For health systems, food insecurity is emerging as a clinical, operational and financial variable that demands a structured response. With the One Big Beautiful Bill Act reducing Medicaid eligibility and tightening Supplemental Nutrition Access Program (SNAP) access for millions of Americans, more patients are arriving with unmet nutritional needs and fewer safety net resources to fall back on.
During a Becker’s Healthcare webinar developed in partnership with Sodexo, Marlena Balcerak, MS, RDN, LDN and Anne Leach, MS, RDN, LD, both Sodexo clinical nutrition leaders embedded within major health systems discussed how integrated food access programs are being built into clinical workflows, and why registered dietitians (RDNs) are central to making them work.
Below are four key takeaways from the conversation.
1. Screening alone doesn’t change outcomes
Panelists emphasized that identifying food-insecure patients is a necessary first step, but without operational follow-through, it doesn’t move the needle. Both Methodist Hospitals and University Hospitals have embedded food access programs directly into clinical workflows rather than relying on external referrals alone.
Marlena Balcerak, clinical nutrition manager with Sodexo at Methodist Hospitals, described how dietitians review EHR screening data daily and add flagged patients to their caseloads. When a connection isn’t made before discharge, the team follows up by phone within a week.
“Identifying patients at risk is extremely important, but on its own, it doesn’t change outcomes,” Ms. Balcerak said. “With the right workflows in place, we’re able to operationalize that handoff so patients receive timely nutrition interventions and not only referrals.”
2. The RDN as a clinical and community asset
RDNs are now designing programs, stratifying risk and connecting food interventions to measurable clinical outcomes. As the only clinicians trained at the intersection of medical nutrition therapy, behavior change and food systems, RDNs are uniquely positioned to connect what a patient eats to what shows up in their chart. At University Hospitals, dietitians staff each of the system’s five Food for Life Markets, where they screen patients, deliver nutrition education and guide food selection using a client-choice model that promotes dignity and ensures dietary needs are met.
Anne Leach, Director of Clinical and Community Nutrition with Sodexo at University Hospitals, noted the broader reach of this work.
“We serve a lot of the families that are living in multi-generational households,” Ms. Leach said. “The care that the dietitian is providing to the patient, it’s not only benefiting that patient, but it’s also benefiting the patient’s family, including their children and grandchildren.”
3. Sustainability depends on integration
Both speakers stressed that programs built as temporary initiatives are the first to be cut when budgets tighten. The programs that last are those embedded into care delivery with infrastructure, staffing and data behind them.
“The programs I have referenced at University Hospitals have been embedded into care delivery and not created as temporary initiatives,” Ms. Leach said. “Having that nutrition expert to share health information and show patients how to cook healthy and how to stretch their food dollars is so important. It is more than just handing them food.”
Both panelists identified reimbursement pathways through Medicaid, Medicare Advantage and value-based care models as the greatest opportunity to accelerate program growth and long-term sustainability.
4. Building the data infrastructure to prove the value
Both organizations are building the data infrastructure to connect nutrition programs to system-level performance. Methodist is tracking malnutrition diagnoses, readmission rates within 30 days, length of stay and chronic disease indicators across its participant population. University Hospitals has distributed over a million pounds of food since launching its Food for Life Markets in 2018 and is partnering with Case Western Reserve University on outcomes research tied to food pharmacy visits.
“These programs are both cost-effective and cost savings by reducing high-cost utilization,” Ms. Balcerak said. “From a systems perspective, this supports performance in value-based environments where outcomes and costs are so closely linked.”
As the policy landscape continues to shift and patient acuity rises, the panelists agreed that nutrition has to formalize within care plans, not alongside them.
For health systems looking to build or expand these programs, Sodexo offers a clinical and operational framework developed across heath system partnerships nationwide.
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