FIM programs are emerging as powerful tools with the potential to deliver meaningful clinical and financial impact.

As evidence continues to grow, FIM programs are increasingly demonstrating their ability to improve health, support cost‑effective care, and enhance equity and member engagement. FIM interventions have potential to directly support a health plan’s core strategic goals:

For more than three decades, clinicians, community organizations, public agencies, and advocates have built and tested programs that use food to support health, often with limited funding. Much of today’s FIM infrastructure was built through a mix of research studies, federal and state demonstration projects, specialized payment pathways such as the Ryan White Act, commercial health plan pilots, and sustained philanthropic investment. Together, these efforts generated meaningful evidence and practical experience, showing how FIM interventions can be designed, delivered, and evaluated.

The evidence base for FIM continues to strengthen, with clear links to improved clinical outcomes, cost avoidance, and higher quality of care. What is less certain is the predictability of scaling pathways, particularly within Medicaid. Federal policy shifts have introduced new uncertainties regarding how states may use Section 1115 waivers or related mechanisms to support nutrition-based services, creating the potential for less uniform expansion across the country.

Despite recent policy changes, many risk-bearing health organizations continue to invest in and explore FIM strategies. Organizations operating under value-based or capitated payment models increasingly recognize FIM as a tool to improve outcomes for high-need populations while stabilizing costs and strengthening member relationships. As a result, FIM remains positioned for growth through more diverse, state-specific, and organization-driven pathways than in prior years.

The section that follows outlines a framework to guide an examination of the value proposition for risk‑bearing health plans and explains why many are still well positioned to integrate FIM into routine care, even as payment mechanisms differ across states.

This first iteration of the FIM toolkit focuses on health plans; a future update will expand to include actions that provider organizations can consider as part of their own integration strategies.