Harnessing outcome-based payments for Food Prescriptions models

The food is medicine movement is growing in the interest of policymakers, scientific research, funding and public acceptance. Several proven models are implementing food utilisation as a medical prevention and intervention. What remains unclear is how we are going to finance sustainability, and in the long run, food is a medicine model. We need to find financial schemes that are very different from those used in the pharmaceutical industry. One of those could be ‘pay for success’ or other outcome payment models.

HarvestCare x SEFA collaboration

In Q1-Q2, a group of students of the Study Association for Economics and Business at the University of Amsterdam (SEFA) collaborated with HarvestCare to conduct in-depth research on how outcome-based payments, specifically Impact Bonds, can be used to finance Food Prescription or Food Pharmacy models.

Food Prescription model

Food Prescription programs aim to reduce barriers for low-income patients and their families to access the fresh fruits and vegetables they need to ensure the consumption of a healthy and balanced diet. Food prescriptions can focus on specific target populations, such as patients with chronic diseases. In the program, patinets, besides the food prescription, receive other necessary support to successfully change their dietary habits, such as coaching, cooking workshops and group support.

There is growing recognition and support for food prescription, with the USDA investing 52 million USD to support nutritional security advancements among underrepresented communities. The Rockefeller Foundation has invested 100 million USD to support Food is Medicine solutions in the USA.

The first Food Prescription RCT in the Netherlands

HarvestCare, together with Erasmus Medical Center and several on-the-ground partners, are facilitating the first Randomised Control Trial in which the intervention group of diabetes type 2 patinets will receive a Food Pharmacy model, which will consist of organic food boxes, weekly healthy recipe inspirations, health coaching from a dietician and culinary workshop with chefs.

The project will take place in Rotterdam South in the year 2024/25.

Long-term financial thinking

The goal of HarvestCare is not only to test the model scientifically but to seek a long-term financial model that could embed food into the healthcare system, creating market opportunities for sustainable local farmers.

We are very pleased to explore, thanks to the SEFA report, what type of Impact Bonds have been created for diabetes type 2 patients and what we can learn based on the work that has been already done internationally.

Access the report

Next steps for our work

The development of our work will depend on the results that we manage to obtain from the first RCT. If they show a beneficial correlation between food pharmacy intervention and Hb1Ac, we will be developing the next randomised trials, with more participants and longer duration.

HarvestCare has applied for a Samenwerken aan innovatie (EIP) 2024 provincies in Provide on South Holland, leading a consortium with Erasmus MC, Social Finance NL, local farmers and supply chains to explore the Agri-Health outcome payment model. We will hear about the result in March 2025.

We are excited about the next tangible steps, linking healthcare and agriculture.