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State Health Care Structures

Find data on Medicaid and Medicare enrollment, coverage, and Food Is Medicine-related benefits by state.

State Examples of Food Is Medicine in Action

Food Is Medicine interventions are increasingly being integrated into healthcare delivery systems to support individuals with diet-related chronic conditions and other nutrition-sensitive health needs. States are pursuing different approaches to connect nutrition services with healthcare, including Medicaid benefits, managed care programs, Section 1115 Demonstrations, health system partnerships, and community-based interventions.

The examples below highlight how selected states are implementing Food Is Medicine programs, how patients are connected to services through healthcare providers, and whether reimbursement mechanisms are currently in place. They include In Lieu of Services (ILOS), 1115 Demonstration Waivers, Value-Based Payment and Grant-Funded models.

Disclaimer: The examples below represent initiatives developed and implemented by state agencies, health plans, healthcare organizations, community-based organizations, and other partners. They are provided for informational purposes only and do not represent HHS-developed programs or endorsements.

Understanding Food Is Medicine Financing Pathways

Food Is Medicine interventions can be financed through a variety of healthcare and community-based funding mechanisms. While approaches vary across states and health systems, 4 common pathways have emerged, including:

Medicaid Managed Care and "In Lieu of Services" (ILOS)

Some Medicaid managed care plans may cover Food Is Medicine interventions, such as medically tailored meals, as cost-effective alternatives to traditional medical services. These services, often referred to as "In Lieu of Services" (ILOS), allow plans to address nutrition-related health needs.

Section 1115 Medicaid Demonstration Waivers

Section 1115 Demonstrations allow states to test innovative approaches to improving health outcomes and healthcare delivery. Several states are using this authority to provide nutrition support and other health-related social needs services for eligible Medicaid members. These demonstrations help states evaluate new models for integrating nutrition into healthcare.

Value-Based Payment and Healthcare System Investment

Healthcare organizations participating in value-based care arrangements may invest in Food Is Medicine interventions as part of broader efforts to improve population health and reduce avoidable healthcare costs. Under these models, providers and health systems have greater flexibility to address factors that influence health outcomes, including access to nutritious food.

Grant-Funded and Community Partnership Models

Many Food Is Medicine programs are supported through grants, philanthropic investments, public-private partnerships, and community-based funding. These models often serve as important testing grounds for innovative approaches and may inform future healthcare financing strategies.

As evidence continues to grow, states, health plans, healthcare providers, and community organizations are exploring sustainable pathways to integrate nutrition interventions into healthcare delivery. While reimbursement approaches differ across states, Food Is Medicine programs increasingly rely on partnerships between healthcare systems and community organizations to connect eligible individuals with nutrition services that support health and well-being.

State-Specific Examples

The examples below highlight California, Kentucky, North Carolina, Oregon, and Texas as unique ways of implementing and financing Food Is Medicine across the country.

California

Medicaid Managed Care and Community Supports

California created one of the nation's most comprehensive healthcare-based Food Is Medicine frameworks through its CalAIM initiative. Under CalAIM's Community Supports program, participating Medi-Cal managed care plans may offer medically tailored meals, medically supportive foods, and other nutrition interventions for eligible members with nutrition-sensitive health conditions. Providers, care managers, and health plans identify eligible patients and connect them to services designed to improve health outcomes and reduce avoidable healthcare utilization. These interventions are integrated into healthcare delivery and financed through Medi-Cal managed care plans.

Current reimbursement model: Medicaid managed care through Community Supports using "In Lieu of Services" authority.

Examples of interventions: Medically tailored meals, medically supportive foods, nutrition support services, and care coordination.

Select references

Kentucky

Rural Health and Community-Based Partnerships

Kentucky's Food Is Medicine efforts were largely developed through partnerships among healthcare providers, community organizations, food banks, public health agencies, and universities. These programs often focus on improving access to nutritious foods for individuals living with chronic conditions, particularly in rural communities where food insecurity and diet-related disease rates are high. Healthcare providers may refer patients to produce prescription programs, nutrition education, and food access initiatives that support disease management and overall well-being.

Current reimbursement model: Primarily grant-supported, philanthropic, healthcare-community partnerships, and pilot initiatives.

Examples of interventions: Produce prescriptions, nutrition education, healthy food access programs, and community referral partnerships.

Select references

North Carolina

Whole-Person Care and Community Care Networks

North Carolina has emerged as a leader in integrating health-related social needs into healthcare delivery. Food Is Medicine efforts are frequently connected to care management programs, community care networks, and partnerships between healthcare organizations and community-based providers. Patients may be screened for food insecurity and nutrition-related needs during healthcare visits and referred to produce prescription programs, medically supportive food programs, and other nutrition services. These initiatives help strengthen connections between clinical care and community resources.

Current reimbursement model: Supported through healthcare partnerships, Medicaid innovation efforts, grants, and community-based funding models.

Examples of interventions: Produce prescriptions, food insecurity screening and referral, medically supportive food programs, and community resource navigation.

Select references

Oregon

Section 1115 Waiver Nutrition Services

Oregon is among the first states to use a Medicaid Section 1115 waiver to support nutrition services as part of broader health-related social needs benefits. Through Oregon's Health-Related Social Needs initiative, eligible Medicaid members may receive nutrition support, including medically tailored meals and nutrition education, when these services are expected to improve health outcomes and reduce healthcare costs. Healthcare providers, care coordinators, and coordinated care organizations play a central role in identifying eligible patients and connecting them to services.

Current reimbursement model: Medicaid Section 1115 waiver authority approved by the Centers for Medicare & Medicaid Services.

Examples of interventions: Nutrition education, medically tailored meals, food supports, and health-related social needs services.

Select references

Texas

Health System Innovation and Value-Based Care

Texas has become a leading environment for healthcare-driven Food Is Medicine innovation. Health systems, academic medical centers, food banks, and community organizations have developed produce prescription programs, medically tailored grocery programs, and nutrition support initiatives addressing diabetes, cardiovascular disease, and other chronic conditions. Many programs operate through referrals from physicians, registered dietitians, and care teams and are increasingly incorporated into population health and value-based care strategies. While Texas does not currently have a statewide Medicaid Food Is Medicine benefit, many healthcare organizations are exploring sustainable financing approaches through value-based care and insurer partnerships.

Current reimbursement model: Health system investment, grants, philanthropic funding, insurer pilots, and emerging value-based payment arrangements.

Examples of interventions: Produce prescriptions, medically tailored groceries, nutrition counseling, and food insecurity interventions embedded within healthcare systems.

Select references

Content last updated on September 29, 2026