(LB03-07-24) Short-Term Nutrition Interventions Designed to Address Food Insecurity Result in Lower Total Cost of Care for Medicaid ACO Enrollees

Objectives: In 2020, Community Care Cooperative (C3), a Federally-Qualified Health Center (FQHC)-led Accountable Care Organization (ACO) launched the Medicaid Flexible Services Program (FSP) to address the problem of food insecurity for patients experiencing complex health conditions. C3 leveraged Medicaid funds to provide medically-tailored meals and/or healthy food vouchers to eligible enrollees. The 6-month interventions were designed to improve food access and were coupled with support for SNAP and WIC enrollment, nutrition and cooking education, and provision of cooking supplies to support diet quality and behavior change. The goal of the Medicaid demonstration was to improve food security, improve health outcomes, and reduce total cost of care (TCOC).

Methods: Between 2021-2022, C3 identified members with complex health conditions who were enrolled in our complex care management program and were experiencing food insecurity. Members received a 6-month intervention of medically tailored meals or healthy food vouchers with additional case management support. We used programmatic data from FSP as well as Medicaid claims and utilization data to conduct a Linear Mixed effects analysis using a log-transformed TCOC outcome variable and utilization by members. Analysis included members who successfully completed the program (n=1,002) and a comparison group of eligible members referred to the program but who neither engaged in FSP nor received services (n=196). We compared TCOC as well as Emergency Department (ED) costs and inpatient (IP) hospital costs for the period of six months prior to enrollment and six months after enrollment in FSP.

Results: Members who completed FSP experience $10,831 reduction in TCOC during the enrollment period, compared to $2,597 increase in TCOC for the comparison group (p < .0001). The TCOC improvement is drive by members experiencing lower IP ($1160 to $262, p < .0001) and ED costs ($961 to $116, p< .0001).

Conclusions: C3’s approach to investing in Flexible Services is effective in supporting FQHC patients and is associated with lower TCOC, lower ED and IP utilization during the program. This program can serve as an example for other ACOs and Managed Care Entities in states implementing similar HRSN programs.

Funding Sources: C3 staff conducted this program evaluation as part of program operations without additional external funding.