HJAR Jan/Feb 2026

46 JAN / FEB 2026 I  HEALTHCARE JOURNAL OF ARKANSAS RURAL HEALTH help ensure continuity and sustainability of services for high-need populations. Moreover, coordination with existing nutrition safety-net programs can expand reach and mitigate access gaps. However, policy innovations may also shape how healthy food incentives and restrictions are structured to support health outcomes. Strategic investment in community health workforce capacity and partnerships with community-based organizations will be crit- ical to operationalizing referrals, coaching, and culturally-tailored education at scale — particularly in rural areas and in regions where the chronic disease burden and food access barriers are most pronounced. Ultimately, embedding FIM into value- based payment frameworks and Medicaid managed care contracts in Arkansas could reinforce financial incentives for improved outcomes and support broader adoption of culinary medicine and nutrition therapy across the care continuum. Hospital-Based Infrastructure as a Scalable Solution While much of the FIM conversation focuses on external partnerships and new infrastructure, rural communities already have an underutilized resource that can support nutrition-based care at scale: Ru- ral healthcare organizations — particularly hospitals — are uniquely positioned to ad- vance FIM initiatives at scale by leveraging existing facility infrastructure. Many rural hospitals operate licensed food service kitchens that meet strict regulatory and safety standards. With tar- geted investment and policy support, these kitchens could be expanded, resourced, or repurposed to support medically-tailored meal preparation, produce aggregation, and culinary medicine programming for patients with chronic disease. Integrating FIM interventions into hospi- tal-based food services provides a scalable, systems-aligned pathway for rural commu- nities where external food access partners may be limited or nonexistent. Hospital kitchens can serve as centralized hubs for meal production, coordination with dieti- tians, and collaboration with CHWs, allow- ing nutrition interventions to be embedded directly into clinical workflows rather than treated as an external referral. For state and federal stakeholders, this model offers a timely opportunity to re- think the role of rural hospital food services within the healthcare delivery system— not solely as an operational function, but as a core component of rural healthcare delivery and prevention infrastructure. Strategic investments through Medicaid benefit design, value-based payment models, and rural health grant programs could unlock hospital kitchens’ capacity to support FIM initiatives (similar to Arkansas Rural Health Partnership’s current Good Food RX initiative), strengthening hospital sustainability while directly addressing diet-related chronic disease in rural communities. Now is the moment to merge healthcare, nutrition, and rural infrastructure into a unified strategy that leverages what rural hospitals already have to meet patients’ urgent needs. n REFERENCES 1 “About Chronic Diseases,” Centers for Disease Control and Prevention, May 6, 2022, https:// www.cdc.gov/chronicdisease/about/index/htm , accessed July 6, 2022. 2 “Arkansas Statistics by State,” Centers for Dis- ease Control and Prevention, August 20, 2025, https://www.cdc.gov/nchs/state-stats/states/ ar.html. 3 “Report Shows Food Is Medicine Interventions Would Save Lives and Billions of Dollars,” Tufts Now, September 26, 2023. 4 “Primary Care Needs Assessment of Arkansas,” Office of Rural Health and Primary Care, Arkansas Department of Health, 2020, https:// healthy.arkansas.gov/wp-content/uploads/ Office_of_Rural_Health_and_Primary_Care_ Primary_Care_Needs_Assessment.pdf; “A Collection of Resources on Health System Performance in Arkansas,” The Commonwealth Fund, n.d., https://arkansasadvocate.com/ wp-content/uploads/2025/06/Arkansas_ EMBARGOED_2025-06-18.pdf. 5 “Food Is Medicine: A Project to Unify and Ad- vance Collective Action,” Office of Disease Pre- vention and Health Promotion, U.S. Department of Health and Human Services, n.d., https://odphp.health.gov/our-work/nutrition- physical-activity/food-medicine. 6 “Healthy People 2030,” Office of Disease Pre- vention and Promotion, U.S. Department of Health and Human Services, n.d., https://odphp. health.gov/healthypeople/priority-areas/social- determinants-health, accessed December 10, 2025. 7 “Fresh Food Farmacy,” n.d., Geisinger Health, https://www.geisinger.org/freshfoodfarmacy/ learn-more. Caleb Cox, a native of Arkansas, is a United States Air Force veteran. He earned his master’s in public service at the University of Arkansas Clinton School of Public Service.As a graduate student researcher at the University of Arkansas for Medical Sciences Center for Health Literacy, he co-led a team that conducted a preliminary assessment of health literacy across all 50 states. At the Arkansas Rural Health Partnership,he worked closely with programs addressing food insecurity for rural individuals. He currently manages a rural development grant and the evaluation and data analysis ofARHP’s programs. “Integrating FIM interventions into hospital-based food services provides a scalable, systems-aligned pathway for rural communities where external food access partners may be limited or nonexistent.”