This bill adds a new model to the Social Security Act that the Center for Medicare and Medicaid Innovation (CMMI) must begin testing within 180 days. The model is called the Accountable Produce Is Medicine (APIM) Bundled Payment Model. It would pay selected Medicare, Medicaid, and CHIP programs with a bundled payment to provide a package of services to people with chronic diseases. CMMI must choose at least 5 programs to take part for at least 2 years each, and the model must run for at least 5 years.
Under the model, selected programs must screen referred patients and, for eligible patients, provide a 1-year set of services. These services include a personalized health assessment and prevention plan, care coordination, telehealth for chronic disease monitoring and education, remote patient monitoring, lifestyle programs such as nutrition counseling, and healthy, nutrient-dense foods (with preference for produce grown within 250 miles or from regenerative agriculture). Programs must collect quarterly weight, blood pressure, and blood glucose measurements and other measurements the Secretary requires. Programs must track services given, evaluate engagement, submit data to the Secretary at year end, and re-check eligibility. A program may disenroll a participant for not engaging or not meeting program standards.
Payment details (form, manner, amount) are set by the Secretary. APIM services must be provided without deductibles, copayments, coinsurance, or other cost-sharing. Beginning in the third year, the Secretary may require participating programs to assume financial risk for performance. The bill defines eligible individuals (Medicare, Medicaid, or CHIP enrollees in underserved, rural, or health professional shortage areas with specified chronic conditions) and defines regenerative agriculture.
The bill also contains a Sense of Congress that diet-related chronic diseases are a leading driver of health care costs and that food-is-medicine interventions may improve outcomes and reduce costs.
No publicly available information on estimated federal costs or savings. The bill gives the Secretary authority to set the bundled payment amount and to require financial risk for programs beginning in year three, but it does not include cost estimates.
The bill’s text states that diet-related chronic diseases drive health care costs and that evidence-based food-is-medicine interventions (like medically tailored meals, produce prescriptions, and nutrition counseling) have the potential to improve health outcomes and reduce health care spending. It says CMMI should incorporate these interventions into models and that doing so may improve quality of care, reduce costs, and support prevention and management of chronic disease.
No publicly available information on opposition views or critiques.