Thursday, June 23, 2011

"Nutrition Reform Act" And Accountable Grocers

Accountable Grocers: A Culture and Payment Change

In today's environment, Grocers are generally paid a fee for each food item purchased. Therefore, Grocers increase revenues by increasing the number and variety of foods sold, and by keeping their stores open for longer hours. But too many Americans are obese from overeating high calorie food with low nutritive value. The new Centers for Food and Nutrition ("CFN") policy and program initiatives are going to drive a new model, Accountable Nutrition. Accountable Nutrition takes the old fee for service model and turns it upside down. 

Under an Accountable Nutrition program, Grocers are paid based on their quality outcomes. The Citizen Protection and Affordable Nutrition Act ("Nutrition Reform Act") created the Shared Calories and Savings Program which promotes Accountable Nutrition Organizations ("ANO"). The ANO model is intended to require Grocers to create a new legal organization that is financially and nutritionally integrated.
This financial and nutritional integration is intended to coordinate sales among restaurants, Grocers and other food suppliers as well as integrate reporting on financial and nutritional metrics. The ANO would be paid for the services rendered, but instead of increasing revenues with increased sales, if the ACO can minimize the costs associated with feeding 5000 beneficiaries then the ANO gets a share of the monetary savings. Thus, Grocers will be motivated to reduce food sales and instead focus upon the customers achieving quality outcomes. However, if the Grocers fail to achieve quality outcomes, the Grocers will not be eligible to share in the savings. Specifically, the proposed ANO require Grocers to report on sixty-five (65) measures that focus upon the following policy priorities: (1) shopper experience; (2) maintenance of balanced diets;  (3) shoppers attaining ideal body mass and (4) managing at risk shopper populations--such as those who purchase tobacco and alcohol. The Grocers will be scored on each measure within each policy priority. If the quality benchmark is achieved, the ANO Grocer is eligible to share in the monetary savings.

This initiative of scoring a Grocer's service will likely change the culture and behavior of Grocer practices. Because the Grocer will be scored based upon the shoppers' perceived experiences, Grocers must focus upon the factors that impact shopper satisfaction scores, i.e. length of check out lines, friendly staff, ease of parking. Grocers must also consider what information technology systems will be used to coordinate nutrition monitoring with other food dispensers and what support tools can be used to prevent junk food binges and promote shopper weight loss. Likewise, engaging the shoppers to modify their behavior will be a critical component of improving quality outcome scores and protecting the Grocer’s ability to receive payment. This concept of reporting on quality measures and tying payment to the quality outcomes will change not only a Grocer’s business plan for profitability/sustainability, but should change the sales patterns of Grocers.

In addition to the ANO concept, CFN has established other programs that require quality reporting to obtain reimbursement. For example, Grocers can receive an increase in their reimbursement from CFN if they participate in the E-coupon program. Likewise, Grocers that report on quality benchmarks in the Grocer Quality Reporting Initiative (“GQRI”) are also eligible for financial incentives. Further, the Centers for Food and Nutrition Innovation (“CFNI”) demonstration projects also focus upon improving quality outcomes and reducing costs. Therefore, the focus on quality nutritional outcomes will likely continue to drive change in behavior while facilitating payment reform.

Don;t know why someone didn't think of this before.

(Original article:

Accountable Care: A Culture and Payment Change


  1. Absolutely brilliant. Why didn't I think of that? Bravo!!!!

  2. Unfortunately the original article was not very well written so this parody could have been better if I had taken the time to find a better template. Only so many hours in the day though.
    Sure brings out how ludicrous payment for medical care has become.

  3. I guarantee if these programs were implemented as they are in the world of healthcare, the cost of food would skyrocket overnight!

  4. To get the full effect of this post, you really need to read the original article on Accountable Care Organizations. All I did was change a few words.