Pilot Serving Patients with Diabetes & Hypertension

About

In late 2020, Ceres Community Project reached out to several of our community health center partners to discuss the potential of conducting one or two small medically tailored meal pilots during 2021. The goal was to strengthen referral partnerships with health centers who serve the majority of MediCal members and develop preliminary data to support coverage of meals for key populations.

Santa Rosa Community Health agreed to partner with Ceres on a pilot serving patients with uncontrolled hypertension and/or diabetes. These conditions can be positively impacted by nutrition, and both are risk factors for cardiovascular disease and for higher utilization of emergency departments and hospitalizations.

Through our contract with Partnership HealthPlan, we are now able to offer this intervention to MediCal members with diabetes.

Patients

The pilot included 244 patients. Each patient received 7 meals per week for 12 weeks, including meals for family members.

Partners

  • Santa Rosa Community Health

  • Partnership HealthPlan

Results

This pilot took place during COVID and one of the challenges faced by SRCH was the ability to collect blood pressure and A1c readings. The final evaluation included only patients for whom we had pre/post readings that fell within 125 days of the intervention.

  • Hypertension – Of 61 patients for whom we had readings, 46% had an improved BP following the intervention. The average improvement was 14.1/11.3

  • Diabetes – Of 148 patients with diabetes for whom we had readings, 66% saw an improvement in their A1c and the average improvement was 1.7 points