Getting Food is Medicine paid for. Supporting the people who make it work.
Food is Medicine needs lasting financing and strong community leadership. We track developments in policy, payment, research, and implementation to identify opportunities for sustainable services and meaningful implementer leadership.
Food is Medicine: Financing & Field Leadership
This dated brief presents selected developments and Caja Solidaria’s analysis. It does not represent an approved coalition position. Program rules and opportunities can change; consult the linked sources for current details.
North Carolina | Medicaid
Healthy Opportunities restart: Building toward durable food-service financing
What changedOn November 9, NCDHHS announced plans to restart Healthy Opportunities in early 2027. Approximately $25 million in combined state and federal funding will support weekly home-delivered healthy food boxes for eligible Medicaid members experiencing food insecurity who meet pregnancy, diabetes, and/or cardiovascular disease criteria. Services will remain within the existing three pilot regions covering 33 counties.
Why it matters for lasting financing
The restart creates an opportunity to examine how a targeted food benefit performs and what sustained purchasing would require. Evaluation should distinguish findings from the redesigned benefit from evidence generated by the earlier, broader program.
Implementers’ leadership
Community providers bring knowledge of delivery costs, participant needs, procurement, staffing, and access barriers. They should help shape implementation and evaluation, including measures of provider sustainability and local economic benefit.
Action to advance
Document full delivery costs and implementation experience alongside health and utilization outcomes. Use that evidence to inform adequate rates and future funding decisions.
ROOTS investments: Connecting startup resources to recurring revenue
What changedOn November 2, North Carolina announced a dashboard of first-year Rural Health Transformation awards and an initial $100 million federal award for Year 2, with additional funding expected in phases. The announcement says ROOTS hubs will soon begin funding projects following regional needs assessments.
Why it matters for lasting financing
Initial investment can build capacity, but sustained services require a plan for ongoing purchasing and operating costs. Food is Medicine proposals should connect infrastructure spending to realistic future revenue.
Implementers’ leadership
Community organizations should help define regional priorities, select workable approaches, and establish the resources delivery requires. Their design and planning contributions need funded roles.
Action to advance
Develop proposals that identify full costs, community-provider responsibilities, potential purchasers, and a path from initial investment to continued payment.
Kansas connects community health workers and Food is Medicine
What changedKansas has opened a Year 2 Rural Health Transformation funding opportunity combining community health worker integration with Accountable Food is Medicine. Applications close November 18, 2026. The funding amount remains subject to CMS approval of the Year 2 budget. This opportunity supports work in Kansas.
Why it matters for lasting financing
The approach offers a model for examining how food services, navigation, and clinical connections can receive coordinated support. These functions have distinct costs that financing arrangements need to recognize.
Implementers’ leadership
Community health workers and food providers contribute expertise in engagement, access, and practical delivery. Their experience should inform service design, staffing assumptions, and payment arrangements.
Action to advance
Compare the Kansas approach with North Carolina’s needs and authorities. Identify transferable design features and questions for regional purchasers and implementers.
Meal support and education: What should purchasers fund over time?
What changedA November 2 American Heart Association announcement describes an eight-month study of adults with Type 2 diabetes and high blood pressure. Both groups received medically tailored meals and nutrition support; one group gradually received fewer meals. Researchers reported improvements in both groups. These findings come from a conference abstract and remain preliminary, pending full peer-reviewed publication.
Why it matters for lasting financing
Purchasers need evidence about service intensity, duration, and accompanying supports. This study raises useful questions but does not establish that programs can reduce food assistance without consequences or that a particular approach will generate savings.
Implementers’ leadership
Providers can explain how food, education, cultural relevance, participant circumstances, and delivery interact. They should help interpret findings and design further testing before purchasing requirements change.
Action to advance
Review the full research when available and evaluate the complete intervention, its costs, and participant outcomes before applying a reduced-service approach.
A Medicaid calculator supports realistic financing proposals
What changedThe Medicaid Food Security Network’s 2026 fiscal-impact calculator helps users examine how grocery-based Food is Medicine programs could affect Medicaid managed care costs. This is an existing resource worth using, rather than a new announcement this week. Its authors emphasize that it supports program design and affordability discussions; it does not formally evaluate first-year savings.
Why it matters for lasting financing
Credible proposals need realistic assumptions about eligibility, participation, service costs, and potential benefits. Understanding purchaser affordability should accompany analysis of adequate provider payment.
Implementers’ leadership
Community providers should supply and validate operating assumptions, including food, staffing, navigation, delivery, administration, and infrastructure. Their costs should inform the model before a rate becomes an expectation.
Action to advance
Bring implementers, purchasers, and actuarial expertise together to test scenarios and identify the difference between an affordable benefit and a financially viable delivery arrangement.
New Medicare payments create opportunities for sustainable partnerships
What changedThe 2027 Physician Fee Schedule establishes payment pathways for shared medical appointments and health and well-being coaching. These changes expand possibilities for financing clinical care and behavior-change support relevant to lifestyle medicine.
Why it matters for lasting financing
Partners can examine whether these payments could sustain clinical components of Food is Medicine programs alongside separately funded food services. A workable model needs full-cost analysis, eligible billing arrangements, and reliable payment for participating organizations.
Implementers’ leadership
Community organizations bring expertise in culturally relevant food, participant engagement, procurement, education, and delivery. They should help design partnerships and negotiate funded responsibilities from the outset. Qualified community-based personnel may have opportunities to provide coaching under the required supervision and billing arrangements.
Action to advance
Bring implementers and clinical partners together to assess a concrete service model, map payment flows, and determine whether reimbursement can support a durable, fairly compensated partnership. Verify qualifications and billing requirements before implementation.
Caja connects research, community implementation, and financing strategy. We welcome scoped, paid collaborations to develop payment approaches, evaluate models, and strengthen implementer leadership.
This dated brief presents selected developments and Caja Solidaria’s analysis. It does not represent an approved coalition position. Program rules and opportunities can change; consult the linked sources for current details.
