In addition to improving health outcomes for patients and helping health systems manage costs, FIM also plays an important role in strengthening the patient-provider relationship. Numerous patients and clinicians have endorsed FIM programs as critical opportunities to offer natural and holistic care “beyond the status quo” at various points along the patient experience.
Consider the following example from the Duke Lifestyle and Weight Management Center, where a 4-session shared medical appointment (SMA) series from the Ardmore Institute of Health’s Full Plate Living program was paired with a PRx. The program aimed to alleviate challenges related to fragmented care, provider capacity, and health-related social needs (HRSN) for patients with obesity. Similar in-person and virtual models of care delivery have been deployed in other clinical settings focused on FIM and a variety of cardiometabolic diseases, including diabetes.
Prior to Visit
Challenges with Standard Care Delivery
- Limited availability for one-to-one appointments with long wait times due to high patient volume
- Inability to systematically address HRSN like food and nutrition insecurity during busy individual visits
- Siloed care across the multidisciplinary provider team
Why These Challenges are Important
- Friction with scheduling and access can deter patients from receiving needed care.
- Fragmented provider coordination lends itself to fragmented patient care.
How FIM Care Models Can Help Alleviate Pain Points
- SMAs create economies of scale by enabling group education about nutrition and behavior change strategies, maximizing provider time by engaging multiple patients simultaneously and allowing for more frequent patient-provider contact than is possible with individual visits.
- SMAs can be hybrid (virtual and/or in-person) to improve access for patients with transportation difficulties.
- SMAs improve multidisciplinary team-based care by offering opportunities for real-time interprofessional collaboration.
- SMAs offer a mechanism to deliver FIM and/or support the use of FIM therapies through longitudinal counseling and support.
During Visit
Challenges with Standard Care Delivery
- Providers have limited time and often give the same advice to patients they see.
- Patients and providers have difficulty connecting on lifestyle changes due to brief interventions in clinic.
- Provider lacks incentive to offer lifestyle and behavior change strategies during brief, busy patient encounters.
- Provider time with patients may be lost due to no-shows or late appointment cancellations.
Why These Challenges are Important
- Duplicative counseling yields clinical inefficiencies.
- Lack of connection, cultural discordance, and limited time can leave the patient and provider feeling frustrated and dissatisfied with the clinical encounter.
- Lack of EHR-integrated billing codes can prevent providers from offering or referring patients to nutrition counseling.
- Lost revenue from patient no-shows or late cancellations can result in significant financial impacts.
How FIM Care Models Can Help Alleviate Pain Points
- Interprofessional collaboration through SMAs enhances counseling efficacy and efficiency and enriches whole person patient-centered care.
- Discussions around food culture, behaviors, and food access programs delivered through SMAs can help providers connect with patients beyond traditional clinical concerns and measures.
- Integrated billing codes for nutrition and lifestyle counseling through SMAs may provide more time with patients and offer viable reimbursement models for providers.
- SMAs insulate providers from lost revenue due to patient no-shows, as providers can still engage with patients who do attend the SMA sessions (attendance rates are often over 75% for SMA participants).
While in Treatment
Challenges with Standard Care Delivery
- Patients may be uncertain about what to eat or how to prepare healthy foods.
- Lack of access to healthy foods may be missed during standard patient encounters.
- Ongoing support for healthy habits is often missing from standard medical care.
Why These Challenges are Important
- Limited nutrition knowledge and food access can prevent patients from adopting healthy eating patterns.
- Fragmented longitudinal support with lifestyle changes may preclude opportunities to support patients working on behavioral changes.
How FIM Care Models Can Help Alleviate Pain Points
- Pairing SMAs with incentives (e.g., FIM food pickup, culinary classes) can encourage attendance, provide direct access to healthy foods, and enhance patient nutrition knowledge.
- SMAs enable nutrition education and culinary skills development opportunities through structured, longitudinal support.
FIM programs provide ongoing, relationship-based support that helps patients build practical nutrition skills and the confidence to sustain healthy habits. Several models exist for delivering FIM, which are described in Section 3. The model described above has been successfully used in clinic to expand care capacity while meeting high patient need.
Section 3: How Organizations Operationalize Food is Medicine ▶
◀ Evidence of the Impact of FIM