STORIES FROM THE FIELD
Health Plan Grocery Benefits

Grocery Assistance as a Health Plan Benefit

Elevance Health offered income-eligible members with type 2 diabetes $1,200 to $3,000 in annual grocery assistance, along with a low-premium health plan option. Compared with eligible members who did not receive the grocery benefit and were not on the low-premium plan, receiving the benefit was associated with: (1) a 3.1 percentage-point lower rate of diabetes with complications, (2) a higher likelihood of taking diabetes medications and antidepressants as prescribed, and (3) no increase in healthcare service use.

Elevance Health
Health Plan
STORIES FROM THE FIELD
Grocery Assistance as a Health Plan Benefit

Story Characteristics and Tags

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Written By
Kofi Essel, MD, MPH, FAAP
Written By
Kofi Essel, MD, MPH, FAAP
The Problem

Poor nutrition and food insecurity are associated with higher rates of diabetes, obesity, cardiovascular disease, and other chronic health conditions. While evidence supporting Food as Medicine interventions continues to grow, there remains limited evidence regarding outcomes associated with health plan–provided grocery benefits within populations of people who are commercially insured.

To address these challenges, Elevance Health designed a grocery assistance benefit alongside a new low-premium health plan for income-eligible members. The study was designed to evaluate whether integrating nutrition benefits into health insurance could improve health outcomes while maintaining affordability and responsible healthcare utilization.

The Intervention

Beginning January 1, 2021, Elevance Health offered eligible members access to a grocery benefit through a select commercial employer led health plan. Members meeting household income eligibility criteria could receive annual grocery assistance ranging from $1,200 to $3,000 depending on household size and could receive the benefit for as long as they were eligible.

The grocery benefit was delivered through a grocery benefits card that could be used at a broad network of participating retailers. Eligible purchases included fruits, vegetables, whole grains, legumes, dairy products, meats, fish, breads, cereals, and cooking oils. Alcohol, tobacco products, and prepared foods were excluded.

The intervention was intentionally designed as a scalable Food as Medicine model that required minimal ongoing program involvement. Unlike other evidence-based and impactful medically tailored meal programs, these members maintained more flexibility and choice in food purchasing while receiving financial support to improve access to more nutritious foods.

The program was developed and implemented through a collaboration between Elevance Health and Carelon Research. Researchers used administrative claims data and health plan enrollment information to evaluate outcomes among members with diabetes who enrolled in the grocery benefit plan compared with eligible members who did not enroll.

Costs And Funding Structure

The grocery benefit provided annual support ranging from:

  • $1,200 for individual coverage
  • $2,400 for employee plus spouse/children coverage
  • $3,000 for family coverage

Participants also paid approximately $428 less in annual premiums by enrolling in the newly designed narrow-network health plan, which limited coverage to a smaller group of doctors and hospitals, compared with alternative plans available to them.

The program leveraged existing health plan infrastructure, retailer partnerships, benefit card administration systems, claims analytics, and research support. Specific startup and operational costs were not reported.

Value
Financial
  • No increase in emergency department visits, hospitalizations, outpatient visits, or primary care utilization.
Economic
  • 3.1 percentage-point lower prevalence of diabetes with complications among enrolled members.
  • 7.5 percentage point higher adherence to diabetes medications.
  • 11.6 percentage point higher adherence to antidepressant medications among members prescribed those medications.
Social
  • The largest differences were observed among members living in lower socioeconomic communities and among Hispanic/Latino members.

Compared with eligible members who did not enroll, members enrolled in the grocery benefit plan had the associated outcomes above.

The study included 411 members with type 2 diabetes who enrolled in the grocery benefit plan and 961 eligible members with type 2 diabetes who did not enroll. Individuals without diabetes were not eligible to participate in this study. The findings suggest that grocery assistance provided through a health plan may be associated with better diabetes management and medication adherence without increased healthcare utilization.

Lessons Learned
  • Nutrition benefits can be effectively integrated into health insurance design. Even a relatively low-touch grocery benefit may be associated with measurable differences in health outcomes.
  • Grocery assistance may be associated with clinical outcomes. Participation in the grocery benefit was associated with higher medication adherence and fewer diabetes-related complications.
  • Tailored investments may support social impact. The largest differences were observed among members living in lower socioeconomic communities, suggesting that nutrition benefits may help address disparities related to food access and chronic disease.
  • Rigorous evaluation is essential. Ongoing research and long-term follow-up are needed to better understand cost-effectiveness, utilization impacts, and opportunities for scaling Food as Medicine interventions across populations.