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New Kentucky pilot programs test prescribing food as medicine

 A row of produce is shown at a store. The lineup includes lettuce, cucumbers, carrots and bell peppers.
Wikimedia Commons
Wikimedia Commons
It's not easy for people facing food insecurity to consistently get fresh fruits and vegetables. Pilot projects led by the University of Kentucky will test ways to prescribe food as medicine.

Nutrition comes up a lot at doctors visits. For people who experience food insecurity, though, it isn’t easy to reliably get healthy meals.

What if doctors actually prescribed food as medicine, and patients’ health insurance covered it?

The University of Kentucky’s new Food as Health Alliance is testing out ways to do that. It will lead pilot programs in five urban and rural counties: Fayette, Floyd, Harlan, Jefferson and Perry.

They’ll focus on patients with certain health conditions, like hypertension or Type 2 diabetes, who also deal with food insecurity. That means they lack steady access to sufficient food to lead an active and healthy life.

“So we know that when you’re experiencing food insecurity, that has metabolic changes on your blood glucose, on your blood pressure,” said UK professor Alison Gustafson, the alliance’s program director. “And that has implications on how medicine might work for you. It has implications on how well you're able to manage your diabetes and your heart disease and certain cancers.”

Gustafson said they’ll try different approaches for different pilots over the next 18 months. For example, one will give people a $50 weekly voucher they can spend on eligible, healthy items at a local grocery store, while another will provide prepackaged meal kits for patients.

They’ll track patients’ health outcomes and how they use their food prescriptions.

“The grocery prescription … it’s kind of free-for-all,” said Gustafson. “They can just go online and order, and maybe this person is just going to order a bunch of lean steak, right, and no produce at all. We don't know.”

The prepackaged meals are more tailored to provide good nutrition to address specific health conditions, but they’ll see how patients like that approach.

“Maybe they get sick of the frozen meals. We don't know. And that's what we're trying to understand, right? What is the best recipe?” she said.

They’re looking at which models across the state are most effective – for who, for how long and in what way, Gustafson explained.

Gustafson said the goal is to use what they learn through this research to advocate for policy change at the state level.

Ideally, she said, they’d like to see Kentucky’s Medicare and Medicaid health insurance programs provide ‘food as medicine’ programs as a covered service for patients.

The Kentucky Association of Health Plans is contributing $200,000 to fund the pilot projects. It’s the trade association for the state’s health insurance companies.

CEO and President Tom Stephens said the projects will examine how different ‘food as medicine’ strategies work in rural and urban communities.

“What works in Clay County, Kentucky, is maybe not the best type of solution for west Louisville. So that was one of the things that I think really drew the association to this pilot,” Stephens said.

One of the projects the Food as Health Alliance will pursue over the next 18 months will focus on pregnant patients in Louisville who have gestational diabetes or Type 2 diabetes.

The alliance is partnering with Dare to Care Food Bank for that.

“We are going to be preparing frozen meals that fit within the diet of someone with gestational diabetes – 10 frozen meals a week – to be home delivered,” said Annette Ball, the organization’s chief programs officer.

Ball said Dare to Care already is working on ‘food as medicine’ efforts. For example, it runs ”prescriptive” food pantries at health clinics in the Louisville area, including some in Southern Indiana.

One of those is located at a local OB-GYN office, which Ball said they’ll focus on for the UK alliance’s pilot program.

“It can be very difficult for people living in food insecurity to access fresh fruits and vegetables,” she said. “That's something that we really work on at the food bank is trying to provide equity.”

Gustafson, the professor leading the alliance’s work, said Dare to Care is one of several groups they’re working with on these projects. Others include Instacart Health, Appalachian Regional Healthcare and the Community Farm Alliance.

“We are excited to partner with a variety of organizations across the state to really … understand how ‘food as medicine’ can work,” she said.

Morgan is LPM's health reporter. Email Morgan at mwatkins@lpm.org.

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