Feeding America Workshop

 Best Practices

1. Tailor Programs to Community Needs

Food banks and community-based organizations that succeed in Food is Medicine initiatives often build customized programs in close collaboration with their healthcare partners. Food Bank of Northwest Indiana's Chief Executive Officer Victor Garcia shared how his organization adapts programs to the clinical priorities and populations of the partner, whether targeting diabetes, heart disease, infant mortality, or mental health. These programs are co-designed to ensure alignment with the healthcare partner’s goals while leveraging the food bank’s logistical capacity and community reach. Building tailored programs requires partnerships that are built on trust and transparency, ensuring that food banks and healthcare partners are providing bespoke services that work best for their community. This may require more detailed up front contracting but it will also serve to ensure that the program meets the needs of the participants like integrating delivery options, culturally preferred food options, and/or access to nutrition education programs.

For more examples on how food banks tailor programs to neighbors’ needs, including a spotlight on Indiana’s Food as Medicine program, see this report.

2. Let Healthcare Partners Manage Reporting of Clinical Data

Many community-based organizations intentionally avoid collecting HIPAA-sensitive or biometric data, choosing instead to let healthcare partners lead on clinical compliance, billing, and reporting. This approach enables food banks to focus on program delivery while sidestepping the complex infrastructure, legal responsibilities, and staffing demands associated with medical data management. It allows programs to move faster and remain accessible, especially for smaller community-based organizations with limited capacity. Food as medicine interventions are still an emerging intervention in healthcare and as such, there are constraints on all sides for effectively analyzing the data and analysis. Community-based organizations  can help to advocate for evaluation support from healthcare partners to show the impacts of the programs that they are investing in.

3. Cost-Sharing Models

For years, food banks have worked closely with healthcare as a service partner, primarily providing on-site pantries at hospitals and clinics. This allows food insecure patients ready access to nutritious food. Many now work closely with healthcare partners to co-create contracts that establish costs for the services they provide, such as per referral or per food box or provision. These contracts often include wrap-around services such as nutrition education, connections to holistic supports, and assistance accessing other food pantries in the area. By adopting fee-for-service or cost-sharing models, both healthcare providers and community-based organizations show that they have a stake in the program and are willing to invest resources. This shared investment helps bridge obstacles and ensures that partners pursue mutually beneficial solutions.

4. Highlight Value of Community Engagement and Increased Access to Social Supports

Community-based organizations and food banks differentiate themselves from venture-backed Food is Medicine vendors by emphasizing their embeddedness in communities. Their longstanding presence, cultural responsiveness, and trusted relationships enable them to serve hard-to-reach populations more effectively than external providers. Highlighting these unique assets, such as sourcing from local farms, reinvesting in the community, and building dignity into service, helps justify investment and policy support. One of the unique values that food bank food as medicine interventions can offer is that, beyond the Food is Medicine box or food provision, they provide the participant with access to the entire pantry network to support individuals experiencing food insecurity with long-term support and access to food. Many pantries have evolved significantly over the years to provide fresh and frozen fruit and vegetables as well as a variety of proteins and foods for those with unique dietary needs.

5. Integrate FIM Across Organizational Strategy

Leading food banks treat Food is Medicine as a core strategy rather than a siloed program. They recognize that food banking is also a way to support broader public health initiatives. In this role, they view themselves not just as food distributors but as public health partners that contribute to long-term well-being. Some are even restructuring strategic plans, staff roles, and tech systems around health equity and nutrition access.

For example, Mid-Ohio Food Collective has embedded Food is Medicine into its organizational core through initiatives like its Farmacy program, designed by Director of Research and Nutrition Amy Headings. The intervention model integrates nutrition prescriptions and education directly into food distribution, linking neighbors to healthier foods while addressing chronic conditions. By incorporating programs like this into strategic priorities, food banks demonstrate that Food is Medicine is not an add-on but central to their mission. This kind of alignment strengthens their ability to attract healthcare partners, anchor reimbursement discussions, and scale interventions sustainably.

Link to their published research: https://onlinelibrary.wiley.com/doi/full/10.1002/joom.1321

Interview with Jennifer Parsons, senior project manager, Mid-Ohio Food Collective

Tensions

1. Sidelining of social, cultural, and relational aspects of healthy eating

There is growing concern that Food is Medicine programs risk becoming too clinical in focus, sidelining the social, cultural, and relational aspects that make community-based organization-led work impactful. Participants noted that traditional health outcomes, such as A1C reductions or blood pressure readings, fail to capture the full value of food programs that also build trust, connection, and community dignity while lowering stress. Pushing community-based organizations to conform to strict medical models may diminish their ability to serve complex needs individuals with the social supports, like housing, childcare, mental health, workforce development, they need to thrive.

