Food As Medicine: Medically Tailored Meals are Transforming People's Lives

We venture into the groundbreaking realm of 'food as medicine' with Jeff Barteau, the CEO of Homestyle Direct. We will be shedding light on how medically tailored meals can revolutionize the management of chronic conditions. By fusing culinary precision with medical insight, Jeff illustrates how these meals are not just a source of sustenance but a cornerstone of comprehensive patient care, particularly for those battling diabetes and heart disease.

The conversation takes a deep dive into the world of medically tailored meals, where we unveil the tangible benefits they bring to the elderly and chronically ill. Imagine a world where your meals are more than just food; they're a balm that soothes, heals, and energizes. Jeff and I explore how these chef-concocted, dietitian-approved dishes make adhering to complex dietary regimens a breeze and how they're associated with reduced hospitalizations and healthcare costs, as evidenced by compelling research from Tufts University.

From those navigating the dietary intricacies of cancer treatments to seniors seeking a hassle-free way to eat healthily, Jeff's insights into these specially crafted meals paint a picture of a health-conscious future. This is about more than food; it's about crafting a life brimming with health and happiness.

SeniorLivingGuide.com Podcast sponsored by TransMed Care Long Distance Medical Transportation

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Transcript

Chapters:

0:01 

Senior Living Guidecom Podcast 

11:57 

Impact of Medically Tailored Meals 

21:10 

Medically Tailored Meals 

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Medically Tailored Meal Delivery Service 

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Senior Living Guide Podcast Information 

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Speaker 1: 0:01 

SeniorLivingGuidecom podcast discusses topics which are relevant to the everyday lives of seniors and their caregivers. We are joined by experts who share their knowledge on a variety of issues. SeniorLivingGuidecom Podcast offer solutions and resources to create the best quality of life as we age. And now let's welcome your host, darlene Mahoney. 

Speaker 2: 0:28 

Does the idea of searching for senior housing solutions seem overwhelming and you just aren't sure where to even begin? SeniorLivingGuide.com is created just for you. We are here to make sure your senior housing search is easy to navigate and right at your fingertips. We provide details on communities to include retirement 55 plus, independent assisted living, skilled nursing, memory care and even home health and home care solutions, all in one easy to navigate website allowing you to decide which best fits your needs and connecting you directly with those communities and senior solutions. Visit us online today at seniorlivingguidecom and you can start destressing. I would like to thank and express our sincere gratitude to our SeniorLivingGuide.com podcast sponsor. Transmed Care Long Distance Medical Transportation. When a loved one with a disability or medical condition needs to relocate, Transmed Care is here to help with safe and secure nationwide medical transport services, with an emphasis on comfort and care. 

Speaker 3: 1:58 

TransMed Care. Long Distance Medical Transportation is a business built on care. Another satisfied customer writes my family and I were extremely pleased with the professionalism, warmth, friendliness and competence of the TransMed Care team. They were on time, patient obliging and kept in touch regularly during the ride from New Jersey to Florida, and they were very kind to my husband. I highly recommend this company. To learn more about TransMed Care, visit the website at trans-medcare.com. 

Speaker 2: 2:30 

And we have Jeff Berteau joining us today on the podcast. He is a season leader in the healthcare industry for over 20 years. He has an extensive background in pharmacy delivery and dialysis care. As the CEO of Homestyle Direct, he oversees the production of medically tailored, home delivered meals, ensuring quality and care for Medicare and Medicaid beneficiaries across the country. I'm so excited to have Jeff on our podcast today because we're going to talk about something that we don't talk about as food or is or as medicine, so we're going to kind of dig into that and get the two differences. 

Speaker 4: 3:09 

Excellent. Look forward to talking about it. 

Speaker 2: 3:11 

Yeah, thanks for joining us. 

Speaker 4: 3:13 

Thank you for the introduction, appreciate it. 

Speaker 2: 3:15 

Absolutely, absolutely. I'm excited to have you because I think a lot of people don't know that medically tailored meals exist. They don't know what they are and they don't know how to get them. So we're going to find out all three of those today. So what is food is, or as medicine? 

