FiMCo · Puerto Rico Food is Medicine
0 years of food · 9 years of Food is Medicine

We didn't start in 2026. We started in 1960.

FiMCo sits on top of Caribbean Produce: 66 years of islandwide fresh fruit and vegetable operations and a documented record of operating at federal scale during the hardest moments in Puerto Rico's recent history. The credentials Food is Medicine asks for: cold chain, integration, compliance, community trust. We already built them. Three times.

0.0M
meals after Hurricane María
0M
USDA boxes during COVID
0
daily meals at peak
0+
nonprofits in alliance
1
2017-2020
Emergency Response
2
2021
Senior Nutrition + Clinical Pilots
3
2022-2023
Platform + Scientific Pilots
4
2024-2026
Digital Access + Federal Scale
Proof in pictures · USDA Farmers-to-Families 2020

3 million boxes. 430+ organizations. 9 months.

When the federal government needed an operator that could move USDA produce across all of Puerto Rico during the COVID emergency, the answer was our own islandwide operation. These photos are from the work that today's FiMCo Food is Medicine programs sit on top of.

Food is Medicine, year by year

The full record.

  1. Jan 1960· Origin

    Caribbean Produce Exchange founded

    CPE is established as a fresh-food distributor in Puerto Rico. Grows into the island's leading fresh-food distributor with 2,000+ active SKUs and an islandwide cold chain, the operational backbone every FiMCo program runs on today.

    66 years
  2. 1972· Community

    Red Caribeña de Varamientos partnership

    Multi-decade alliance with the Caribbean Sea Turtle Stranding Network. Native species preservation through supplier alliances and consistent corporate giving.

  3. 2016· Community

    Cataño children's summer-camp meals

    Recurring contribution to the Municipality of Cataño's summer programs: healthy snacks for children. Still active today.

  4. Sept 2017· Emergency

    Hurricanes María & Irma · Red Cross + FEMA alliance

    When María made landfall, Caribbean Produce activated a multi-month logistics alliance with the American Red Cross and FEMA. CPE's cold chain, distribution center and procurement network were placed at the service of the federal and humanitarian response. More than 3.2 million meals delivered over six months; at peak, over 10,000 elderly and food-insecure Puerto Ricans served per day. The alliance with the Red Cross would continue across future emergencies as a standing partnership.

    3.2M meals · 10K/day peak
  5. Jan 2020· Emergency

    Southwest earthquake sequence · community + farmer support

    When a sequence of strong earthquakes hit Puerto Rico's southwest, Caribbean Produce coordinated in-kind food contributions and labor support for affected communities, community-based organizations, displaced families and southwest agricultural farms and farm workers. Distribution into shelters, schools and municipal coordination centers across Guánica, Yauco, Peñuelas, Guayanilla and Ponce.

    In-kind + farmer support
  6. May 2020· Emergency

    USDA Farmers-to-Families · 3 million boxes

    During COVID-19, CPE distributes 3 million USDA Farmers-to-Families food boxes in 9 months in alliance with 430+ nonprofits and faith-based organizations. Simultaneously launches food deliveries to Medicare elder members, the seed of today's Caja de Alimentos.

    3M boxes · 430+ orgs
    USDA Farmers-to-Families packing operation in PR
  7. 2022· Emergency

    Ukraine humanitarian aid · international shipment

    Caribbean Produce participates in the humanitarian-aid effort for Ukraine, contributing food and logistics capacity through international relief channels, extending the disaster-response capability beyond Puerto Rico for the first time.

    International deployment
  8. Sept 2022· Emergency

    Hurricane Fiona · disaster response

    Caribbean Produce reactivates the Red Cross / FEMA disaster-response playbook for Hurricane Fiona: cold-chain distribution, emergency procurement, and last-mile delivery to affected communities across the island. The post-María partnership infrastructure proves durable.

    Reactivated Red Cross alliance
  9. Feb 2021· Clinical

    Fresenius CKD · first Food as Medicine pilot

    Launches medically-tailored food box pilot for renal patients with Fresenius Medical Care: low-K / low-P boxes, direct-to-patient. Significant clinical response observed in patient adherence.

