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A landmark study published last week in Nature Medicine confirms that medically tailored meals (MTM), when delivered at the highest standard of quality, significantly reduce hospitalizations, emergency department visits, and total healthcare costs for patients with serious diet-related illnesses. The savings essentially offset the cost of the intervention.
The study is the largest evaluation to date of the impact of MTM authorized through a Medicaid Section 1115 demonstration program. It analyzed the claims data of nearly 2,000 Medicaid members from 2020 through 2023. All individuals received MTM prepared and delivered by Community Servings, the Boston-based nonprofit and the nation’s leading nonprofit researcher of MTM.
Patients receiving MTM experienced 31% fewer hospitalizations, 20% fewer emergency department visits, and $3,433 lower total healthcare costs over the program period compared with similar patients who did not receive meals. Healthcare savings offset 98% of the cost of the meals, making the intervention effectively cost-neutral while delivering meaningful improvements in patients’ health.
The gross savings were substantially greater for populations with costly chronic conditions:
- Cardiovascular disease: $10,450 in savings per patient over six months
- Chronic kidney disease: $12,312 in savings per patient over six months
- Depression and anxiety disorders: $5,597 in savings per patient over six months
- Diabetes: $4,123 in savings per patient over six months
The study was co-led by the Food is Medicine Institute at Tufts University and UMass Chan Medical School, in partnership with the AMPL Institute at Community Servings. Researchers analyzed claims data for 1,866 adults receiving MTM across 11 MassHealth Accountable Care Organizations.
What the Findings Mean for Health Policy
As the largest MTM study to date, the findings provide strong, real-world evidence that MTM should be a standard covered service within Medicaid. Massachusetts was among the first states in the nation to reimburse MTM providers through Medicaid. Today, 13 states are piloting similar models through Medicaid Section 1115 demonstrations, with more expected to follow.
The findings also underscore the urgency of expanding access to MTM in Medicare, which serves nearly 69 million Americans — many of them older adults managing serious diet-related conditions. There is currently no access to MTM in Original Medicare and limited access in Medicare Advantage. The Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439 / S. 2834), introduced in the 119th Congress as a bipartisan, bicameral bill and co-led in the House by Massachusetts Rep. James McGovern, would establish a six-year Medicare pilot at 40 hospitals to test the model for Medicare beneficiaries discharged with diet-related illness. The Nature Medicine findings support that this is exactly the kind of test Medicare should be conducting now.
“Medicaid has shown what’s possible. Medicare is the next frontier,” Waters said. “The patients in this study are exactly the patients Medicare serves every day, and the federal pilot in front of Congress right now is how we find out whether what worked in Massachusetts can work nationally. The evidence is there. What’s needed is the will to test it at scale.”
Protecting the Integrity of MTM
Community Servings is accredited by the Food is Medicine Coalition (FIMC), the national association of nonprofit MTM providers that maintains the standards for the field. The accreditation matters: The outcomes and cost-savings reflect what is possible when food is treated as medicine — based on evidence and prepared with rigor, precision, and patient-centered care. The meals studied were designed by registered dietitian nutritionists, tailored to each individual’s medical diagnosis and dietary restrictions, and prepared from scratch in Community Servings’ Boston kitchen. Ingredients are always whole, as well as fresh and locally sourced wherever possible.
“This study tells us something important about what works — and what doesn’t,” said David B. Waters, CEO of Community Servings and Founder of the AMPL Institute. “Medically tailored meals are a clinical intervention, not just a meal delivery. The results published today reflect the work of dietitians, chefs, and clinicians coordinating around each patient’s diagnosis. As more states and health plans look at covering Food is Medicine, the question they should be asking isn’t just whether food is on the menu. It’s whether the food meets the standard that produces clinical results like these. If payors and providers turn to lower-quality interventions that don’t meet the FIMC standard, patients won’t see these outcomes, and the promise of Food is Medicine could be lost.”