How health care, retail and tech can work together to change how we eat

Health care payers and providers, food retail, and technology companies each have a role to play in supporting consumers’ healthier eating habits, and each can profit from being part of the ecosystem. While getting to a truly connected ecosystem may be a long-term project, requiring work around payment alignment, each player can start with some basic steps.

Payers and self-insured employers

Payers and self-insured employers that carry the health care costs for their employees have traditionally reimbursed medical treatment and bear the bulk of the expense of chronic nutrition- related illnesses.⁴ While some plans have reduced health care spending by providing medically tailored meals to members on dual Medicare and Medicaid plans, financial incentives to buy and eat healthy food have not yet been extended to a larger population.⁵ Instead of facing the increasing costs of treating illnesses, some payers, such as Medicare Advantage and Medicaid payers, and jumbo or large administrative services only (ASO) employer groups can take steps to transition to a preventative model by providing more broad nutrition support:

• Expand coverage for nutrition education and support. A starting point could be providing an easily accessible consultation with a dietician as a regular, free service, just like other preventative services, such as yearly physicals. Another option could be covering or providing a discount on nutrition-related coaching programs. These programs are often financially out of reach but would be a preventative tool that would help people set goals (e.g., reduce blood pressure, achieve a fitness goal or reduce fatigue and anxiety) and achieve them through better nutrition.

• Cover healthy food. Using a “food-as-medicine” approach, payers and self-insured employers could cover healthy food just as they cover medications. While some provide general funding for health and wellness, specifically covering food could be an important first step in helping people afford and prioritize healthy food. A starting point could be providing discounted healthy food at employer cafeterias, covering “prescriptions” for healthy food at retailers or even certain healthy items at restaurants based on income level or broader health risks that could be improved through nutrition. Covering healthy food could help reduce food insecurity and nutrition-related illnesses for the approximately 20% of US households who do not qualify for federal and state food assistance programs.⁶ It could also affect many more by covering the many Americans who make below the average living wage of $68,000, as calculated by the Massachusetts Institute of Technology (MIT).⁷

• Reward healthy choices. Providing rewards right when a consumer takes a healthy action, such as buying healthy food, could increase engagement. A starting point could be to gamify food shopping and healthy eating through a health technology platform that provides rewards tailored for individual preferences.

All innovators face hurdles and these companies will need to determine the right partnership structures, including advocating for payment alignment, defining ownership and sharing of data, and how to approach implementation.

Earning consumer trust

Payers and employers will need to prove the benefit to their members and employees and demonstrate true support and empathy to mitigate privacy concerns.

Partnership terms

Just as food retailers work with the U.S. Department of Agriculture’s food and nutritional service food assistance programs like the Supplemental Nutrition Assistance Program (SNAP) to determine payment arrangements, pricing terms for food items will need to be determined with payers and self-insurers. Additionally, health technology companies should consider pricing models where a portion of their fees are based on meeting goals for member engagement and satisfaction, in line with value-based care structures.

Use of data

Payers and self-insured employers will need to develop mechanisms to quantify the return on investment (ROI) of reimbursing food and providing rewards. While this ROI calculation has been challenging in the past, additional data gleaned from this new ecosystem could facilitate these calculations. Food retailers will need to work with partners to develop a system to track consumer purchases and related information, such as nutrition facts, then transfer this data to the health technology application. Additionally, food retailers will need to adapt their systems to use increased access to health data to drive operational improvements, such as marketing, space planning, demand forecasting and supply chain management.

Technology development and usage

While many of the needed capabilities exist today, health technology companies tend to focus on one area. Technology deals may be needed to create a comprehensive experience that can allow users to access these features in one place, and new technology would also be needed to share data between health technology and food retail companies.

Building this ecosystem will require companies to work with partners they may have never considered and to reimagine how they work with existing partners. This important undertaking is complex and will likely take time to design and implement. They will need to first identify and evaluate potential partners that can offer complementary services and then determine partnership structures that most effectively benefit both partners and consumers, all with the goal of promoting healthier eating. Working together, health care, retail and technology companies can build a connected, consumer-centric food ecosystem with access, education, support and incentives. This ecosystem can make a big impact on helping people make healthier food choices and improve the health outcomes driven by those choices.