Grocery Assistance Benefit Linked to Fewer Diabetes Complications

This week's Managed Care Cast episode features a conversation between The American Journal of Managed Care^® and August 2026 authors Jeff Romine, PhD, and Kofi Essel, MD, MPH, about their study, "Insurance-Provided Grocery Assistance and Health Care Outcomes Among Patients With Diabetes."

It examined the association between a commercial health plan's grocery assistance benefit and health care use and outcomes among members with type 2 diabetes, offering evidence in a space where prior food-as-medicine research has centered largely on Medicare and Medicaid populations.

The benefit provided members between $1200 and $3000 annually, distributed across pay periods on a card usable at a range of grocery chains. Purchases excluded alcohol, tobacco, and preprepared foods, with an emphasis on fruits, vegetables, and other healthy items. Essel noted the design was a deliberate light touch, requiring no dietitian or health coach support, which he said made it more scalable than medically tailored meal programs that have driven much of the existing food-as-medicine literature. Romine, an economist by training, added that the appeal of studying a lighter intervention was the chance to observe how members made decisions about food and health without the more rigid structure of prior research.

To evaluate the benefit, the team used a difference-in-differences design, comparing changes in utilization and clinical outcomes over time for members receiving the benefit against a control group of members with type 2 diabetes who were not eligible. Romine highlighted 3 main results: a 3.1% decrease in diabetes complications, no significant change in overall health care utilization, and improved medication adherence. He said the utilization finding was a positive surprise, since it suggested members retained access to needed care even within a narrower network.

Essel pointed to a secondary finding as especially notable: the largest reduction in diabetes complications occurred among members living in lower socioeconomic areas, indicating a potential role for grocery assistance in narrowing health disparities. He emphasized that Elevance Health's approach to food as medicine considers both diet-related chronic conditions and social drivers of health such as food and nutrition insecurity, rather than treating them as separate levers.

Looking ahead, Essel said future iterations of the benefit could be strengthened by tailoring groceries to individual cultural and dietary needs, adding nutrition education such as medical nutrition therapy or culinary counseling, and integrating the benefit more closely with primary care and specialist providers.

"We are incredibly excited to see what we've seen here, and we can continue to build off of these learnings across the board," Essel concluded.

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