Throughout the country, governors lead a new phase of health care processing – which positions healthy food As a refundable and clinically relevant intervention to resolve chronic diseases. Although the link between food and health is well established, what emerges is the integration of food services in Medicaid and other health care service systems. Known as food is medicine (FIM), these interventions – including medically tailor -made meals, produce prescriptions and tailor -made grocery products – state a tool relevant by the policy to reduce avoidable health costs and improve results for people with food conditions. The opportunity to build healthier communities thanks to strategic food interventions has never been more innocent or more exploitable.
The definition of food is a medicine
The American Heart Association defines Food is medicine Like the provision of healthy foods – such as meals, grocery products or prescriptions – to process or manage specific clinical conditions in a manner that is integrated and paid by the health system. These targeted interventions differ from nutrition assistance programs such as the additional nutritional assistance program (SNAP) and the special additional nutrition program for women, infants and children (WIC), which are designed to treat food insecurity in the population. Instead, FIM focuses on individuals whose diet needs are part of a clinical care plan and linked to a chronic diagnosed disease, and the intervention is paid and delivered by the health care system.
Why now: alignment of health, cost and politics
Food as medicine is gaining ground partly due to its potential to meet some of the most urgent challenges of public health. According to the Centers for Medicare & Medicaid ServicesMore than 90% of the 4.5 billions of dollars that the United States spends each year for health care consult chronic conditions, many of which are closely linked to the diet. Conditions such as type 2 diabetes, hypertension and cardiac diseases lead to avoidable health costs, state budgets to maintain and disproportionately affect low-income and historically undercered populations.
For governors who seek profitable means of treating chronic diseases, FIM can represent an opportunity to integrate nutritional support based on evidence in the provision of health care. More importantly, these interventions are not abstract. Governors test them through MEDICAIDE MEDICAIDE MEDICAI DEMOTATION.
Governors and States open the way
According to KFF’s derogation tracker16 States (California, Colorado, Delaware, Hawai’i, Illinois, Maine, Massachusetts, Nevada, New Jersey, New Mexico, New York, Caroline du Nord, Oregon, Pennsylvania, Rhode Island and Washington), approved the demonstrations of section 1115 pending which offer coverage for nutritional interventions, including medically tailor -made meals and grocery stores. Many of these initiatives are directly supported by the leadership of governments and cross -collaboration:
- CMS approved a five -year extension For Delaware, the demonstration of the “Delaware Delaware Diamond State Health Plan (DSHP).” Approval includes the authorization of new services for postpartum registrations, including coverage of two meals delivered per day or a medically appropriate stable shelving food.
- The agenda of the health policy of the Governor of Oregon Tina Kotek continues to support the benefit of health related social needs (HRSN), approved by virtue of a Five -year -old Medicaid in 2022. The state uses this authority to finance meals and tailor -made grocery products medically for certain chronic conditions, emphasizing equity and upstream prevention.
- Pilots of healthy opportunities in North CarolinaInitiated by the former governor of North Carolina, Roy Cooper, have become a national model to test the use of Medicaid to cover non -medical services, including food, housing and transport.
- Under the direction of the Governor of Massachusetts, Maura Healey, Massachusetts Tire of his derogation 1115 to extend the delivery of tailor -made meals medically in partnership with community organizations.
- Oklahoma Governor Kevin Stitt recently signed the Act of medicine (SB 806), create certain incentives for entities contracted by Medicaid; provides for a certain expansion of nutrition services.
In addition to these initiatives, Colorado,, new York,, Washington,, New Jersey Pilot or expansion of food care models in their Medicaid programs. Many align these efforts with wider state objectives concerning health equity, integration of behavioral health and access to rural health.
For an additional context, the The Kaiser Family Foundation MEDICAID (May 2025) provides detailed information on derogations from article 1115 approved and awaiting the State, including those which are aimed at social health engines, such as nutrition.
The upcoming challenge: from practice to politics
Despite early momentum, FIM scaling requires more than promising pilot results. The current, growing evidence is still limited.
Governors can consider creating more robust data that resonates with budget managers, Medicaid directors and federal regulators to make FIM part of the landscape of the coverage of Medicaid. This includes the demonstration of profitability, clinical impact and operational feasibility in various populations.
Thanks to executive leadership, governors can consider:
- Define a vision at the level of the state for the integration of foods as a drug in health systems;
- Direct collaboration between Medicaid, public health agencies and social services;
- Invest in evaluation data and infrastructure; And
- Promote partnerships with health care providers, community organizations and researchers.
The American Heart Association Health Care By Food ™ initiative directly works with states to support these efforts. The initiative provides technical assistance in collaboration with the American Ministry of Health and Social Services to design FIM interventions which are based on evidence and evolving while helping states to develop evaluation plans which meet both scientific and political standards.
Look forward to
While the American health system continues its evolution towards value -based care, food as medicine is no longer a foreign concept. It is a pragmatic and promising solution with bipartite support and an impact on measurable health. Governors and their teams have a unique window of opportunity to direct this change: not only by piloting new programs, but creating the policy, infrastructure and the evidence necessary to make healthy foods a sustainable part of the health system.
For more information on NGA food as a medical work and RX for healthier America, please contact Brittney Roy-Morals.