INDIANAPOLIS, IN. – One of the best things a food bank can do to get started in Food is Medicine is to lobby their state food-bank leadership to get involved.
That’s because the managed care organizations seeking to use nutritious food to improve public health generally operate statewide and even across states. Food banks, meanwhile, tend to operate by county. But food banks with a statewide approach to getting healthy food to patients make more attractive partners in Food is Medicine, said panel participants at Fresh Connect Central’s food sourcing conference last week.
“MCOs are operating across the state,” said Michael McKee, CEO of Verona, Va.-based Blue Ridge Area Food Bank, referring to managed care organizations. “They don’t want to work with seven or eight or nine different food banks.”
In Virginia, the seven members of the Federation of Virginia Food Banks have been working together for a few years to promote partnerships between hunger relief and healthcare (for more on this initiative, see our article here). “Being able to tackle this as a state has been really fundamental to our success in Virginia,” McKee said. “It really puts us much further along in the minds of the MCOs.”
The food banks of Michigan are also working together on a statewide approach to Food is Medicine. The Food Bank Council of Michigan is building a database that would ease the administrative burden of sharing all the information that needs to pass between healthcare partners and food banks, such as claims, invoices, orders, utilization rates and so on. The database, which is expected to roll out in June, will also keep patient data confidential.
“Creating that system for our state enables our food banks and pantries to participate in Food is Medicine at a much higher level,” said Dawn Opel, Chief Innovation Officer at Food Bank Council of Michigan, who is spearheading the initiative. “We can also absorb some of the cost and the risk on their behalf.”
Economies of scale came up more than once as an advantage of food banks working together on Food is Medicine. “Working as a state, you’re able to build out that infrastructure more efficiently and without as much pain as trying to do that individually,” McKee said. Opel put it more forcefully: “This Medicaid work, I think, only really survives if it’s done at scale,” she said. “If your state can join forces, you’re in a much better situation to compete with our competitors in this space.”
That competition includes a host of private-sector companies, including FarmboxRx (see our article on FarmboxRx here) and others, many of which have backing from venture capital firms. Often, these companies have the large-scale reach that food banks usually lack.
But, McKee noted, they don’t have relationships with the patients who need healthy food. “The real advantage that we as food banks and our partners have is that deep connection to the people we’re serving, who happen to often be the plan members,” McKee said.
Falon Owen, Principal at Health Management Associates, agreed that food banks have distinct advantages in Food is Medicine, especially if they can operate at scale. “Don’t sell yourselves short,” she said. “I think your value proposition, your mission, what you have is way better than what the current market has.” Even so, collaboration will be important. “The more you work together, the better you collaborate at the state level and ultimately nationally, I think you guys could run them [the competition] right out of the market.”
But it won’t be easy, cautioned Opel, noting the “hard reality” of building partnerships with healthcare. “It means that you’ve got to source differently. Your ops have to be different. You probably have to do home delivery. You have to track the food at an individual level. You have to have inventory control that you’ve never had before. That’s the kind of stuff that health insurance requires,” she said.
At the same time, each state is putting its own spin on Food is Medicine policy. In some states, such as North Carolina, which has championed the use of food to bring down medical costs, the ability to generate revenue from Food is Medicine appears more within reach. North Carolina’s Healthy Opportunities Pilot offers a generous reimbursement for each box of food that gets distributed to a patient (see more here for our article on a North Carolina pantry taking advantage of the pilot program.)
The Healthy Opportunities Pilot means that Food Bank of Central & Eastern North Carolina is earning income of about 12% on each of the 540 boxes it is distributing weekly to patients in its Food is Medicine program, said Carter Crain, Vice President of Food Procurement. The reimbursement covers the cost of the food in the box, as well as the associated overhead. So far, the food bank has hired a program manager, a program coordinator, and a finance officer to manage its Food is Medicine program. (See more here on Food Bank of Central & Eastern North Carolina’s Food is Medicine program.)
The impact of state policy speaks to the importance of getting involved early on in any conversations at the state level around Food is Medicine. A big break for the Virginia food banks, for example, came when the state had to create a request for proposal for Medicaid contracts. “This was an opportunity for the Federation of Virginia Food banks to provide some input into what that RFP looked like,” McKee said. “The lesson learned for other states is to seize that opportunity, possibly with other stakeholders, so that you can work language into the plan that favors community-based organizations as partners in providing Food is Medicine services.”
Opel concurred, noting that Michigan’s state policy dictates that 30% of Food is Medicine activity has to be local or community-based to satisfy the requirements of the Medicaid office. “That allows us to have more of a foothold in the policy,” she said.
What if your state just isn’t interested in Food is Medicine? There’s still a lot to be done, the panelists said. “I can’t stress enough the importance of getting to know the MCOs in your state and collaborating with hospitals and clinics around health-related programming,” McKee said. “There’s a lot we can do in the absence of legislation or a statewide commitment to Food is Medicine to move the programming forward.” – Chris Costanzo
PHOTO, TOP: The Food is Medicine panel at Fresh Connect Central’s food sourcing conference.
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