  10. Feb 2021· Payer

    First payer-integrated produce incentive in PR

    FiMCo launches its first produce-purchase incentive for Medicare Advantage members in PR via a national payer. Validates the SFTP / member-data integration model that today powers all of FiMCo's payer programs.

  11. Apr 2022· Platform

    Nutrisana launches

    FiMCo launches Nutrisana, the only online grocery platform in Puerto Rico that delivers islandwide AND accepts NAP. The digital-access backbone.

    Islandwide · NAP-enabled
  12. Apr 2022· Community

    Cáritas PR · 200,000 boxes

    200,000 food boxes distributed in partnership with Cáritas as part of federal emergency-response food.

    200K boxes
  13. Jan 2023· Payer

    Healthy Food Box launches as Medicare Advantage covered benefit

    Launches the healthy food box as a covered benefit for Medicare Advantage members in PR, 100% covered by the plan. Becomes the foundation for the 2026 launch at scale.

    MA covered benefit
  14. Aug 2023· Research

    Project Precision · Harvard cultural-adaptation trial

    Partners with the Harvard T.H. Chan School of Public Health on a Culturally-Adapted Dietary Clinical Trial in Puerto Rico.

  15. Oct 2023· Federal

    GUSNIP grantee · Fundación MMM 1:1

    Awarded the USDA GUSNIP Nutrition Incentive grant. In partnership with Fundación MMM, launches a 1:1 produce incentive that doubles fruit and vegetable purchases for NAP recipients.

  16. Oct 2024· Federal

    GUSNIP 1:3 · Banco de Alimentos · Produce Rx Pilot

    1:3 incentive launched with Banco de Alimentos PR, tripling F&V value. Companion Produce Prescription pilot for diabetic patients (delivered via the Fundación MMM channel) shows significant HbA1c improvement. The results were included in the foundation's federal grant submission and cited in an external letter of recommendation.

    1:3 match · HbA1c↓
  17. 2025· Payer

    Medicare Advantage Three-Pillar Nutrition Benefit Proposal

    Proposal presented to a Medicare Advantage payer in Puerto Rico to drive member retention and CMS Star Rating performance. Three components: prepared meals, grocery box, and a fresh-produce bonus via the payer's benefit card. Grounded in Tufts evidence (HbA1c −0.8%, F&V intake +22%, food insecurity −50%) and MTM evidence from Berkowitz et al., Health Affairs 2018 (ER −70%, hospital admissions −52%, healthcare cost −16% in a high-utilization dual-eligible cohort).

    MA proposal · 3-pillar
  18. 2026· Payer

    Medicare Advantage Healthy Box launches at scale

    Grocery-box component launches across the eligible Medicare Advantage population in Puerto Rico. Strong satisfaction and near-perfect delivery success rate from month one.

    4.7/5 at launch · 99%+ delivery
  19. 2026· Payer

    Medicare Advantage Healthy Box · program-best month

    Operations review documents the program's best month to date: record-high member satisfaction, record-low delivery failures, and record-low call-center abandonment. Eligible base continues to grow as enrollment expands.

    4.9/5 · 99%+ delivery · record-low abandonment
Evidence base

Why Food is Medicine is national policy now.

The peer-reviewed evidence base for FAM has crossed the threshold from "promising" to "policy-grade." CMS's HRSN Coverage Framework (2023) and Section 1115 now allow states to reimburse medically-tailored meals, groceries, and produce prescriptions.

0%
Fewer hospitalizations among Medicaid members receiving MTM (Nature Medicine 2026)
0%
Fewer ER visits in the same Medicaid evaluation (Nature Medicine 2026)
$0.0B
National annual savings if MTM reaches all eligible (JAMA Network Open 2022)

Sources: Hager et al., Nature Medicine 2026 (medically tailored meals in Massachusetts' Medicaid 1115 demonstration, 2020-2023); Hager et al., JAMA Network Open 2022 (national-savings model assuming MTM reaches all eligible). Earlier cohorts reported larger effects, up to −70% fewer ER visits among high-utilization dual-eligible members (Berkowitz et al., Health Affairs 2018).

See what 66 years of food can do for your population.

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