The Executive Suite: A three-step nutrition intervention model associated with better health outcomes and reduced costs

Improving health outcomes while reducing costs, regardless of the setting of care, includes an often overlooked and rarely discussed element that has the potential to prohibit success on both fronts: nutrition health. Understanding and addressing patients' nutrition status is often a key component of reducing the length of hospital stays, decreasing the use of medical resources and lowering the total cost of care.

The Burden of Malnutrition

According to the World Health Organization, malnutrition is defined as an imbalance, deficiency, or sub-optimal intake of nutrients.1 Whether undernourished or overnourished, the effects of malnutrition can be harmful to achieving good health, and costly for patients and the larger healthcare system alike. In the United States, the cost of disease-associated malnutrition stemming mainly from conditions such as cancer or cardiovascular disease has been estimated at more than $147 billion per year, with $15.5 billion attributed directly to treatment costs.2,3 But health systems aren’t the only ones bearing the burden—people who are hospitalized and found to be malnourished may incur hospital costs nearly twice as high as those who are adequately nourished.4

Comprehensive nutrition care that delivers the nutrients patients need can support care across the continuum, including in hospitals, outpatient clinics, and community care settings. Furthermore, intentional effort to ensure patients are receiving proper nutrition improves overall patient health and reduces the use of healthcare resources and costs.

One Model to Address Malnutrition Across Care Settings Equals Better Outcomes for All

Healthcare providers often have only a few minutes to connect with their patients to evaluate their condition and address their concerns, which means that many may feel they don’t have enough time to discuss important topics with their patients like diet and nutrition. By implementing simple but comprehensive nutrition programs, healthcare providers can screen for undernutrition or overnutrition to assess risk and quickly determine if further intervention is needed. This screening includes a three-step approach:

1. Screen Patients to Determine Malnutrition Risk

Screen patients for undernutrition or overnutrition risk with a few simple questions such as: Has food intake reduced recently? Have they lost weight without trying? Have they experienced a recent illness or injury that suggests they may be undernourished? Have they noticed weight gain within the past 3-6 months? Have they noticed a change in fitting of clothing recently?

2. Communicate a Personalized Nutrition Care Plan

Create a customized plan for patients at risk for malnutrition and recommend an appropriate nutritional drink such as Ensure or Glucerna to help patients get the nutrients they need.

3. Deliver Nutrition Education

Educate patients and their caregivers on the importance of nutrition and nutritional drinks compliance.

When introduced as part of a comprehensive nutrition program, these three steps provide a model that has been successful in acute care settings, like hospitals where results from a study by Advocate Health Care and healthcare company Abbott included cost savings of nearly $4,000 per patient, shortened length of hospital stays, and reduced readmission rates.5,6 Another study by Advocate Health Care and Abbott which implemented a similar nutrition program using these three steps for patients at risk for malnutrition in transitional care touchpoints like home healthcare settings has also shown to have significantly reduced hospitalization rates and healthcare costs by an estimated $1,500 per patient treated.7

Quality of Care is Everyone's Priority

Stakeholders across the continuum of care benefit when people are properly nourished. And, when these benefits are realized, there is the ability to drive that value in communities by improving the health of the members within it. The three clinics that participated in the study and implemented a nutrition program saw a significant decrease in the percentage of patients using healthcare resources over 90 days, allowing healthcare providers to better manage their patients while reducing costs. The quality of care also improved, with 81.8% of patients reporting high levels of satisfaction with their nutrition care.8,9

While managing costs is important to leaders in healthcare practices and systems responsible for managing healthcare expenditure, healthcare professionals and administrators are generally more concerned about delivering quality care to their patients and enabling healthy outcomes for long-term success.

When nutrition is considered as a component of the overall treatment plan, patients can feel better about the holistic regimen of care they are receiving to actively treat symptoms and successfully manage conditions. To bring the value of nutrition to healthcare, healthcare authorities have an opportunity to develop effective practices, policies, and comprehensive malnutrition strategies for implementation across the continuum of care at hospitals, post-acute or primary care settings, and at home, making our communities healthier for all.