HJAR Jan/Feb 2026

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2026 45 federal strategy that aims to reduce nutri- tion-related chronic diseases and food inse- curity in the U.S. 5 According to the Office of Disease Prevention and Health Promotion, FIM acknowledges that “consistent access to diet- and nutrition-related resources are a critical component to achieve this goal.” 6 FIM programs consist of the following components: • Medically-tailored meals that are cus- tomized to participants’specific dietary needs; • Produce “prescriptions” that provide access to produce through partnership with food retailers; and • Nutrition education/counseling that provides coaching to help participants choose and prepare foods that support improvements in their condition(s). Ideally, local FIM programs would en- compass most of these components to en- sure the best outcomes and adhere to the model. In a program that integrates all the components, SDOH questions are asked of patients in order to assess their access to healthy food and determine eligibility for an intervention. Following screening and eligibility determination, patients are referred to a dietitian or to an appropriate hospital-based provider capable of deliver- ing culinary medicine interventions. Based on patients’ circumstances, they receive ei- ther prepackaged, medically-tailored meals or food vouchers to support adherence to prescribed dietary treatment plans. Lastly, patients have periodic biometric screenings to monitor health outcomes with their care team. Community HealthWorkers (CHWs), especially in rural healthcare settings, play a vital role in fostering this continuumof care. A real-world example of a FIM program in action is the case of a patient with type 2 diabetes who incurred nearly $200,000 in medical bills due to their condition. The patient could not afford to eat nutritious, healthy foods, so relied on fast-food andmi- crowavable meals. The patient was enrolled in Geisinger Health’s Fresh Food Farmacy in Pennsylvania. Six months after enrolling, the patient lost more than 45 pounds and their HBA1c level dropped into the normal range. 7 Examples like this demonstrate how this program makes not only a clinical impact, but also a holistic one, with the patient not- ing an increased affinity for healthy cooking and reporting finding it much easier to climb a flight of stairs or take a walk. Economic and Policy Implications of Food Is Medicine FIM’s holistic treatment of patients’ chronic illnesses may lead to cost savings. According to the 2025 report from Tufts University mentioned earlier, the medical- ly-tailored meal components of FIM alone could save upwards of $13.6 billion by curb- ing preventable hospitalizations, and FIM also may reduce costs for healthcare sys- tems by reducing hospital and emergency visits and medication costs. The expansion of value-based contracting models further strengthens the case for FIM. Value-based care (VBC) emphasizes patient outcomes versus patient volume, creating financial incentives for preventative medi- cine. FIM programs align well with the VBC framework as they target SDOH that directly influence costly outcomes. By leveraging data-driven performance metrics, such as reductions in readmissions, food accessi- bility, biometric data, and the cost of care, health systems and payers can more effec- tively justify investment in nutrition-based interventions. As VBCmodels evolve across Medicare, Medicaid, and other payers, FIM initiatives are well-positioned to function as both a population health strategy and a financially sustainable component of mod- ern healthcare delivery. For these benefits to be realized through FIM, collaboration among governments, insurance companies, and health systems is required. In Arkansas, the 1115 Medicaid waiver has expanded services for Medicaid beneficiaries through various interventions, including nutrition services. Utilization of this waiver shows promise, especially if FIM interventions are targeted to the needs in rural communities. However, CMS has emphasized that reli- ance on 1115 waivers alone is insufficient for long-term sustainability. CMS encourages states to partner with federal, state, and local nutrition programs such as SNAP andWIC, recognizing that while these programs pro- vide baseline food access, they are, at times, inadequate to meet the nutritional needs of those with chronic disease(s). Abundance Without Access: The Arkansas Paradox In Arkansas, a state where agriculture is the largest industry and two of the world’s largest food corporations operate, nutrition insecurity reflects systemic access failures rather than food scarcity. Implementing FIM models at scale in Arkansas presents both opportunities and challenges that are emblematic of broader state-level efforts to integrate nutrition into healthcare delivery. As already mentioned, Arkansas is le- veraging its Section 1115 Medicaid waiver authority to pilot coverage for innovative supports that include food and nutrition services as part of “whole-person care,”sig- naling state and federal willingness to test nontraditional interventions aimed at social drivers of health. Given the evidence that medically-tailoredmeals, produce prescrip- tions, and related FIM strategies can reduce food insecurity and costly healthcare utiliza- tion, aligning referral workflows with per- manent Medicaid benefit design — beyond temporary demonstration waivers — would Caleb Cox, MPS Senior Program Officer Arkansas Rural Health Partnership