Industry Voices—Payers can and should erase food deserts

The White House recently held a highly successful summit on nutrition, hunger and health—the first of its kind in more than 50 years.

It was gratifying to see that “food-as-medicine” was a front-and-center topic in the weeks leading up to the event and during the day’s vibrant discussions. Food-as-medicine is being talked about in more and more healthcare circles these days, and I’m optimistic that the seminal event will be a catalyst for more action. While the discussions hit on some key points, including food insecurity and meal reimbursement, I would have liked to see more exploration on the key role payers can play, especially when it comes to food deserts, in expanding this tool for better health outcomes.

Food deserts are not something that immediately come to mind when thinking about the payer landscape. Open enrollment, reimbursements and payment models are all phrases that are synonymous with health plans. Increasingly, however, conversations across the industry have been turning to that of food access and health, part of a broader burgeoning movement to better integrate food and nutrition into the healthcare system. 

Food insecurity and chronic diseases caused by poor nutrition are some of the largest health issues plaguing the nation. Again, it was reassuring to hear them discuss the issues at the summit. When you consider how widespread food deserts are across the country, however, this doesn’t come as too much of a surprise. The two main culprits? Access to and affordability of good, healthy food. A 2017 USDA report found that near­ly 39.5 million people liv­e in low-income and low-food access areas. Furthermore, with­in this group, an estimated 19 million people had lim­it­ed access to a super­mar­ket or gro­cery store. While these numbers are concerning in and of themselves, the negative health consequences present a more dire ripple effect.

Diet-related chronic diseases cost the healthcare system up to $50 billion a year. To zoom in further, compared to those with no unmet social needs, food-insecure individuals are more than twice as likely to report poor physical or mental health. They also frequent the emergency room more often and are twice as likely to report inpatient hospital stays

As it stands, the picture isn’t pretty. The good news, though, is that developments outside of healthcare have now made it possible for payers to seize the opportunity to begin to erase food deserts. Over the last decade, venture capital firms have poured billions into food delivery and related platforms. UberEats, Instacart, HelloFresh and the like are now mainstays on the scene (along with established players such as Walmart), used by major swaths of the population to buy and receive food with ease and speed—by and large, erasing the access dimension of food deserts.

During COVID, the adoption of these services skyrocketed even further, so much so that nearly 80% of Americans now report having ordered groceries online. Affordability, along with education and behavior change, remain the last barriers to true systemic change.

Some initiatives do currently exist to provide greater nutrition support—many payers have begun to implement home-delivered and medically-tailored meal programs. While a step in the right direction, particularly for those with chronic conditions, these programs are usually limited in duration, are available only for one member of a household, and leave individuals with little to no choice in what they eat. Suffice it to say, when these benefits expire, members are not equipped with the tools to maintain nutritious diets and healthier eating habits over the long term—they’re left with their all too familiar low-quality food options. 

As the primary source of benefits for many, payers are thus faced with a unique opportunity to address the affordability and behavior change elements of food deserts. Taking advantage of the brave new world of digital food platforms, they can lead the charge in investing in scalable, turnkey solutions that change the food environments of members at scale. Alongside a targeted nutrition strategy, say for a specific condition like diabetes, this can then be seamlessly rolled out as part of their overall benefits offering. 

The ideal solution would not only offer members access to quality clinical nutrition care, the logistics to ensure food arrives at their homes, but an array of tailored food options. By harnessing these newly scaled, consumer-ready digital food platforms, culturally appropriate options that appeal to entire households are available today at low prices. For food insecure members, payers can also further increase their impact by providing food credits and education to put these nutritious food options within reach. Changing the default food environment in these communities would then make healthy, affordable food the ongoing choice for many members at scale, as well as promote long-term behavior changes. 

Investing in innovative solutions to erase food deserts offers enormous upside in improving members’ health and quality of life. Payers also reap the economic benefits of total cost-of-care reductions, and the potential to differentiate themselves in what has become a saturated and competitive market. Thankfully, all the right tailwinds are in place, especially after the spotlight earned from the White House summit. The next step is to act. 

Josh Hix is the CEO and co-founder of Season Health, a food-as-medicine platform that enables people with chronic conditions to eat well and be well.