Editor’s note: We clarified this story Friday, Nov. 1, 2024 at 12:40 p.m. to more accurately describe the timeframe for medically tailored meals and to say they will not be available for fee-for-service Medicaid members. We also corrected the story to say health plans can cover meals for high-risk and postpartum Medicaid members, not just those leaving the hospital.
An initiative set to go into effect next year will reimburse medically tailored meals for some at-risk Medicaid members who are leaving the hospital.
Medically tailored meals are healthy, nutritious and designed to prevent, manage and reverse chronic diet-related diseases, said Kathy Koshgarian, CEO of Food for Health, which provides medically tailored meals.
Starting early next year, Medicaid health plans will be able to seek reimbursement to cover up to two medically tailored meals a day for up to 12 weeks for members leaving the hospital and diagnosed with diabetes and heart disease. They will also be able cover the meals for high-risk pregnant or postpartum members, according to DHS. After the initial 12 weeks, Medicaid health plans will be able to reauthorize meals every 12 weeks for up to a year, as long as they’re medically necessary. The initiative does not cover the meals for Medicaid fee-for-service enrollees.
Readmission rates are “extremely high” with the populations targeted by the initiative, especially if they’re food insecure, Koshgarian noted.
“Being able to mitigate that reoccurrence provides a higher quality of life,” she said at a Wisconsin Health News event Tuesday.
Koshgarian said a number of Medicaid health plans are exploring how to participate in the initiative.
iCare CEO Tony Mollica said the change will let them submit claims for the cost of food-for-medicine programs. That will help with data collection, including information on why patients were hospitalized, why they left the hospital, whether they met with a dietitian and if they are on a food program.
The goal is to prevent further hospitalization, especially at a time when beds are needed.
“We’re all financially incented to do those things,” he said. “This gives us an avenue to do it.”
Rachel Roller, CEO of the Dohmen Company Foundation, which is working to fight diet-related diseases, said Medicaid is key in that work.
“We’re so excited to see a growing momentum across the nation in adopting this,” Roller said. “We hope it becomes a standard best practice and, ultimately, becomes a benefit that is truly integrated within healthcare.”
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