Where the data is sharpest, the case is strongest.
Puerto Rico is the U.S. jurisdiction with the highest age-adjusted diabetes prevalence and the highest Medicare Advantage penetration. A natural test-bed for Food is Medicine outcomes at unusual signal-to-noise ratio.
Concrete, not aspirational.
Real cohort, real evidence
An active Tufts Friedman School DUA on the Nutrisana cohort, plus observational impact across an active program portfolio. Not a hypothesis.
Payer & HRSA alignment
Live payer integrations, ASPPR-aligned FQHC pipeline, federal mechanism map. Your grant compounds into sustainable system financing.
Catalytic geography
78 municipalities of cold-chain operations in a U.S. territory with the federal program tools and the disease burden to show ROI in 12 months, not 5 years.
Four ways to put capital to work, this year.
Each opportunity rides on infrastructure that already runs. Ranges are indicative and scoped per funder in the first conversation.
Take the MA Healthy Box to the next 20 municipalities
The delivery, call-center and eligibility rails already run islandwide. Philanthropic capital extends the active Medicare Advantage food-box program into municipalities where the payer benefit alone doesn't reach the food-insecure population.
- Municipality-level reach and delivery data, quarterly
- Independent member-satisfaction evaluation
- Co-branded impact report for your board
- Naming recognition on program materials
Fund the first condition-specific food box RCT in Puerto Rico
The condition-specific pilot (renal, cardiac, diabetic boxes) is live and instrumented. A funded randomized trial turns observational signal into publishable causal evidence, with Harvard and Tufts relationships already in place.
- IRB-approved protocol co-designed with academic partners
- Peer-reviewed publication with funder acknowledgment
- Full de-identified dataset access under DUA
- Biannual scientific advisory briefings
Match the GUSNIP incentive and scale Fresh Access PR
GUSNIP achieved 100% redemption (NTAE-confirmed) and demand structurally exceeded federal incentive supply. Every philanthropic dollar matches a federal dollar, doubling fruit-and-vegetable purchasing power for NAP families.
- 1:1 federal match on every dollar
- Redemption and consumption data via active Tufts DUA
- NTAE-comparable evaluation metrics
- Recognition in USDA-facing program reporting
Build the public Food is Medicine outcomes dashboard for PR
The field lacks a public, recurring view of Food is Medicine outcomes in a whole jurisdiction. Fund the open dashboard that tracks reach, adherence and health signals across the portfolio, and set the transparency standard for the field.
- Public dashboard with funder attribution
- Open methodology note reviewed by academic partners
- Quarterly public data releases
- First-look briefings before each release
What we've built for people like you.
Five ways FIM pays off, with our proof points.
Medical cost containment & ROI
Targeted FIM in high-risk populations is associated with fewer hospital admissions and ED visits.
Built on islandwide operations proven at 3M-box federal scale.
Patient diet & health outcomes
Every FIM type supports healthier intake aligned to chronic-disease management: HbA1c, blood pressure, diet quality.
Fresenius CKD pilot observed GFR/albumin signals consistent with improved nutrition.
Engagement, retention & growth
A tangible, culturally-relevant benefit builds trust and member satisfaction, strengthening plan competitiveness.
4.9/5 member satisfaction and 95% plan-retention intent in independent evaluation.
Quality performance & Star Ratings
Supports HEDIS measures, social-needs screening, CAHPS, and CMS Star Ratings through better chronic-disease control.
Reporting maps to HRSA UDS and payer audits; Z-code documentation in production.
Workforce satisfaction
Gives clinicians an effective tool for root causes instead of symptoms, reducing moral injury.
FiMCo absorbs sourcing, logistics, and support so clinical teams stay clinical.
The funding already exists, across every line.
Food is Medicine is reimbursable today through multiple mechanisms. FiMCo maps the right ones to your population.
Medicaid
FIM is not a guaranteed Medicaid benefit, but several mechanisms already reimburse it.
- Section 1115 demonstration waiversActive in 13+ states
Federal approval to cover nutrition supports, typically over 5 years.
- In Lieu of Services (ILOS)Authorized in 10+ states
Cost-effective substitute services counted in capitation and MLR.
- HCBS authorities (1915c/i)Most states
Home-delivered meals (capped at two/day) under existing waivers.
- Value-Added Services (VAS)Plan option
Nutrition supports MA plans offer beyond the state benefit.
Z-codes documented today translate directly to a Medicaid 1115 amendment or ILOS line. The rails are already in production.
Medicare Advantage
Not in standard Medicare, but MA plans can offer FIM through several voluntary pathways.
- Primarily Health-Related Supplemental Benefits~70% of MA enrollees have access
Short-term meals post-discharge or in a supervised program.
- SSBCI (chronically ill)Available, SNP-weighted
Broader food and produce supports for serious chronic conditions.
- CMS LEAD ModelLaunches Jan 2027
Lets ACOs offer MNT and healthy-food incentives in Original Medicare.
Multiple MA payer integrations are live with SFTP eligibility sync, call center, and post-delivery surveys. Add FIM as a benefit, not a pilot.
Commercial / Employer
Employer-sponsored plans aren't required to cover FIM, but voluntary pathways are well established.
- Disease-management programs~64% of large employers
Nutrition supports for employees with chronic conditions.
- Participatory wellnessOpen to all employees
Subsidized grocery delivery, produce boxes, health coaching.
- Health-contingent wellnessIncentives capped at 30%
Rewards tied to participation or outcomes, HIPAA-compliant.
Caribbean Produce's own Nutrición Plus employee program is a live, real-world signal of what subsidized household nutrition does to the basket.
Federal Safety-Net (PR)
The rails FiMCo already runs on (HRSA, USDA, and NAP), where most PR funding actually originates.
- HRSA Section 330Active enabling service
Permits FIM as an enabling service at Federally Qualified Health Centers.
- USDA GUSNIPFIP closed · FLSP submitted FY26
1:1 federal match for produce-incentive programs.
- NAP (PR nutrition assistance)Operational
The purchasing base nutrition incentives layer onto, via Nutrisana.
FiMCo maps HRSA 330 base + supplements + GUSNIP match + payer reimbursement to a center's eligible cohort. Funding isn't built from scratch.