2. Evolving Food is Medicine Definitions and Interventions

The term “Food is Medicine” is relatively new and lacks a widespread industry-aligned definition - the widely used terms "food is medicine, food as medicine, food as health" reflect that consensus has yet to be resolved.. As the field matures, food banks and their partners are steadily moving toward greater alignment. Terminology is becoming clearer, and interventions are being codified into models that healthcare systems can understand, measure, and integrate. This development reflects the sector’s ongoing progress in positioning Food is Medicine as a credible, scalable approach within public health and healthcare settings.

3. State and Regional Alignment is Needed for Consistent Offerings

Across the country, Partner State Associations are bringing food banks together to align on shared terminology and standardized interventions. This state and regional alignment is critical for creating consistent offerings that can be presented to Medicaid, managed care organizations, and hospital systems. By working collectively, food banks strengthen the credibility of Food is Medicine programs and position themselves as reliable partners in both clinical and public health initiatives.

4. Funding is Unreliable and Inconsistent Across States

Sustainable financing is a universal challenge. Some programs rely on Medicaid 1115 waivers, others on hospital foundations or temporary grants. Delays in state Medicaid implementation, lack of clear reimbursement rates, and shifting political landscapes make it difficult to plan or scale. Organizations expressed frustration that promising models are constrained by fragmented and unreliable funding streams that vary drastically by geography.

5. Technology and Staffing Infrastructure are Underdeveloped

Even when healthcare partners are willing to pay for services, food banks face internal barriers to implementation. Many lack the data systems, referral platforms, and billing software needed to meet partner expectations. Staffing is another constraint. Hiring and training billing specialists, data analysts, and case managers requires upfront capital that many food banks do not have. These gaps limit the speed and consistency of program delivery.

6. Outpaced by Venture-backed Competitors

Community-based organizations are increasingly worried about being pushed out of the Food is Medicine space by for-profit startups that can scale quickly and attract venture capital. These companies may lack cultural competency, community trust, and long-term presence, yet their polished tech platforms appeal to health systems under pressure to show results. Without deliberate investment in community-led infrastructure, community-based organizations risk being sidelined in a field they helped build.

7. Misconception of Food Quality in the Charitable Food Sector

A misconception within the charitable food sector is that food banks and pantries primarily distribute unhealthy, processed food. In reality, pantries across the country increasingly provide fresh and frozen produce, as well as proteins, with many adopting the Healthy Eating Research (HER) guidelines to shape purchasing decisions. For example, the majority of food from Gleaners Food Bank of Indiana was rated as nutritious according to Healthy Eating Rating guidelines. Despite these shifts, outdated perceptions remain a barrier to positioning food banks as legitimate public health partners and can undermine opportunities for collaboration with healthcare systems.

Feeding America Session Notes

Session One

• The purpose of this workshop was to gather input from food bank leaders on best practices and value framing for Food is Medicine.
• Participants discussed how food banks can communicate their unique value in the Food is Medicine space to healthcare and payer partners.
• Core value proposition identified: food banks are trusted, embedded, community-based organizations with deep relationships and reach into vulnerable populations.
• Food banks can provide culturally tailored food, respond to dietary preferences, and build flexible, responsive systems in ways that many for-profit Food is Medicine providers cannot.
• Some food banks integrate Food is Medicine broadly into all operations, not as a standalone program but as an organizational approach to health and nutrition.
• Terminology varies across organizations; some use “food is health” to frame their work instead of “food is medicine.”
• There is tension between having a broad definition of Food is Medicine (which enables inclusivity and flexibility) versus a narrow one (which supports reimbursement and clearer healthcare alignment).
• Broad definitions can support innovation and local adaptation but may complicate conversations with healthcare partners looking for clarity.
• For reimbursement, food banks often have to productize services (like medically tailored boxes or case management) to match payer expectations.
• Many food banks are working with state associations to standardize offerings across regions to engage with statewide health plans.
• Reimbursement pathways vary by state; some rely on Medicaid 1115 waivers, others use hospital foundations, MCOs, or philanthropic grants.
• States like New York and Illinois have approved Medicaid waivers but face major delays in implementation, contract negotiation, and lack of transparency.
• Challenges cited include lack of clear payment rates, timelines, and tech infrastructure to support billing, coding, and referrals.
• Some states (e.g., Ohio, Illinois) are exploring collective action across food banks through their state associations to align with Medicaid or health plans more effectively.
• Medicaid 1115 waivers are helpful but not reliable in all states; political context influences whether Medicaid can fund food-based interventions.
• Alternative funding sources discussed include hospital community investment funds, operational health system budgets, and Medicare.
• Concerns raised about scalability and equity: for-profit Food is Medicine providers may scale more quickly, so food banks must emphasize their community reinvestment, local sourcing, and holistic benefits.
• Many food banks are starting to restructure internal staffing, tech systems, and strategic plans around health equity and Food is Medicine.
• Technology gaps are widespread: food banks need better systems for API integration, referral processing, and billing platforms.
• Staff capacity and forecasting are key constraints. Many participants emphasized the need for upfront funding to hire billing staff, data analysts, and case managers.
• Participants noted the importance of defining consistent, statewide offerings (e.g., medically supportive groceries, food pharmacies) to secure payer contracts.
• Some food banks are considering U.S. Postal Service or mail delivery to expand rural reach.
• Community-based sourcing and economic reinvestment are emerging as powerful framing tools to differentiate food banks from for-profit vendors.
• Participants emphasized the importance of alignment across food banks within a state to present a unified front to Medicaid and MCOs.
• Interest in ongoing knowledge-sharing and follow-ups to continue building collective strategy around Food is Medicine, state advocacy, and reimbursement.

