New research from The Rockefeller Foundation shows that scaling Food is Medicine (FIM) programs—offering produce prescriptions and medically tailored meals to people with diet-related conditions—could generate over $45 billion in state economic activity, create 316,000 jobs nationwide, and generate $5.6 billion for small and mid-sized farms. The report, From Farm to FIM: The Economic Impact of Local Food is Medicine, highlights how prioritizing local farms and food businesses in program design can transform healthcare spending into a driver of rural development and economic growth across all 50 U.S. states.
FIM programs have already demonstrated significant healthcare benefits. With 129 million Americans suffering from chronic diseases, and 75 million having two or more, 90% of U.S. healthcare spending goes toward managing these conditions. Medically tailored meals alone could save $23.7 billion annually and prevent 2.6 million hospitalizations if scaled to all eligible patients. At the same time, small and mid-sized farms face financial strain, with more than 20,000 disappearing each year. FIM programs offer these farms a stable market, supporting revenue growth, regenerative practices, and the long-term sustainability of local agriculture.
The report emphasizes that local sourcing multiplies economic benefits. Keeping FIM dollars in-state stimulates local businesses providing aggregation, processing, storage, transportation, meal preparation, and delivery, creating jobs across urban, suburban, and rural areas. For example, California could see $511.9 million in farmer revenue and 32,050 new jobs, while Texas could gain $315.1 million and 29,800 jobs. The analysis details state-by-state projections, showing how intentional program design can maximize both economic and health outcomes.
FIM programs’ success depends on policy choices such as embedding local sourcing in Medicaid contracts, multi-year purchasing commitments, and investing in food system infrastructure. Without these measures, healthcare dollars are likely to flow to large national distributors rather than strengthening local economies. Case studies from Massachusetts, Oklahoma, and California illustrate how FIM programs already benefit from local procurement strategies.
The Rockefeller Foundation commissioned Dalberg Advisors to conduct the analysis, drawing on expertise from agricultural economists, FIM providers, policy experts, and farmer organizations. The report is part of the Foundation’s $220 million “Big Bet” on nutrition, which includes a $100 million commitment to expand Americans’ access to FIM programs and support research, policy, and program implementation. FIM is presented as both a health intervention and an economic opportunity, connecting healthcare spending with local agriculture to strengthen community resilience, create jobs, and support the long-term viability of American farms.
