Building Food as Medicine Into the Health System

The idea of food as medicine has captured the attention of policymakers, healthcare providers, and food companies alike. Pilot programs across the United States are testing how targeted nutrition interventions can help manage chronic conditions, improve outcomes, and reduce healthcare costs. But moving from small-scale demonstrations to nationwide adoption remains a major challenge.

In the IFT FIRST Hot Topics Studio session “Scaling Food as Medicine: From Pilot to Population Health,” Dana Thomas, managing director of Food is Medicine at The Rockefeller Foundation, joined Anna Rosales, vice president of science and policy at IFT, to discuss what it will take to make food as medicine a routine part of healthcare.

Defining Food as Medicine

Thomas framed the concept as “the provision of nutrition interventions, namely medically tailored meals, produce prescriptions, [and] medically tailored groceries to individuals who have a diet-related illness or a chronic disease related to diet, and most importantly paid for by the healthcare delivery system.”

She noted that while evidence is still emerging, “there is a significant amount of research currently that demonstrates that if you provide individuals with healthier food … you can reduce their utilization, improve their health outcomes. It is a cost-effective solution.”

Why Insurers Matter

Thomas emphasized that reimbursement is central: “Insurers are how people get their health services paid for. And so because we think this is the intervention that should be paid for in the healthcare delivery system, insurers are the solution for that.”

Rosales underlined how transformative this could be. “This is uniquely different, the concept that we could potentially have medically tailored groceries, meals, foods paid for by insurers, and that’s one of the really novel things that we’re seeing and looking at as a potential innovation for the future,” she said.

Infrastructure Needs

Scaling food as medicine requires more than payer buy-in. “One of our strategic pillars … is investing in the infrastructure pillar of food as medicine,” Thomas said. “How can we help local producers, local, regional, small-scale farmers, [and] community-based providers … scale up to meet the demands of the healthcare system?”

She pointed out that many community organizations “don’t have the technology to partner with an insurer. We don’t know how to bill and code. We don’t know how to negotiate contracts. So those are solvable solutions that we just need to invest in.”

Evidence in Progress

Thomas highlighted The Rockefeller Foundation’s partnership with the American Heart Association. “It’s called the Healthcare by Food Initiative,” she said. “There is evidence that supports the provision of healthy and nutritious food to people to reduce chronic disease and reduce healthcare costs. But there still needs to be work around more specificity, dose, duration, [and] which interventions for which populations.”

Policy Pathways

While careful not to make policy recommendations, Thomas noted that Medicaid is a natural entry point. “There are 70 million people who are in Medicaid … and currently there are 14 states that are covering some type of [food as medicine] intervention,” she said. She also pointed to pilots with the Veterans Health Administration that will test how nutrition programs affect outcomes for veterans.

A Call to Action

Rosales encouraged food professionals to make food as medicine part of their innovation pipelines. “Showcase [food as medicine]. If it’s not in your innovation pipelines, start putting it there,” she said.

Thomas urged stakeholders to step up as well: “Get in the game. … If you are the solution, be the solution.”

Looking Ahead

Audience questions touched on how GLP-1 medications fit into the food as medicine paradigm. Rosales emphasized complementarity: “GLP-1s are not mutually exclusive to food as medicine … it’s almost giving an even more important opportunity to have a medically tailored intervention to complement their pharmacological intervention.”

Thomas added that structural barriers to healthy food access remain and must be addressed alongside new medical therapies. “It is not always the case that the grocery store down the street from you has healthy and nutritious food at a reasonable price point that allows you to feed your family,” she said.

Despite hurdles, Thomas pointed to the growing momentum: “If we are going to meet [the] demand, there needs to be dollars for that. And philanthropy can’t do it alone.”ft