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THE IMPACT OF HOME-DELIVERED MEALS ON OVERALL HEALTH AND ASSOCIATED USE OF HEALTHCARE SERVICES

Despite the mounting evidence that the trusted Meals on Wheels model is associated with improvement in overall health and well-being among older adults, funding for these vital programs has not kept pace with the growing demand. This has resulted in millions of fewer meals provided, thousands of seniors going unserved, and waiting lists continuing to grow. That is why Meals on Wheels America has set out to validate what we’ve known for decades anecdotally through firsthand experience: that Meals on Wheels does in fact deliver so much more than just a meal.

The More Than a Meal Medicare Claims Analyses, conducted by researchers at Brown University’s Center for Gerontology and Healthcare Research and funded by the Gary and Mary West Foundation in 2016, was designed to help us better understand the impact of home-delivered meal services on overall health and well-being and associated use of high-cost healthcare services.

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MEDICARE CLAIMS ANALYSES APPROACH

To achieve the project goal, records for more than 29,000 Medicare beneficiaries who received Meals on Wheels services between 2009 and 2014 were compiled from 13 Meals on Wheels programs across six states. The final analytic sample included 14,000 Meals on Wheels/Medicare beneficiaries.

Two sets of analyses were conducted. Method 1 compared healthcare utilization and costs for Meals on Wheels clients prior to and following receipt of Meals on Wheels services over a 30-, 90- and 180-day period. Method 2, describes differences in healthcare utilization and costs between Meals on Wheels clients and a control group of Medicare beneficiaries who did not receive Meals on Wheels services.

METHOD 1

Findings suggest that Meals on Wheels recipients’ healthcare utilization and costs declined post-enrollment periods compared to the equivalent amount of time before enrollment.

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METHOD 2

Findings suggest that Meals on Wheels clients had higher rates of healthcare utilization than those who did not receive Meals on Wheels services.

Researchers speculate that findings may be limited and should be interpreted with caution for a number of plausible reasons. Explanations range from a clear pent-up need for short-term services from a highly vulnerable population which could level out and result in savings over time with continued delivery of Meals on Wheels services; to the possibility that the data available in the Medicare Claims records may not have included all factors that could have resulted in some significant differences in those receiving services compared to those not receiving services. 

CONCLUSION

These findings add to our existing portfolio of research documenting the value of home-delivered meals to clients’ health and well-being. Meals on Wheels America will continue to invest in building our knowledge base to better understand the relationship between Meals on Wheels services and healthcare utilization.

Distinct from the retrospective Medicare Claims Analyses study, work is underway in Baltimore, Maryland to prospectively identify another control group of patients who did not receive services to further evaluate the effect of Meals on Wheels on healthcare utilization and costs. We intend to compare patients who are referred to Meals on Wheels against a control group of patients who are not referred to Meals on Wheels to learn if there are differences in healthcare utilization and outcomes among the two groups. The division between those referred to Meals on Wheels or those placed in the control group would be randomized, creating an environment to test for a cause and effect relationship. This study will further explore the value that Meals on Wheels services bring to the holistic health of at-risk seniors, adding to Meals on Wheels America’s body of research.

To learn more about the completed and current More Than a Meal research studies, visit www.mealsonwheelsamerica.org/MTAM.


 
ABOUT THE BROWN UNIVERSITY SCHOOL OF PUBLIC HEALTH

Through research, education, and public service, the Brown University School of Public Health strives to improve the health of individuals as well as populations. Working within all of Brown University, and the wider community, students benefit from substantial opportunities to gain and apply knowledge, while faculty members put their findings into practice to impact local, state, and national policy.

ABOUT THE GARY AND MARY WEST FOUNDATION

The Gary and Mary West Foundation is a private, 501(c)(3) non-operating foundation solely funded by Gary and Mary West and is dedicated to helping make successful aging a reality for America’s seniors. Working with grantees such as the Gary and Mary West Health InstituteGary and Mary West Health Policy Center and other senior-focused national and community-based organizations, the Foundation’s outcomes-based philanthropy supports initiatives to advance home- and community-based healthcare delivery, services and supports that preserve and protect seniors’ dignity, quality of life and independence. The San Diego-based Foundation is celebrating its 10-year anniversary in 2016 and accepts grant proposals by invitation only. Learn more at gmwf.org, and follow us @GMWFoundation.