PHILADELPHIA, Pa., October 19, 2021 – Higher enrollment by older adults in the Supplemental Nutrition Assistance Program (SNAP) is associated with fewer hospital and long-term care admissions as well as emergency room visits – and an estimated Medicaid cost-savings of $2,360 per person annually, according to newly published research findings. The research also found that data-driven outreach and assistance in applying for SNAP significantly increases enrollment by older adults.
Published in the Annals of Internal Medicine, the study analyzed the relationship between SNAP participation and health outcomes among more than 115,000 North Carolina residents who were 65 and older and enrolled in Medicare and Medicaid, and therefore likely eligible for SNAP, but not participating in SNAP. National nonprofit Benefits Data Trust (BDT) was one of two data sources for the study and shared data with the researchers on its randomized outreach to these individuals between 2017 and 2020; BDT conducted mail outreach and offered telephone-based screening and comprehensive application-filing assistance.
SNAP is a public benefit designed to help cover the cost of grocery bills and make it easier for those in need to afford healthy food. However, even before the pandemic, nearly 8 million individuals were eligible but not enrolled in SNAP, leaving millions of families hungry and billions of dollars in assistance unclaimed. Seniors age 60+ have some of the lowest rates of SNAP participation: only 48% of eligible seniors participate in SNAP nationwide, and in North Carolina senior participation is even lower at 34%.
“Good food is medicine, and SNAP puts groceries within reach of those older adults who need it,” said Trooper Sanders, CEO of BDT. “There are more efficient ways to tackle economic security and health outcomes, including streamlining public benefits. The data in the study shows how states can significantly reduce Medicaid costs, while giving older adults a chance to continue to put food on their table and live healthier lives.”
The study found that the SNAP enrollment rate was 7.6 times higher for individuals who received BDT’s outreach and application assistance compared to those who did not. It also found that SNAP enrollment was associated with decreased emergency room visits and admissions to hospitals and long-term care facilities, leading to approximately $2,360 lower annual Medicaid spending per person in North Carolina. This reduction in health care costs exceeds the $1,440 estimated average annual national SNAP benefit level for households with seniors, according to the USDA Food and Nutrition Service data. The study’s results are consistent with previous findings that SNAP is associated with improved health outcomes and Medicaid cost savings, and it expanded on prior studies by linking comprehensive data sets.
“SNAP is a vital part of the U.S. safety net and addresses both food insecurity and poverty for millions of Americans. In this study, we find that SNAP is also associated with meaningfully lower health care use and cost,” wrote the study’s lead author, Seth A. Berkowitz, MD, MPH, Assistant Professor of General Medicine and Epidemiology at the University of North Carolina School of Medicine. “Given the clear connection between income and health, programs, like SNAP, that provide nutrition and income support to vulnerable individuals are a key tool for advancing health equity.”
This study was funded by the National Institutes of Health. BDT's randomized benefits outreach and assistance studied in this research were made possible through state funding from North Carolina, federal SNAP Outreach Plan match dollars, and funding from the Walmart Foundation.
Despite the study’s positive findings, SNAP enrollment was low overall – only about 5,100 of the eligible older adults in the study enrolled in SNAP - leaving substantial room for improvement. BDT meets this challenge through not only data-driven outreach to connect individuals to benefits for which they are eligible, but also technical assistance to state governments to streamline their public benefits systems. BDT has provided outreach and assistance to older adults in North Carolina since 2017 through a contract with the state’s Department of Health and Human Services (DHHS). BDT also helped DHHS submit and secure approval of a federal waiver to simplify SNAP access for older adults.
“Food security has a direct impact on health. This study shows that leveraging programs that support healthy nutrition both improve health outcomes for people they serve and reduce health costs for the state,” said North Carolina Secretary of Health and Human Services Mandy K. Cohen, M.D. “It’s more evidence that our focus on whole-person care is essential to fulfilling our mission to improve the health and wellbeing of North Carolinians.”
The Annals of Internal Medicine editorial accompanying the study called the findings on the reduction in health care costs “astounding,” providing further evidence that “SNAP is medicine” and that SNAP “actually saves the government money.” The editorial by Baylor University economist Craig Gunderson proposes making SNAP enrollment automatic given its dramatic impact on health and healthcare spending.
About Benefits Data Trust
Benefits Data Trust (BDT) harnesses the power of data, technology, and policy to provide efficient and dignified access to assistance, improving people’s health and financial security. Together with a national network of government agencies and other partners, we streamline public benefits systems and directly connect eligible families and individuals to programs that help pay for food, healthcare, housing, and more. A nonprofit since 2005, BDT has secured more than $7.5 billion in benefits for households across the country, building pathways to economic mobility and a more equitable future.
For more information on BDT's data and outreach that supported this study, view this fact sheet.