Open access or referral only: Health systems take different approaches to food pantry programs

Intermountain Primary Children’s Hospital in Utah, where a tenth of kids face hunger, recently announced it opened a food pantry

At outpatient clinic visits, Intermountain patients are screened for social determinants and then referred to the pantry. “Giving food to those who need it can make a world of difference in their health and wellbeing, and influence their health for years into the future,” the hospital’s CEO Katy Welkie said in the announcement. 

The food pantry launch comes at a time when a growing number of providers are pursuing food distribution programs in addition to referring patients to community-based resources. Payers and startups are also increasingly interested in the movement. 

Poor nutrition is a leading cause of illness in the U.S. More than half a million Americans die each year from diet-related diseases, and Black and Latino households are more than twice as likely as white households to face food insecurity. One estimate pegs related healthcare costs at $160 billion a year.

Tracking impact for reimbursement  

There's an increasing desire for data to back up the efficacy of food distribution efforts in healthcare. The Veterans Health Administration has teamed up with About Fresh to source better data on food programs’ impact. Others have already begun to collect it.

Blue Cross and Blue Shield of North Carolina demonstrated concrete reductions in body mass index, obesity and medical costs with its recent pilot delivering food to diabetes patients. Geisinger’s Fresh Food Pharmacy similarly found decreasing risk of death or serious complications and reduced medical costs.

For patients of ProMedica Health System, serving communities in 30 states, food insecurity is among the most prominent social needs. Of 160,000 patients ProMedica screened in 2021, 40,000 had SDOH needs, with 7% found to be food insecure in primary care settings. 

ProMedica launched its first food clinic in 2015. By 2019, it had opened its third location. 

“Hunger is a health issue, it’s part of the care model,” Kate Sommerfeld, president of ProMedica’s Social Determinants of Health Institute, told Fierce Healthcare. 

Like Intermountain, the health system screens patients for food insecurity and “prescribes” them three days of emergency food. And it tracks the downstream impacts of its interventions to make a compelling case to payers. Among 1,753 food clinic participants in 2021, ProMedica saw a 20% reduction in ED visits and more than $6,000 in cost savings. The vast majority of these patients were Medicaid beneficiaries, more than half were Black and more than a third had complex chronic conditions.

“It goes back to the data. How do you prove the impact that food has on things like cost and utilization?” Sommerfeld said. Payers reimburse ProMedica for costs of food and screenings in both fee-for-service and value-based care contracts, she said. 

The health system also does fundraising and grant writing to subsidize the effort, and sets aside dollars as part of its community benefit requirement as a nonprofit.  

An older model demonstrating the power of open access 

The University of Chicago Medicine established its food pantry program in 2010. To date, the self-serve program, Feed1st, has reached more than 58,700 people with about 65 tons of food. 

The health system argues open access is critical to the effort’s success. While screenings and food prescriptions gather valuable data, they can also contribute to stigma around food insecurity, argues Stacy Tessler Lindau, M.D., professor and physician at the University of Chicago who leads and helped found the program.

“We’ve been on a mission to prove that emergency food support in the healthcare setting can be delivered with no questions asked,” Lindau told Fierce Healthcare. 

During the pandemic, the health system added five new pantries and increased its food distribution by 124%. 

UChicago Medicine compared its program to what it says is the only other hospital-based food pantry also reporting its impact during COVID. That program, at Boston Medical Center, requires a referral and access is limited to twice a month

In its study, UChicago Medicine noted that Boston Medical Center reported a decrease in food procured and families served from March to August 2020 compared to before the pandemic. During the same period, Feed1st’s open-access model saw a 27% increase in food distribution. 

Feed1st receives feedback on its food pantries and offers the community the option to serve on advisory boards. Several volunteers have also organized food drives or donated money. “This open access approach gives people the dignity not just to receive without shame, but also to give back,” Lindau said.

Housing a food pantry at a hospital can not only help with immediate hunger but can also help raise awareness of food insecurity in a community. 

“This is something every nonprofit hospital in the country could do,” Lindau said. “It’s hard to imagine that the cost is not outweighed in multiples by the benefits.”