Advocating for Expanded Access to Medical Nutrition Therapy in Medicare

Martin, Hannah; Kushner, Sara; Iles, Kim; Montgomery, Hailey

doi:10.1016/j.jand.2021.02.024

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…This study concluded that low-income families experienced less food insecurity because out-of-pocket health care expenses were reduced because of Medicaid expansion, thereby increasing expendable income to purchase food. One possible explanation for the limited impact of the ACA on the general population nutrition status is a lack of patient knowledge surrounding benefits of coverage of available nutrition services (40). Additionally, primary care providers do find value in nutrition counseling but often feel poorly trained to discuss nutrition with their patients, and too short on time to engage with their patients (42,43).…”

Section: Discussionmentioning

confidence: 99%

The association of the Affordable Care Act with nutrient consumption in adults in the United States

Kirk,

Tufuor,

Shaver

et al. 2023

Front. Public Health

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The Patient Protection and Affordable Care Act, more commonly known as the ACA, was legislation passed in the United States in 2010 to expand access to health insurance coverage for millions of Americans with a key emphasis on preventive care. Nutrition plays a critical role in overall wellness, disease prevention and resilience to chronic illness but prior to the ACA many Americans did not have adequate health insurance coverage to ensure proper nutrition. With passage of the ACA, more individuals received access to nutritional counseling through their primary care physicians as well as prescription vitamins and supplements free of charge. The objective of this study was to evaluate the impact of a national health insurance reform on nutrient intake among general population, including more vulnerable low-income individuals and patients with chronic conditions. Using data from the National Health and Nutrition Examination Survey (NHANES), we identified 8,443 adults aged 21 years and older who participated in the survey before (2011–2012) and after the ACA (2015–2016) implementation and conducted a subgroup analysis of 952 respondents who identified as Medicaid beneficiaries and 719 patients with a history of cancer. Using pre-post study design and bivariate and multivariable logistic analyses, we compared nutrient intake from food and supplementation before and after the ACA and identified risk factors for inadequate intake. Our results suggest that intake of micronutrients found in nutrient-dense foods, mainly fruit and vegetables, has not changed significantly after the ACA. However, overall use of nutritional supplements increased after the ACA (p = 0.05), particularly magnesium (OR = 1.02), potassium (OR = 0.76), vitamin D (both D2, and D3, OR = 1.34), vitamin K (OR = 1.15) and zinc (OR = 0.83), for the general population as well as those in our subgroup analysis Cancer Survivors and Medicaid Recipients. Given the association of increased use of nutritional supplements and expansion of insurance access, particularly in our subgroup analysis, more research is necessary to understand the effect of increasing access to nutritional supplements on the overall intake of micro- and macronutrients to meet daily nutritional recommended allowances.

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Section: Discussionmentioning

confidence: 99%

The association of the Affordable Care Act with nutrient consumption in adults in the United States

Kirk,

Tufuor,

Shaver

et al. 2023

Front. Public Health

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“…Registered dietitian nutritionists (RDNs), conversely, are expertly trained in nutrition and dietary counseling. Unfortunately, patient access to RDNs remains limited due to insufficient insurance coverage, 20 inappropriately low referral rates from clinicians, 21 and an enduring public undervaluing of their knowledge and skills. 22 Although recent legislative efforts have sought to remediate this discrepancy by codifying into law provisions that would increase patient access to RDNs, so far these proposals have not passed.…”

Section: Introductionmentioning

confidence: 99%

Physician-Chef-Dietitian Partnerships for Evidence-Based Dietary Approaches to Tackling Chronic Disease: The Case for Culinary Medicine in Teaching Kitchens

Wood¹,

Stone²,

Siler³

et al. 2023

JHL

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Since the middle of the 20th century, the American food environment has become increasingly ultra-processed. As a result, the prevalence of chronic, diet-related disease in the United States has skyrocketed. Meanwhile, physicians are still poorly trained in nutrition. A recent innovation that aims to address this is "culinary medicine" programming taught by teams of physicians, chefs, and registered dietitian nutritionists. Culinary medicine is an evidence-based, interprofessional field of medicine that combines culinary arts, nutrition science, and medical education to prevent and treat diet-related disease. It employs hands-on learning through healthy cooking and is typically taught in a teaching kitchen, either in-person or virtually. It can be dosed either as a patient care intervention or as experiential nutrition education for students, medical trainees, and healthcare professionals. Culinary medicine programs are effective, financially feasible, and well-received. As a result, healthcare systems and medical education programs are increasingly incorporating culinary medicine, teaching kitchens, and interprofessional nutrition education into their patient care and training models.

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Expanding Time Covered for Medical Nutrition Therapy: A Need for Clear Reporting on the Intensity of Nutrition Interventions

Hand,

Schofield

2024

Journal of the Academy of Nutrition and Dietetics

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Advocating for Expanded Access to Medical Nutrition Therapy in Medicare

Cited by 4 publications

References 9 publications

The association of the Affordable Care Act with nutrient consumption in adults in the United States

The association of the Affordable Care Act with nutrient consumption in adults in the United States

Physician-Chef-Dietitian Partnerships for Evidence-Based Dietary Approaches to Tackling Chronic Disease: The Case for Culinary Medicine in Teaching Kitchens

Expanding Time Covered for Medical Nutrition Therapy: A Need for Clear Reporting on the Intensity of Nutrition Interventions

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