Speaker 4: 3:33 

Yeah, food is medicine is kind of a movement and it's really accelerated over the last five years. So at its core, food is medicine is the use of food and nutrition to either prevent illness or improve the health of those with an illness. Mostly it's related to chronic illness like diabetes, but it can also be used for acute illnesses like cancer, things of that nature. Many diseases have very specific nutritional requirements, like diabetes, heart disease and renal failure, and it's very helpful in those areas to have the proper nutrition. It can go a long way. Traditionally, we hear about diets from our physicians like Mediterranean diets or low sodium diets. This kind of takes it a step further, where we're designing meals specifically for certain chronic illnesses and nutrition required to serve people with those chronic illnesses. 

Speaker 2: 4:27 

Yeah, I think people think of Mediterranean and they think they're going to go to a Greek restaurant or they're going to eat just like Greek food, and then the cancer diet. Cancer diet is huge. It's a very difficult diet to follow. If you're trying to eat out or you're trying to do, you know, even making it at home, it can be really hard and it's problematic for a lot of people with those illnesses if they don't have help at home. Or when you're going through cancer, when you're going through chemo or you've had cancer, you a food is not your friend. When you're trying to prepare it it's hard because you're not feeling well and food can upset your stomach on chemo. So to really understand what types of food cancer patients need, what's a great cancer diet? Clearly, diabetes. Diabetes is caused typically and maybe I'm wrong, but can be caused by not eating properly and it's it can get worse by eating improperly if you're not eating the correct foods. Right. 

Speaker 4: 5:27 

Certainly yeah, Diabetes is one of the biggest chronic illnesses that if you look at any sort of insurance provider or healthcare group, they're trying to help manage the chronic illness of diabetes. Blood sugar management is probably what you're referring to. And that's most important with type 2 diabetics, so people that acquire diabetes over their lifetime. They're not born with it. Bad foods, if you will, can certainly be a contributor to higher blood sugars and increased cases of diabetes. 

Speaker 2: 6:00 

Yeah, my grandmother was a diabetic years ago, so I think that things have probably changed. And I can remember her coming to visit me and she would go put her suitcase in the room and she would say, do your dogs get into suitcases? And I'm like, well, what you got in there? So she would be someone that would be like hoarding her snacks and her things like that because she would be a good Diabetic in front of everyone. And then she'd go to her room and I she had candy, I don't know what else you had in there. But yeah, so educating on what you need and making it available, I think is really important. So why not food and medicine? How does? How does prescriptions and Pharmacies? How does that play a role in meal programming? Because that is like you mentioned. It is new. It's a new thing that has kind of started. 

Speaker 4: 6:51 

Sure, it's actually a really interesting question, you know, because everything that people consume gets metabolized. That's often the pills we take, the medicines we take and also our food. They kind of work together. There are existing offerings that are starting to get recognized that actually map individuals DNA to determine what is most optimal for them, both in the medicine side of the world and on the food side of the world. So medicine and nutrition, these things, like I said, work together. The the labs that I'm referring to are called Pharmacogenomics on the pharmacy side and neutrogenomics kind of on the food or nutrition side. If you have those conducted, you can kind of identify not only what pharmaceutical regimens are most likely to work with your DNA but what foods help you absorb those medicines, which it's kind of a new area that hasn't had a ton of notoriety, you know, sort of historically, but it's starting to emerge here in the last, say, several years. 

Speaker 2: 7:51 

Yeah, I had no idea. This is all brand new to me as well, so I think that that is really cool. And do they do that with, like a blood test, hair analysis? You know how do they conduct those tests. 

Speaker 4: 8:02 

Yeah, the lab test is simple. It's a cheek swab, similar to what we might have done whether we're all familiar with COVID testing. Obviously that's typically done through the nose, but it's a cheek swab very similar, very similar process sent into a lab and in that lab is Provides the results to a pharmacist or your physician to review them in conjunction with the neutrogenomics Testing, which would have to be reviewed. Similar process, same thing swap swab, the, the cheek. In fact both tests can be run off the same swab and A dietitian you know would meet with you or consult with you in Conjunction with that pharmacist or physician to make sure you optimize both things. 

Speaker 2: 8:41 

That is the coolest. You don't even have to get you know a poke for it, they can just swab your swab, your cheek. 

Speaker 4: 8:47 

Yeah, no blood donation required. 

