For the millions of Americans living with serious illness, the standard picture of medical care — appointments, medications, procedures — leaves out something fundamental: what they eat. People managing conditions like cancer, congestive heart failure, COPD, or chronic kidney disease have complex, specific nutritional needs that generic food assistance programs aren’t designed to meet. When those needs go unaddressed, patients deteriorate faster, cycle in and out of the hospital more often, and miss the kind of targeted nutritional support that could help them stabilize and stay home.
Food is Medicine is designed to solve this problem. It is a growing movement — and an increasingly evidence-backed framework — that treats medically appropriate nutrition as a reimbursable health care intervention, not an afterthought. The most intensive form this takes is the medically tailored meal (MTM): clinically prescribed, dietitian-designed, home-delivered food built around a patient’s specific diagnosis. MTMs are not meal kits or food assistance. They are a targeted clinical intervention for people whose nutritional needs are too specific and too consequential to be left to chance.
What the Research Shows
The outcomes data on medically tailored meals is compelling. A 2025 analysis conducted by researchers at the Tufts University Friedman School of Nutrition Science and Policy found that MTM could prevent more than 2.6 million hospitalizations annually and generate approximately $23 billion in health care savings in the first year alone — and was projected to be net cost-saving in 49 of 50 states.
At the provider level, the numbers are similarly striking. Research using Colorado All Payer Claims Database data found that MTM recipients experienced a 13 percent reduction in hospital readmissions and a 24 percent decrease in monthly medical costs for patients with congestive heart failure, COPD, and diabetes. A separate study of MTM recipients found a 63 percent reduction in hospitalizations, a 50 percent increase in medication adherence, and a 58 percent decrease in emergency room visits.
The mechanism isn’t complicated: when a seriously ill person receives food that is actually designed for their condition — portioned, prepared, and delivered to their door — they stabilize. They stay out of the emergency room. They take their medications more consistently. They don’t deteriorate as quickly. The downstream savings are a byproduct of doing something straightforwardly humane.
A Policy Environment in Motion
Federal and state policymakers have been paying attention. According to the National Governors Association, 16 states now have approved or pending Medicaid Section 1115 waivers that provide coverage for nutrition interventions including medically tailored meals. The 2022 White House Conference on Hunger, Nutrition, and Health — the first such event since 1969 — placed Food is Medicine on the national agenda explicitly, calling for expanded MTM access as part of a broader strategy to reduce avoidable health system costs.
The challenge is that policy momentum doesn’t automatically translate into sustainable funding for the organizations actually doing the work. Most MTM providers operate as nonprofits, funded through philanthropy, volunteers, and a patchwork of grants. The reimbursement infrastructure to compensate them at scale — through Medicaid managed care, Medicare, and commercial payers — is still being built.
The Work at Third Horizon
This is precisely the gap that Third Horizon works to close. Nonprofit organizations delivering medically tailored meals are generating real clinical value — reducing hospitalizations, lowering costs, keeping people healthier at home — but they exist largely outside the reimbursement systems that reward that value. Third Horizon’s role is to help these organizations navigate the path toward sustainable payer relationships, so that the work can grow without depending indefinitely on goodwill and grant cycles.
In this month’s Impact Story, Third Horizon’s Erica Bauer speaks with Dr. Marti Macchi, President and CEO of Project Angel Heart — a fully Food is Medicine Coalition-accredited nonprofit providing medically tailored meals at no cost to people with serious illness across Colorado — and with Bo Nemelka, one of Third Horizon’s Managing Directors, about what it takes to shift this work from mission-driven to systems-supported.
Watch the conversation.