The food as medicine movement has been picking up steam, with the White House gathering $8 billion in commitments for food programs, payers launching medically-tailored meal pilots and startups gaining funding from investors. Growing research shows that there are both health and cost benefits to food and nutrition programs. 

There are a variety of food as medicine models, such as medically tailored meals (ready-to-eat meals), produce prescriptions (when patients get vouchers to purchase healthy foods) and medical and functional foods (condition-specific foods that require preparation).

While there are benefits to food as medicine, there are several challenges facing the movement, according to a report published Friday by PitchBook. The report, authored by Emerging Technology Analyst Aaron DeGagne, laid out four key challenges and critiques:

1. Resistance to diet restrictions: Some consumers may push back against food restrictions in food as medicine programs, particularly government-led programs because “they could be seen as the government telling people what to eat,” the report stated. However, several vendors told PitchBook that their food programs offer “flexibility” to participants. Additionally, some participants may be willing to engage in a more restrictive diet if it means they can avoid expensive prescriptions and costly surgeries in the future.

2. Food quality: One concern for food as medicine programs is that some vendors offer “highly processed food.” Additives like corn syrup and preservatives are known to increase the risk of chronic diseases, and “medical and functional foods that are highly processed may face a more challenging path in receiving recommendations from care providers,” DeGagne stated.

“This raises the bar for medical & functional food vendors to show their food products not only accomplish medical objectives but also limit unnecessary additive ingredients (while remaining palatable to consumers),” the report said.

3. Attribution: A balanced diet is only one factor to being healthy. Other factors that affect health include genetic risk, environmental exposure and autoimmune conditions. 

“Given that food as medicine must be part of a balanced approach, it may also be difficult to attribute health improvements to a single prepared-meal vendor or a limited-dollar produce subsidy,” DeGagne noted. “Additional clinical data could support greater reimbursement of food as medicine, though considering these attribution challenges, there is an element of trust at play that food-as-medicine vendors must be careful not to lose.”

4. Compliance: It is very difficult to track compliance with food as medicine programs, as there aren’t any wearable devices that can do so. This makes it even more challenging to collect clinical data and understand the impact of food as medicine programs.

While there are challenges to food as medicine programs, DeGagne still anticipates a future for them, particularly given the interest from investors during a difficult fundraising climate. Several food programs have raised funds so far in 2023, including Mend ($15 million in Series A), Modify Health ($10 million in Series B), Bitewell ($4 million in seed funding) and Free From Market ($2.1 million in seed funding). PitchBook foresees companies with “integrated” programs — such as a combination of food delivery, coaching and nutrition services — being the most successful. One company the report called out is Faeth, which offers ready-to-go meals to support cancer care and an app that gives on-demand support from nutritionists.

The report noted that several healthcare players have a role to play in advancing food as medicine programs. Providers will likely start to offer nutrition programs to patients when they become more available through health plans. 

Managed care organizations (MCOs) also have an opportunity, as food programs are often targeted toward underserved and low-income groups. MCOs have two major incentives for getting involved in these kinds of programs: they could lead to less costly procedures down the road and the programs can “be used as a marketing effort” to gain more members.

Payviders have a role as well, since they are in the “unique position of owning their own practices and are therefore highly incentivized to reduce the cost of chronic conditions that can be prevented through proper nutrition,” DeGagne said. Kaiser Permanente and Geisinger, both payviders, have launched pilot food as medicine programs, and these efforts could be advanced after Kaiser’s acquisition of Geisinger.

While healthcare players may be wary of programs like medically-tailored meals because they may require long-term funding, PitchBook said they could be a good starting point.

“We hold the view that medically tailored meals can be a good initial entry point for food as medicine, and members could later transition to lower-cost programs focused on nutrition and dietary guidance,” the report said. “For example, in a consolidated platform, users could have access to medically tailored meals that are fully covered for a period of time and then be offered regular appointments with a coach or dietitian on an ongoing basis. This approach serves a dual purpose of keeping users active on a food-as-medicine platform for a longer period and controlling costs to enable greater scale.”

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