Speaker 2: 8:49 

There you go. I think most people like that. I think people, especially our seniors, get tired of being proked and prodded, so that's good to know. We talked a little bit about medical meals that work. You know this is exactly what we're talking about. But when you sit down with a dietitian and you get, you know, eat this, eat that, eat this, eat that as we know that can be, that can be a chore. I know people that do like meal planning and I. They'll spend their entire Sundays Just doing that, or even just you know, going to the store and getting the right ingredients, how expensive that can be. If you're buying a big thing of celery or a big thing of this and then you not don't necessarily Use all of it, and then coming up with recipes and cooking it, it becomes a whole new job. When you have restricted diet, that has to work with your body and your DNA and your medicine, just kind of like what we talked about, that it all works Together so that you stay and remain healthy. So one thing that your company does and it is available and it's the coolest, as you can actually Get them directly into your home and you don't even have to cook them correct right yeah, all prepared meals and they're medically tailored, so I have heard that term. So medically tailored. What does that mean in layman's terms? 

Speaker 4: 10:11 

Yeah, so medically tailored meals and you'll often hear it referred to as MTM, potentially by you know, people in our industry or others in health care. The meals are really developed by, they're developed by, a registered dietitian for people with specific illnesses or, in many cases, multiple illnesses, which we refer to as comorbidities, people that might have a combination of, you know, heart disease and diabetes, or you know, the beginnings of renal failure and heart disease. Those kinds of things actually go hand in hand and a lot of them are caused by diet. You know, high sodium intake, those types of things. And these meals are really tailored specifically for people that are struggling with a chronic illness to make sure that they can one manage it if they have it, but also stop the progression of that illness so they can live a healthier lifestyle. It goes well beyond the traditional Mediterranean diets and, or you know, sort of just low sodium and, as you mentioned, it is difficult for an individual, whether they're elderly or not elderly, to meal plan and prep for multiple chronic illnesses and nutritional requirements associated with both of those. It can be tough. It is difficult to sort of manage the grocery shopping, the appropriate ingredients, the low sodium proteins, and then compile those into a meal that's right for you and your chronic illnesses and nutrition you require. 

Speaker 2: 11:32 

Yeah, I 100% agree. My mom had cancer and she did try doing the cancer diet and she struggled so much with it that I think that she just started not eating, versus trying to figure it out, which was very disturbing to kind of see that happen with her. Because she was, so she got to be where she was afraid to eat anything that she didn't know for sure, so she just didn't eat. That's not a good thing and I did want to ask you. The other question is when you're doing the medically tailored meals and you have multiple I'm going to say this correct comorbidities, Comorbidities yeah. Comorbidities. I know I've heard the word, but just you know spitting that out. So if you're, if you're doing the tailored meal medically tailored meals you're taking your medication. So not only is it slowing down the progression of the diseases, which is the goal, but I would think you would feel better, that you would have more energy, maybe sleep better and those types of things. So there is that bonus side to it as well. 

Speaker 4: 12:33 

Yes, yeah, people often report our members and others across the industry that are regularly utilizing medically tailored meals, that they do feel better and it's usually a result of them, you know, optimizing their health for the chronic illness that they're managing. So, yeah, we often hear that from our members. 

Speaker 2: 12:51 

Okay, so the other question is that I think probably the folks that are listening are really interested in is how do the right meals help our elderly population? 

Speaker 4: 13:01 

Yeah, many elderly people, as we've been talking about, are contending with, you know, more than one chronic illness. So you know, most commonly we talked about diabetes. Other common ailments are, you know, heart disease, renal failure, things of that nature, If you have diabetes, you're trying to manage your blood sugar, which requires you to monitor your intake of carbohydrates. Similarly, if you're dealing with heart disease, your physician will often ask you to control your sodium intake. So if you're dealing with one of those things, it's difficult. If you're dealing with both or more illnesses, it becomes really, really challenging to be able to manage a diet that has the nutritional requirements of all the illnesses that you might be contending with, or those comorbidities, as we've talked about. These meals kind of allow for a very easy and convenient way pre-made, ready to eat, ready to eat types of meals that allow you to just consume and enjoy them and know that you're treating your chronic illness in the best way possible through nutrition. So there's a hugely convenient element to it, which is important, I think, for prepared meals as an industry to communicate, because many will often talk about grocery boxes or produce or discount cards at a grocery store. It's very difficult for anybody, including an elderly person, to be able to compile the right ingredients, mix them together into a meal and have it aligned specifically with their chronic disease. It's a tough thing to do and we kind of make that process easy and simple for all the seniors we care for, and our competitors and or others that produce medically tailored meals allow for the same thing. 

