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October 23, 2013 Articles

Miracle Drugs Have a Familiar Face

Food and nutrition make a tremendous difference in health-care costs.

By Lydia Cipriani

When Brown University researchers conducted a study detailing the positive effects of “Meals on Wheels” on health-care outcomes, they didn’t tell us anything we didn’t know already. But our results at MANNA (Metropolitan Area Neighborhood Nutrition Alliance)—dealing not simply with the elderly but with a diverse population of young and old, working and non-working, poor and middle class—highlight a new miracle drug that most hospitals and health-care professionals overlook: food.

At MANNA, we know food. We live food. Every month we prepare over 75,000 meals to deliver to critically ill people in the Delaware Valley. These meals provide the patients (and in some cases their at-home children and caregivers) with three healthy, delicious meals a day, seven days a week, tailored specifically for their medical conditions. Over a third of MANNA clients have cancer, 25 percent suffer from renal disease, and 17 percent are HIV/AIDS positive.

“This is where we can do the most good and make the biggest difference,” says Sue Daugherty, MANNA’s executive director. “Our own studies have shown that medically supervised nourishment reduces hospital stays, lowers hospital costs, reduces actual hospitalizations, and MANNA clients are more likely to be released to their homes rather than long term care facilities.”

Daugherty is referring to a pilot study conducted by the OMG Center for Collaborative Learning. The study tracked average monthly health-care expenditures for MANNA clients and compared them with expenditures for a control group. The results were extraordinary.

  • Average monthly health-care costs of MANNA clients fell 62 percent for three consecutive months after beginning service, for a drop of almost $30,000.
  • Monthly inpatient hospital costs of clients were 30 percent lower over the six months following initiation of services than in the six months prior to starting MANNA.
  • Even when MANNA clients needed hospitalization, their improved nutritional status resulted in reducing the average number of monthly visits to half that of the comparison group, and their length of stay for inpatient visits was 37 percent shorter.
  • The costs of inpatient hospitalizations of MANNA clients were $87,000 lower than those of the control group.
  • MANNA clients were over 20 percent more likely to be released from the hospital to their homes rather than to long-term-care or health-care facilities.
  • MANNA clients living with HIV/AIDS cost the managed care organization an average of $20,000 less per month, and costs fell over 80 percent in the first three months.

The cost-saving evidence produced by this study was powerful enough to garner the right attention. Soon MANNA had the satisfaction of seeing its results published in a peer-reviewed journal, a fact that has opened many doors for MANNA among health-care providers. MANNA is presenting the data at two national meetings this fall. The full study will be presented at the Food & Nutrition Conference in Houston. The HIV/AIDS data will be presented as part of a panel at the American Public Health Association Annual Meeting in Boston, along with other research on food security and impact on health from Columbia University and Harvard.

MANNA has also been able to engage leaders in academic health systems in the Philadelphia area in talks about engaging in future studies.

But the real advantage of MANNA can be seen in that most elusive of all elements—patient health and satisfaction. Over 30 percent of current MANNA clients surveyed reported feeling strong enough to return to work, and the majority said that even after the program, they continued to eat healthier, showing a long-term beneficial effect on client lifestyles. Last year, 97 percent of our recertified clients reported a better understanding of healthy foods, and 99 percent reported improved health overall.

“Our clients report feeling better and stronger when they finish with our program,” explains Daugherty. As Lamont Bennett, a MANNA client and renal patient says, “After MANNA I wasn’t just 100 percent better. I felt like me again. I was Lamont again.”

Results like these spur Daugherty and her staff to work hard to be heard in Harrisburg . . . and Trenton. “People expect routine reimbursement for pills and surgery,” she explains “but this, the most basic of things—nourishing food—continues to be ignored by our representatives and remains unreimbursed. The irony is that we could save the medical system so much if they would invest just a little in nourishment.” Advocating for reimbursement, however, is a long and winding road. “You expect reimbursement because it’s the right thing to do, because it’s the smart thing to do. That doesn’t always resonate politically.”

MANNA is a small non-profit with a small budget. But maybe, just maybe, our legislators could learn a lesson from us in the smart way to save money . . . and lives.

Keywords: litigation, access to justice, patient, hospital, health, health care, health-care costs, food, nourishment, reimbursement, nutrition, non-profit, disease, diet, HIV, cancer, renal disease, meal delivery

Lydia Cipriani is director of development and communications at MANNA in Philadelphia, Pennsylvania.

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