Who We Are
Meals on Wheels America is the leadership organization supporting thousands of community- based programs across the country that are dedicated to addressing senior hunger and isolation. This network, along with more than two million staff and volunteers, delivers nutritious meals, friendly visits and safety checks that enable America’s seniors to live nourished lives with independence and dignity. Through funding, leadership, education, research and advocacy, Meals on Wheels America empowers its local member programs to strengthen their communities, one senior at a time. More than 5,000 independent community-based providers across the country deliver nutritious meals and moments of connection to those who need them most. These providers are not one-size-fits-all organizations – they are deeply embedded in their communities and serve as a critical part of the aging services infrastructure in the United States. Whether in rural counties or urban centers in diverse communities throughout a state or region, Meals on Wheels providers operate in every corner of the country, offering their services to reflect local values and need. For more information or to get involved in advocacy efforts, visit www.mealsonwheelsamerica.org.
Meals on Wheels programs have been part of the Food is Medicine movement before there was a “Food is Medicine” movement. Since before the passage of the Older American Act Nutrition Program in 1972, which formally established and provided federal funding to support senior nutrition programs, Meals on Wheels programs have always prioritized the nutrition needs of seniors. Senior nutrition providers have long provided a vital platform for Food is Medicine interventions for community residing older adults. Meals on Wheels services and the broader aging network are an important part of the larger health care system in our nation and help save lives and taxpayer dollars. Meals on Wheels can support a senior for an entire year for roughly the same cost as ten days in a long-term care facility or a single day in the hospital.
How We Think of Food is Medicine
Food is Medicine interventions encompass a broad range of approaches that promote optimal health and manage or reduce disease burden by providing nutritious food. With a focus on older adults, Meals on Wheels America defines Food is Medicine as the provision of senior nutrition services that encourage optimal health and well-being, support disease prevention, management, treatment, and addresses food security and malnutrition. Food is Medicine for community-residing older adults requires the provision of flexible, age- and condition-specific services and supports that play a critical role in addressing nutrition security for the senior population and keeping them healthy and independent.
Meals on Wheels providers understand that an older adult’s nutrition needs can range along a continuum of needs, with some seniors requiring a limited mix of nutrition and meals services to those in need of a more complex, resource-intense array of services, including Medically Tailored Meals. For example, most seniors require meals aligned with national dietary guidelines and support overall health, while others may require therapeutic meals designed by a registered dietitian nutritionist, coupled with nutrition counseling, to help them manage specific chronic conditions like diabetes and heart disease. Meals on Wheels programs can also provide seniors with nourishing meals or texture-modified options (i.e., soft, pureed, mechanically chopped or liquid meals) for those with a swallowing or chewing impediment.
These modified meals allow older adults to meet both their nutritional and medical needs and are often not discussed as part of mainstream Food is Medicine interventions. Driven by an aging population with high rates of chronic disease and risks of malnutrition, the need to provide a variety of meal types across a continuum has never been greater for the national Meals on Wheels network.
How We Put Food is Medicine Into Action
Meals on Wheels America does not provide direct services. We support our members through grants, advocacy, learning opportunities, technical assistance, access to national campaigns and more. Local providers offer a range of meals aligned with the health and nutrition needs of the seniors they serve in their respective communities. The primary objective of the meals is to address food insecurity and malnutrition and provide education and access to supportive nutrition services (as noted above). These include meals that address the following chronic conditions: diabetes, heart disease, renal disease, chronic obstructive pulmonary disease, allergies, and difficulty swallowing and chewing. Eligible seniors are typically those 60 years of age and older. However, several Meals on Wheels providers do offer Food is Medicine interventions such as medically tailored meals to those under the age of 60. Specifically, Meals on Wheels America defines medically tailored meals as meals produced or sourced under the consultation of a registered dietitian nutritionist (RDN) or state-credentialed nutrition professional to support an older adult’s medical condition. The ways in which older adults are served by the Meals on Wheels network is at the center of our definition for medically tailored meals – to ensure that these meals are described as inclusively as possible.
Meals are provided to older adults for as long as they are eligible, have need for the service, and the local Meals on Wheels provider has sufficient funding to serve them. Meals on Wheels America provides an array of capacity- and capability-building support to our members to support equitable access to Food is Medicine interventions like medically tailored meals to the seniors served across our network. For example, through our Meeting Unmet Needs Grant program we prioritize communities in the greatest need as venues in which to seed and scale medically tailored meal services for underserved or unserved older adults. In addition, we provide both in-person and online learning opportunities to members seeking to improve their skills and boost their ability to provide tailored nutrition services to the seniors they serve.
How We’re Funded and How the Future Looks
Food is Medicine interventions are funded and reimbursed by a range of governmental and private sources. For instance, Meals on Wheels America provides capability and capacity building resources to ensure that members are able to evolve their nutrition and meal service offerings. Since 2022, we have provided funding in select markets to seed and scale the provision of a specific Food is Medicine intervention, medically tailored meals. Funds from external funding partners have also powered these investments.