Speaker 2: 14:43 

No, I literally, as you're talking about it and as we're talking about having these medically tailored meals, it sounds exhausting if you were to try to do it yourself and I know we've already just chatted about that a little bit but it's something that I feel would be such an overwhelming task that I don't know that people could stick with it for a long period of time before you finally just say forget it. This is just too much. So I think it's great to have that option. Now let me ask you this question can seniors, if they have some of these things and their doctor hasn't mentioned medically tailored meals, does that mean they can bring up, and that physician would have some idea on that. 

Speaker 4: 15:23 

I think many do, and the reason for that is medically tailored meals are offered to almost all Medicaid beneficiaries and about 80% of Medicare Advantage beneficiaries. So not through traditional Medicare, but you know the meals are offered to many seniors. So if you have a physician that's dealing with the elderly, for the most part they're likely heard of it and have have sort of explored it a bit. But for those that do not have access, maybe through their insurance plan or through Medicare or Medicaid, there is an offering through our company and through many others that allow people to buy those meals, to act. 

Speaker 2: 16:00 

They're available, that's the best news ever, right? So you know what? I think we're going to take a quick break for our podcast sponsors, transmedcare Long Distance Medical Transportation. Then we're going to come back and we're going to talk more about the impact on our healthcare system and how it's translating over to our seniors and consumers. 

Speaker 5: 16:20 

Hi, this is Andrew Brainerd, owner of TransMedCare Long Distance Medical Transportation. When the time comes to relocate a loved one under medical care, TransMedCare is here to help. We offer nationwide medical transport services with fully customized vans providing all the comforts of home and licensed medical professionals to accompany your loved one along every mile. At TransMedCare, nothing is more important than bringing your loved one home safely. Visit our website at trans-medcarecom. 

Speaker 2: 16:50 

And we are back from our break and we are with Jeff from Homestyle Direct and we're going to dig into our healthcare system and how that translates to the consumer or our elderly and seniors. 

Speaker 4: 17:05 

Yeah. So you know there's been a lot of emergence of medically tailored meals and kind of nutrition to be used as medicine or sort of in conjunction with medicine. That we've been discussing and there's been a lot of studies done as well. As you can imagine, a lot of Universities and institutions have started measuring the impacts of this. One of the most significant is Tops University did a study in October of 22 that was published by the American Journal of Medicine. The study found that medically tailored meals could prevent over 1.5 million hospitalizations annually and saving shares about 13.6 billion a year after the cost of the medically tailored meal or the food that was involved in the study. So most of these savings would occur in the Medicare and Medicaid programs. But over a 10-year time horizon the study showed that savings would be about 185 billion and over 18 million less people would be hospitalized or hospitals Hospitalizations would be averted, according to the study. So pretty significant numbers there. I think that study is what really sort of propelled the industry forward and got the federal government interested in how we could promote this as a Preventative measure and improve people's health. So that's the one that most people point to. But there's been numerous studies done before and Since then, but that was the most impactful, I believe. 

Speaker 2: 18:28 

Yeah, the reality is is, if you're eating healthier you have Even in your younger years at any stage if you're having a healthier diet, I think it's gonna definitely lead to less disease and then also less Hospitalizations. And then, clearly, if you you get a disease and you start working on the better nutrition with the medically tailored meals, that's clearly gonna cut down on the hospitalization, the visits. It's common sense that I can't believe it's taking us so long to realize how important it is. 

Speaker 4: 19:01 

Yeah, what's interesting about most of the studies that have occurred is they're done over a relatively short time horizon, so all the savings that are identified for the health care system are for a year or maybe a two-year period of time. The longitudinal studies really haven't had time to be conducted yet. So certainly, implementing a nutrition regimen that's aligned with your specific chronic illness is Gonna help over, not just over the next year or two, but over the next 10, 20, 30 years as people extend into sort of their elderly years of life. I think the, the return on investment, if you will, related to our industry, is much higher than is being recorded, but it'll be interesting to see those long, long-term studies sort of play out as well in the future. 

Speaker 2: 19:45 

I I 100% agree with you. I think that there are a lot better than what, what they're getting, due to the studies, because clearly there's a lot that's going on that's not included in a study. But one thing that you did mention is the legislation that's kind of helped boost solutions for those with multiple illnesses in the food, food arena. So tell us a little bit Is there like new legislation that's happening and what's needed, do you think? 

