Food as a Foundation for Affordable Health Care
Diet-related chronic conditions are one of North Carolina’s largest health cost drivers. They claim nearly 50,000 lives each year and are projected to cost our state $65 billion over the next five years (PDF). That burden doesn’t just strain families. It slows business growth and weakens workforce productivity statewide.
Health care affordability will not improve if we keep intervening after disease takes hold. Today, we spend most of our resources managing chronic conditions once they are entrenched. Then we ask why costs keep rising.
The outcome is predictable. If we want different results, we must act earlier. We need smarter support, introduced sooner.
That shift begins with nutrition.
Nutrition remains one of the most underused levers in health care, even though many of the conditions driving long-term costs are related to diet. Diabetes. Heart disease. Hypertension. These conditions don’t appear overnight. They develop gradually, shaped by limited access, uneven support, and gaps in nutrition knowledge.
When nutritional support starts earlier, risk is easier to manage. Outcomes improve. Costs grow more slowly. Early intervention changes the trajectory before care becomes complex, reactive, and expensive.
This is why many Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plans include up to 30 visits each year with an in-network licensed dietitian at no cost. The benefit is available to covered family members and designed to fit into members' lifestyle.
Through in person or virtual visits, members work with licensed dietitians who tailor guidance to their health conditions, routines, and preferences. The goal is not rapid transformation, but steady sustainable progress. That kind of personalized and preventive support matters because it addresses a major cost driver before it accelerates.
At the same time, clinical care alone cannot solve the health care affordability issue.
Colleen Briggs: Right now it feels like the entire system is focused on treating symptoms which we know costs more.
Couldn't we instead invest in prevention which we know costs less?
And I'll give you a concrete example. Diet related chronic conditions is one of the biggest cost drivers in the state of North Carolina. We know that we see 50,000 deaths every year in North Carolina around diet related chronic conditions. And that's going to cost the state another $65 billion over the next 5 years. And that's huge because we know it's also a drag on businesses that bear the brunt of a lot of these costs. And it's a drag on productivity for our workforce and others.
So here's the thing. We know what works though. We know that when you invest in lifestyle changes like improvements in diet and food that we actually see people improving their health and we're seeing lower costs.
So that's an example of something where we are committing all of our resources as a company to try to improve health through food. And we're going to do it in three ways.
We're trying to figure out how can we help people actually live healthier lives by eating healthier food. Right? So we're going to do first is how do we make it easier for an individual to eat healthier? And that's things like hosting teaching kitchens in a lot of our Beyond Blue neighborhood centers all across the state. And we also offer free nutrition counseling benefits so you can get that customized support you need.
The second is how do you scale this kind of food is medicine programs into the health care system. And so we are working on a program. We're one of the only payers in the country that offers food is medicine. So that's no cost to you food and a nutrition coach for our individuals who have type two diabetes. And we're actually seeing significant health improvements and cost savings.
Sougata Mukherjee: Wow.
Colleen Briggs: And then the third is how do we make sure that everyone no matter where you live has access to healthy food so that you can actually take these behaviors and actually adopt them because you need access to be able to do it. So these are the kind of things if we invest earlier we can actually improve health outcomes improve savings and get a system that works better for the state.
Sougata Mukherjee: That's fantastic. I mean we have we just have a minute left. Becky you asked the last question.
Becky Troyer: I um you know in terms of the impact and how what what sort of impact uh reports do you gather on how I know it's a long-term process. Um you'd rather have people eating healthy than buying weight loss drugs, right? Uh so how do you you know follow through to prove that what you did actually had an impact on say costs?
Colleen Briggs: It's a great question. So some of our programs that we measure, we look at things like let's say we're focused on a population with type two diabetes. We actually look at do we see blood sugar levels improve and the answer is yes in our programs. We also track do we see physical and mental health improvements and the answer is yes.
We see significant improvements when they engage in these kind of food as medicine programs. So improvements meaning fewer claims for those things or well it's actually reported data. So they come back and they actually show we're able to pull and we're able to see that their blood sugar levels are actually decreasing because they've engaged in this program. We're seeing you know we also have the quantitative data to be able to show that it does drive cost savings to your point. So we are seeing that it's delivering cost savings but then we also get qualitative feedback. People say they feel more confident, they feel healthier and they're seeing mental health improvements and that is already proven right when when you when you eat healthy.
Sougata Mukherjee: Thank you for joining us today. Um, go ahead. No, I was just going to say thanks. It was great. It was you. You were great. Thank you for tuning in in another edition of Bottomline Triangle. We'll be back again next time with more in-depth business news and analysis. So, make sure you like and subscribe.
Access to healthy foods
Across North Carolina, access to healthy food varies widely by community. Food and nutrition insecurity shape health outcomes in ways medical care cannot fully offset. As Dr. Tunde Sotunde, President and CEO of Blue Cross NC, recently noted in the Triangle Business Journal, food must be treated as a core health care strategy, not a peripheral concern.
Affordability requires action beyond traditional care delivery. Food and nutrition sit at the center of that shift.
Blue Cross NC is among the first commercial payers in the country to offer a Feed Your Health program at no cost to members.
The program targets chronic conditions by combining access to nutritious, medically tailored, and culturally relevant meals with one-on-one support from a registered dietitian. Members receive groceries, prepared meals, and personalized nutrition coaching, at no cost.
Results show measurable impact: participants have achieved an average 1.5-point reduction in A1C within 16 weeks, demonstrating meaningful improvement in diabetes management and overall health outcomes.
These efforts are long-term investments (PDF), focused on improving affordability by better managing and preventing chronic conditions, lowering total medical costs.
Affordability is shaped by how care is designed and when support begins.
Access to nutritious food is essential for the health and well-being of our members and communities. By improving health through food, we can not only positively impact health outcomes and help prevent and manage chronic conditions but also make health care more affordable for all.
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