Medically tailored meals may cut health costs

Davita Butler delivers meals in West Philadelphia for MANNA in 2009. (April Saul / Staff Photographer)
Davita Butler delivers meals in West Philadelphia for MANNA in 2009. (April Saul / Staff Photographer) (INQ SAUL)
Posted: August 12, 2013

Home-delivering meals that are medically tailored for seriously ill patients' diagnoses and conditions improves health outcomes and cuts health-care costs, researchers report.

It seems like a no-brainer. But the pilot study is thought to be the first to measure actual health-care costs.

The program it examined, Philadelphia's MANNA, is one of the few in the country to offer free delivery of 21 meals a week that are nutritionally customized for patients.

Health insurance generally does not reimburse for such services. One of MANNA's goals in commissioning the study was to present evidence that it should.

The study found an average 28 percent decrease in monthly health-care costs for MANNA clients over their first six months of meals vs. the previous six months. The researchers also compared those clients' billed costs for 12 months after they started getting meals with the costs of a control group, matched for diagnosis and condition, and found a 31 percent saving. Hospital stays were shorter,

and more MANNA clients were discharged directly to home.

"I think the key is that it's not just about food, it's about getting someone better and involved in their care," said Blair Weikert, an infectious-disease doctor whose clinic at the Hospital of the University of Pennsylvania refers a few people a week to the program. "They are much more likely to be able to come for health-care visits, to take the treatments and the medications."

MANNA (Metropolitan Area Neighborhood Nutrition Alliance), which funds the deliveries mostly through charity, began as an AIDS group. In 2006, it expanded to include anyone with a life- threatening condition who is at measurable nutritional risk.

The frozen meals delivered to 850 clients around the region are customized for 11 diets or conditions, with almost limitless combinations, said Cyndi Dinger, MANNA's director of programs.

Potassium and phosphorus must be restricted for people with kidney disease, for example; they get rice and pasta instead of potatoes.

Chemotherapy messes with taste buds. So cancer patients, now the biggest client group, talk with nutrition staff, who may adjust spices or sourness.

The new study, in the peer-reviewed Journal of Primary Care and Community Health, compared health costs for 65 MANNA clients and 633 controls. All were covered by the unnamed Medicaid HMO that provided the data.

The small MANNA group and lack of information on the controls - nutritional support, extent of regular care - limit the findings.

It is "circumstantial evidence," said Mark Pauly, a Wharton health economist who was not involved with the study.

Though insurers don't reimburse for meals, he said, there is a trend toward paying providers a flat fee to care for their patients. They could contract for medically tailored meals.

Dinger, who was listed as a study coauthor but was not involved with the analysis, hopes the findings will bring funding for a broader study. "We really do fit with where they want to go in health care," she said.


Contact Don Sapatkin

at 215-854-2617 or dsapatkin@phillynews.com.

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