MTMs Gain Momentum as a Valuable Health Care Strategy

Nourishing Discourse
Written By Kim Lampi

Ceres’ meals are vegetable-rich and colorful, and made with only organic, fresh, whole ingredients including whole grains, legumes, nuts, seeds, pasture-raised animal proteins, and line-caught fish.

Medically Tailored Meals (MTM) have gained visibility over the past several years as a growing body of published research has demonstrated their ability to improve the health of patients while also reducing health care costs.  The September 2022 White House Conference on Hunger Nutrition and Health, and the Biden Administration’s national strategy on the topic named MTMs as a promising strategy for addressing the country’s epidemic of diet-related illness. For organizations like Ceres that have been providing the MTM intervention for years, this is exciting news because of the potential to expand access of this impactful intervention to those that need it.  

California is one of ten states that are piloting coverage of MTMs and other nutrition interventions in their Medicaid programs. And federal legislation is moving towards funding an MTM pilot within Medicare. Why are MTMs gaining traction as an important health care strategy? When were they first developed and what are they exactly? This edition of Nourishing Discourse answers these questions and more! 

How it all began 

MTMs start is rooted in the HIV/AIDS epidemic dating back to the mid-1980s. Across the US in areas of high concentration of people suffering from a deadly virus we knew very little about. As a young RDN at the time, I remember how communities of volunteers mobilized to prepare and deliver meals to combat wasting, improve medication side effects and to make those with AIDS feel cared for when food was the most impactful treatment available. As the epidemic grew, funding for home delivered meals became available through the Ryan White Care Act. Until 2020 when Medicare Advantage plans were allowed to provide meals for patients with some conditions, Ryan White was the only place in the federal budget where food was reimbursed as a health care expense.   

Through Ryan White, agencies were required to connect the service via a medical referral from a physician and employ Registered Dietitians to oversee the intervention and provide nutrition counseling and education. Thus, the start of the concept of connecting food to medical care. Physicians were essentially “prescribing nutrition” via a referral to these agencies.  The agencies delivering meals and the medical practitioners involved quickly learned that their patients living with HIV/AIDS fared much better with the support of healthy, high-quality meals. This impact led to opportunities for expansion of the MTM intervention to address the nutritional and medical needs of patients with cancer, diabetes, heart disease and more.

So, what is a Medically Tailored Meal?  

As defined by the Food is Medicine Coalition (FIMC) medically tailored meals are delivered to individuals living with severe illness through a referral from a medical professional or healthcare plan. Meal plans are tailored to the medical needs of the recipient by a Registered Dietitian (RDN), and are designed to improve health outcomes, lower cost of care and increase patient satisfaction.   

For Ceres, this means providing meals that are made from ingredients that are whole and minimally processed, organic and local, and have a low glycemic load. Because many of our clients are living with complex, severe, or chronic illnesses, Ceres meals are further tailored to meet the needs of those with diabetes, cardiovascular disease, and experiencing treatment side effects, malnutrition or have food allergies and intolerances. As Ceres Nutrition Care Manager and an RDN, I oversee the development of our meal plans and review medical referral forms to ensure each client receives the meals that will be most supportive of their health. With our nutritionist and nutrition educator, we also support our clients by offering medical nutrition therapy and nutrition education programming. Ceres clients are living with one or more serious health conditions and most are managing with limited resources.  

The information above shows who we served in 2022. Learn more in our Annual Report.

The combination of providing MTMs along with access to an RDN and nutrition education aims to assist clients in learning to self-manage their medical condition(s). 47% of Ceres clients are food insecure and 83% live on less than $25,000/year. Many also have difficulty leaving their home, and/or shopping and preparing meals. As an RDN in this field for more than 25 years, I’ve seen how receiving healthy, nourishing meals allows clients to have more bandwidth to address their complex health needs. Knowing you have a prepared meal everyday allows a reduction in the stress of obtaining a healthy meal and provides space to contemplate eating better for their health challenges.  

Gail is enjoying our Broccoli Frittata; Beet, Barley and Arugula Salad; and roasted yams.

“Your food deliveries are helping me have more time to myself for my own self-care and keeping myself well fed. I spend a lot of time in the kitchen trying to keep up my food supply and having available, ready to eat, foods. It is a dream to go to the freezer and see I have a selection which usually covers one meal each day for a week. Really lowers the stress I feel around this weekly activity.”  

Lack of access to food that supports health is a barrier experienced by those that cannot leave their home, lack transportation, and are challenged with accessing health care. In addition, having to make difficult choices between spending money on food and necessary medication is a reality for many people in our community.  

Why are MTMs important and what does the future look like for MTMs? 

As a nation, we spend 90% of our healthcare dollars on chronic and mental health conditions. Yet many of these, such as diabetes, heart disease, stroke and cancer, can be prevented or managed through changes in diet or eating patterns.  Sadly, our food system lacks equitable access to high quality nutrient dense foods that are key to prevention and amelioration of chronic diseases.  

MTMs have been proven to improve health outcomes and reduce healthcare costs. At the federal level, a bipartisan bill introduced by Congressman Jim McGovern from Massachusetts would fund a 10-state pilot of MTMs for patients on Medicare. This is the first step to expanding coverage of MTMs for the millions of Americans who rely on this federal health care program.  

In California, thanks to Ceres’ leadership, MediCal Managed Care plans have been able to offer and pay for MTMs since January 2022 under a five-year demonstration waiver with Center for Medicaid Services.   Now the work has begun to make this a permanent benefit in the state through Assembly bill 1644 which would make MTMs a permanent benefit in the state’s MediCal program starting in 2026.   

A growing body of research has proven the value of MTMs to improve quality of life and health outcomes for patients while reducing health care costs. It’s time to make this win-win medical intervention a permanent – and covered – benefit so that millions of people can experience the same support and care that Ceres’ clients receive.  

Interested in learning more? 

Kim Lampi
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