Session with Victor Garcia, President & CEO of Food Bank of Northwest Indiana

• Emphasized his food bank is not a charitable food organization but a public health organization engaged in economic development.
• Organization uses social determinants of health and adverse childhood experiences as primary frameworks.
• Food is Medicine is central to their mission and not new in concept, TFAP and CSFP have long functioned as Food is Medicine even if not labeled that way.
• Food banks are uniquely positioned due to logistics infrastructure, stakeholder relationships, and operational agility.
• Each Food is Medicine program they run is customized to the healthcare partner’s needs, no two programs look the same.
• Most partnerships are funded by healthcare organizations, typically through hospital foundations or philanthropic dollars.
• Opens conversations with high estimates to set up cost negotiations favorably.
• FQHCs are often more flexible and collaborative than large hospital systems.
• Their Food is Medicine programs are mostly funded under fee-for-service lines, with the food bank not running any programs at a loss.
• Emphasized that philanthropy alone cannot sustain Food is Medicine: Medicaid, Medicare, and private insurance reimbursement are essential for long-term viability.
• Expressed frustration with overemphasis on data collection to prove what is already well known about the connection between food and health.
• USDA Foods are misunderstood by policymakers and the public; many assume food banks distribute unhealthy food when in fact products are often nutrient dense.
• Food banks are essential for getting affordable, nutritious food to communities without access to fresh produce or grocery stores.
• Community-based organizations like food banks are trusted messengers and have credibility with hard-to-reach populations.
• Food is Medicine programs at the food bank include medically tailored shelf-stable boxes for diabetes, heart disease, infant mortality, and mental health.
• They are exploring rural partnerships with Meals on Wheels and refrigerated smart lockers for joint delivery of groceries and prepared meals.
• Funding remains the only major barrier to scaling programs, not interest, leadership, or demand.
• Advised that food banks without current Food is Medicine programs can start small and bypass HIPAA compliance by letting healthcare partners manage data and reporting.
• Partnership-building takes time; success depends on deep community roots, strategic networking, and trust-building.
• Relationship-based partnerships are more valuable than transactional ones, staff are encouraged to serve on boards and integrate with other organizations.
• Even when a food bank doesn't have funding, it can often act as an implementation partner while the healthcare system leads on grant writing and compliance.
• Strategic plan includes expanding healthcare and K-12 pantry partnerships, since schools and clinics are permanent, trusted, and accessible community sites.
• Co-location of services (e.g., health care, pantry access) is key to overcoming transportation barriers and supporting young families.
• Interested in targeted messaging campaigns like geofencing legislators at steakhouses with strategic ads about food programs.

Session 2 

• The term “Food is Medicine” brings validation and funding, but also frustration, as it risks erasing the decades of health-focused food work already led by community-based organizations.
• Many community organizations have long addressed nutrition, health, and social needs, even if they never labeled it as “Food is Medicine.”
• Food access, wraparound support, and trusted relationships have always been core to community-based organization missions, regardless of shifting healthcare trends.
• Community-based organizations offer culturally tailored services, respond quickly to local needs, and reach populations that healthcare systems often struggle to engage.
• Collecting biometric or clinical data is a barrier for many community-based organizations, who lack the infrastructure and legal protection required for medical billing
• Several organizations intentionally avoid handling HIPAA-sensitive data, instead letting healthcare partners manage compliance and reporting.
• Programs are more effective and sustainable when healthcare systems fund and manage medical components, while community-based organizations lead implementation and delivery.
• Venture-backed or tech-driven Food is Medicine models may scale quickly, but often lack community trust and can displace local organizations.
• Community-based organizations' leaders expressed concern that well-funded newcomers could overshadow grassroots efforts unless policy frameworks prioritize equity and place-based work.
• Long-term sustainability requires public investment in community-based organization capacity, not just pilot grants or short-term contracts.
• Medicaid waivers and other funding mechanisms should explicitly include and compensate community-based organizations as essential delivery partners.
• Traditional clinical outcomes fail to capture the full impact of community-based organization-led programs, which also build connection, dignity, and community health.
• Any national guide or policy tool should center community voices, not just serve as a technical manual for institutional partners.
• Shifting the Food is Medicine model from hospital-centered to community-centered is necessary to ensure health equity and long-term impact.
• Funders, researchers, and healthcare leaders must recognize the relational, non-transactional work that makes community-based organizations interventions effective.