Abstract MPTU23: A Payor-Supported, Post-Discharge Medically Tailored Meal Intervention Reduces Readmissions and Medical Spending in Medicare Advantage Members

Abstract

Background: Medically tailored meals (MTMs) are an emerging strategy to improve access to evidence-based nutrition, support recovery, and prevent avoidable readmissions for older adults in the post-acute period. In alignment with the AHA Health Care by Food™ initiative, scaling MTM programs requires robust systems to identify eligible members, coordinate timely interventions, and measure their real-world clinical and economic impact. Objective: To describe outcomes of a payor-supported, post-discharge MTM supplemental benefit for Medicare Advantage (MA) members of a large national health plan. It was hypothesized that MTM recipients would have relatively lower utilization and expenditures than non-recipients. Methods: Interoperable administrative claims and vendor data identified MA members discharged to home following acute inpatient hospitalization in 2023 with 6-mo continuous coverage. MTM-eligible members were contacted within 3–5 days post-discharge and offered MTMs tailored to dietary and clinical needs. Meal quantity varied by plan design and member preference. A propensity score–matched (PSM) cohort design with difference-in-difference analysis compared 3-mo pre- and post-discharge outcomes between MTM recipients and matched members who declined MTMs. Supplementary analyses evaluated outcomes by meal volume (≤14, >14 meals). Results: Of 276,226 MTM-eligible members, 113,498 (41.1%) opted in. The final study sample included 103,684 PSM members (51,842 per cohort; mean age 73.6y; 55% female; hypertension [87%], diabetes mellitus [41.9%], and heart failure [37.5%]). At 3-mo post-discharge, MTM recipients had relatively fewer 30-day all-cause readmissions (−2.8 per thousand per member, PTPM), inpatient visits (−62.2 PTPM), and lower total medical spend (−$507.81 per member per month; all P<.001). Utilization and spend were relatively lower among members receiving ≤14 (all P<.001), with mixed findings for >14 meals. Conclusions: A data-informed implementation model enabled timely identification, engagement, and scaled delivery of a MTM benefit to support MA members residing across the US. MTM receipt was associated with favorable differences in 30-day all-cause readmissions, inpatient visits, and medical spend, with variable results by meal volume. Findings may inform policy efforts to advance integration of nutrition-based interventions in post-acute care pathways and emphasize the value of multi-stakeholder coordination across the health care ecosystem.