Collaborative Healthy Eating Initiative Sees Substantial Improvement in Food Security and HbA1C Levels for Type 2 Diabetes Participants

A one-year Finger Lakes initiative demonstrates the power and scalability of an integrated health and community care model; results show medically tailored food assistance improved food security for 67% and HbA1C levels for 50% of participants, leading to estimated healthcare savings up to 13% annually per member.

NEW YORK--(BUSINESS WIRE)--Unite Us, the nation’s trusted technology partner for integrating health and community-based care, reports significant health improvements from a year-long collaboration with Jordan Health and Foodlink through the Finger Lakes Performing Provider System’s (FLPPS) System Transformation & Community Investment program. Together, they launched the Healthy Eating Pilot Program, a local initiative in the Finger Lakes region focused on addressing food insecurity among patients with Type 2 Diabetes. This program demonstrates the transformative impact of integrating food assistance with nutrition-focused care to significantly improve health outcomes, setting a new national benchmark for managing chronic diseases through holistic, community-driven solutions.

The program, in effect from August 2023 to August 2024, connected food-insecure patients with Type 2 Diabetes to medically appropriate food assistance through a comprehensive network powered by Unite Us, which includes more than 650 providers in the Finger Lakes region.

“This program has demonstrated how critical it is to have strong partnerships between community-based organizations and the healthcare system. Partnerships like this benefit the participants, improve health outcomes, and keep dollars circulating within local communities,” said Dr. Mitch Gruber, chief impact officer at Foodlink.

Key findings from the program highlight its success in improving participants’ health and overall well-being:

• 72% of participants increased their fruit and vegetable consumption
• 67% of participants reported improved food security
• 53% of participants reduced their stress levels
• 50% of participants improved their HbA1C
• 42% of participants increased the number of mental and physical healthy days per month

Participants experienced a statistically significant HbA1C reduction of, with the potential to reduce total annual healthcare costs by as much as 13% PMPY.

“Our goal is to ensure everyone has access to high-quality care regardless of their ability to pay. We know that our diet impacts our overall health. So, we were thrilled to serve as a partner for this pilot which we know resulted in such a significant improvement for many of our patients,” said Dr. Linda Clark, president and ceo of Jordan Health. “Our hope is for pilots like this to develop into long-lasting and sustainable programs which help everyone with the ability to lead a healthy lifestyle as a direct result of the provided information and resources.”

Beyond improved health outcomes, participants also appreciated the program’s holistic approach, which included regular deliveries of fresh produce, essential cookware, and helpful recipe cards. For one participant, the program’s thoughtful design and practical resources made a meaningful impact on their life.

They said, “Whoever thought of the program did a very good job. It was very convenient to know I was getting fresh fruits and vegetables every two weeks. The cookware—I really needed a lot of those things, so it helped out 100%. It was very good for my family. The recipe cards were extremely helpful. I enjoyed it.”

The Unite Us platform was instrumental in the program’s success, simplifying access to vital community resources and fostering seamless collaboration across the network of community-based organizations (CBOs). Additionally, the use of Unite Us’ social care revenue cycle management solution enabled timely reimbursements for CBOs, providing sustainable support for the program’s goals.

“This program shows that we can tackle major public health challenges through partnership, technology, and innovation,” said Dr. Amanda Terry, senior director of research and evaluation at Unite Us. “By addressing non-clinical needs, we not only improve individual outcomes but also create a replicable model that communities across the country can adopt.”

The program provided significant benefits across multiple stakeholder groups. For CBOs, it validated their impact on public health, strengthened their capacity to serve, and opened new funding streams. Government leaders saw how community-driven interventions improved health outcomes and received data to support evidence-based policy decisions. Healthcare providers were empowered to address social determinants of health, improving patient engagement and health outcomes. Payers gained valuable insights into the cost-saving potential of preventative care models, emphasizing the role of nutrition in reducing healthcare expenditures tied to chronic diseases.

All non-profit community-based organizations can use Unite Us’ platform free of charge. Contact us to learn more: uniteus.com/contact/.

About Unite Us:

Unite Us is the nation’s premier technology provider for integrating health and community-based care. Our advanced product suite is used to proactively coordinate services using data-driven insights, streamline referral and case management, and facilitate eligibility assessments and reimbursements across government, healthcare, health plans, and community organizations. The first of its kind, our closed-loop referral system prioritizes privacy and dignity and has integrated data and analytics tools used to measure impact, optimize programs, and shape policy. With over 1.7M services, we host the nation’s largest network of community-based health and economic services dedicated to improving whole-person health. Learn more at UniteUs.com and LinkedIn.

About Jordan Health:

The Anthony L. Jordan Health Center began more than 100 years ago and was one of the first Federally Qualified Health Centers established in the nation. Located in neighborhoods where the most pressing need exists, our roots are steeped in service to underserved and uninsured residents, and building a safe, quality place for healthcare is our cornerstone. Learn more at JordanHealth.org.

About Foodlink:

Foodlink is a Rochester-based nonprofit dedicated to ending hunger and building healthier communities by addressing both the symptoms and root causes of food insecurity. We serve as the hub of the emergency food system across a 10-county service area. As a leading public health organization, Foodlink administers many programs and initiatives that aim to build the health and wealth of communities. Learn more at FoodlinkNY.org.