Speaker 4: 20:12 

Well, there's definitely legislation that's progressing. So, interestingly enough, I mentioned that tough study which was done in October of 22. In September of 22, the Biden-Harris administration announced an eight billion dollar commitment to improve hunger, nutrition and health Not directly related necessarily to only medically tailored meals, but multiple areas for nutrition. Within the funding that, however, there's a program to accelerate the emergence of medically tailored meals. They are utilizing about 10 million meals in a couple of states over the course of a year or two I think those states are Massachusetts and Rhode Island to get a program started and to learn, educate Sort of ourselves as a society about the impact of it, to see if there's further investment that can be made and to more Broadly impact you know, sort of the US across all states. So that investment is a significant one Obviously eight billion and overall investment is significant. So you asked about whether or not I believe there should be more done. Of course I'm a proponent for Medically tailored meals. I do think that there's an opportunity for us to refine our national standards so we can conduct large studies similar to the ones that Tufts did for medically tailored meals together. So, as I mentioned at the at the onset of the call, medically tailored meals have to be sort of designed. If you will buy a registered dietitian and that's true, they all are, whether they're from Homestyle Direct or others in the industry but those registered dietitians also have their own perspectives on what is exactly right for a diabetic patient, what is exactly right for a heart patient, and those things can have some variance. So our diabetic meal may be slightly different than somebody else's. I think there's opportunity to have a national standard and so as we identify more science and evidence-based Sort of outcomes for health improvement, we can do it based upon a national standard of meals as well. So we can replicate, continue the the benefits, show the benefits on a continual basis, because we know that the you know the meals being used are configured kind of similarly. Somebody does a study based on a pharmaceutical or a molecule. They know it's the same molecule every time. Meals are a little bit different, there's larger variety. So if we could tighten up the requirements there, I think it'd be helpful For for us sort of society at large, if you will. 

Speaker 2: 22:40 

Yeah, and I will tell you. I remember when that did get passed, the commitment to improve hunger, the name of the bill. I'm not sure what that was, but I will tell you. I had no idea included this and I'm so Happy to see it because I think that a lot of times, our elderly get forgotten when it comes to social programs and getting funding for social programs, so I do love the fact that that was something that was considered in that package. These meals well, you mentioned they're covered by Medicare and Medicaid, so tell us a little bit about that. I know that you talked about the advantage, but is there like a percentage of people that are able to take advantage of this? 

Speaker 4: 23:26 

Yeah, so most Medicaid programs across the country have adopted some form of medically tailored meals or meals in general. So in Medicaid people often refer to food insecurity. People that live in food deserts or otherwise can't get nutritious meals, not necessarily aligned with a disease state, but just for general health, and about 45 states have those types of programs. So whether it's for medically tailored or more general health type meals programs, there's an offering there and if you're eligible for that, your case manager through Medicaid would know whether or not you're eligible, so that's who you might reach out to. You talked about Medicare Advantage Over the last. I'll probably get this wrong, but over the last five years I believe, we've increased the number of Medicare Advantage programs with a meals offering from somewhere around 30% to almost 80%, so we've seen huge increases in adoption in Medicare Advantage, and it's a supplemental benefit typically. Sometimes it's offered only post discharge for people that are being released from the hospital for recovery, but those benefits are often in an MA plan. Traditional Medicare, however, does not pay for meals, and so that's something that maybe addressed in future legislation. Maybe that's additional area to be focused on, but today, to my knowledge, meals aren't offered there. 

Speaker 2: 24:53 

You would think that they would see the savings and having healthy people versus hospitalizations as a benefit to funding more of that, because I mean, you're actually going to save money. 

Speaker 4: 25:07 

Absolutely. We think there's a tremendous return on investment for medically tailored meals to be adopted a lot more broadly. I may be a little biased in that perspective, but I've seen the studies. They're out there, they're available for all of us. So I do believe that there probably will be wider adoption. Things take a little bit of time for wide, broad based adoption, but the fact that sort of privatized insurance carriers that offer Medicare Advantage programs have adopted these offerings is, I think, a good sign that they're effective, that they work, and that they've been adopted at such a high percentage, I think sort of indicates that we will likely see adopted more broadly from government programs. So we'll see how it plays out. 

Speaker 2: 25:48 

Okay. So if you are like one of our listeners is a Medicaid beneficiary, would they just contact their case manager to get more information about everything that we're talking about, if this is all news to them? 

