Medically Tailored Meal (MTM) Interventions:

Impact of Medically Tailored Meals on Obesity, Other Health Outcomes, and Healthcare Utilization under Medicaid Flexible Services

Medically tailored meal (MTM) interventions are of rapidly growing interest to healthcare systems, payers, patients, and policy makers. MTMs are fully prepared, nutritionally customized, and generally home-delivered healthy meals for individuals living with advanced and costly diet-sensitive conditions, such as diabetes, heart failure, end stage renal disease, HIV, and cancer.

Several preliminary studies have suggested that MTM programs can reduce healthcare utilization (e.g., doctor and ER visits) and healthcare costs for high-risk patients. However, impacts of MTMs on obesity, glucose control, and related health outcomes have not been thoroughly evaluated, particularly in relation to other intervention types. This collaborative initiative will assess the impacts of MTMs on obesity, diabetes control, blood pressure, healthcare utilization, and healthcare costs under an ongoing Commonwealth of Massachusetts’ Medicaid pilot involving multiple hospitals in the state.

Aim One

To estimate health impacts, costs, cost-effectiveness, and effects on disparities of specific health system strategies to improve diet and reduce cardiometabolic disease (CMD). Evaluated strategies will include:

1. 1. MTMs,
   2. Healthy food prescriptions,
   3. Food insecurity screening and referral, and
   4. Integration of nutrition into medical training strategies

Aim Two

To estimate health impacts, costs, cost-effectiveness, and effects on disparities of specific state-level policies to improve diet and reduce CMD. Evaluated state-specific strategies will include:

1. 1. Sugar-sweetened beverage (SSB) or junk food taxes,
   2. SNAP incentive and disincentive programs for healthier food choices,
   3. State Medicaid-based actions including MTMs, food insecurity screening, and healthy food prescriptions, and
   4. Product warning labels on SSBs or junk foods and related media campaigns.

Aim Three

To assess administrative and legal feasibility of the main interventions in Aims 1 and 2 strategies to improve diet and reduce CMD.

Aim Four

To disseminate top findings from the prior period, related grants, and this new work to relevant stakeholders in key legislative, agency, and advocacy positions.