Centene executives are hoping to unlock healthy food as a Medicare Advantage benefit more broadly.
In a May 11 Health Affairs article, Centene leaders and a University of California, San Francisco, professor made the case for CMS to expand access for nutritious food benefits in MA, as well as to publish supplemental benefit data.
Currently, healthy food is offered under Special Supplemental Benefits for the Chronically Ill, which require a beneficiary to have a chronic condition, be at high risk of hospitalization and in need of intensive care coordination. Centene leaders are advocating for nutritious food to be designated a “primarily health-related supplemental benefit,” the same category fitness already occupies. CMS defines those as benefits that diagnose, compensate for physical impairments, ameliorate the functional or psychological impact of injuries or health conditions, or reduce avoidable emergency and healthcare utilization.
Centene’s chief health officer, Alice Chen, MD, and group president of Medicare and specialty, Michael Carson, broke down their ask in an interview with Becker’s.
“It is a policy decision that I think in some ways is historical and unintentional,” Dr. Chen said. “In many ways, it’s as straightforward as designating nutrition interventions as primarily health related, the way fitness currently is.”
CMS rebates finance supplemental benefits. The Medicare Payment Advisory Commission estimated that, in 2025, $86 billion in rebates went to plans. The article’s authors said healthy food is one evidence-based path to focus those dollars.
Broader research, including a recent Nature Medicine article, suggests medically tailored meals are associated with reduced hospitalizations, emergency department visits and overall healthcare costs.
“When you target these benefits to the right cohort, it really is a win-win, so I mean it does have that impact of both improving their health outcomes and reducing spend,” Dr. Chen said.
Centene’s own data adds weight to the argument and shows how those with chronic conditions may benefit. In reviewing roughly 300,000 dually eligible MA members who received supplemental benefits through a restricted-use card — covering food and nutrition, transportation, and housing — all had at least one chronic condition and nearly 75% had three or more. Healthy food came out on top as the most used benefit.
Despite support for healthy food as a supplemental benefit, it may not be a top priority for the government, but the “Make America Healthy Again” movement could bring it to the forefront.
“As you can imagine, the administration today is trying to tackle many, many different things. This is just one of a long list. I think we believe it fits very nicely with the MAHA movement component,” Mr. Carson said. “I don’t think it’s a disagreement or a desire not to do it. I think it’s a matter of prioritization and having the evidence to support that this is the right thing to do.”
In terms of what a food benefit would look like as a primarily health related benefit, Centene has already analyzed appropriate dollar amounts on its spendables cards to drive outcomes. Mr. Carson said Centene also wants to couple beneficiaries with nutritionists.
Mr. Carson expects a reclassification to push the broader MA market to lean into certain benefits that work in beneficiaries’ favors.
“What we’re suggesting happen here is not an increase in Medicare spend. It’s an allocation of that spend … for the accessibility and streamlining of the competitive landscape and normalizing the supplemental benefit component,” Mr. Carson said.
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