Massachusetts study finds 20% fewer emergency visits, 31% fewer hospitalizations
On a weekday morning in a quiet Boston neighborhood, a kitchen at the nonprofit Community Servings bustled with activity. Volunteers sliced chicken breasts, stuffed bell peppers, filled trays, and carefully labeled each item. The meals are part of an experiment to deliver nutritious, medically tailored food to Medicaid patients who are unable to shop for groceries and cook for themselves.
A study published in the journal Nature Medicine found that Massachusetts residents who received medically tailored meals for at least three months used less medical care than similar patients who did not. Among about 1,900 residents studied, those who received the meals had 20% fewer emergency department visits and 31% fewer hospitalizations, according to the analysis led by Dariush Mozaffarian, a cardiologist and professor at Tufts University.
The program costs $125 per person per week, but the meals essentially paid for themselves, the Massachusetts researchers found. Over six months, patients with heart disease used about $10,000 less in healthcare services, and patients with kidney disease used $12,000 less. There were also savings for people with diabetes, depression, and anxiety. “Those are pretty big numbers when you think of how expensive those diseases can be and the prevalence in the population,” David Waters, chief executive of Community Servings, said.
Mozaffarian has estimated that 10 million Americans would benefit from medically tailored meals, though only a small fraction currently receive them. He estimated such meals could help patients avoid 1.6 million hospitalizations and save the U.S. $13.6 billion in healthcare costs each year. “It actually saves the healthcare system money,” Mozaffarian said. “That’s a really big deal, because most things in healthcare don’t.”
The cost-saving findings come as states face deep Medicaid cuts. The One Big Beautiful Bill Act of 2025 slashed projected federal Medicaid funding by more than $900 billion. Many of the Republicans who backed the bill said federal health spending is too high and riddled with fraud; Sen. John Kennedy, a Louisiana Republican, has accused California of “outrageous fraud” for using Medicaid dollars to fund housing and nutrition programs.
Thirteen states have received federal waivers to use Medicaid dollars for medically tailored meals — part of an approach known as “food is medicine” — and three other programs are awaiting federal approval. Amaya Diana, a policy analyst at the nonprofit KFF, said states will have to make tough choices in the coming years as they figure out how to fill funding gaps. “If states are not able to offset the loss of federal funds with new taxes or reductions in other state spending, they may have to make program cuts,” she said.
The Trump administration’s posture has shifted since its first term. While the first Trump administration allowed states to pursue medically tailored meals and other social supports, the second Trump administration rescinded Biden-era guidance for Medicaid initiatives that address social needs and has not detailed a replacement policy. Administration officials have warned they will focus more on the budget impacts of such initiatives. “They signaled they’re going to be a lot more skeptical,” said Kurt Hager, an assistant professor at the University of Massachusetts Chan Medical School who studies nutrition programs and helped lead the Massachusetts study. “Instead of using a broad-based approach nationwide, they’re going to make decisions on a state-by-state basis.”
At the same time, Health and Human Services Secretary Robert F. Kennedy Jr. and Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, have pushed hospitals to serve healthier food to improve patient outcomes. In a social media video in June, Oz said the healthcare system “is often willing to pay for surgeries, but not always willing to pay for the nutrition that might help prevent those outcomes in the first place. That’s bothered me my whole career.” He added the agency is evaluating several strategies, including medically tailored meals, to prevent illness and hospitalization. CMS officials did not respond to several emailed requests for comment.
Katie Garfield, who studies social determinants of health at Harvard Law School’s Center for Health Law and Policy Innovation, said the lack of federal guidance is stirring uncertainty for states seeking to pursue nutrition programs in Medicaid. “We’re still waiting to see that big step forward around ‘food is medicine’ interventions,” she said. “We need to see that step forward to resolve some of the uncertainty.”
U.S. Rep. Jim McGovern, a Massachusetts Democrat, sponsored a bill that would pilot meal deliveries for chronically ill seniors on Medicare. The legislation has yet to come up for a vote. “I had thought, based on some of his rhetoric before he entered the Trump administration, that RFK Jr. would be a natural ally on this,” McGovern said. “But we can’t seem to get his attention.”
Some companies have been accused of billing Medicaid for meals that were neither healthy nor nutritious, raising concerns about program oversight. At Community Servings, the food is prepared with attention to sugar, salt, fat, vitamins, and minerals and tailored to a person’s health needs, Waters said. Many recipients need food that is mild or low in fiber. “What we’re able to do is to work with your healthcare provider to understand your health realities — what your diagnoses are, what your medications are, side effects, food allergies, cultural norms — and then prescribe a diet for you that is scratch-made,” he said.
For Vanessa Georges, who is in remission from throat cancer, the benefit has been personal. “Once I started to eat these meals that were geared toward my illness, I built up my muscle mass again, built up my strength, built up my confidence in myself,” she said. Georges said she noticed she spends less time at the doctor’s office. “These meals have given me a second chance.”
Steve Honyotski, 71, receives 10 meals at his Boston home each week, cooked fresh and delivered cold or flash-frozen and ready to eat after a couple of minutes in the microwave. He has diabetes, obesity, and high blood pressure. He said he has needed less insulin to control his diabetes since starting the meals and lost enough weight to delay a knee replacement surgery. “The carrot ginger soup is my favorite,” he said.
Ryan Schwarz, Massachusetts’ Medicaid director, said the state will seek federal approval to continue medically tailored meals in the coming years. “We feel very strongly committed to continuing these services,” he said.
In North Carolina, researchers found that food and housing supports lowered Medicaid spending over time. State lawmakers suspended those services in 2025 over budget concerns, then partially restored funding after deliberations this summer. Hager called the reversal “a signal of what might occur in other states as these Medicaid cuts hit.” Even where states have authority to run such programs, “it might be a lot harder for the states to actually implement them,” he said.