Preliminary findings in Massachusetts demonstrate promising potential for utilizing Medicaid funds to address food insecurity, but caution there may be technological obstacles to contend with. In September, MassHealth received federal approval to use Medicaid to support nutrition initiatives as part of a $67 billion healthcare reform package. This shift could enable hunger relief and healthcare organizations to collaborate more closely, but setting up the systems required for this integration proves challenging.

Catherine Lynn, Vice President of Communications and Public Affairs at Greater Boston Food Bank, emphasized the technical complexity of linking the emergency food system with healthcare. The organization, who has been exploring the nexus between healthcare and hunger relief since November 2016, faced a myriad of challenges in the run-up to a smaller Medicaid pilot. Deciding whether to hire additional staff, identifying partner agencies, and connecting with the state’s 17 accountable care organizations were several issues of note.

Ultimately, the food bank decided not to enter the business of medically tailored meals. Instead, they chose to supply food to organizations specialized in such meals, acknowledging the complex finance, technological, and contractual hurdles involved. With the recent expansion of Medicaid‘s nutrition funding in Massachusetts, the food bank is learning from early program participants and partners.

Food Bank of Western Massachusetts, active in merging healthcare and hunger relief efforts for years, initially hired a bilingual staff member to link food-insecure patients referred by local healthcare centers to emergency food services. With the 2020 launch of the smaller-scale Medicaid pilot, their efforts broadened to include grocery store gift cards, diet-specific meals and kitchen equipment. These costs, plus time spent connecting individuals to the program, are reimbursed by MassHealth.

While working with different affordable care organizations is complicated, as each one independently decides how to allocate funds between nutrition and housing, food banks themselves are not tasked with measuring medical outcomes; this responsibility falls to the affordable care organizations. Food banks gather service information, like the number of delivered meals, and conduct surveys on wellness for its own records.

One notable advantage of coupling healthcare with hunger relief is the de-stigmatization of the latter by presenting it as a health issue, rather than a matter of financial status. Despite initial challenges, there is significant potential for food banks to promote programs that treat food and nutrition security as reimbursable healthcare expenses. Some consider this model the future and believe making the connection between hunger, nutrition, and health is fundamental to their mission.