Providence Health Plan’s food-as-medicine program has “blazed a trail” in the space, according to Melissa Topp, MSN, RN, executive director for care management.
The program has led to 82% of participating members seeing an improvement in their food disparity score, 90% becoming more connected to or aware of community resources and 58% seeing an improvement in their nutrition. Ms. Topp sat down with Becker’s to explain how.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Food as Medicine can cover a lot of interventions. What does it look like in practice at Providence Health Plan?
Melissa Topp: Our food-as-medicine intervention came about as an effort to bring together health and food in addressing food disparity and insecurity. In care management at Providence Health Plan, we work really hard to provide an intervention as close to real time as possible for our members that we have care plans for. Looking at the data across the United States, simple food needs became a focus of ours.
Our main goals were No. 1: to provide food, when we identified that a member needed it. No. 2: to provide choice in that food. One of the barriers that we found in some of the more familiar food offers like food banks, food pantries or [Supplemental Nutrition Assistance Program], is that the choices are quite limited. We wanted to make sure we provided choices. Members can pick food based on culture, likes and dislikes, on their ability to consume food.
Finally, one of the main purposes was dignity in choice. We purposely developed three pathways: prepared meals, food boxes or gift cards for self shopping. We wanted to encompass it with care management services — education and navigation of food sources in the communities. It’s not just delivering food, not just handing someone a food voucher, but encompassing that with shopping techniques, nutrition guidelines, how to get the most out of your dollar so you can have more meals, how to feed your family, how to understand what nutrition is and where you’ll find that in the grocery store.
Q: How do you identify members experiencing food insecurity?
MT: We simplified it. We wanted to make sure that we were providing an intervention that did not have robust [eligibility] criteria. Aligning with the promise of easing our members’ way, we simply asked: “Do you have enough food? Do you need food?” After our pilot, we added an additional question: “Do you have the right foods to support your health conditions?” That is the criteria we launched with.
How do we identify that? We went down a few different routes. We straight-up asked them. We also use claims data. We also accept referrals from our community providers, our primary care network, our specialty network, and even hospital case managers or folks that come into contact with members. A member can self refer. This is not a benefit. This is a care management intervention. These are things that we’re doing in collaboration with the members based on their healthcare goals.
Q: How do you keep members engaged?
MT: No. 1, it’s really important that when you ask someone about areas of their life that could be vulnerable, that you show compassion. In our follow-up survey on member satisfaction, members commented that they had the freedom to choose. They had the freedom to use other budgeted money on bills. They had the freedom of talking with a nurse or dietician outside of a provider’s office. They had the freedom to decline. If they didn’t want a specific food type, they could say no.
Another area we really sought after was engaging our members to build trust in the healthcare system, in their care manager, in the information we deliver to help with their healthcare, their navigation and their overall health. We’re having conversations weekly and answering those questions. The first couple weeks they answer the questions. By the seventh and eighth week, they know the questions are coming, and they’re more talkative. It’s more conversational, because we’ve allowed dignity and choice, diversity of options and they could switch tiers. If they started with the prepared meals and it didn’t meet their needs, they could switch to the pantry box. They could switch to the gift card. All of that is really important.
Also, we didn’t just hone in on food. We asked, “How’s your family? How’s your other health? What other needs do you have and how can we connect you to those services?” Our intervention is meant to be a bridge to community services, to some of the other benefits that are out there. We are bridging for eight weeks to those services. So, at the end of the intervention, their engagement has put them in a place where they are more food secure.
Q: How do you see this program evolving in the coming years?
This is a really exciting program. I feel like we blazed a trail. Our goal is to deliver on our promise, to align with our mission. I see this expanding and scaling with community partners, that food becomes a staple and a foundation in healthcare, that it is part of prescriptions written by providers. That is happening today. I see that growing and expanding.
There are more partners in the ecosystem of food as medicine every day. We are working with a couple different vendors and partners today, but more and more are coming to the table. The American Heart Association, the American Diabetes Association, those folks are part of this discussion. AHIP is also part of the discussion. Those are areas where I really see growing momentum, and we are learning that a food intervention can be just as effective as pharmaceutical intervention.