Speaker 4: 26:02 

Absolutely, if you're in Medicaid and you haven't assigned either case manager, social worker or even a 1-800 line, if you will, to reach the Medicaid department, these programs, if they offer them, they're going to be well known. It's considered an ancillary benefit, but they are well known, well publicized within the state Medicaid department and so I feel like anybody that would be eligible would be able to find that out through the contact of their case manager, and oftentimes different states have different requirements for being eligible, so you'll have to check those. Like I said, I believe it's around 45 states that offer it, so it's the vast majority and if you're interested, I would really encourage you to reach out. 

Speaker 2: 26:45 

Yeah, I really love that. So I wanted to also ask Gail. So, when it comes to the delivery of the meals, what are the prepared meals and why are they better than if you're trying to get some of the boxes or you're trying to make it yourself? Or what makes them? You know to me? I'm just listening. Convenience, yeah Well there's really. 

Speaker 4: 27:09 

I mean, there are a number of different offerings, but I think the primary mainstream two offerings for meals today are either a produce box or a medically tailored pre prepared meal and our pre prepared meals, which is typical for the industry. It's not, you know, the only way meals are provided, but we pre make the meals, we flash freeze the meals and then we deliver them, frozen, to the door of the recipient. You know produce boxes are literally boxes of, you know, vegetables and other produce items that people would then manufacture a meal in their house from or cook a meal from, as we talked about before, when you're dealing with multiple illnesses or comorbidities and you have very strict sort of nutritional requirements, they're going to help you maintain sort of your health and managing those illnesses. It's difficult to make a meal from raw ingredients. I think we've taken all the guesswork out of it, we've made it super convenient and a pre prepared meal and it comes right to your door, you stick it in your freezer and then you you know you sort of heat it up with your oven or microwave whenever you're ready. We think utilization rates of medically tailored meals are much higher if you provide them that way, and obviously the higher utilization, the more benefit you're going to get more, the more your health is going to improve. At least, that's the way we think about it. 

Speaker 2: 28:27 

Yes, and I do want to throw this out because I know that a lot of our listeners are probably having this in the back of their mind Everybody loves to eat. People enjoy food, Even if you're not feeling well. There's going to be days where you're really going to enjoy that food. And then some folks we mentioned cancer you may not really want to eat that much. But my question is do you consider taste when you're, when you're putting these meals together? 

Speaker 4: 28:50 

Ideally, yeah, absolutely. I will say this, and it's probably uncommon, but I eat our meals myself about three days a week for lunch when I'm here at our offices, because they're manufactured sort of right across the parking lot. Our dietitians do a great job of and I think dietitians from many in this space do an excellent job of balancing flavor profile and nutritional requirements. It's a difficult balance, honestly, but we all know that if the member doesn't eat the meal or the recipient doesn't eat the meal, they don't get the benefit, and so we want to make sure that the flavor profile is not only good, but it's also we have enough variety within the meals that we offer so it stays interesting and we get those high levels of utilization to be able to improve health. 

Speaker 2: 29:39 

You're exactly right. If they don't like it, they're not going to eat it. So then we have the problem of not eating enough food or they're going to start going into the pantry. I know some seniors and I'm referring to my own family and does he eat crackers and peanut butter because it's just there? So I did want to cover the one meal a day thing. Would you normally recommend one to two meals? 

Speaker 4: 30:05 

Usually I would go two meals a day, and the reason for that is if you're offering somebody enough meals to cover two thirds of their daily requirements, then the majority of the nutrition that they're consuming is aligned with their chronic illness, and so a lot of the studies that you'll see the one I referred to earlier my understanding is that they utilize two meals per day. One is better than none, of course, but two or more is the preference, and I think what it does is it allows you, like you had just mentioned, to have nutrition available that's consistent with your chronic illness, and there's maybe less snacking and or less eating outside of the meals that you're supposed to be consuming to help manage that chronic illness. I would say two at minimum, but I know one is better than none. I guess that's the way I'd respond to that. 

