The Health Care Service Corporation (HCSC) and Blue Cross Blue Shield (BCBS) Institute have teamed up to bring healthy food delivery options to those living in food deserts.
The partnership has debuted foodQ, which offers affordable meals delivered to a participant’s home. The program aims to improve health outcomes for people with chronic conditions, particularly those conditions which are diet related.
Ultimately, the partnership signifies the growing trend of prevention being initiated by insurance companies and other payers in an effort to reduce emergency room visits, hospital admissions and costs.
“Currently, no state in the country has less than a 20% obesity prevalence rate and we know that the lack of adequate access to nutritious meals may accelerate the complications of diabetes and hypertension,” Trent Haywood, M.D., president of the Blue Cross Blue Shield Institute, told FierceHealthcare.
Program development
FoodQ was originally developed through the BCBS Institute, the company’s experimental arm aimed at addressing the social and environmental conditions affecting 60% of health outcomes. These “Affordability Cures,” as BCBS refers to them, are the company’s commitment to long-term solutions that address the root of expensive healthcare services by investing in social preventions.
“Like other offerings by the BCBS Institute, the intent is to align business practices in a model that achieves viability and sustainability without the need for continuous grants from philanthropic organizations,” Haywood said.
The program will pilot in 25 Chicago ZIP codes followed by 15 Dallas ZIP codes, all of which are consumer coverage locations for HCSC. All people living in these ZIP codes qualify, regardless of their health insurance carrier.
“We used our Community Health Management Hub to identify the neighborhoods in Chicago with the least access to fresh, nutritious food and subsequent overutilization of emergency room and avoidable hospital visits,” Haywood added.
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According to a study published in the Culture of Health in April 2018, meal delivery can reduce the cost of healthcare in dual beneficiaries of Medicare and Medicaid. According to the study, participants who participated in a meal delivery service had fewer emergency department visits, both for medically tailored and nontailored food programs. Participants in medically tailored delivery programs also had fewer inpatient admissions.
“While further, preferably randomized, evaluations are needed, this study suggests that meal delivery may be an important way to improve the health of vulnerable patients,” the study concluded.
Being a part of the solution
While BCBS and HCSC are some of the first healthcare companies to get involved with food delivery, fresh, prepared meals could become a new track for several companies and payers in 2019.
Manika Turnbull, vice president and community health and economic impact officer at HCSC, said that the ultimate goal of foodQ is to offer consumers access to affordable, healthy foods to help improve their health outcomes, particularly for diet-related, chronic conditions.
“HCSC and the BCBS Institute are working diligently to address the gaps and fragmentation in the healthcare system that often increase cost and prevent people from being healthy and at their best,” Turnbull told FierceHealthcare. “One of the areas that is widely known is nutrition, specifically for people living in food deserts that lack adequate access to fresh foods that make up a healthy diet.”
HCSC is committed to developing long-term solutions that address the root causes of expensive healthcare, which more and more point toward the social determinants of health. One of the main social determinants in 2019 is the prevalence of diet-related chronic conditions, including diabetes and obesity, which are highly influenced by a consumer’s neighborhood.
Research from the National Academy of Sciences revealed that medical care accounts for between 10% and 20% of health outcomes, with the remaining percentages attributed to environmental and socioeconomic factors—social determinants of health.
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For example, in New Jersey, Horizon Blue Cross Blue Shield linked up with RWJBarnabas Health (RWJBH) in 2017 to meet the needs of a community with a high emergency room admittance rate in the state. By combining Horizon analytics with knowledgeable practitioners in the community, Horizon and RWJBH have seen a 25% drop in care costs for this population, a 24% reduction in ER visits and a 35% increase in behavioral health visits.
Costs versus results
When debating where to pilot the program, the BCBS Institute used its Community Health Management Hub to identify the specific ZIP codes in Chicago and Dallas with the least access to fresh, nutritious food.
The foodQ program is open to all consumers, including those using Medicaid, regardless of health insurance status or insurance carrier. HCSC and the BCBS Institute hope to see tangible results in the Chicago and Dallas neighborhoods. Throughout the pilot, consumers will be asked to complete a survey to provide the program with tangible data.
The pilot is set for six months and began in February in Chicago, followed by Dallas in April. The evaluation will consider potential expansion into the delivery of meal kits so that consumers can prepare meals in their homes.
So, what are the costs for consumers?
The foodQ program costs $10 per meal, with an additional $6 fee per delivery. People have an option of a monthly subscription for $10, which negates the $6 delivery cost. The monthly subscription also includes a buy-one-get-one option, allowing users to purchase a meal for $10 and receive a second meal for free. Each user can order up to 20 meals per week and a monthly subscriber can order up to 10 meals per week (with the buy-one, get-one option this equates to receiving up to 20 meals per week).
“Food choices available to these communities often consist of calorie-dense meals that may be perceived as more ‘value’ per dollar spent when compared to healthy meal options available at higher price points,” said Haywood. “Our market research helped us identify a $10 price point.”
To order, participants go to the foodqhub website and enter their ZIP code, which determines if they are eligible for the service. Once eligibility is verified, participants enter their payment information, select their meal choice, then choose a date and time for meal delivery. Participants will then receive a text message confirming the order as well as notifications as to when the order is on its way and has been delivered.
Food options include five meal categories: beef, chicken, fish, pork and vegetarian. HCSC and the BCBS Institute collaborated with Kitchfix and Front Porch Pantry in Chicago and Dallas, respectively, to develop the menu. Kitchfix and Front Porch Pantry will be responsible for cooking the meals and delivering them to users’ homes.
"Kitchfix is proud to partner with BCBSI to bring nutritious meals to food deserts in Chicago via foodQ," Eva Lindpaintner, director of meals delivered at Kitchfix, told FierceHealthcare. "We know that diet is major determinant of health, and believe that improving access to fresh foods will have wide-ranging positive impacts for individuals and communities."
The success of the pilot will be determined by three factors:
- Ability to demonstrate that people in eligible communities have pent-up demand for access to healthy nutrition options if given access at an affordable price.
- Ability to demonstrate the sustainability and scalability of the service delivery infrastructure.
- Assessment of the correlation of nutritional consumption with healthcare utilization patterns.
Haywood believes this program is being introduced at the perfect time because overcoming barriers that limit access to healthy food will continue to grow as a priority for U.S. healthcare in 2019. Plus, online food delivery services in the U.S. are estimated to grow an additional $6 billion in the next five years from $17 billion to $23 billion.
Not to mention, this is the natural progression of healthcare prevention that moves away from the clinical setting and into the community setting.
“This transition means that food and fitness will become an integral component of how we evaluate holistic approaches to population health,” Haywood added.