Helping people stay out of the hospital through better nutrition

As doctors, caregivers and healthcare foodservice pros know, it’s a vulnerable time for low-income patients when they first return home after being in the hospital. Cooking meals—let alone healthy meals—can seem to be an insurmountable challenge for someone who’s used to fast food, is low on funds and on top off all that is probably feeling pretty sick.

That vulnerable situation leads to worsening health and to patients being readmitted again and again, something that costs taxpayers money when patients are on Medicaid and leads hospitals to get lower ratings in benchmarking reports.

In California, the “revolving hospital door” situation is being addressed with a new three-year pilot program, Food is Medicine, in which nonprofits across California will team up to get healthy food into the hands of sick Californians covered by Medi-Cal (the state’s version of Medicaid).

The initiative, which starts this January, will be led by Project Open Hand, a San Francisco nonprofit that got its start serving free, nutritious meals to HIV patients in 1985. Project Open Hand expanded from HIV to helping people with other chronic illnesses like diabetes, cooking and delivering 2,500 meals and 200 bags of groceries to sick and disabled people every day.

Food is Medicine will use the funds to target Medi-Cal patients who suffer from chronic illnesses including congestive heart failure, cancer, diabetes, chronic obstructive pulmonary disease and renal disease. That funding is a result of SB 97, a budget bill approved by Senate last summer and signed into legislation by Governor Jerry Brown.

The program will be modeled after a study in Philadelphia by an organization called Manna. The numbers from that project are promising: After delivering three medically tailored meals to 65 patients with chronic diseases every day for six months, their healthcare costs plummeted from $38,937 per month to $28,183 per month. Read more about the study here. 

Kim Madsen, RD, director, nutrition services, Project Open Hand, has worked with Project Open Hand for 17 years. Describing the work she currently does, it’s clear a lot of time and planning goes into the medically tailored meals, which Project Open Hand cooks in a central production kitchen.

“We try to do all our food from scratch and as whole as possible, making sure everyone gets mostly whole grains and lots of vegetables,” Madsen says. “We analyze every recipe and all of our meals are on an eight-week cycle.”

Kim points to a recent study done by UC San Francisco and San Francisco General Hospital with heart failure patients as further evidence that food can be medicine.

“Heart failure patients are very sick; they get readmitted all the time and it’s very expensive,” Madsen says. “They used meals, education and counseling to reduce the readmission rate.”

When the program begins, patients who are eligible for the program will be referred to Food is Medicine by their doctors and then they’ll begin to receive two meals and a breakfast snack bag each day. Typical selections will include well-balanced meals with lots of leafy greens, whole grains, lean protein and legumes, with each ingredient carefully evaluated based on its healing properties and tailored to each recipient.

Currently, the Food is Medicine project hasn’t partnered with any hospital foodservice professionals, but Madsen says she’s very interested in a possible collaboration since the goal of both groups is essentially the same: helping people stay out of the hospital though better nutrition.

After three months, the goal is, “hopefully they will have a better idea of how to take care of themselves and hopefully haven’t been readmitted,” Madsen says. “Getting our meals and eating the food is educational. We’ll teach them how they can cook cheaper and healthier. It’s amazing what a difference that makes.”