Speaker 2: 30:52 

Yeah, and the other thing that I was thinking is we had someone that was here for dinner this past week and he is doing the cancer diet. He's on a very strict diet and we prepared something separate for him that worked for him, because we were having beef. He can't have beef, he needed to have fish, et cetera. I just remember thinking, as you were talking, that while we absolutely did not mind doing that, he could have brought a prepared meal and then he wouldn't have to worry about imposing, or if he's even going to go watch the grandkids, he, she, can just take the meal, versus trying to figure out what their daughter or granddaughter has in the house in order to make a meal for themselves, and they can still cook something separate for the kiddos. So I think that that's really great. You can just take it with you. That's just fabulous. Did COVID and Medicaid disemrolments based on Medicaid being able to help with this programming? Just depending on what you're getting? Did it affect anything? 

Speaker 4: 31:53 

Medicaid redeterminations. Obviously, millions of people lost coverage across the country and had to reapply, and that's still going on today. It was actually intended to be all wrapped up by November 11th of last year, but we still see people being re-enrolled. I think it was a difficult task for the states to take on and it was from a communication perspective. How do you get ahold of millions of Medicaid beneficiaries and have them re-enroll? We've seen a little bit of an impact of it, but, quite frankly, most of our members we deal with the elderly primarily, but also the disabled, who utilize our meals because they can't cook for themselves, and we saw a relatively limited dip in overall membership as a result of it and with our growth rate it covered up the vast majority of it. I don't want that to discount the fact that I think there are a number of people that lost services for a period of time and that's really unfortunate. One thing we do more related to Homestyle Direct is we connect with our members every month. So we talk to them every month. We understand whether or not they're enjoying the meals, whether or not they receive their deliveries on time those types of operational things, but we also try to connect with them on a human level and whether or not they're really enjoying the meals themselves and if there's anything challenging going on. We've heard through some of those conversations that people were fearful of losing benefits and in some cases we did see people come off of services and then come back on. But it hasn't been a large impact for us, and I'm hopeful that it wasn't for many seniors that depend on these meals. 

Speaker 2: 33:24 

Yeah, absolutely so. I really appreciate all the feedback and all the information. It's a lot of it. For me, to be honest, was mind blowing that these meals are available and what they can do to improve someone's life on a significant level. You know, even just cutting out hospitalizations going to the hospital and being hospitalized is a miserable experience. No one looks at that and says it's a vacation. So just cutting that back is a benefit with delicious meals that you can get right at your doorstep. But I did want you to share, because you are with Homestyle Direct and you do provide these amazing services. So give us just a little bit a lowdown of what Homestyle Direct does and provides. 

Speaker 4: 34:06 

Yeah, so, as we've been talking about, we are a national provider of prepared meals, medically tailored, and really our mission is to empower healthy lifestyles, food security and promote health equity by offering a variety of nourishing, medically tailored meals that taste delicious and meet the dietary needs of individuals under managed care. Kind of to break that up a little bit is, we want to make sure we really strike that balance of nutritionally appropriate meals with food flavor profile and variety of meals that really help people increase their utilization of food. That's good for them. We are present in the Medicaid space significantly and also in the Medicare Advantage space not as significantly, but we do do business in that channel and we're based in Twin Falls, idaho, so we ship all across the country from here, from our rural location, and our real approach to food is making sure it is convenient and approachable type of food that people would align themselves with normally. So you might see things on our menu that look like they're more traditional American fair type items, and that's because we want to make sure it's consistent and kind of approachable for all walks of life, if you will, and that that increases utilization. Pretty often we're one provider in the space. There's numerous good ones. But we're really proud of what we do, the meals that we provide and the members that we serve, so really appreciated the time today. 

Speaker 2: 35:33 

Yeah, and I did want you to provide the website. 

Speaker 4: 35:36 

Yeah, so very easy. Homestyledirectcom. We've newly revamped our website recently, so go check it out. Wwwhomestyldirectcom is our website. You can contact us there. There is also, on that website, contact for our customer service department, which we can, you know, obviously field any questions related to the items we talked about today. Or if people are interested in ordering, you can order meals directly through our website. 

Speaker 2: 36:02 

I love all that. That's fabulous. What a great resource. I really appreciate having you on the podcast today and hopefully we'll do some more podcasts here in the future. 

Speaker 4: 36:13 

Yeah, thank you, it's my pleasure. Thanks so much. 

Speaker 2: 36:15 

Absolutely. If you enjoyed this podcast, please feel free to share with a senior or caregiver that you appreciate and love and want to get this information out to them. And we can also be found on Spotify, Apple Podcast, Google, good pods. There's a variety of different