The Second Annual National Summit on the Social Determinants … · 2017. 10. 16. · The Second Annual National Summit on the Social Determinants of Health The Root Cause Coalition

The Second Annual National Summit on the

Social Determinants of Health

The Root Cause Coalition

Louisville, Kentucky

October 9, 2017

Food is Medicine Research: Building the evidence-base for

medically tailored home-delivered meals as a high-value, low-cost intervention

in healthcare

Community Servings is a

Boston-based not-for-profit

organization with a 27 year history

of providing medically tailored

meals and nutrition services to

individuals and their families coping

with critical and chronic illnesses.

Community Servings: Who We Are

Food is Medicine: A National Movement

We are partners of The Food is Medicine Coalition (FIMC), a

volunteer association of nonprofit, medically-tailored food and

nutrition services (FNS) providers seeking to preserve and expand

coverage of FNS for the critically-ill.

Embarking on Research to Demonstrate the Impact

of Medically Tailored Home-Delivered Meals

Along with our colleagues in the Food is Medicine Coalition, we

have set about to demonstrate the impact of medically tailored

home-delivered meals on health outcomes and healthcare

costs.

How Has Community Servings Developed the

Capacity to Engage in Research?

Through Evolving Research Partnerships and

Projects.

Client Satisfaction

Surveys

Congressional Hunger Center

Referral Partner Surveys

Mass. General Hospital Diabetes

Pilot (n = 43)

AARP Foundation Funded Study of

Healthcare Claims Data (n =

133)

Robert Wood Johnson

Foundation Study of

Healthcare Claims Data (n =

2000)

Moving from soft to hard data.

Our First White Paper: Surveys and Interviews of

Our Referral Partners, In Collaboration with the

Congressional Hunger Center

• 96% of healthcare professionals reported

that our meals program improved their

clients’ health

• 65% believed the program resulted in

decreased hospitalizations

• 94% believed the program significantly

improved patients’ access to healthy food

Recurring themes:

Summary of Our Research Projects

With Dr. Seth Berkowitz as Primary Investigator

Pilot study of impact of our diabetic meals on patients with

advanced diabetes and food insecurity (submitting manuscript in

September 2017 to Diabetes Care) (n = 43)

Retrospective evaluation of claims data of clients we have served

through Commonwealth Care Alliance (manuscript submitted in

August 2017 to Health Affairs) (n = 133)

Retrospective evaluation of clients we have served from 2011-2015,

through examination of the All-Payer Claims Database (30-month study

launched in December 2016) (n = 2000)

• 133 clients receiving Community Servings’ medically tailored home-delivered meals (MTM) for at least six months vs. 2 control groups – one receiving non-medically tailored home-delivered meals (NTM), and the other receiving no meals.

• Analysis of healthcare claims data.

• For MTM group, across the board reductions in “big ticket” healthcare services, including inpatient admissions, ED visits, and emergency transportation events.

• NTM group also had reductions in ED visits and emergency transportation events, but not inpatient admissions.

Preliminary data (embargoed – under review by Health Affairs): AARP/CCA Evaluation Project

Food is Medicine for Diabetes: Study Design

• Randomized Control Trial of patients with advanced diabetes and food insecurity – 12 weeks on meals; 12 weeks of assessment; 43 participants.

• Interim results: Statistically significant improvements in dietary quality, according to the Healthy Eating Index (HEI) 2010. Improving HEI score by at least 5 points results in meaningful clinical improvements in HA1c and the reduction in heart attacks and the need for dialysis.

• While receiving the MTM intervention, average HEI score increased by 15 points.

• Patient reported reductions in food insecurity, trading off buying food for medications or medications for food, and better control of hypoglycemia.

Interim data (embargoed – pending submission to Diabetes Care):

Food is Medicine for Diabetes

All-Payer Claims Database Study Status

• 30-month study funded in December 2017; results anticipated in June 2019

• Massachusetts Department of Public Health joined as Co-PI, to ensure access to identifiable claims data (which will almost immediately be “de-identified” once the data-set is linked to our clients)

• IRB has been approved, and data use agreements executed

• Awaiting data transfer and analysis

How Do We Plan to Disseminate and Utilize the

Results?

Through state and federal policy development, in collaboration with the

Center for Health Law and Policy Innovation of Harvard Law School,

the Food is Medicine Coalition, and the Root Cause Coalition.

Through outreach to additional healthcare payers, providers, and policy

leaders.

Through dissemination in peer-reviewed publications (Health Affairs, Diabetes Care).

How Can We (All) Improve the Process for

Collaborative Research on the Social Determinants

of Health Between Community-Based Organizations,

Researchers, and Healthcare Policy Leaders?

• Work together, at the outset, in determining

proposed outcomes and evaluation methods.

• Develop a plan for sharing de-identified patient

claims data with an agreed-upon evaluator.

• Develop a plan for collaboratively evaluating patient

experience outcomes and quality of life metrics.

Questions?

David Waters

CEO

[email protected] | 617-522-7777 x210