Who We Are
About Fresh is a mission-driven team of activists, systems thinkers, technologists, and strategic operators dedicated to a future where everyone has access to the food they need to be happy, healthy, and connected. Josh Trautwein co-founded About Fresh in 2013 to address food insecurity across Boston neighborhoods. Its original program, Fresh Truck, operated converted school buses as mobile markets to get food into low-income, food insecure Boston neighborhoods. Operating Fresh Truck brought into focus the role that affordability plays as a barrier toward healthy eating and inspired About Fresh to develop its Fresh Connect food prescription technology. Five years after launching Fresh Connect, which features a very smart pre-paid card, a powerful program management and analytic platform, and a call center to support cardholders, we have enabled the purchase of more than $10M of fresh produce by over 20,000 cardholders, powering cutting-edge implementation science and health outcomes research and informing critical advances in public policy. We work with a wide range of customers, including major health systems like MassGeneral Brigham and the Veterans Administration, health plans like Point32Health, and grassroots community-based organizations like DC Greens and Adelante Mujeres.
How We Think of Food is Medicine
We use the term “Food Care” to describe the wide spectrum of health-related food programs and strategies, including specific interventions like food prescriptions and medically tailored meals, that are being integrated into healthcare finance and delivery. We think Food Care is a stronger term than “Food is Medicine” because it encompasses health promotion and the prevention and treatment of specific health conditions. Food Care is also less "medicalized" than Food is Medicine. While we are dedicated to integrating Food Care into the standard definition of quality care so that it is prescribed and paid for, we also want to center the patient and their joyful experience of food. We want all people to be able to afford a wide variety of nutritious foods, to make choices for themselves and their households whenever possible about what they consume , and for food to continue being central to how people connect with one another.
How We Put Food is Medicine Into Action
About Fresh’s signature program is Fresh Connect, a technology-enabled food prescription program that addresses affordability as a barrier to healthy eating. Fresh Connect consists of a prepaid card we can program with item-level spend parameters based on a patient’s health goals, a web application that facilitates end-to-end program management and analytics, and a specialized Cardholder Success team to maximize program engagement.
Since launching Fresh Connect in 2019, health plans, providers, and community-based organizations have used it to cover the cost of food for more than 22,000 people experiencing nutritional insecurity. Those cardholders have purchased over $11.5M of food across our nationwide grocery retail network of more than 13,000 locations.
We designed Fresh Connect to meet the diverse needs of cardholders, CBOs, health plans and providers, digital health platforms, and the broader healthcare sector. Our customers define most program parameters, so the programs powered by Fresh Connect vary in terms of cardholder eligibility, monthly benefit value, and enrollment duration. Based on our program data and the research landscape, we have a six-month enrollment minimum, but customers can keep cardholders enrolled as long as they want.
How We’re Funded and How the Future Looks
Our customers fund their Fresh Connect programs in several ways, including Medicaid 1115 Waiver funds, public and private grants, and through their own operating budgets. As a nonprofit, About Fresh raises philanthropic capital from individual and institutional donors to support our operations, invest in product innovation, and grow our overall capacity. We are excited to see the growing momentum in the Food is Medicine space and increased interest from the healthcare sector in incorporating food into care to improve overall well-being and reduce avoidable health spending. Despite an overall sense of uncertainty driven by the current political environment, we are optimistic that we will accelerate Fresh Connect’s growth on the strength of our learning and evaluation efforts and investments into scalable, tech-enabled infrastructure. Our non-profit status enables us to leverage philanthropy as a source of funding to expand our programming, research, and advocacy, de-risking the impact of impending cuts to Medicaid.
Which Metrics and Outcomes We Track
At About Fresh, our north star is program quality, which we measure using a set of output metrics associated with program engagement and cardholder satisfaction. Our program engagement metrics include the percent of enrollees who activate their card, the percent that shop every month, and the percent of available funds those shoppers use. We also track cardholder satisfaction with a semi-annual cardholder survey. Over the years, we have seen significant improvements in those metrics, largely associated with the growth and diversification of our retail network and contact with our Cardholder Success team. Because About Fresh centers the lived experience of people enduring food insecurity to deliver an intuitive, dignified, and joyful shopping experience, our cardholder satisfaction numbers are consistently higher than 95%, and our engagement rates are among the best in the sector.
Our flexible payment technology and powerful program management platform enable our customers to associate our program metrics to their priority outcomes. Many programs using Fresh Connect focus on increasing consumption of fruits and vegetables, improving key health metrics like A1C levels and emotional stress, and decreasing overall food insecurity.
Lessons Learned
- Participant choice matters. The more freedom and agency we give food prescription program participants to obtain the food they want, where and when they want to go shopping, the more likely they are to utilize Fresh Connect funds. This core tenet of our program was validated by research published late last year that found that redemption rates were positively correlated with the number of retail options at which participants could use their Fresh Connect cards.
- Program quality and participant experience are critical to engagement and effectiveness. As the FIM world expands and program investments increase, it's essential to sustain a dignified, frictionless, and intuitive experience oriented toward delivering healthcare value. Those commitments are central to the ultimate success of our movement.
- Community-based organizations must be centered in the delivery of Food is Medicine. As FIM has gained traction, local community-based FIM providers are at risk of being displaced by large, for-profit competitors promising lower costs. While cost efficiency is an important goal, many for-profit FAM providers fall short on dignity, cultural alignment, and engagement. Even worse, there are documented instances of for-profit “FIM providers” actively undermining health equity and healthcare transformation in favor of short-term profits. Our data tells us that CBOs consistently deliver high-quality, effective FIM programs when they are supported by high quality FAM infrastructure.
Why We Want to Keep Providing Food is Medicine
We are wholeheartedly committed to advancing the Food is Medicine or Food Care movement. For more than a decade, our team has been dedicated to getting food to the people that need it most and moving healthcare to invest in healthy food as a driver of health. We remain optimistic about realizing a future where everyone has access to the food they need to be happy, healthy, and connected to loved ones.