On a weekday morning in a quiet Boston neighborhood, a kitchen bustled with activity. Volunteers sliced chicken breasts, stuffed bell peppers, filled trays, and carefully labeled each item. It was part of an experiment to offer nutritious and medically tailored meals to Medicaid patients who are unable to shop for groceries and cook for themselves.<\/p>\n
\u201cOnce I started to eat these meals that were geared toward my illness, I built up my muscle mass again, built up my strength, built up my confidence in myself,\u201d said Vanessa Georges, who is in remission from throat cancer and said she would struggle to consume enough calories without the deliveries. \u201cThese meals have given me a second chance.\u201d<\/p>\n
Georges said she noticed another benefit from the meals: She spends less time at the doctor\u2019s office.<\/p>\n
Researchers have found evidence backing her observation. About 1,900 Massachusetts residents who, like Georges, received medically tailored meals for at least three months needed less medical care, according to a study<\/a> published in the journal Nature Medicine. They had 20% fewer emergency department visits and 31% fewer hospitalizations than similar patients who did not receive meals.<\/p>\n \u201cIt actually saves the healthcare system money,\u201d said Dariush Mozaffarian<\/a>, a cardiologist and professor at Tufts University who led the study. \u201cThat\u2019s a really big deal, because most things in healthcare don\u2019t.\u201d<\/p>\n The research from Massachusetts adds to evidence<\/a> that medically tailored meals could save states money \u2014 in addition to improving health. Yet such programs could land on the chopping block as states look to tighten spending under Trump administration budget cuts, even as federal officials argue that food is a critical component of health.<\/p>\n Medicaid Budget Cuts Loom<\/strong><\/p>\n The 2025 law known as the One Big Beautiful Bill Act slashed projected Medicaid funding by more than $900 billion. Many Republicans who backed the bill believe federal health spending is too high and riddled with fraud. Sen. John Kennedy, a Louisiana Republican, for example, has accused California of \u201coutrageous fraud\u201d<\/a> for using Medicaid dollars to fund housing and nutrition programs.<\/p>\n Amaya Diana<\/a>, a policy analyst at KFF, said states will have to make tough choices in the next few years as they figure out how to fill funding gaps. \u201cIf states are not able to offset the loss of federal funds with new taxes or reductions in other state spending, they may have to make program cuts,\u201d she said. (KFF is a health information nonprofit that includes KFF Health News.)<\/p>\n Thirteen states have received federal waivers to use Medicaid dollars to pay for meals \u2014 part of an approach known as \u201cfood is medicine.\u201d Three other programs are awaiting federal approval.<\/p>\n President Donald Trump\u2019s support for social services has wavered. While the first Trump administration allowed states<\/a> to pursue medically tailored meals and other social supports, the second Trump administration rescinded Biden-era guidance<\/a> for Medicaid initiatives that address social needs. It hasn\u2019t detailed a new policy. Administration officials have warned that they will be more focused on the budget impacts<\/a> of such initiatives.<\/p>\n \u201cThey signaled they\u2019re going to be a lot more skeptical,\u201d said Kurt Hager<\/a>, an assistant professor at the University of Massachusetts Chan Medical School who studies nutrition programs and helped lead the Massachusetts study. \u201cInstead of using a broad-based approach nationwide, they\u2019re going to make decisions on a state-by-state basis.\u201d<\/p>\n At the same time, health leaders in Trump\u2019s administration have made nutrition a major focus, including by promoting less-processed foods<\/a>. Robert F. Kennedy Jr., who leads the Department of Health and Human Services, and Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, have pushed hospitals<\/a> to serve healthier foods to boost patient outcomes.<\/p>\n Trays of stuffed peppers and carrots from Community Servings are ready to be sealed and delivered to Boston-area residents who receive medically tailored meals. (Robin Lubbock\/WBUR)<\/p>\n The healthcare system is often willing to pay for surgeries, Oz said in a social media video in June, \u201cbut not always willing to pay for the nutrition that might help prevent those outcomes in the first place. That\u2019s bothered me my whole career.\u201d He added that the agency is evaluating several strategies<\/a>, including medically tailored meals, to prevent illness and hospitalization. CMS officials did not respond to several emailed requests for comment for this article.