Food is at the center of many discussions in our lives. We talk about it, we plan for it, we enjoy it, and we even write about it. Nutrition on the other hand, is something health-conscious people talk about. And now, the conversation has shifted to talking about food and its effectiveness as medicine to improve health.
Nutritionists, dietitians, doctors, and health workers have known for decades that healthy eating can have a significant impact on overall health and the prevention of common chronic diseases. Yet, many Americans find it tough to know which foods are best for their health and face mixed messages about what to eat or avoid.
Limited food literacy and financial constraints make it difficult for Americans to make the right food choices. The challenge grows even more complex for people living in food deserts and swamps with fewer options and reduced access to healthy foods. And complexities abound when we factor in dietary restrictions, cultural beliefs, and clinical conditions. Food as Medicine serves as both a downstream solution to manage and treat chronic diseases and an upstream approach to prevent them before they start. By prioritizing nutrition, we can reduce healthcare costs and improve overall well-being.
Food and nutrition programs at the federal, state and local levels, such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), have long attempted to address this issue with controlled funding and education. But more effort is needed to increase food literacy and access to counteract the mounting cost of healthcare and rates of chronic illness such as diabetes and heart disease. Food and nutrition are central themes in discussions around rising medical costs. Successful food interventions have been shown to reduce the cost of care by billions of dollars1, however, success has been sporadic and highly localized.
At GroundGame.Health, food is only one of several health-related social needs (HRSNs) we solve for. Over the last four years, we have understood that underserved populations have complex, often intertwined HRSNs. Our approach to social care coordination has focused on making a measurable difference. We do this by leveraging the innate empathy and deep knowledge of our community health workers, along with a national network of aligned community-based organizations. We empower these passionate and dedicated individuals with secure and sophisticated technology, deep process expertise, and compliance with regulatory and standards frameworks. We have worked tirelessly with health plans and other stakeholders to bridge the gap between them and community organizations.
For more than eight years, community-based organizations have been utilizing our technology platform, Implify™, to develop and manage comprehensive social care plans, and interoperable electronic social records. Community-based organizations also use the platform to submit claims and invoices to health plans, as well as reporting. Food, along with other social needs such as access to care, housing, transportation, and financial and legal assistance, is an integral part of these efforts.
Working closely with our partners — Umoja Health, a food, health, and logistics company; Ujima Hunger Coalition, a leader in childhood nutrition security and health; and others — we are supporting Medicaid members in California with nutrition assessments and counseling, and with the delivery of nutrition and culturally appropriate "medically tailored groceries" across 30 of 58 counties in California. We plan to expand these services to include all 58 counties by Q4 of 2025.
Under the aegis of CalAIM, we are creating a community food hub in Northern California, in partnership with multiple local community-based organizations and other Food as Medicine participants. This hub will gradually evolve into a true community hub, addressing most HRSNs and a majority of CalAIM Community Supports, along with enhanced care management. In parallel, Ujima is working with local health plans and community-based organizations to deliver medically tailored groceries to children.
We intentionally launched this model in Northern California as most of these 20+ counties are sparsely populated, deeply rural, and food deserts. Sacramento, on the other hand, is intensely urban, with low-income inner-city populations, and a majority of the county is also classified as a food desert.
With this partnership, we are blending our expertise in addressing social needs, expertise in Food as Medicine, our technology platforms for social needs and logistics, and our revenue cycle management processes to create a new model for Medicaid reimbursed Food as Medicine interventions.
Together, Umoja Health, Ujima, and GroundGame.Health, plan to scale this model in underserved communities nationwide. We understand the difference Food as Medicine can make as a social intervention and are confident, we can make a difference. We call on community organizations, meal providers and others to join us on this journey, in Northern California and beyond.
Together, we can nourish lives and make a difference now.
Footnote:
1Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy. Food is Medicine Institute. “True Cost of Food: Food is Medicine Case Study.” March 12, 2025. https://tuftsfoodismedicine.org/true-cost-fim-case-study-report/