Health insurance plans cover a variety of medical procedures, prescriptions and provider visits. A recent change in how some plans interpret health-related insurance benefits may see more plans offering food-based benefits, including meals and healthy groceries.
Hippocrates, of the eponymous Oath, famously wrote “Let food be thy medicine.” A little over a decade ago, the editor of the British Medical Journal lamented, “Although many patients are convinced of the importance of food in both causing and relieving their problems, many doctors’ knowledge of nutrition is rudimentary.” Fortunately, food as prevention-based medicine is gaining traction across the country, with some seeing the paradigm already shifting.
The federal government recently gave the go-ahead for Medicare Advantage plans to broaden the scope of supplemental, “health-related benefits” for individuals. The Centers for Medicare & Medicaid Services (CMS) has signaled that they will consider approving insurance plans with additional benefits that “compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”
The scope of these new “health-related benefits” is considerably broad. Insurers are readying their 2019 plans to incorporate this new definition, and it remains to be seen what these benefits will include. Kaiser Health Newsreports that insurers might include “air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals.”
The new supplemental benefits might induce more beneficiaries to switch from traditional Medicare to Medicare Advantage, despite CMS’ caution to the contrary. Unlike the traditional government Medicare program, Medicare Advantage program is run via private insurers offering CMS-approved plans. Given the inclusion of the word “Medicare” in Medicare Advantage, the similarities in name between the two programs may be confusing to some beneficiaries.
Time will tell how successful these additional “health-related benefits” will be at improving health outcomes or driving down the costs of healthcare. As Kaiser Health News noted, some consumer advocates warn that the extra benefits in Medicare Advantage could come at the detriment of individuals on traditional Medicare. The decision to enroll in Medicare or Medicare Advantage can have ramifications for the beneficiary, including coverage limitations regarding providers and hospitals. Additional money for groceries should not come at the expense of a plan that more appropriately meets an individual’s healthcare coverage needs. Even so, two aspects of the “health-related benefits” program are particularly exciting.
First, the new plans could lead to new data available for health quality researchers, which would increase the body of knowledge regarding evidence-based interventions around food and health. Given that the parameters of the “health-related” food benefits are undetermined, they might be specifically tailored to meet the needs of particular health conditions, like heart disease or diabetes. The variety of potential interventions could provide ample room for researchers to determine what interventions have the greatest impact for individuals and the healthcare system overall.
Data regarding costs and health outcomes gleaned from the new plans might be in line with a recent Health Affairsstudy, in which participants in a food program experienced a statistically significant decrease in overall medical spending. Those in a medically-tailored meal program not only had a 16% decrease in overall medical spending but also reduced emergency department visits, inpatient hospital admissions, and emergency transports.
Second, many Medicare Advantage insurers also operate individual and group plans. If these extra benefits in Medicare Advantage are successful in reducing costs and advancing beneficiaries’ health, more plans could offer similar benefits. In doing so, insurers could be incentivized to increase their use of food as a preventative tool to improve health or food as medicine, providing individuals with medically-tailored meals to meet the nutritional needs of particular disease processes.
While the details of the new Medicare Advantage plans are still undetermined, one hopes they build on the existing evidence regarding successful interventions. Food-based interventions in the healthcare system are only set to grow to stem rising healthcare costs and improve individual and community health. The new plans could be a step in the right direction for insurers, and the basis for future pilots or studies to build evidence for further food-related health interventions to lower costs and improve health outcomes.[“Source-forbes”]