By Stacy Bates, MS, RDN, SPAN Health Strategies
Grocery retailers are one of the most visited places in health care. Most shoppers come in every week, which is more often than they see any clinician. That frequency is why Food as Medicine belongs at retail. The harder question is how to make it pay for itself.
I spent 12 years at H-E-B, most recently as Director of Nutrition Strategy. There I built one of the first retail practice groups of registered dietitians billing medical nutrition therapy, in stores and virtually. Here is what I learned about building programs that last.
Start with the business model, not the program
Many retail Food as Medicine efforts start as goodwill and stall when grant or internal innovation money ends. Sustainable programs answer one question first: who pays, and for what outcome?
The most common revenue paths are:
Medical nutrition therapy (MNT). Registered dietitians can bill insurance for MNT. Medicare covers it for diabetes and chronic kidney disease, and many commercial plans cover more. An in-store or virtual RDN practice turns nutrition counseling into billable care.
Health plan and health system partnerships. Plans and providers want ways to reach members between visits. Retailers can deliver produce prescriptions, medically tailored groceries and nutrition education at scale.
Brand partnerships and retail media. Brands want credible, health-focused ways to reach shoppers. Clinically grounded programs create sponsorship and retail media opportunities that standard promotions can't.
Loyalty and basket growth. Shoppers who get real help with their health shop more often and trust the banner more. This is the hardest return to measure and often the largest.
Connect the parts of the business that rarely talk
The biggest barrier is internal. Pharmacy, nutrition, category management, marketing, e-commerce and loyalty often run separately. At H-E-B, I built a Nutrition Strategy Center of Excellence to connect them.
When those teams share goals, one program can do several jobs at once:
A dietitian's recommendation becomes a shoppable list online.
Category managers know which products to feature.
Loyalty data shows whether shopping behavior changed.
Build credibility before you build scale
Health care partners will ask about clinical oversight, privacy and outcomes before they sign. Retailers that win these partnerships have:
Credentialed staff, including registered dietitians
Clear, compliant product criteria, not marketing-driven "healthy" labels
A plan to measure results that health care partners recognize
Start small and measure early
A pilot with one health plan, one condition and a handful of stores teaches more than a broad launch. Pick a measurable outcome, report it honestly and use it to earn the next partnership.
Where to get help
SPAN Health Strategies helps grocery retailers design, launch and monetize Food as Medicine programs. We bring retail nutrition, category management and broker experience to the table. Contact us to talk through your program or email me at stacy@spanhealthstrategies.com