The Cheapest Prescription a Health System Can Write

On June 24, 2026, Philadelphia City Council’s Food and Nutrition Security Task Force released its final report at a press conference at City Hall. Twenty five people had spent more than a year gathering testimony, running listening sessions, and arguing through drafts before landing on a set of recommendations. Most of them read the way you would expect from a city task force: expand SNAP and WIC enrollment support, invest in food infrastructure, stand up a permanent office to coordinate it all. Then, tucked into the fourth and final category of the report, was a line that reads differently from the rest. A coordinated Food as Medicine strategy. Not a pilot. Not a one time grant. We work in food relief across this city, and we want to walk through why that single line has the clearest business case in the entire document.

What the Task Force Actually Recommended

The report organizes its work into four categories: governance and accountability, immediate stabilization and resident access, food production and economic systems, and health, education, and human development. It is inside that fourth category, easy to skim past on the way to the more visible asks like a new city office, that the task force calls for development of a coordinated Food as Medicine strategy. Philadelphia City Council’s Food and Nutrition Security Task Force framed the recommendation alongside expanded nutrition education and procurement reform, part of a broader push to treat food access as infrastructure rather than an annual charity drive. The full report lays out the other three categories in more detail, and The Philadelphia Tribune’s coverage puts the recommendation in the context of the task force’s broader push for a permanent Office of Food and Nutrition Security.

We think it is worth saying plainly why this recommendation is different from the others. Nutrition education and procurement reform are worth doing regardless of who funds them. A Food as Medicine strategy asks something more specific of a very particular kind of institution, the ones that already spend money on health outcomes as a matter of course. Hospitals. Insurers. Health systems. The task force is not asking them to try something experimental. It is asking them to treat food the way they already treat a prescription refill.

The Receipts: What Produce Prescriptions Measurably Do

Produce prescription programs are not a new idea in 2026. Clinics across the country have spent nearly a decade handing patients a card, usually worth somewhere around sixty dollars a month, that can be spent on fruit and vegetables at a grocery store or farmers market instead of on nothing in particular. What changed is how much evidence now exists about what that card actually does to a patient’s health.

A 2023 multisite evaluation published in Circulation: Cardiovascular Quality and Outcomes pulled individual level data from 22 produce prescription sites run by 9 programs across 12 states, covering 3,881 participants, 2,064 adults and 1,817 children, over a median of six months. Among adults with diabetes, HbA1c fell by 0.29 to 0.58 percentage points. Among adults with hypertension, systolic blood pressure fell more than 8 millimeters of mercury and diastolic fell nearly 5. Participants were about a third less likely to report being food insecure after the program than before it, and adults were 62 percent more likely to describe their own health as improved. The American Heart Association’s summary of the results puts those numbers next to the plainest possible framing: participants who received produce ate close to a full cup more of fruit and vegetables a day, and their bodies responded the way a body responds to a working intervention.

We want to be careful here, because this is exactly the kind of claim that gets oversold. These are not numbers that mean a grocery card replaces insulin or blood pressure medication. Nobody involved in this work, including us, is suggesting that. What the data shows is narrower and, we think, more useful. Give a food insecure patient with a chronic condition reliable access to produce, and the standard clinical markers a doctor already tracks move in the right direction, on top of whatever else that patient’s care team is doing.

What the National Numbers Could Look Like

The 2023 evaluation measured what happened inside programs that already existed. A separate study asked a different question: what would happen if produce prescriptions were available to everyone who might benefit from them, nationally.

Researchers at the Tufts Food is Medicine Institute built a microsimulation model and published the results in the Journal of the American Heart Association. They modeled what would happen if the 6.5 million American adults who live with both diabetes and food insecurity had access to a produce prescription over their lifetimes. The model estimated 292,000 cardiovascular events averted, heart attacks and strokes that never happen, and about 260,000 additional quality adjusted years of life across that population. On the financial side, the model put healthcare cost savings at roughly 39.6 billion dollars. Tufts Now’s coverage of the modeling is careful to note the other half of that number: running the program at that scale was modeled to cost about 44.3 billion dollars, so the healthcare savings alone do not clear the cost of the program. Add in an estimated 4.8 billion dollars in productivity gains from a healthier workforce, and the researchers described the program as cost effective from a health system’s perspective and close to a wash, tipping slightly positive, from a full societal one.

We are choosing to be precise about that instead of rounding it up into a cleaner story. Thirty nine billion dollars in healthcare savings is real and it is large, but it is not a windfall sitting untouched. It is closer to an argument that the program pays for itself through better health outcomes rather than draining a budget for no return, which is a different and, honestly, a more durable case to make to a payer than pure profit would be.

Why We Don’t Want This to Be a Grant Program

Here is the part of this we know from direct experience, not from a study. Every food relief organization in this city, us included, has watched a promising pilot get funded for eighteen months, produce good numbers, and then quietly disappear the moment the grant cycle ends. The people running these programs are not naive about how funding works. Neither are we.

Groceries are not a one time fix for a chronic condition. A produce prescription only keeps producing better HbA1c numbers and lower blood pressure readings for as long as someone keeps receiving it, the same way a blood pressure medication only works while a patient keeps taking it. That is not a flaw in the model, it is the entire point of calling it Food as Medicine instead of Food as Charity. Feed Philly Coalition exists because we believe food access has to be treated as ongoing infrastructure, something a neighborhood can count on being there next year, not a program that has to reapply for its own existence every few grant cycles.

That is why the honest version of this recommendation cannot stop at a task force endorsing the idea. Somebody with a standing budget has to write the check every month, not just for the pilot year.

The Ask: A Payer, Not a Philanthropy

So here is the plain version of what we are asking for. The organizations that already fund insulin, dialysis, and every other standing prescription without a second thought are the same organizations that could fund a standing produce line. Not a foundation grant that sunsets. Not a one time community health fund. A line item that a payer treats the way it treats every other maintenance cost of keeping a patient population healthier.

This is not a new idea for Philadelphia’s civic and health policy conversations either. I have heard the argument for years: the systems supporting daily life in this city, food included, deserve the same kind of standing investment as roads or utilities. A produce prescription line is a small, specific, well evidenced place to start proving that argument with numbers instead of just principle.

We are not going to name a specific insurer or health system here and ask them to be first, because that is not really the point and it is not fair to single one out. The point is that the evidence already exists, the modeling already exists, and the only open question left is which payer in this region decides to write the first standing produce line and keep it on the books after the first year is over. We would like to find out, and we suspect the answer says something about how seriously this city takes the idea that food is, in fact, infrastructure.

Sources and references

• Philadelphia City Council’s Food and Nutrition Security Task Force
• The full report
• The Philadelphia Tribune’s coverage
• Circulation: Cardiovascular Quality and Outcomes
• The American Heart Association’s summary of the results
• Journal of the American Heart Association
• Tufts Now’s coverage of the modeling
• Feed Philly Coalition