Weekend Update

Congress remains in session on Capitol Hill this coming week. Here's a link to The Week in Congress's report on last week's actions on Capitol Hill.

In 2011, the FEHBlog's internist advised him strongly to change his diet in order to reduce the risk of diabetes. The FEHBlog took his advice, which worked. Health Payer Intelligence reports

Philadelphia-based Health Plan Partners (HPP) reduced blood glucose levels of diabetics and care utilization of other chronically ill members by implementing a healthy meal program to address food-related social determinants of health (SDOH). 

The Food-as-Medicine program targets chronically-ill Medicaid and Medicare members by working with the state’s Metropolitan Area Neighborhood Nutrition Alliance (MANNA). The targeted meals helped HPP and MANNA to reduce hospital admissions by 27 percent, ED visits by 6.9 percent, provider visits by 15.9 percent, and specialist visits by 7.9 percent. 

HPP contracted MANNA to provide members 21 meals per week for a six-month duration in 2015. HPP extended the Food-as-Medicine program into 2017 and increased the meal outreach program from 200 Medicaid diabetic members to 1900 Medicare and Medicaid beneficiaries. 

Leaders from both organizations developed the program based on MANNA’s previous research on food-related SDOH, which found that providing healthier meals can drastically improve beneficiary health and lead to lower utilization rates over a long-term period. 

HPP and MANNA hope that other payers and organizations will borrow the insights from the program to address food-related issues in their chronically-ill populations.

This SDOH coverage is a new trend in health plan coverage, and if this is what it takes to help people change their habits, the FEHBlog supports it.

OPM makes it difficult for plans to innovate on their own (as opposed to adopting OPM's ideas). In the call letter for benefit and rate proposals, OPM routinely states (and did this year, page 6) "Except where noted, all benefit enhancements must be offset by proposed reductions so that premiums are not increased due to benefit changes."  This is not a particular thoughtful way to control costs. Spending money on SDOH or similar innovations would add new benefit costs but can reduce overall benefit spending. OPM should be looking at merits of new benefits rather than placing focus on offsets, in the FEHBlog's view.