<\/p>\n Katie Garfield<\/a>, who studies social determinants of health at Harvard Law School\u2019s Center for Health Law and Policy Innovation, said the lack of federal guidance is stirring uncertainty for states that want to pursue nutrition programs in Medicaid. \u201cWe\u2019re still waiting to see that big step forward around \u2018food is medicine\u2019 interventions,\u201d she said. \u201cWe need to see that step forward to resolve some of the uncertainty.\u201d<\/p>\n Lawmakers have had a hard time engaging administration officials on medically tailored meals, said U.S. Rep. Jim McGovern, a Massachusetts Democrat who sponsored a bill that would pilot meal deliveries for some chronically ill seniors on Medicare<\/a>. The legislation has yet to come up for a vote.<\/p>\n \u201cI had thought, based on some of his rhetoric before he entered the Trump administration, that RFK Jr. would be a natural ally on this,\u201d McGovern said. \u201cBut we can\u2019t seem to get his attention.\u201d<\/p>\n The Costs of Poor Nutrition<\/strong><\/p>\n Some companies have been accused of billing Medicaid<\/a> for meals that were neither healthy nor nutritious, raising concerns about lax regulation of these programs.<\/p>\n But at Community Servings<\/a> in Boston, the food is prepared with specific attention to sugar, salt, fat, vitamins, and minerals and is based on a person\u2019s health needs, said David Waters<\/a>, chief executive of the nonprofit. Many recipients require food that is mild or low in fiber, for example.<\/p>\n \u201cWhat we\u2019re able to do is to work with your healthcare provider to understand your health realities \u2014 what your diagnoses are, what your medications are, side effects, food allergies, cultural norms \u2014 and then prescribe a diet for you that is scratch-made,\u201d Waters said.<\/p>\n The Massachusetts researchers found that the meals \u2014 at a cost of $125 per person per week \u2014 essentially paid for themselves. Patients with heart disease used about $10,000 less in healthcare services over six months, and patients with kidney disease used $12,000 less in healthcare. There were also savings for people with diabetes, depression, and anxiety.<\/p>\n \u201cThose are pretty big numbers when you think of how expensive those diseases can be and the prevalence in the population,\u201d Waters said.<\/p>\n Nationally, researchers estimate<\/a>, 10 million Americans would benefit from medically tailored meals, though only a small fraction are enrolled.<\/p>\n \u201cPoor nutrition is the top cause of poor health in this country. It\u2019s the top cause of preventable healthcare spending,\u201d said Mozaffarian, director of the Food is Medicine Institute at Tufts. He has estimated that medically tailored meals could help patients avoid 1.6 million hospitalizations and save the U.S. $13.6 billion<\/a> in healthcare costs each year.<\/p>\n A Weekly Delivery That Makes a Difference<\/strong><\/p>\n Steve Honyotski receives 10 meals at his Boston home each week, cooked fresh and delivered cold or flash-frozen. They\u2019re ready to eat after just a couple of minutes in the microwave.<\/p>\n \u201cThe carrot ginger soup is my favorite,\u201d Honyotski said.<\/p>\n Honyotski, 71, lives with several chronic conditions, including diabetes, obesity, and high blood pressure. He said he\u2019s noticed improvements in his health since he started eating medically tailored meals. He needs less insulin to control his diabetes, and he\u2019s lost enough weight to delay a knee replacement surgery.<\/p>\n Community Servings is a nonprofit that provides medically tailored meals in the Jamaica Plain neighborhood of Boston. (Robin Lubbock\/WBUR)<\/p>\n For now, those meals will keep coming. And Massachusetts\u2019 Medicaid director, Ryan Schwarz, said the state will seek federal approval to continue medically tailored meals in the coming years. \u201cWe feel very strongly committed to continuing these services,\u201d he said.<\/p>\n In North Carolina, researchers found that food and housing supports lowered Medicaid spending over time. Yet even with federal approval for medically tailored meals, and evidence that the meals \u2014 along with housing and transportation support \u2014 were helping people, North Carolina state lawmakers suspended the services in 2025 over budget worries. After budget deliberations this summer, state legislators changed course and decided to partially fund<\/a> the program.<\/p>\n \u201cTo me, that\u2019s a signal of what might occur in other states as these Medicaid cuts hit,\u201d said Hager, the UMass researcher. \u201cEven though they have the authority to run these programs, it might be a lot harder for the states to actually implement them.\u201d<\/p>\n This article is from a partnership that includes\u00a0<\/em>WBUR<\/a><\/em>,\u00a0NPR<\/a>, and KFF Health News.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" On a weekday morning in a quiet Boston neighborhood, a kitchen bustled with activity. Volunteers sliced chicken breasts, stuffed bell peppers, filled trays, and carefully labeled each item. 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