Abstract 022: Cost-Effectiveness of Financial Incentives and Disincentives for Improving Diet and Health Through the Supplemental Nutrition Assistance Program

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Junxiu Liu ◽  
Dariush Mozaffarian ◽  
Stephen Sy ◽  
Yue Huang ◽  
Yujin Lee ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Incentives ◽  
Cost Savings ◽  
Cost Effective ◽  
Supplemental Nutrition Assistance Program ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Life Years ◽  
Nutrition Assistance ◽  
Meta Analyses

Introduction: The 2018 Farm Bill represents a major opportunity to reduce disparities in diet and health. The largest component is the Supplemental Nutrition Assistance Program (SNAP), feeding 1 in 6 Americans. Potential options include subsidizing fruits & vegetables (F&V), restricting sugar-sweetened beverages (SSBs), or implementing a broader food incentive/disincentive framework that preserves choice. Their comparative health impacts and cost-effectiveness are not established. Methods: Using a validated microsimulation model (CVD PREDICT), we estimated changes in CVD events, quality-adjusted life-years (QALYs), costs, and cost-effectiveness of 3 policy scenarios in SNAP adults: 1) 30% subsidy on F&V; 2) 30% F&V subsidy + SSB restriction; and 3) 30% subsidy on F&V, whole grains, nuts/seeds, seafood, plant-based oils, and 30% disincentive on SSBs, junk food, and processed meats. Model inputs included national data from NHANES (2009-2014), policy effects from SNAP pilots and food pricing meta-analyses, diet-disease effects from meta-analyses, and policy, food subsidy, and healthcare costs. Results: From a societal perspective, all 3 scenarios were cost-savings at 5, 10, 20 y and lifetime ( Table ). At 5 y, a F&V subsidy would prevent 32,218 CVD events, gain 18,072 QALYs, and save $1.04B ($6.05B lifetime). Corresponding values for a F&V subsidy + SSB restriction were 63,898, 45,772, and $4.47B ($38.83B); and for a broader incentive/disincentive framework that preserved choice, 65,078, 26,663, and $3.98B ($29.90B). Government affordability varied by program duration and by whether subsidy costs for SNAP adults or all SNAP participants were included. Scenario 3 was generally most cost-effective or -saving, followed by scenario 2 and then scenario 1; all were cost-effective over a lifetime from a government affordability perspective. Conclusions: Financial incentives/disincentives through SNAP could generate substantial health benefits and be cost-effective or cost savings.

Abstract 037: Cost-effectiveness of Financial Incentives for Improving Diet Through Medicare and Medicaid

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yujin Lee ◽  
Dariush Mozaffarian ◽  
Yue Huang ◽  
Junxiu Liu ◽  
Stephen Sy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Incentives ◽  
Cost Effective ◽  
Economic Incentives ◽  
Sensitivity Analyses ◽  
Incentive Programs ◽  
Life Years ◽  
Dual Eligible ◽  
Meta Analyses ◽  
Healthful Food

Background: While economic incentives through health insurance are being considered to promote healthy behaviors, little is known about health or financial impacts of incentivizing diet, a leading risk factor for CVD. We estimated health and economic impacts of programs to incentivize healthful foods through Medicare and Medicaid over a 5, 10, and 20 y horizon. Methods: A validated microsimulation model, CVD PREDICT, was used to estimate reductions in CVD events, gains in quality-adjusted life-years (QALYs), costs, and cost-effectiveness of two policy scenarios within Medicare and Medicaid: (1) 20% subsidy on fruits and vegetables (F&V), and (2) 20% subsidy on broader healthful foods including F&V, whole grains, nuts/seeds, seafood and plant-based oils. Model inputs included national demographic and dietary data from NHANES 2009-2014, policy effects from pricing meta-analyses, diet-disease effects from meta-analyses, and policy costs including program and healthcare costs, inflated to constant 2017 US dollars and discounted at 3% annually. Productivity gains were conservatively excluded. Results: Both incentive programs were cost-effective from a healthcare (government affordability) perspective ( Table ). Over 20 y, a 20% F&V subsidy could prevent 1.24M CVD events; while a broader 20% healthful food subsidy could prevent 1.91M CVD events. Incremental cost-effectiveness ratios for the F&V program ranged from $19,773/QALY for dual eligible to $26,862/QALY for Medicaid beneficiaries; and for the broader healthful food program, from $9,020/QALY for dual eligible to $13,484/QALY for Medicare beneficiaries. Findings were robust to a range of sensitivity analyses; within Medicare, the incentive program was more cost-effective among individuals with lower income. These incentive programs were also cost-effective at 5 and 10 y (not shown). Conclusions: Economic incentives for healthier foods through either Medicare or Medicaid could generate substantial health gains and healthcare cost savings.

