A conversation with Erin Martin, director of Fresh RX, about insurance providers and what is holding them back, why we haven’t seen any outcome-based structures being set up, where is the first social impact bond in healthy nutrient-dense food, savings, diet-related diseases and more.

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This episode is part of the Nutrient Density in Food series!
This series is supported by the A Team Foundation, who support food and land projects that are ecologically, economically and socially conscious. They contribute to the wider movement that envisions a future where real food is produced by enlightened agriculture and access to it is equal. The A Team are looking to make more investments and grants in the space of bionutrients. You can find out more on ateamfoundation.org.

What happens when you give nutrient-dense, locally grown fruit and vegetables to people suffering from severe diet-related diseases like diabetes? Discover how a program in Tulsa Oklahoma is trying to prove just that: healthy food grown in healthy soils leads to healthier people.

THE SAVINGS ARE ENORMOUS!

Fresh RX Oklahoma’s goal was to minimize risks for diabetes-related catastrophic health events. 36 people out of 50 of those involved in their program had some type of reduction in their A1C. Some people even came off of their insulin shots and were able to take less intense medications. Others felt less anxious or depressed.

“When you have uncontrolled diabetes, it’s at an 8, and so that’s really severe, an 8 A1C where your chances of having kidney failure, stroke, all these things skyrocket, and they actually stopped measuring at a 14. So it’s measured all the way from 5 as a normal up to 14. So we were seeing people in the 11, 12, 13, 14. So that’s the high end of the spectrum. So you can see, when it’s measured just to a 14, a 1% to 2% reduction is huge. It’s actually equated to 16 to $24,000 per year in health care, cost prevention and savings by 1% to 2%.” – Erin Martin

“The ripple effect was just enormous. We estimated that with just 50 people, we saved the state of Oklahoma nearly three quarters of a million dollars. And it only cost us about $150,000 to do it. So, you invest 150 grand and save 750, the ROI makes sense to me.” – Erin Martin

GETTING MORE NUTRIENT-DENSE FRUIT AND VEGETABLES INTO PEOPLE’S DIETS IS KEY

Eating more fruits and vegetables has been proven to have direct impact on health outcomes, whether people really change much of their diet or not. Their job at Fresh RX Oklahoma is to increase people’s knowledge and increase their consumption of fruits and vegetables.

“We’re trying to help them definitely make better choices when they’re shopping and outside of the food that we provide, we definitely want them to be eating at least half their diet in vegetables. We help them change their habit, but really, the intention and other studies have proven that if you just increase their consumption of fruits and vegetables, we’re not really changing their whole diet, we’re just increasing their consumption of fruits and vegetables, and through just simply increasing that and increasing their knowledge, they definitely make different choices. But we’re not telling them, you can’t have meat, you can’t have dairy, we just want them to have more fruits and vegetables in their diet.” Erin Martin

COOKING CLASSES AND RECIPES ARE ESSENTIAL TOO

Fresh RX Oklahoma is a produce prescription program where doctors prescribe fruits and vegetables to people who have type 2 diabetes and are North Tulsa residents, where they have the highest rate of diabetes and mortality in the entire state of Oklahoma. During their first year, they had incredible outcomes. They’ve doubled the size of the program and are now seeing 100 people. They’ve been funded for the next three years through the USDA NIFA grant. So, they’ll be on the national level, contributing that data to move the needle along with these programs.

“We started with 52 people for a 12-month period. So, people who have type 2 diabetes who live in North Tulsa, they get free food for 12 months, every two weeks, they get fruits and vegetables. And they also have correlating recipes that go with that food. And then we also have cooking and nutrition classes, about four opportunities a month for them to go for 12 months. And we do a lot of data metrics. We are looking at several different things from food security, to healthcare utilization, but we’re also measuring their health metrics, their A1C, their weight, and their blood pressure. And we measure that every three months. So we can see how people are progressing.” Erin Martin

GETTING INSURANCE PROVIDERS TO PAY FOR THESE PROGRAMS WOULD BE THE HOLY GRAIL

Erin argues that we’re going through a transition right now, moving into a more value-based and outcome-based models. There’re venture capital opportunities to make relationships, engage an operator, and create a viable business model to not only make money and save the healthcare industry money, but also help people have an incredible quality of life and stimulate the local economy and agriculture.

“There’s a viable investment model for this type of program, and it’s the Holy Grail, which is getting the insurance to pay. And if you have investment money and you have relationships often because of that, you can have relationships with insurance and you need someone who’s an operator who knows what they’re doing like myself and if those relationships are connected and the insurance is willing to pay, I do believe that they would be willing to pay and the cost savings that you can prove, you could even get a contract going, where they would give you back some of those savings to continue the program, but their cost savings will be huge.” Erin Martin

“It’s not going to be a fee for service, every time you go to the doctor, they get paid, it’s going to be based on outcomes and values. And one of the pieces of implementing that shift is penalizing hospitals for readmissions within 30 days. And so these hospitals, these managed care insurance companies are going to be very interested in programs that are going to save them money, and they’re going to be willing to pay and they have the budget to pay.” – Erin Martin

INSURANCE PROVIDERS MIGHT BE MOVING INTO THE SPACE SOON

Erin argues it’s just a domino effect. There is a group called the food as medicine coalition that is lobbying and working on these things, there has been a federal pilot that has been approved. Other insurances are going to look at what other insurances have done.

“I think it’s just a domino effect from there. like Medicare and Medicaid have already started paying for something called medically tailored meals for people that get discharged from the hospital […] So, there have been a couple that has been done. And I think it’s going to have wider adoption, and then it’ll really push forward. And it’s really just a matter of time, I think before that happens.” – Erin Martin

“It could happen at any time and cost savings are ready to be had. So anytime. It may take another couple of years, but I wouldn’t be surprised if we got a contract with an insurance company this year and just started moving that way.” Erin Martin

OTHER POINTS DISCUSSED

Koen and Erin also talked about:

• Investors have the relationships to influence the change
• People’s taste buds change
• Erin’s view on animal protein
• What would Erin change if she had a magic wand

LINKS:

• FreshRx
• Conscious Aging Solutions
• White paper Human Health Nexus The Regenerative Agriculture, insights from field to body
• Social Impact Bond
• Impact Accelerator

LINKED INTERVIEWS:

• Finian Makepeace – How to get regeneration at the heart of the next US Farm Bill
• Lauren Tucker, co-founder of Kiss the Ground helps the next generation of regenerative businesses to thrive
• QA Webinar The Regenerative Agriculture and Human Health Nexus: Insights from Field to Body
• Nutrient Density in Food series
• Nutrient Dense Food

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The above references an opinion and is for information and educational purposes only. It is not intended to be investment advice. Seek a duly licensed professional for investment advice.