For the launch of the AMPL Institute, Community Servings’ new initiative to advance access to medically tailored nutrition through policy and leadership, we spoke with member organizations of the Food is Medicine Coalition and experts in health policy. The result: a comprehensive report on the state of the field in a time of major transition.
Long-awaited milestones have finally arrived. The integration of medically tailored nutrition into healthcare is well underway. There is much to celebrate. However, there is also a sense of concern.
The following is an excerpt from AMPL’s inaugural report. Read the complete report here.
Opportunity and Uncertainty
Two policy examples, one at the state level, another at the federal level, illustrate the remarkable yet uncertain nature of the current moment.
- Across the country, Medicaid Section 1115 demonstration waivers are creating access to medically tailored meals (MTM) and other health-related social needs services in order to improve the efficiency and quality of care. In Massachusetts, for example, the Health-Related Social Needs Supplemental Services Program, which launched in January 2025 through an 1115 waiver, now requires contracting providers to offer MTM to all eligible individuals who meet clinical and social risk criteria. As of this writing, 1115 demonstrations in 13 states are approved with meal services.
- The bipartisan Medically Tailored Home-Delivered Meals Demonstration Pilot Act may be re-introduced in the 119th U.S. Congress. It would provide MTM to qualifying Medicare-enrolled seniors and individuals with disabilities in diverse geographic regions, urban and rural, throughout the country.
These two policy opportunities have the potential to establish long-term pathways for the provision of MTM. Both require evaluation, the findings of which could support the case for MTM as a healthcare service in Medicaid and Medicare, powerfully advancing one of the AMPL Institute’s core objectives. However, both opportunities could face policy setbacks, setbacks that could put at risk the progress of recent years.
2025 marks the start of a new era of health policy, one that may introduce new opportunities. Created through an Executive Order in February 2025, the Make America Healthy Again Commission tasks its members, which include as chair Secretary of Health and Human Services Robert F. Kennedy Jr., with understanding and lowering chronic disease rates and ending childhood chronic disease. The AMPL Institute shares these goals and is eager to participate in new policy initiatives to address chronic diseases with evidence-based interventions.
However, this new era is also a time of upheaval.
Federal agencies and programs that provide children, older adults, people with disabilities, and lower-income adults with access to healthcare and social services are facing funding cuts, actual and threatened. It is thanks to programs like Medicaid, the Ryan White HIV/AIDS Program, and the Older Americans Act that community-based organizations in this field have progressed over the years. If these programs are significantly reduced, how exactly will the federal government advance MTM access moving forward? What does the future hold for the approval — or the possible withdrawal — of Medicaid Section 1115 waivers, which have proven so important in creating state-level access? How will MTM providers navigate the funding challenges of such a rapidly changing landscape?
The sense of concern has other sources, as well. Among them is the need for the consistent definition, provision, and quality standardization of MTM. The field faces a tremendous risk if MTM is provided at varying levels of quality and quantity — and then evaluated.
According to Food is Medicine Coalition Executive Director Alissa Wassung, a failure to define the MTM intervention robustly could derail years of research and advocacy, and further delay more widespread access to MTM. “If we implement interventions that don’t meet standards, evaluate them, and get sub-par outcomes, we might, as a nation, abandon the whole concept of Food is Medicine as part of healthcare,” Wassung says.
Maintaining Momentum for MTM
Throughout the country, nonprofit community-based organizations (CBOs) that provide MTM are navigating the challenges of integration with the healthcare system. Surveying their experiences, key themes stand out:
- Scientific evidence supporting the health benefits and cost-effectiveness of MTM continues to drive adoption in policy and healthcare. In the years to come, researchers are poised to evaluate the impact of MTM at even larger scales. This is the result of new policy opportunities, major investments from organizations like the American Heart Association and The Rockefeller Foundation, and emerging guidelines for accurate service coding for Food is Medicine interventions.
- The structural framework of MTM coverage — the regulatory work of making MTM a healthcare benefit — continues to evolve. Those evolutions can pose formidable administrative and financial challenges to CBOs.
- The need for philanthropic support is growing among CBOs. Under the new Administration, longstanding federal funding, such as the Ryan White Program, the Older Americans Act, and FEMA’s Emergency Food and Shelter Program, are facing significant uncertainty. Historically, philanthropy was the primary funder of community-based Food is Medicine services. In the coming years, private philanthropic support may play an increasingly important role in sustaining momentum and mitigating the impact to direct services.
- With approval from the Centers for Medicare and Medicaid Services (CMS), new standard service codes for MTM and medically tailored groceries would endorse national concepts for medically tailored nutrition. This would be a huge step forward for the standardization of medically tailored nutrition interventions.
- The field’s nonprofit pioneers have produced the first-ever quality standard for MTM through the new FIMC Accreditation program. These criteria and requirements comprehensively define and guide MTM service provision — a tremendous milestone for MTM’s integration within the heavily regulated healthcare system.
Amid uncertainty, there are reasons to hope for enduring momentum. Two reasons are bipartisan enthusiasm for Food is Medicine and a growing evidence base.
In May 2024, Representatives James P. McGovern (D-MA) and Vern Buchanan (R-FL) submitted a bipartisan letter to the House Committee on Appropriations, co-signed with 35 members of the U.S. House of Representatives, requesting greater federal investment in Food is Medicine and expansion of access to MTM.
“Let’s Make America Healthy Again – and I think that starts with food as medicine. It starts with a healthy diet, it starts with declaring war on chronic diseases.” —SENATOR ROGER MARSHALL (R-KS)
“It remains to be seen how the Trump Administration plans to lower chronic disease rates,” says Community Servings’ Senior Director of Policy and Research Jean Terranova. “What AMPL wants stakeholders to understand is that Food is Medicine interventions are strongly complementary of the MAHA Commission’s stated purpose. Medically tailored meals should figure prominently in any strategy to lower the country’s healthcare spending and improve health outcomes among people with chronic illnesses. We can change lives and achieve billions in savings through this intervention. We should continue investing in MTM so that more people across the country can stay out of the hospital and, if possible, manage their health independently.”
Research will shed new light on how effectively MTM achieves those goals in the coming years. The AMPL Institute is collaborating with the Tufts University Food is Medicine Institute and UMass Chan Medical School on a claims-data study that is evaluating the impact of MTM in Massachusetts Medicaid.
The findings may be especially important during challenging times for state Medicaid budgets. “I think this is a moment to be doubling down on evaluation,” says Katie Garfield, Director of Whole Person Care at the Center for Health Law and Policy Innovation of Harvard Law School. “Seeing the Evaluation Consortium findings could play a huge role in the renewal of Massachusetts’ 1115 waiver, which is set to occur in 2027.”
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The AMPL Institute’s inaugural report explores areas where the healthcare system and nonprofit CBOs are coming together — and preparing to more effectively come together — to support their shared goals.
