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Malnutrition, defined as the “inadequate intake of nutrients, particularly protein, over time,” affects 20 percent to 50 percent of hospitalized patients despite only 8 percent being diagnosed. Malnutrition has been shown to increase hospital costs (34 percent more) and 30-day readmission rates (54 percent higher) compared to hospitalizations in patients without a malnutrition diagnosis. Addressing malnutrition through targeted nutrition interventions improves outcomes and reduces costs, directly supporting value-based care goals. For example, in one study, a multihospital accountable care organization (ACO) that optimized malnutrition care achieved a 27 percent reduction in 30-day readmission rates, while another nutrition-focused quality improvement program generated $4.8 million in cost savings. Evidence demonstrates the power of nutrition-focused quality improvement initiatives in enhancing performance on quality metrics that are central to value-based care arrangements.
Malnutrition can be multifactorial, rooted in medical conditions that impair nutrient absorption or feeding ability, as well as socioeconomic factors such as food insecurity and limited access to healthy food. Food insecurity, defined by the US Department of Agriculture as “a household-level economic and social condition of limited or uncertain access to adequate food,” is a significant driver of malnutrition and a known social determinant of health. Addressing malnutrition requires a coordinated, multipronged effort that mobilizes the right care team members to implement targeted, patient-centered interventions. Interventions are particularly important for older adults as patients identified with malnutrition tend to be older than patients without malnutrition.