Medicare Advantage members with an acute condition, such as a circulatory, digestive, infectious or respiratory disease, who received two or three meals a day after discharge had significantly lower odds of 30-day death and rehospitalization compared with those not in a meal program.
Researchers assessed the effects of home-delivered meals in the month after hospitalization among 4,032 MA members with heart failure and 7,944 with a different acute medical condition.1 The groups were compared with a matched cohort who were referred in 2021 and 2022 but did not receive meals due to unsuccessful outreach or because they declined, and a matched cohort that would have been eligible for home-delivered meals in a separate 2019 study.
In the recent study, members in the heart failure cohort had lower odds of 30-day death and rehospitalization compared with those who did not receive meals, but the association was not significant compared with the no-meals cohort of the 2019 study.
That study found an association between medically tailored nutritional support programs and reductions in hospital and skilled nursing facility admissions, as well as a reduction in spending.2 Driven in part by this evidence, nearly 75% of MA plans offered meals as a supplemental benefit last year.
MA plans are still determining the optimal mix of supplemental benefits to address social drivers of health, and the patient populations for which those benefits will be of greatest value.
The findings of the 2019 study suggested that MA plans need to be strategic in selecting patient populations for medically tailored meals. Nearly 38% of those who received meals had a cancer diagnosis, more than one-third had diabetes, and meal recipients had clinical, nutritional and social risk factors that put them at high risk for deteriorating health in the absence of nutritional intervention. “It is unlikely that similar results would be seen were the intervention applied to a healthier population, as the risk of admission or high health care costs, even in the absence of intervention, would be substantially lower,” the researchers wrote.
The authors of the more recent study note that MA plans “may need to consider whether a triggering acute event is required to initiate meals to support recovery or whether more proactive, population-based screening and preemptive nutrition support achieve the greatest effect.” Also to be determined are the appropriate number of meals and duration of meal delivery to achieve the best outcomes.
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References
- Nguyen, H.Q., Duan, L., Lee, J.S., et al. Association of a Medicare Advantage Posthospitalization Home Meal Delivery Benefit With Rehospitalization and Death. JAMA Health Forum. June 25, 2023. https://doi.org/10.1001/jamahealthforum.2023.1678
- Berkowitz, S.A., Terranova, J., Randall, L. et al. Association Between Receipt of a Medically Tailored Meal Program and Health Care Use. JAMA Internal Medicine. Apr. 22, 2019. https://doi.org/10.1001/jamainternmed.2019.0198
