Table 3. Estimated 1-Year Averted Hospitalizations, Savings in Health Care Expenditures, and Net Policy Cost Savings Associated With Provision of MTMs, by Eligibility Criteriaa.
| Insurance type | Individuals, No. | Averted annual inpatient hospitalizations, No. (95% UI)b | Savings in annual health care expenditures, $, in billions (95% UI)c | MTM program costs, $, in billions (95% UI) | Net policy cost savings, $, in billions (95% UI) |
|---|---|---|---|---|---|
| Noninstitutionalized US adults with nutrition-sensitive disease and IADL limitations | |||||
| Private | 1 485 365 | 290 000 (173 000 to 419 000) | 8.9 (2.7 to 15.7) | 5.9 (5.1 to 6.7) | 3.0 (−2.8 to 9.4) |
| Medicare | 2 571 562 | 712 000 (455 000 to 1 013 000) | 13.4 (4.4 to 22.7) | 10.1 (8.8 to 11.6) | 3.4 (−5.4 to 12.1) |
| Medicaid | 697 292 | 195 000 (102 000 to 327 000) | 4.5 (1.5 to 8.0) | 2.8 (2.4 to 3.2) | 1.7 (−1.1 to 5.1) |
| Dual eligible | 1 555 779 | 397 000 (241 000 to 579 000) | 11.9 (4.0 to 20.7) | 6.1 (5.3 to 7.0) | 5.9 (−1.9 to 14.1) |
| Total | 6 309 998 | 1 594 000 (1 297 000 to 1 912 000) | 38.7 (24.9 to 53.9) | 24.8 (23.1 to 26.8) | 13.6 (0.2 to 28.5) |
| Noninstitutionalized US adults with nutrition-sensitive disease, IADL limitations, and food insecurity | |||||
| Private | 330 587 | 78 000 (37 000 to 126 000) | 2.7 (0.5 to 5.8) | 1.3 (1.1 to 1.5) | 1.4 (0.7 to 4.3) |
| Medicare | 587 828 | 167 000 (86 000 to 272 000) | 3.1 (1.0 to 5.5) | 2.3 (2.0 to 2.6) | 0.8 (−1.3 to 3.2) |
| Medicaid | 286 066 | 117 000 (76 000 to 171 000) | 2.8 (0.6 to 5.8) | 1.1 (0.9 to 1.3) | 1.7 (−0.4 to 4.6) |
| Dual eligible | 683 200 | 144 000 (76 000 to 228 000) | 4.4 (1.4 to 8.0) | 2.7 (2.3 to 3.0) | 1.8 (−1.1 to 5.3) |
| Total | 1 887 681 | 506 000 (398 000 to 654 000) | 13.0 (7.9 to 18.9) | 7.4 (6.9 to 8.0) | 5.5 (0.7 to 11.1) |
| Noninstitutionalized US adults with diabetes and IADL limitations | |||||
| Private | 636 320 | 118 000 (62 000 to 183 000) | 4.3 (1.2 to 7.9) | 1.9 (2.1 to 1.6) | 2.4 (−0.7 to 6.1) |
| Medicare | 1 001 345 | 304 000 (180 000 to 463 000) | 5.6 (1.9 to 9.5) | 3.0 (2.5 to 3.4) | 2.6 (−1.2 to 6.5) |
| Medicaid | 368 460 | 63 000 (24 000 to 120 000) | 2.5 (0.7 to 4.6) | 1.1 (0.9 to 1.2) | 1.4 (−0.3 to 3.5) |
| Dual eligible | 824 381 | 216 000 (123 000 to 326 000) | 7.0 (2.3 to 12.4) | 2.4 (2.1 to 2.8) | 4.6 (−0.1 to 10.0) |
| Total | 2 830 506 | 701 000 (524 000 to 911 000) | 19.3 (12.2 to 27.3) | 8.4 (7.8 to 9.1) | 10.9 (3.6 to 18.8) |
| Noninstitutionalized US adults with congestive heart failure and IADL limitations | |||||
| Private | 374 445 | 77 000 (31 000 to 128 000) | 2.5 (0.7 to 4.5) | 1.1 (0.9 to 1.3) | 1.4 (−0.4 to 3.4) |
| Medicare | 871 058 | 288 000 (168 000 to 436 000) | 5.0 (1.7 to 8.7) | 2.6 (2.2 to 2.9) | 2.4 (−0.8 to 6.1) |
| Medicaid | 119 035 | 37 900 (24 000 to 57 000) | 0.7 (0.2 to 1.5) | 0.4 (0.3 to 0.4) | 0.4 (−0.1 to 1.1) |
| Dual eligible | 330 745 | 127 000 (68 000 to 196 000) | 2.6 (0.8 to 5.0) | 1.0 (0.8 to 1.1) | 1.6 (−0.2 to 4.0) |
| Total | 1 695 294 | 530 000 (373 000 to 705 000) | 10.9 (6.3 to 15.6) | 5.0 (4.6 to 5.4) | 5.8 (1.3 to 10.6) |
Abbreviations: IADL, instrumental activities of daily living; MTM, medically tailored meal; UI, uncertainty interval.
a
Estimates are the mean of 1000 Monte Carlo simulations, with the 95% UI defined as the 2.5th percentile to the 97.5th percentile of the simulations. The policy simulation model ran 1000 Monte Carlo simulations using inputs and their uncertainties from the 2019 Medical Expenditure Panel Survey, relative risks of annual hospitalizations, and annual percentage change in health care expenditures associated with MTM receipt, screening costs, and meal costs.
b
Rounded to the nearest 1000.
c
Rounded to the nearest $100 000 000.