SNAP benefits are lapsing. How can docs help hungry patients?

Food security at risk with SNAP lapse

Fundamentally, what's at risk is food security, which most healthcare experts acknowledge has a direct effect on patient health.

"Patients who lack consistent access to nutritious food are at higher risk for glycemic dysregulation, diabetes, hypertension and heart disease," according to Kelseanna Hollis-Hansen, a research assistant professor at the Tufts University Friedman School of Nutrition Science and Policy.

"It also contributes to poor mental health, including increased rates of depression and anxiety," Hollis-Hansen added in an emailed statement.

For kids, the impacts of food insecurity can run deep. For example, kids experiencing food insecurity can also see impacts to their cognitive functioning, development and ability to attend and perform well in school.

Food can also be medicine, with many healthcare providers prescribing diets to help control chronic and diet-related illnesses, according to Gabby Headrick, assistant professor, director of Undergraduate Programs in Nutrition and IFSAN associate director of Food and Nutrition Policy at George Washington University's Milken Institute School of Public Health.

"If you're living with type two diabetes and high blood pressure, the diet you've been prescribed from your provider is going to be one that is rich in fruits and vegetables, rich in high fiber foods, rich in whole grains and lean proteins," Headrick said in an interview.

"People are going to have a much harder time being able to afford all of those foods that they typically maybe were able to afford with the combination between their SNAP and their own income contribution."

Those potential health risks have resonated with healthcare organizations, many of which have increased investments in SDOH work in the past decade. And it's not just a moral obligation -- healthcare organizations see a fiduciary responsibility to address food insecurity.

According to one 2023 report in Health Affairs, that price tag can run upwards of $2,500 in family healthcare expenditures.

Although many healthcare organizations have set up their own systems for supporting individuals experiencing food insecurity, SNAP has been a key lifeline in supplementing that work.

With its lapse slated for Saturday, organizations will need to reassess their strategies to mitigate adverse health outcomes.

Providers can inform patients of SNAP changes

According to Headrick, providers can be instrumental in messaging about SNAP issues.

"It's really crucial that anyone that has access to vulnerable populations right now helps amplify messaging and outreach about resources that are available," she explained.

Lapsing SNAP funding is an evolving issue, and it will be difficult for individuals affected to cut through the noise and determine what these changes mean for them.

Providers might consider using broad patient outreach campaigns, like automated patient portal, email or SMS texting campaigns, to outline the changes coming to SNAP as well as the local resources available to patients.

There's also room for providers to work with patients one-on-one during visits. Clinicians might detect food insecurity via an SDOH screening, but according to Headrick, they can also integrate the issue into conversation given the current context.

"Providers are going to be regularly seeing patients one-on-one and have the opportunity to just simply ask, 'are you struggling to get enough food right now?'" Headrick advised.

"You don't even need to ask if someone's receiving SNAP or not," she added. "If someone's not able to get enough food, that provider should then help link them up to either other people in that care network that can help them find resources to get enough food or have a brochure handy to be able to hand off to patients to help them know where they can go for additional support."

SDOH referrals more important than ever

From there, healthcare organizations need to leverage the systems they might already have in place for SDOH referrals, particularly referral to food banks and pantries.

"Healthcare providers can play a vital role in supporting patients toward healthier outcomes by connecting them with community-based resources and tools that promote food security and nutrition," Hollis-Hansen said.

Again, either using the patient-provider communication skills Headrick outlined or SDOH screening, providers can refer patients to the right resources.

According to Headrick, this is a great use case for team-based care.

"It's going to be important to partner with other people on the care team, such as social workers and registered dieticians, who may have a better understanding of the food assistance landscape outside of the healthcare system," she noted.

Indeed, those experts might have insights into food banks that specialize in ensuring access to nutritious foods, which is key to preventing adverse health outcomes stemming from food insecurity.

"Many food pantries now offer guidance on making healthier selections, and providers can encourage patients to seek out client choice pantries that prioritize fresh produce and whole foods," Hollis-Hansen said.

For older adults over age 65, Hollis-Hansen emphasized the role that programs like Meals on Wheels can play in supporting not just food security but also social isolation and loneliness. Clinicians should check on senior patients and ensure their enrollment in the program.

But it's clear healthcare and nutrition advocates will be facing an uphill battle come SNAP's funding lapse. After all, food pantries are stressed right now, with many saying that their capacity to help people pales in comparison to the impact that SNAP can have.

Headrick stressed the risk to patient health any cut to SNAP will have, as it can cut off access to the nutritious food people need to stay healthy.

Can providers tap medically tailored meals?

There could be some potential for healthcare providers to actually prescribe healthy food for their patients in need, Hollis-Hansen indicated.

"While I know Medicaid is facing cuts and funding challenges as well, in states with Medicaid 1115 waivers, providers can still advocate for and help patients access innovative Food is/as Medicine programs that may be covered under those waivers (e.g., nutritious prepared meals, groceries, produce prescriptions)," she suggested.

Providers can check whether their state is participating in one of those programs through KFF and assess which of their patients qualify.

Still, the murky outlook for Medicaid funding might mean this option could soon be limited. Provider organizations might consider looking at other low-cost food sourcing programs to "prescribe" food security to their patients.

"Lastly, community cafes and mobile food sourcing applications like Olio and Misfits Market also offer creative ways to access free or low-cost food locally," Hollis-Hansen said. "By staying informed about a variety of resources and integrating them into care and referral plans, healthcare providers and support teams can help bridge the gap between clinical advice and real-world access to nutritious food during a time when federal food assistance benefits are in jeopardy."

Headrick recommended providers also check with local community leaders, as well as the Feeding America Network, to learn more about their local resources.

Sara Heath has reported news related to patient engagement and health equity since 2015.