HJBR May/Jun 2025

HEALTHCARE JOURNAL OF BATON ROUGE  I  MAY / JUN 2025 45 Dana Lawson, DNP, MHA, MSN, APRN, CCM Senior Vice President of Population Health Clinical Operations and Health Equity Louisiana Healthcare Connections ANCIENT wisdom recognized the power of nutrition as foundational to achieving overall health and in staving off the dev- astating effects of disease. Today, this ad- age underpins the shift toward preventive, patient-centered care that includes food access and nutrition as goals rather than afterthoughts. In recent years, the phrase “food is med- icine” (FIM) has moved from a visionary concept to an evidence-backed strategy reshaping healthcare delivery, particularly for vulnerable populations. Among them, Medicaid recipients — who often face eco- nomic hardship, chronic illness, and food insecurity — stand to benefit the most. Inte- grating medically tailored meals, “produce prescriptions,” and nutrition support into Medicaid programs is more than a trend, it is an essential pivot toward preventive, whole-person care. Understanding the Challenge Medicaid serves more than 71 million Americans, including over 1.3 million in Louisiana, many of whom grapple with multiple social determinants of health (SDOH) challenges that directly affect their well-being. 1 One of the most pressing is food insecurity. According to the USDA, food inse- curity affected approximately 13.5% of U.S. households in 2023 (up from 12.8% in 2022), with rates significantly higher among Medicaid enrollees. 2 The inability to access sufficient, nutritious food has long been linked to increased risk for obe- sity, type 2 diabetes, hypertension, heart disease, and poor mental health. In Louisiana, more than 700,000 people face hunger, and of these, over 260,000 are children, with estimates indicating these residents need over $553 million more per year just to meet their food needs. 3 When compounded by illness, this creates the perfect storm: poor nutrition worsens health outcomes, increases hospitaliza- tions, and drives up healthcare spending. Overall, Medicaid enrollees dispropor- tionately bear the burden of these chronic illnesses, and the costs to healthcare sys- tems are staggering. In response, states, providers, and policymakers are asking, “What if we shifted our focus from treating the symptoms of diet-related disease to addressing its root cause: malnutrition and poor access to healthy foods?” An Evidence-Based Model FIM encompasses a range of interven- tions designed to improve health through food-based strategies that have been re- searched and supported by a growing body of irrefutable evidence. The three most common approaches are: • Medically tailored meals (MTMs): fully prepared meals tailored by di- etitians to meet the specific medical needs of individuals with complex ill- nesses. One study showed significant benefits for malnutrition risk, blood pressure, A1c, perceptions of physical health, and BMI after receiving MTM meals for just two months in a com- munity setting. 4 • Medically tailored groceries (MTGs): nutrient-dense groceries designed for specific health conditions, often paired with education and counsel- ing. • Produce prescription programs (PPRs): vouchers or subsidies for fruits and vegetables, often delivered alongside nutrition education and support. These interventions, backed by key research findings, recognize food as a powerful determinant of health, one that should be managed with the same inten- tionality as medication or clinical care. 4,5 Food-Based Innovation: What’s Happening Now? In recent years, several states (includ- ing Louisiana) have incorporated SDOH screenings for food insecurity, transpor- tation and housing needs, and other fac- tors into their overall health assessment process for Medicaid beneficiaries. Health plans use this information as part of a risk stratification tool for help with outreach to connect recipients to resources such as SNAP, WIC, and FIM or similar programs. In addition, stateMedicaid programs are experimenting with food-based interven- tions through Medicaid section 1115 waiv- ers and managed care organization (MCO) flexibility in offering nutritional supports, such as obesity counseling. In Louisiana, many of the Medicaid health plans offer these services as a value-added or similar benefit, which is usually accessed through the health plan’s clinical program such as care management. Other examples of FIM programs around the country include: • To encourage health eating, Florida provides nutrition program incentives through Fresh Access Bucks that facilitate the purchase of fresh, local produce from statewide