Medicare Advantage enrollees who received home-delivered meals after being hospitalized had lower odds of rehospitalization and death, a new study found.
The Kaiser Permanente Southern California study was published Sunday in JAMA Health Forum. In 2021, the organization began supplying home-delivered meals twice a day to eligible Medicare Advantage members who were hospitalized for heart failure. It also provided meals three times a day to a group of Medicare Advantage members covered under certain employer group plans who were hospitalized for any condition. The program followed the 2018 Chronic Care Act, which gave Medicare Advantage plans “greater flexibility” in providing supplemental benefits, including meals and transportation, according to the study.
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The study examined 4,032 adults who were admitted to the hospital for heart failure and 7,944 adults who were admitted for non-heart failure conditions and analyzed their outcomes 30 days after hospitalization.
It discovered that for patients with heart failure, receiving meals was “significantly associated with lower odds” of death and rehospitalization after 30 days compared to those in 2021 and 2022 who did not receive meals (these patients were referred to receive meals, but did not because of “unsuccessful contacts and active declines,” the study stated). However, there was not a significant difference when compared to those who did not receive meals in 2019 but would have been eligible had the program been available.
For patients with conditions other than heart failure, receiving meals was associated with lower odds of death and rehospitalization after 30 days when compared to those who didn’t receive meals in 2021 and 2022, as well as those who didn’t receive meals in 2019.
“We found that exposure to [a Medicare Advantage] supplemental benefit that offers up to four weeks of post hospitalization home-delivered meals was associated with lower odds of all-cause rehospitalization and death 30 days after hospital discharge for [heart failure] and other medical conditions compared with both a historical and concurrent control cohort,” the researchers stated.
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In addition, the study found that the benefits continued into 60 days post discharge for those in the non-heart failure group. For those with heart failure, results were similar to the 30-day results, according to the study.
The researchers questioned how long meal delivery programs should last and how many meals should be provided.
“[An] important unanswered question in the field is the number of meals and duration of nutritional support that is needed to achieve outcomes of importance to patients, health systems, and payers,” the researchers stated. “While this home-delivered meals benefit was intended to be a short-term bridge for patients during a vulnerable period after discharge from the hospital, it was encouraging to see this association persisting into the 60-day period, especially for the non-[heart failure] cohort. It is unclear if the more robust outcomes observed in the non-[heart failure] vs the [heart failure] cohort were due to the larger number of meals (84 vs 56), a reflection of the clinical conditions that are more amenable to nutritional support, or some other factors.”
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