# NIH grant: Evaluating impacts of a food prescription program embedded into a health plan for dually-eligible older adults: A natural experiment (1R01NR022318-01) — retained record

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[original source ↗](https://reporter.nih.gov/project-details/1R01NR022318-01)

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NIH grant 1R01NR022318-01: Evaluating impacts of a food prescription program embedded into a health plan for dually-eligible older adults: A natural experiment
Institute: {'code': 'NR', 'abbreviation': 'NINR', 'name': 'National Institute of Nursing Research', 'admin_org_id': '12500052', 'admin_funding_url': ''}. PI: Melissa L Horning. Award: $595958.
Start: 2026-08-27T00:00:00.
PROJECT SUMMARY/ABSTRACT
Impacting 1 in 5 older adults with low incomes, food insecurity is the uncertain or insufficient access to enough
food for an active, healthy life. Food insecurity has been linked to serious outcomes—like heart disease,
diabetes, and premature death. Older adults with low incomes and dual eligibility for Medicare and Medicaid
are particularly at risk for food insecurity and poor diet and health outcomes. Food prescription programs have
been promoted as a strategy for improving outcomes because they can provide high-quality nutritious food to
those who need it most. Food prescription programs are growing nationally, but food prescription program
effectiveness research is hampered by methodological limitations, and these programs often have designs that
limit sustainability and reach. In 2022, in response to community and social needs and changes to Medicare
guidance for supplemental benefits, a non-profit health plan connected to a large integrated healthcare care
system launched a food prescription program, FarmboxRx, as a new insurance benefit. The FarmboxRx
benefit provided 2 boxes of fresh produce each month to low-income older adults with dual eligibility for
Medicare and Medicaid and one or more chronic conditions. Leveraging this natural experiment, we will
rigorously evaluate the impact of this food prescription program. We will compare multiple health outcomes of
those eligible for the program with a robust control group of dually-eligible older adults whose health plans do
not offer FarmboxRx. To assess program impact on health outcomes—blood pressure, blood lipids,
hemoglobin A1c, depression, and body mass index—we will leverage electronic health record data for
approximately 3117 patients either eligible for the FarmboxRx benefit or the control group. We will test impact
at the population level and in condition-specific subsamples and will assess the outcomes during the 12
months before first eligibility for the food prescription program or control group and over 6, 12, 18, 24, and up
to 36 months after becoming eligible. In addition to eligibility for the FarmboxRx benefit, we will also assess the
impact of FarmboxRx program enrollment on outcomes. Finally, we will explore program and medical care
costs, cost-effectiveness, and other factors influencing food prescription enrollment. The long-term goal is to
generate rigorous evidence on the effectiveness of food prescription programs as health plan benefits to
improve food security- and diet-related health outcomes. This innovative research will provide timely evidence
on food prescription program effectiveness over the long-term to inform health plan benefits and policies
nationally.
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