Session: Health Equity/Social Determinants of Health 7
751 - The Nutrition Insecurity Cross-Enrollment (NICE) Pilot: Enhancing Child and Family Enrollment in Federal Nutrition Programs through Health System Outreach
Sunday, April 27, 2025
8:30am – 10:45am HST
Publication Number: 751.6618
Sophie Ravanbakht, Duke University School of Medicine, Durham, NC, United States; Greeshma James, Westat, Indianapolis, IN, United States; Congwen Zhao, Duke University School of Medicine, watertown, MA, United States; Kate Hanson, Meals4Families, Chapel Hill, NC, United States; Chelsea A. Swanson, Duke Margolis Institute for Health Policy, Durham, NC, United States; Chavanne Lamb, NC Department of Health and Human Services, Greensboro, NC, United States; Carolyn L. Bird, North Carolina State University, Raleigh, NC, United States; Latechia Bryant, Duke Health, Mebane, NC, United States; Judy Lawrence, North Carolina Division of Health Benefits, Raleigh, NC, United States; Rushina Cholera, Duke University School of Medicine, Durham, NC, United States
Medical Instructor Duke University School of Medicine Raleigh, North Carolina, United States
Background: Federal programs like SNAP and WIC improve child and family health, but enrollment remains low. With more pediatric screenings for food insecurity, strategies to increase SNAP and WIC enrollment are gaining interest. The Nutrition Insecurity Cross-Enrollment (NICE) pilot in North Carolina (NC) is a partnership among NC Medicaid, managed care organizations, health systems, and community groups to improve enrollment through cross-program data sharing and stepped-intensity outreach. Objective: To evaluate the feasibility and impact of the NICE pilot, which identifies Medicaid patients likely eligible for but not enrolled in SNAP and WIC, and tests the effectiveness of various outreach methods to boost enrollment. Design/Methods: The NICE pilot integrates monthly data from Medicaid, SNAP, and WIC across five NC counties. Medicaid patients are matched to find those eligible but unenrolled in SNAP or WIC and assigned to three outreach groups: Group 1, Automated: text messages, portal message, mailer; Group 2, Standard of care: phone calls, portal message; Group 3, Control: no outreach. Outreach includes assisted enrollment referrals or self-enrollment instructions. Descriptive statistics and enrollment rates are reported, with final outreach effects expected by December 2024. Results: As of October 2024, 12,025 patients (7,831 households) are enrolled in NICE, with 4,298 SNAP-eligible patients (2,793 households), 601 WIC-eligible patients (460 households), and 524 eligible for both (374 households). Patient group allocation: 37.4% Group 1 (n=4,494), 20.5% Group 2 (n=2,464), 42.1% Group 3 (n=5,067). Of 4,307 patients outreached, 87% speak English (n=3,733) and 13% speak Spanish (n=574). Table 1 shows outreach breakdown by method and language. Mid-pilot SNAP enrollment rates for outreached patients are 21.58% (Automated; n=648/3,003), 16.79% (Standard of care; n=329/1,959), and 15.73% (Control; n=599/3,807). WIC enrollment data will be available in December 2024.
Conclusion(s): The NICE pilot leverages cross-enrollment data to reach Medicaid families for SNAP and WIC outreach, addressing food insecurity in underserved pediatric populations. This scalable approach underscores the importance of data sharing, targeted outreach, and collaboration to expand access to nutrition programs. Additionally, this program offers a promising framework to inform policies integrating healthcare and nutrition assistance for improved food security and child health outcomes.
