Earlier this month, Project FoodBox VP and GM Xavier Heriat joined health plan executives, clinical leaders, and program officers on stage at the Nourishing Change Conference to address a question that is no longer theoretical: when peer-reviewed evidence shows that medically tailored produce reduces A1C by a full percentage point, what is the managed care system waiting for? The conversation at that panel — organized around the theme of making Food as Medicine operational at health plan scale — surfaced both the genuine progress underway and the structural friction that still slows adoption across Medicaid and commercial markets.
A produce prescription is a covered benefit in a growing number of Medi-Cal managed care contracts. That shift did not happen because of advocacy alone. It happened because programs like Project FoodBox generated documented outcomes that health plan finance teams could evaluate. Research conducted through our partnership with UC Irvine Health found an average A1C drop from 8.5% to 7.5% among enrolled members managing diabetes — a reduction that carries a 40% decrease in downstream complication risk. For a health plan actuarial team, that is not a wellness amenity. It is a claims reduction pathway. Xavier's point on the panel was direct: health plans that are still categorizing Food as Medicine as a supplemental benefit are reading the evidence selectively. The clinical case and the financial case have converged.
Data from our 2025 Member Outcomes Survey, drawn from more than 3,000 responses, reinforces the durability argument that plan administrators ask about most. Enrolled members reduced fast-food consumption by 1.17 meals per week, a result that held through program completion. Symptom frequency declined by 0.51 points on a weekly basis. These are not pilot numbers. They come from a program that has delivered more than 97 million pounds of produce and reached over 5 million lives since 2020 — a scale that changes what "infrastructure" means in this context.
The Nourishing Change Conference draws health plan administrators alongside retailers, clinicians, and policy stakeholders — which makes it a useful diagnostic of where cross-sector alignment actually stands. What emerged from the panel discussion was a consistent pattern: health plans express strong interest in Food as Medicine, but many remain at the pilot stage because their internal infrastructure for encounter reporting, eligibility screening, and outcomes attribution has not been built to accommodate food-based interventions. This is a solvable problem, but it requires a program partner with the operational architecture to handle it — HIPAA-compliant eligibility screening, registered dietitian curation, encounter data aligned with national standards, and claims support that integrates with existing managed care workflows. Xavier's argument to the room was that health plans should be evaluating program partners the way they evaluate any clinical vendor: on outcomes documentation, compliance capability, and the ability to scale without degrading quality.
The conversation also surfaced something that rarely appears in conference presentations: the cost of inaction. Chronic conditions like diabetes, hypertension, and cardiac disease account for the majority of Medicaid expenditure, and diet is a modifiable upstream factor in all three. A health plan that waits for additional evidence before acting on the evidence already available is making a financial decision, not a clinical one. That framing — offered plainly from the stage — is the kind of directness that the Food as Medicine movement needs more of at industry gatherings.
The momentum coming out of Nourishing Change points in one direction. Health plans that have already integrated produce prescription programs into their Medicaid managed care contracts are reporting member satisfaction gains and outcomes they can present to state agencies. Those that are still evaluating are competing against a shrinking runway — CalAIM in California and analogous Medicaid flexibility initiatives in New York and other states are creating structural on-ramps that will not remain open indefinitely. Project FoodBox is built to serve health plans at scale: the logistics network, the dietitian oversight, the technology layer, and the outcomes reporting infrastructure are operational today across Medi-Cal and Medicaid in New York. The question Xavier left with the audience at Nourishing Change was the right one: if the evidence is sufficient for your clinical team, what does your contracts team need to move forward?
If you are a health plan administrator, program officer, or clinical director evaluating Food as Medicine partnerships, share this post with a colleague who leads your Medicaid strategy — and reach out to our team at projectfoodbox.org to discuss what a managed care partnership looks like in practice.