Medicaid Waiver in Oregon Scales Medically-Tailored Meal Delivery Program

Federal approval comes through as Oregon attempts to bolster Medicaid coverage of non-clinical, non-pharmaceutical treatments with expanded nutrition program and more.

According to Pew Research, the last 10 years has seen trends across a handful of states to organize funding for “medically tailored meals prescribed by hospital dieticians.” One such initiative in Oregon was tracked over a three-year period of time at multiple participating hospitals. They found “that patients with diabetes, congestive heart diseases and other chronic illnesses who received what are known as medically tailored meals were half as likely to be admitted to the hospital compared with those who didn’t receive meals, and the total cost of their care was substantially lower.”

From the article:

Meals on Wheels had been delivering healthy meals to thousands of older adults in Portland, Oregon, for more than 50 years when a local hospital asked whether the group could cook similar meals for patients leaving the hospital after acute bouts of diabetes, heart disease and other chronic illnesses.

The answer was a resounding yes, according to Suzanne Washington, CEO of the local organization Meals on Wheels People. The group signed on with that Portland hospital five years ago and later agreed to provide meals for two others in the area.

Oregon Health Authority Director Patrick Allen, in an interview with Pew, said that different programs have attempted to address the need for services like nutrition program coverage to improve outcomes for patients in recovery. “Never have those efforts become a defined benefit in Medicaid that everyone who qualifies is entitled to receive,” he said. “This is a really big deal.”

This signals a potential shift regarding what historically constitutes healthcare itself especially as it relates to funding preventive vs curative care and incidence outcomes. Ongoing coverage around this development was hailed by some with the title “Food is Medicine.” A local news report ended a recap of the story with an audience poll featuring one question – “Do you support Medicaid expanding beyond health care?” The waiver represents a potential windfall for programs such as Meals on Wheels and the like, but there are also provisions for housing, utility and adverse weather support during extreme cold and heat in the recent approval.

Over the next 5 years Oregon will fund the pilot programs outlined under the waiver at $500M to the federal governments input of $1.1B. The timeline represents an opportunity to study whether the government’s ability to address root-cause issues that lead to poor health outcomes for low-income residents will alter the definition of care as well as the distribution of funding between clinical and non-clinical/non-pharmaceutical Medicaid coverage.

Read more on the full scope of the Oregon Medicaid waiver.

Read the Kaiser report of recent Medicaid waiver developments.

Read the Health and Human Services release on the recent Medicaid initiatives.