Thanks to a push by several nonprofit organizations and the natural evolution of Medicare coverage, the time could be ripe for the federal government to make home-delivered meals a part of the nation’s healthcare continuum. But experts note that coverage limitations would need to be lifted first.
Earlier this week, the Food is Medicine Coalition, a group of nonprofits focused on the intersection of nutrition and healthcare, sent a letter to U.S. Department of Health and Human Services Secretary Xavier Becerra, calling for broad reimbursement of so-called medically tailored meals (MTMs) under Medicare and Medicaid.
MTMs are designed for patients suffering from heart disease, kidney disease, diabetes, HIV and a variety of other chronic illnesses. Many of those patients are too sick to shop or cook for themselves.
In the letter to Becerra, FIMC said MTMs are not only better nutritionally for chronically ill patients, they also lower the overall cost of healthcare to that population.
“There’s a 70% reduction in the use of emergency departments, a 52% reduction in hospital admissions, a 72% reduction in skilled nursing admissions and a 16% decrease in the net cost of healthcare. With those numbers, (MTMs) more than pay for themselves,” Karen Pearl, CEO of God’s Love We Deliver and an FIMC member, told McKnight’s Home Care Daily.
Recently expanded CMS meal benefits fall short
For several years, Medicaid and Medicare have covered home-delivered meals for some beneficiaries, but the meals are typically limited in duration and only to patients recently released from a hospital or skilled nursing facility.
In 2018, the Centers for Medicare and Medicaid Services (CMS) expanded what it considers primary health-related services that prevent and treat illness and injury. Under Special Supplemental Benefits to the Chronically Ill (SSBCI), Medicare Advantage (MA) plans are now allowed to cover meals for beneficiaries beyond the previous limits set by CMS.
While about 40% of Medicare beneficiaries are covered by Medicare Advantage plans, a little more than half of the 6,200 MA plans are currently providing expanded meal coverage. Each plan has different parameters covering MTMs and some providers find the myriad of rules onerous to navigate.
Ottawa, IL-based Seattle Sutton, which makes and sells fresh MTMs, has been trying unsuccessfully for the past year to negotiate with MA plans covering clients in the Midwest.
“There are just so many hurdles that we’ve experienced in trying to get these meals reimbursed. It’s always an uphill battle,” Seattle Sutton owner Rene Ficek told McKnght’s Home Care Daily.
ATI Advisory’s Tyler Cromer told McKnight’s Home Care Daily that CMS should investigate how expanding meals to the chronically ill further would impact medical spending and hospitalizations.
“Building that evidence base makes a ton of sense because we may find that this is an investment that is worth it because it doesn’t actually cost us anything. It might save us from avoidable bad outcomes,” Cromer said.