In addition to the Older Americans Act at the local level, the Ryan White HIV/AIDS Program is a key federal funding source for Meals on Wheels providers that meet the nutrition needs of older adults, as well as the needs of crucially ill individuals, such as people living with HIV. Meals on Wheels providers also leverage a range of private funders (i.e., health care organizations, health insurers, foundations, local grantmakers, donated funding and in-kind donations) to secure the needed investments to seed and scale Food is Medicine interventions.
Nine out of every ten Meals on Wheels programs are supported by federal funds, and for more than 60% of these providers, federal funding represents half or more of their budget. Funding cuts at the federal level or continued flat funding threatens the ability of Meals on Wheels programs across the country to address the continuum of senior nutrition needs in their respective communities, resulting in new and long wait lists for nutrition related services.
Which Metrics and Outcomes We Track
Through our research and evaluation activities we track the following client level, program level, and network-wide outcomes:
Health and wellness outcomes (client level) include general nutrition and health, self-reported health, food insecurity, hospital admission, client satisfaction, self-reported impact medically tailored meals, nutrition risk.
Programmatic outcomes (member level) include medically tailored meal types produced and the ability to bring new recipes into production.
Network-wide outcomes include the number of members producing medically tailored meals, and medically tailored production readiness--planning to within the next 18 months, currently offering medically tailored meals, attempts to provide medically tailored meals, etc.
Tracking client-level health outcomes is a challenge due to variations in local staff capacity and capability, and challenges working with seniors. Client-level data collection by Meals on Wheels providers can be expensive and require sufficient staffing, as well as data collection acumen and capacity in data storage and data entry support. In addition, it is not always possible to collect client data for older adults who have been receiving nutrition services over time. Older adults might relocate outside of the service area to live with family members or to a senior living or healthcare facility, refuse to participate, or stop receiving services, or suffer an adverse health event.
Supporting the Food is Medicine needs of community-residing seniors requires a responsive, effective, age-appropriate service model, one that addresses important nutrition concerns in this population. Examples include malnutrition, food insecurity, nutrition security, and high-cost healthcare usage such as hospital readmission.
In 2025, Meals on Wheels America launched its Core Client Insights initiative to support the consistent collection of rigorous and practice tested measures by our members. Through this initiative, Meals on Wheels members continue to build capacity to leverage data to better manage and reduce their waiting lists, deliver person-centered care, and scale successful programs through improved data-driven decision making. The Core Clients Initiative is an important step forward to achieving a consistent approach in client assessment and health outcomes for future scaling.
What would make it easier for local programs to collect and track Food Is Medicine related data are investments in building data collection acumen at the local level, such as long-term grant funding, training, and peer mentors. Also helpful would be an easy to use, consistent sets of data collection tools and interoperable platforms to support in-person and online data collection.
Lessons Learned
In just a few decades, adults 65 years of age and older are projected to outnumber children for the first time in American history. Yet older adults are not considered in the design of many Food is Medicine initiatives. A growing body of research suggests that Food is Medicine interventions such as medically tailored meals can be effective in improving health outcomes including inpatient admission, admission to skilled nursing facilities, rehospitalization, mortality, and lower healthcare costs.
Seniors recognize the value and health impact of consuming meals that are able to meet their nutritional and medical needs. But broader and more equitable access to nutrition services such as nutrition education and dietary counseling is vital to ensure successful adoption and adherence to medically tailored meals regimens in order to see demonstrative health outcomes.
According to a recent survey of Meals on Wheels providers, most (82%) identify medically tailored meals as the biggest need for tailored nutrition. Ensuring that these meals are routinely available to seniors who need them is critically important. We are committed to building the capacity of Meals on Wheels providers to produce or procure Food is Medicine interventions like medically tailored meals that support the health and well-being of the seniors they serve. We have found that strategic partnerships, targeted investments, and improved training opportunities have increased the number of Meals on Wheels programs that provide medically tailored meals to their clients. However, it is critical that available funding support the full continuum of nutrition needed for older adults
Why We Want to Keep Providing Food is Medicine
Providing services with a Food is Medicine lens is at the heart of the way services have been provided by the Meals on Wheels network since our founding over 50 years ago. It is essential to meeting the holistic and evolving health and nutrition needs of a growing population of older adults.
The hallmark of Meals on Wheels is a regular, in-person nutritious meal delivery paired with a safety check and social connection. Clients – typically older adults with limited mobility, chronic conditions, or lacking nearby family support – are enrolled in a formal intake process, which may include a nutrition risk assessment, referral from a healthcare provider, or coordination through state aging systems. The direct and relationship-driven approach helps detect health risks early, builds trust, and fills critical gaps in both the social safety net and healthcare continuum.
By uniting thousands of local providers through a shared mission, we are advancing an evidence-based, powerful and proven model of care, addressing both the causes and consequences of food insecurity in older adulthood – maintaining and improving health outcomes for those who are most at risk and have the fewest resources.
