Part 3: Expanding Access Through Medicare and Medicaid

At the 2025 Tufts University Food is Medicine Summit, Katie Garfield, Director of Whole Person Care at the Center for Health Law and Policy Innovation (CHLPI), offered a clear-eyed update on where Food is Medicine stands within Medicare and Medicaid. 

Her message was simple but urgent: momentum is real, and lasting progress will depend on policy clarity, sustainable funding, and operational scalability. 

Food is Medicine Gains Ground in Medicaid

In just a few years, Medicaid has become one of the most dynamic testing grounds for Food is Medicine innovation. 

✅ 13 states have approved Section 1115 demonstration waivers, major five-year pilots that fund nutrition and medically tailored meal (MTM) services. 
✅ 3 more states are awaiting federal approval. 
✅ Around 10 additional states are launching programs through Medicaid Managed Care, covering nutrition as a cost-effective alternative to traditional treatment. 

And the results are compelling: 

📉 47% drop in hospitalizations 
🚑 21% fewer emergency department visits 
💰 Significant cost savings over time 

As Garfield explained, 

“The longer people stayed on these interventions, the more we saw real reductions in utilization and cost.” 

These outcomes validate what advocates have long argued: when nutrition becomes part of medical care, both patients and systems benefit. 

Medicare: Two Speeds, One Direction

While Medicaid is leading in Food is Medicine implementation, Medicare tells a more complex story. 

🩺 Traditional Medicare (Parts A & B), covering about half of participants, still does not include Food is Medicine benefits. 

🌿 Medicare Advantage (Part C) plans, however, can, and increasingly do. Nutrition and produce benefits have become among the most popular supplemental offerings for members managing chronic conditions. 

Momentum is building on the federal level too: 

• Congress has reintroduced the Medically Tailored Home-Delivered Meals Pilot Act, which would fund a national pilot under Medicare Part A. 

• The Centers for Medicare & Medicaid Services (CMS) is exploring new billing codes and reimbursement models for MTMs, a strong signal that nutrition is gaining real policy traction. 

Despite CMS rescinding some 2024 guidance, Garfield clarified that Food is Medicine programs remain fully permissible: 

“These programs are still allowed. CMS continues to approve new proposals, the framework changed, not the authority.” 

The Path Forward: Refining, Scaling, and Sustaining 

Across both programs, the next step is clear: refine, scale, and sustain the Food is Medicine interventions that work. 

That means turning promising pilots into standardized, reimbursable models backed by clear outcomes of data and interoperable systems. The challenge now isn’t proving value, it’s embedding that value into everyday care delivery. 

How Nurish’d Is Helping Accelerate Access and Impact

At Nurish’d, we’re working with Medicaid managed care organizations, Medicare Advantage plans, and state agencies to make that integration real. 

Our platform simplifies Food is Medicine delivery by: 

• Enabling data sharing between healthcare systems, payers, and food providers 

• Streamlining eligibility, authorization, and claims workflows 

• Supporting scalable infrastructure for medically tailored meals and nutrition benefit programs 

• Measuring clinical and financial outcomes to strengthen the evidence base for reimbursement 

By connecting clinical intent with operational execution, Nurish’d helps payers and providers implement Food is Medicine programs efficiently, reducing administrative friction while maintaining compliance and accountability. 

This is how Food is Medicine moves from policy promise to practice reality, improving health outcomes, driving cost savings, and ensuring equitable access at scale. 

Looking Ahead 

As Garfield and others emphasized, the future of Food is Medicine will depend not just on advocacy, but on infrastructure. Medicare and Medicaid are paving the way, but the systems that deliver these interventions, from digital platforms to local food providers, must work together seamlessly. 

Nurish’d is helping make that possible, supporting healthcare partners as they expand access, scale delivery, and measure real impact. 

Because when nutrition becomes part of care, from policy to patient, everyone wins.