Medicaid Nutrition Supports Associated With Reductions In Hospitalizations And ED Visits In Massachusetts, 2020-23

Area of Science:

• Public Health
• Health Services Research
• Health Economics

Background:

• Food insecurity is a significant social determinant of health.
• Medicaid programs are exploring innovative interventions to address food insecurity.
• The Massachusetts Flexible Services Program (FSP) utilizes Food Is Medicine (FIM) interventions.

Purpose of the Study:

• To evaluate the impact of the FSP's nutritional services (FIM programs) on healthcare utilization and costs.
• To assess the effectiveness of FIM programs within a Medicaid Section 1115 demonstration waiver.

Main Methods:

• Propensity score-weighted analyses of pooled data from 20,403 FSP participants and 2,108 eligible nonparticipants.
• Evaluation covered the initial three-year program cycle (January 2020–March 2023).
• Comparison of healthcare use (hospitalizations, emergency department visits) and costs between participants and nonparticipants.

Main Results:

• FSP participation was linked to a 23% reduction in hospitalizations and a 13% reduction in emergency department visits.
• While not statistically significant, health care costs were modestly lower for FSP participants.
• Post-COVID-19 emergency (2022-23), costs were $1,721 lower for participants; adults with >90 days enrollment saw $2,502 lower costs (2020-23).

Conclusions:

• Food Is Medicine interventions within Medicaid demonstrations show promise in reducing healthcare utilization.
• Findings support the expansion of similar Section 1115 demonstrations for addressing food insecurity in other states.
• Further research is needed to confirm cost savings and long-term impacts of FIM programs.