scholarly journals Reductions in national cardiometabolic mortality achievable by food price changes according to Supplemental Nutrition Assistance Program (SNAP) eligibility and participation

2018 ◽  
Vol 72 (9) ◽  
pp. 817-824 ◽  
Author(s):  
Parke Edward Wilde ◽  
Zach Conrad ◽  
Colin D Rehm ◽  
Jennifer L Pomeranz ◽  
Jose L Penalvo ◽  
...  
Keyword(s):  
National Health ◽  
Supplemental Nutrition Assistance Program ◽  
Dietary Quality ◽  
Healthy Foods ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Processed Meats ◽  
The Usa ◽  
Nutrition Assistance ◽  
Meta Analyses

BackgroundSuboptimal diets are a major contributor to cardiometabolic disease (CMD) mortality, and substantial disparities exist for both dietary quality and mortality risk across income groups in the USA. Research is needed to quantify how food pricing policies to subsidise healthy foods and tax unhealthy foods could affect the US CMD mortality, overall and by Supplemental Nutrition Assistance Program (SNAP) eligibility and participation.MethodsComparative risk analysis based on national data on diet (National Health and Nutrition Examination Survey, 2003–2012) and mortality (mortality-linked National Health Interview Survey) and meta-analyses of policy-diet and diet-disease relationships.ResultsA national 10% price reduction on fruits, vegetables, nuts and whole grains was estimated to prevent 19 600 CMD deaths/year, including 2.6% (95% UI 2.4% to 2.8%) of all CMD deaths among SNAP participants, 2.7% (95% UI 2.4% to 3.0%) among SNAP-eligible non-participants and 2.6% (95% UI 2.4% to 2.8%) among SNAP-ineligible non-participants. Adding a national 10% tax on sugar-sweetened beverages (SSBs) and processed meats would prevent a total of 33 700 CMD deaths/year, including 5.9% (95% UI 5.4% to 7.4%) of all CMD deaths among SNAP participants, 4.8% (95% UI 4.4% to 5.2%) among SNAP-eligible non-participants and 4.1% (95% UI 3.8% to 4.5%) among SNAP-ineligible non-participants. Adding a SNAP-targeted 30% subsidy for the same healthy foods would offer the largest reductions in both CMD mortality and disparities.ConclusionNational subsidies for healthy foods and taxes on SSBs and processed meats would each reduce CMD mortality; taxes would also reduce CMD mortality more steeply for SNAP participants than for non-participants.

scholarly journals Does Supplemental Nutrition Assistance Program Reduce Food Insecurity among Households with Children? Evidence from the Current Population Survey

2021 ◽  
Vol 18 (6) ◽  
pp. 3178
Author(s):  
Jun Zhang ◽  
Yanghao Wang ◽  
Steven T. Yen
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Current Population Survey ◽  
Population Survey ◽  
Supplemental Nutrition Assistance Program ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Current Population ◽  
Households With Children ◽  
Nutrition Assistance

The Supplemental Nutrition Assistance Program (SNAP) is designed to improve household diet and food security—a pressing problem confronting low-income families in the United States. Previous studies on the issue often ignored the methodological issue of endogenous program participation. We revisit this important issue by estimating a simultaneous equation system with ordinal household food insecurity. Data are drawn from the 2009–2011 Current Population Survey Food Security Supplement (CPS-FSS), restricted to SNAP-eligible households with children. Our results add to the stocks of empirical findings that SNAP participation ameliorates food insecurity among adults only, but increases the probabilities of low and very low food security among children. These contradictory results indicate that our selection approach with a single cross section is only partially successful, and that additional efforts are needed in further analyses of this complicated issue, perhaps with longitudinal data. Socio-demographic variables are found to affect food-secure households and food-insecure households differently, but affect SNAP nonparticipants and participants in the same direction. The state policy tools, such as broad-based categorical eligibility (BBCE) and simplified reporting, can encourage SNAP participation and thus ameliorate food insecurity. Our findings can inform policy deliberations.

Predictors of Farmers’ Market Shopping among People Receiving Supplemental Nutrition Assistance Program Benefits

2018 ◽  
Vol 61 (3-4) ◽  
pp. 488-499 ◽  
Author(s):  
Darcy A. Freedman ◽  
Eunlye Lee ◽  
Punam Ohri-Vachaspati ◽  
Erika Trapl ◽  
Elaine Borawski ◽  
...  
Keyword(s):  
Supplemental Nutrition Assistance Program ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Farmers Market ◽  
Program Benefits ◽  
Nutrition Assistance
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