Photo: Bryan Goodchild and Faith Ninivaggi
In two recently published peer-reviewed studies, UMass Chan Medical School researchers found that targeted nutrition and housing support services funded through Medicaid led to fewer hospital and emergency department visits and, in some cases, net cost savings for Massachusetts’ Medicaid program, MassHealth.
“These nutrition and housing services represent a fundamental shift in how we think about healthcare,” said Kurt Hager, PhD, assistant professor of population & quantitative health sciences. “Instead of only paying for clinical care, MassHealth is now investing in the root causes of health and improving member’s material wellbeing and we’re seeing measurable benefits.”
One study, published in Nature Medicine and led by UMass Chan in collaboration with researchers at the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University, examined the impact of medically tailored meals, which are home-delivered meals designed specifically for patients with serious chronic conditions. The program is the most intensive nutrition intervention covered under MassHealth, according to Dr. Hager.
The researchers found that participants receiving medically tailored meals had significant reductions in hospitalizations and emergency department visits, along with lower overall healthcare spending. Among all meal recipients, the healthcare costs savings offset the meal costs. For patients with advanced conditions such as diabetes, cardiovascular disease and kidney disease, the program generated net cost savings even after paying for the meals.
“These findings show that medically tailored meals can be both clinically effective and economically sustainable within Medicaid,” Hager said.
“As the first state to broadly offer medically tailored meals in Medicaid to Americans with diet-related diseases, Massachusetts provides an important opportunity to evaluate the real-world impact of such a program,” said senior author Dariush Mozaffarian, MD, DrPH, cardiologist and director of the Food is Medicine Institute at the Friedman School at Tufts University. “Our results show that food really is medicine, with major clinical and policy implications for health-insurance coverage of medically tailored meals to impact diet-related diseases and healthcare costs.”
A second study, led by UMass Chan researcher Meagan Sabatino, PhD, instructor in population & quantitative health sciences, focused on Medicaid-funded housing support services that help individuals with complex health and social needs find and maintain stable housing. The study, one of the largest of its kind to date, according to Dr. Sabatino, was published in Health Affairs.
Unlike direct housing subsidies, the program provides “wraparound” services, such as housing search assistance, case management and help with maintaining stable housing.
Sabatino and colleagues found that individuals with behavioral health conditions, including mental health and substance use disorders, receiving housing support services had substantial reductions in total healthcare costs within six to 12 months. The study also found decreases in hospital readmissions and emergency department visits within the 12 months after starting services.
“Housing stability is a critical component of health, especially for people with behavioral health conditions,” Sabatino said. “Our findings show that providing services to help people secure and maintain housing can lead to meaningful improvements in both health outcomes and healthcare spending.”
Both studies are part of a broader, statewide evaluation, conducted by UMass Chan researchers, of MassHealth programs designed to integrate care, improve care quality and outcomes, and reduce overall healthcare costs.
The results come at a time of heightened national attention on Medicaid spending and ongoing policy debates about how to control costs while improving care.
“There’s growing recognition that addressing social determinants of health is essential,” Hager said. “But there are also real concerns about budgets and sustainability, especially with impending Medicaid cuts. Our research shows that these programs can align both goals.”
