Better outcomes, lower costs tied to medically tailored meals

Clinical takeaway: For low-income patients with diet-related disease and food insecurity, tailored meal programs may be worth flagging where Medicaid covers them, especially for the sickest patients, where the cost case is strongest.

Food-as-medicine programs have shown promise in small studies, but until now none had been tested at the level of a statewide insurance program. Massachusetts was the first state to broadly cover medically tailored meals through Medicaid, offering a real-world test of whether the approach holds up when delivered at scale.

Recipients used acute care substantially less than comparable patients who didn't enroll. Over roughly seven months on the program, they had 31% fewer hospitalizations and 20% fewer emergency visits.

Total healthcare costs fell by about $3,433 per person during enrollment, enough to offset 98% of the program's cost, leaving a net cost of under $15 per person per month. For several high-risk conditions the meals more than paid for themselves: net savings reached about $10,000 per person in patients with cardiovascular disease and $12,000 in those with chronic kidney disease, with significant savings also in diabetes and depression.

The benefit tracked with how sick patients were. Among those with the lowest comorbidity burden, no significant reductions appeared; the cost gains concentrated in the highest-risk patients. Longer enrollment was also associated with larger cost reductions, and the effects emerged within months rather than years.

Importantly, primary care visits held steady. The meals reduced unplanned, expensive care without cutting into routine engagement, arguing against the worry that lower utilization simply meant patients disengaging from the system.

The analysis covered 1,866 adults who received meals for at least three months across 11 health systems, compared with 1,372 eligible Medicaid members who didn't enroll, weighted to balance demographics, conditions, and prior healthcare use. All meals came from a single established nonprofit, with each recipient's plan set by a dietitian.

With 13 states now approved to cover such programs through Medicaid, the Massachusetts data offer the strongest evidence yet that the approach pays off.

"It's rare to find anything in medicine that both improves health and saves money," said senior author Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute at Tufts University. "It should be a no-brainer to extend similar programs to patients in other states and covered by other health insurance programs, such as Medicare and employer-based insurance."

Source: Hager K, et al. Nat Med. 2026 Jun 2. Medically tailored meals receipt and healthcare utilization and costs in Massachusetts' Medicaid demonstration