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<\/p>\nRecovery requires fuel, and the fuel the body needs for healing is food.<\/p>\n
Under the watchful eyes of caregivers at hospitals, rehab centers, nursing homes, assisted-living units and similar organizations, interventions to improve intake and nutrition can happen quickly and on-site. <\/p>\n
But once a patient is discharged, nourishment can slide. One way to address this is by developing a meal service program that provides the nutrition people need whether they are discharged to acute care or senior living. Doing so, whether it\u2019s offered for free or for a nominal fee, has been shown to have a big payoff in quicker recovery time and reduced readmission rates.<\/p>\n
This is especially true for \u201cpatients\u2014most typically in the 55-plus range\u2014who have some form of acute or chronic disease state that causes them to not get adequate nutrition and who are at risk for malnutrition,\u201d says Larry Altier, System Director of Food and Nutrition Services at Lee Health System in Fort Myers, Florida. <\/p>\n
Many factors can account for inadequate nutrition and the impact plays out in many ways. \u201cPeople who are undernourished or don\u2019t eat enough will have a harder time healing,\u201d says Dana Fillmore, Gordon Food Service Healthcare Segment Manager, RD \u201cand they\u2019re at a higher risk for being readmitted to the hospital.\u201d <\/p>\n
The objective of meal service programs, Fillmore explains, is \u201cto stick to the role of general good nutrition, to make eating convenient for people and to make sure they\u2019re not skipping meals. Eating well is key to one\u2019s well-being and ability to heal.\u201d<\/p>\n
These programs are more UberEATS (an expansion of Uber, the on-demand driving service, UberEATS will pick up your order from a restaurant and deliver it to you) than traditional Meals on Wheels. With Meals on Wheels, meals must follow strict nutritional requirements and organizations are often reimbursed for them. The home meal programs that target this population offer components of simple, tasty meals for pickup or delivery in small enough portion sizes for households with one or two people. The menu can be flexible, anything from prepared in bulk, pre-portioned and provided shelf-stable to fresh and\/or frozen.<\/p>\n
For individuals discharged from the hospital, a rehabilitation center, or are just in need of some help, this type of outreach overcomes obstacles such as acquiring foods and having to prepare them. For these individuals\u2014especially the elderly\u2014who are not ready for traditional Meals on Wheels or who can\u2019t afford commercial meal-kit delivery, a home meal program facilitates eating, healing and remaining in their homes.<\/p>\n
The following example shows how a home meal program that is targeted to independent living apartments in a continuing care community might look.<\/p>\n
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1. Clients place orders in advance, allowing operators to plan for inventory, staffing and workflow needs.<\/p>\n
2. Convenience or scratch meals or meal components are prepared and packaged.<\/p>\n
3. Pickups occur and\/or food is delivered on a set schedule.<\/p>\n
Clinically driven and targeted to specific patient needs, Lee Health\u2019s Flavor Harvest at Home program typically serves those ages 55-plus who have some form of acute or chronic disease that causes them to be inadequately nourished. They also must meet two of the six clinical criteria for malnourishment identified by the Academy of Nutrition and Dietetics. Once a week for four weeks, a combination of fresh, frozen and shelf-stable meal components that support their nutritional needs is delivered by a driver who makes sure the food is secured properly in the home. After 28 days, recipients are re-evaluated. <\/p>\n
After just 18 months, Altier notes, enrollment eclipses 1,000 participants\u2014and it is well-received. \u201cThe first week of the program the recipients are reserved; they barely open the door and keep drivers at arms\u2019 length. By week three, there\u2019s a total change in demeanor, health status is elevated and they open the door and engage with the drivers.\u201d<\/p>\n
Even better, the results are positive. \u201cAbout 59 percent of the patients with similar conditions who didn\u2019t take the meal program were readmitted,\u201d Altier says, \u201cwhereas the group that got the meals had a readmission rate below 25 percent. Flavor Harvest at Home had a positive effect from a variety of different measures. This is not just a food program; this is a medical-care program that incorporates food.\u201d<\/p>\n
Such programs, Fillmore says, offer opportunities to feed the bottom line and improve an operation\u2019s financial health. Moreover, Altier notes, the cost\/benefit ratio can be impressive: Lee Health estimated that the cost of Flavor Harvest at \u201c$231,000 and change,\u201d but assessed the net value at \u201cclose to $1.3 million, conservatively,\u201d in savings on readmissions and reduced acute-care stays.<\/p>\n
Reduced readmissions penalties.<\/strong> \u201cReimbursed more and more to keep people out of their beds, hospitals are being proactive about improving care by helping with food at home,\u201d Fillmore says. At Lee Health, a significant decline in readmissions yielded significant savings.<\/p>\n Improved Medicare quality ratings.<\/strong> \u201cBecause malnutrition is a significantly complicated factor in co-morbidity,\u201d Altier explains, \u201cit has an impact on Medicare mortality or quality ratings for all cases in the system. Improved nutrition can mean no penalties, no increased costs.\u201d<\/p>\n Marketing.<\/strong> It\u2019s important for home meal services to build awareness of who they are and what they offer. Whether it\u2019s a hospital providing meals to discharged patients, a rehabilitation center providing meals to previous clients, a continuing care retirement community offering meals to independent clients or some other form of nutrition care, it sends a positive image to the local community. It builds awareness of who they are and the services they offer.<\/p>\n Narrow networks.<\/strong> \u201cHospitals are the ones who refer to rehab, skilled nursing and senior living communities,\u201d Fillmore says. \u201cIf they\u2019re going to recommend continuing care for a patient, they\u2019ll recommend the one that offers innovative services to keep people healthier longer.\u201d<\/p>\n Sales-driven revenue streams.<\/strong> Fillmore says there may be room \u201cto make money back at minimum and potentially upcharge if you want the program to be revenue-generating.\u201d Whether your home meal program should be free or revenue-generating will depend on the circumstances of your operation. She adds that if you do upcharge, be sure it\u2019s a nominal amount that the target market can bear. <\/p>\n Another option: scale up production even further to offer the meals as takeout fare for employees and\/or visitors. <\/p>\n The bottom line? \u201cMore and more people will be doing this to reduce healthcare costs,\u201d Altier predicts. \u201cIt costs less to feed people for 28 days than to bring them back to the hospital.\u201d<\/p>\n Altier adds that, \u201cbetter basic care doesn\u2019t get any more basic than nutrition.\u201d <\/p>\n The following principles, Altier says, laid the foundation for Lee Health\u2019s Flavor Harvest at Home program. <\/p>\nGetting started<\/h3>\n
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