Journal of general internal medicine
September 3, 2026 · via Europe PMC
Higher and Lower Intensity Outreach to Increase Enrollment in a Medicaid Food Is Medicine Program: A Randomized Controlled Trial.
Matathia S, Alani S, Cheng D, +5 more, Thorndike AN.
AI summary — for doctors, generated from the abstract only
A randomized trial found that proactive outreach, especially a letter plus phone call, substantially increased enrollment in a Medicaid Food is Medicine nutrition program compared with usual care.
What was studied
A three-arm randomized controlled trial at one Massachusetts Medicaid accountable care organization (August 2023-May 2024) comparing higher-intensity outreach (letter plus telephone), lower-intensity outreach (letter only), and usual care, for enrolling food-insecure patients into a Food is Medicine (Flex) nutrition program; the primary outcome was enrollment within 90 days.
Key findings
- 255 individuals were randomized; mean age 33 years (SD 20), 34% children, 51% female.
- Enrollment was higher with higher-intensity outreach than usual care (78% vs 6%); the exact statistical comparison (p-value) is not reported in the available abstract text.
- The abstract states the lower-intensity group also had higher enrollment than usual care, but does not report the specific enrollment percentage for this comparison.
- The study authors concluded higher-intensity outreach was the most effective strategy.
Clinical relevance
The findings suggest that proactive outreach combining mailed letters with telephone contact may meaningfully increase enrollment in food-insecurity support programs, which could be relevant to primary care teams or health systems implementing similar programs.
Who should care
Limitations
This trial was conducted at a single accountable care organization in Massachusetts; it assessed enrollment at 90 days only, not longer-term participation or health outcomes; cost-effectiveness was not assessed in this study per the authors' own statement, and some statistical details are not reported in the available abstract text.
Combining a letter with phone outreach greatly increased enrollment in a Medicaid food-insecurity program compared with usual care.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Medicaid accountable care organizations (ACOs) are increasingly implementing Food is Medicine (FIM) programs, but enrollment typically relies on clinicians identifying and referring eligible individuals. Systematic proactive outreach has potential to improve FIM program enrollment.
Objective
Determine the effectiveness of two outreach strategies (letter + telephone (higher intensity) and letter only (lower intensity)) compared to usual care on enrollment into a Medicaid FIM program.
Design
Three-arm randomized controlled trial conducted at one ACO in eastern Massachusetts between August 2023 and May 2024.
Participants
Adults and children eligible for Flexible Services (Flex) nutrition services (Medicaid ACO insurance, food insecurity identified on two-item primary care-based screener, eligible diagnosis).
Interventions
The higher intensity group received a letter, followed by telephone outreach, offering Flex enrollment; the lower intensity group received a letter only. The usual care group received no outreach and could be referred by the clinical team.
Main measures
The primary outcome was the proportion of participants enrolled into Flex within 90 days of initial letter outreach, comparing each intervention group vs. usual care and higher vs. lower intensity groups. A secondary outcome was documented receipt of Flex services.
Key results
A total of 255 individuals were randomized. Mean (SD) age was 33 (20) years, with 86 (34%) children; 131 (51%) were female. Compared to usual care, a larger proportion of intervention participants were enrolled in Flex in both the higher intensity (78% vs. 6% [p < 0.001]) and lower intensity (39% vs. 6% [p < 0.001]) groups. Higher intensity was more effective than lower intensity outreach (adjusted difference 39.0%; 95% CI 25.6%, 52.4%). Results were similar in comparisons of receipt of Flex services.
Conclusions
Proactive outreach increased enrollment into a Medicaid FIM program. Results suggest higher intensity outreach is most effective, but further research is needed to assess cost-effectiveness to guide implementation in other health systems. NIH TRIAL REGISTRY NUMBER (IF APPLICABLE): n/a CLINICAL TRIALS REGISTRATION NUMBER: NCT05972421.
DOI
10.1007/s11606-026-10558-5
PMID
42768178
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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