eat the way doctors want them to, costs can be steep if it isn’t covered by insurance, Heller said.

Even without delivery, patients may still be able to get help planning meals from a registered dietician or another healthcare provider, Heller said. Too often, however, patients are not aware of these services and don’t seek help.

“Patients, families and caregivers should check with their local hospitals, social workers, health insurance company, registered dietitians and health care providers for resources available in the community to help them manage their meals, budgets and health,” Heller advised.

SOURCE: bit.ly/2IER8yM and bit.ly/2PrO1dU JAMA Internal Medicine, online April 22, 2019.

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