Examining healthcare Costs Among MANNA Clients and a Comparison Group

Gurvey J, Rand K, Daugherty S, Dinger C, Schmeling J, Laverty N
Source: J Prim Care Community Health
Publication Year: 2013
Patient Need Addressed: Chronic Conditions, Food insecurity
Population Focus: Vulnerable/disadvantaged
Intervention Type: Best practices
Study Design: Pre-post with Comparison Group
Type of Literature: White

Chronically ill populations have a strong need for quality public health nutrition services to aid in disease management and improve health outcomes. Evidence suggests that neglecting the importance of adequate nutrition in chronically ill patients has far-reaching implications on the health status of the individual and the healthcare costs. Research is currently lacking a focus on this topic. This pilot study done through the nonprofit organization MANNA (Metropolitan Area Neighborhood Nutrition Alliance), which serves the greater Philadelphia area, explored the healthcare expenditures of 65 MANNA clients over time in comparison with a similar group of Medicaid patients who did not receive MANNA services. healthcare expenditures were examined before and after clients began receiving services. The study found that the mean monthly healthcare costs decreased for three consecutive months after initiation of MANNA services. Other healthcare cost-related factors, such as inpatient costs, length of stay, and number of hospital admissions also displayed a downward trend. These results help show the significance of medical nutrition therapy and home-delivered meal services on overall healthcare.

Insights Results

Overview of article/program

  • The objective of this pilot was to compare Metropolitan Area Neighborhood Nutrition Alliance (MANNA) program’s outcome in lowering the overall cost of healthcare in individuals battling chronic diseases between individuals that receive MANNA services and a comparison group of Medicaid patients who did not
  • MANNA is a nonprofit, nonsectarian, volunteer-intensive organization that serves clients in the greater Philadelphia and Southern New Jersey area who are at acute nutritional risk and battling any life-threatening illness. MANNA provides each client 3 nutritionally balanced meals a day, 7 days a week, free of charge. Meals can also be modified to accommodate various dietary restrictions and cultural preferences. MANNA’s registered dietitians provide medical nutrition therapy (MNT) to the clients and offer support through nutrition counseling and meal planning. MANNA’s goal is to improve our clients’ nutritional status, strengthen their ability to fight their disease, and improve their quality of life

    Methods of article

    • The MANNA client group and the comparison group were well matched on gender, age, race, and ethnicity. Both groups were predominantly African American and almost entirely non-Hispanic
    • The outcomes examined included overall healthcare costs and healthcare costs for emergency room visits and cost as well as admissions, length of inpatient stay, and cost


    • Overall healthcare costs and average monthly in-patient costs decreased over the study’s duration. Among all MANNA clients, the average monthly costs dropped from $38,937 to $28,183. The total average monthly cost was $28,000 for MANNA clients versus $41,000 for the comparison group, a difference of 55%
    • When comparing the MANNA client group to the control group (did not receive services), total healthcare costs decreased except for emergency room visits
    • Cost and frequency of hospital admissions and length of stays were all significantly lower in the MANNA client group
    • A key finding was that, on average, in the 12 months following the start of MANNA services, 93% of clients with inpatient hospitalizations were discharged to their homes as opposed to 72% of the comparison group who were discharged to an acute care facility

    Key takeaways/implications

    • Study results supplement prior research that shows that nutrition is an integral part of disease management
    • Future research related to MANNA will address the aforementioned limitations and look to expand the study to allow for more external validity in application. For example, expanding the potential partnerships with insurance and medical care providers that exist outside of Medicaid populations
    • Limitations to the study include sample size of MANNA clients, identification of the comparison group, lack of background information pertaining to the comparison group, and the overall timeline in which the outcomes of the study was examined