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Stanford Medicine Scope - October 2nd, 2017 - by Beth Duff-Brown
As the national debate over health-care costs continues, it’s good to learn that one government program appears to be lowering medical expenditures for those Americans who need it most.
Stanford Health Policy’s Sanjay Basu, MD, PhD, an assistant professor of medicine and a primary care physician and epidemiologist, has published new research that indicates participation in the federal Supplemental Nutrition Assistant Program (SNAP) is associated with lower health-care expenditures by about $1,400 a year per participant.
The researchers, who published their results last week in JAMA Internal Medicine, conducted a cohort study of about 4,450 adults with income below 200 percent of the federal poverty threshold. These individuals participated in the 2011 National Health Interview Survey and the 2012-1013 Medical Expenditure Panel Survey.
Of the 4,447 adults enrolled in the study, 1,889 were SNAP participants and 2,558 were not. Compared with other low-income adults, and using models adjusted for demographic and socioeconomic variables, SNAP was associated with lower estimated annual health-care expenditures of $1,409.
That seems like a pretty big figure, which would indicate programs that address food insecurity may have a large impact in reducing health-care spending over time. Basu agrees.
“Our results suggest that spending on preventative programs like SNAP, which is associated with improvement in nutrition, may be helping us prevent some of the large burden of chronic illness we see in our country from nutrition-related diseases like type 2 diabetes,” Basu told me. “Those ultimately are much more expensive to treat than to prevent.”
Basu said that in the past, some analysts had simply presented the finding that people enrolled in SNAP had higher health-care expenditures than those not enrolled in the federal food program, even when adjusting for factors like income.
“But we know that people who are enrolled in SNAP are systematically different from those not in SNAP, not just for easily-measured reasons, but also for factors not commonly measured in health expenditure datasets, like neighborhood conditions and social strife,” Basu told me.
The results of the study have several policy indications, the authors wrote.
“Prioritizing ways to make it easier for eligible Americans to enroll in SNAP is likely to be a feasible way to help reduce health-care costs,” they said. “This may be of particular interest to states because of differences in the funding source between SNAP and health care costs.”
As an entitlement program, SNAP benefits are paid for by the federal government, while Medicaid, which would likely see some of the savings if health-care costs are reduced, the authors note, is paid for jointly by states and the federal government.