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February 18, 2019

Why this Blue Cross insurer is launching a meal subscription service

Daily Briefing

    Read Advisory Board's take: How to start your own program addressing food insecurity (and a possible new source of funding)

    One of the largest Blue Cross Blue Shield operators in the country has launched a six-month meal subscription pilot program, called FoodQ, to deliver "affordable, nutritious foods" to people living in food deserts in Chicago and Dallas.

    Subscription service details

    Health Care Service Corp (HCSC), which operates Blue Cross Plans in five states, launched the pilot program with the Blue Cross Blue Shield Institute.

    Through FoodQ, the organizations will deliver healthy foods to 40 service areas that lack affordable, fresh foods. Deliveries to 25 Chicago ZIP codes have already begun, and the operation will expand in April to 15 ZIP codes in Dallas, HCSC said in a press release.

    The program is open to all residents of the service areas' ZIP codes, including those who are not members of a BCBS health plan, according to HCSC.

    To initiate a delivery, consumers enter their ZIP code into the FoodQ website to determine their eligibility. Once verified, consumers can choose from five categories of "ready-to-heat" lunches and dinners and select a date and time for their delivery.  Once the order is confirmed, participants will receive notifications when their order is in transit and delivered.

    Eligible consumers can subscribe to the program for a monthly service fee of $10, which includes free delivery, according to HCSC. Each meal costs extra, but consumers are eligible to receive a free meal for every meal they purchase.

    Non-subscribers who are interested in the program can still have food delivered for $10 per meal plus a $6 delivery charge.

    Insurers direct efforts to social determinants of health

    The move is part an effort by insurers to improve health outcomes by addressing the social determinants of health.

    "Food deserts are one of the key social determinants of health impacting millions of Americans," Manika Turnbull, VP and community health and economic impact officer for HCSC, said. "For us, it's really part of our effort to address root causes of an expensive health care system."

    According to HCSC, the program aims to help prevent "diet-related, chronic conditions, while reducing avoidable [ED] visits, and hospital admissions."

    To measure the program's impact on participants' health outcomes, HCSC will survey FoodQ participants to identify any correlation between the food deliveries and reductions in ED and hospital visits, according to HealthLeaders Media.

    "We know a ZIP code is just as important as a genetic code in determining a person's health," BCBS Institute president Trent Haywood, said. "With the alarming rates of obesity and diabetes in our country, we need a different approach to supporting healthy living, and this pilot program can help remove the barriers that keep people from accessing healthy, affordable and nutritious foods" (Japsen, Forbes, 2/12; Commins, HealthLeaders Media, 2/12).

    Advisory Board's take

    Tomi Ogundimu, Practice Manager, Population Health Advisor and Darby Sullivan, Senior Analyst, Population Health Advisor

    I'm excited to hear about this program as it reflects an increasing understanding about the importance of addressing food insecurity within the health care industry. And for good reason, as we know that one in six households experience food insecurity, and individuals who are food insecure are two times as likely to suffer from diabetes and three times as likely to have poor overall health status.

    “Food insecure individuals are three times as likely to have poor overall health status.”

    But while food insecurity is often among the first targets for hospitals looking to address the social determinants of health, starting a program to address the issue is not an easy task.

    To learn what makes a program successful, we recently sat down with Alisa Craig, administrator of wellness and population health at Hurley Medical Center in Flint, Michigan who launched a program to address food insecurity last year. Here are six things Alisa wishes she had known when it first launched:

    1. Staff education provided only one time won't be sufficient to drive home the urgency of addressing food insecurity and cement a new workflow. Plan to host multiple sessions with clinic and inpatient staff to ease the transition to incorporating additional screening and referrals into their care protocols.
    2. Screening for food insecurity isn't an inherent skill, but must be taught to the right staff to unearth the most accurate picture of patient needs. Use staff trained in cultural humility and nonjudgmental language to increase the efficacy of screening given the sensitivities for this social need. Social workers or community health workers are often the best positioned to carry out screening without adding to stigma. 
    3. Community partnerships will be essential to your success, and even more effective if you formalize each party's roles. Draft a memorandum of understanding to delineate responsibilities of all parties, hold community partners accountable, and drive program efficacy.
    4. Food safety protocols are required learning—sooner rather than later. Prioritize hiring staff with food service experience to ensure offerings are up to health department and Joint Commission codes. If not, programs run the risk of being shut down.
    5. Unaddressed social co-morbidities can derail your food insecurity efforts. Other social needs, like housing insecurity, will impact the social care you provide. Monitor patients' additional social needs (e.g., lack of electricity) to ensure food offerings are relevant (e.g., food that doesn't require cooking).
    6. Patients won't eat your food if it doesn't taste good, so supply a range of spices. Explain how to use spices in cooking to encourage people to actually eat the food without unhealthy additives (e.g., butter, salt).

    Another key tip in starting a program? Working with the community to secure funding. And we have good news. Last week, the Treasury Department announced a new funding opportunity for states and local governments looking to invest in addressing the social determinants of health. Through a provision in the Bipartisan Budget Act of 2018, the agency has allocated over $66 million to fund outcomes-based social impact projects. We're still analyzing this news to see how hospitals and health systems can access these funds and will provide more information soon. In the meantime, you can read the Notice of Funding Availability (NOFA) here.

    To learn how other hospitals and health systems are taking on food insecurity—and 16 action steps you should follow in starting a program—be sure to download our research report on Provider-Led Strategies to Address Food Insecurity.

    Download the Report

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