What Makes Food Is Medicine Referrals Stick
The launch of the Tufts Food is Medicine Institute and Kaiser Permanente toolkit marks a real inflection point for the field. As a Tufts Friedman School alum, I’m especially energized to see it land – six sections, dozens of frameworks, and a clear-eyed roadmap for designing, operationalizing, and evaluating Food Is Medicine (FIM) programs at scale. The clinical evidence is apparent. The implementation roadmap is here. The momentum is real.
Every FIM referral comes alive in the moment a patient or resident picks up a fork. The toolkit captures the conditions for that moment beautifully, and they line up closely with what we see in practice every day.
As the Director of Nutrition, Health & Wellbeing of Phoenix3 Collective, I think about this from multiple vantage points. Through Culinour, we partner with health systems to feed patients during some of the most consequential moments of their lives. Through Restaura, we feed residents in senior living communities where the dining room is the heartbeat of daily life. Different settings. Same insight: FIM works when the food is worth showing up for.
Here’s where our operating experience lines up with the toolkit:
Quality is the lever operators can move most. Section 2 names access, dose, duration, quality, and delivery mode as the five design considerations. All five matter. The one that most directly shapes adherence is quality. The food has to be appealing and enjoyable enough that patients actually want to eat it. Nutrient density is the floor; craveability is the ceiling.
Cultural preference is a clinical variable. One of the most important framings in the toolkit is the explicit link between cultural and religious food preferences and intervention effectiveness. Pair that with values-based procurement and local sourcing, and you get food that patients and residents recognize as theirs.
Duration is the difference between a pilot and an outcome. The toolkit recommends three months as the minimum to see clinically meaningful HbA1c change, with six-plus months tied to greater impact on utilization and cost. Any culinary partner supporting a FIM program has to be designed for the long arc: consistency, variety, and freshness sustained over months and years.
Delivery mode shapes who actually receives the food. A striking toolkit data point: food hubs report participation rates approaching 100% with home delivery, compared to as low as 65% when patients have to travel to a pick-up site. The principle translates everywhere – the more the food meets people in the rhythm of their day, the more the intervention works.
Step therapy is the right mental model. The toolkit’s framing of escalating and de-escalating across the spectrum of interventions reframes FIM from a static benefit into a dynamic care pathway. Good operators build the culinary and clinical infrastructure to flex across the continuum, not lock into a single product. A resident’s needs in independent living look very different from their needs in skilled nursing, and the food has to evolve with them.
The Tufts toolkit gives the field a tremendous foundation for the why and the how of Food Is Medicine. The chapter operators like us get to contribute is the what it tastes like, day after day. Because that’s where the prescription becomes a habit, and the habit becomes an outcome.
— Camille Finn, MS, RD, LDN, Director of Nutrition, Health & Wellbeing, Phoenix3 Collective; Alum, Tufts Friedman School of Nutrition Science and Policy