On the finish of 2021, the federal company that oversees Medicare and Medicaid made an enormous resolution that made little information. With all of the fanfare of a stack of papers getting a stamp of approval, California received permission to pilot new approaches to offering healthcare to the greater than 13 million Californians who depend on Medi-Cal.
With that approval, the onus is now on native well being plans, together with San Francisco Well being Plan, to implement methods that would profoundly enhance folks’s well being and lives. One cutting-edge side of the reforms is Community Supports. There are 14 pre-approved Group Helps designed to deal with social drivers of well being, similar to lack of entry to meals. These are non-obligatory companies, that means particular person well being plans should choose into offering these interventions.
To stop, deal with and reverse persistent situations, San Francisco Well being Plan and well being plans throughout California ought to choose into offering medically supportive meals and diet, one of many 14 Group Helps. Medically supportive meals and diet interventions embrace produce prescriptions, meals pharmacies, wholesome groceries and medically tailor-made meals.
Proof strongly means that this spectrum of interventions will help scale back average blood sugar in those with diabetes, blood pressure and preterm birth. Many of those situations put people at greater risk for hospitalization, needing a ventilator to breathe and potentially dying from COVID-19. By investing in upstream interventions, California will be higher ready for our present well being disaster — and the subsequent one.
However is San Francisco — and California typically — ready to drastically increase entry to those food-based interventions?
My sense is sure. SPUR — in collaboration with the College of California San Francisco Middle for Weak Populations, Harvard Middle for Well being Legislation and Coverage Innovation, and the Meals as Medication Collaborative — just lately revealed “Integrating Food into Health Care,” a report based mostly on a survey of 145 organizations throughout the state. The analysis reveals there may be already a powerful community of community-based organizations, authorities businesses and conventional well being care suppliers providing — and poised to increase — food-based companies. In San Francisco, greater than a dozen organizations present not less than one medically supportive meals and diet intervention. Nevertheless, to construct upon the prevailing community of suppliers, the Division of Well being Care Providers, which administers Medi-Cal, and well being plans should deal with obstacles to development.
Practically 70% of suppliers surveyed reported a scarcity of sustainable funding as a barrier to providing meals and diet companies. These interventions are primarily funded by philanthropy, hospital neighborhood profit {dollars} and different exterior sources, quite than insurance coverage. In different phrases, they lack long-term monetary sustainability.
But researchers have estimated these interventions could save $40 billion to $100 billion in health care costs nationwide. Transitioning these companies from pilots to straightforward plan advantages would guarantee their sustainability and allow extra sufferers to enhance their well being whereas additionally lowering total well being care prices.
Whereas some could argue that insufficient wholesome meals entry is an issue to be solved by social companies businesses, Dr. Kim Newell Inexperienced, former president of the San Francisco Marin Medical Affiliation, explains, “If a brand new drug got here to market that confirmed these well being outcomes and no unintended effects, we’d instantly prescribe it to sufferers.”
A future the place we pay for the prevention — and never simply the remedy — of persistent illness is inside our grasp. The San Francisco Well being Plan should take the lead by seizing this uncommon alternative to enhance care by offering medically supportive meals and diet interventions.
“An apple a day retains the physician away” isn’t only a smart adage – it’s evidence-based drugs that well being plans ought to embrace.
Katie Ettman is the meals and agriculture coverage supervisor at SPUR, a nonprofit public coverage group within the San Francisco Bay Space.