From Cost to Care: How Nutrition Is Reshaping Healthcare Spending

Panelists representing health insurers, food banks, and academic medicine explored a sobering reality: most healthcare spending today is tied to preventable, diet-related conditions, yet nutrition remains largely sidelined in policy and payment models.

The result is a system that treats symptoms at scale while underinvesting in one of the most powerful tools for prevention: food.

The Price of Poor Nutrition

Anuraag Chigurupati, COO of Devoted Health, shared striking data from the Medicare Advantage population. Among seniors, approximately 73% of total healthcare costs are linked to preventable chronic diseases—including diabetes, heart failure, and hypertension—conditions deeply influenced by nutrition.

Devoted Health’s internal data reinforced this connection. After offering a grocery benefit to members, they examined purchasing patterns and downstream health outcomes. The findings were hard to ignore.

Members with high soda purchases showed:

• 14% higher obesity rates

• 16% higher overall medical costs, including hospitalizations and specialist visits

• 31% higher rates of depression

The takeaway was clear: food purchasing behavior is not just a lifestyle issue—it’s a cost driver.

When Benefits Drive Better Behavior

In response, Devoted Health made a bold shift. Leveraging updated CMS guidance clarifying that Medicare Advantage benefits should not include non-healthy foods, the organization restricted soda and candy purchases on grocery cards.

Starting in 2026, those items will no longer be eligible.

While concerns about member backlash were real, the response told a different story. Brokers applauded the move, and members largely understood the rationale. A prevention-first healthcare model, it turns out, resonates when it aligns incentives with long-term health.

Yet panelists noted that Devoted Health remains an outlier. Despite CMS guidance, most plans continue to allow unhealthy purchases, highlighting the need for stronger enforcement and clearer accountability.

Food Banks as Health Interventions

Radha Muthiah, President and CEO of the Capital Area Food Bank, underscored that the role of food banks has fundamentally evolved. Serving 1.5 million people across the greater Washington region, the organization made an early and controversial decision: not all food donations are acceptable.

More than a decade ago, the Capital Area Food Bank became the first in the country to refuse foods high in sugar, salt, and low in fiber—despite pushback rooted in the idea that “food is food.”

Their stance was simple: if food banks are serious about reducing hunger and improving health, nutritional quality must matter.

Today, their model reflects that commitment:

• At least 40% of all distributed food is fruits and vegetables

• A minimum of 10% is protein, plant- or animal-based

• Philanthropic dollars are used intentionally to fill gaps where donations fall short

The impact has been measurable. Through partnerships with hospitals and community clinics, the food bank has helped improve outcomes in diabetes, hypertension, cardiovascular disease, and high-risk pregnancies.

Measuring Health—and Cost

What sets this work apart is measurement. Nutrition interventions are tracked not only for health outcomes, but also for cost effectiveness.

By demonstrating that food-based interventions improve health at relatively low cost, these programs make a compelling case to payers, foundations, and policymakers that nutrition is not an added expense—it’s a high-return investment.

This shift—from food security to nutrition security—is attracting new funding partners focused on community health, prevention, and long-term sustainability.

Integrating Food into Clinical Care

Devoted Health’s journey into nutrition began during the COVID-19 pandemic, when outreach calls revealed food access as the most common unmet need among seniors. That insight reshaped their care model.

Nutrition is now embedded across their approach:

• Grocery benefits aligned with health goals

• Medicare-covered medical nutrition therapy with registered dietitians

• Intensive, multi-week nutrition coaching for diabetes and hypertension programs

• Continuous feedback loops connecting food choices to real-time health markers
  
  

These programs highlight a critical truth: behavior change accelerates when patients can see the impact of nutrition on their own health data.

Affordability, Access, and System-Level Change

A recurring challenge remains cost. Ultraprocessed foods are often cheaper and more accessible than whole foods, particularly for low-income populations.

But as Dariush Mozaffarian, MD, DrPH, emphasized, the issue isn’t a lack of money—it’s how existing dollars are spent.

• $10–15 billion annually on Medicare Advantage grocery cards

• ~$100 billion through SNAP (Supplemental Nutrition Assistance Program)

• $5 trillion in total U.S. healthcare spending

Redirecting even a fraction of healthcare dollars toward healthy food could dramatically reshape supply chains, support American farmers, and improve outcomes—especially for the most vulnerable populations.

“If we invested just $100 billion of healthcare spending into nutrition,” Mozaffarian noted, “that’s a 10% increase in the entire grocery budget for Americans.”

A Clear Call to Action

As the session closed, panelists delivered a unified message to policymakers:

• Make nutrition and ultraprocessed foods a top-tier priority

• Enforce existing CMS and FDA authority

• Expand Medicaid and Medicare pathways that reimburse for nutritious food

• Use current investments more effectively, rather than relying on new funding

Food policy, they argued, is economic policy, healthcare policy, and national security policy.

Looking Ahead

The evidence is no longer emerging—it’s established. Poor nutrition is the leading driver of poor health, and ultraprocessed foods sit at the center of the crisis.

The path forward is not theoretical. Health plans, food banks, clinicians, and policymakers already have the tools to act. What’s needed now is alignment, accountability, and the courage to treat food as what it truly is:

Foundational healthcare

When nutrition becomes embedded in benefit design, clinical care, and policy, costs fall, outcomes improve, and prevention finally becomes more than a buzzword—it becomes the standard of care.